1. Growing Healthy Kids Columbus is facilitated by Columbus Public Health Building Children Up With Words Bob Murray MD Medical Director, Good4Growth Ohio Chapter, American Academy of Pediatrics

2. We Are Born With... Potential Pregnancy: Brain cells, the spine, nerves and blood vessels form and grow during pregnancy The Big Bang: Birth Information floods the brain from All 5 senses Muscles Movement & Balance

3. A Neonate’s “Birthday Kit” Reflexes will become skills through sensory- motor exploration Startle reflex (Moro) Palmar & plantar grasp Suck, swallow, gag Rooting reflex Stepping (placing) reflex Fencing posture Trunk curvature

4. The Brain’s Executive Functions

5. We Are All Different Prior Experiences Expectations & Culture Stresses Depression Anxieties Support System Response to Baby

6. Communication Wires the Brain

7. The brain doubles in size in the first year and triples in size by the third year. Massive synaptic connections are strengthened by use, and lost if unused. The Developing Brain

8. The First 1000 Days are Crucial

9. Adult support throughout everyday routines: highly responsive, encouraging, interactive, and playful www.EarlyLiteracyLearning.org“Scaffolding”

10. How to Talk with a Child

11. Serve & Return

12. The Language Gap A dramatic difference in words addressed to the child per hour Drs Betty Hart & Todd Risely The Study 42 families Video 1 hour/ month x 2.5 years in home 1,318 hours analyzed Families :  13 = upper SES  10 = middle SES  13 = lower SES  6 = poverty (welfare)

13. The 30 Million Word Gap By age 4… A child from a professional family experiences 45 million words, A child from a working class family 26 million words, And a child in poverty 13 million words

14. Childhood Language Experiences are Not the Same Affirmations/ hrProhibitions/ hrRatio Professional3256:1 Working Class1272:1 Impoverished5111:2 Hart & Risley, 1995 Early language experiences are built on one another Brain development depends on stimulation Language experiences occur one-on-one -- with emotion and expression

15. What Happened to Those Kids? Dale Walker, et al The Risley/ Hart Study: Now 3 rd graders 9-10 yrs Restudied 29 of 42 families Age 3 experiences predicted: Peabody Picture Vocabulary Test of receptive language r = 0.58 Test of Language Development & its subsets r = 0.74 Comprehensive Test of Basic Skills r = 0.56

16. A Critical Finding Rowe ML. J Child Lang, 2008; 35:185 “The relation between socioeconomic status and child-directed speech is mediated by parental knowledge of child development” (and that’s simple to fix)

17. ADULT Can remember multiple tasks, rules, and strategies that may vary by situation 5-16 YEARS Develop ability to search varying locations, remember where something was found, then explore other locations (e.g., a game of Concentration or hiding a penny under one of three cups) 4-5 YEARS Comprehends that appearance does not always equal reality (e.g.) when given a sponge that looks like a rock) 3 YEARS Can hold in mind two rules (e.g., red goes here, blue goes there) and act on the basis of the rules 9-10 MONTHS Can execute simple means-to-ends tasks and two-step plans; also able to integrate looking one place and acting (e.g., reaching) at another place 7-9 MONTHS Develops ability to remember that unseen objects are still there (toy hidden under a cloth); learns to put two actions together in a sequence (remove cloth, grasp toy) Working Memory

18. ADULT Consistent self-control; situationally appropriate responses (e.g., resists saying something socially inappropriate, resists “tit for tat” response) 10-18 YEARS Continues to develop self-control, such as flexibility switching between a central focus (such as riding a bike or driving) and peripheral stimuli that may or may not need attention (road signs and pedestrians vs. billboards and passing houses) 7 YEARS Children perform at adult levels on learning to ignore irrelevant, peripheral stimuli (such as a dot to the side of a screen) and focus on the central stimulus (such as a picture in the middle of the screen) 4-5 YEARS Reductions in perseveration (persisting with following a rule even when knowing that the rule has changed). Can delay eating a treat; also can begin to hold an arbitrary rule in mind and follow it to produce a response that differs from their natural instinct (sort colored cards by shape rather than color) 9-11 MONTHS Able to inhibit reaching straight for a visible but inaccessible reward, such as a toy on the other side of a window, and instead delay a moment to recognize the barrier and detour around it. 8-10 MONTHS Begins to maintain focus despite distractions during brief delays in a task 6 MONTHS Rudimentary response inhibition (able to not touch something instructed not to touch) Inhibitory Control

19. ADULT Able to revise actions and plans in response to changing circumstances 13-18 YEARS Continued improvement in accuracy when switching focus and adapting to changing rules 10-12 YEARS Successfully adapts to changing rules, even along multiple dimensions (okay to shout on playground, not okay in school, okay sometimes in theater rehearsal) 2-5 YEARS Succeeds at shifting actions according to changing rules (e.g., takes shoes off at home, leaves on at school, puts boots on for rain) 9-11 MONTHS Develops ability to seek alternate methods to retrieve objects beyond directly reaching for what’s in view Cognitive Flexibility

20. Specific Baby Talk Tamis-LeMonda, et al 2001 Mothers who… Pointed, described and affirmed the child’s object attentions (0-12 months) -- Exploration Practiced vocal imitations, expanded on child speech, and asked questions back (1-2 years) -- Elaboration Had a child who learned… Sound imitations and first words Affect with words 50 words, combination speech, and talk about the past (memory) Pretend and symbolic play

21. Focus on the Child’s Object of Attention Add words and affect to the child’s exploration “In this way Mother & Child share a way of looking at the world” Snow, 1986

22. Language Literacy YearsPlaySkills 1Play with soundsSocial communication 2Play with wordsGrammar, communication 2-4Play with songs, rhymes & chants Literacy, expression 3-5Play with grammarCognitive, social, language

23. The Second Year Play (Pretend) Symbolism (Language) RealityMake-believe

24. Language is Play 0-12 mo: Plays with sounds 1-2 yrs: Plays with words 3-5 yrs: Songs, rhymes, chants 2-5 yrs: Plays with grammar

25. “The Magic of Everyday Moments” T Berry Brazelton, MD

27. Thank You!