| Research Article |
Open Access |
|
| Kindergarten Readiness and Performance of Latino Children Participating
in Reach out and Read |
| Marissa L Diener1, Wendy Hobson-Rohrer2 and Carrie L Byington2* |
| 1Department of Family & Consumer Studies, University of Utah, USA |
| 2Department of Pediatrics, University of Utah, USA |
| *Corresponding author: |
Carrie L. Byington
Department of Pediatrics
University of
Utah
295 Chipeta Way, Salt Lake City
UT 84108, USA
Tel: 801-213-3499
E-mail:
carrie.byington@hsc.utah.edu |
|
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| Received January 06, 2012; Accepted March 24, 2012; Published March 26,
2012 |
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| Citation: Diener ML, Hobson-Rohrer W, Byington CL (2012) Kindergarten
Readiness and Performance of Latino Children Participating in Reach out and
Read. J Community Med Health Edu 2:133. doi:10.4172/jcmhe.1000133 |
| |
| Copyright: © 2012 Diener ML, et al. This is an open-access article distributed
under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the
original author and source are credited. |
| |
| Abstract |
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| Background: Literacy is a vital skill that forms the basis for academic, occupational, and social success. Minority
populations, especially immigrant Latinos in the US, have achievement gaps in literacy when compared to the White
population. The Reach Out and Read (ROR) program is a pediatric, primary-care intervention designed to promote
emergent literacy skills. The objectives of this study were to provide descriptive information at kindergarten on Latino
immigrant children’s emergent literacy skills and home literacy environments, and correlation data between ROR
exposure and emergent literacy skills. |
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| Method: A sample of 40 low-income Latino immigrant mothers and their children participated. Medical records were
reviewed to determine level of ROR exposure. Home literacy environment was assessed through maternal interview.
Children’s emergent literacy skills were assessed before kindergarten through interviews with the children and with the
Dynamic Indicators of Basic Early Literacy Skills (DIBELS), and at the end of kindergarten through teachers’ reports
based on a modified version of the Kindergarten Teacher Questionnaire – Part C from the Department of Education
Early Childhood Longitudinal Study-K (ECLS-K). We completed descriptive analyses for the demographics of our
sample, ROR exposure, home literacy environment, emergent literacy skills and teacher evaluations. We created
composite scores of children’s print awareness, teacher-rated literacy skills, and ROR exposure. Finally, partial
correlations controlling for child age and maternal education were conducted between the composite score of ROR
exposure and children’s literacy skills as assessed by the child interview, the DIBELS test, and teacher-report. Child
age and maternal education were controlled. |
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| Results: The majority of children evaluated came from two-parent households and had high compliance rates with
well-child care. All children began ROR at 6 months; the mean number of ROR books received was 6. Home literacy
environments of families were strong as demonstrated by book ownership and parent-reported adult-child reading.
Evaluation of early literacy skills in the clinic demonstrated children had good familiarity with print, and greater ROR
exposure was related to significantly greater print and phonemic awareness before kindergarten entry. DIBELS testing
performed in the clinic setting identified 37%-45%of the children as at risk for reading difficulty prior to kindergarten. At
the end of kindergarten, teachers reported ECLS-K identifying 60% of children as intermediate or proficient in reading
and rated the literacy skills of 77% of the children exposed to ROR as average, above average, or far above average
when compared to all students of the same grade. |
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| Discussion: The kindergarten literacy performance of this small sample of Latino children participating in the ROR
program from infancy was good. Though these children were living in poverty and had other risk factors for poor-school
performance, they had good home literacy environments and average or above average literacy skills by the end of
kindergarten. Protective factors including family stability, well-child care, and early and consistent participation in the
ROR program may have improved the school readiness of these high-risk children. |
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| Keywords |
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| Literacy programs; Hispanic/Latino Americans;
Intervention; School readiness; Reach out; Read |
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| Introduction |
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| Literacy is a vital skill that forms the basis for academic, occupational,
and social success [1,2]. Low-literacy and poor educational attainment
have been correlated with poor health outcomes and all-cause
mortality [3,4]. Poor emergent literacy skills predict lower levels
of academic achievement later [5-7]. Children from low-income,
immigrant families are at risk for poor emergent literacy skills and
reading difficulties [8]. Moreover, a well-documented achievement gap
