Family Medicine Clinic Adopts a Program for the Books

This article originally appeared in the National Commission on Certification of Physician Assistants’ April 2019 newsletter and is reprinted with permission from the organization.

Clinically-practicing certified physician assistant Joanna Hebgen is doing her part to change the lives of children through a simple-yet-effective method: books. 

At the SSM Health Family Medicine Clinic in Oregon, Wisconsin, Hebgen implemented the Reach Out and Read program, which strives to incorporate books into the daily lives of children and encourages families to read aloud together. 

Staff members including Physician Assistant of SSM Health Oregon clinic at Wellness Expo showcasing their Reach Out and Read program
SSM Health Dean Medical Group Oregon staff at the Oregon Wellness Expo

The clinic has distributed more than 450 children’s books and created a literacy-friendly waiting area and exam rooms. By adding books and comfy, child-size chairs, children can relax and read before their appointments. 

During wellness visits, providers give each child a book they can take home. Upon presenting the book, providers can observe the child’s and parent’s reactions, which offers insight about the child’s development and the parent’s comfort with reading to the child.  It also paves the way for discussion about the importance of daily reading. 

According to the American Academy of Pediatrics (AAP), benefits from reading can begin as early as infancy. Kids who are read to regularly have a stronger bond with their parents and learn valuable language and literacy skills. Reading also improves their social, vocabulary, and writing skills, and it can make kids kinder and more empathetic individuals as they grow.

“I love giving out books that I read as a child and also read to my children,” said Joanna Bisgrove, MD. “Parents and kids love the books. I find that the book is a good way to calm a child during an appointment and build rapport with both the children and parents.”

The clinic’s interprofessional staff all contributed to the program’s success, dedicating an estimated 40 hours to the project last year. Three staff members attended the annual Reach Out and Read conference to share experiences with others implementing the program. 

Additionally, the clinic participated in the Oregon Wellness Expo, a free event for families to visit local wellness vendors. Clinic volunteers distributed free books to kids and network within their community.

Due to the program’s overwhelming success, SSM Health plans to make the Reach Out and Read program available at their 25 family medicine and pediatrics clinics in Wisconsin; and funding for the books will be included in the annual budget.

“’Reach Out and Read makes appointments fun.” said Bisgrove.

This project was funded in-part by the NCCPA Health Foundation’s Be the CHANGE grant. Learn more about the Foundation’s grant programs here.

young boys read books aloud together

Reach Out and Read Wisconsin’s first legislative visit of 2019

On April 22, the ThedaCare Physicians Pediatrics Neenah clinic hosted a legislative visit with State Representative Mike Rohrkaste. During the visit, Rep. Rohrkaste learned about Reach Out and Read Wisconsin and read aloud to a group of children from the Neenah and Menasha communities. The children’s excitement was evident as the representative read From Head to Toe while they acted out the actions described on each page. 

Wisconsin state representative Rohrkaste reads aloud at medical clinic
Rep. Rohrkaste reading aloud from Dog Breath: The Horrible Trouble with Hally Tosis.
Wisconsin state representative Rohrkaste with children and families at ThedaCare clinic
Rep. Rohrkaste with children and parents after the reading
Rep Rohrkaste and Reach Out and Read Wisconsin staff and partners including Appleton Public Library
Reach Out and Read Wisconsin community partners, including United Way Fox Cities and Appleton Public Library, were also in attendance

Following the reading, Dr. Eileen Jekot, the clinic’s Reach Out and Read medical champion, led Rep. Rohrkaste on a tour of the clinic. Dr. Jekot talked about the program’s positive impact on her patients and their families, and how it has changed the way she practices medicine for the better. Since 2016, the ThedaCare Physicians Pediatrics Neenah clinic has given more than 7,300 books to children ages 6 months through 5 years.

Reach Out and Read Wisconsin is grateful for the opportunity to bring together legislators, the medical community and community organizations to promote, educate and engage around early literacy and children’s health.

Reach Out and Read Wisconsin welcomes national medical director Perri Klass, MD

Reach Out and Read national medical director Perri Klass, MD, recently visited Madison, Wisconsin to give a presentation to Reach Out and Read Wisconsin supporters and stakeholders. During this talk at the Madison Central Library, Dr. Klass emphasized the importance of using books to promote healthy brain development in young children. One of the ways reading aloud supports brain development is through the parent-child relationship. “If we want to promote healthy child development in the early years, then we have to promote that parent-child relationship,” said Dr. Klass.

