Improving early child development with words | Dr. Brenda Fitzgerald | TEDxAtlanta

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Thank you very much.

There is a profound predictor
of health and wealth

that can be determined
by three years of age.

And that predictor is language.

Language is the essence
of what it means to be human.

Now, animals may have noises or gestures
that they can communicate with,

I can assure you my cat

can get me up out of the bed
at five o'clock in the morning

because he is hungry,

but human beings are much more adept

and much more facile at language.

I can tell you that language in
the Oxford Unabridged English Dictionary,

there are 600,000 different words

that American,
that English people can know.

Lots of people spoke,
speak more than one language.

So the ability of humans is enormous,
you never really and truly see

a chimpanzee or a rhinoceros
reading a book,

but humans commonly read books,

and we understand language.

Babies come into this world

acutely programmed
to learn all these different words,

to learn the essence of language,

because language is what makes
us human, and quite frankly,

language is what makes us survive.

There is a huge growth spurt,

a huge increase in capacity
in the brain by at least a third

that occurs in the last part of pregnancy,

right before babies come into this world.

And I can tell you that babies are
hard-wired to learn different languages.

I can tell you that

because the important thing about babies
is not only that there is the capacity,

but how we learn language
is from our caretakers.

That means mothers and babies
have this unique experience.

I can tell you from
the maternal point of view

that I experienced that in my own life.

Now, I'm an obstetrician-gynecologist;

I delivered lots and lots
and lots of babies,

but the experience of delivering
somebody else's baby

was completely different
than my own pregnancy.

Now, I gotta tell you,
I came to pregnancy,

and I was already a doctor.

I've known I wanted
to be a doctor from age eight.

I loved it.

I was a really good surgeon.

I wasn't really even sure
I wanted children.

And then, this pregnancy occurred -

by choice -

and all of a sudden,

I was acutely aware of my unborn daughter.

All of a sudden,

this woman that had been interested
in the outside world

was only concentrated
on my pregnant belly.

I wasn't really interested in anything

more than ten feet away from me.

The evidence of hard-wire
is even more profound in babies.

What you are looking at is
the development of language,

because language is the interaction
between caretaker and baby.

This experiment from the Harvard
Child Development Center

is about the importance
of the hard-wire that is existing.

This is called
the "Still Face Experiment."

What happened

is the mothers
are instructed to turn away

and then turn back to the child
and have a still face.

Watch what happens to the baby.

What you'll see happening is,
first, she tries to engage.

"Ah-ah," smiles, coos, points -
that's to elicit a response.

Points, then she coos,
"Ah, ah, ah,"

"ma, ma, ma,"
and then she reaches out.

This is important, this is hard-wired.

And all of a sudden,
she starts to get frustrated,

nothing is catching attention,
there is this screech, "Ahhhhh."

She tries to comfort herself.

And then she looks away,
tries to disengage,

makes one final, one more attempt
to get her mother's attention.

And then she dissolves
into hopeless crying.

It's hard-wired.

The Still Face Experiments are
clear indicators that this is hard-wired.

So what's the importance?

What's the long-term consequence
of this kind of biologic stuff?

Why is it important that a mother
concentrates on her baby,

or that a baby concentrates and demands
the attention of its mother?

The long-term effect
of all this primitive stuff

was done in some, I think, some kind
of brilliant work by Hart and Risley.

And they were experimenters who had been
involved in the war on poverty.

They'd been involved
in the war on poverty,

and they said,

"You know, there's a problem here,

because we are not really seeing,

with these early
educational interventions,

although they are good,
although there are some results,

we are really not seeing
what we wanted to see."

So, they said,

"Can we look earlier?

Is there something that is happening
before these babies get to kindergarten,

before these babies get to first grade?

Is there something happening
that is important?"

Their work was an extreme,
involved, deep observation of family life.

They went into the homes of 42 families,

and they had an intense
observation of those families.

They looked at those families
an hour a month, every single month,

from the time their children
were seven months of age

until the end of the third year.

And what they found,

as by the title of my talk,

was really not what they expected.

First of all,

the children were all well-cared-for.

So it wasn't the changes in the children,

the difference in the children
had nothing to do

with not having the physical needs met.

Secondly, it was not about race,

it was not about gender.

And here's the key:

it was not about money.

It wasn't determined by the number of toys
that could be purchased by the parent.

It wasn't determined
by the neighborhood they lived in.

