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Reach Out and Read

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Evidence rating: 2+
Cost rating: 2

Reach Out and Read (ROR) is a clinic-based paediatric literacy intervention for parents with a child from infancy through to five years and is focused on, but not restricted to, families living in disadvantaged communities.

The programme is delivered individually to parents and their children by clinicians, including paediatricians, nurse practitioners and primary care physicians, at each of 10 routine health checkups. Practitioners talk with families about the importance of reading aloud and engaging with their young children as an integral part of the checkup. They show the parents how to look at books with their children and encourage them to read together at home and build routines around books. The child is given a new developmentally appropriate book to take home and keep. The aim of the programme is to both to improve the child’s language development and to encourage parent-child bonding through reading aloud that has both cognitive and social-emotional outcomes.

EIF Programme Assessment

Evidence rating: 2+
Level 2 indicates that the programme has evidence of improving a child outcome from a study involving at least 20 participants, representing 60% of the sample, using validated instruments. This programme does not receive a rating of 3 as its best evidence is not from a rigorously conducted RCT or QED evaluation
Cost rating: 2
A rating of 2 indicates that a programme has a medium-low cost to set up and deliver, compared with other interventions reviewed by EIF. This is equivalent to an estimated unit cost of €125 - €599. This figure is based on an analysis of UK costs and a conversion rate of 1.19.

What does the plus mean?

The plus rating indicates that a programme’s best available evidence is based on an evaluation that is more rigorous than a level 2 standard but does not meet the criteria for level 3.

Child outcomes

This programme can affect outcomes for children in Active and healthy, physical and mental wellbeing.

According to the best available evidence for this programme's impact, it can achieve the following positive outcomes for children:

Enhancing school achievement & employment

Improved receptive vocabulary

based on study 1

Improved expressive vocabulary

based on study 1

This programme also has evidence of supporting positive outcomes for couples, parents or families that may be relevant to a commissioning decision. Please see About the evidence for more detail.

Who is it for?

The best available evidence for this programme relates to the following age-groups:

Infants Toddlers Preschool

How is it delivered?

The best available evidence for this programme relates to implementation through these delivery models:

  • Individual

Where is it delivered?

The best available evidence for this programme relates to its implementation in these settings:

  • Out-patient health setting

How is it targeted?

The best available evidence for this programme relates to its implementation as:

  • Targeted selective

Where has it been implemented?

  • United States

Ireland provision

This programme has not been implemented in Ireland.

Ireland evaluation

This programme’s best evidence does not include evaluation conducted in Ireland.

About the programme

What happens during the delivery?

How is it delivered?

  • Reach Out and Read is delivered by one practitioner (QCF-7/8) to individuals.
  • Read Out and Read is delivered over 13 sessions of 20 minutes each.

What happens during the intervention?

  • Reach Out and Read (ROR) is a clinic-based paediatric literacy intervention for parents with a child from infancy through to age five, and is focused on, but not restricted to, families living in disadvantaged communities.
  • The programme is delivered individually to parents and their children by clinicians, including paediatricians, nurse practitioners and primary care physicians, at each of 10 routine health check-ups.
  • Practitioners talk with families about the importance of reading aloud and engaging with their young children as an integral part of the check-up.
  • They show the parents how to look at books with their children, and encourage them to read together at home and build routines around books.
  • The child is given a new developmentally appropriate book to take home and keep.

What are the implementation requirements?

Who can deliver it?

  • Reach out and Read is delivered by a physician, nurse practitioner or physician’s assistant with recommended NFQ-9/10 qualifications.


What are the training requirements?

  • The practitioner receives one hour of programme training. Booster training of practitioners is recommended.

How are the practitioners supervised?

  • It is recommended that practitioners receive supervision from a host-agency supervisor with NFQ-9/10 level qualifications.


What are the systems for maintaining fidelity?


Is there a licensing requirement?

There is no licence required to run this programme.


How does it work? (Theory of Change)

How does it work?

  • Reach Out and Read (ROR) is based on the assumption that children’s early language is supported through book sharing.
  • Parents experiencing economic and social disadvantage are less likely to read out loud and share books with their children. Parents are taught how to read books with their children and are encouraged to read together at home and build routines around books.
  • In the short term, ROR aims to improve the child’s language development and to encourage parent-child bonding through reading aloud.
  • In the long term ROR aims to improve the child’s cognitive thinking abilities.

Intended outcomes


Contact details

Barbara Ducharme
barbara.ducharme@reachoutandread.org

Wendy Hart
wendy.hart@reachoutandread.org


About the evidence

Reach Out and Read’s most robust evidence comes from one QED, which was conducted in the USA.

This study identified statistically significant positive impact on a number of child and parent outcomes.

A programme receives the same rating as its most robust study, which in this case is the Mendelsohn et al. (2001) study, and so the programme receives a Level 2+ rating overall.

Study 1

Citation:Mendelsohn et al (2001)
Design:QED
Country:United States
Sample:138 families attending two urban paediatric clinics for well-child care
Timing:Post-test
Child outcomes:
  • Improved receptive vocabulary
  • Improved expressive vocabulary
Other outcomes:
  • Increased frequency of parent-child reading
Study rating:2+

Mendelsohn, A. L., Mogilner, L. N., Dreyer, B. P., Forman, J. A., Weinstein, S. C., Broderick, M., Cheng, K. J., Magloire, T., Moore, T., & Napier, C. (2001). The impact of a clinic-based literacy intervention on language development in inner-city preschool children. Pediatrics, 107, 130-134.

Available at
https://www.ncbi.nlm.nih.gov/pubmed/11134446

Study design and sample

The first study is a QED.  

Eligible families presenting to two paediatric clinics in an urban US setting were enrolled into this quasi-experimental study retrospectively.  Participants at one of the clinics had all previously received Reach Out and Read, and participants at the other had received business-as-usual only.

This study was conducted in the US, with a sample of 138 children. Children were between two and 5.9-years old when enrolled into the study, though it is unclear what age they were when they began the intervention. Although the populations in each of the clinics are made up of a large number of ethnic groups, Latino and African-American families together make up more than 85% of registered families.

Measures

The child’s home environment was assessed using the READ subscale of StimQ (parent report). Child receptive and expressive vocabulary were measured using the One-Word Picture Vocabulary Test (direct assessment).

Findings

This study identified statistically significant positive impact on a number of child and parent outcomes.

Child outcomes include:

  • Improved receptive vocabulary
  • Improved expressive vocabulary

The conclusions that can be drawn from this study are limited by methodological issues pertaining to non-blind data collection and the treatment condition not being modelled at the level of assignment, hence why a higher rating is not achieved.

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