Portrait of UChicago Prof. Dana Suskind
Big Brains podcst

Why we need to invest in parents during a child's earliest years, with Dana Suskind (Ep. 91)

Book examines how better policies can bolster families and boost early childhood development

Portrait of UChicago Prof. Dana Suskind
Big Brains podcst

Show Notes

The United States is an outlier when it comes to parents. Compared to similar countries, the U.S. has the largest happiness gap between the 63 million parents and the child-free. This statistic is not shocking when you consider how other societies support parents with things like paid parental leave and high-quality child care.

In her new book, Parent Nation: Unlocking Every Child's Potential, Fulfilling Society's Promise, Prof. Dana Suskind of the University of Chicago makes the case for how America can—and should—improve societal support for parents during the early childhood period. 

Through her work as director of the Pediatric Cochlear Implant Program and co-director of the Thirty Million Words Initiative, Suskind has observed why the first three years of a child's life are the most crucial for their brain development. She argues that investing in early childhood by supporting parents—notably, paid parental and family leave—is not only beneficial for them, but it's also beneficial for our economy and society.

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(Episode published April 28, 2022)



Paul Rand: We all recognize this sound…

Tape: (Baby sounds)

Paul Rand: And we’ve probably heard something like this…

Tape: Sweet baby. Yes you are. And you’re getting so big.

Dana Suskind: People call it baby talk, but it really is building the brain. They are the brain architects.

Paul Rand: We all understand the importance of building the brains of the next generation. That’s why we fund public education from grades K-12. But what if the most important part of a child’s development is already over by that point?

Dana Suskind: We’ve got this huge disconnect between what we know children need to thrive and reach their potentials and what we do.

Paul Rand: That’s Dana Suskind, a pediatric surgeon and professor at the University of Chicago, where she also directs the Pediatric Cochlear Implant Program.

Dana Suskind: Look, the first three years of life are just the most rapid and critical periods of growth for brain development. There will be never a more effective time to establish the foundations for thinking and learning. And the science is there. It is so robust.

Paul Rand: If you’ve ever wondered, why decades of effort to move the needle on educational outcomes and equity haven’t seem to work, this could be it.

Dana Suskind: For generations, we’ve had this disconnect between our public attention and sort of investment, which really has focused on education being in the K-12 space. It means that we’ve skipped over those first three years of life, which are the foundations for all of our thinking and learning. So that’s where the disconnect is.

Paul Rand: You’ve probably heard Dana Suskind’s name before. Her bestselling book about the importance of early language exposure, Thirty Million Words, became an international phenomenon. Now she’s out with a new book.

Dana Suskind: It’s called Parent Nation, and it asks the question: How can we use the neuroscience to understand how to give every child the best chance at reaching their potentials? The big difference is my first book really looked at it from the individual level at what can each parent, caregiver do to give their child the best opportunity to thrive. This really expands it and says, well, what does the neuroscience say for a country or a society to give every child a chance to thrive? What does that look like?

Paul Rand: From the University of Chicago Podcast Network, this is Big Brains, a podcast about the pioneering research and the pivotal breakthroughs that are reshaping our world. On this episode, using neuroscience to improve early childhood development and how to support parents along the way. I’m your host, Paul Rand.

Paul Rand: It can be tempting to think of the earliest part of a baby’s life as a waiting period until they’re old enough to really start learning. But we’ve discovered that couldn’t be further from the truth.

Dana Suskind: When you think about the educational continuum, we all think pre-K to 12, right? But if we’re going to really align our society with the brain science, that learning doesn’t start on the first day of school, but the first day of life, you’ve got to really focus on those early years.

Paul Rand: But why are these first three years so much more important? Decades of neuroscience and behavioral development research have given us a clearer picture of what’s going on in a baby’s brain during this time.

Dana Suskind: 85% of the physical growth happening, you just don’t see it. They all look like cuddly, sweet kids.

