The Other 60 Percent

Early education…in the doctor’s office

Stepheny Renteria, six months old, tentatively took the brand new board book from pediatrician Meghan Treitz just as the check-up began. It was called “Dulces Sueños,” or “Sleepy Heads.”

Sitting in her mother’s lap in a sunny exam room at the Child Health Clinic at Children’s Hospital in Aurora, she gazed wide-eyed at the book’s baby faces. She turned it upside down. She brought it to her mouth as if she might take a bite out of it. A few minutes later, she dropped it on the floor.

Stepheny Renteria, who is six months old, takes a new board book from Dr. Meghan Treitz at a Children's Hospital clinic in Aurora.
Stepheny Renteria, who is six months old, looks at a new board book held by Dr. Meghan Treitz at a Children’s Hospital clinic in Aurora.

While Stepheny played with her new book, Dr. Treitz spoke to Stepheny’s mother Maria Giron about the importance of reading, using a phone interpreter to translate her words into Spanish.

It only took a few minutes, but Dr. Treitz and others who hand out free children’s books and reading advice at routine doctor visits through the “Reach Out and Read” program believe it makes a difference for the low-income families it targets.

The same is true of another early childhood program called Colorado Bright Beginnings, which encourages all parents, regardless of income, to talk to, read to and play with their zero to three-year-old children, usually through doctor’s office visits or home visits by volunteers.

As advocates pay more attention to the power of early exposure to language, many of the most well-known programs are far from meeting demand. In Colorado, only a small fraction of young children are served by programs like Early Head Start, Head Start or intensive home-visiting programs.

Programs like Reach Out and Read and Bright Beginnings step into that void with a unique offer: to reduce early literacy deficits at a much lower cost and on a greater scale. Plus, by connecting with so many families at clinics or other medical establishments, both programs capitalize on the fact that during the early years of their children’s lives, many parents have their only contact with trusted professionals in health care settings.

The importance of starting early

It may seem strange that babies would be the focus of school readiness efforts when they are years away from entering a classroom, but there’s lots of evidence to support the idea that the first years of a child’s life are critical to future success.

One often-cited piece of evidence is a book published in 1995 called “Meaningful Differences in the Everyday Experience of Young American Children.” In it, two university professors, Betty Hart and Todd Risley, share findings from their painstaking study examining how and how much parents of difference socioeconomic statuses talk to their babies and toddlers.

A stack of Bright Beginning bags containing books, learning games and parent guides.
A stack of Bright Beginning bags containing books, learning games and parent guides.

“It was an amazing study,” said Treitz.

One of the most jarring results from the research, she said, demonstrated that babies of higher-income parents begin pulling away from the pack in terms of vocabulary size at just 14 months old. Children of working class families pulled away from their low-income peers when they were 22 to 23 months old.

In other words, massive differences in literacy can be traced back to the parent-child banter that takes place before most children celebrate their second birthdays. By four years old, Hart and Risley assert that children of professional parents hear nearly 45 million words compared to about 13 million words for children of low-income parents.

It’s statistics like this that drive programs like Reach Out and Read and Bright Beginnings, as well as others such as Parents as TeachersHIPPY and the Parent-Child Home Program.

Dr. Stephen Berman, chair of general pediatrics at Children’s Hospital and a founding member of the Bright Beginnings board, said the idea behind Bright Beginnings is to give parents and caregivers the tools they need “to lessen the socioeconomic influence on school readiness.”

And while intensive preschool programs such as Head Start attempt to compensate for deficits accumulated in early childhood, they are very expensive relative to programs like Bright Beginnings, he said.

In 2011, only about 16.5 percent of low-income Colorado children aged zero to five were served by Head Start or Early Head Start, according to data from Kids COUNT, an annual report on the well-being of children. In addition, 51 percent of the state’s three- to four-year old children didn’t attend any kind of preschool program between 2009 and 2011.

Low intensity and low cost

At baby Stepheny’s check-up, Treitz spent only a few minutes at the beginning of the appointment talking about the benefits of reading. She explained to Giron that reading to Stepheny would improve her vocabulary and make it easier for her to learn to read. She noted that babies Stepheny’s age are likely to put books in their mouth.

“That’s normal. That’s a six-month-old’s way of getting to know things” said Treitz,who is also an assistant professor of pediatrics at the University of Colorado.

While Treitz and others hope the impact of those bite-sized Reach Out and Read sessions will last a lifetime, their short-and-sweet nature is part of what makes the program inexpensive and scalable.

All told, Reach Out and Read includes eight to 10 doctor visits in which children get free books and parents get free advice on reading to their children. The cost, which is covered through private grants and donations, is $5 per visit or up to $50 per child over five years. About 86,000 children in 48 of 64 Colorado counties receive new books through the program annually. 

