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Dana Suskind: Talk to your baby early and often

Dana Suskind’s mantra is written on a whiteboard in her office at the University of Chicago. She developed the easy-to-remember shorthand for parents to remind them of the importance of spoken language and warm interactions during a child’s first three years of life: Tune in, talk more, take turns. The “three T’s,” for short.

Suskind’s work in early childhood development started in the operating room. As a surgeon at the university’s Comer Children’s Hospital, she pioneered a cochlear implant program that allowed deaf children to hear for the first time. Yet some children with an implant never learned to speak, even though they could hear. Often, those were children from poorer families. 

Illustration by Viktor Miller Gausa

That led Suskind to wonder, what is the key to a child’s brain development? The short answer is language, and lots of it. The words a child hears in those first three years nourish the brain. She also made a surprising discovery: It isn’t only deaf children who struggle academically because of a lack of exposure to language in the early years — hearing children who aren’t exposed to enough words also lag behind.  

In 2015, Suskind wrote a book called Thirty Million Words, a reference to the gap in the number of words children from affluent families hear in their first three years, as opposed to children from low-income families. While the exact number may be debated, the science is clear: Affluent children hear millions more words by age three, and that can offer lifelong advantages. 

“Learning starts on the first day of life, not the first day of school,” Suskind says. That idea is the foundation of the TMW Center for Early Learning & Public Health, which Suskind founded to educate parents on the science of brain development and the powerful role that caregivers play.  

 “If we make healthy early brain development our north star, everything else falls into place,” she says. By “everything else,” she means less poverty, better academic outcomes, improved school readiness, even better “soft skills” such as impulse control and resilience. All of it starts with conversation, she told contributing editor Vanessa Glavinskas at Suskind’s Chicago office.  

Q: You wrote Thirty Million Words in 2015 to explain the importance of the words a child hears in its first three years. What has happened since your book came out?

A: The book set the foundation for the idea that it’s language, and parent-child interaction in the first three years of life, that builds a child’s brain. Thirty Million Words evolved into the TMW Center for Early Learning & Public Health. We asked, how do we get all parents from all backgrounds to understand the importance of the first three years of life? We are taking what I like to call a public health approach to early learning.  

Q: What do you mean by a public health approach? 

A: It means thinking about the importance of language in the same way we think about car seats, about “back to sleep” for sudden infant death syndrome, about not smoking around children. Our program meets parents where they are in their child’s first three years of life. For example, we developed a program that is combined with the universal newborn hearing screening. The idea is that every parent, when their child gets that hearing test, should understand why. It’s not simply to see if your child is born deaf; it’s because language is the food for the developing brain.

Q: How do you hope to help parents?

A: Here in Illinois, 76 percent of kids going into kindergarten aren’t ready. Our education system starts too late. The science shows that parents are children’s first and most important teachers, but we have no system to support parents in that. Now, some people say it’s just intuitive to love and nurture your children. Yes, but that’s different from understanding the brain science. We’ve got to share with families the science behind how babies’ brains develop and how powerful parents are in influencing that.

Q: You’re a surgeon specializing in cochlear implants. How did you end up focusing on helping all children, rather than only deaf children?

A: Often, the difference in outcomes among my patients was divided along socioeconomic lines. Children from poorer homes had poorer outcomes. I realized that what was going on in my patient population mirrored the larger population. That’s what took this project from my patients, children with hearing loss, to all children.

Q: Is it a matter of simply talking to your kids more, or is the way you talk with them also important?

A: It’s not just about the quantity of language; it’s also the unspoken aspect that comes with the language which is so important in those first 1,000 days, when neuronal connections, or brain connections, grow rapidly. There are a million new connections made every second. What stimulates that? It’s that warm, nurturing interaction. On the flip side, when interactions are absent or angry or harsh, it negatively impacts a child’s development. Think about the three T’s: Tune in, talk more, and take turns. That “tune in” is so important — the attention, looking at your baby, following their lead. Talking more is important, but it’s especially important to use rich vocabulary, to talk not only about the present but about the past and the future, and to take turns. Have a conversation with your baby from day one.  

Q: What if a parent is not educated or doesn’t have a particularly rich vocabulary? Do you have specific tips for people who perhaps didn’t grow up in a language-rich environment themselves?

A:  One of the most important tenets of all TMW programs is the belief that within every parent, regardless of their level of education or socioeconomic status, lies the ability to use language to build their child’s brain and shape their future. It’s not about using big, complex words; it’s about good old-fashioned talk and interaction.   

The great thing about the three T’s is that they can be used in any and every parent-child interaction. And when you use all three T’s at once, you’re building the strongest possible brain for your child.   

Q: Are smartphones diminishing the time parents spend interacting with their babies? 

A: That is one of the greatest risks facing us — addiction to cellphones. The science is just coming out about the impact of it. One of my colleagues did a study that shows the impact on vocabulary development. It’s not good. While we’re advancing technologically, evolutionarily our brains still develop in the same way. In fact, that’s the fourth T: Turn it off.

Q: What happens if you miss this window of brain development? What if a child doesn’t get enough nurturing interaction in the first three years?

A: I try to put forward the message that, of course, it’s never too late. It’s just much easier and more effective to build a child’s brain earlier. But we haven’t aligned our public policies with what we know about the brain science.

Q: What policies do you advocate for through the TMW Center?

A:  We’re testing a model in Palm Beach, Florida, to connect education with the health sector and social services. You go to the pediatrician; they collect data. Your child goes to child care; they collect data. They go to school, more data. They don’t see the whole child; they just see little snippets. But in Palm Beach, our partner organization, the Children’s Services Council, has built a data system that connects it all.  

First we’re going to partner with the hospital system, educating parents on the importance of language on development when their newborn has a hearing screen. Next, we’ll go into the pediatricians’ offices. Then after that we’ll partner with the libraries, community-based organizations, grassroots organizations.  

TR: Using a public health approach to solve a problem is something that Rotarians understand well because of Rotary’s focus on eradicating polio. Do you see similarities with the approach to eradicating polio?

A: I see a great analogy with that. When you look back at polio, once the Salk vaccine came to fruition, it was a grassroots effort by all people, but especially parents, that got it into motion. By activating parents, a lifesaving vaccination — or in the case of what we’re doing, the power of talking and interaction to build children’s brains — can change the world.

Q: Part of the reason for that incredible grassroots effort was that parents were so terrified of polio. Do you think you can convey the same kind of urgency about the importance of building a child’s brain?

A: It’s one of our greatest public health issues in this country. You only have to look at the data: Only 24 percent of children in Illinois are ready for school! The problem is that it sounds like an education issue. But it’s about foundational brain development. And that is a big public health issue, not just for the individual, but for society.  

Q: What’s next for you?

A: I’m thinking about another book. It’s going to be about what we need in terms of policy change. Things like high-quality early child care and paid parental leave. We need to let parents have time to talk to their kids.

I’ve also been thinking about how to get business owners behind the idea of offering more support for employees with young children because of the importance of early childhood development. It would be great if Rotarians could advance this idea of the importance of the first three years of life. I would also encourage Rotary clubs to think about early childhood development as a part of literacy, because the building blocks of literacy start with healthy early brain development. Babies aren’t born smart; they’re made smart.

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