Talk the talk: Early language exposure impacts brain development

It’s no secret that babies love to look at their parents’ faces and hear their voices, but pediatricians are now being challenged to help parents understand that what they say to their children in the first years of their life can have a lasting effect on their brain development and scholastic achievement.

In her session “Thirty Million Words: A public health approach to early childhood” at the American Academy of Pediatrics (AAP) 2017 National Conference and Exhibition on Sunday, September 17, Dana L. Suskind, MD, professor of Surgery and Pediatrics, director of the Pediatric Cochlear Implantation Program, and founder and director of the Thirty Million Words (TMW) Initiative and Project ASPIRE (Achieving Superior Parental Involvement for Rehabilitative Excellence) at the University of Chicago Medicine, Illinois, discussed how she came to move from pediatric cochlear implant surgery to launching a translational research program to promote healthy brain development, and explained the science behind the TMW Initiative.

“Fostering healthy human development is central to all we do as pediatricians,” Suskind says. “What we so often bill as ‘early learning disparities’ are in fact impacts on healthy brain development. Even though language is the driving force, particularly parental and caregiver input, foundational brain development absolutely falls within the domain of healthcare.”

According to Suskind, the quality and quantity of adult-child interactions in the first 3 years of life-often called the 30-million-word gap-are critical factors in a child’s school readiness and ultimate school achievement. This issue disproportionately affects children born into poverty, she notes. Neuroscience has shown that socioeconomic status has an impact on achievement gaps and the developing brain, specifically demonstrating the correlation between socioeconomic status on the brain regions most important for learning.

Two variables can mediate the impact of socioeconomic status on foundational brain development, Suskind says, and these are the quality and quantity of the early language environment, and the level of stress within a household.

“In essence, the 30-million-word gap is really a metaphor for the power of parent language and adult-child interactions,” Suskind says. “All parents and caregivers have an inherent capacity to use their words and interactions to build their children’s brains.”

The TMW Initiative works to develop and test sets of evidence-based interventions that focus on increasing parent knowledge and ultimately change the behavior of parents and caregivers in an effort to prevent disparities in brain development.

“Our end goal is a population-level shift in the knowledge, beliefs, and behaviors of parents and adults who interact with and care for young children,” Suskind says. “We advance a community-wide approach in which our evidence-based interventions create multiple touchpoints for English- and Spanish-speaking families. For example, TMW-Newborn is administered at the universal hearing screening, and TMW-Well Baby follows the standard immunization schedule of pediatric well-baby visits.”

Pediatricians and the healthcare system overall play an important role in the public health approach of this initiative, beginning at birth and following children through the continuum of care, Suskind says. “Such an approach unifies existing health and education systems and focuses every effort toward the prevention of early cognitive disparities-and not their remediation,” she says.

The next step for Suskind’s team is to learn how to bring what they know works into practice. The TMW Center for Early Learning + Public Health creates a platform for practitioners, researchers, policymakers, and parents to drive healthy brain development and prevent early learning disparities before they start, she says.

Suskind says she hopes pediatricians will embrace the work of the project.

“As pediatricians, we play a pivotal role in engaging parents and advancing healthy brain development in all children. To impact this from the very start, we must reimagine what an early learning space looks like, one that is aligned with the powerful brain science [that] shows us that learning begins not on the first day of school but, the first day of life,” Suskind says.

Science has already demonstrated that the primary architects of our young citizens’ brains are the parents and caregivers of this country and the power of their talk and interaction, Suskind adds.

“This science also calls out the need to enhance parent and caregiver knowledge of early cognitive development, and their role therein, by placing an intentional focus on the behavioral inputs needed to optimize foundational brain development,” Suskind says. “To do this for all children, we are advancing a public health approach during the first years of life, where prevention, rather than remediation-our current standard bearer-becomes the mainstay and where we look for the greatest impact at scale.”

Pediatricians can help, and by educating parents in their practice, Suskind hopes to foster permanent changes in parenting. “Ultimately, we envision a world where all parents understand the power of their words in building their children’s brains, where this knowledge is a part of basic childrearing practice-as common and every day as wearing seat belts or eating a healthy dose of fruits and vegetables,” she says.