“When a child comes into your practice who needs more than clinical care, what can you do?”
That’s the essential question animating the United Hospital Fund’s PEDS Learning Network. More often than not, some part of the answer will be “to support the parent or caregiver.”
Providers have always done their best to support families with referrals to social services like food and housing assistance. However, in the past few years, we have seen a remarkable shift in the mindset among providers, who increasingly view the literacy and language skills of parents and caregivers as a critical resource beyond clinical care. Experience from UHF’s Partnerships for Early Childhood Development (PECD) initiative found that adult education, inclusive of literacy and language skills, was consistently among the top unmet social needs identified when screening families of pediatric patients.
While pediatricians have long recognized literacy and language development as central to children’s healthy development—and have implemented various approaches of anticipatory guidance and family reading promotion—awareness has been growing that literacy in most families begins with parents and caregivers. However, the task of promoting the benefits of children’s literacy to an audience of adults who themselves are disenfranchised from the culture of literacy was always going to be an uphill battle.
Literacy practitioners have long known that if you can boost the reading skills and confidence of parents, their children’s reading proficiency will follow. Because children can be reached before they begin school and outside of school in their pre-K, kindergarten, and early elementary years—and because parents and caregivers have the power to shift their expectations and the home culture—boosting parents’ literacy skills is one of the most effective interventions for children’s early academic success.
The Emerging Two-Generation Framework to Address Literacy
In the past few years, pediatricians and community-based adult literacy practitioners have joined forces with advocates for health literacy who have a deep concern about the myriad challenges the health care system creates for adults with limited literacy skills. Together, they are creating a new framework to engage parents and caregivers not only in promoting their children’s early literacy but in developing their own literacy skills as well.
Two-generation approaches provide a way to bridge literacy gaps caused by the pandemic and systemic inequities. A two-generation model can take many forms and have names ranging from “whole family” to “multigenerational.” At its heart, it is simply a way to recognize the whole family unit—as families define themselves—as essential for meaningful learning and growth. As such, it does not just focus solely on the child’s literacy or the needs of the adult but integrates services and supports to help move the whole family forward.
A key component of a two-generation approach is the idea that designing programs to support children and families together is better for both generations—it’s also ultimately better for communities when everyone achieves their full potential. Although this approach has been around for decades and is part of the founding vision for Head Start and Family Literacy programs, the focus has shifted in the past few years to more fully center families as experts and essential agents in shaping the policies and programs that will affect them.
Literacy Partners as a Case Study
A two-generation approach is most beneficial when engaging parents of young children. Investing in the early years is essential to breaking the cycle of poverty and ensuring that families have what they need to thrive. At Literacy Partners, we focus our programs on parents of young children (ages 0-7) to maximize our impact. Whether teaching adults to read, speak English, or pass the high school equivalency exam, we use a two-generation approach that places the voices and lived experiences of the family at the center of instruction. Early child development and health literacy are integrated into lessons, so parents can learn the words and practice the skills necessary to advocate for their child in complex educational and health systems.
Our programs also work with outside agencies and health providers to align systems and help parents identify and access the services they need. For example, English for Parents, an English-language learning class for parents of young children, works with health providers to connect parents with third-party platforms such as UniteNYC and NowPow. Once in the program, these parents are then provided with referrals to support services through the same platforms. Aided by a Parent Ambassador and parent-led WhatsApp group, parents are encouraged to share their expertise and build the social capital necessary to access future support independently.
Literacy Partners' Spanish-language parent engagement program, La Fuerza de Familias Latinas, takes the model a step further by creating a series of workshops that place parent voices and experiences at the center of each session. Prompted by scenes from the popular telenovela, La Fuerza de Creer, parents share related stories from their own families and then apply what they have learned at home with their children. A key part of both programs is a free home library program that provides developmentally and culturally appropriate books to each family.
Next Steps for Pediatric Literacy Partnerships
This past summer, Literacy Partners worked with United Hospital Fund to share two-generation approaches and programs with the first cohort of the Pediatric Steps to Literacy project.
Over the course of two seminars, we provided a research framework and rationale for using a two-generation approach and presented a panel of two-generation community-based organizations. Organizations like Children’s Aid, which manages nine early childhood programs throughout New York City, and Public Health Solutions, which seeks to strengthen maternal child health systems of care, shared how they worked with Literacy Partners and each other to create a two-generation ecosystem that centers the needs of the whole family and recognizes the parent as an expert in their child’s learning.
These lessons and this guidance offer a way forward as we work together to close the pediatric literacy gap.
Anthony Tassi is the CEO of Literacy Partners and formerly led the New York City Mayor's Office of Adult Education. Lynn Clark, PhD, is an educator and former Chief Program Officer of Literacy Partners.