exists in literacy performance among different racial and ethnic groups
in the United States (US) [9-11]. Recent research suggests that the
difference in literacy achievement between Latino children and White,
non-Latino children is even greater than that between Black and White
children, and that the gap appears as early as 4-years [9-12]. |
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| Hispanics or Latinos are the largest minority group in the US, and
the Hispanic population increased 43% between the 2000 and 2010
census [13]. Hispanic children constituted 23% of the population of
children from the 2010 census. Based on data from the 2000 Census,
40% of US children in immigrant families are from Mexico [14,15]. The growth of the Hispanic immigrant population and their lower literacy
achievement is a challenge to the US school and health systems. Early
literacy support to immigrant Latino families may be an important
factor in preparing children for school and for closing the achievement
gap. |
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| Despite the achievement gap between Latino children as a group
and their White peers, recent research also indicates substantial
variation among individuals and families. The development of literacy from an eco-cultural perspective suggests that ecological and cultural
factors shape daily family routines, which then shape children’s
development [16,17]. The daily family interactions in which children
participate can shape their literacy skills and access to literacy activities
[18]. When literacy is examined from the family perspective rather than
the population level, the diversity of ways in which people in seemingly
similar groups (e.g., recent Latino immigrant families) differ in their
home literacy-related experiences becomes apparent [19,20]. |
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| The present study examined the home literacy experiences and
emergent literacy skills of Latino children in immigrant, low-income
families participating in a pediatric early intervention program
designed to promote home literacy-related experiences. Shared book
reading is critical to the development of literacy skills [21,22]. Parentchild
reading predicts later child outcomes [23-25]. Families living in
poverty read together less frequently and own fewer books [26-28]. For
example, one study estimated a middle-class child may enter first grade
having spent 1,000 hours in one-on-one shared reading, whereas a lowincome
child averages only 25 hours of shared reading [29]. Despite
these large group differences based largely on income, it is likely that
there is substantial diversity among low-income families in parentchild
reading. Furthermore, programs that promote shared parentchild
book reading and more books in the home may be one facet of a
multidimensional intervention approach for improving impoverished
children’s literacy skills. |
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| The Reach Out and Read (ROR) program is a pediatric, primarycare
intervention designed to promote emergent literacy skills. It has
three components: 1) anticipatory guidance about shared book reading
is provided by pediatricians during preventive care visits, 2) children
receive a book at each well-child check (WCC) between 6 months
and 5 years, and 3) volunteers model effective shared book reading
techniques. Pediatricians are critical to the intervention because of the
importance parents place on guidance from their child’s physician [30],
as well as the regular contact between parents and their pediatrician
during the pre-school years. ROR has been implemented at more than
4500 clinics since 1989, reaching almost 4 million children in all US
states and territories [31,32]. |
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| Previous research evaluating the ROR program demonstrated
that parents who participated in ROR were more likely to report
reading as a favorite activity, to read aloud to their children, and to
have richer home literacy environments than non-ROR parents [33-
38]. Furthermore, children participating in ROR show higher receptive
and expressive vocabulary scores than non-ROR children [34,39-41].
Several studies suggest a dose-dependent effect, with larger effects
observed with greater ROR exposure [38,41]. |
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| Despite these promising outcomes, most previous research has relied
on parent-report measures and evaluations of preschool-aged children.
No research has examined children’s school performance after the
ROR intervention using objective assessments and teacher-report. The
objective of our study was to provide descriptive information on Latino
children from immigrant families at kindergarten who participated in
a ROR program from infancy. More specifically, we examined the 1)
reported home literacy environment, 2) emergent literacy skills and the
associations between ROR exposure and emergent literacy skills, and
3) teacher evaluations of literacy skills. |
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| Methods |
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| Participants |
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| Participants were drawn from a clinic providing primary care to
low-income women and children. Approximately 75% of the children served by the clinic were enrolled in Medicaid, and 25% were uninsured.
