{"product_id":"thirty-million-words-isbn-9780525954873","title":"Thirty Million Words","description":"\u003cb\u003eThe founder and director of the Thirty Million Words Initiative, Professor Dana Suskind, explains why the most important—and astoundingly simple—thing you can do for your child’s future success in life is to to talk to them.\u003cbr\u003e\u003cbr\u003e\u003c\/b\u003e\u003ci\u003eWhat nurtures the brain to optimum intelligence and stability?\u003cbr\u003e\u003cbr\u003e\u003c\/i\u003eIt is a secret hiding in plain sight: the most important thing we can do for our children is to have conversations with them. The way you talk with your growing child literally builds his or her brain. Parent talk can drastically improve school readiness and lifelong learning in everything from math to art. Indeed, parent–child talk is a fundamental, critical factor in building grit, self-control, leadership skills, and generosity. It is crucial to making the most in life of the luck you have with your genes.\u003cbr\u003e\u003cbr\u003eThis landmark account of a new scientific perspective describes what works and what doesn't (baby talk is fine; relentless correction isn't). Discover how to create the best \"language environments\" for children by following the simple structure of the Three Ts: Tune In; Talk More; Take Turns. Dr. Suskind and her colleagues around the country have worked with thousands of families; now their insights and successful, measured approaches are available to all.\u003cbr\u003e\u003cbr\u003eThis is the first book to reveal how and why the first step in nurturing successful lives is talking to children in ways that build their brains. Your family—and our nation—need to know.\u003cbr\u003e\u003cbr\u003e\u003cb\u003e*Nominated for the Books for a Better Life Award*\u003c\/b\u003e | \u003cb\u003ePraise for \u003ci\u003eThirty Million Words\u003c\/i\u003e\u003c\/b\u003e\u003cbr\u003e\u003cbr\u003e“[Suskind has] written a book that gives parents the tools they need to maximize their children’s potential, one word at a time.”—\u003ci\u003ePregnancy and Newborn\u003c\/i\u003e\u003cbr\u003e\u003cbr\u003e“Parents, other caregivers, and early childhood educators will be moved and inspired by this work.”—\u003ci\u003eLibrary Journal\u003c\/i\u003e, starred review\u003cbr\u003e\u003cbr\u003e“Suskind's vision is empowering, her methods are surprisingly simple to execute, and the results have been proven to nurture children toward becoming stable, empathetic adults. Informative, exciting new data that confirms the significant benefits gained by talking to your child.”—\u003ci\u003eKirkus Reviews\u003c\/i\u003e\u003cbr\u003e  \u003cbr\u003e  “Dr. Dana Suskind has written a passionate, engaging and informed account of the importance of early exposure to language in child development. It is a valuable 'call to words' for parents, educators, and anyone invested in the success and well-being of children.”—James Heckman, University of Chicago, Nobel Laureate\u003cbr\u003e  \u003cbr\u003e “Dr. Dana Suskind is a one-person change agent. In this beautifully written book, she infuses the wisdom of a physician with the heart of a mother. Parents, policy makers and educators, this book is for you. It is informative, compassionate and a call to action designed to enrich our greatest natural resource, our children.”—Kathy Hirsh-Pasek, Temple University, author of \u003ci\u003eEinstein Never Used Flashcards\u003c\/i\u003e\u003cbr\u003e\u003cbr\u003eCan a surgeon help solve poverty and improve equality of opportunity? Dr. Dana Suskind has a simple but effective strategy: more talking, with more complex words directed at children from zero to three mainly by parents.  Her lucid book will persude you that talk and more talk directed at the developing brains of infants and toddlers can drastically improve our country. Read it and try it.”—Ezekiel Emanuel, author of \u003ci\u003eHealthcare, Guaranteed\u003c\/i\u003e\u003cbr\u003e\u003cbr\u003e  “Dr. Suskind weaves science and her journey from surgeon to champion for children showing the profound power of words spoken to infants. Anyone who cares about children will benefit from learning how much language shapes our very existence from the earliest age.”