It wasn't determined by the size
of the house they lived in.

It was determined by the interaction
of the parents with the child.

And the interaction that they saw
after three years of observation

was that there were 30 million more words

that those families that were
identified as professional families,

30 million more words that those families,

those mamas and daddies,
said to their children

than the children in poverty.

The reality is,
for those families in poverty,

those parents were only saying
about 600 words an hour.

For the professional families,
it was over 2000 words an hour.

Because the professional families

were having constant
talking with their baby.

"Oh, your diaper needs to be changed.

Oh, bless your heart,
I'll take care of that."

"Oh, look at those toes.
Aren't those toes wonderful!

Oh, and look at that belly button.
That is the cutest thing I've ever seen.

You are my beloved child."

Thirty million more words.

That's important because
neurological development of the brain,

actual physical development
of the brain, depends on words.

Each time a word is said,

it shoots up the neuron,

it stimulates the neuron.

And when that word is repeated,

that same path is stimulated again,

and it'd get stronger
and stronger and stronger,

and it branches out
so there's capability of learning.

And if those words are not repeated,

the opposite occurs.

Those neurons shrink and die

and go away.

The scientific word is pruning.

But what it means is,
it decreases the ability to learn.

Now I've got to tell you one more thing,
it's not just hearing the words.

Because babies
put in front of televisions,

it's like the Still Face Experiment,

they don't learn.

They don't learn,
because it is the interaction.

And children who are deaf
can learn language.

"Thank you,"

in sign language is language,
it is symbols that mean something.

It's language.

So it's not the hearing,

but it's the interaction
that is most important.

And it is enormously important.

This is a graph

of the effect of those 30 million
different words on these children.

At the end of the three years,

those babies that were born
to welfare parents knew 500 words,

while those babies in the "professional"
families knew over a thousand words.

It makes a difference.

This whole process is language nutrition.

And what it means is

that language is absolutely important
for the development of the brain.

Language is absolutely the basis
from which all human learning occurs.

If you think about it,

what language nutrition really is,

is the development of neurons,

the development of the brain,

is absolutely, biologically
dependent on language,

which leads directly
to the ability to read,

which leads directly
to graduation from high school,

which leads directly to college education,

or high school education.

The importance of learning to read,

the importance of this language nutrition,

is that there were profound effects
that they observed that were long-term.

It wasn't just short-term,

it was long-term.

They looked at these same children
five years later,

and they found that they could tell
that the gap had increased

between those children.

It'd gone from 500 to 1000 words

to the ability to pass
standardized tests at third grade.

And why is that benchmark so important?

Third grade is important
in the whole part of human learning

because up to third grade
you learn to read.

After third grade,

you read to learn.

If you cannot read on level
by third grade,

you can't read the text,

so you can't keep up.

You may never catch up.

For those children who are not reading
on level by third grade,

they are four times more likely not to be
able to graduate from high school.

And remember this language
nutrition model?

If they can't read,

they don't graduate from high school,

and that leads directly to a problem
with success in the society.

If you are really behind in reading,

there's a six times greater chance
that you won't graduate from high school.

Now, the problem in Georgia is

that 70 percent of Georgia's children
do not read on third grade level.

70 percent.

That has profound
implications for the state

and profound implications
for the individuals that are involved.

There is this ranking called
"American's National Health Rankings."

And in those health rankings,

there are two clusters
that keep me up at night.

Two clusters that,

as a state health officer,

I worry about.

One cluster is about infant mortality,
and prematurity, and all that.

And we have made some progress there;

that's a talk for another day.

The other cluster where they
were at the very bottom of the pack,

where we are at the lowest
tenth of the country,

has to do with this whole business
about literacy at third grace.

We have high numbers
of children in poverty,

high numbers of failure
to graduate from high school,

high numbers of income disparity,

lack of health insurance,

underemployment,

unemployment.

All of this caused

by our lack of ability
to read on level at third grade.

Also, as a state health officer,

I can tell you,

that is unacceptable.

It is unexpectable,

especially since I know
it's not the neighborhood,

it's not the income,

it's not the genetics,

it's the exposure to language,

the early exposure to language.

So we are involved in a public-private
partnership called "Talk with me baby."

And this is to solve this problem
that we have here in Georgia.

This is a public-private partnership.

It involves United Way,

it involves The Anne E. Casey Foundation,

it involves Public Health,

it involves the Department
of Early Child Care and Learning.