Books aid in the development of the parent-child relationship because they spark back-and-forth conversations. These conversational turns are what form connections in babies’ brains. Even young babies who are not themselves talking yet, show signs of engagement when these back-and-forth interactions are happening. Examples of this include, smiling at a book or the parent, looking at the pictures, reaching out to grab the book, trying to turn pages, cooing or babbling along with the story, or even trying to put the book in their mouth.

When parents read aloud they are not only helping foster brain development but development in all kinds of areas, like math, language, vocabulary, socio-emotional, school readiness and attachment.

Dr. Perri Klass presents at Madison Public Library about the importance of books and reading aloud for healthy child development
Dr. Perri Klass shares the importance of books and reading aloud to an audience of Reach Out and Read Wisconsin supporters and stakeholders.

Screen time

Dr. Klass also shared her thoughts about screen time and e-readers. She recommended physical books for newborns and children younger than age 2. Physical books allow babies to touch, feel, learn how to turn pages and put books in their mouths – all of which are appropriate developmental milestones for young children. Screens and enhanced e-books (stories that make sounds when tapped or have animations) can be distracting for young babies. New research shows that when e-readers are used, the number of conversational turns and back-and-forth interactions between parents and children decrease. Dr. Klass recently wrote about this new research in her weekly New York Times column.

When kids are older, using electronic reading devices can help them gain access to a wide range of information. However, it is still important for parents to provide supervision and make time for reading physical books aloud together.  

Reach Out and Read Wisconsin would like to thank Dr. Perri Klass for sharing her time and expertise. Also, thank you to the Wisconsin Academy of Sciences, Arts & Letters and the Madison Public Library for co-presenting this event. To learn more about Reach Out and Read Wisconsin and how to support us our work, please visit our website.

Every parent is their child’s first and best teacher

As an early literacy librarian, I see 50-100 parents and young children at my birth to 2-year-old storytime every Monday morning. Some parents come to get out of the house, socialize with other grown-ups, or give their child a chance to socialize with other babies their age. Some parents might know that storytime is a great place for their child to learn early literacy skills while others come simply because their child enjoys the books, songs and rhymes.

Many parents look to me as one of their child’s first teachers, but a child’s first and most important teacher is their parent.

parents reading to their child

Some parents don’t realize this or don’t feel confident in their ability to be a teacher. Teaching your child early literacy skills isn’t as daunting as it may sound. Storytimes are the perfect opportunity for librarians to model simple strategies that parents can use to help their child develop early literacy skills. We use strategies based on the American Library Association’s Every Child Ready to Read initiative, which includes:

1. Talking: Talking is important because language is the foundational skill that leads to academic and life success. Children with larger vocabularies do better in school. The best way for kids to learn new words is by including them in every day conversations. This is one of the easiest strategies. You simply talk to your child. Encouraging babies to babble, practicing nursery rhymes and asking your child open-ended questions are great ways to focus on this strategy.

2. Writing: Writing is important because it is directly related to reading skills and helps improve fine motor skills. Don’t worry, I’m not suggesting that your baby sit down and write the next great American novel. Strong fine motor skills support the development of future writing skills. Grabbing toys, stacking blocks and playing with Play-Doh are all great ways to work on writing skills.

3. Reading: Reading is important because so many of our daily activities require the ability to read. Some parents think that their baby is too young to be read to, but this is not the case. You can start reading to your child starting at birth. At first babies will seem to play with books more than look at them, but that is perfectly fine. This will allow them to get comfortable with books and learn skills such as turning pages. It’s important for parents to make reading part of their daily routine so their child can continue to improve their literacy skills and develop a love of reading.

4. Playing: Playing is important because it helps children develop fine and gross motor skills, imagination, and creativity. Children can discover so much about the world around themselves simply by playing and exploring. Babies can start playing during tummy time by placing toys in front of them to look at and reach for. As children get older they learn to play with others and to use their imagination by playing pretend.

