Posted tagged ‘reading’

Electronic readers versus paper books: Should we fight the future?

June 13, 2016

The Pediatric Insider

© 2016 Roy Benaroch, MD

Holly wrote in:

What is your opinion on e-readers vs paper books for kids? My kids have begun to associate reading with something that ‘has to be done for school’ instead of something to be enjoyed, and I’m wondering if letting them read on their tablets would spark new interest. It seems that schools are turning more and more to electronic devices for teaching, so how do e-readers factor into the ‘screen time’ equation? Can reading on a tablet at a young age affect eyesight?

It’s been a long time since reading technology has changed as much as it’s changing now. 2000 years ago moms were admonishing their children to read their baked clay instead of that new-fangled papyrus. Around 1440 Ms. Guterberg gave her one of the first mechanically printed books while her neighbors edged away. 200 years later, Ms. Lincoln yelled at young Abraham to stop reading the back of the shovel. I think that’s about it in terms of major reading changes until now, when lit screens seem to be taking over as The Medium of reading. When things change, they change fast.

Let me say for the record that I love to read, and I’ve loved books since forever. I rode my bike to the NMB library a few times a week to load up on dusty, musty, wonderfully-smelling books for many of the best years of my youth. I still love book stores (new and used). There is nothing like browsing through a real store or library with real books you can touch, and I hope those places never go away. Still, I’ve got to admit, Kindles and their ilk have some big advantages:

  1. No wasted paper, and no wasted shipping and storage and all of those other book costs.
  2. It’s really easy to keep a huge library on hand—including thousands of titles that are free (out of copyright), plus borrowed e-books from libraries.
  3. Backlit screens = nice.
  4. They’re light and easy to read lying in bed. And that adjustable print size is great for those of us whose eyes aren’t so young anymore. I cannot read old paperback books anymore, at least not without holding up a looking glass.
  5. Textbooks, technical manuals, medical references, and similar things can be kept up to date without tossing out old versions.
  6. Ebooks make it really cheap and easy for anyone to publish anything (even junk like this!) That’s unshackled aspiring writers from the whole agent-editor-publisher gateway.

Still, for every advantage, there are disadvantages too:

  1. Sure, they don’t waste paper. But you can’t easily share them. Or trade them, or keep them on your shelf with scribbled notes in the margin to remind you of a crush you had in high school.
  2. Sure, you can keep a huge library – but browsing a list of titles just isn’t the same as looking across a shelf and picking a new or old favorite.
  3. Though I love the backlight, we know staring into a lit screen before bed can interfere with sleep.
  4. Though in some ways they can be easier to read (their print size and lightness), there’s some evidence that we don’t retain as much as we do when reading an electronic book – especially the temporal sequence of events in a story. That might be because while reading an ebook you don’t get that feeling of pages turning, and the physical reminders of reaching the middle or end of a book as the pages stack up in your hand. I’m not sure this will be true for children who grow up with ebooks, but it does seem true for people of my generation.
  5. The widespread adoption of ebooks will lead to the disappearance of old, out-of-date printed books – which still have value, both as history and as a resource for people who can’t afford the newest stuff.
  6. Sure, any aspiring writer can publish an ebook. But agents and editors actually help writers do a better job. Most of the amateur writing out there is crap. Just because you don’t have to have an agent or editor doesn’t mean you don’t need one.

I wonder about the social impact of the widespread use of e-readers, too. You can no longer see and talk about what people on the bus or in the break room are reading. Would 50 Shades of Grey have done as well if everyone knew you were reading it? And is that a good or bad thing?

Back to Holly’s questions. I think reading is good, on any media; and even though I’m nostalgic for book-books, I’d be just as happy for my kids to enjoy their books on a screen as on paper. That’s the way things are going. To me, reading doesn’t count as “screen time” (nor does homework. That makes it difficult, sometimes, to judge and count screen time, which is one reason I don’t think rigidly counting minutes is a good long-term solution.) There’s no particular reason to think reading on a screen will affect eyesight differently from reading printed words on a page – in both cases, it’s light transmitting shapes, and whether is reflected or projected light, it probably doesn’t matter. Either way, more time outside may be the best way to prevent near-sightedness, rather than trying to change the way children read.

I’ve got a Kindle Voyage, and I love it. And I also still have shelves of books, including many I’ve held for years, and I love them, too. The important, fun thing is the reading – and it probably doesn’t matter how your kids do it.


Dr. Roy’s Summer Reading Suggestions:

For young adults, and the young at heart

Anne of Green Gables – Ever wonder what it’s like to be a talkative, dreamy red-headed girl? No? Read it anyway.

The Wee Free Men – A wonderful introduction to a sprawling, magical series. Young Tiffany wants to be a witch, but has no idea what she’s getting into.

The Thief – No spoilers, but there’s more to this than… never mind!


For adults, or near-enough adults

Never Go Back — Uber-investigative butt kicker Jack Reacher investigates. And kicks butt. This isn’t literature, but it sure is satisfying.

The Crazyladies of Pearl Street – A life-in-the-slums coming of age story, with grace and wit.

Zombie, Ohio – Murder mystery + romance + zombie brain eating goodness. What’s not to like?

Tortilla Flat –These aren’t the smartest, prettiest, or most-likeable protagonists—but you’ll end up rooting for them.

Joyland – In one memorable summer, a boy becomes a carny, a carny becomes a man.

Anne with an E

Vision therapy for dyslexia and reading disorders

September 14, 2015

The Pediatric Insider

© 2015 Roy Benaroch, MD

Dyslexia is a specific learning disorder—a problem not with intelligence or a lack or trying, but with the ability of children to learn to read. It affects 3-20% of children (depending on the exact definition used). Because reading is essential to school success in almost every subject, problems with reading need to be addressed as early as possible.

One kind of therapy for dyslexia is based on the premise that reading problems are caused by vision problems—though the scientific community isn’t convinced that this is the case. The large, national professional bodies representing pediatricians, ophthalmologists, and optometrists recommend only routine vision screening for children having reading difficulties. Nonetheless, there’s a cottage industry of so-called developmental or behavioral optometrists who offer a variety of services commonly called “vision therapy” to help with reading problems and other developmental challenges. There is very little objective evidence that any of these therapies offer more than short-term improvement. Besides, they’re very expensive, and often not covered by medical or vision insurance. Parents need to know whether this kind of therapy is worth pursuing.

Researchers in the UK published a study in May, 2015, looking at a large number of children in a birth cohort from the early 1990’s. These children had all had thorough serial health assessments as they grew. For this specific study, they found that 3% (172 kids) in the birth cohort of 5822 children met objective criteria for reading impairment. All of these children had a very through vision evaluation, and most of those were completely normal; the small number of reading-disabled kids who weren’t 100% normal on their vision assessment had subtle abnormalities. The authors concluded “We found no evidence that vision-based treatments would be useful to help children with severe reading impairment.”

A strength of the study was that it was population-based—it didn’t just include children referred to a clinic because of problems. And the findings were objective and validated. However, the authors only looked at the most severe level of reading impairment. It’s possible they may have missed vision issues in less-affected children (though one would think, if vision were the root of reading problems, that the worst readers would have the most egregious and easily-identified vision problems.)

This study adds to the weight of evidence that “vision therapy” is unlikely to be useful for reading problems, and may be a waste of time and money.