Talking ABCs in the office

Doctor-assisted reading programs in the US are getting kids reading earlier. Here in Canada the onus is left to the individual MD

By Katherine Addelman

Will a regular bedtime story with a six-month-old improve that kid's future ability to read? "Definitely! " says Dr Perri E Klass, a pediatric neurologist at Boston University. A ta recent conference sponsored by the Nemours Foundation in Orlando, Florida, Dr Klass reported on several studies that found measurable cognitive advantages in kids whose parents read to them. The difference was evident by the ripe old age of two.

Dr Klass is medical director and president of Reach Out and Read (ROR), an organization that promotes early literacy by running reading programs out of primary care doctors' offices and clinics. Through doctors, nurses and trained volunteers, ROR provides an age-appropriate book to every child at each visit -- over three million books a year -- starting when the children are six months old and continuing until age 12. The book is presented at the beginning of every appointment. The doctor reads to the child for a minute or so, implicitly modelling and encouraging an appropriate reading approach for the parent. At the same time the child's reaction can serve as a quick developmental assessment tool -- ie, does the kid just chew on a corner or actually verbalize "doggie jump! "

Studies have shown that children in the ROR program read more often and enjoy it more -- and so do their parents. The ROR kids also score higher than controls in expressive and receptive vocabulary and complex sentence structure, both linked to reading success. If they're being read to three times a week or more, their school-readiness skills -- recognizing letters, counting to 20 and writing their own name -- are noticeably improved. One study, carried out at the New York University School of Medicine, found that toddlers in the intervention group had a whopping 8.6 point increase in receptive language scores compared with controls. That translates into a six-month developmental advantage.

CANADIAN PROGRAMS?
In 2002, the Canadian Paediatric Society (CPS) issued a report entitled "Promoting Literacy in the Physician's Office. " Like ROR, it highlights the unique position primary care doctors can play in encouraging parents to read to their kids. The CPS recommends that doctors provide kids and parents with age-appropriate books and magazines, encourage parents to turn off the TV and read regularly to their children, start reading programs in their offices and connect parents with other literacy sources. Another advocacy group, ABC Canada, sponsors Family Literacy Day (January 27). ABC Canada agrees that early reading, storytelling, rhyming and repetitive word games are powerful brain development tools. Their website provides links to literacy groups in every province and territory in the country. But with no direct equivalent of ROR in Canada, it's basically up to individual physicians and parents to get babes and books together.

GOOD BEDTIME STORY
Research from leading experts in brain development has begun to shed light on how important word-sound interpretation is to reading. For example, Bruce McCandliss of the Sackler Institute for Developmental Psychobiology in New York has devised a simple cascading model for how dyslexia develops. Mr McCandliss has found a location in the visual cortex that's especially critical in rapid reading. He calls it the "visual word form area. " Combining state-of-the-art brain imaging with human genetics, he's closing in on reading problems like dyslexia, which appears to be based on problems with the neurological interface between sound interpretation brain areas and visual areas. Another leading researcher, Dr Sally Shaywitz of Yale University, notes that reading problems in young children usually relate to deficits in phonology -- the underlying sound structure of words.

True dyslexia is a problem of genetics and will stay with the child throughout his or her life, although it can certainly be treated. But when reading difficulty stems from environmental factors, the ROR approach can really tip the balance. And the earlier the intervention, the better -- in either genetic or environmental reading disabilities. Functional magnetic resonance imaging has shown that the brain does change -- even in dyslexic readers -- when good reading programs are carried through. With early intervention, even Mr McCandliss's "visual word form area " -- the seat of rapid reading -- changes.

More early reading information from CPS is available at (613) 526-9397, or online at www.caringforkids.cps.ca/behaviour/Reading2Kids.htm