—Patricia K. Kuhl, University of Washington, co-author of \u003ci\u003eThe Scientist in the Crib\u003c\/i\u003e\u003cbr\u003e  \u003cbr\u003e \u003ci\u003e“Thirty Million Words\u003c\/i\u003e tells the story of a remarkable woman’s unrelenting mission to give every child the chance to thrive. Dana Suskind’s work as a pediatric surgeon with the deaf helped her to understand the amazing power that words have on a child’s development. She offers a simple but profound understanding of how language affects the brain and provides insights into how to create a rich language environment so your child can soar. Every page overflows with warmth and intelligence—share it and become part of something amazing.”—Steven D. Levitt, University of Chicago, coauthor of \u003ci\u003eFreakonomics\u003c\/i\u003e\u003cbr\u003e  \u003cbr\u003e “This is a page-turner tale of birth and transformation—the birth of a medical miracle and the transformation of a compassionate surgeon. Dr. Suskind recounts her journey with humor and humility. Her remarkably intimate voice opens up a fresh path alongside those of physician writers Oliver Sacks, Atul Gawande, and Paul Farmer. It will enthrall any reader who is exhilarated by human possibility and inspire the next generation of physicians.”—Dr. Joshua Sparrow, Harvard Medical School, Children’s Hospital Boston\u003cbr\u003e  \u003cbr\u003e “How empowering, the realization that each of us can be our children's personal neuro-developer, that the sheer quality of our interactions can impact the attitude of inquiry and health of our kids.  The practical application of Dr. Suskind's work is limitless; as a dad, and as (a “gritty”) someone invested in early child development, I’m excited to see how far it takes us.”—Steve Nash, President, the Steve Nash Foundation and two-time National Basketball Association MVP\u003cbr\u003e  \u003cbr\u003e“As a pediatrician, I want everyone to read this wonderful book--to understand how health and learning fit seamlessly together as young children develop, and to appreciate the neurological wonder and the social urgency of using language and love to nourish the brains of babies and children everywhere.”—Perri Klass, author of \u003ci\u003eQuirky Kids \u003c\/i\u003eand National Medical Director of Reach Out and Read\u003cbr\u003e\u003cbr\u003e “I thank Dana Suskind for opening doors to solutions and hope. The answer to the growing problem of social inequalities in our country is to make use of America’s top two resources: its children and their parents. If we care about this country, and the children who will live in it as adults, we have to make Dr. Suskind’s advice become reality.”—Sandra Gutierrez, Founder and National Director of Abriendo Puertas \/ Opening Doors\u003cbr\u003e  \u003cbr\u003e “Grounded upon experience as a cochlear implant surgeon, informed by compelling social science research, and inspired by a profound commitment to children and families, this book helps all of us understand the importance of communicating abundantly, pleasantly, and responsively with infants and toddlers. Tell everyone you know to read it! Together, we can enrich language environments for generations to come, in all types of homes and communities. The book is a gem!”—Ronald F. Ferguson, Faculty Director, the Achievement Gap Initiative, Harvard University\u003cbr\u003e  \u003cbr\u003e “Straight from the front lines Dr. Dana Suskind tells the story of the power of talk in helping children learn. Easy to read and with striking insights on every page, this book will not only make you think differently about how you parent, but will give you the tools to help your child be at his or her best.”—Sian Beilock, University of Chicago, author of \u003ci\u003eChoke\u003c\/i\u003e and \u003ci\u003eHow the Body Knows its Mind\u003c\/i\u003e\u003cbr\u003e  \u003cbr\u003e “Suskind writes with clarity and authority to explain why parents need to talk to their infant children, and why some forms of communication are better than others. Thirty Million Words belongs on the shortlist of books that every parent, teacher, and education policymaker should read.”—Adam Alter, New York University, author of \u003ci\u003eDrunk Tank Pink\u003c\/i\u003e\u003cbr\u003e  \u003cbr\u003e  “Anyone who cares about children, anyone who cares about the future of this country, should read this book.”—Barbara Bowman, Irving B. Harris Professor, Erikson Institute\u003cbr\u003e  \u003cbr\u003e “A passionate, personal account of the power all parents have to raise thriving, successful children.”