Inclusion criteria for this study were: 1) child entering kindergarten
fall 2008, 2) child gestational age 37 weeks or greater, 3) child had
no known major physical or psychological problems and no history
of chronic illness, 4) child had the first WCC at or before 6 months,
5) primary language spoken at home was either Spanish or bilingual
Spanish-English, 6) child and family participated in ROR from the age
of 6 months, and 7) mother provided consent. |
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| Two hundred ninety-six children whose birthdates made them
eligible to start kindergarten in 2008 were randomly selected from all
clinic patients. We attempted to contact families at least three times by
phone. Of those eligible, 231 did not have working phone numbers.
Of the 65 families contacted, 61 (94%) agreed to participate. Of those,
21 did not come for the research visit and thus, were not included in
the final sample. The final sample was comprised of 40 children with a
mean age of 64 months (range 59-72 months) at the pre-kindergarten
assessment and their mothers. All mothers were immigrants to the US
(87% from Mexico) and spoke Spanish as their primary language. All
families had incomes that fell below the federal poverty level; average
monthly income per person in the household was $251, Median =
$250, SD = $176. Other demographic data for children, mothers, and
families are shown in Table 1. |
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|
Table 1: Demographics of the Study Population of 40 Mother/Child Pairs and
Reach Out and Read Exposure. |
|
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| ROR intervention |
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| The clinic implemented the ROR program in 1998. The clinic
ROR program contains the three core components described above
and in response to parent interviews before the ROR program was
implemented, also includes several cultural adaptations: 1) all attending
and most resident physicians are bilingual and speak to parents in both
Spanish and English, 2) Spanish books are offered initially, to meet
parental preferences to retain a connection with their native language,
with bilingual books provided subsequently; 3) physicians discuss the
importance of looking at rather than reading books to accommodate
parental low literacy, 4) physicians instruct parents in dialogic reading
[42]; 5) the clinic includes a children’s library, staffed by a bilingual
librarian, to address the barriers to public library use identified in
previous research [26]. The library is operated in collaboration with
Salt Lake County Library System, contains ~5,000 children’s books,
provides bilingual story time, a summer reading program, and literacy
resources. Children may keep one book each time they visit the library. |
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| Data collection |
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| The University of Utah Institutional Review Board approved this
research. All mothers provided informed consent for family and child
participation and permission to contact the child’s teacher. Medical
records were reviewed to document the number of clinic visits and
WCC. In the summer before kindergarten entry, children and their
mothers participated in an interview in Spanish with a bilingual
interviewer, and children completed emergent literacy assessments.
Kindergarten teachers completed questionnaires on the children’s
literacy skills at the end of kindergarten. Mothers and teachers were
blind to the purpose of the study. |
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| Measures |
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| Home literacy environment: Mothers were interviewed to assess
the home literacy environment. Interview questions were based on
previous research [26,39] and addressed frequency and enjoyment of
adult and child book-reading activities. Several open-ended questions
focused on the child’s favorite activities, the child’s bedtime routine,
and whether the child had engaged in specific activities the previous
day. Each question was coded on the basis of whether reading was mentioned as a favorite activity, as part of the bedtime routine, and as
an activity from the previous day. Closed–ended questions followed,
including items on book ownership, demographics, ROR exposure,
and library use. |
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| Evaluation of emergent literacy: We sought to objectively analyze
emergent literacy prior to the entry of kindergarten and the initiation
of structured reading education. Children were interviewed in Spanish
to assess familiarity with print in the summer before the start of
kindergarten. Each child was asked whether they could name a favorite
book, identify the front of a book, identify a word, identify the starting
point for reading, and identify the direction to read a book. A writing
sample was taken from each child. |
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| Several tests of the Dynamic Indicators of Basic Early Literacy
Skills (DIBELS) were administered in the summer before kindergarten
entry to provide a standardized measure of early literacy skills. The
DIBELS are validated criterion-based measures [43]. Specific goals
or benchmarks have been identified that predict reading outcomes
[43,44]. DIBELS scoring identifies children at high, some, or low risk
for reading difficulties. |
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| The DIBELS Initial Sounds Fluency (ISF) measures phonemic
awareness by assessing children’s abilities to identify and produce
the initial sound in a word presented orally to the child. The DIBELS
Letter Naming Fluency (LNF) assesses the extent to which children
can correctly label letter names. Children are presented a page of
upper- and lower-case letters arranged randomly and asked to name
as many letters as they can. The number of letters they named correctly
in either Spanish or English in one minute was the child’s score on
the test. Kindergarten assessments of letter naming fluency predict
first-grade reading scores [44]. The ISF and LNF were administered
in English. The DIBELS Fluidez en la Segmentación de Fonemas (FSF)
was administered in Spanish in order to obtain a measurement in the
child’s native language. The test assesses a student’s ability to segment
one, two, or three syllable words into their individual phonemes
fluently and is a good predictor of later reading achievement [45,46].