Paul Rand: Every one of those little brains is born with billions of neurons. At this point, neuroplasticity is at its highest.

Dana Suskind: And neuroplasticity is really its capacity to change with experience, really to rewire itself based on the experience and sort of the instructions that the environment is giving in those first few years of life. And during those early years, neuroplasticity is at its greatest.

Paul Rand: And very quickly in a baby’s first years, those neurons start communicating with each other and making new connections.

Dana Suskind: These neural connections that are happening, it’s million every second.

Paul Rand: Each of those million connections comes from a new piece of information, a smell, a touch, a sound. When neurons start to connect regularly, they form a routine. And just like with anything else, the routines we form determine much about who we are.

Dana Suskind: Because babies come out absolutely helpless and waiting for this input, the brain development is absolutely dependent on that nurturing interaction from parent, caregiver, early child care provider, any adult in the world.

Paul Rand: And one of the interactions, these neurons form the most routines around is language.

Dana Suskind: If you’re born into a world without a lot of language input and vocabulary, those neural connections won’t be as strengthened as if you were born into an environment with a lot of language.

Paul Rand: In Suskind’s first book, Thirty Million Words, she demonstrated that the more words a baby is exposed to before age three, the more routines the brain will form and their likelihood of educational success increases.

Dana Suskind: And it’s not just words, right? It’s just not the number of words or the quality of words. It’s that serve and return, sort of the conversation between adult and child building those strong neural connections.

Paul Rand: Is that what you call the feedback loop? Is that how you reference that?

Dana Suskind: Yeah. Well, the feedback loop researchers like at Princeton have been able to show that their neural synchronization between adult and child occurs actually during this interaction. It’s almost like a mind meld, if you will. And it’s really very powerful.

Paul Rand: But why is it so crucial that these interactions happen before three years old? What happens at that exact age that makes forming these connections at say age four or five more difficult?

Dana Suskind: At some point the brain has to sort of go through this ruthless sort of process of elimination of connections that aren’t used.

Paul Rand: Think of a baby’s brain like a plant. By removing any buds, branches, or roots that haven’t formed strong routines, brains are able to grow bigger. It’s called pruning. And it happens at exactly three years old.

Dana Suskind: The pruning really allows our brains to remain efficient. Because if you had just a whole tangle of neural connections that weren’t being used, it wouldn’t be very efficient. So that pruning during that period of time starts removing unnecessary circuits if they were. And those circuits that are used are going to be more strengthened.

Paul Rand: Which means the connections that get strengthen before the pruning are crucial for lifelong outcomes and not all connections are good either. A brain could end up pruning unused connections that we would’ve wanted to strengthen while also strengthening connections that we’d prefer to have pruned.

Dana Suskind: And during those early years, neuroplasticity is at its greatest, right? I mean, that’s why you can so easily learn three languages as opposed to later on. It’s much, much more difficult, right? But it’s also great risk. While the brain is accepting all this information to tell it how to wire and all this neuroplasticity, if you don’t get the inputs that you need and want for let’s say educational trajectories, that brain won’t wire as if it’s going to be expecting a lot of language or interaction. If a child’s brain is exposed to stress and toxic stress, that brain is going to wire, assuming that the environment is always going to be like that. So I really want to emphasize that neuroplasticity is the greatest trick if you will, but it places us at risk, is why we need to be very careful in those first few years of life.

Paul Rand: And this Suskind says is exactly what we’re missing. We’re trying to rewire brains in grades K-12, when the best period for rewiring brains is already over. And the results are obvious. America lags behind much of the developed world in educational outcomes.

Dana Suskind: Yeah, I wrote the first book. I co-direct the TMW Center with John List, working with families across the Chicagoland and across the country and seeing how you can develop these great interventions, help parents understand the power that they have to build their child’s brain. And what I would see over and over again is how societal structures got in the way over and over again, despite how much parents wanted.

