Reading exam

Dr. Lourdes Valdez was in the first year of her pediatric residency when she became a mother for the first time, and near graduation when she had her second child. A native of Peru training in Iowa, Valdez raised her infant daughter and son with the help of her husband, and from an early age made reading an important part of child-rearing.

“That was part our routine, like brushing their teeth or giving them baths—reading them a book,” she said. “It was important. Nobody told us that was a good thing. At that time, it didn’t come from a pediatrician. I think if I would’ve gotten that advice to read more, I would have done that even more.”

Her children now grown, Valdez gives that guidance to other parents. She is a pioneering pediatrician in Butte County for the Reach Out and Read program, providing books for children ages six months through five years at their well-child checkups.

The Northern Valley Indian Health Children’s Health Center, where Valdez practices, is the only pediatric office in Chico participating in Reach Out and Read; Dr. Maria Alino in Oroville is the county’s other pediatrician affiliated with the program. The First 5 Butte County Children and Families Commission, which supports Reach Out and Read locally, has fielded inquiries from eight additional pediatricians.

“Right now there are 20,000 ROR doctors in the United States and they’re giving out 6.5 million books to 4 million children [annually], so it’s not like we’re a new program,” said Sandra Machida, a Chico State psychology professor and First 5 Commissioner. “What we’re trying to do is develop it.”

What distinguishes Reach Out and Read from other literacy programs is scientific research. Fifteen independent published studies backed up the national organization’s findings that children served by Reach Out and Read enter kindergarten three to six months ahead of their peers in vocabulary skills.

That statistic jumped out at Valdez when she learned about the program at a conference 10 years ago.

“That’s a big advantage,” she said. “Programs like Head Start do a great job, but really there’s no better teacher than the parents. That’s the message we send: ‘You’re your children’s first preschool teacher.’”

NVIH had all pediatric clinic caregivers trained and the program launched in November. Through March 31, they’d distributed 975 books. Grant money covers the purchases; Valdez, with input from colleagues, chooses titles from a Scholastic publishing catalog.

Of course, she has personal favorites from when she reads to her children (such as Polar Bear, Polar Bear, What Do You Hear?). Valdez also makes sure to stock bilingual and Spanish books, and order volumes that prove particularly popular with patients and parents.

Staff members also bring in books for older children, not covered by the program, so siblings don’t feel left out. Thus, the clinic has a tall bookshelf in the back office that’s become a de facto library of kid lit.

Why bring literacy into the exam room, instead of just the classroom? The answer stems from the pediatrician-parent relationship.

“In the lives of these parents, the pediatrician is the be-all, end-all,” said Yvonne Nenadal, executive director of First 5 Butte County. “To have a pediatrician talk about books and reading is incredibly validating and important.”

Beyond acting as mentor, a pediatrician serves as an observer.

“One of the focuses of [monitoring] development is on surveillance,” Machida explained, “and so the doctor can watch the parent-child interaction, how they’re mouthing the book, and if there’s some delay the doctor can see that more naturally through observation.”

Most of all, education represents an integral part of medicine. Valdez informs parents about a variety of issues related to their children, including cognitive development. Reading fits into that conversation like a piece clicking into a puzzle.

“Basically, through this program, we’re giving parents tools to improve the development of their children,” she said. “So, I think looking at it that way, it’s part of the medical [process].”

The book itself serves as a diagnostic tool: Valdez can glean developmental cues just from how a baby or toddler interacts with the volume. Teething, manipulating, focusing, vocalizing—each offers insight into a specific stage.

The main goal, however, is fostering a parent-child relationship through reading. Valdez says she has been gratified to see so many families positively affected and hopes other pediatricians in the area will incorporate Reach Out and Reach into their practices.

She’s found that encouraging literacy isn’t an additional task to shoehorn into an already-crammed office visit. Rather, it fits organically—holistically—and adds joyful satisfaction to the nine well-child checks.

“It has not been a burden at all,” she said. “Actually, it’s something that makes all of us [at the clinic] very happy to do.”

Personal experiences also stoke her enthusiasm.

“As a mother, that connection I had with my kids, even tired coming back from work, reading to them was a special moment,” Valdez shared. “We repeated the same books over and over. My kids still remember; I still remember. I think that connection is very valuable.

“I tell these stories to my [patients’] parents. ‘You’re so lucky to be able to do this now; take advantage of it. It’s very precious.’”