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AR Well Child Reads/Reach Out and Read Hunger Conference


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AR Well Child Reads/Reach Out and Read Hunger Conference

  1. 1. Low Literacy in Arkansas What’s Food Got to Do With It? Arkansas Hunger Coalition Conference May 26, 2004 Dr. Peggy Sissel-Phelan for AR Child READs! Well ^
  2. 2. What is Literacy? <ul><li>Meaning of Literacy Differs </li></ul><ul><ul><li>Over time </li></ul></ul><ul><ul><li>By place </li></ul></ul><ul><ul><li>Within cultural groups </li></ul></ul><ul><ul><li>When new conceptual frameworks are developed </li></ul></ul>
  3. 3. What is Literacy? <ul><li>Meaning is affected by </li></ul><ul><ul><li>Politics </li></ul></ul><ul><ul><li>Resources </li></ul></ul><ul><ul><li>Biases </li></ul></ul>
  4. 4. Who Is Literate? <ul><li>Until recently, no one expected everyone to be literate </li></ul><ul><li>Emerging views in 60’s and 70’s </li></ul><ul><ul><li>International development </li></ul></ul><ul><ul><li>Space race </li></ul></ul><ul><li>Now, literacy as Crisis </li></ul><ul><ul><li>Greater expectations for educational attainment </li></ul></ul><ul><ul><li>Information society </li></ul></ul>
  5. 5. National Assessment of Adult Literacy <ul><li>16,000 adults ages 16+ </li></ul><ul><li>Tested literacy tasks, not just decoding </li></ul><ul><li>5 reading skill levels </li></ul><ul><ul><li>Level 1 – approx. first grade </li></ul></ul><ul><ul><li>Level 2 – approx. fourth grade </li></ul></ul><ul><li>National Results </li></ul><ul><li>State by State extrapolations </li></ul>
  6. 6. Level 1 Literacy Among Adults Age 16 + by County Number of Counties n = 17 n = 27 n = 14 n = 9 n = 4 n = 3 13-19% 20-24% 25-29% 30-34% 35-39% 40-45% Level 1 Level 1 Level 1 Level 1 Level 1 Level 1 Note: Level 1 equates to about 1 st grade reading skills Missing Data
  7. 7. Level 2 Literacy or Below Among Adults Age 16 + by County Number of Counties n = 3 n = 8 n = 19 n = 29 n = 12 n = 3     Note: Calhoun County data not available   43-45% 46-51% 52-59% 60-69% 70-79% 80-89% at Level 2 at Level 2 at Level 2 at Level 2 at Level 2 at Level 2 Note: Level 2 equates to about 4th grade reading skills Missing Data
  8. 8. Generational Illiteracy Parents/Adult % 8 th Graders % City Low Literacy Low Literacy 78 90 Forrest City 71 92 Pine Bluff 62 83 Texarkana 64 70 Blytheville 63 69 El Dorado 54 77 North Little Rock 58 68 Paragould Note: Parents data derived from National Adult Literacy Survey, 1992 Students data derived from National Assessment of Educational Progress, 2002
  9. 9. Generational Illiteracy Parents/Adults % 8 th Graders % City Low Literacy Low Literacy 59 58 Magnolia 46 70 Little Rock 49 61 Arkadelphia 50 58 Benton 46 55 Searcy 42 57 Rogers Note: Parents data derived from National Adult Literacy Survey, 1992 Students data derived from National Assessment of Educational Progress, 2002
  10. 10. Generational Illiteracy Parents/Adult% 8 th Graders % City Low Literacy Low Literacy 44 50 Jonesboro 42 46 Conway 48 40 Springdale 44 37 Bentonville 32 34 Fayetteville Note: Parents data derived from National Adult Literacy Survey, 1992 Students data derived from National Assessment of Educational Progress, 2002
  11. 11. Generational Illiteracy 8 th Graders Parents/Adults %
  12. 12. Child-Well Being Infant mortality rates – 37 th in U.S. Low birth weight - 41 st Child death rates - 46 th Overall child well-being - 47 th
