Prescription: Story Time - Literacy and Oral Health at Reach Out and Read

Bringing Families Together

Founded in 1989 by a group of pediatricians at Boston Medical Center, Reach Out and Read (ROR) works with health care providers to strengthen children and families through shared reading.

ROR's premise is simple: A primary care provider brings an age-appropriate book to a child's checkup. The provider shows and sometimes reads the book to the child. The child then gets to take the book home.

Talking about a book with a provider can add an element of fun to a routine visit. But it can also have a profound impact on a child's future.

"Literacy and relationships are vital parts of a child's overall well-being," said Emily Bartels, state director of ROR South Carolina. "Lifelong health is linked to the literacy skills and relationships children build in the first years of their lives. That's why our intervention assists children from the time they are born until they are 5 years old."

A child's reaction to a book helps the provider assess his or her developmental milestones. The book also helps the provider start important conversations with parents and caregivers. Providers can discuss a child's holistic needs and emphasize how shared reading is a key part of a child's development.

"These providers empower parents and caregivers to be teachers to their young children," said Bartels. "Shared reading can help families forge strong relationships that can have a lasting effect on a child. When families leave these checkups, we want them to look at reading as a doctor-recommended activity that is just as important as exercise and eating healthy foods."

ROR has programs in every state; Washington, D.C.; and Puerto Rico. It serves 4.2 million children and gives special focus to families who are uninsured or use Medicaid. Forty thousand medical providers at 6,100 sites take part in ROR.

ROR has been helping children in South Carolina for the past 25 years. South Carolina was the first state in the organization to formally train all clinicians to start ROR at the earliest well visit. It was also the first state where clinics began sharing books at the first newborn well-child visit. Because these practices were so successful, ROR now implements them across the country.

"The ROR training pioneered in South Carolina allows medical clinicians to support families at the earliest moments of life," said Bartels. "They can shape how families spend time together, create relationships and support whole-child development."

Brush. Floss. Read. Repeat.

In 2020, ROR joined forces with the BlueCross BlueShield of South Carolina Foundation to improve children's oral health.

According to the Centers for Disease Control and Prevention, cavities can negatively affect children's quality of life. The pain that results from cavities can cause them to miss class and prevent them from paying attention if they do attend. Because cavities make eating painful, children can suffer from undernourishment. Dental pain also might cause children to withdraw from social activities.

Poor oral health is a major problem in South Carolina, especially for low-income children. These children are twice as likely to develop cavities than their peers. The high cost of filling cavities and the shortage of dental providers in parts of the state stop many families from seeking help. In some counties, up to 20 percent of children have untreated cavities. An estimated 1.6 million people in the state live in an area where there are not enough dentists.

With support from the Foundation, ROR worked with primary care providers to increase the number of low-income children between the ages of 6 months and 2 years who receive dental care. ROR chose to target this age range because the American Dental Association recommends that children see a dentist by age 1, when the first tooth usually erupts.

During a 12-month period, ROR providers shared 4,600 books about oral health with families during routine well-child visits. The books allowed providers to talk to families about fostering healthy habits, such as brushing and flossing.

The books also gave providers a creative way to offer fluoride varnishes to low-income children with limited access to dental care. According to the American Academy of Pediatrics (AAP), fluoride varnish is a sticky resin of highly concentrated fluoride, a mineral that can prevent and slow tooth decay. It can greatly reduce a child's risk of getting cavities if it is professionally applied at least twice a year. In the project's first year, ROR providers gave varnishes to 15,000 children who may have otherwise been unable to access care.

Finally, the clinics that took part in this project made 2,500 referrals to connect children with dental homes. The AAP suggests that primary care providers refer children to a dentist as early as possible. This can prevent disease, foster good oral health and lessen expense. By connecting vulnerable children to dental homes, ROR and the Foundation made a key investment in their long-term dental health.

"The Foundation strives to reduce the barriers to care that many low-income children face," said Erika Kirby, the Foundation's executive director. "We recognize the importance of oral health towards overall health. We look forward to the impact this project will have on increasing fluoride varnishes and integrating oral health into well-child visits across South Carolina."

ROR is grateful the Foundation's grant made such a big difference in children's lives.

"As we work to make ROR the standard of pediatric primary care, we are extremely grateful for the support and encouragement from the Foundation," said Bartels. "ROR is an essential tool for clinicians and a resource for families. It enhances healthy routines and relationships. By incorporating this approach into their practices, clinicians foster positive child development. The Foundation has always been supportive and excited when we have new ideas, and we consider the Foundation a thought partner in helping children and families in South Carolina."

When asked how readers can help ROR in its mission, Bartels suggested that they:

• Ask their primary care provider to get involved with ROR.
• Take part in an online book drive. ·
• Become a monthly donor, or Book Buddy.
• Donate funds or gently used books to ROR.

Learn more about how to help ROR at www.RORCarolinas.org*.

The Centers for Disease Control and Prevention, the American Dental Association and the American Academy of Pediatrics are independent organizations that provide health information you may find helpful.

*This link leads to a third-party website. Reach Out and Read Carolinas is solely responsible for the contents and privacy policy on its site.

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