How does income affect childhood brain development Kimberly Noble

What I’m about to share with you
are findings from a study

of the brains of more than 1,000
children and adolescents.

Now, these were children
who were recruited

from diverse homes
around the United States,

and this picture is an average
of all of their brains.

The front of this average brain
is on your left

and the back of this average brain
is on your right.

Now, one of the things
we were very interested in

was the surface area
of the cerebral cortex,

or the thin, wrinkly layer
on the outer surface of the brain

that does most
of the cognitive heavy lifting.

And that’s because past work
by other scientists has suggested

that in many cases,

a larger cortical surface area

is often associated
with higher intelligence.

Now, in this study, we found one factor

that was associated
with the cortical surface area

across nearly the entire
surface of the brain.

That factor was family income.

Now, here, every point you see in color
is a point where higher family income

was associated with a larger
cortical surface area in that spot.

And there were some regions,
shown here in yellow,

where that association
was particularly pronounced.

And those are regions that we know support
a certain set of cognitive skills:

language skills
like vocabulary and reading

as well as the ability
to avoid distraction

and exert self-control.

And that’s important,

because those are the very skills

that children living in poverty
are most likely to struggle with.

In fact, a child living with poverty

is likely to perform worse on tests
of language and impulse control

before they even turn two.

Now, there are a few points
I’d like to highlight about this study.

Number one:

this link between family income
and children’s brain structure

was strongest at the lowest income levels.

So that means that dollar for dollar,

relatively small differences
in family income

were associated with proportionately
greater differences in brain structure

among the most disadvantaged families.

And intuitively, that makes sense, right?

An extra 20,000 dollars for a family
earning, say, 150,000 dollars a year

would certainly be nice,
but probably not game-changing,

whereas an extra 20,000 dollars

for a family only earning
20,000 dollars a year

would likely make a remarkable difference
in their day-to-day lives.

Now, the second point
I’d like to highlight

is that this link between family income
and children’s brain structure

didn’t depend on the children’s age,

it didn’t depend on their sex

and it didn’t depend
on their race or ethnicity.

And the final point –

and this one’s key –

there was tremendous variability
from one child to the next,

by which I mean there were plenty
of children from higher-income homes

with smaller brain surfaces

and plenty of children
from lower-income homes

with larger brain surfaces.

Here’s an analogy.

We all know that in childhood,

boys tend to be taller than girls,

but go into any elementary
school classroom,

and you’ll find some girls
who are taller than some boys.

So while growing up in poverty
is certainly a risk factor

for a smaller brain surface,

in no way can I know an individual
child’s family income

and know with any accuracy

what that particular child’s brain
would look like.

I want you to imagine,
for a moment, two children.

One is a young child
born into poverty in America;

the other is also an American child,

but one who was born
into more fortunate circumstances.

Now, at birth, we find
absolutely no differences

in how their brains work.

But by the time those two kids
are ready to start kindergarten,

we know that the child living in poverty

is likely to have cognitive scores
that are, on average, 60 percent lower

than those of the other child.

Later on, that child living in poverty

will be five times more likely
to drop out of high school,

and if she does graduate high school,

she’ll be less likely to earn
a college degree.

By the time those two kids
are 35 years old,

if the first child spent
her entire childhood living in poverty,

she is up to 75 times
more likely to be poor herself.

But it doesn’t have to be that way.

As a neuroscientist, one of things
I find most exciting about the human brain

is that our experiences change our brains.

Now, this concept,
known as neuroplasticity,

means that these differences
in children’s brain structure

don’t doom a child
to a life of low achievement.

The brain is not destiny.

And if a child’s brain can be changed,

then anything is possible.

As a society, we spend billions of dollars
each year, educating our children.

So what can we tell schools,
teachers and parents

who want to help support kids
from disadvantaged backgrounds

to do their best in school and in life?

Well, emerging science suggests

that growing up in poverty is associated
with a host of different experiences

and that these experiences
in turn may work together

to help shape brain development
and ultimately help kids learn.

And so if this is right,

it begs the question:

Where along this pathway
can we step in and provide help?

So let’s consider first intervening
at the level of learning itself –

most commonly through
school-based initiatives.

Now, should we be encouraging teachers
to focus on the kinds of skills

that disadvantaged kids
are most likely to struggle with?

Of course.

The importance of high-quality education
based in scientific evidence

really can’t be overstated.

