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How home visits for vulnerable moms boost kids’ brainpower

March 18, 2016 at 6:25 PM EDT
A rapidly expanding medical program for low-income first-time mothers combines social services with the latest in brain science. The Nurse-Family Partnership provides in-home advice on health and parenting, which can lead to improved cognitive development and language skills for their children, who are showing up to school better prepared for learning. Special correspondent Cat Wise reports.
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JUDY WOODRUFF: Next: a look at a political rarity: an expanding health program supported by both Democrats and Republicans.

Special correspondent Cat Wise reports.

KIMBERLY HIRST, Registered Nurse: I have a book for you guys today.

CAT WISE: In Aurora, Colorado, registered nurse Kimberly Hirst is checking in on 19-year-old Sinai Herrera and her 2-year-old son, Caleb.

SINAI HERRERA: One, two, buckle my shoe.

CAT WISE: The visits are part of a rapidly expanding program called the Nurse Family Partnership. The partnership combines old-fashioned social services with the latest brain science, all to help low-income first-time mothers and their children.

KIMBERLY HIRST: Time and time again, I see these young girls drop out of school, so they’re at risk for that and living in poverty forever.

CAT WISE: The regular visits begin in pregnancy and continue until the children are 2 years old. Nurses offer advice on health, parenting, and self-sufficiency.

KIMBERLY HIRST: It’s really so much more educational, rather than clinical. And so I feel like sometimes I’m, like, a life coach.

CAT WISE: Improved outcomes, like a 48 percent reduction in child abuse and an 82 percent increased employment for mothers, have been so significant that Congress recently voted to infuse home-visit programs with $800 million in new funding.

But while the Nurse Family Partnership is focused on health and poverty, another outcome is catching the attention of early learning experts. Kids from the program are showing up at school better prepared.

David Olds, the project’s founder and a professor of pediatrics at the University of Colorado’s School of Medicine, says the educational benefits are no surprise.

DAVID OLDS, University of Colorado Medical School: Nurse-visited mothers are spending more time talking to their babies, guiding them.

WOMAN: Where does the A go?

CHILD: A go right there.

DAVID OLDS: All of that earliest process that gets set in motion sets in motion a positive cycle of interaction that leads to significant reductions in children’s behavioral problems when they enter school, significant improvements in their language development.

CAT WISE: On this day, Hirst uses simple props to explain the importance of talking to Caleb long before he can talk back.

KIMBERLY HIRST: So, way before Caleb could talk, he was learning how to talk by hearing you talk. All of these things were adding to him having language. When you read to him every night, when you told him what things were, it bubbled over into language.

CHILD: Baseball.

KIMBERLY HIRST: A baseball?

CHILD: Yes, baseball.

KIMBERLY HIRST: Yes, baseball.

CHILD: Go — it.

KIMBERLY HIRST: Go get it? Go get the baseball?

CHILD: Yes, get ball.

KIMBERLY HIRST: It seems so simple, but if he only hears 500 words an hour verses 3,000 words an hour, it makes a huge difference and it’s a lasting difference.

CAT WISE: Clinical trials show a 50 percent reduction in language delays by age 2 and a 67 percent reduction in intellectual problems by age 6. Such results bolster a growing area of brain science that looks at a baby’s early environment.

Here at the Laboratories of Cognitive Neuroscience at Boston’s Children’s Hospital, researchers are studying how a child’s early learning experiences can shape their developing brain and impact early learning.

CHARLES NELSON, Harvard Medical School: What many of us are starting to argue is that, to foster success as children make the transition to school, you need to invest in what’s going on in those first few years.

CAT WISE: Charles Nelson is a professor of pediatrics and neuroscience at Harvard Medical School.

CHARLES NELSON: Over those first few years, basically, the general architecture of the brain forms in a way that sets it up for the rest of your life.

CAT WISE: At the Nelson Lab, researchers use noninvasive sensors to pick up communication between brain cells.

CHARLES NELSON: Millions and millions and millions of brain connections are being built. And so as we build the scaffolding for subsequent learning in those first few years, that scaffolding enables learning that occurs over the lifespan.

CAT WISE: Tell me what we’re seeing here.

CHARLES NELSON: So, we’re doing is, we’re presenting babies with images of different facial expressions. We want to determine at what age are they able to discriminate different emotions? So the baby sees the different emotions by different people, and as they do that, each time the picture comes up, we’re recording the brain activity,

CAT WISE: Nelson believes emotions play a big role in brain development. When parents are depressed, afraid, or stressed, their babies’ brain development can suffer.

CHARLES NELSON: If you look here, she’s clearly happy, and she’s clearly angry, and she’s afraid. Infants who are brought up in environments where they do not see happy, mom is depressed or there’s something else going on the environment, respond very differently to facial emotion.

Development is seriously impacted. And, more importantly, if they don’t get them in the first two or three years, development probably is derailed permanently.

CAT WISE: Nelson says high-poverty homes, like the kind targeted in Nurse Family Partnership, are vulnerable to stress, depression, and abuse.

In these homes, he says, early intervention can make a big difference in brain development. When Sinai Herrera discovered her junior year of high school that she was pregnant, it was a tough time for her.

KIMBERLY HIRST: She was struggling with some depression and trying to figure out what her life was going to look like.

CAT WISE: Hirst directed Herrera into mental health counseling, and ultimately back to school.

WOMAN: With that counseling, I know I’m a good mom now. And I know that I can do everything that he needs me to do.

CAT WISE: For Stormee Duran, who went through the program with her first child, Sophia, the issue was an abusive relationship. Duran says her nurse gave her the strength to move on.

STORMEE DURAN, Nurse-Family Partnership Participant: She was really there to help me through that deep, dark place that I was in. I have always had low self-esteem issues, and so I didn’t want my daughter to grow up like that.

CAT WISE: The home visits are not cheap. Each family-nurse two-year partnership costs on average $10,000. But a RAND Corporation analysis found the investment actually saves money. Every dollar spent today prevents another $5 of social welfare spending in the future.

DAVID OLDS: This is work that is not just somebody’s good idea, but has been developed and tested and retested using rigorous approaches.

CAT WISE: The nurse-family home visits have expanded to 43 states and recently became part of the Obama administration’s push for early learning initiatives.

For the PBS NewsHour, I’m Cat Wise.

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