Understanding ‘Ba Ba Ba’ as a Key to Development

Baby babble developmentBy PERRI KLASS, M.D.

As a pediatrician, I always ask about babble. “Is the baby making sounds?” I ask the parent of a 4-month-old, a 6-month-old, a 9-month-old. The answer is rarely no. But if it is, it’s important to try to find out what’s going on.

If a baby isn’t babbling normally, something may be interrupting what should be a critical chain: not enough words being said to the baby, a problem preventing the baby from hearing what’s said, or from processing those words. Something wrong in the home, in the hearing or perhaps in the brain.

Babble is increasingly being understood as an essential precursor to speech, and as a key predictor of both cognitive and social emotional development. And research is teasing apart the phonetic components of babble, along with the interplay of neurologic, cognitive and social factors.

The first thing to know about babble is also the first thing scientists noticed: babies all over the world babble in similar ways. During the second year of life, toddlers shape their sounds into the words of their native tongues.

The word “babble” is both significant and representative — repetitive syllables, playing around with the same all-important consonants. (Indeed, the word seems to be derived not from the biblical Tower of Babel, as folk wisdom has it, but from the “ba ba” sound babies make.)

Some of the most exciting new research, according to D. Kimbrough Oller, a professor ofaudiology and speech-language pathology at the University of Memphis, analyzes the sounds that babies make in the first half-year of life, when they are “squealing and growling and producing gooing sounds.” These sounds are foundations of later language, he said, and they figure in all kinds of social interactions and play between parents and babies — but they do not involve formed syllables, or anything that yet sounds like words.

“By the time you get past 6 months of age, babies begin to produce canonical babbling, well-formed syllables,” Professor Oller said. “Parents don’t treat those earlier sounds as words; when canonical syllables begin to appear, parents recognize the syllables as negotiable.” That is, when the baby says something like “ba ba ba,” the parent may see it as an attempt to name something and may propose a word in response.

Most of the time, I ask parents: “Does he make noise? Does she sound like she’s talking?” And most of the time, parents nod and smile, acknowledging the baby voices that have become part of the family conversation.

But the new research suggests a more detailed line of questions: by 7 months or so, have the sounds developed into that canonical babble, including both vowels and consonants? Babies who go on vocalizing without many consonants, making only aaa and ooo sounds, are not practicing the sounds that will lead to word formation, not getting the mouth muscle practice necessary for understandable language to emerge.

“A baby hears all these things and is able to differentiate them before the baby can produce them,” said Carol Stoel-Gammon, an emeritus professor of speech and hearing sciences at the University of Washington. “To make an m, you have to close your mouth and the air has to come out your nose. It’s not in your brain somewhere — you have to learn it.”

The consonants in babble mean the baby is practicing, shaping different sounds by learning to maneuver the mouth and tongue, and listening to the results. “They get there by 12 months,” Professor Stoel-Gammon continued, “and to me the reason they get there is because they have become aware of the oral motor movements that differentiate between a b and an m.”

Babies have to hear real language from real people to learn these skills. Television doesn’t do it, and neither do educational videos: recent research suggests that this learning is in part shaped by the quality and context of adult response.

To study babbling, researchers have begun to look at the social response — at the baby and the parent together. Michael H. Goldstein, an assistant professor of psychology at Cornell, has done experiments showing that babies learn better from parental stimulation — acquiring new sounds and new sound patterns, for example — if parents provide that stimulation specifically in response to the baby’s babble.

“In that moment of babbling, babies seem to be primed to take in more information,” he said. “It’s about creating a social interaction where now you can learn new things.”

A study this year by this group looked at how babies learn the names of new objects. Again, offering the new vocabulary words specifically in response to the babies’ own vocalizations meant the babies learned the names better.

