From risk to resilience in human brain development:

A framework for planning early childhood interventions

Courtney Stevens, PhD
Brain Development Laboratory
University of Oregon &
Sarah Lawrence College

World Bank
May 2008
 Broad Framework
1.! Some neural systems and subsystems are highly
modifiable (neuroplastic), with the potential for either
enhancement or vulnerability.

2.! The most plastic neural systems are also vulnerable

among individuals from lower socioeconomic
backgrounds.

3.! Early environmental enrichment in the form of

interventions can protect and enhance the plastic and
thus potentially vulnerable neurocognitive systems in
children with, or at risk for, developmental deficits.

Neville, H., & Bavelier, D. (2000), Specificity and Plasticity in Neurocognitive Development in
Humans, in The New Cognitive Neurosciences
Stevens, C., & Neville, H. (2006). Journal of Cognitive Neuroscience
A Human Brain
Human Brain Development
Conel (1939~1963)

Birth! 6 years! 14 years"

Old!
 Synapse Development
Human Brain

Adapted from P. Huttenlocher et. al. (1979-1997)

 Specialized Adult Brain
Motor
control!

Language!

Hearing!
Emotions! Vision!
Social skills!
Faces!

Approaches to studying brain plasticity

Retrospective studies: adults with different sensory or language experience
Prospective studies: Children of different ages
 MRI Images

Structure Function Connectivity

Event-related Brain Potentials (ERPs)
 Different Profiles of Plasticity

1.!Constrained
2.!Modifiable by and dependent on
experience during particular time
periods (multiple)
3. Modifiable throughout life
 Western Society
Socio-economic status (SES) gradients
CUBA

High
SWE
NL,G
Language
Literacy
Numeracy CAN
GB
NZ
Health NI

Longevity US
IRE

Low

Low High
SES
(parents’ education and occupation)
 Vulnerability of Syntax:
Adults with lower language proficiency

Pakulak E, Harris AM, Yamada Y, Coch D, Schachter J & Neville H (2002)

Cognitive Neuroscience Society
 Vulnerability of Syntax:
Adults from lower SES backgrounds

Pakulak E, Harris AM, Yamada Y, Coch D, Schachter J & Neville H (2002)

Cognitive Neuroscience Society
 Attention in typically developing children

ba! buzz! buzz ! buzz! ba! buzz!

Story 1unattended
Harry the! Dog! Blue Kangaroo!
Story 2 attended!

ERP to probes in Blue Kangaroo story!

Attend Blue Kangaroo Story!

Attend Harry the Dog Story!

Sanders, L., Stevens, C., Coch, D., & Neville, H. (2006). Neuropsychologia
 Attention vulnerability:
Children from lower SES backgrounds

High
SES*

Low
SES*

Mean amplitude, 100-200 msec (in microvolts)

4

3.5

2.5

High SES
2
Low SES

1.5

Difficulty suppressing response 1

to unattended stimuli. 0.5

0
Attended Unattended

Stevens, C., Lauinger, L., & Neville, H. (In press). Developmental Science
 Unpacking SES

Prenatal care Cortisol

Nutrition Perception of inequality
Depression Parental Attitudes/
Nurturance/neglect education
$ Social support
SCHOOLS! Books
 Differences in Amount of Language
from Parent to Child

talkative

moderately
talkative

not
talkative

Hart B & Risley T (1995) Meaningful Differences in the Everyday Experience

of Young American Children
 Differences in Growth of Child Language

children
talkative families

children
moderately
talkative families

children
families
not talkative

Hart B & Risley T (1995) Meaningful Differences in the Everyday Experience

of Young American Children
Sorting Out Genes and Environment
Correlation ! Causation
 Specific Language Impairment (SLI)
Attention only modulated early sensorineural processing in the TD group
(group x attn, P < .005; see figure)
SLI TD

