Pediatrics

Building brain architecture one conversation at a time

Conversational turn-taking is important for building strong neural connections and pathways. By encouraging these serve and return interactions, we are promoting language development and healthy brains.

There has been a debate about what influences who we are since at least 1869 when Francis Galton coined the term “nature versus nurture”. Are our genes fixed at birth (nature) or does the environment in which we grow up (nurture) determine our outcomes?

A new challenge for professionals

Research is showing that it is a combination of the two. Furthermore, there is now the study of epigenetics – how our behaviors and experiences can actually change how our genes express themselves. Epigenetics provides professionals working with children with hearing loss with a new challenge: how do we interact with a child with hearing loss to help develop their brains and influence whether genes are turned on or off to promote best outcomes? The short answer: we build the brain.

How to become a brain architect

Professionals who work with children with hearing loss are brain architects (a term used by the Center on the Developing Child at Harvard) tasked with helping build the brain of the child. Many professionals at this point know the words of Carol Flexor, “it’s all about the brain”, and the concept that the ears bring sounds to our brains but the brain is what truly hears and listens.

We can acknowledge that we are brain architects, but what part of the brain are we building? The language cortex in the temporal lobe? …The auditory system in the temporal lobe?…Executive function in the frontal cortex? What about emotional regulation and resilience in the limbic system?

Even if we know what areas of the brain we are building, how do you build the brain and provide the correct supports for appropriate brain architecture? As professionals working with children with hearing loss, we have many tools to give children: appropriate amplification, strategies for language development, techniques for speech articulation development, methods for enhancing social skills, and myriad other areas.

Responsive parenting changes the brain’s response

How do we build the brain and how do we make this easy for families with children with hearing loss? Are hearing aids and appropriate amplification enough?

A growing bed of research is finding that the most effective way to build strong neural connections and pathways is turn-taking conversation between a child and another person. MIT’s McGovern Institute for Brain Research investigator Rachel Romeo used functional magnetic resonance imaging (fMRI) to demonstrate that the brain region responsible for production of language, Broca’s area, responds more in children who have had more conversational turn-taking with an adult. By having conversation with turns, the brain’s response was actually changed. Even when researchers looked at socioeconomic levels, IQ, and other factors, conversational turn-taking emerged as the most important factor.

Furthermore, studies have shown that children in responsive parenting relationships have higher social competence, better cognitive skills, have better work skills in school, more self-confidence, and better language development (National Scientific Council on the Developing Child, 2004).

Serve and returns optimize neural development

Our “hammer and nails” when we are building brains is the serve and return between a child and their parent. While we do need children to have appropriate amplification to have listening access to the oral part of these conversations, we need serve and return between the child and the parent for optimal brain development.

For serve and return, the parent or caregiver needs to look for communication efforts from the child and provide an appropriate response back. If the parent tickles the baby and the baby wiggles, the parent then recognizes that the wiggle is a communication attempt for “more.” The parent can respond with, “You want more tickles? More tickles!” and repeat the desired action. This does not seem hard because it is natural and involves very intrinsic interactions with the child.

Parents can impact outcomes

Teaching parents about the significance of natural interactions through serve and return and to encourage these interactions is so important for brain architecture. Serve and return builds language centers in the brain and resilience, and changes the child’s gene expression to promote better outcomes. Using serve and return helps parents and professionals to become brain architects and impact outcomes.

Serve and return is natural to do and research keeps proving that it may be the most important tool in our arsenal when promoting language development and healthy brains.

References:

National Scientific Council on the developing Child (2004). Young Children Develop in an Environment of Relationships:Working Paper No. 1. Retrieved from www.developingchild.harvard.edu.

Romeo, R et al. (2018). Beyond the 30-Million Word Gap: Children’s Conversational Exposure is Associated with Language-Related Brain Function. Psychological Science, 29(5): 700-710.

 

If you would like to learn how Roger technology increases a young child’s access to words and conversations, we invite you to read a previous blog post, Millions of words to build a child’s growing brain.

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