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Updated June 4, 2025 Reviewed by Kaja Perina
The latest data from the 2024 Nation’s Report Card is a sobering indictment of the state of American education. While slight improvements in math scores offer a glimmer of hope, the continued decline in reading proficiency — particularly among fourth-graders — is cause for urgent concern. To frame this solely as an education crisis is to miss the broader implications: This is, in every sense, a public health emergency.
As a pediatrician, I’ve long understood that literacy is not just an academic skill — it’s a vital developmental sign. In the exam room, alongside questions about sleep, vaccines, and nutrition, I ask about reading routines. That’s because brain development in early childhood is not a passive process. It’s actively shaped by human connection, responsive interactions, and, perhaps most powerfully, the simple act of reading aloud.
When a toddler eagerly explores Brown Bear, Brown Bear, What Do You See? in a parent’s lap, they are not just enjoying a story. They are forming neural connections at an astonishing rate. In that moment, we are witnessing cognitive, emotional, and social architecture being constructed — laying the groundwork for not only language acquisition, but also empathy, curiosity, executive function, and resilience.
My mom was a librarian, so I was fortunate to grow up in a home filled with books. I didn’t realize then what an extraordinary privilege that was. But I’ve cared for thousands of children for whom books are a rarity. Too many families are never told that talking, singing, and reading aloud with young children aren’t simply enrichment activities — they are foundational brain-building tools.
For more than 20 years, I’ve championed the integration of early literacy into pediatric care. Starting in infancy, families receive not just books, but guidance on how shared reading supports connection, language development, and brain growth — making literacy a key part of well-child visits and overall wellness.
Crucially, it takes a two-generation approach. To support early literacy in children, we must engage and empower their parents. Many caregivers — especially in under-resourced communities — may not have been read to when they were children. By modeling shared reading in the exam room and offering culturally responsive books, we help build parental confidence, strengthen the parent-child bond, and promote emotionally rich interactions.
The act of shared reading does even more than support literacy — it opens a window into a child’s development. When a child points to a picture, turns pages, or imitates sounds we’re seeing early indicators of motor coordination, language acquisition, and social-emotional well-being. These moments can help us identify potential developmental delays or concerns and connect families to additional services earlier when intervention can be most effective.
A common misconception is that literacy begins with kindergarten. But the most critical period for brain development occurs from birth to age 5. These are the years when language pathways are formed, self-regulation skills begin to take shape, and a child’s cognitive and emotional foundation is most malleable. Waiting until school starts is not just a missed opportunity — it’s a developmental setback with long-term consequences.
Of course, parenting in the early years is a beautiful but demanding season. Between sleepless nights, work obligations, and the constant juggle of daily life, the idea of adding “read aloud every day” to an already overflowing to-do list can feel overwhelming. But here’s the powerful truth: Even a few minutes of shared reading are deeply meaningful. They stimulate brain growth, nurture bonds, and offer children the kind of emotional scaffolding that lasts a lifetime.
A parent’s voice is one of the most powerful stimuli a young child can experience. It offers comfort, builds trust, and sparks neural growth in ways that no screen ever could. Even a few moments of shared reading strengthen your child’s developing brain and your connection with them.
Here are some simple, achievable ways to weave literacy into everyday life:
● Make it part of the routine. Reading doesn’t need to be a grand production. A few pages at bedtime, during a diaper change, or while waiting at the doctor’s office can go a long way.
● Talk through your day. Narrate what you’re doing. “Now we’re stirring the soup,” or “Look at the red bird!” These small conversations help build your child’s vocabulary and sense of language.
● Follow your child’s lead. If your toddler prefers to flip pages or point at pictures rather than listen to the full story, that’s perfectly fine. Those interactions are still valuable — and often reveal important developmental milestones.
● Keep books within reach. Stash a few board books in the car, the diaper bag, or near the high chair. When books are part of a child’s environment, they naturally become part of play.
● Embrace repetition. That book you’ve read a dozen times? Read it again. Familiar stories help children build memory, vocabulary, and confidence. Repetition is not just OK, it’s essential.
And always, remember that representation matters. Children need mirrors of their lives and also windows into the greater world. When a child sees themselves, their family, and their culture reflected in the pages of a book or experiences someone else’s perspective, they grow both confidence and empathy. Both are essential not just for your individual child, but for creating more inclusive, compassionate communities.
Ultimately, we all have a stake in this. Low literacy rates are tied not only to poor educational outcomes, but also to long-term health disparities, mental health challenges, and economic instability. The science is clear, and so is the solution. Early literacy is one of the most cost-effective, evidence-backed interventions we have for improving population health.
So tonight, pick up a book. Share a story. And know this small act has profound ripple effects. When you read with a child, you’re not just preparing them for school, you’re strengthening their brain, your bonds, and our collective future.
Terri D. McFadden, MD, FAAP, is a General Pediatrician and Professor in the Department of Pediatrics at Emory University School of Medicine.
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The brightest way to shine is by being fully, imperfectly yourself.
Self Tests are all about you. Are you outgoing or introverted? Are you a narcissist? Does perfectionism hold you back? Find out the answers to these questions and more with Psychology Today.