—Diana Mendley Rauner, President, Ounce of Prevention Fund\u003cbr\u003e  \u003cbr\u003e “Prepare for a revolution. This book will make you cry, laugh, and deeply reflect on what we should be doing to give everyone a chance to succeed in life. As a scholar I was in awe, as a teacher I was dazzled, and as a father I was thankful to the authors of this book. When you pick it up, have a few hours to spare because you will not put it down.  Unequivocal 5 star.”—John A. List, University of Chicago, author of \u003ci\u003eThe Why Axis\u003c\/i\u003e\u003cbr\u003e  \u003cbr\u003e “Dana Suskind hails others as heroes but she is the true hero! She stepped out of the safe harbor of her role as a pediatric cochlear implant surgeon when she realized that helping deaf children hear was not enough to help them learn language. She takes us on her compelling and page-turning journey, navigating the best research on children’s early learning, always sharing sound and extremely helpful examples of what we all must do to help children learn language and much more, always in joyful and loving ways.”—Ellen Galinsky, President, Families and Work Institute, author of \u003ci\u003eMind in the Making\u003c\/i\u003e\u003cbr\u003e  \u003cbr\u003e “Dr. Suskind’s work reveals that the greatest gift we can give our children is free. How empowering to understand that it doesn’t take money to give our children advantages in the world, it takes words. Her research is vital, and it is our responsibility to make sure Suskind’s message reaches the masses.”—Chris Nee, Creator and Executive Producer, Doc McStuffins\u003cbr\u003e\u003cbr\u003e“Dr. Suskind’s work is empowering—illuminating that every parent already has what it takes to give their child the best start in life: their words. This account tells the amazing impact of language development on the young child’s developing brain, and provides valuable insight on how we, as parents, educators, and caregivers can create a profound difference in our children’s lives through the simple act of talking with them.  Chicago Children’s Museum has long created rich environments that naturally inspire talk—and we are thrilled that Dr. Suskind’s research provides new evidence of the deep importance and positive effects of these early interactions.”—Jennifer Farrington, President and CEO of Chicago Children’s Museum and Board President of the Association of Children’s Museums\u003cbr\u003e\u003cbr\u003e “Three cheers for the promise of parents, prevention and neuroplasticity!”—Dr. T. Berry Brazelton, Harvard Medical School\u003cbr\u003e  \u003cbr\u003e“Captivating!   Great examples and an easy read but full of scientific information. Can we   make this required reading for couples prior to conception?”—Roberta Golinkoff, University of Delaware, author of \u003ci\u003eHow Babies Talk\u003cbr\u003e\u003c\/i\u003e | \u003cb\u003eProfessor Dana Suskind, MD\u003c\/b\u003e, is both founder and director of the Thirty Million Words Initiative, which is based on scientific research that demonstrates the critical importance of early language exposure on the developing child. Dr. Suskind received the University of Chicago Medical Faculty Award as “Distinguished Leader in Program Innovation.” She is an advisor on The Clinton Foundation’s Too Small to Fail Initiative and part of the White House initiative on creating a pathway to ending the achievement gap. She lives in Chicago, Illinois.\u003cbr\u003e\u003cbr\u003e\u003cb\u003eBeth Suskind\u003c\/b\u003e is codirector of the Thirty Million Words Initiative and is integral to translating the complexities of the science behind their research into a curriculum. She lives in Chicago, Illinois.\u003cbr\u003e\u003cbr\u003e\u003cb\u003eLeslie Lewinter-Suskind\u003c\/b\u003e, BS, MSS, MFA, former Director of International Program, Psychiatry and Pediatrics, LSU Medical School in New Orleans, provided invaluable assistance in the writing of \u003ci\u003eThirty Million Words. \u003c\/i\u003eShe lives in southern California.      | \u003cp\u003e\u003c\/p\u003e\u003cp\u003ePRAISE FOR \u003ci\u003eTHIRTY MILLION WORDS\u003c\/i\u003e\u003c\/p\u003e\u003cp\u003e“Suskind’s vision is empowering, her methods are surprisingly simple to execute, and the results have been proven to nurture children toward becoming stable, empathetic adults. Informative, exciting new data that confirms the significant benefits gained by talking to your child.”