5. Singing: Singing is important because it helps break words down into syllables that are easier for babies to understand and remember. Many parents are intimidated by singing because they feel silly or think they have a bad voice. Luckily babies don’t care what your voice sounds like; they just like hearing singing. You can sing lullabies, kid’s songs (If You’re Happy and You Know It, The Itsy Bitsy Spider, ABC’s etc.), your favorite songs from the radio, or even make up songs. Listening to music in the car or around the house is another way for children to learn new words and sounds.  

It is important that parents feel empowered in this role as their child’s first and best teacher. Early literacy librarians and Reach Out and Read medical providers want parents to know they already have the power to make a difference in their child’s life. We are here to provide extra support and guidance to assist parents as they help their children achieve their full potential.

Wisconsin Medical Society provides books and grants to Reach Out and Read Wisconsin

ROR project manager Karin Mahony and Wisconsin Medical Society stand with books that were donated in 2017

Since the founding of Reach Out and Read (ROR) Wisconsin, the Wisconsin Medical Society (WMS) has graciously donated hundreds of new books and has provided funding to ROR Wisconsin to make our work possible. WMS is a policy leader and professional development resource for physicians across the state. They are a unified voice for physicians and their mission is to improve the health of people in Wisconsin. Through their grants and book drives to ROR Wisconsin, WMS is advancing its mission by helping to improve the lives of children and families across the state.

With grant funds provided by WMS, ROR clinics have been able to purchase 17,800 new books. These books are given to grateful children across the state during their well-child exams. ROR providers use these books in their exam rooms as tools to measure developmental milestones. This makes the visits more efficient and fun. At the end of the visit, each child 6 months – 5 years leaves the clinic with a new book in hand. Families are encouraged to read every day and enjoy these books over and over again.

Additionally, for the past two years, WMS staff has hosted a book drive to purchase and collect new books that are given to ROR Wisconsin. Since 2017, 275 books have been donated. Most of these books are purchased by WMS staff at Books4School, a local Madison retailer with books for children of all ages. Books4School is open to the public and has books for as low as $1.00!

With the support from WMS, our work is able to continue. We are able to train more providers, launch more programs, assist in maintaining high-quality programs and provide books for children across the state.  We are grateful for WMS’s mission and the generosity they’ve shown ROR Wisconsin!

ROR project manager Karin Mahony and Wisconsin Medical Society stand with books that were donated in 2017
ROR Wisconsin Project Manager Karin Mahony with WMS staff picking up the books donated by WMS.

Children’s books that make great gifts

Toys, games, electronics — there are so many options when it comes to kids’ gifts during the holiday season. However, one of the best gifts you can give is a book. Books open the door to new ideas and they can teach kids important lessons about empathy, diversity and kindness. A book is a low-cost gift that can build stronger parent-child relationships and they can be enjoyed over and over again.

With so many options available for children’s books, we curated this list to take some of the guesswork out of purchasing a great book this holiday season.

* Reach Out and Read Wisconsin does not endorse or support any particular author, title or publisher.

I'm Learning Letters

Picture 1 of 9

Recommended ages: 6-18 months

This board book is dominated by large, colorful pictures. Coupled with minimal text, it’s a great book to engage young eyes and start conversations between the reader and child as they point to pictures associated with different letters of the alphabet.

Buy from Books4School

Want to read these books but don’t want to buy them all? Check out your local library for copies.

Thanks to Appleton Public Library, Books4School, Dr. Deirdre Burns and Susan Golz for their recommendations. Do you have other titles to add to this list? Comment below!

Reach Out and Read Wisconsin Advisory Council Member spotlight: Family Physician Wendy Molaska, MD, FAAFP

The Reach Out and Read (ROR) Wisconsin Advisory Council is made up of 14 individuals from across the state who support our early literacy work. The Advisory Council includes, doctors, community leaders and business owners. These members all have a connection to and passion for literacy and the lifelong benefits programs like ROR provide. For a full list of our advisory council members, visit our website.  

Our first member spotlight is one of our Advisory Council co-chairs, Wendy Molaska. Wendy is a family physician who has served on our council since ROR Wisconsin started in 2010. Prior to joining the Advisory Council, Wendy used ROR during her residency. She continues to use the program today as the ROR medical consultant for UW Health Cottage Grove. Now a mother of two, Wendy tries to find time every day to read aloud with her kids.