But all of it is the same;

all of it is to change the paradigm.

For example, The Marcus Foundation,
which is one of our partners,

they are involved in developing the tools
to teach healthcare providers,

to teach nurses, hospitals, and doctors
how to tell their patients about this,

the importance of early learning,

and also how to tell
their patients how to do it.

In public health,

we are going directly to the mamas,

because in public health,

we have an interesting little
program called WIC.

WIC is the Women, Infant
and Child Nutrition Program.

Now, WIC is different
from a regular food stamp program.

In WIC, you don't just get
a little plastic card

and go to the grocery store
and do whatever you want.

In WIC, you have to come to see us,

every three months to see a nutritionist.

And you can only purchase
certain foods with your WIC card.

We see this as a unique opportunity
to take food nutrition,

which is so important
for our citizens of this state,

and talk to them about language nutrition.

And there are a lot of people in WIC,

50 to 60 percent of Georgia's babies
qualify and are in WIC.

50 to 60 percent.

And all those low-risk mothers.

And WIC is everywhere,

there are 159 counties in Georgia,

and we have 159 or more
WIC offices in Georgia.

We have a WIC office
capable of reaching these people,

every single place in Georgia.

There is not a single place in Georgia
that you can't get to a WIC office.

We hired the Marcus Foundation
to come up with some videos,

and these videos will be played
in the WIC clinics.

And they'll tell these young mothers,

these young needy mothers,

these poverty mothers that we're
going back to the original studies,

about the importance
of food nutrition.

They'll tell these mothers how to do it,

because it is not just straight forward,

"Oh, talk to your baby
and you'll be fine."

There are subtleties
that you need to know,

and these videos are designed to do that.

It'll tell them such things as

a baby is born recognizing
its mother's voice,

therefore when you start
talking to your baby,

it's when your baby is still in the womb.

So this program is designed
to get to all these mothers.

So far, what we have done is,

we want to know what works.

I believe it'll work,

but what we want to know is,
does it really work?

So we have evaluated

the average number of words
that the children in our WIC clinic know.

And we are going to start the videos,

and we are going to couple it
with the reinforcement -

remember those every-three-month
visits for pregnant women and children?

We are going to reinforce that
with the nutrition saying to them,

"Food nutrition is important,

but language nutrition may be
even more important for your baby."

And when that mama goes home
from the WIC clinic,

she's going to be taking a book.

I really think that ...

this will change the dynamics
here in Georgia.

I know for a fact

that it is all about language.

The most important concept
is the development of language.

I know that the Office of the Budget
for the House of Representatives

recently did a study, and they looked
at the evaluation of the war on poverty

that was started back in the '60s,

and according to our budget office,

we've spent five trillion dollars on it.

And here's what's happened
to the poverty rate.

In 1965, when it started,

the poverty rate was 17.3.

In 2012, after five trillion dollars,

it is 15.

That's not much progress.

I present to you,

I think the problem is

we didn't look for the answer
to the problem early enough,

and we didn't -

we weren't including language.

We have to include language.

Language is the very basis
of solving the problem of poverty.

Life expectancy at the time of Christ
was 20 to 30 years.

Life expectancy for human beings
a thousand years later was 20 to 30 years.

Today, you people sitting out there,

your life expectancy is 80 years or more.

You survive birth,

you survive learning
to drive as a teenager,

and you have a great chance
of living to 80 or more.

That expected change in life expectancy

is not because of
bypass surgery or CAT scans.

Bypass surgery and CAT scans are great;

they may add a year or two.

But those transformational changes

are from more basic, primary,
primitive public health initiatives.

Those changes in life expectancy
are from clean water,

and an effective sewer,

and vaccinations,

and the developement of antibiotics.

I can tell you that in 1900,

the things that were killing us,

the three killers of human beings in 1900,

was pneumonia, TB, and diarrhea.

And I can also tell you

that the things I mentioned -

clean water, sewers,
vaccinations, antibiotics -

those are responsible for
the expected change in life expectancy.

I can also say to you

that I believe

that we are on the precipice
of the next transformational change

in public health.

That transformational change,

I truly believe,

is the deep understanding
of the importance of language development,

and the determination that we have

absolutely universal, effective,
early language development.

My message to you as a state health
officer of Georgia today is really simple,

but I think it is important.

And my message to you is:

talk with your baby.

Thank you.

(Applause)