\u003c\/p\u003e\u003cp\u003e—\u003ci\u003eKirkus Reviews\u003c\/i\u003e\u003c\/p\u003e\u003cp\u003e“How empowering the realization that each of us can be our children’s personal neuro-developer, that the sheer quality of our interactions can impact the attitude of inquiry and health of our kids. The practical application of Dr. Suskind’s work is limitless; as a dad, and as (a ‘gritty’) someone invested in early child development, I’m excited to see how far it takes us.”\u003c\/p\u003e\u003cp\u003e—Steve Nash, president of the Steve Nash Foundation and two-time National Basketball Association MVP\u003c\/p\u003e\u003cp\u003e“I thank Dana Suskind for opening doors to solutions and hope. The answer to the growing problem of social inequalities in our country is to make use of America’s top two resources: its children and their parents. If we care about this country and the children who will live in it as adults, we have to make Dr. Suskind’s advice become reality.”\u003c\/p\u003e\u003cp\u003e—Sandra Gutierrez, founder and national director of Abriendo Puertas\/Opening Doors\u003c\/p\u003e\u003cp\u003e“Grounded upon experience as a cochlear implant surgeon, informed by compelling social science research, and inspired by a profound commitment to children and families, this book helps all of us understand the importance of communicating abundantly, pleasantly, and responsively with infants and toddlers. Tell everyone you know to read it! Together, we can enrich language environments for generations to come, in all types of homes and communities. The book is a gem!”\u003c\/p\u003e\u003cp\u003e—Ronald F. Ferguson, faculty director at the Achievement Gap Initiative at Harvard University\u003c\/p\u003e\u003cp\u003e“Straight from the front lines Dr. Dana Suskind tells the story of the power of talk in helping children learn. Easy to read and with striking insights on every page, this book will not only make you think differently about how you parent but will give you the tools to help your child be at his or her best.”\u003c\/p\u003e\u003cp\u003e—Sian Beilock, professor at the University of Chicago and author of \u003ci\u003eChoke\u003c\/i\u003e and \u003ci\u003eHow the Body Knows Its Mind\u003c\/i\u003e\u003c\/p\u003e\u003cp\u003e“Suskind writes with clarity and authority to explain why parents need to talk to their infant children, and why some forms of communication are better than others. \u003ci\u003eThirty Million Words\u003c\/i\u003e belongs on the shortlist of books that every parent, teacher, and education policy maker should read.”\u003c\/p\u003e\u003cp\u003e—Adam Alter, associate professor at New York University and author of \u003ci\u003eDrunk Tank Pink\u003c\/i\u003e\u003c\/p\u003e\u003cp\u003e“Anyone who cares about children, anyone who cares about the future of this country, should read this book.”\u003c\/p\u003e\u003cp\u003e—Barbara Bowman, Irving B. Harris Professor at Erikson Institute\u003c\/p\u003e\u003cp\u003e“A passionate, personal account of the power all parents have to raise thriving, successful children.”\u003c\/p\u003e\u003cp\u003e—Diana Mendley Rauner, president of the Ounce of Prevention Fund\u003c\/p\u003e\u003cp\u003e“Prepare for a revolution. This book will make you cry, laugh, and deeply reflect on what we should be doing to give everyone a chance to succeed in life. As a scholar I was in awe, as a teacher I was dazzled, and as a father I was thankful to the authors of this book. When you pick it up, have a few hours to spare because you will not put it down. Unequivocal 5 stars.”\u003c\/p\u003e\u003cp\u003e—John A. List, Homer J. Livingston Professor at the University of Chicago and author of \u003ci\u003eThe Why Axis\u003c\/i\u003e\u003c\/p\u003e\u003cp\u003e“Dana Suskind hails others as heroes, but she is the true hero! She stepped out of the safe harbor of her role as a pediatric cochlear implant surgeon when she realized that helping deaf children hear was not enough to help them learn language. She takes us on her compelling and page-turning journey, navigating the best research in children’s early learning, always sharing sound and extremely helpful examples of what we all must do to help children learn language and much more, always in joyful and loving ways.”\u003c\/p\u003e\u003cp\u003e—Ellen Galinsky, president of Families and Work Institute and author of \u003ci\u003eMind in the Making\u003c\/i\u003e\u003c\/p\u003e\u003cp\u003e“Dr. Suskind’s work reveals that the greatest gift we can give our children is free. How empowering to understand that it doesn’t take money to give our children advantages in the world, it takes words. Her research is vital.”