Mom reading with two childrendoctor dressed up as cat in the hat

What is your background?

I am a family medicine physician working in Cottage Grove, Wisconsin. Originally from Wisconsin, I went to undergrad and medical school at the University of Wisconsin. I was first introduced to ROR when I started residency at the University of Minnesota working in an underserved inner-city clinic. When I moved to rural Colorado, my clinic there did not have a ROR program so I started a program. I then moved back to rural Wisconsin and again my clinic did not have a ROR program. By now, I couldn’t imagine practicing without the program, so I did all the fundraising myself and started yet another ROR program at my clinic in Platteville. Shortly after I started my program ROR Wisconsin started and I was honored to be asked to join the Advisory Council.

What are your favorite or funniest memories about reading as a child?

My dad would often read my brother and I bedtime stories. But before he started the book he would always tell his own version of a fairy tale. So we listened to Mac and the Cornstalk and Little Red Riding Hood. Except that in his version, Little Red Riding Hood was crossing the road and ‘Vrooom!’ a big Mack truck came and ran her over and that’s the end of the story! Then my brother and I would yell and complain say, “Daaad! That’s not a real story!” So then he’d be forced to read our book of the night.

If you have children, do you read aloud with them? How did you incorporate reading into your routine?

I have two young children and am a proud Reach Out and Read mama, as my kids love to read! We started reading to them as soon as they were born. We read before naps and bedtimes every day and whenever the kids want to read. They will often grab books during play times and bring them over to us to read. We went through periods where the kids would choose the same book over and over so I can still recite verbatim some of those books. Now they love to go to the library to pick out new books which means I get to read more variety. And it certainly is fun for the kids when they make me read The Book With No Pictures. “Glug, glug, glug, my face is a bug! I eat ants for breakfast right off the rug!

young girl reading and sleeping in the carpicture of young boy reading in the car and sleeping

How did you get involved with literacy promotion? Why is it important to you?

I first became involved with literacy promotion through the ROR program in residency. My residency clinic was an inner city clinic and the patient population faced a lot of adversity. It was also a diverse patient population with Spanish, Hmong and Somali languages being common, in addition to English. During that time I saw how important books were for the patients. I also learned how important it was to discuss how to use books in the home as many parents did not have confidence in their own reading abilities but did want their children to do well in school. It was in stark contrast to how I grew up, as I was surrounded by books and loved going to the Book Mobile to pick out new books. The joke among my relatives was that my nickname was “Nose-in-a-book” and they didn’t know what I looked like because my face was always stuck in a book. This helped propel me to want to share the magic of books with others.

What advice would you give parents about reading?

The most important thing I talk about with parents in my clinic is that reading is not just about actually reading the words on the page. This is especially true with young children. The most important part of reading is spending the time together enjoying each other’s company and enjoying books. That can mean making up stories based on the pictures, using the pictures to play ‘I spy’ or even just having the child point to different things on the page.

I also emphasize that toddlers have short attention spans so even if they only seem to sit and pay attention for a minute or two that is actually great.

For older kids, I discuss with parents that reading can entail all kinds of different options. As kids develop their own interests, reading can be tailored to those interests. If that means comic books, non-fiction, magazines or video game manuals – it still counts as reading!

Lastly, I encourage parents to lead by example whenever they can. Being able to see a parent reading is important to showing children that reading is important all throughout our lives!

young children reading together

What is your favorite children’s book? Why?

This is a difficult question to answer as there are so many great children’s books! I love Hippos Go Berserk by Sandra Boyton just because who wouldn’t love hippos going berserk!

Hippos_go_berserk book cover

I love The Lorax by Dr. Seuss. Any of his books are great, even if many are tongue twisters! But The Lorax has such a great underlying message about taking care of the earth that it is timeless.

the lorax book cover

And I love The Book With No Pictures by B.J. Novak because it makes my kids giggle when mom has to say “My best friend is a hippo named boo-boo butt!”

the book with no pictures book cover

What is the best book you’ve read recently?

A book I will never tire of and have read more than a dozen times,A Girl in the Limberlost book cover is A Girl of the Limberlost by Gene Stratton-Porter. This is more of a young adult book but the way it is written brings the imagery to life.