Fluency in one’s native language is associated with better literacy and
language acquisition in a second language [47]. |
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| Teacher assessment of child’s emergent literacy skills: In order to
gain a more holistic view and to evaluate the child’s literacy performance
in the classroom setting at the end of kindergarten, teachers completed
a modified version of the Kindergarten Teacher Questionnaire – Part
C from the Department of Education Early Childhood Longitudinal
Study-K (ECLS-K) [48,49]. Teachers rated children’s proficiency
(1 = not yet, 2 = beginning, 3 = in progress, 4 = intermediate, and 5
= proficient) on 12 indicators of early literacy (i.e., uses complex
sentence structure, understands and interprets text or story, easily
and quickly names letters, produces rhyming words, reads simple
books independently, uses different strategies to read unfamiliar word,
composes stories, understands conventions of print, matches letters to
sounds, identifies beginning sounds of words, identifies ending sounds
of words, overall literacy skills). Teachers also rated the child’s skills
on a 5-point Likert scale (from 1 = far below average to 5 = far above
average) relative to all other children of the same grade level (“How
would you rate this child’s academic skills in each of the following
areas, compared to all other children of the same grade level?” and to
other Latino children of the same grade level who spoke English as a
second language (ESL) (“How would you rate this child’s academic
skills in each of the following areas compared to other Latino children
you have taught of the same grade level who speak English as a second
language?”. Teachers were told that the study was investigating factors associated with school readiness; teachers were blind to the purpose of
the study and to ROR exposure. |
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| Data analysis: We completed three analyses in this study. First,
we completed descriptive analyses for the demographics of our
sample, ROR exposure, home literacy environment, emergent literacy
skills and teacher evaluations. Second, we created composite scores
of children’s print awareness, teacher-rated literacy skills, and ROR
exposure. In order to reduce the number of analyses relative to sample
size, a composite score of children’s emergent literacy skills based upon
the child interview was created by taking the mean of the following
items: child able to 1) identify his or her name 2) write his or her name,
3) identify a favorite book, 4) describe the sequence of events in the
favorite book, 5) identify the front of a book, 6) identify a word, and 7)
show the place to start reading and the direction to read, Cronbach’s
α = .61, M = .43, SD = .23, Range = 0 – 1. Similarly, a composite
variable of teacher-rated literacy skills was created by taking the mean
proficiency of the teacher items on the 12 literacy skills, Cronbach’s α =
.97, M = 3.62, SD = 1.04, Range = 1.50 – 4.83. A composite variable of
ROR exposure was created by taking the mean of the number of clinic
visits, number of WCC, and number of books received, as documented
by chart review, Cronbach’s α = .81, M = 9.65, SD = 3.56, Range =
1.33 – 18.33. Third, partial correlations controlling for child age and
maternal education were conducted between the composite score of
ROR exposure and children’s literacy skills as assessed by the child
interview, the DIBELS test, and teacher-report. Child age and maternal
education were controlled. |
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| Results |
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| Demographics and ROR exposure |
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| Table 1 details the demographics and ROR exposure of participants.
