PolicyLab

According to the 2024 Nation’s Report Card, one in three students in Pennsylvania—and even fewer in Philadelphia and among marginalized communities—can read proficiently by fourth grade. Pennsylvania’s students are not alone; there is a downward trend in fourth grade reading proficiency across the nation. This statistic is alarming as research demonstrates early literacy is an important social driver of health and is linked to educational, economic, socio-emotional, and physical and mental health well-being outcomes.

As we celebrate National Reading Month, we’re drawing attention to the importance of early literacy promotion and shared reading, and their role in setting children up for a strong start in learning and life. In this post, we spotlight new data, resources, and projects that emphasize the need for effective literacy promotion strategies for our youngest children and their families.

Why Early Literacy Matters

Fourth grade reading proficiency is an important benchmark as students transition from “learning to read” to “reading to learn”—a fundamental shift for students’ success in future academic subjects. While the gaps in fourth grade reading proficiency across racial and socioeconomic groups are decreasing, disparities persist. As noted by the newly formed Pennsylvania Literacy Coalition (a group with which our team is engaged), the effects of low literacy early in life create a “ripple across communities, hindering economic growth and deepening systemic disadvantage.” Children who struggle with early literacy are more likely to experience poor mental health outcomes, including higher rates of anxiety, depression, and low self-esteem, as well as increased risks of chronic stress due to academic challenges.

Intervention related to literacy early in childhood is crucial because it helps build foundational language and cognitive skills, a steppingstone for literacy development. A rich evidence base demonstrates the impact of early literacy promotion, which includes providing access to books and fostering healthy relationships through shared book reading and storytelling opportunities.

Evidence-based Shared Reading & Early Literacy Promotion Strategies

We are excited about two new resources that specifically highlight the impacts of caregivers reading together with their children as well as the role pediatric primary care can play in early literacy promotion. 

The Prenatal-to-3 Policy Impact Center released an Evidence Review of shared book reading programs, which encourage shared reading practices by providing free, developmentally appropriate books to children and families. This review emphasizes that shared book reading programs support nurturing and responsive child-parent relationships and developmental outcomes by improving child language and vocabulary skills.

These findings are reiterated by the American Academy of Pediatrics’ (AAP) recent Policy Statement, which draws attention to life-long impacts of early literacy promotion. The authors highlight the unique and valuable role pediatric clinicians play in supporting parents and caregivers to build shared reading into their routines, starting in infancy. “Parents read and children learn” when pediatricians integrate guidance around literacy promotion into their practice as a strengths-based approach to supporting brain and child development and mitigating the effects of adverse childhood experiences.

Both resources call out the national model Reach Out and Read due to the program’s rigorous evidence base. Serving 4.6 million children annually, Reach Out and Read leverages a two-generational approach in which pediatric clinicians integrate books into well-visits as a tool for providing guidance around shared reading and early relational experiences. The AAP statement also spotlights PlayReadVIP, a program that integrates real-time video-feedback of reading and play during pediatric visits with Reach Out and Read, and has demonstrated improved outcomes in language, literacy and socio-emotional development. 

These resources also discuss current and possible public funding mechanisms and policy opportunities that could support evidence-based shared book reading programs and early literacy promotion as a standard of pediatric primary care. A 2023 PolicyLab brief similarly highlighted strategies for leveraging Medicaid and the Children’s Health Insurance Program to promote early literacy in the pediatric primary care setting.

Supporting Early Literacy Through New Efforts

At Children’s Hospital of Philadelphia (CHOP) and PolicyLab, we are excited to support the early literacy ecosystem through research and evaluation efforts led by the Literacy Lab (LitLab) and our work with the local and statewide Reach Out and Read network. 

LitLab, which Dr. Erkoboni leads, works on projects to support the integration of evidence-based literacy promotion into pediatric care, understand the linkages between early learning, language development, and caregiver-child relationships, and address early learning disparities in under-resourced communities.

We recently kicked off a new study led by Dr. Erkoboni, supported by the Overdeck Family Foundation, and conducted in partnership with Reach Out and Read, Inc. and The Institute for Child Success. The study explores how Reach Out and Read supports a family’s experience at the medical office, relationship building, and the formation of trust between families and their pediatric primary care providers. The team will also examine whether stronger relationships lead to higher rates of well-visit attendance, improved vaccine adherence and greater perceived value of pediatric primary care. We hope to use our findings to inform advocacy and sustainability efforts to support early literacy programs embedded in pediatric primary care.

Lastly, CHOP and Reach Out and Read Greater Philadelphia have long partnered to support the implementation and growth of Reach Out and Read across the region. The first site launched in 1996 at CHOP, and with strong support across the state, the model now reaches nearly 193,200 children and families at more than 260 locations in Pennsylvania. This spring, all Reach Out and Read sites in Pennsylvania will become part of a newly established Reach Out and Read Pennsylvania. This strategic growth builds upon nearly 30 years of work and community building in this region with the goal of scaling the quality programming, reach and impact across the state.

Knowing that fewer of Pennsylvania’s children are meeting important reading proficiency milestones today than in recent years, we seek to leverage the settings in which we work to advance literacy promotion for our youngest residents and their families, and ensure they experience all the lifelong benefits of reading.