\u003c\/p\u003e\u003cp\u003e—Chris Nee, creator and executive producer of \u003ci\u003eDoc McStuffins\u003c\/i\u003e\u003c\/p\u003e\u003cp\u003e“Three cheers for the promise of parents, prevention, and neuroplasticity!”\u003c\/p\u003e\u003cp\u003e— Dr. T. Berry Brazelton, Clinical Professor of Pediatrics Emeritus at Harvard Medical School\u003c\/p\u003e\u003cp\u003e\u003c\/p\u003e\u003cp\u003e\u003c\/p\u003e\u003cp\u003eAn imprint of Penguin Random House LLC\u003c\/p\u003e\u003cp\u003e375 Hudson Street\u003c\/p\u003e\u003cp\u003eNew York, New York 10014\u003c\/p\u003e\u003cp\u003eCopyright © 2015 by Dana Suskind and Beth Suskind\u003c\/p\u003e\u003cp\u003ePenguin supports copyright. Copyright fuels creativity, encourages diverse voices, promotes free speech, and creates a vibrant culture. Thank you for buying an authorized edition of this book and for complying with copyright laws by not reproducing, scanning, or distributing any part of it in any form without permission. You are supporting writers and allowing Penguin to continue to publish books for every reader.\u003c\/p\u003e\u003cp\u003eDUTTON—EST. 1852 and DUTTON are registered trademarks of Penguin Random House LLC\u003c\/p\u003e\u003cp\u003eLIBRARY OF CONGRESS CATALOGING-IN-PUBLICATION DATA\u003c\/p\u003e\u003cp\u003ehas been applied for.\u003c\/p\u003e\u003cp\u003eISBN 978-0-698-19432-8\u003c\/p\u003e\u003cp\u003eWhile the author has made every effort to provide accurate telephone numbers, Internet addresses, and other contact information at the time of publication, neither the publisher nor the author assumes any responsibility for errors or for changes that occur after publication. Further, the publisher does not have any control over and does not assume any responsibility for author or third-party websites or their content.\u003c\/p\u003e\u003cp\u003e\u003c\/p\u003e\u003cp\u003e \u003c\/p\u003e\u003cp\u003eFor Amelie, Asher, and Genevieve\u003c\/p\u003e\u003cp\u003eDS\u003c\/p\u003e\u003cp\u003eFor Lily, Carter, and Michael\u003c\/p\u003e\u003cp\u003eBS\u003c\/p\u003e\u003cp\u003eFor Bob and our wonderful family\u003c\/p\u003e\u003cp\u003eLL-S\u003c\/p\u003e\u003cp\u003e\u003c\/p\u003e\u003cp\u003ePraise for \u003ci\u003eThirty Million Words\u003c\/i\u003e\u003c\/p\u003e\u003cp\u003eTitle Page\u003c\/p\u003e\u003cp\u003eCopyright\u003c\/p\u003e\u003cp\u003eDedication\u003c\/p\u003e\u003cp\u003e1. CONNECTIONS: Why a Pediatric Cochlear Implant Surgeon Became a Social Scientist\u003c\/p\u003e\u003cp\u003e 2. THE FIRST WORD: The Pioneers of Parent Talk\u003c\/p\u003e\u003cp\u003e 3. NEUROPLASTICITY: Riding the Revolutionary Wave in Brain Science\u003c\/p\u003e\u003cp\u003e 4. THE POWER OF PARENT TALK: From Language to an Outlook on Life\u003c\/p\u003e\u003cp\u003e 5. THE THREE Ts: Setting the Stage for Optimum Brain Development\u003c\/p\u003e\u003cp\u003e 6. THE SOCIAL CONSEQUENCES: Where the Science of Neuroplasticity Can Take Us\u003c\/p\u003e\u003cp\u003e 7. SPREADING THE WORDS: The Next Step\u003c\/p\u003e\u003cp\u003e  EPILOGUE: Stepping Off the Shoreline\u003c\/p\u003e\u003cp\u003eAppendix: Early Childhood Organizations and Resources\u003c\/p\u003e\u003cp\u003eNotes\u003c\/p\u003e\u003cp\u003eAcknowledgments\u003c\/p\u003e\u003cp\u003eIndex\u003c\/p\u003e\u003cp\u003e\u003c\/p\u003e\u003cp\u003eCHAPTER 1\u003c\/p\u003e\u003cp\u003eCONNECTIONS\u003c\/p\u003e\u003cp\u003eWHY A PEDIATRIC COCHLEAR IMPLANT SURGEON BECAME A SOCIAL SCIENTIST\u003c\/p\u003e\u003cp\u003eBlindness separates me from things; deafness separates me from people.\u003c\/p\u003e\u003cp\u003e—Helen Keller\u003c\/p\u003e\u003cp\u003eParent talk is probably the most valuable resource in our world. No matter the language, the culture, the nuances of vocabulary, or the socioeconomic status, language is the element that helps develop the brain to its optimum potential. In the same way, the lack of language is the enemy of brain development. Children who are born hearing, but in an austere language environment, are almost identical to children who are born deaf who have not received a rich sign environment. Without intervention, both can suffer the critical, lifelong effects of silence. On the other hand, children in a rich language environment, whether born hearing or given the gift of hearing via cochlear implants, can soar.