 

 

 

 

 

Eat, Pray, Love by Elizabeth Gilbert is how I imagine I would write if I wrote a novel, eat_pray_love book coverpoints in time, often centuries apart. and I could intimately relate to this book. My current favorite authors are Ken Follett as I love historical fiction and his long tomes span many years really drawing you into the lives of his characters. Kate Morton’s books are also outstanding. She has a unique way of weaving her stories together using perspectives from different

 

 

Lastly, I will recommend Being Mortal: Medicine and What Matters in the End Being mortal book coverby Atul Gwande. Most people don’t really understand what can happen at the end of life and this book really can provide perspective on what this can look like. As I always encourage my patients to have these difficult end-of-life discussions with their family and friends, this book helps the reader understand why these difficult conversations are important. Reading is the generally the last thing I do as I wind down my days.

 

And lucky for me, my ‘to read list’ continues to grow and grow.

Appleton Ready to Read: Outreach program brings early literacy to Hmong and Hispanic families

Appleton Ready to Read banner

Appleton Ready to Read (ARTR) is an outreach program for Hmong and Hispanic families with children ages birth to five. The program is based on the American Library Association’s Every Child Ready to Read initiative, which provides strategies that caregivers can use to develop children’s early literacy skills.

ARTR was created as a result of the Leading Indicator for Excellence (LIFE) study conducted by  United Way of Fox Cities. In 2011, the LIFE study found that third grade reading scores had declined every year since 2006. Among those with declining reading scores, 36% were Asian (predominately Hmong) and 38% were English language learners (ELL) who were predominately Hispanic. Since library staff and community leaders knew literacy skills develop earlier than third grade, they decided to target Hmong and Hispanic families with children age birth to 5.  

A Hmong family outreach specialist, Pa Ja Yang, and a Hispanic family outreach specialist, Norma Oliveras, were hired to work closely with local families. Their positions were originally funded through a grant from United Way of Fox Cities but they are now funded through the City of Appleton. Pa Ja and Norma educate families on the importance of building early literacy skills through five practices: reading, writing, singing, talking, and playing. ARTR’s goal is to better prepare Hmong and Hispanic children for kindergarten and school success. There are three components to the program

1. Home Visit:

Specialists meet with families in their homes to provide free books and educational information on reading, writing, and children’s brain development.

2. Library Visit:

Specialists meet with families at the library to discuss library services, programs, and resources. Families receive a tour of the children’s section, music CDs and information on the benefits of singing and talking with their children.

3. Participation in Play & Learn:

Families attend a children’s program called Play & Learn. Specialists incorporate early literacy skills and the five practices to discuss the importance of dramatic and imaginary play, as well as narrative skills.  

Pa Ja Yang, Hmong Family Outreach Specialist
Pa Ja Yang, Hmong Family Outreach Specialist

Norma Oliveras, Hispanic Outreach Specialist
Norma Oliveras, Hispanic Outreach Specialist

 

 

 

 

 

 

 

 

 

The success of ARTR would not be possible without community partnerships, in-kind contributions from local businesses and continuous support from the city. Community partnerships include the Appleton Area School District, Outagamie Birth to Five Intervention, UW-Oshkosh Head Start, Fox Valley Literacy Council and a variety of other organizations. Contributions from Bouwer Family Foundation and Bob’s Discount Furniture have provided new literature, music CDs and coloring books for families. Since 2014, Pa Ja and Norma have served more than 230 Hmong and Hispanic families.

Play & Learn: Hispanic Edition is offered on Sundays from 1-2 p.m. at the Appleton Public Library and Play & Learn: Hmong Edition from 2:30-3:30 p.m. Visit the Appleton Public Library’s classes and events calendar for upcoming classes and updated information.

Looking for Hmong family resources near you? Check out some of these other websites:

Madison: http://hmongmadison.com/

La Crosse: www.ciasiabinc.org  

Milwaukee: http://www.hawamke.org/

Hmong National Development, Inc.: www.hndinc.org

Appleton public library ready to readAppleton Ready to Read programAppleton Public library ready to read program Appleton Ready to read

New research links talking to babies with their IQ and verbal abilities 10 years later

By: Steve Hannon, president, LENA

LENA president Steve Hannon
LENA president Steve Hannon

We’re excited to share the results of a newly-published longitudinal study that researchers here at LENA have been working on for more than 10 years. The findings confirm that the amount of talk with adults that babies experience in the first three years of life is related to their verbal abilities and IQ in adolescence. Two-way conversations in the 18- to 24-month age range may be particularly important.

