ADRIAN MA, HOST:
The first doctor I can really remember interacting with was a pediatrician. And whenever I visited the pediatrician, I remember there were all these tests - tests for vital signs, reflexes and allergies. One thing I do not remember being tested on, though, was my ability to read, which is why it's interesting that several pediatric centers are trying something new. In response to a nationwide dip in reading proficiency, they're starting to screen kids as young as 3 for literacy skills.
SARA BODE: What we say when we're doing these screenings is that we almost see, like, a lightbulb or an aha moment go off in a lot of these parents when they're really first starting to understand, wow, I should be doing this with my child before kindergarten.
MA: Dr. Sara Bode is with Nationwide Children's Hospital in Columbus, Ohio. She's their medical director of school-based health, and she co-authored a study in the Journal of Pediatrics about literacy and developmental screening for preschoolers. Recently, she spoke with my colleague Emily Kwong about this unique approach and how it's being received by educators.
EMILY KWONG, BYLINE: I want you to imagine that I'm a parent, and I'm bringing my kid to your clinic for a literacy screening. What would we do there?
BODE: So when you come in, what we're doing at this literacy checkup is when you come in at age 3 for your regular checkup, we're doing all the things you normally do in the doctor's office. So we're checking your physical health, we're giving you any vaccinations you need, any laboratory evaluation. But now what we're doing is we're also using a book to do literacy-based screener with your child. Pediatrician comes into the office - they're talking about all these things. Now they're also sitting down with you and testing your child on those early literacy skills.
KWONG: That's got to be fun for the kids, to be handed a book at the doctor's office.
BODE: Yes, the kids love it, and they love to turn the pages. You ask them questions about each page. And a lot of times, what we find is parents are either surprised when their kid is answering a lot of questions, and they'll say, hey, I didn't even know they knew that, or they might notice or be concerned when it doesn't seem like their child can identify any of those early skills that we're looking for, recognizing any of the letters or recognizing any of the objects within the book.
KWONG: If a pediatrician trained in doing this, in screening for literacy, identifies a kid may have - may be behind in their reading skills, what happens then?
BODE: Yeah, so this is really three-pronged approach. First is that parents are child's first teachers. So nobody teaches you how to teach your child how to read at age 3. And so part of what they're doing is teaching the parent what are the activities they can do at home to promote these literacy skills.
The second thing we do is give them all the materials they need. So we have a literacy kit that has all of these workbooks, different programs, different resources they can use, like whiteboards, and really the ideas in there on how they can implement this at home.
And then the third thing we do is really think about, how do we connect them with those programs in their community that are high quality that might help? So think about a kid that's not yet in preschool and would benefit from that. Maybe there's a home school readiness program that's available in their community. So our program works to then connect them directly to those resources.
KWONG: Oh, you know, reading has been the purview of schools for so long - early reading. Have you gotten any pushback from teachers on this?
BODE: Not only have we not gotten pushback, but we partner with them. So I'm a pediatrician. I'm not a teacher. So when we first started this and we wanted to build those resources and really help families understand how to teach their kids, the first thing we did was go to our local teachers. So we partnered with our local school district to understand, from a group of kindergarten teachers, what should we be putting in these kits, and what activities should we be listing?
So this is really done in collaboration so that it's seamless for the families, so that when their child gets to kindergarten, they're recognizing all the same activities, same resources, because we're using those in this early space. So it really is trying to come alongside our education experts and figure out how we can help.
KWONG: Yeah. You know, identifying that a child at age 3 is at risk to struggle in reading is one thing, but actually improving their reading before kindergarten is a whole other thing. So how are you measuring the success of this intervention?
BODE: Yeah, so in a couple ways. One is that we do have them come back for their checkups. So we're repeating this screening tool and seeing and measuring how they're progressing at age 3, 4 and 5. So seeing a lot of great results when we're checking back in with families to understand what resources they have used and where they're connected.
The other thing is that we're actually tracking these kids to see how they do on this state kindergarten readiness assessment they have to take. So in the state of Ohio, every child that starts kindergarten that fall is actually tested by their teacher to see how they're doing. So we're looking at the kids that we're intervening with and measuring, are we moving the needle, so that when they take that test, are they more likely to score better and pass and be ready?
KWONG: I got to ask - I mean, it does come down to pediatricians, the people who are in these offices with kids and their families, and pediatricians are already stretched pretty thin. You know, appointments can be really short. So is there realistically capacity to add this to the list of what pediatricians need to do in the limited time they have?
BODE: Yeah, it's such a good question. So, you know, one of our first things we studied in our first publication a few years ago on this was, can we even do this? So this Reading House literacy-based screener takes less than 5 minutes. We found a way to incorporate this at the end of the physical assessment but before you're giving any immunizations 'cause nobody wants to read with you when they've just gotten a few shots.
And we really were able to show and prove that even in a busy pediatric practice, we were able to add this component in without slowing down the clinic, so without having any unintended consequences of delay in care. Families are busy, too, and they want to kind of get in and out of the office. So this is really tailored to be done in a busy pediatric practice.
KWONG: Dr. Sara Bode is a primary care pediatrician at Nationwide Children's Hospital in Columbus, Ohio. Thank you so much for talking to us. Thank you for having me. Transcript provided by NPR, Copyright NPR.
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