Early Literacy Research Library (ELRL) - Article

The Impact of Early Literacy Guidance on Language Skills of 3-Year-Olds

Theriot, J.A., Franco, S.M., Sisson, B.A., Metcalf, S.C., Kennedy, M.A., Bada, H.S. (2003) The Impact of Early Literacy Guidance on Language Skills of 3-Vear-Olds. Clinical Pediatrics (Phila), 42(2), 165-172.,

Access: Institutional Access

Publication year


study description

Prospective study.

Population Characteristics

Medicaid , Medical Trainees , Race, Ethnicity, and Culture , Toddler/Preschool , Urban

Exposures, Outcomes, Other

Anticipatory Guidance , Child Behaviors and Skills , Language and Literacy Development


The objective of this prospective study was to determine the impact of early literacy anticipatory guidance (AG) with provision of books on language development in 3-year-olds in an early literacy program at a University-affiliated inner-city pediatric clinic.


Reach Out and Read (ROR).

outcomes evaluated

Language development.


An inner-city pediatric clinic that serves children who are predominantly Medicaid recipients (95%) and African-American (82%). The clinic is affiliated with the Department of Pediatrics, University of Louisville, and is a training site for 40 Pediatric and Medicine/ Pediatric residents and medical students.


The Peabody Picture Vocabulary Test (PPVT-III) and the Expressive One Word Picture Vocabulary Test (EOWPVT-R) were administered to 33-39-month-old children exposed to an early literacy program, which included AG and provision of an age-appropriate book at each well-child visit starting at 2 months old. Children with developmental delays were excluded. Parental surveys on literacy and demographic data were obtained. Univariate and multivariate analyses were performed.

sample size

n=64 (children)


Measure of Receptive Language Development: Peabody Picture Vocabulary Test III-Revised (PPVT-III).


Measure of Expressive Language Development: Expressive One Word Picture Vocabulary Test-Revised (EOW-PVT-R).


Other Measures of Early Literacy: questions about the activities the parent and child most enjoyed doing together, the frequency of reading with the child at home and at daycare, attendance at daycare, and the number of books purchased by the parents for the child, and demographic data.


Sixty-four children were evaluated; 88% African American, 89% Medicaid recipients. Fifty-eight percent of families reported family-centered literacy orientation. The PPVT-III scores directly correlated with the number of AG visits with book given x number of books purchased (r2 = 0.025, p = 0.0006). Higher scores in EOWPVT-R were predicted by race and the number of visits with books given x number of books purchased (r2 = 0.182, p = 0.0009). All families reported reading together, half reporting positive family-centered literacy.


Given the same number of books purchased for each child, the outcome scores were higher the greater the number of clinic visits wherein anticipatory guidance included early literacy and provision of books.


We did not have controls since all of our children under 5 years old were exposed to the early literacy program. The absence of a control group and the small sample size are limitations of our study.