Paul Rand: In Suskind’s new book, Parent Nation, she’s making a case for why this support our society does or doesn’t give to parents during this early childhood period is the source of the problems and the possibilities of our future generations.

Dana Suskind: The way I think about it is what do children need for healthy brain development in the first three years of life? It is not rocket science, right? They need time and enrichment with their parents. They need that nurturing interaction that we talk about, the serve and return that build those connections and they need protection from toxic stress. They need calm environments to allow that brain development to flourish. And parents need exactly the same thing. So when we think about what society can better do to support parents, you use that same sort of framework if you will.

Paul Rand: With more than 60 million parents in the United States, Suskind is proposing what could happen if they organized into a political coalition.

Dana Suskind: I really believe that the greatest potential for shifting what we see in this country is through this unified voice. The middle of the last century, the poorest segment of the population wasn’t as it is today, children of the poorest segment of the population, children between zero and five and the poorest segment of the population. Back then, it was the elderly. Over 50%, according to a government report, lived in poverty below the minimum levels of decency and through the AARP and of bringing together of their voice fast forward today, no age demographic is better supported. Through the power of the Medicare and social security, right, we have decreased the poverty rate in the elderly by 70%, 70%.

Dana Suskind: And let me tell you. You could say, well, children don’t vote. Yeah, I get it. Children don’t vote, but they have parents and caregivers and all of us that care about them and care about ourselves that could come together, pushing forward what almost everyone wants in this country, a country that really puts children and families at the center. So I actually believe that this type of AARP sort of model could be transformational in this country.

Paul Rand: What a parent nation could look like … after the break.

Paul Rand: Big Brains is supported by the University of Chicago Graham School. Are you a lifelong learner with an insatiable curiosity? Join us at Graham and access more than 50 open enrollment courses every quarter in literature, history, religion, science, and more. We open the doors of UChicago to learners everywhere. Expand your mind and advance your leadership. Online and in person offerings are available. Learn more at graham.uchicago.edu/bigbrains.

Paul Rand: If our society is going to shift its energy toward early childhood development, it’s going to have to focus on the people in the room during that time, parents. And Suskind thinks that the shift is going to have to start with more education.

Dana Suskind: What system do we have that reaches almost all parents and all children? Health care. Pediatric health care providers can provide the important knowledge and information that all parents deserve about how important they are as the brain builders of the next population. I think for some reason, we sort of think that this knowledge is intuitive, that because we love and want the best for our children, that we know that different ways to build the brain comes with the instruction package that a child comes with, but kids don’t come with instruction packages. So I think that the health care system can provide the education for all people and all new parents, but really in a tiered approach where we give information to all parents, but some families need more supports and more connections to let’s say different what we call social determinants of health that impact the ability to parent. Is this family having issues with homelessness or mass incarceration? Having within the health care system providers that can help navigate parents to help stabilize their home life.

Dana Suskind: And really just reimagining this. The system is a team-based approach, because so often we think of health care as it’s the doctor and the nurse. Right. But it can be so much more, it can be sort of that holistic hug that families need as they go through those early years. I mean, I don’t know about you, but I remember when I first had my children, I was like, oh, and here I was a doctor. I was like, oh my gosh, I have to raise this little one. Even though I know so much, I felt like I knew nothing. And I think that the health care system can be that continuum.

Paul Rand: What do you see then about business and employers? Because some of these things, there’s a big burden that is going to have to be felt by all impacts of society and business and employers is going to be not insignificant in this mix. Are they?

Dana Suskind: I actually have great hope with business employers, not only because what’s going on right now with the lack of infrastructure and the imploding child care system, it’s impacting them, right? The great resignation of women leaving the workforce and the ability to retain and maintain talent has a huge economic impact. Not only do I think that this will be in their best interest, which I feel very strongly about, but I think that they can bring their sort of innovation and ingenuity to this area and help sort of create and be at the forefront of creating family friendly policies, because it makes sense both in the short run for short run returns, getting women back into the workforce, maintaining the talent, but also for the long run.

