Share story

Equal opportunity is at the heart of many civic discussions, from preschool to the minimum wage. Rarely is it emphasized that a child’s chance to reach his or her potential is greatly impacted by what happens before he or she utters a word.

The stark reality is that inequities related to both economics and race are present in infants. Brain and economic research unequivocally demonstrate that the earliest experiences matter the most.

As pediatricians, we’ve shared the joy as families welcome newborns into their lives. We’ve helped them understand that babies are wired to learn, innately attracted to their parents’ voices and faces, and actively engaged with the people around them.

The latest University of Washington study from Patricia Kuhl at the Institute for Learning and Brain Sciences (I-LABS) demonstrates that “babies practice speech long before they can talk.” Helping parents support their child’s learning from birth should be among the highest of our priorities as pediatricians. Children’s doctors are trusted by families and are uniquely able to support parents through each stage of their child’s development.

It’s been almost 20 years since Betty Hart and Todd Risley described a striking “30 million-word gap” between what 4-year-old children in low-income versus more-affluent families hear. What children learn and say is in great part determined by conversations within a loving parent-child relationship, and early language and social-emotional skills set the stage for all future learning.

The gap has been measured at 18 months of age. Children who start kindergarten behind rarely catch up, while those who arrive ready are on track toward proficiency in third-grade reading and high-school graduation.

There is good news — parents who have children’s books and learn how to nurture their child’s language development will talk and read with their child, and outcomes will improve.

More than 25 years ago, a simple concept was developed in a Boston hospital to help parents, including those who don’t speak English or cannot read. Doctors began giving new books to families and teaching parents to share books regularly with their young child, starting at the six-month checkup.

Thus Reach Out and Read, an evidence-based program delivered by doctors, was born. Fifteen research studies later, medical providers across the nation, including 1,400 right here in Washington, have shown that it works. Families who participate read together more often, and children have improved language skills that help them be ready for kindergarten.

With developmentally appropriate children’s books in multiple languages, this program is embraced by families across cultures, as seen at Harborview, Sea Mar Community Health Centers, International Community Health Services (ICHS) and 16 tribal clinics across the state.

In 2007, we started a public-private partnership to expand Reach Out and Read across Washington. This work is now a priority strategy in Washington’s Early Learning Plan and in the Road Map Project in Seattle and South King County. We have focused first on supporting families furthest from opportunity. Washington doctors are now reaching an estimated 100,000 children and their families, of which 45 percent are children of color and 28 percent live with a home language other than English.

A new American Academy of Pediatrics Policy statement captures the rationale: “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.”

We must teach families how language develops, and support them so that they talk and read regularly with their children, starting in infancy. Parents are eager to support their child’s potential, and generally trust guidance from their child’s doctor. By using the health-care system to support parents as first teachers, we can effectively and efficiently reach all families. Together we can reduce inequities before they take root, helping to fundamentally transform education in Washington state, starting with babies.

Jill Sells, a pediatrician, is executive director of Reach Out and Read Washington State. Mary Ann Woodruff, a pediatrician in Tacoma, is Reach Out and Read Washington State’s medical director.