Eighty percent of children had six or more WCC, as documented by
medical record review. Almost all mothers (97%) reported that their
child had received a book from the doctor and 68% received 5 or more.
According to mothers, 90% of the children visited the clinic library at
least once and 72% had taken books home. |
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| Home literacy environment |
|
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| As shown in Table 2, mothers reported that children enjoyed being
read to and book sharing was common. An adult in the home shared
books with the child at least three or more times per week in 80% of
households. Book sharing began early with 58% of mothers initiating
book sharing by 12 months. Reported book ownership indicated 33%
of the families owned 3-10 children’s books, 21% 11-25, and 46% more
than 25. |
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|
Table 2: Description of Home Literacy Environment. |
|
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| Emergent literacy skills |
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| In terms of print awareness, during the interview in the summer
prior to kindergarten, 76% of children were able to identify a favorite
book by name, 68% were able to identify the front of the book, 50%
were able to identify a word, and 32% were able to identify the place
to start reading and the direction to read. 56% of children were able to
write their first name. |
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| The results of the DIBELS emergent literacy testing are shown in
Table 3. On the DIBELS ISF, LNF, and the FSF, 37%, 41%, and 45%
of the children, respectively, were identified as at high risk for poor
reading skills. The same measures identified 21%, 16%, and 21% of
children as low-risk. |
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Table 3: Percentage of ROR Children At-Risk for Reading Difficulties Based on the
DIBELS Measure in the Summer before Kindergarten Entry. |
|
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| Teacher Evaluations |
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| Thirty-one teachers (78%) from 26 different schools completed
questionnaires to evaluate children’s literacy skills at the end of
kindergarten (Tables 4 and 5). Teachers identified over 50% of the
children as proficient in easily and quickly naming all upper- and
lower-case letters of the alphabet, matching letters to sounds, and
identifying the beginning sounds of words. Teachers reported that 60%
of the children were proficient or intermediate in reading simple books
independently. Only 10% of children were “not yet” reading simple
books independently. |
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|
Table 4: Teacher Reported Literacy Skills based on ECLS-K Measures at the End of Kindergarten. |
|
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Table 5: Teacher Ratings of Literacy Skills of ROR Exposed Children at the End of Kindergarten Relative to All Other Children. |
|
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| When teachers rated children’s overall literacy skills at the end of
kindergarten (Table 5) relative to all children of the same grade, 77%
of the ROR children were rated as average, above average or far above
average relative to all other children at the same grade level. Teachers
also rated 67% of the ROR children as above average or far above
average compared to other Latino ESL children. |
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| Associations among ROR exposure and children’s literacy
skills |
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| Partial correlations were conducted among between the composite score of ROR exposure and children’s literacy skills as assessed by
the child interview, the DIBELS test, and teacher-report (see Table
6). Child age and maternal education were controlled. Greater ROR
exposure was significantly associated with phonemic awareness on the
DIBELS ISF test and greater understanding of print at kindergarten
entry, after controlling for children’s age and parents’ education levels.
Partial correlations indicated no significant associations between Head
Start attendance and the child’s emergent literacy skills assessed in the
clinic, performance on DIBELS, or teacher ratings of literacy skills,
controlling for children’s age and parents’ education levels. |
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|
Table 6: Partial Correlations between ROR Exposure and Children’s Emergent Literacy Skills Controlling for Child Age and Mother’s Education Level. |
|
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| Discussion |
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| Our study builds on previous research describing parental reported
outcomes of the ROR program by assessing children’s emergent
literacy skills using quantitative measures before kindergarten entry
and teacher report at the end of kindergarten. The kindergarten
performance of this small sample of Latino children participating
in the ROR program from infancy was good. Though these children
were living in poverty and had other risk factors for poor-school
performance, they had good home literacy environments and average or
above average literacy skills by the end of kindergarten. ROR exposure
was associated with greater print and phonemic awareness prior to
kindergarten. Finally, by teacher evaluation, the majority of children in
spite of low socioeconomic status, low educational attainment of their
mothers, and English as a second language, demonstrated literacy skills
that were average or above average levels by the end of kindergarten.
