Early storybook reading and childhood development: A cross-sectional study in Iran

Introduction

Development is a complex process through which an individual acquires various capabilities to improve performance and have better adaptation to the environment. Although, this process continues from childhood to death, most developmental process occurs during the first few years of life¹, during which the neural structure evolves². Although the opportunity for early childhood interventions is short, it has significant results³, and it is believed that a better beginning of life will lead to a better future⁴. Therefore, providing the best beginning for children can lead to success in life, employment, higher earnings, active participation in society, increased responsibility, and reduction of crime and some chronic diseases^5,6. The prevalence of developmental disorders in Iranian children is between 7 and 22.4%⁷ and is reported to be 14–20% in other countries^8–11. However, by encouraging mothers and community participation, and timely and appropriate intervention in controlling the risk factors, the ability to promote development, health, well-being and suitability of the child can also be provided^12–14.

Many social factors and environmental stimuli are effective in health and early childhood development (ECD)¹², which include useful books and toys that provide a healthier life in the long run for the individual. Book reading is regarded as one of the most powerful protections for mental growth and development, and psychological and social stimulation of a child at home^15,16. UNICEF introduced early storybook reading (ESR) and storytelling as child care indicators¹⁶. In addition, the parent-child's common interest and joint attention in reading picture books provides the basis for social and emotional communication during childhood. Reading books to children promotes their development of speech and language, and cognitive and emotional social behavior^17–19, and provides them with joy²⁰. In addition, the infant learns how to take the books in their hands and try to turn its pages. Hence, it can promote gross and fine motor coordination and also a love for reading²¹. When book reading is started in early months of life, a longer and more stable effect on child development will be observed²², as reported by Senechal and LeFevre²³ who found that parents should begin book reading to infants at the age of 4 months, since these children had better literacy skills at school age. It is believed that ESR promotes the development of children; Murray and Egan²⁴ reported a positive relationship between reading books and the score of cognitive development in 9-month-old infants. Cline and Edwards stated that ESR in addition to enhancing child's development and learning skills, also creates an interest, motivation and habit of regular book reading in the individual in the future²². Therefore, it is good for all family members to participate in book reading to children, and children’s books should be made available for them at home²². Additionally, during reading, a warm and intimate interaction between adults, especially parents and the children is created, and along with playing, can create love and reading infrastructure for motivation in later years^22,25. In addition to book reading, storytelling and singing also have similar benefits in children and can be done anywhere or any time²². It is believed that ESR, storytelling and singing to children are a series of activities that help in the development of speech and language, literacy and children's brain development²⁶. The most important ESR barriers are inadequate access to children's book²⁷, and parents' lack of awareness on the positive effects of ESR and inappropriate strategies for promoting children development^27–29.

In general, few studies have been conducted on the role of children's books in the lives of children under the age of three³⁰. Reading books to children is considered as an important activity in Western culture³¹, including the BookStart program in the United Kingdom, which over two decades implemented reading books in the early years of life has as an Early Interventions (EI)³². Although there have been numerous studies on ECD in Iran, reading to young children is not considered as one of the environmental stimuli affecting ECD. Accordingly, this study aimed to examine the status of book reading on Iranian children, including children's books, parents' participation in reading, storytelling and singing to children based on ECD in infants and toddlers without any developmental delay during early childhood in Tehran.

Methods

Results

The number of mothers included in the study was 272. Most of the children (86.86%) were born by cesarean section method, 50.9% were girls, and 21.5% were also cared for by grandparents in addition to their parents. As shown in Table 1, the mean age of mothers and fathers was 31.72 ± 4.450 and 35.5 ± 5.149 years, respectively. 68.4% of mothers were housewives and 5.5% of fathers were unemployed. The average income of families was 31,150,000 Rials, 54.8% of whom were satisfied with their income. 73% of children did not have any siblings.

On average, every child had 10.2±8.642 books. Among the children, 30 (11.20%) did not have any books and 228 (84.75%) had at least 3 books. Only five children (1.83%) had more than 37 books each. The average daily reading time for children was 9.65 ± 10, while for half of them, nobody read 5–15 min to them a day, and 27.6% of them were never read to. The average storytelling time for children was 11.48 ± 11.756 min per day, while 25.7% of parents had never told the children a story. The average duration of singing for children was 23.88 ± 17.880 min per day, but for 11.4% of them, nobody has ever sung.

According to the results in Table 2, the number of children's books owned, duration of ESR, storytelling and singing in children was significantly different between children aged 3 to 17 months and those aged 18–30 months (p=0.0001 for all). There was a significant relationship between the number of children’s book owned with duration of ESR, storytelling and singing (p<0.0001). In addition, there was a significant association between the number of children's book owned and children's age (p<0.0001), mother's age (p=0.021), family income (p=0.009), income satisfaction (p=0.026), father's occupation (p=0.04), and mother's and father's educational level (p<0.0001). ESR duration for children was significantly correlated with the age of the child, mother and father (p<0.0001). Singing duration was significantly correlated with only the mother's educational level (p=0.011).

The correlation between ESR variables is shown in Table 3. From the viewpoint of development, the scores of communication and problem-solving from the ASQ questionnaire showed a significant relationship with the number of children's books owned (p<0.0001 and p=0.016). Also, there was a significant correlation between the score of communication and duration of ESR and storytelling (p=0.002 and p=0.028). There was no significant relationship between variables and duration of singing (P>0.05 for all variables). Based on linear regression, children's age, income, and mother's and father's educational level can be models for predicting the number of children's books owned (p<0.0001 for all).