The paper, “Language Experience in the Second Year of Life and Language Outcomes in Late Childhood,” was published in the October 2018 edition of Pediatrics. Its conclusions affirm exactly the kind of work Reach Out and Read (ROR) is doing to educate families about the importance of early interaction and providing them with the tools to build early literacy.

“By showing that parent-child verbal interactions in early childhood predict critically important outcomes through age 14 years (∼10 years later), the authors of this study have made a major contribution to this topic, with strong implications for American Academy of Pediatrics policy and clinical practice recommendations,” Drs. Perri Klass, ROR’s medical director, and Dr. Alan L. Mendelsohn, ROR’s principal investigator, wrote in commentary for Pediatrics.

LENA photo of mom and baby and young boy in school

While it may seem intuitive that adults should talk with children, many people don’t realize just how important conversations actually are.   

For example, two other studies this year from Harvard University and Massachusetts Institute of Technology have shown that the amount of conversation children experience is related to changes in their brain structure and function. Additionally, other studies have indicated that language exposure is related to children’s brain processing speed, subsequent vocabulary acquisition and success transitioning to kindergarten.

Research also tells us that adults who talk with children the least tend to overestimate the most. That’s why LENA technology, which provides objective feedback, is a helpful tool. In the same way a pedometer provides objective feedback on how many steps you take each day, LENA helps caregivers get an accurate understanding of children’s language environments and identifies specific areas for growth.

To truly improve outcomes for children and make progress toward closing opportunity gaps, we must capitalize on the power of conversation to build babies’ brains.

If you’re interested in learning more about this important research, sign up to view a discussion with the lead researchers moderated by policy expert Shannon Rudisill. Click here for more information and to register.

There’s still time to support Reach Out and Read Wisconsin’s Advisory Council learning and fundraising event

Last weekend, Reach Out and Read (ROR) Wisconsin’s Advisory Council hosted a learning and fundraising event at 702WI, a creative space in Madison, Wisconsin. ROR Wisconsin donors and guests gathered to learn about the program’s impact on early literacy, clinical care and parent support. Together, they raised hundreds of dollars to keep ROR Wisconsin programming strong throughout the state.

ROR Wisconsin learning and fundraising event
ROR Wisconsin supporters gather to learn more about our work and how they can help

During the event, Dipesh Navsaria, MPH, MSLIS, MD, ROR Wisconsin medical director and Dennis Winters, MS, chief economist for the State of Wisconsin, gave a presentation about the link between high-quality, early interventions like ROR and future economic benefits to the community. For example, every dollar invested in early interventions yields a $7 return on investment to society (Heckman, 2012). Investing in early interventions have shared benefits across sectors. Not only is personal success impacted with better employment opportunities and improved health outcomes but communities as a whole see lower crime rates, less social intervention and higher civil contributions. The business community also sees long-term benefits with a more skilled workforce, higher worker productivity and less employee turnover. To learn more about ROR Wisconsin and our impact please visit our website.

Dipesh Navsaria presents at learning and fundraising event
Dipesh Navsaria, MPH, MSLIS, MD, ROR Wisconsin Medical Director presents to ROR Wisconsin supporters and donors

If you were unable to attend this event, you can still support ROR Wisconsin. Please click here to make a donation today. A gift of just $5 will help provide a local child with a new book and parental support.

Thank you to the in-kind donors who made this event possible: Mary Morgan for the event space, Johnson Public House for coffee and Madison Chocolate Company for chocolates and other treats. 

If you would like to receive an invitation to the next ROR Wisconsin event, please email Alex Rogers.

Heckman, J. J. (December 2012). Invest in early childhood development: Reduce deficits, strengthen the economy. Retrieved from: https://heckmanequation.org/assets/2013/07/F_HeckmanDeficitPieceCUSTOM-Generic_052714-3-1.pdf