  13. 13. Youth Well-Being Teen birth rate - 42nd in U.S. School dropout rate - 41 st in U.S. CDC study on youth behavior in Arkansas: 23% Rarely/never use safety belts 31% Rode with drinking driver in past month 22% Carried a weapon in the past month 30% Report episodic heavy drinking during the past month
  14. 14. Community Well-Being Low-literate adults - 56% Less than h.s.diploma -22.8% Bachelor’s degrees or more -18% Person’s Below Poverty – 15.8% Families making less than $25,000 - 28.1%
  15. 15. Illiteracy — A Health Problem? <ul><li>Medication Errors </li></ul><ul><li>DNKA’s (did not keep appt.) </li></ul><ul><li>Misunderstanding Diagnosis </li></ul><ul><li>Compliance issues </li></ul><ul><li>Access to Medical Care </li></ul><ul><li>Unable to read Patient Education </li></ul><ul><li>Materials </li></ul><ul><li>Perceptions of Health </li></ul>
  16. 16. Health Literacy “ The ability to read , understand , and act on health care information”
  17. 17. Findings of American Medical Association <ul><li>Affects 90 million Americans </li></ul><ul><li>Critical health issue </li></ul><ul><ul><li>2x more likely to be hospitalized </li></ul></ul><ul><ul><li>2x more likely to report poor health </li></ul></ul><ul><ul><li>Less likely to access health care system </li></ul></ul><ul><li>Costs estimated $73 billion annually to health care system </li></ul>
  18. 18. Where are the Roots of Illiteracy?
  19. 19. Reading and Children’s Brain Development <ul><li>The architecture of the brain is shaped by early experiences </li></ul><ul><li>Under-used nerve connections are “pruned” </li></ul><ul><li>Cognitive skills associated with book sharing - memory, comprehension, creativity, and language - ensure that associated brain connections persist </li></ul>
  20. 20. Emergent Literacy <ul><li>Literacy Develops </li></ul><ul><li>Literacy acquisition begins before formal instruction </li></ul><ul><li>Critical cognitive work from birth to age six </li></ul><ul><li>Literacy develops in real life settings for real life activities </li></ul>
  21. 21. Parental Language and Children’s Language <ul><li>Children’s language evolves primarily through parent-child interactions </li></ul><ul><li>By two years of age, children’s language correlates with later cognitive performance </li></ul>
  22. 22. Hoff-Ginsberg, 1991 <ul><li>Children 18-29 months old videotaped with mother </li></ul><ul><li>Measured shared language during routine activities and reading aloud </li></ul><ul><li>Number and frequency of utterances, number of words, and syntactic complexity were 2 times higher during reading aloud </li></ul>Reading Aloud Promotes Maternal-Child Language
  23. 23. Reading with Children <ul><li>Dialogic Reading </li></ul><ul><ul><li>Ask “What” and “Where” questions </li></ul></ul><ul><ul><li>Label </li></ul></ul><ul><ul><li>Give feedback </li></ul></ul><ul><li>Age appropriate expectations </li></ul><ul><li>Child directed </li></ul><ul><li>Part of daily routines </li></ul><ul><li>Fun </li></ul>
  24. 24. Children from Low-Income Families <ul><li>Low-income status significantly predicts children’s exposure to language (Bloom, 1998) </li></ul><ul><li>Children from low-income families are far less likely to be read to on a daily basis (National Research Council, 1999) </li></ul>
  25. 25. Consequences of Poverty <ul><li>In general, children living in poverty: </li></ul><ul><ul><li>Are 1.3 times more likely to exhibit developmental delays </li></ul></ul><ul><ul><li>Are 1.4 times more likely to be diagnosed with a learning disability </li></ul></ul><ul><ul><li>Are 2 times more likely to repeat a grade </li></ul></ul>Brooks-Gunn & Duncan, 1997