Protective factors including family stability, well-child care, and early
and consistent participation in the ROR program may have improved
the school readiness of these high-risk children. |
| |
| Latino or Latino origin is a self-designation made by over 50
million Americans in 2009, [50] 16 million of whom are children,
representing 23% of the US child population [50,51]. Approximately
2/3 of Latino children in the US are either first or second-generation,
meaning that they are foreign-born or US-born sons and daughters of
at least one foreign-born parent [51]. These children, like those in our
study, are more likely to live in poverty, to have parents who did not
complete high school, and to speak English less well than White, Black,
or 3rd generation or higher Latino children [9]. These risk factors may
contribute to Latinos having the lowest literacy proficiency scores and
high school graduation rates in the US [9]. These data have important
implications for the US educational and health systems. Programs that
support early literacy and take advantage of the strong Latino home
and family orientation may be important in mitigating the achievement
gap and the poor health outcomes associated with low literacy [9,52]. |
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| Although the educational achievement gap for Latinos has been
documented by age 4 years, a national sample of Latino families
demonstrated that Latino infant cognitive development as measured
by the Bayley Scales of Infant Development did not differ from other
racial and ethnic groups, and parenting behaviors, particularly reading
and linguistic engagement, predicted infant developmental outcomes
[9,12,53]. An early literacy intervention such as ROR that is initiated
by six months may encourage parenting behaviors associated with
cognitive development. In another study from this clinic population,
Latino parents expressed their gratitude for the ROR program and the
advice given to help prepare their children for school and indicated
they made changes in their activities with their children to incorporate
the literacy advice given in clinic [54]. |
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| Although the sample was not randomly assigned to the ROR
program, all families were living and poverty, nearly half (44%) of the
mothers had not completed 8th grade, and only 38% of children had participated in a preschool program (Head Start). Thus, it is unlikely
that the present sample was advantaged in terms of educational
attainment, socioeconomic status, or resources relative to other samples
of Latino families. However, the families sampled in our study also had
evidence of protective factors. The majority of children evaluated lived
in two parent homes. These children had completed 90% of WCC and
had participated consistently in ROR interventions since early infancy.
These markers of family stability confound our ability to attribute
literacy outcomes solely to the ROR intervention. |
| |
| Despite the risks of poverty, low maternal education, and English
as a second language, our study demonstrated that the home literacy
environment, in terms of book ownership and regular parent-child
shared book reading, of these Latino children was good. The literacy
orientation of study families was strong in that the majority reported
initiation of book sharing by age 12 months and reading with the child
several times per week. This finding is in contrast to a survey of Latino
parents from the same clinic conducted in 1998, before the introduction
of the ROR program, where the majority of parents reported that book
sharing should begin by age six years [26]. In addition, 59% of mothers
reported that their child had been read to the day before and that 44%
requested to be read to daily. National surveys have demonstrated that
the US average for daily reading is 48% with 59% of children from
high income families read to daily compared with 36% of low-income
children [55]. The families in our study, though living in poverty, had
reading habits more similar to average or high income Americans [55].
Children who are read to more frequently demonstrate significantly
higher reading knowledge in the spring of kindergarten and spring of
first grade [56]. Finally, nearly half of the families reported owning 25
or more children’s books, in contrast to national estimates and a survey
in this same clinic prior to the initiation of the ROR program, indicating
that significant proportions of low-income families own fewer than
5 books [26,31]. The ROR program provides ~ 10 books between 6
months and 5 years. The literacy programs sponsored by the library,
including story time and summer reading, may have further increased
book ownership. Other ROR providers might consider partnerships with public libraries as a beneficial extension of the traditional ROR
intervention. |
| |
| This is the first study to describe children who have participated in
ROR from infancy as they enter the educational system. The literacy
skills identified by teachers, including phonemic awareness and
comprehension, predict later reading achievement [57]. Children with
greater exposure to ROR showed more print awareness and phonemic
awareness than children who had less ROR exposure and these skills
may have contributed to their school performance. |
| |
| Although we do not have a formal control group, several familylevel
risk factors have been identified as predictors for poor school
performance by the ECLS-K and allow us to make some comparisons.