\u003c\/p\u003e\u003cp\u003eMY STORY\u003c\/p\u003e\u003cp\u003eThe irony is not lost on me that a pediatric cochlear implant surgeon is writing a book on the power of parent talk. Surgeons are known for many things; talk is not among them. Rather than words, we are defined by our hands, our dexterity in the operating room, and our ability to identify problems and find solutions. To a surgeon, there is nothing more gratifying than when the puzzle pieces fit just so.\u003c\/p\u003e\u003cp\u003eCochlear implantation, allowing a child born deaf to hear, is an extraordinary example of all those components. Coiled two and a half times around the snail-shaped cochlea, the organ where the nerve part of hearing begins, a cochlear implant successfully skips over the defective cells, the point along the hearing pathway where sound had come to a screeching halt, going directly to the \u003ci\u003eacoustic, \u003c\/i\u003eor \u003ci\u003ehearing,\u003c\/i\u003e nerve, the superhighway that connects the ear to the brain. The amazing result is that a child born into silence now has the ability to hear, to talk, and to meld into the world both educationally and socially. The cochlear implant is a puzzle piece that fits, just so, a miraculous solution to total deafness.\u003c\/p\u003e\u003cp\u003eAt least, that’s what I thought.\u003c\/p\u003e\u003cp\u003eIn medical school, it was the brain, not the ear, that captured my imagination. The brain seemed a profound mystery holding the key to all the unanswered questions about life. My dream was to be a neurosurgeon, fixing with my hands some of the most important and vexing issues facing humanity.\u003c\/p\u003e\u003cp\u003eMy first neurosurgical case in medical school did not, however, go smoothly. The chief of neurosurgery, Dr. R., had invited me to “scrub in” on a meningioma resection, the removal of a benign brain tumor. We’d been writing a textbook chapter on meningioma resection and he thought it might be helpful if I actually saw one. When I came into the operating room, Dr. R. gestured me toward the operating room table, where a shaved head, stained with the yellow and red of Betadine and blood, confronted me. Inside a large gap of missing skull, a grayish gelatinous mass pulsated rhythmically, as if trying to escape its bony confines. The patient’s torso had disappeared completely, like a magician’s assistant’s, under long blue drapes.\u003c\/p\u003e\u003cp\u003eAs I walked toward the patient, I suddenly became aware of my own pulsations. Could this blob of overly congealed gelatin really be the epicenter of who we are? Dazzling lights crisscrossed my vision and I could barely register what Dr. R. was saying. The next thing I knew, I was being lowered onto a chair by one of the surgical nurses. Humiliating? You bet!\u003c\/p\u003e\u003cp\u003eBut that was not the reason I did not go into brain surgery. Ultimately, that was more a fantasy-meets-reality decision.\u003c\/p\u003e\u003cp\u003e“When the air hits the brain, you’re never quite the same” was a common saying in neurosurgery back in the 1980s. At that time, surgery on the brain often left patients severely debilitated, though alive. In the intervening years, of course, things have changed for the better, but my own experience prompted me to think of other ways of working with the brain. And, in a circuitous way, I did: the ear. Under the guidance of my extraordinary mentor, Dr. Rod Lusk, during my fellowship at Washington University in St. Louis, I learned the skills necessary to help ensure the success of cochlear implantation.\u003c\/p\u003e\u003cp\u003eCochlear implantation is, to me, one of the most elegant of surgeries. Performed under a high-powered microscope that magnifies the inner ear from the size of a tiny pea to the size of a quarter, it relies on small, precise instruments that match its small, precise movements. I operate with the room lights off, the single light beam from the microscope a spotlight on the star of the show, the ear. The microscope’s penetrating beam has been said to cast an almost romantic halo around the patient and surgeon. And while many surgeons operate with music, I prefer my operating room to be quiet and calm, with only the hum of my drill as backdrop to my concentration on the surgical procedure.