  26. 26. Reach Out and Read! <ul><li>Clinic-based pediatric literacy intervention by health care providers </li></ul><ul><li>Adds a literacy component to every well child visit </li></ul><ul><li>Health care provider gives away free books </li></ul><ul><li>Educates parents about reading to their child </li></ul><ul><li>Identifies low literacy parents </li></ul>
  27. 27. Reach Out and Read <ul><li>Founded in 1989 at Boston City Hospital </li></ul><ul><li>Over 1400 sites at present </li></ul><ul><li>Over 14,000 pediatric providers trained </li></ul><ul><li>Over 1.5 million children from low-income families reached annually </li></ul><ul><li>Over 3 million books distributed per year </li></ul><ul><li>Hopes to double sites to 3000 in five years </li></ul>
  28. 28. The ROR Model <ul><li>Culturally and developmentally books given by the pediatric provider at well child visits 6 months to 5 years of age (~10 visits) </li></ul><ul><li>Volunteers in the waiting room demonstrating reading techniques </li></ul><ul><li>Anticipatory Guidance for parents at each visit - repeated and reinforced!! </li></ul>
  29. 29. ROR Research <ul><li>Parents who received books </li></ul><ul><ul><li>more likely to remember the anticipatory guidance given by their physician </li></ul></ul><ul><ul><li>4 times more likely to report reading to their children at follow up (Needlman et. al., 1991) </li></ul></ul><ul><li>More positive attitudes toward reading (High et. al., 2000) </li></ul><ul><li>Children in the ROR program had higher receptive and expressive language scores (Mendelsohn et al., 2001) </li></ul>
  30. 30. “ Anticipatory guidance for parents about sharing books with young children may be the only concrete activity of a pediatric provider that has been proven to promote child development .” -Barry Zuckerman, MD Founding Director, Reach Out and Read
  31. 31. Our Vision – A Healthier and More Literate Arkansas Awareness, Education, & Outreach, Book Distribution Collaboration
  32. 32. What You Can Do (1)   Spread the news about the concept of early intervention literacy programs (2)    Advocate for emergent literacy programming in their communities   (3)  Invite us to speak: civic, nonprofit, corporate, governmental, professional groups, organizations, and agencies
  33. 33. Questions
  34. 34. Relationship Between Literacy and Health Status <ul><li>1/3 could not understand basic health related materials </li></ul><ul><ul><li>42% misunderstood medication directions </li></ul></ul><ul><ul><li>26% couldn’t understand appointment slip </li></ul></ul><ul><ul><li>60% did not understand consent forms </li></ul></ul><ul><ul><li>49% couldn’t figure out if they were eligible for hospital financial aid from forms </li></ul></ul>
  35. 35. More Implications <ul><li>Lower income </li></ul><ul><li>Poor nutrition </li></ul><ul><li>Substandard Housing </li></ul><ul><li>Violent Neighborhoods </li></ul><ul><li>Low Ratings/Perceptions of Health </li></ul><ul><li>Lack of preventative care </li></ul>
  36. 36. <ul><li>Nationally, 35% of first graders are labeled as “slow” and placed in remedial reading programs. </li></ul><ul><li>Dyslexia—prevalence 4-10% </li></ul><ul><li>Most of these children, who are not dyslexic, remain in these programs throughout school. </li></ul><ul><li>Creates a vicious cycle for school failure and failure in life. </li></ul>Childhood Roots of Illiteracy
  37. 37. Contact Us! <ul><li>Peggy Sissel-Phelan, Ed.D. or </li></ul><ul><li>Chad Rodgers, MD, FAAP </li></ul><ul><li>Email: [email_address] </li></ul><ul><li>Phone: 228-0908 </li></ul><ul><li>P.O. Box 21712, LR, AR 72221-1712 </li></ul><ul><li>Order copies of “Volumes to Go Before We Rest”-- $10 each </li></ul>