Thirty Million Words

Dr Dana Suskind, a pediatric otolaryngologist at the University of Chicago Medical School wrote the wonderful book Thirty Million Words – Building a Child’s Brain, She is Director of the 30 million words initiative at the University of Chicago Medical School – a program to build language and build the brains of children who are growing up in poverty who have families, who, because they are overwhelmed with survival have not been able to provide children with sufficient language development to help build the brain. It was the difference in the success rates of children who received cochlear implants who lived in language rich homes and those who did not that inspired her to write the book and to develop the program.


What happens if babies do not receive sufficient language stimulation?

Dana points out that children’s future and the future of the country depends on having children who develop good language skills. Children who are delayed in language will find themselves less ready to start kindergarten, and less ready to learn to read.


Language is a very post powerful force – it is the heart of the most central component of developing the brain. Children who live in poverty often do not get a fair start. It is not because they are not as smart or because their parents are not smart or do not love them. It is because their families are often overwhelmed with the basics of life – managing to have a roof cover their heads and finding enough to eat. And, since we know that poverty breads poverty, we know they these parents have often not had the opportunity to learn how to be good language models from their parents.


The Hart and Risley data has shown that children living in poverty heard 30 million few words the their more affluent peers by age three. As a result they were not in a position to compete with their peers who had had better language exposure which resulted in better brain development.


We know that the first three years are the most critical time for language development. During this time, the brain is most plastic and open. The child brain develops 70,000 new neural connections every hour. 80-85% of brain development happens in the first 3 years. As children get a little older, the neural connections in the parts of the brain that have not been used well start to be pruned away. If we don’t stimulate the brain early, we don’t get a do-over. Science strongly indicates that reaching that potential depends on early years parent talk and exposure to language.


Parent talk impacts every aspect of a child’s abilities – language, socio emotional development, literacy, math and spatial skills, executive function, self regulation and behavior.


Can we fix it?

The 30 Million Words Project is developing a home visiting program designed to help families who live in poverty, to develop the skills that can allow their children to begin at the same starting line has children who have had more opportunity for language exposure. The things this program suggests are very applicable to families of children with hearing loss who may also be deprived of language exposure.


Parents must believe that they can make a difference in their child’s development. They need to understand that words are what grow your babies brain and that they are the architect of their babies brain. They need to understand the importance of the parent-child bond in child development and in building intelligence. If parents do not believe that they can make a difference then we can not expedt parents to do the necessary work. As any of us who have been parents of babies know, parenting is hard work.


Parents need to understand what makes a rich language environment. The 30 million word project talks about the three T’s – Tune in, talk more, take turns.

  • Talk more – encourages parents to describe the world the child is in, (“I’m putting your foot into your pants”), share your thoughts.
  • Tune in – Pay attention to what your child is communicating. For infants look for eye gaze and gurgling sounds and respond to them. As children get older, respond to even minimal language. “Do you want juice? I can get you juice. Should we have apple juice? Let’s look in the refridgerator.”
  • Take turns – Have a conversation. Even before a child speaks, you speak, and wait for them to gurgle and then confirm that they were talking and you say more. Let it be a conversation.

All language exposure should include a rich vocabulary with complex sentences.


The additional components of the program include helping families who are trained in the Three T’s spread the word to other parents – teach other parents what they have learned. Parents are encouraged to be positive, and reinforce good behavior, to share books with the child to build literacy, and to share an oral story with the child. Parents are encouraged to teach about numbers and shapes around the house. And critical – reduce screen time. It does not build language.


What about children with hearing loss?

In many ways, children with hearing loss are in a different kind of poverty if they do not receive good technology and their families do not learn to talk, talk, talk. Parents are the key to developing children. Families of children with hearing loss who come from poverty are in a very difficult situation. If these kids are going to succeed, these families need all the same kinds of instruction that Dana is talking about in building parents skills to provide good language stimulation to build the brain. We can and we must do it for all children. If we do, every child can reach her potential and live stable fulfilled lives.




About Jane Madell

Jane Madell has a consulting practice in pediatric audiology. She is an audiologist, speech-language pathologist, and LSLS auditory verbal therapist, with a BA from Emerson College and an MA and PhD from the University of Wisconsin. Her 45+ years experience ranges from Deaf Nursery programs to positions at the League for the Hard of Hearing (Director), Long Island College Hospital, Downstate Medical Center, Beth Israel Medical Center/New York Eye and Ear Infirmary as director of the Hearing and Learning Center and Cochlear Implant Center. Jane has taught at the University of Tennessee, Columbia University, Downstate Medical School, and Albert Einstein Medical School, published 5 books, and written numerous books chapters and journal articles, and is a well known international lecturer.