A Preschool Program Conservatives Can Love


Reach Out and Read’ enlists 12,000 doctors as volunteers and costs only $10 per child per year.

How can anyone be against expanding preschool programs?” a liberal friend asked. “If you want to break the cycle of poverty and dependence, there’s no better investment.” Not necessarily.

The record of most preschool programs is disappointing. For example, a federal study recently found that the $167 billion spent on Head Start since 1965 has failed to deliver sustainable improvements in school readiness among the children who go through it. That program has recently undergone some changes, but there is understandable skepticism about the Obama administration’s plan to spend $10 billion a year making preschool universal.

Anyone involved in such efforts should consider an atypical “pre-preschool” program called Reach Out and Read, which may be the most effective literacy program in the nation. Started 24 years ago by two doctors at Boston City Hospital, the program now touches four million low-income children a year at a cost of $10 per child. Here’s how it works:

Whenever a parent brings a child to a participating doctor’s office for a checkup, the staff “prescribes” that the parent read to that child. Doctors and nurses—who volunteer to incorporate literacy into regular checkups—demonstrate how to do so and why. Many parents have no tradition or habit of reading themselves, so doctors explain how important it is to read to children every day and give the family an age-appropriate children’s book to keep.

Research has found that reading aloud to babies and toddlers helps their brain development and dramatically increases their receptive and expressive language abilities. These are essential for developing pre-reading skills and ultimately for success in school.

According to a 2001 study in the journal Pediatrics, children of preschool age who participate in Reach Out and Read are typically three to six months ahead of their peers in vocabulary, language development and pre-reading skills. “That is a huge difference,” says the study’s author, New York University’s Dr. Alan Mendelsohn.

Another study, published in Ambulatory Pediatrics by Dr. Robert Needlman of Case Western Reserve School of Medicine in 2005, found that parents exposed to the program are more than twice as likely to value reading, keep books in their home and enjoy reading to their children.

Positive outcomes have been reported in 15 peer-reviewed studies—and more than 28,000 doctors have gone through Reach Out and Read training, with some 12,000 currently participating at 5,000 sites across all 50 states. Physicians receive no payment for participating. A small national staff raises half the money for books from foundations, individuals and corporations (including a donation of two million books over the past two years from the publisher Scholastic), and the local sites raise additional funds for the more than six million books distributed annually.

Several important lessons can be learned from this program’s success:

1. Parents must take responsibility. Reach Out and Read isn’t a book giveaway program or a volunteer tutor program. It succeeds because parents are vested in their own children’s success. Whatever their own educational deficiencies or exhaustion, they understand that they have to try to read to their kids every day. There is no substitute for such parent involvement.

2. Preschool preparation need not take place in a school environment. Most of the education establishment doesn’t “get” this program. I was on its board from 2004 through 2010, and my appeals in 2011 and 2012 to the presidents of the National Education Association and the American Federation of Teachers fell on deaf ears. Perhaps because the program doesn’t provide employment opportunities for teachers or education bureaucrats, it doesn’t interest their unions.

3. Focus on the very youngest children first. As Nobel Prize-winning economist James Heckman testified before the congressional Joint Select Committee on Deficit Reduction in 2011: “We can gain money by investing early to close disparities and prevent achievement gaps, or we can continue to drive up deficit spending by paying to remediate disparities when they are harder and more expensive to close.”

Yes, education is the only way to break the cycle of poverty and dependence, and preschool programs are far more complicated and expensive than a medical program like Reach Out and Read. Yet before Congress and the administration pour $10,000 per child, per year into traditional preschool programs, they should look carefully at evidence-based practices—and at how to leverage the demonstrated success of a program that costs only $10 per child, per year.

Mr. Cohen was co-chairman of Hillary Clinton‘s Prescription for Reading Partnership task force in 1995 and is a director emeritus of Reach Out and Read.

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