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Brain buildup early in life pays dividends

Anne Lee, chair of the board of United Way of Manatee County, reads to children at Blackburn Elementary School during the ReadingPal program.
Anne Lee, chair of the board of United Way of Manatee County, reads to children at Blackburn Elementary School during the ReadingPal program.

There is a largely ignored aspect of economic and workforce development which has benefits to society as a whole. This also has long-term effects that stretch out over decades, and has a proven return on investment that a Nobel Prize-winning economist has made his life’s work. It reduces dependency on government social programs and it supports national security. Most importantly, it takes a potentially lost benefit to society and allows it to flourish.

I am referring to meaningful investment in brain development early in life. The science has long been there, showing us that the right conditions for early brain development mean a child who enters adulthood with skills and the ability to contribute productively and happily to society as a worker, a creator, a consumer, and a citizen.

The National Scientific Council on the Developing Child’s first key point in a 2007 report referenced child development as a foundation for community and economic development. Additionally, Nobel Laureate Dr James Heckman has shown that early childhood investment has a compelling return.

And the worst part of it is that as a health care practitioner, I feel helpless to know how to fix this, because there is no magic prescription I can write to ameliorate the effects of poverty and adversity on young children.

This may seem like a tall order — and you may ask why a pediatrician is discussing community development and economic issues. The answer is that I (and my colleagues) are the first to see what happens when we don’t get it right in early childhood. We see children struggling in school. We witness the problems building up. We see how society fails children long before those children “fail us.”

And the worst part of it is that as a health care practitioner, I feel helpless to know how to fix this, because there is no magic prescription I can write to ameliorate the effects of poverty and adversity on young children.

However, there is something I do have: a fantastic program which has been around for almost 30 years called Reach Out and Read (which Dr. Navsaria will discuss with pediatricians and organizations on Friday). Reach Out and Read trains health care providers to make early literacy part of the regular checkups children experience early in life. We provide a brand-new, high-quality, developmentally-appropriate, culturally-responsive book to each child, along with advice about reading together.

Reach Out and Read trains health care providers to make early literacy part of the regular checkups children experience early in life.

Having said that, this isn’t merely a book giveaway program. There’s three somewhat-hidden aspects of Reach Out and Read that many don’t discern, and I’d like to let you in on them:

▪ First, the book given in the clinic is actually a tool for the health care provider — by walking into the room with the book in my hand and handing it directly to the child, I have a valuable opportunity to watch what happens. It allows me to assess development (language, motor skills, etc). It lets me observe the parents’ reaction and to seamlessly begin a conversation around reading behaviors at home, screen media use, sleep, and so on. It’s a great, efficient use of my limited face-to-face time with children and families.

▪ Second, the power of the evidence-based Reach Out and Read model doesn’t really happen in the clinic itself. By giving supportive, customized, nuanced advice to families about how to effectively read well with their children at different developmental stages, we aim to support and change reading behaviors at home. A book remaining on a shelf — or only being used in clinic — won’t do the trick. The “secret sauce” is when a loving, nurturing, responsive adult shares a book together with a child on a regular basis. Reach Out and Read doesn’t only have value for the child. It benefits adults in the always-challenging job of parenting — a true two-generation solution.

▪ Third, it’s hard to find an intervention that contributes to the long-term outcomes I mentioned above that is so cost-effective and scalable. Doctors who provide primary care to children make this a part of their regular care, so we’re not carrying the cost of new staff or buildings. The main cost of Reach Out and Read is in the books given and in training health care providers to deliver this program in a high-quality way — and in doing some follow-up to ensure good fidelity to the model. Virtually any community that wishes to invest in this manner could easily afford to bring Reach Out and Read to almost every one of their children, should they choose to.

Through my fellowship with Ascend at the Aspen Institute, I have been introduced to the exciting work being done as part of the Suncoast Campaign for Grade-Level Reading. I am heartened by the community’s initiative, the expanding partnerships/collaboration and the wise investment into the early brain. I look forward to learning and sharing with many of you during my visit to the area.

Remember, books build better brains!

Dr. Dipesh Navsaria, MPH, MSLIS, MD, is an associate professor of pediatrics, University of Wisconsin School of Medicine and Public Health; and the founding medical director of Reach Out and Read Wisconsin.

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