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BACKGROUND AND OBJECTIVES: The American Academy of Pediatrics recommends literacy promotion as well as routine developmental surveillance during well-child visits to improve academic, relational, and health outcomes. In this study, we examined the possible association between shared reading and social-emotional problems among young children. METHODS: We conducted a retrospective review of longitudinal records for children aged 30 to 66 months presenting for visits to an academic pediatric primary care center between July 1, 2013, and February 1, 2019. The outcome was evidence of social-emotional problems, defined by an Ages and Stages: Social Emotional Questionnaire (ASQ:SE) score above the established cutoff. The predictor was caregiver-reported frequency of shared reading (most = 5–7 days per week, some = 2–4 days per week, rarely = 0–1 days per week) at a previous visit. Generalized linear models with generalized estimating equations were used to assess the association between the longitudinal outcome and predictor, adjusting for child demographics and needs reported on routine social history questionnaires. RESULTS: Analyses included 5693 children who completed at least 1 ASQ:SE (total of 7302 assessments) and had shared reading frequency documented before each ASQ:SE assessment. Children were predominantly Black (75%) and publicly insured (80%). Sixteen percent of ASQ:SE scores were suggestive of social-emotional concerns; 6% of caregivers reported sharing reading rarely. Children with rare shared reading had a higher risk of an ASQ:SE above cutoff compared with those with shared reading on most days (adjusted risk ratio, 1.62; 95% confidence interval, 1.35–1.92). CONCLUSIONS: Less-frequent caregiver-reported shared reading was associated with higher risk of social-emotional problems in young children presenting for primary care. This highlights potential relational and social-emotional benefits of shared reading.

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Literacy development is a complex process. It is well established that the Home Literacy Environment influences literacy development. To better understand the influence of the Neighborhood Literacy Environment, we examined the distribution of public library branches across neighborhoods in an American midwestern city and associations between book circulation rates and childhood poverty rates. This study used children's book circulation data provided by the Hamilton County Public Library in the state of Ohio (U.S.). The primary outcome variable was the branch-specific, five-year mean circulation rate of books-per-child living within the branch neighborhood. The predictor variable was the childhood poverty rate of the neighborhood. There was a significant, moderate negative correlation between book circulation and childhood poverty rates (Spearman's r= -0.52, p<0.001). Using data from a public library system in a large midwestern American city, this study found significant disparities in branch access and children's book circulation in high-poverty neighborhoods.