\u003c\/p\u003e\u003cp\u003eMy decision to become a pediatric head and neck surgeon specializing in cochlear implantation was serendipitous. Because the confluence of two historic medical events was about to usher in a golden age for children born deaf.\u003c\/p\u003e\u003cp\u003eIn 1993, the National Institutes of Health recommended that all newborns undergo a hearing evaluation, the universal newborn screening, before leaving the hospital. This astute public health initiative plummeted the age of the diagnosis of deafness from three years to three \u003ci\u003emonths.\u003c\/i\u003e No longer could parents and pediatricians rest comfortably with “He’s just a slow talker” or “Her older brother does all her talking,” when, in fact, the child was deaf. But its significance was increased exponentially because it coincided with the development of a neurologic miracle, the cochlear implant. The possibility of changing the life course for millions of deaf children had arrived.\u003c\/p\u003e\u003cp\u003eTHE COCHLEAR IMPLANT\u003c\/p\u003e\u003cp\u003eThe brain and neural structures in the human body are generally unforgiving. From cerebral palsy to strokes, from spinal cord injuries to football-related head trauma, “making better” rather than “correcting” tends to be the medical dictum. Hearing loss is a spectacular instance where something can, in fact, be done.\u003c\/p\u003e\u003cp\u003eIn 1984, the first single-channel cochlear implant for adults, allowing sound detection and some awareness of voice, although not “hearing” as we know it, was approved by the FDA. This was followed, in 1990, at about the same time as the new recommendations for universal newborn screening, by a new multichannel cochlear implant with complex speech processing ability, approved for young children. For the first time in history, a child born deaf would be able to hear at an age \u003ci\u003ewhen the brain pathways for language were being created.\u003c\/i\u003e\u003c\/p\u003e\u003cp\u003eIt’s important to understand why the timing of these two coinciding events was so critical. By the end of age three, the human brain, including its one hundred billion neurons, has completed about 85 percent of its physical growth, a significant part of the foundation for all thinking and learning. The development of that brain, science shows us, is absolutely related to the language environment of the young child. This does not mean that the brain stops developing after three years, but it does emphasize those years as critical. In fact, the diagnosis of hearing loss in babies had often been called a “neurologic emergency,” essentially because of the expected negative impact on a newborn’s development.\u003c\/p\u003e\u003cp\u003eThe importance of early screening coinciding with cochlear implantation for children cannot be overstated. If they had \u003ci\u003enot \u003c\/i\u003etaken place simultaneously, if, for example, diagnoses of deafness came at a later age, and the cochlear implant had been placed in older children’s ears, the cochlear implant may have been deemed a fabulous piece of technology but not much more, certainly not the game changer that it is. That’s because successful cochlear implantation requires \u003ci\u003eneuroplasticity,\u003c\/i\u003e the ability for a brain to develop with new stimuli. And although neuroplasticity for learning language may occur, to some degree, at all ages, it is integral to the young brain from birth through about three to four years of age. Exceptions are those who have gone deaf \u003ci\u003eafter\u003c\/i\u003e having learned to talk and whose brain’s language pathways are already established. Those who are born deaf and receive implantation at a much later age will hear sounds, but rarely will they gain the ability to understand their meanings.\u003c\/p\u003e\u003cp\u003eI soon learned, however, that even when cochlear implants are put in place at an optimum time, there are other factors that may preclude their success.\u003c\/p\u003e\u003cp\u003eTHE ADVANTAGE OF STARTING SLOWLY\u003c\/p\u003e\u003cp\u003eThe University of Chicago is an island in a sea of inequality on Chicago’s South Side. Adding to the overwhelming social and economic challenges facing many families on Chicago’s South Side, before I began my cochlear implant program there was the added barrier of communication between children born deaf and their families. This presented both a remarkable opportunity and an extraordinary challenge for me and my incredible, dedicated cochlear implant team. It would also prove to be the experience that would entirely change the direction of my thinking and my career.