PARTNERSHIPS FOR EARLY LITERACY PROMOTI0N IN HEALTH CARE SETTINGS:

THE PHILIPPINE EXPERIENCE

Asia-Pacific Regional Conference on Early Childhood Development:

“Early Childhood Development on the Global Agenda-

Building partnerships for sustainability and harmony”

Manila, Philippines

Dec. 3-5 2014

Early Brain and Child Development

Brain architecture and development abilities are built “from the bottom up”

via simple circuits and skills which provide the scaffolding for more

advanced circuits and skills over time.

AAP EBCD Initiative:

“Building Brains, forging Futures”

Early Brain and Child Development

Interactive influences of genes and experience literally shape the architecture of the developing brain.

The active ingredient is the “serve and return” nature of children’s engagement in relationships with their parents and other caregivers in their family or community.

Relational Development

Children’s language and social/emotional development primarily through parent/child interactions

Key aspects of responsive parenting

impacting language/cognition

• Richness of verbal input – labeling objects and actions (Weizman, 2001)

• Verbal scaffolding – structuring language interaction to meet child’s needs; providing child with language that they need (Vygotsky, 1978; Snow, 1977)

• Verbal responsivity – responding to vocalizations with imitations or expansions, engaging in back-and-forth conversation and asking questions (Hart and Risley, 1994)

Meaningful Differences in the Everyday Experience of Young Children

Hart and Risley (1995)

Children in professional homes heard 382 words an hour while children raised in welfare homes heard an average of 167 words an hour. In a month, the difference in words heard was 1,100 (professional) to 500 (welfare).

“…early childhood is the best investment.”-James Heckman, Nobel Prize Winning Economist

“Investment in early education … helps reduce the achievement gap [and] the need for special education, increase the likelihood of healthier lifestyles, lower the crime rate, and reduce overall social costs. … Every dollar invested in high-quality early childhood education produces a 7-10% per annum return on investment.”

Heckman, J. The Economics of Inequality, The Value of Early

Childhood Education, American Educator. (Spring, 2011)

HEALTH AND EARLY LITERACY

• “US National Research Council: REACH OUT AND READ is an early literacy intervention that works because it strengthens the link between literacy and a healthy childhood.

• UNESCO in 2007 awarded REACH OUT AND READ the Confucius Prize for Literacy for “reaching low income children who are most at risk of school failure by offering literacy guidance to their families and promoting a reading culture .”

Department of Education 2011-2012

National Achievement Test (NAT)

MPS of 3rd graders in public schools

• Reading comprehension in English: 54.42%

Filipino: 58.61%

• Grammar in English: 57.23%

Filipino: 56.97%

American Academy of Pediatrics

Literacy Promotion: An Essential Component of Primary Care Pediatric

Practice

COUNCIL ON EARLY CHILDHOOD

“Reading regularly with young children stimulates optimal patterns of brain development and

strengthens parent-child relationships at a critical time in child development, which, in turn, builds

language, literacy, and social-emotional skills that last a lifetime.

Pediatric providers promote early literacy development for children beginning in infancy and

continuing at least until the age of kindergarten entry.”

REACH OUT AND READ:A Strategy to Promote Parent/Child Interactions and School Readiness

Reach Out And Read is an evidence-based school initiative that prepares children to succeed in school by partnering with doctors and other health care providers to prescribe books for children and to encourage parents to read with their children.

The Reach Out and Read Model

(ABE)

• Advice: Encourage parents to read aloud daily and offer age-appropriate advice

• Books: From 6 months – 5 years old, clinicians give children a brand new developmentally appropriate book at well child visits

• Environment: The practice is made into a literacy-rich environment with posters, gently used books, library information and volunteer readers where feasible

Advice

Medical providers offer

parents literacy- and

language-related

anticipatory guidance and

encourage daily reading

aloud at home.

Books

At every health supervision visit from 6 months through 5 years, children receive a brand-new, developmentally-appropriate book to take home and keep.

Environment

Literacy-rich waiting areas include used

books, posters, library information, and

literacy resources. Volunteer readers

sometimes read to waiting children,

modeling the techniques and joys of

reading aloud.

Path to success in school and life

Graduation from High School

3rd grade Reading Proficiency

Kindergarten readiness

Early Language and Literacy Skills

Why Early Literacy Matters

Compelling Evidence Base (15 studies) for literacy promotion in primary care

• Parental attitudes and practices change

• Home environment changes

• Children’s attitudes change

• Children’s skills change

www.reachoutandread.org

Reach Out and Read Philippines

An advocacy program of the Philippine Ambulatory Pediatric Association

Mission:To provide training, support and guidanceto develop Reach Out and Read (ROR)Programs in our most at-risk communities,to teach parents the importance of earlychildhood literacy, and to put books intothe hands and homes of disadvantagedyoung Filipino children

CHALLENGES TO IMPLEMENTATION

OF REACH OUT AND READ

• Lack of awareness and knowledge of the role of health care providers in the promotion of early pediatric literacy as part of health care supervision

• Lack of developmentally and culturally appropriate books for children from birth to 5 years of age, in Filipino or Filipino/English

• Cost of books

• Availability of volunteer readers

• Sustainability of the program

METHOD

• Introduction of ROR Philippines, its components and its mission

• Partnership with a publisher of children’s books to develop and print age and culturally-appropriate books in Filipino and Filipino/English

• Partnership with several booksellers to secure discounted rates for books

METHOD

• Partnership with Adarna Group Foundation and local government units to bring early literacy promotion directly to poor communities

• Partnership with schools to provide volunteer readers

• Fund raising for book purchases• Measuring the impact on parents and

children after ROR exposure in a hospital based and in a community-based program

RESULTS

• A pilot study of 40 families with children getting pediatric health care services in a military hospital in Quezon City was done to determine the effects of Reach Out and Read on their child centered literacy orientation. Standardized interviews after 3 consecutive exposures to ROR intervention were done. Post-exposure analysis demonstrated statistically significant results in increased mean parental scores on knowledge and attitude toward early literacy promotion. Child reading motivation scores were likely significantly improved.

RESULTS

• Study done with children 6-24 months of age in a community center located in a low income neighborhood in Pasig, Rizal aimed to determine the efficacy of Reach Out and Read on language development and home reading orientation. Results showed that after 2 ROR exposures, both auditory and expressive language scores improved significantly. Frequency of shared reading activities more than tripled in the group that received the ROR intervention.

Carmen Ramos-Bonoan, MD, FAAPPhilippine Ambulatory Pediatric Association

National Director, Reach Out and Read

crbonoan@yahoo.com

0917-819-6193

www.papainc.org