Bright Beginnings, which  can include up to three annual sessions in which parents receive advice and age-appropriate kits containing children’s books, learning games and parent guides, has a similarly modest price tag. It costs about $55 per visit or $165 per child over three years.

Last year, just over half of Bright Beginning sessions took place at medical clinics. About one-third took the form of home visits led by volunteers and the rest occurred in group settings at libraries, museums or other locations.

Christopher Price, chief operating officer at Colorado Bright Beginnings, said the program reached around 19,000 parents and caregivers last year.

Like Reach Out and Read, Bright Beginnings relies on private grants and donations to cover costs. Leaders of both organizations say they don’t anticipate receiving funding from President Obama’s early learning initiative, which proposes a variety of investments in early education efforts.

While the low-intensity aspect of the two interventions are part of what makes them easy to disseminate, there is sometimes skepticism about the impact of  programs that take only about 15 to 45 minutes a year to administer to a family.

Price said his organization must constantly overcome the question: “How much difference can you really make with a single visit?”

New research

Guidelines on Reach Out and Read posted  at the Child Health Clinic at Children's Hospital.
Guidelines on Reach Out and Read posted at the Child Health Clinic at Children’s Hospital.

More than a dozen studies have been done on Reach Our and Read since its creation 24 years ago. They have found that parents served by the program are four times more likely to read aloud to their children and that preschool children served by Reach Out and Read score three to six months ahead of peers who have not participated.

While there have been a few studies on Bright Beginnings and several surveys that generally show positive feedback from participants, the organization continues to seek evidence supporting its model.

“We have validity to what we’re doing,” said Price. “What we need is credibility.”

New studies underway on both Bright Beginnings and Reach Out and Read in collaboration with Children’s Hospital  may strengthen those findings and explore new ways of reinforcing the early intervention message with parents.

Dr. Treitz is just beginning a $15,000 study that will determine whether a video tutorial demonstrating a technique called “dialogic reading” will help parents engage their children in conversations about books.

“You don’t necessarily read every word that’s on the page. It’s kind of a dialogue between the parent and child,” said Treitz. “The more we can get parents to talk to their kids the better.”

The study will examine whether the video is effective in teaching parents of two- to three-year-olds dialogic readings skills.

The goal, Treitz said, is to “take Reach Out and Read to the next level.”

“[Treitz’s] research, I know for a fact, it will impact our clinics across Colorado, but we’ll share that nationally as well,” said Megan Wilson, executive director of Reach Out and Read Colorado.

Osvaldo Narvaez-Huerta, two, looks at his new book while Dr. Meghan Treitz looks on.
Osvaldo Narvaez-Huerta, two, looks at his new book while Dr. Meghan Treitz looks on.

Wilson noted that because Reach Out and Read occurs in a health care setting, “we have unprecedented access to children…and also the parents themselves.”

She cited a Colorado Trust brief stating that while 90 percent of children ages five and under go to the doctor for preventive care, less than 30 percent are in a child care setting, the next most common contact with a “formal service system.”

Dr. Maureen Cunningham, co-investigator on a planned study of 2,000 Aurora and Denver children in Bright Beginnings, agreed that doctors’ offices are an ideal vehicle for disseminating early learning materials.

“Everybody brings their child to the doctor,” said Cunningham, a primary care research fellow at Children’s Hospital.

Dr. Cunningham and Dr. Berman are collaborating on the Bright Beginnings study, which will pilot an effort to reinforce the program’s face-to-face parent interactions with text messaging and social networking.

For example, researchers may include daily text messages reminding parents to read with their children or suggesting learning games from the Bright Beginnings kits, which come in brightly colored cloth bags. They may also organize “virtual playgroups” of six to eight moms with babies the same age who will share their experiences with Bright Beginnings games and books through online posts or photos.

The additions “will speak the language of young moms,” said Dr. Berman.

The study will initially target families with children in the 12-24 month age range, with follow ups into their school-age years.

Dr. Berman said the study will help answer the question, “Can we strengthen the ability to change parent behavior?”

Price said if the study by Dr. Berman and Dr. Cunningham goes as planned, it will provide indisputable evidence that the effects of early disadvantages can be eliminated with a program that costs around $150 per child

“Where else are you going to get that impact with so little cost?” he asked. “We can change the world with that.”

Coverage of early literacy is supported in part by a grant from Mile High United Way. EdNews Colorado retains sole editorial control over the content of this coverage.


Starting young

These 11-year-old Brooklyn students are asking New York City to do something about segregated schools

PHOTO: Christina Veiga
Matilda and Eliza Seki, left, and their friends Noa and Benji Weiss, right, collected signatures at a district 15 meeting to discuss middle school integration efforts.

