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Where Equity Begins: A Book on the Pediatrician’s Exam Table

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Why Education Is Important

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Shared reading in infancy builds brains, bonds, and long-term opportunity.

Books in well-child visits help level an uneven starting line.

Two minutes of story time daily can shape a child’s future.

Black History Month invites us to reflect not only on the past but also on the conditions shaping children’s lives today. As families across the country navigate stress, uncertainty, and persistent inequities, it’s worth remembering that some of the most powerful tools for fairness begin early and quietly. One of them often rests on the exam table during a well-child visit: a simple board book.

My work with Reach Out and Read is centered on the belief that reading with young children, starting in infancy, is not merely enrichment. It is a core part of early development and a quiet yet profound lever for social justice—because the gap we see in reading scores, high school graduation rates, and adult health outcomes begins long before a child ever steps foot inside a classroom.

The Early Window and the Uneven Starting Line

The earliest months of life are a time of astonishing neurological growth. Babies are building millions of neural connections, laying the pathways that will later support language, attention, emotional regulation, and the ability to engage with others. By the time children arrive in kindergarten, much of that foundational work has already happened.

But not all children have equal access to the quality experiences, like shared reading, that build those sophisticated neural pathways. Families living in under-resourced communities often face barriers, including fewer books, less time, and limited support. These conditions can lead to children entering kindergarten less familiar with storytime, exposed to tens of thousands of words fewer than their peers, and less experienced with the joy of reading together. That is not a reflection of parental love or commitment but, rather, a reflection of inequity.

When we hand a 6-month-old a board book during a well visit and coach a caregiver on the power of describing pictures, following the child’s lead, and enjoying those small moments together, we are doing more than promoting literacy. We are leveling a starting line that was uneven long before a child could crawl.

How Reading Shapes the Brain, Bonding, and Behavior

Reading aloud with an infant may seem simple, but simplicity is sometimes where the most profound work happens. When a caregiver turns the pages of a book and names the images, their baby is not passively absorbing sound. They are actively wiring neural pathways for language. They are learning the rhythm of communication and absorbing emotional cues, facial expressions, and patterns of speech. They are also learning that their voice matters, because every coo, smile, and gesture is met with warmth and attention.

This is also where emotional resilience begins. The child who has spent hundreds of tiny moments on a caregiver’s lap, hearing a soothing voice and sharing a story, is building the foundation for secure attachment. That attachment becomes a protective buffer against stress in later childhood and adulthood.

Why Education Is Important

Find a Child Therapist

Representation also plays a central role. When a child sees their skin tone, family structure, language, neighborhood, or cultural experiences reflected in a book, it sends a crucial message: “You belong.” For children from marginalized communities, that affirmation supports not only literacy but also dignity. Books that celebrate the different cultures that make up our American story further affirm the value of all children. During Black History Month, especially, books can be used to share stories, pride, and legacy. This is a critical element of early brain development. Young brains thrive when children feel connected and loved.

Why This Work Is Social Justice

Educational disparities connected to race and ethnicity don’t suddenly show up in third grade. They grow out of structural barriers that make it harder for some families to access books, stable routines, and language-rich environments from the very beginning. These gaps start in infancy, quietly and over time. When some children grow up surrounded by books and everyday conversation, and others don’t have the same opportunities, school becomes about catching up instead of thriving. And the “achievement gap” is really a reflection of an opportunity gap.

The research is unmistakable: Children who are read to from infancy have stronger language skills, better social-emotional development, and more positive caregiver relationships. And those early developmental advantages ripple out into long-term health, academic success, and well-being. By embedding books and shared reading guidance into pediatric care, we can reach nearly every family, including those least likely to have access to early literacy supports elsewhere. The pediatric exam room becomes a place where equity begins, one story at a time. A book given at birth or at a 6-month visit is a signal: “Your child deserves opportunity. Your voice matters. Your love builds their brain."

What Parents Can Do—and Why It Doesn’t Need to Be Complicated

The beauty of this work is that it does not require perfection or long stretches of time. Two minutes of looking at pictures together after a diaper change matters. Talking about the color of the dog or the size of the truck matters. Responding when a child points, babbles, or reaches for a page matters. These tiny acts of connection accumulate into the architecture of the mind.

Storytime does not need to be quiet, structured, or elaborate. It simply needs to be loving. The moments you share matter far more than the method you use. Storytime is also an opportunity for families to share their traditions and history. Stories about family members and their journeys may not be understood by a 6-month-old, but as that infant becomes a toddler, they begin to appreciate the living history of the elders in their midst.

What Clinicians and Communities Can Do

For clinicians, integrating literacy into the well-child visit is an evidence-based way to address early inequities. Modeling how to read with an infant for just a few minutes can shift a parent’s confidence and behavior more effectively than any handout. Discussing books and storytime as part of the child’s developmental health helps caregivers understand its importance.

The Small Moments That Change a Child’s Future

The work of equity often feels enormous. But sometimes the biggest transformations begin in the smallest places: a lap, a book, a few minutes before bedtime. Every shared story builds language. Every smile exchanged over a picture strengthens attachment. Every book in the home expands a child’s sense of possibility.

Reading with infants is justice in action because it ensures that children do not begin their educational journey already behind. It affirms that every child and every family deserves a strong start.

And that work matters more than ever.


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