My South Side Education in the Role of SES in Early Childhood Language Development
As a pediatric cochlear implant surgeon, I've spent many years studying medicine and have devoted my professional career to
helping children who are deaf to hear. I know now that successful implantation is only the first step on the path to acquiring
language and speech. My real education has come from learning what happens next, post implementation, when some of my patients
make great strides but others stumble.
In 2007, I started the Pediatric Hearing Loss and Cochlear Implant Program at the University of Chicago Comer Children's
Hospital. The hospital is located in Hyde Park, a high-SES island in the historically low-SES sea of the South Side of Chicago.
As a result, my patients are both children of affluence and children of poverty. Almost immediately after I started the program,
it became apparent that there were stark differences in the post-implantation trajectories of each population. Generally speaking,
the higher SES children gradually gained the listening and spoken language skills necessary to mainstream into elementary school
systems; meanwhile, children of poverty often lagged behind, sometimes to the point of not acquiring adequate listening and
spoken language.
The challenge that lower SES children face is heart wrenching. They struggle not simply with a lack of school readiness or school
performance but in the possible course of their lives. It is important to emphasize that I am not describing a lack of potential
in these children but the tragic effects of an inadequate early language environment and a dearth of societal supports needed to
help optimize their development. Studies have clearly shown that all children, regardless of socioeconomic environment, are
successful at acquiring language, understanding speech, gaining knowledge, and ultimately melding productively into society and
reaching their potential when they are offered a nurturing and stimulating beginning.
The wasted potential resulting from these disparities, to the child and to the society in which he or she will live, is
inexcusable. But it is also rectifiable.
Although I am a surgeon by profession, when I became aware that success after implantation seemed socio-economically dependent I
decided to make understanding and finding a solution to this discrepancy a prime goal of my career. I have spent long hours
learning what is known about health disparities and early childhood language development. I have conducted independent research,
coauthoring “Working with Children from Lower SES Families: Understanding Health Disparities,” a chapter in a cochlear implant
textbook. In addition, I have participated in community-based programs such as the Southside Health and Vitality Study and the
Woodlawn Children's Promise Zone, which is being modeled on the highly successful Harlem Children's Zone project.
"LENA provides a way of both studying and solving the disparities in language acquisition for children of low SES
environments, and the impact will be seen in the childrens' school readiness, ability to learn, and life trajectories."
LENA Pro has been an essential tool in my research. Its revolutionary technology has been invaluable in helping to answer
important questions about the home environment of the child with cochlear implants, including the amount and type of parental
input and other acoustic elements of the home language environment. It's almost impossible to imagine designing an effective
language-research project without it.
In addition to facilitating my research, LENA has helped me to design interventions to improve the post-implantation outcome for
disadvantaged children. Three years ago, I began development of Project ASPIRE (Achieving Superior Parental Involvement for
Rehabilitative Excellence), an evidence-based, parent-directed intervention that provides low-SES parents with the knowledge and
skills to help their children develop spoken language after cochlear implantation. Project ASPIRE empowers parents, not only
improving the lives of their children but their lives as well. And the project wouldn't exist without LENA.
LENA has also been instrumental in the success of my most recent research, the Nanny Study. Research has shown significantly less
child-to-adult engagement for employed caregivers versus maternal caregivers. For the Nanny Study, I selected 19 families with
nannies from the Hyde Park neighborhood and other high-SES neighborhoods of Chicago. Both the nannies and the children they cared
for were recorded to provide baseline data. After the initial recordings were analyzed, nannies were provided individualized
interventions of various intensities. The study continued for eight weeks, with LENA recordings analyzed after each weekly
session. Nannies were also provided feedback after each weekly coaching session to gauge adherence to the study, improvement, and
areas that needed improvement.
The preliminary results of the Nanny Study are positive. A significant elevation in post-intervention language experiences was
shown in terms of both adult word exposure and conversational interactions between caregiver and child. The results suggest that
LENA feedback, in conjunction with the appropriate coaching, could have meaningful influence on the behavior of caregivers.
Furthermore, we expect the impact of LENA feedback to be even stronger when used in interventions conducted directly with parents.
But my partnership with LENA has just begun. With the objective, easily analyzed data that the technology provides, the
possibilities for future research and community projects that measure and optimize the language environments of children are
unlimited. LENA provides a way of both studying and solving the disparities in language acquisition for children of low-SES
environments, and the impact will be seen in the childrens' school readiness, ability to learn, and life trajectories. As a
result, I believe that LENA's ultimate impact will be the betterment of our society.