Identified risk factors for poor school performance include 1) having
a mother with less than a high school education, 2) living in poverty,
3) living in a single-parent household, and 4) having parents whose
primary language is other than English [49]. Every child in our
study had two or more risk of these factors for poor kindergarten
performance, 77% had 3 or more, and all had parents whose primary
language was not English. Thus, the study children would have been
predicted to perform poorly on objective measures of literacy and
would be expected to perform at a similar or even worse level than
Latino children in the ECLS-K lowest quartile. The results of our study
are distinctly different than what would be predicted, with the majority
of children (77%) performing at an average or above average level.
These findings highlight the heterogeneity among Latino parents and
their children [58]. |
| |
| This study has several limitations. First, the sample size is small.
However, this is the largest sample reporting on kindergarten
performance for children participating in ROR since infancy. Second,
the children in this study were drawn from families who, though living
in poverty and thus at risk for poor school performance, may have had
unmeasured factors that contributed to school performance, such as
family stability. The majority of child participants (85%) lived in twoparent
families, a factor associated with better school performance [49]. Family stability was also demonstrated by having a working telephone
number, transportation, attending 90% or more of recommended
WCC, participating fully in the ROR program and using the library.
Additional factors may have also included traditional Latino values
such as familismo, respeto, and cariño [59]. It may be that the parents in
this study, especially those who were most consistent with WCC, were
also motivated to provide other literacy experiences to their children.
The range of emergent literacy skills of the children in this study points
to the importance of moving beyond the achievement gap between
Latino and white children and examining the factors associated with
the heterogeneity in low income, Latino families literacy practices
[18]. The contribution of these factors and traditional Latino values
on ROR engagement and school performance deserve further study
[59]. Third, we are unable to measure the individual components of
the ROR program that might contribute to literacy orientation. The
number of books received was dependent on physician record keeping
and may result in under-reporting. The presence of the library in the
clinic offered additional opportunities for book ownership and literacy
encounters beyond the traditional ROR program. Finally, there is no
control group for this study. We believed there were ethical issues
that prohibited the creation of a control group denied early literacy
interventions that were standard of care in the clinic. Efforts to recruit
controls from the community failed to identify families with similar
socio-economic or education levels as the families served by our clinic.
Further, it was difficult to identify children with similar risk factors
from our community who did not receive healthcare in a clinic with a
ROR program because of its widespread implementation. Despite this
limitation, we believe that the Latino children described in this study
are at even higher risk than those that have been evaluated in national
samples and that suitable comparisons can be made. |
| |
| Reports from the National Task Force on Early Childhood
Education for Hispanics in 2007 and 2008 identified the most urgent
need as improving school readiness and achievement among low
SES Latino children from immigrant families [60,61]. The report
recommends that state and federal governments, in collaboration with
foundations, Latino organizations, educators and researchers, increase
investments in the design and evaluation of infant/toddler and prekindergarten
literacy programs that serve Latino families [60,61]. The
ROR Program is a low-cost intervention at ~$50/per child for 5 years
of support [31]. In combination with other programs, ROR may be
helpful in supporting the emergent literacy skills of Latino children
from immigrant families and thus improve their school readiness and
achievement. |
| |
| Acknowledgements |
| |
| This study was supported by Reach Out and Read, National Center. Portions
of this research were presented at the Pediatric Academic Societies meeting
on May 1, 2010 in Vancouver, BC Canada. The authors would like to thank the
many resident physicians and the attending physicians including Mandy Allison,
MD, Karen Buchi, MD, and Kristine Campbell, MD, who daily support the early
literacy interventions at the University South Main Clinic. We also acknowledge
the support of Jennifer Buchi, Israel Najar, David Norton, and Nate VanHoff who
served as research assistants. The Reach Out and Read Program at the University
South Main Clinic receives financial support from the National Reach Out and Read
Organization, and the Foundations of Primary Children’s Medical Center, Katherine
Gilbert, Starbucks, and Target and the Travis Gurr Endowment for Children. |
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