Discussion

In the present study, the average number of children’s books owned was 10.23±8.642, which increased significantly in infants aged 18 to 30 months as compared to infants less than 17 months old (p=0.0001). In other studies, this number was reported to be 2.6± 3.600 to 7.9± 10.9 for children aged 6 to 18 months, indicating an increase in the number of children's books owned based on the age of the children, and it is believed that during early infancy, playing is considered more important than book reading³⁰. A total of 84.75% of the children had at least 3 children’s books; this was reported to be 97% in Ukraine and 3% in Laos¹⁶. According to the results of the current study, more than 68% of the parents had a university education, although in Shahshahani et al.’s⁴⁰ only 34% of parents had a university education. In the present study, there was a significant relationship between the number of books and the duration of ESR with parental education, while in this case Boyle and colleagues believed that educated mothers used better medical education recommendations⁴¹, while fathers with university education can provide a more sustainable financial and social environment for their children²¹. In addition, mother's level of education plays a facilitating role in the book reading of children and ECD²¹. According to some similar studies, educated parents also read more books to their children⁴². However, in the study by Tomopoulos et al.³⁰, maternal education was not associated with ESR. The mean ESR time in the current study for children aged less than 17 months and from 18 to 36 months was 7.42±8.571 and 13.04±11.058 minutes per day, while in the study of 30, the mean for the ages of 6 and 18 months was 2.1±2.300 and 3.5±2.800 days per week, respectively. Although in the present study, father's employment was significantly correlated with the number of children's books owned; there was no significant relationship between father's occupation and ESR, which is similar to result presented in 30.

Given the average number of books in this study, for 61.4% of children aged 0–17 months, book reading was begun at the time of sampling; this statistic increased to 86.5% in children aged 18 to 30, while based on the results of Duursma²¹, book reading was done daily or weekly for 77% of the children who were 14 and 24-months-old, 52% of children aged 4 to 35 months⁴³ and 50% of children aged 0 to 36 months²⁷. According to Senechal and LeFevre²³, the number of picture books in a home has a strong relationship with the children's receptive and expressive language. Therefore, parents should be advised to read books to their children at the earliest opportunity, from birth, because it can be effective in their development⁵. Meanwhile, in the current study, 28.6% of the children had never been read to, while in other studies, this statistic was 4% in the UK²⁷ and 6–23% in the USA^{21, 43}.

According to the present findings, family income showed a significant relationship with the number of books owned and duration of ESR. In this regard, Karrass and his colleagues⁴⁴ also found in 2013 that mothers of higher income families had a greater tendency for ESR for their 8-month-old infants. Additionally, according to a UNICEF report¹⁶ in 2012, children from poor families had fewer children’s books at home.

In the present study, 62.5% and 90.4% of children aged 0–17 and 18 to 30 months were told stories. Also, 84.6% and 94.24% of children aged 0–17 months and 18 to 30 months were sung to, indicating an increase in these stimuli with the age of the child. In confirmation, other researchers also believe that storytelling and singing to children helps in speech evolution, language and literacy, as well as the evolution of the baby's brain⁴⁵.

Having a book and reading it at home will provide more opportunities for improving skills⁴⁶. According to the results of the current study, there was a positive correlation between the number of children's books owned and problem-solving scores. In confirmation of this result, by using ASQ, Murray and Egan’s research also found that reading books to infants had a positive impact on problem-solving and communication issues¹¹. In this regard, Duursma²¹ also proposed the ability to predict 24-month cognitive skills score by Bayley MDI based on the time spent in reading to a child. Also, loud book reading had a significant effect on the cognitive development of premature infants after two years⁴⁷. In the present study, there was a positive correlation between the number of children's books owned, the duration of ESR and storytelling for children and the communication score. In relation to the impact of ESR on speech-language development, results of research indicates that children use a rich vocabulary during book reading^18,31 and interventions for the development of the children's language, focusing on reading books whenever possible in children's lives are required⁴⁸. However, in the current research, there was no relationship between ESR and other developmental domain scores, but in another study it was reported that ESR may promote language and social communication skills⁴⁹.

Conclusion

According to the results of this study, ESR is considered as an early environmental stimulus and interventions in domains of communication and problem-solving in children. Therefore, the establishment of ESR culture among families and individuals in the Iranian community as a recreational and inseparable part of children's life from birth is recommended. As a result, due to the differences between culture and traditions among Iranian people, it is suggested more extensive studies be conducted on the quality, style of reading, and the views of parents and other caregivers on EI when dealing with reading books to children and its effects on ECD in Iran. The results of this study are only generalizable to Iranian children of Tehran.

Data availability

Dataset 1: ESR and ECD data from the East and West of Tehran. Variables are coded as follows: Birth rank: 1=The first child, 2=The second child and more; Caregivers: 1=mother, 2=father, 3=grandparents, 4=others; Age group: 0=3 to 17, 1=18 to 30; New Gestational age: 1<37 Week, 2≥37 Week; New mother educate: 1=diploma and below, 2=academic; New father educate: 1=diploma and below, 2=academic; New mother job: 1=Employed, 2=Housewife; New father job: 1=Employed, 2=Unemployed. DOI, 10.5256/f1000research.14078.d198657⁵⁰

Formula

¹$n=\frac{(Z_{1–\frac{\alpha }{2}})2\times P(1–P)}{d^2}$