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The United States’ Reach Out and Read model
Reach Out and Read (ROR) is a paediatric primary care based intervention to encourage parents to read aloud to their young children. Doctors give books to children at each well child visit from 6 months of age to 5 years, and accompany these books with developmentally appropriate, individualised advice to the parents about strategies of enjoying books and reading aloud with their children. A growing body of peer reviewed research has shown this model to be effective in changing parental beliefs and behaviour and in accelerating language development in young children from low income families.
Scientific knowledge regarding early brain development has progressed rapidly, eliciting widespread academic and popular interest. Much of the new understanding of the brain in the early years of life emphasises the translation of early experiences into neuronal connections, which in turn may influence later child development. We report an evidence based innovation in paediatric primary care in the United States that builds on recent research in brain development to promote learning in infancy and early childhood, with specific reference to books and language.
BRAIN DEVELOPMENT
Our new and rapidly expanding understanding of early brain development has elucidated the anatomical and physiological consequences of early experiences. Children are born with all their neurones already formed. However, the connections between these neurones are in large part established and elaborated after birth, as the synapses proliferate, forming and branching dramatically during early childhood, and reaching a peak count by 3 years of age. Half of these synapses are lost by age 15, suggesting that they are more than are needed for function in any human setting.1 Synapses are lost through the “pruning” of unused neural connections and the selective strengthening of those that are used to foster environmental adaptation.2 Recent …