Paul Rand: And one of the policies that Suskind thinks would make the biggest impact is paid parental leave.

Dana Suskind: And let me tell you about Kimberly Monte. She’s a pediatrician, Harvard, Stanford-trained. She gave birth to a baby Penelope, prematurely at 27 weeks. Her little Penelope. Penelope stayed in the NICU for 109 days. And guess what? Her mother, a pediatrician wasn’t able to stay by her side because she didn’t have paid parental and family leave. Right. And for her to take off, she wouldn’t be able to afford all the other things that she needed to do. And so she had to leave her child in the NICU because she didn’t have paid leave. Here, a pediatrician, right? And so like one in four mothers who give birth in this country, she had to go back to work within two weeks despite having a 27-weeker in the NICU. So this is just one of many, many examples.

Paul Rand: Recent attempts to institute paid family leave have shown that it’s beneficial for businesses as well.

Dana Suskind: And it was actually California in 2004, who did the first mandated paid leave. And they’ve basically shown worker retention was greatly improved. Mothers who took the paid leave were more likely to come back less stressed, more productive. And there long, I mean, even in the family, I mean, fathers taking paid leave, which is really important, improves the bond with the child and actually improves if they’re married, the relationship. It actually decreases divorce.

Paul Rand: And recent studies have found that paid parental leave has direct benefits for babies too.

Dana Suskind: A really neat recent study by Natalie Brito, she did a really great job looking at mothers with paid leave and unpaid leave. And basically showed differences in the EEG profile of the babies who had mothers with paid leave a more mature pattern of activity. Obviously, you can never totally pin down, but she hypothesizes that it really was about decreasing the stress of the mother because she found decreased cortisol level in the hair. But paid leave doesn’t just help the economy and mothers stay in the workforce, et cetera, et cetera. It helps the early brain development of children.

Paul Rand: Well, the group that’s going to certainly be in a position to help make some of that happen, of course is going to be the government. And so I think as you look at the biggest group to help on these things, the government seems like it’s going to play a very likely oversized role.

Dana Suskind: Yeah. Well, I mean, I think that every group, every part of society is going to play a role, but certainly policies play a huge role.

Paul Rand: If you looked at, for example, you talked about Finland and what they were spending per child and other countries that are putting so much money and resources into this, what is it that they are doing or getting for that money? And then how does that set the stage for the recommendations that you’re thinking of for this country?

Dana Suskind: I love the example of Finland, because right now we think about Finland as riding high on the international tests for reading, etc. And obviously their population is doing very well, but it wasn’t always that way. Finland was not always a leader. And in fact, they didn’t invest in this in the way that they’re investing now. And by really transforming their education and especially the early years by providing paid leave, high-quality child care, the opportunity for parents to stay home, they’ve really transformed how their population is doing. Looking at child care, the average child care expenditure, Finland at $28,000 per year, but the average is about 14,000 per year. Guess how much we invest per child in this country per year? $500. Despite having the largest economy in the world, right? We spend 2.2% of our gross domestic product on children and families compared to like 0.7% of other nations.

Paul Rand: Well, and at least in academia, we hear about the concept of achievement gap, but you guys talk about this idea of an opportunity gap.

Dana Suskind: I think the term "opportunity gap" really more accurately describes what’s going on in this country—and really around the world. It’s more that it’s a systemic problem, not a kid problem. And I think when you say achievement gap, that’s what you think of. When you say opportunity gap, it more clearly shows it’s the lack of opportunity that we can change for these kids, for all kids. What will that include? That’ll be seen. I’m hoping that it includes paid parental and family leave, high-quality child care, child allowances, which shows huge returns on investment.

Paul Rand: And we saw a glimmer of how effective child allowances could be during the pandemic. In 2021, for the first time the U.S. expanded the child tax credit. The credit reached more than 61 million kids and lifted around three million kids out of poverty. But when Congress let it expire last December, those kids fell back into poverty.