P > .4

Stevens, Sanders, & Neville (2006). Brain Research

Stevens C, Fanning J, Coch, D., Sanders L & Neville H (2008) Brain Research
Building an intervention framework
•! Using neuroimaging techniques, we observe
differences in brain function among children and
adults from different socioeconomic
backgrounds
•! However, vulnerable neural systems can also be
enhanced
Neville, H. & Lawson, D. (1987). Brain Research
Roder, B.,Teder-Salejarvi, W., Sterr, A., Rosler, F., Hillyard, S., & Neville, H. (2001). Nature
Stevens, C., Fanning, J., Coch, D., Sanders, L., Neville, H. (2008). Brain Research

•! Could an early intervention serve to buffer and

protect these vulnerable neural systems?
Intervention Overview:
Collaborations with Head Start
•! All children living at or below
the poverty level
•! Participating families
randomly assigned to a
control group or one of
several training programs
•! Over 100 participants to
date

Today’s focus: Parent training model

 Parent Training
•! Identified known risk factors for children
–! Stress
–! Language
–! Behavioral control/ emotional regulation

•! Identified evidence-based strategies / approaches

for targeting each domain
Reduce child stress: Patterson et al., 1975; Deater-Deckard, 2005; Kazden & Whitley, 2003
Enhance language: Bruner, 1983; Maccoby & Martin, 1983; Hart & Risley, 1995
Support behavioral control / emotional regulation: Patterson et al., 1973, 1982

•! Examined literature for existing programs using

these strategies / approaches
Success in Parenting: Fischer et al, 1997
INteREActive Language training program (INREAL): Weiss et al, 1981

Fanning, J., Sundborg, S., Neville, H. (2007). Cognitive Neuroscience Society

Fanning, J. (2007). Doctoral dissertation, University of Oregon.
 Parent Training
Adapted elements of existing programs to target
parents of typically developing preschool children.

!!Eight weekly, 2 hour sessions

Reduce family !!Food, childcare, transportation, and

stress prizes provided as attendance and
participation incentives

Enhance Promote
language & pro-social
cognitive behavior & self-
development regulation

Fanning, J., Sundborg, S., Neville, H. (2007). Cognitive Neuroscience Society

Fanning, J. (2007). Doctoral dissertation, University of Oregon.
Parent Training: Key Components

•! Provide high levels of positive reinforcement and

specific praise
•! Use consistent discipline with clear expectations
& natural consequences
•! Use language differently to encourage high-
quality interactions
•! Provide frequent opportunities for the children to
Choose, Think, Solve Problems

Fanning, J., Sundborg, S., Neville, H. (2007). Cognitive Neuroscience Society

Fanning, J. (2007). Doctoral dissertation, University of Oregon.
 Hypothesis
Training parents in these strategies will change
their parenting behaviors and stress levels.

These parenting changes will have a “trickle down”

effect on children such that children’s increased
emotional regulation & decreased stress " will
lead to improved cognition, language, & brain
organization

Fanning, J., Sundborg, S., Neville, H. (2007). Cognitive Neuroscience Society

Fanning, J. (2007). Doctoral dissertation, University of Oregon.
Participants
•! 28 children, randomly assigned
–! 14 children’s parents receive training
–! 14 children in control group

•! No differences between groups in:

–! Children’s age, gender, receptive language, or nonverbal
intelligence
–! Parents’ age, marital/partnered status, or education level
–! Family’s socioeconomic background

Fanning, J., Sundborg, S., Neville, H. (2007). Cognitive Neuroscience Society

Fanning, J. (2007). Doctoral dissertation, University of Oregon.
•! Primary caregiver’s language use and interaction
behaviors during 10-minute free-play with child
(SALT-8 transcription)
•! Primary caregiver’s self-reported parenting stress levels
(Parent Daily Report)
•! Child’s language and cognition (standardized
assessments)

All testers/raters blind to intervention condition

Fanning, J., Sundborg, S., Neville, H. (2007). Cognitive Neuroscience Society

Fanning, J. (2007). Doctoral dissertation, University of Oregon.
 Changes in Parent Interaction Behaviors
100 Parent InteractionParent Interaction
BehaviorsParent Behaviors (SALT-8)
(SALT-8)Interaction Behaviors (SALT-8)
0 100
90 *
0 90 *
0 80 80
*
Percentage Occurence

