Abstract

Pediatricians, who are at the frontlines of caring for children growing up in low-income households, are dedicated to promoting language acquisition. Early literacy is incorporated into pediatric care with a number of successful programs, including the well-known program Reach Out and Read, which provides free books to families at children’s well visits.1 Much of the support and scientific backing for these interventions and concerns about lags in language development are couched in terms of closing the “word gap” between children from low-income families and their more privileged counterparts.2 Recent studies, however, have not replicated these word gap findings and show substantial variations in sociolinguistic environments even within socioeconomic strata. This suggests that there is no singular gap. We question the use of the word gap concept and the reliance on an approach in which the deficits, rather than strengths, of low-income and minority families are highlighted. We argue instead for a universal, nonstigmatizing approach to enhancing childhood literacy and propose using a positive framework of language building to replace the concept of a word gap. Numerous language acquisition programs are focused on increasing the number of words spoken to children from low-income families in an attempt to address what is termed the word gap. In an often-cited 1995 study, Hart and Risley3 found that young children from low-income homes were exposed to ∼600 words per hour. This was considerably fewer than the 2100 words per hour heard by children from high-income families. Extrapolating, Hart and Risley3 suggested that by … Address correspondence to Mical Raz, MD, PhD, Perelman School of Medicine, University of Pennsylvania, 1310 Blockley Hall, 423 Guardian Dr, Philadelphia, PA 19104. E-mail: mraz{at}ur.rochester.edu

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