While they learned about the history of segregation, a group of Brooklyn 11-year-olds took a good look around their classrooms and realized their schools weren’t so different from the photos in their textbooks.

So Matilda and Eliza Seki paired up with their friends Noa and Benji Weiss — two sets of twins — and decided to do something about it. They launched a petition on calling on the city to integrate its schools.

“We learned about separate and equal in the civil rights movement, and that it was not equal,” Eliza said, referring to the “separate but equal” legal doctrine once used to justify segregation. “And since there are schools with people of only one race, and it’s all separated, it cannot be equal.”

Matilda and Eliza are in the sixth grade at M.S. 839, and Noa and Benji are fifth-graders at P.S. 10. They already have a bit of experience in activism, having joined the Women’s March in D.C., and helping to lead environmental clubs at their school. They hold sophisticated views for kids their age, and are aware of the hurdles ingrained in addressing school segregation.

Describing how housing patterns can tie into school quality, Benji began his thoughts by saying: “Let’s say you’re from a different culture or race and you don’t have as much money as other people do — because we still live in a racist country — and you’re in an area where the housing is cheaper but you don’t have as good schools.”

Across New York City, adults have debated how to spur integration in the country’s largest school system — and one of the most segregated. According to one recent analysis, the city’s most selective high schools enroll 84 percent white and Asian students, even though those groups make up only 30 percent of the city’s student enrollment.

But student-organized groups have also been at the forefront of a grassroots movement for more diverse schools. The work of budding advocates Matilda, Eliza, Noa and Benji caught the attention of some those groups, and they’ve now joined the ranks of Teens Take Charge and IntegrateNYC as some of the youngest members. The changes they’d like to see go beyond admissions policies, but also include a push for additional resources for underserved schools, hiring more teachers of color and curricula that reflects all students and cultures.

“We decided it was an important issue and we wanted to help fix it,” Noa said.

Matilda added: “Our schools should look like our city.”

Their schools are in District 15, where 81 percent of white students are concentrated in just three of the district’s most selective middle schools, according to an analysis by parents. The city has launched a series of public workshops to craft a new admissions model to integrate middle schools there, but these kids already have their own ideas for how to do that.

Benji, who is heading to middle school next year, said it would be “pretty good” if schools stopped picking students based on criteria such as class grades and attendance. Such “screening” contributes to segregation because of a number of factors — from which elementary schools students attend, to their parents’ ability to navigate the complicated admissions process.  

“It’s… important to learn about different peoples’ backgrounds, and religions, and cultures,” he said. “And also to make sure that all kids, no matter their race, religion or where they live can get the same, good education.”

Raised Voices

Balloons, hearts, and ‘die-ins’: How Colorado students marked National Walkout Day

Students gather at the Colorado State Capitol to protest gun violence. (Melanie Asmar)

Thousands of students across Colorado poured out of their schools Wednesday to protest gun violence and to remember 17 victims of last month’s deadly shooting in Florida. Chalkbeat’s Melanie Asmar walked with students from East High School to the Colorado State Capitol, where Gov. John Hickenlooper and Speaker of the House Cristanta Duran urged them to remain politically active.

The protests took different forms at other schools – and not everyone wanted the event to be political. There were balloon releases, voter registration drives, and public “die-ins” at major intersections. And in one Denver area school district, a surge of threats cast a pall over events.

Here’s a look at #NationalWalkoutDay from around the region.

Students at Skinner Middle School in northwest Denver marched in silent solidarity.

In Colorado, teenagers can register to vote before their 18th birthday.

At schools in the Adams 12 district north of Denver, a big uptick in threats the night before – and a warning letter from the superintendent – led many students to skip school altogether.

Students at McAuliffe International School in northeast Denver spoke with their shirts. Instead of “Thoughts & Prayers,” they asked for “Policy & Change.”

But their event was not all about politics. They formed a heart with their bodies and read the names of the dead.

At Jefferson Jr./Sr. High School, students promised to work to change school culture.

Many schools released balloons to honor the victims and found other ways to advocate for change.

Unlike some Colorado districts, St. Vrain didn’t officially condone the walkouts, but students at Longmont schools walked out anyway.

Students at Denver’s South High School have been vocal about gun violence. In a recent visit from U.S. Rep. Diana DeGette, they rejected the idea that armed teachers would make them safer and demanded that lawmakers do more.

Students from one of Colorado’s KIPP charter schools used their bodies to send a message at a major intersection in west Denver.

Students of color in Denver reminded the public that gun violence is not limited to mass shootings.

Students aren’t just marching. They’re also writing their representatives. State Rep. Faith Winter, a Westminster Democrat, tweeted a picture of her inbox full of emails from students.

Colorado carries the legacy of the 1999 mass shooting at Columbine High School, where a memorial asks urgently as ever: “How have things changed; what have we learned?”