\u003c\/p\u003e\u003cp\u003eWhen I was an infant in the late 1960s, at the height of the civil rights conflict, my mother, a social worker, took me to work with her in inner-city Baltimore. I slept in a room near her office with someone sitting outside of the door to tell her when I woke up. Later that year, sent to Peru to do a study of the possibilities for creating infant care centers in the \u003ci\u003ebarriadas\u003c\/i\u003e circling Lima, she would sometimes carry me through the hills on her back in an aluminum-sided baby carrier, an “in,” she said, with skeptical inhabitants who had never seen a foreigner do that. Much later she told me that whatever she did, anywhere, never came close to how much she learned, especially about the wealth of untapped potential in people who never had a chance. It’s the same experience I’ve had with my own patient population. Little did I know, when I began this journey, that one of the biggest impacts of my work would be, in fact, on me.\u003c\/p\u003e\u003cp\u003eMy cochlear implant program at the University of Chicago started slowly. Patients weren’t, as I had thought they would be, lining up at my door like at a big sale day at a shopping mall. But it was the slow start that gave me a crucial perspective I might otherwise have overlooked.\u003c\/p\u003e\u003cp\u003eBecause there were so few, I tended to each patient as if he or she were my own child, noticing each milestone, a first smile, a first step, with all the pride of a parent. I was present at every activation, the moment a child’s cochlear implant is turned on and sound is heard for the first time. And, like a parent, while I was rejoicing successes, I was also agonizing when things were not as they should have been.\u003c\/p\u003e\u003cp\u003eThe problems I saw bothered me tremendously; lagging responses to first hearing sound, lack of reaction to hearing their names, slowness in saying a first word or reading a first book. Adding to this burden was the fact that the profound differences I saw occurred in children who had looked very similar to the others at the outset. The path to find out why would eventually lead me into the world of children born hearing.\u003c\/p\u003e\u003cp\u003eThe truth is, at one time I would have likely dismissed my observations of the children as non-science, interesting anecdotes at best. For me, as for many others in academia, science became “true” science only when the numbers were big enough to prove or disprove something, a sample size with “power,” as we say. But I soon came to realize that the power of numbers, disregarding the significance of individual experience, can obscure important insights.\u003c\/p\u003e\u003cp\u003eZACH AND MICHELLE\u003c\/p\u003e\u003cp\u003eZach was my second cochlear implant patient; Michelle, my fourth. Both diagnosed as profoundly deaf at birth, they were strikingly similar in many ways. Both showed similar innate potentials, both had mothers who loved them and wanted them to live in the speaking world, and both were recipients of some of the most powerful technology science had to offer. But that’s where the similarities ended. Same potential, same surgery, but very different outcomes.\u003c\/p\u003e\u003cp\u003eI could never have learned what I learned from Zach and Michelle in any medical textbook. It is not just that my experience with them made me become aware of the limits of technology; it also made me acknowledge a force whose potential impact I may have always known but had failed to recognize, a force that irrevocably impacts the arcs of all of our lives.\u003c\/p\u003e\u003cp\u003eZach\u003c\/p\u003e\u003cp\u003eZach was about eight months old when his parents brought him to see our team, a peanut with hair so light you barely realized he had any. He smiled easily; his blue eyes, the color of a clear\u003c\/p\u003e","brand":"Dutton","offers":[{"title":"Default Title","offer_id":48338554290405,"sku":"NP9780525954873","price":30.0,"currency_code":"USD","in_stock":false}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/1842\/7735\/files\/9780525954873.jpg?v=1769572669","url":"https:\/\/k12savings.com\/products\/thirty-million-words-isbn-9780525954873","provider":"K12savings","version":"1.0","type":"link"}