The more you read, the more you know

It was a doctor who once said “The more that you read, the more things you will know. The more that you learn, the more places you’ll go.” That was, of course, Dr Seuss in his wonderful book I Can Read with My Eyes Shut! (1). Dr Seuss, also known as Theodor Seuss Geisel, was not a paediatrician, but he has had enormous impact on the health of millions of children. He did this by creating literature that was simultaneously wacky, inviting and subliminally educational. Generations of children have been lured into an appreciation of books and reading by works like The Cat in the Hat (2) at the same time that their brains were being exposed to the cadence and rhyme that we now understand is so important for the development of literacy.

Unfortunately, the existence of quality children’s literature is not enough to ensure the development of literacy in Canada. Forty-two per cent of Canadians over 16 years of age lack the reading proficiency required for full participation in our society. This is a critical health issue, and we need to understand it better. In this special issue of Paediatrics & Child Health, a commentary by Don Jamieson (pages 573–574) sets the stage by exploring the social, educational, economic and health implications of literacy. Articles by Fraser Mustard (pages 571–572) and by Susan Rvachew and Robert Savage (pages 589–593) look at the neurobiology of reading, and the organic, social and environmental elements that affect reading development. The important area of dyslexia, which affects 5% to 10% of children, is reviewed by Linda Siegel (pages 581–587). She offers a conceptual framework that may surprise some readers, as well as information about the important areas of assessment and intervention. Dufresne and Masny (pages 577–580) tackle the complex issue of multiple literacies, obviously very relevant in our multicultural and multilinguistic country. We are also fortunate to have a piece from the inspirational Sheree Fitch (pages 575–576) to remind us of the joy of reading and its crucial role in ‘thrival’.

For physicians, simply discussing a problem is never quite enough. We are compelled to action. This issue of the Journal heralds a new literacy promotion initiative by the Canadian Paediatric Society called ‘Read, Speak, Sing’. A statement from the Psychosocial Paediatrics Committee, with suggestions on how to promote literacy in one’s practice, can also be found in this issue (pages 601–606). There are also tools that can assist with the critically important step of early identification of risk – a checklist of conditions that are associated with increased risk for poor reading, and a table that reviews normal milestones for language and literacy development. The Canadian Paediatric Society will be developing more literacy promotion materials in the coming months.

It is our hope that this special issue on literacy will inspire readers to use these ideas and also to become advocates for those at risk for poor reading skills. We invite not only paediatricians and family physicians who care for children, but also other health care providers, health care administrators, care-givers, educators, correctional agencies, economists and governments to take heed. Low literacy in Canada affects all Canadians.

We urge health care providers across Canada to look more closely at the supports and interventions available to babies and children in their local communities. Because of our early and frequent contact with families, we have a powerful role in encouraging parents to read daily with their children. In Lewis Carroll’s Alice’s Adventures in Wonderland, Alice says, “What is the use of a book without pictures or conversations?” (3). Parents, especially those who do not read well themselves, need to know that it is in talking about the pictures and making the connection between the story and their child’s own experiences that they make reading come alive for their child. We need to actively promote reading from birth onward, and to support families in creating and maintaining a love of reading in their children. We need to work in our communities to make sure all children have access to books. The first step can be as simple as ensuring that every child in your practice has a library card and knows how and where to use it. In remote areas, where formal public libraries may not exist, we can help find other ways for families to access books. Schools, churches, community centres and our own offices can set up book exchanges. Parent-tot groups in those same settings can help families with limited literacy skills through group storytime.

We also need to ask frequently, and loudly, this key question: Are our schools, preschools and child care centres using evidence-based methods to promote reading and to intervene early for those who are lagging behind? Until the answer becomes ‘yes’ everywhere in Canada, we will continue to fail our children. Delayed reading development is a health emergency that must be treated early to prevent a lifetime of educational underachievement.

We hope that the more that you read, the more things you will, indeed, know.