Dana Suskind: As you mentioned, we’re losing a huge return on investment because while the price tag may seem high, not only are the returns on investments significant, we’re going to pay in the long term.

Paul Rand: Not investing in early childhood is estimated to cost are country billions. So why is the United States so far behind in making these investments to make parenting easier? And what implications is this having today? Well, you’ve seen the headlines.

Dana Suskind: Our birth rate has plummeted, and we are far below replacement. So we’re not regenerating our population. So as our society shrinks, so will our economy. And to be able to even address some of that, we’re going to have to reframe the policies in our country so that we actually look like we care about children and families. Most of us end up being parents. And if not, we all love a child. And I think there really is a lot of good data showing that it is a bipartisan. Most, oh, at 84% of people believe that we should have paid parental and family leave, that one in four parents shouldn’t have to go back to work two weeks after giving birth. I mean, we agree on it. We just haven’t brought our voices together yet. Right now we look at parents having children as sort of like getting a puppy, it’s all on you and rather than seeing it as someone who is investing for the future of our country.

Paul Rand: Yes, exactly. That we look at it as having a puppy is pretty, I think you’re not far off.

Dana Suskind: Right. And well because why are we in this place is a really interesting question as opposed to so many other countries. I mean, almost any other country gets that investing in parents and children is good for society and the bottom line. But in this country, we sort of push forward this idea that well, American individualism, which has meant that we need to be tough and independent and go it alone has seeped into this idea of being a parent. And that raising a human being means, look, there’s only one parent. I’m not talking about anybody else doing the job of parenting, but that we should do it without any support.

Dana Suskind: It’s sort of like me going into the operating room and saying, OK, I’m the surgeon. I’m the only one who does the surgery. Therefore, I’m not going to have any anesthesiologist, circulating nurses or infrastructure. So I have the supports that I need to get the job done. In that same way parents are asked for the same thing and parents in some ways have internalized this idea, especially mothers. One story Thalia, from the book who actually, she was a postdoc here, brilliant postdoc, who because of having two children and the cost of child care, had to leave her really wonderful postdoc because she said in her own words, “I felt like I was failing in all parts of my life.”

Dana Suskind: Parents in this country are stressed. I mean, there is so much data out there. Jennifer Glass and her colleagues looked at this thing called the “parent happiness gap” across many countries. And in general, parents are less happy than non-parents, because it’s hard to raise kids, but she looked at the parent happiness gap and societal structures, how family friendly the societies were.

Dana Suskind: And you can imagine in societies where they had more societal supports, paid leave, high quality child care, child credits, parents were much happier. That gap was much tinier. Where do you think the largest parent happiness gap was? Our country. We’re resulting in one of the greatest joys becoming so, so difficult. And we will always love our children, but people make impossible choices. That’s where the great resignation is coming from. How can you ask a mother? Who’s going to... I’ve had to talk to parents who have had to leave their children at home, right, to go to a work that has inflexibility and then gets in trouble for it, like seriously. I know we are a great nation and our people want better. We just need to come together and say it loudly.

Paul Rand: If you’re getting a lot out of the important research that’s shared on Big Brains, there’s another University of Chicago Podcasts Network show that you should check out. It’s called Capitalisn’t. Capitalisn’t uses the latest economic thinking to zero in on the ways that capitalism is and more often isn’t working today. From the debate over how to distribute a vaccine to the morality of a wealth tax, Capitalisn’t clearly explains how capitalism can go wrong and what we can do about it. Listen to Capitalisn’t, part of the University of Chicago Podcast Network.

Matt Hodapp: Big Brains is a production of the University of Chicago Podcast Network. If you like what you heard, please leave us a rating and review. The show is hosted by Paul M. Rand and produced by me, Matt Hodapp and Lea Ceasrine. Thanks for listening.

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