And there are a number of examples
of excellent interventions

targeting things like literacy
or self-regulation

that do in fact improve kids' cognitive
development and their test scores.

But as any intervention scientist
doing this work would tell you,

this work is challenging.

It’s hard to implement high-quality,
evidence-based education.

And it can be labor-intensive,

it’s sometimes costly.

And in many cases, these disparities
in child development emerge early –

well before the start
of formal schooling –

sometimes when kids are just toddlers.

And so I would argue:

school is very important,

but if we’re focusing
all of our policy efforts

on formal schooling,

we’re probably starting too late.

So what about taking a step back

and focusing on trying to change
children’s experiences?

What particular experiences
are associated with growing up in poverty

and might be able to be targeted
to promote brain development

and learning outcomes for kids?

Of course, there are many, right?

Nutrition, access to health care,

exposure to second-hand smoke or lead,

experience of stress or discrimination,

to name a few.

In my laboratory,

we’re particularly focused
on a few types of experiences

that we believe may be able to be targeted

to promote children’s brain development

and ultimately improve
their learning outcomes.

As one example,

take something I’ll call
the home language environment,

by which I mean, we know
that the number of words kids hear

and the number of conversations
they’re engaged in every day

can vary tremendously.

By some estimates,

kids from more advantaged backgrounds

hear an average of 30 million
more spoken words

in the first few years of life

compared to kids from less
advantaged backgrounds.

Now, in our work, we’re finding

that kids who experience
more back-and-forth,

responsive conversational turns

tend to have a larger brain surface
in parts of the brain

that we know are responsible
for language and reading skills.

And in fact, the number
of conversations they hear

seems to matter a little bit more
than the sheer number of words they hear.

So one tantalizing possibility

is that we should be teaching parents
not just to talk a lot,

but to actually have more conversations
with their children.

In this way, it’s possible
that we’ll promote brain development

and perhaps their kids' language
and reading skills.

And in fact, a number
of scientists are testing

that exciting possibility right now.

But of course, we all know

that growing up in poverty is associated
with lots of different experiences

beyond just how many
conversations kids are having.

So how do we choose what else to focus on?

The list can be overwhelming.

There are a number
of high-quality interventions

that do try to change
children’s experience,

many of which are quite effective.

But again, just like
school-based initiatives,

this is hard work.

It can be challenging,

it can be labor-intensive,

sometimes costly …

and on occasion,

it can be somewhat patronizing
for scientists to swoop in

and tell a family what they need to change
in order for their child to succeed.

So I want to share an idea with you.

What if we tried to help
young children in poverty

by simply giving
their families more money?

I’m privileged to be working
with a team of economists,

social policy experts and neuroscientists

in leading Baby’s First Years,

the first-ever randomized study

to test whether poverty reduction causes
changes in children’s brain development.

Now, the ambition of the study is large,

but the premise is actually quite simple.

In May of 2018,

we began recruiting 1,000 mothers
living below the federal poverty line

shortly after they gave birth
in a number of American hospitals.

Upon enrolling in our study,

all mothers receive
an unconditional monthly cash gift

for the first 40 months
of their children’s lives,

and they’re free to use this money
however they like.

But importantly,
mothers are being randomized,

so some mothers are randomized
to receive a nominal monthly cash gift

and others are randomized to receive
several hundred dollars each month,

an amount that we believe is large enough

to make a difference
in their day-to-day lives,

in most cases increasing
their monthly income by 20 to 25 percent.

So in this way,

we’re hoping to finally move
past questions

of how poverty is correlated
with child development

and actually be able to test
whether reducing poverty causes changes

in children’s cognitive, emotional
and brain development

in the first three years of life –

the very time when we believe

the developing brain may be
most malleable to experience.

Now, we won’t have definitive results
from this study for several years,

and if nothing else,

1,000 newborns and their moms
will have a bit more cash each month

that they tell us they very much need.

But what if it turns out
that a cost-effective way

to help young children in poverty

is to simply give their moms more money?

If our hypotheses are borne out,

it’s our hope that results from this work
will inform debates about social services

that have the potential to effect millions
of families with young children.

Because while income may not be the only
or even the most important factor

in determining children’s
brain development,

it may be one that,

from a policy perspective,

can be easily addressed.

Put simply,

if we can show that reducing poverty
changes how children’s brains develop

and that leads to meaningful
policy changes,

then a young child born into poverty today

may have a much better shot
at a brighter future.

Thank you.

(Applause)