Nurturing brain development in young children through shared reading

The American Academy of Pediatrics encourages parents and caregivers to read aloud with their newborns and young children as an opportunity to foster loving, nurturing relationships during a critical time of brain development, and recommends that pediatricians support families with guidance and books at well-child visits, according to an updated policy statement.

The policy statement, "Literacy Promotion: An Essential Component of Primary Care Pediatric Practice," marks the first update in AAP recommendations since 2014. Given the extraordinary amount of research in this area, an accompanying new technical report reviews the evidence for shared reading as a way to strengthen and nurture relationships, stimulate brain circuitry and create early attachments.

"Reading together with young children weaves joyful language and rich interactive moments into the fabric of daily life," said Perri Klass, MD, FAAP, lead author of both statements. "As a pediatrician and parent, I suggest making books your bedtime routine, using them to connect and wind down after a busy day, and generally building them into life with a young child. It will strengthen the bonds that hold you together, and build your child's developing brain."

The policy statement, written under the auspices of the AAP Council on Early Childhood, will publish on Sunday, Sept. 29 in Pediatrics online during the AAP 2024 National Conference & Exhibition in Orlando, FL. Claudia Aristy and Dr. Klass will discuss the policy during a plenary session, "Turning Pages Together: How Pediatricians Rewrote the Book on Early Literacy," from 10:30-noon ET Sunday in the Orange County Convention Center Valencia Ballroom.

Both the policy statement and technical report will be published in the December 2024 issue of Pediatrics. Policy statements and technical reports created by AAP are written by medical experts, reflect the latest evidence in the field, and go through several rounds of peer review before being approved by the AAP Board of Directors and published in Pediatrics. 

The AAP emphasizes that, as a positive parenting practice, shared reading helps build the foundation for healthy social-emotional, cognitive, language, and literacy development. This sets the stage for school readiness and providing enduring benefits across the life course.

Turning the pages of a high-quality, print book filled with colorful pictures and rich, expressive language are best. While touchscreens and other electronic devices may be popular, they are typically passive or solitary experiences for children and do not offer the same benefits of interactivity and relationship-building."

Dipesh Navsaria, MD, MPH, MSLIS, FAAP, co-author of the technical report and chair of the Council on Early Childhood

The American Academy of Pediatrics recommends that pediatricians:

• Encourage shared reading beginning at birth and continuing at least through kindergarten, including, when possible, in the NICU.
• Develop skills to discuss with parents strategies for mutually joyful and developmentally appropriate reading activities. Encourage meaningful, language-rich engagement with books, pictures, and the written word, and model techniques to prompt reciprocal, responsive, positive experiences.
• Provide high-quality, developmentally and linguistically appropriate, and culturally diverse books at health supervision visits for all young children.
• Place the highest priority on offering books for children from low-income families who may lack access to them.
• Support the AAP recommendation of limited screen use in early childhood with an emphasis on print books for young children. Digital books do not foster equivalent parent-child interactions. If screen-based reading or audiobooks are used, recommend parents include reciprocal interactions with their children around these digital activities to promote relational connection and enhance child learning.
• Emphasize the value of books representing diverse cultures, characters, and themes for all children, and supporting the use of these books to generate conversations about cultural pride, inclusion, belonging, and equity.
• Incorporate guidance and encouragement about reading aloud even in child well visits when books may not be readily available, including when primary care is provided virtually.
• Advocate toward establishing public and private funding for diverse high-quality, developmentally appropriate children's books to be provided at pediatric health supervision (wellness) visits to all children.

The AAP has recommended literacy promotion as an essential component of pediatric primary care since 2014, finding that activities that foster early relationships affect a young child's capacities for sustained attention, executive function, self-esteem, and social behavior. These are all qualities that profoundly shape school readiness, success, and thriving across the lifespan.

"Research tells us that reading proficiency by third grade is a significant predictor of high school graduation and career success," Dr. Klass said. "Children who first encounter books in the arms of their parents, when they are very young, arrive at school associating books and reading with lap-time, a sense of security, interactions, stories, rhymes and entertainment, and above all with the beloved voices of the adults with whom they have those all-important early relationships."