Once upon a time when children visited their doctor, they could count on getting a lollipop. Now, all they want to know is, “Where’s my book?”
“This is a wonderful cultural change,” says Dr. Sheila Upadhyay, a pediatrician at SBH, who is medical co-director of the hospital’s Reach Out and Read program. The program, which has been revitalized over the last year by Dr. Upadhyay, annually prescribes nearly 2,500 books to outpatients up to the age of five.
Reach Out and Read, which was started as a pilot study by a pediatrician at Boston City Hospital in 1989, is an evidence-based program that builds on the relationship between parents and medical providers to develop critical early reading skills in children, beginning in infancy. As recommended by the American Academy of Pediatrics for hospitals and clinics located in poorer neighborhoods, Reach Out and Read incorporates early literacy into pediatric practices, equipping parents with tools and knowledge to ensure that their children are prepared to learn when they start school.
“The founder of the program saw a major discrepancy in development between children from lower socioeconomic families and more affluent families,” says Dr. Upadhyay. “The difference was in the number of words and the type of interaction between baby and parent. He believed if we started to introduce books to these families, and show parents during their pediatric visits how to interact with their babies, it would help make a difference in preventing language delay.”
The program was brought to SBH in 2000 under the direction of Dr. David Rubin, the chairman of the pediatrics department, and pediatrician Dr. Karen Greer.
“It’s really a great program,” says SBH President and CEO Dr. David Perlstein, who as the director of ambulatory pediatrics was integral in developing the program here. “It’s shown conclusively that children who participate in the program are far ahead in their language and reading skills than those who are not, and it’s been a great determinant of increased school readiness.”
Today at SBH, literacy promotional materials line the walls of the pediatric and family medicine clinics’ waiting rooms, while exam rooms overflow with books. Patients, including siblings, receive books at their newborn, two-, four- and six-month visits, up until they reach the age of five, when they enter kindergarten (at which time they should have a library with a minimum of 10 books). Residents in family medicine, internal medicine and pediatrics are now trained in early literacy at hospitals across the country.
“Subliminally, it makes a difference for parents to see their health care provider interacting with their baby,” says Dr. Upadhyay. “They see the child moving his eyes, giving a social smile. They say, ‘I didn’t know my baby understood.’ We motivate parents to read to their child. We ask them what materials they have at home and if they know where their local library is.”
Books also serve as an important diagnostic tool for the pediatrician.
“I’m finding that I use the book as a developmental assessment as much as I use the stethoscope for the physical exam,” says Dr. Upadhyay. “I watch how the baby is interacting with it. I look at fine and gross motor skills, their parent’s interaction with the baby. For a nine-month-old, for example, I want to see that the baby is interested in the book, has a pincer grasp of a board book with her fingers, and pays attention to the action as we read with the parent. I explain to parents that it’s normal that their infant is mouthing the book. They’re still teething and it helps them understand what objects are. If I have a two-year-old that is still mouthing the book, then I’m concerned because they shouldn’t be doing that at this age.”
Books at the SBH clinics are available in English and Spanish, with the hope to soon have books in French and Arabic as well, says Dr. Upadhyay.
It Takes a Village
The program is supported financially by the pediatrics department and the hospital auxiliary. Yet, says Dr. Upadhyay, it “takes a village” to keep the program going strong. Physicians and staff members, as well as members of their families, routinely come to the clinic to read to the children, and/or to donate new or gently used books.
Dr. Amanda Ascher, an internist at SBH and chief medical officer at Bronx Partners for Healthy Communities, will occasionally find her daughter Aracelis still awake with her head in a book at 2 a.m. It was the 13-year-old’s love of reading that convinced her to make Reach Out and Read her bat mitzvah project. Ara collected more than 1200 books, donated to the program in two batches. The first was the result of a book swap at her school – families donated books to the school and sold them to other students very inexpensively to raise money for the school. Ara asked if any books that didn’t sell, and would normally be discarded, could be donated to SBH’s pediatric reading program. She then came into the pediatric clinic during spring break and read to the kids in the waiting room.
Rather than include an RSVP card for her bat mitzvah, she had people reply to an email address with the automatic reply:
I can’t wait to read your email and find out if you can come to my bat mitzvah! Either way, I’d like to let you know about my mitzvah project. I’ve been volunteering for Reach Out and Read, a nonprofit organization that gives young children a foundation for success by bringing readers and books into pediatric waiting rooms. I collect new or gently used books, bring them to the pediatric waiting room at St. Barnabas Hospital in the South Bronx, and read to kids there while they wait to see their doctors. If you could look around your house for gently used children’s books that you no longer need and bring them to my bat mitzvah or let me know how I can get them from you that would be great!
Between drop-offs at her house and the books people brought to the ceremony, she collected another 600 books. She returned to the hospital on Columbus Day to read to the kids again.
Other family members at SBH have also been supportive. The daughter of a hospital nurse, for example, had her girl scout troop run a book drive and conduct a waiting room promotion. Students from local schools have volunteered to read to the children and medical students from the CUNY School of Medicine and Albert Einstein School of Medicine have participated in early outreach literacy programs with the hospital. The librarian from the Belmont Library visits the pediatric clinic on Fridays to read to the children and inform families of available community services.
To find out how you can help SBH’s Reach Out and Read program, contact Yvonne Robles, volunteer director (firstname.lastname@example.org), or Dr. Uphadhyay (email@example.com).