70
Percentage Occurence

0 70
0 60 60
0 50 50
0 40 40 *
0 30 30
20
*
0 20
0 10 10
0 0 0
Bal. Trn. Bal.
Bal. Trn. Trn. Bal. Bal. Trn.
Ch.Trn.
Dir. Bal. Ch. Dir.
Ch.Trn.
Dir. Ch. Dir.
Ch. Dir.
Lang. Mod. Lang.
Mod.Mod.
Ch. Dir.
Lang. Lang. Mod.
Lang. Mod. Lang. Mod.
TX CTL TX TX CTL
TX CTL TX
CTL TX CTL
TX CTL TX
CTL TX CTL CTL

Balanced Turn Taking Language Modeling

Direction: Optimal
Therapeutic Gain

Fanning, J., Sundborg, S., Neville, H. (2007). Cognitive Neuroscience Society

Fanning, J. (2007). Doctoral dissertation, University of Oregon.
 Changes in Parent Stress

*
*

Perceived Stress
Direction: Optimal
Therapeutic Gain

Fanning, J., Sundborg, S., Neville, H. (2007). Cognitive Neuroscience Society

Fanning, J. (2007). Doctoral dissertation, University of Oregon.
 Changes in Child Conduct Problems

*
*

Conduct Problems
Direction: Optimal
Therapeutic Gain

Fanning, J., Sundborg, S., Neville, H. (2007). Cognitive Neuroscience Society

Fanning, J. (2007). Doctoral dissertation, University of Oregon.
 Changes in Child Language

*
*

Receptive Language
Direction: Optimal
Therapeutic Gain

Fanning, J., Sundborg, S., Neville, H. (2007). Cognitive Neuroscience Society

Fanning, J. (2007). Doctoral dissertation, University of Oregon.
 Changes in Child Nonverbal IQ

*
*

Nonverbal IQ
Direction: Optimal
Therapeutic Gain

Fanning, J., Sundborg, S., Neville, H. (2007). Cognitive Neuroscience Society

Fanning, J. (2007). Doctoral dissertation, University of Oregon.
 Changes in Child Attention

*
*

Sustained Attention
Direction: Optimal
Therapeutic Gain

Fanning, J., Sundborg, S., Neville, H. (2007). Cognitive Neuroscience Society

Fanning, J. (2007). Doctoral dissertation, University of Oregon.
 Changes in Child Memory

*
*

Direction: Optimal
Associative Memory
Therapeutic Gain

Fanning, J., Sundborg, S., Neville, H. (2007). Cognitive Neuroscience Society

Fanning, J. (2007). Doctoral dissertation, University of Oregon.
•! Following short-term parent training,
#! Parents changed their behaviors
#! Parents reported reduced stress

#! Children’s language, cognition, and attention improved

•! Ongoing studies
#! Examining effects on electrophysiological measures of brain
organization
#! Following children longitudinally as they enter the K-12
school system
#! Replicating study with a larger sample

#! Contrasting parent-focused training with child-focused, pull-

out training during the school day
 Future Research

1. Determine time periods of plasticity of other brain systems.

2. Determine the mechanisms that confer plasticity.

3. Determine the interventions that can enhance plasticity.

**4. Convince the public and policy makers to be guided

by evidence from brain research.

5. Design and implement evidence-based educational and

support programs that optimize human development.
Research Associates Research Assistants Technical Staff
Ted Bell Olivia Bagdade Paul Compton
Jessica Fanning Mark Dow Linda Heidenreich
Christina Karns Scott Klein Ray Vukcevich
Courtney Stevens David Paulsen
Yoshiko Yamada

Graduate Students Collaborators

Annika Andersson Bavelier, Daphne (U of Rochester)
Jeff Currin Coch, Donna (Dartmouth)
Justin Hulbert Corina, David (UC Davis)
Eric Pakulak Mills, Debra (Emory University)
Stephanie Sundborg Roeder, Brigitte (U of Hamburg, Germany)
Sanders, Lisa (U Mass Amherst)
Funding: NIH, IES Weber-Fox, Chris (Purdue)