The experimenters argue that a baby’s vocalizations signal a state of focused attention, a readiness to learn language. When parents respond to babble by naming the object at hand, the argument goes, children are more likely to learn words. So if a baby looks at an apple and says, “Ba ba!” it’s better to respond by naming the apple than by guessing, for example, “Do you want your bottle?”

“We think that babies tend to emit babbles when they’re in a state where they’re ready to learn new information, they’re aroused, they’re interested,” Professor Goldstein said. “When babies are interested in something, they tend to do a furrowed brow,” he continued; parents should understand that babble may be “an acoustic version of furrowing one’s brow.”

Right there, in the exam room, I have that essential experimental combination, the baby and the parent. It’s an opportunity to check up on the baby’s progress in forming sounds, but also an opportunity to help parents respond to the baby’s interest in learning how to name the world — a universal human impulse expressed in the canonical syllables of a universal human soundtrack.

In Young Kids, Lack Of Sleep Linked To Obesity Later

Lack of sleep and obesityby Patti Neighmond

Can you sleep away pounds? Well, not exactly, but research has shown that people who sleep a good eight hours-plus are more likely to maintain a normal weight than those who sleep less than eight hours a night. Now, a new study finds that even for infants and preschoolers, a good, long night’s sleep may be just as important as diet and physical activity.

Over the past three decades, obesity rates have doubled among children age 2 to 5, and tripled among 6- to 11-year-olds. So University of Washington maternal and child health researcher Janice Bell wanted to know whether sleep had anything to do with it.

She looked at federal data collected on nearly 2,000 children and compared those who slept 10 hours or more a night with those who slept less. She also looked at how much the children weighed over a five-year period. The most striking findings had to do with infants and toddlers. The study appears in the Archives of Pediatrics and Adolescent Medicine.

“They were nearly twice as likely to move from normal weight to overweight, or overweight to obese in that five-year period,” she says.

Can’t Catch Up With Naps

This is also an important message to parents, Bell says, to encourage them to help their children get on routine schedules of a long and solid night’s sleep. Especially, she says, because it turned out that napping during the day did not reduce the risk that these kids would gain weight.

“We found that their napping didn’t have any effect on their later obesity, whereas the nighttime sleep was significant,” Bell says. That led her to conclude that napping didn’t seem to be a substitute for nighttime sleep in terms of obesity prevention.

Psychiatrist Emmanuel Mignot, who directs the Center for Sleep Sciences at Stanford University School of Medicine, suggests that one reason naps may not work is because daytime sleep is qualitatively different than nighttime sleep. Mignot says that sleeping at night is deeper and therefore more restorative than sleeping during the day. It makes sense, he says, that one can’t “make up” for lost sleep by dozing during the day or even having scheduled naps as toddlers often do.

Why The Connection?

Bell’s study didn’t examine the reasons why children who sleep less have an increased risk of gaining weight within just a few years, but she does have some theories.

“It may be that children who don’t sleep enough at night are too tired to engage in the kind of physical activity that may prevent obesity,” Bell says. She adds that another reason may be the result of the relationships between hormones that control appetite and sleep.

Mignot says that studies done in his sleep lab found that if you sleep less, certain hormones like leptin and ghrelin change in a way that stimulates appetite. Leptin, which is a starvation signal, decreases and gives you the feeling that you should eat more. At the same time, levels of ghrelin, which stimulate the appetite, increase.

It’s an unfortunate combination adding up to an increased risk of weight gain. Mignot’s studies were done in adults, but he says a similar hormonal shift likely takes place in children as well. This hormonal shift also increases cravings for unhealthy foods like those high in salt, sugar and fat.

On average, Mignot says children up to age 5 need at least 10 hours of sleep a night. Infants and young toddlers, of course, need even more.

Smoking when pregnant may lead to behavior problems in kids

Tobacco exposure and behavior issuesBy MICHELLE CASTILLO

Smoking during pregnancy can increase the likelihood of a miscarriage, Sudden Infant Death Syndrome (SIDS), certain birth defects like a cleft lip or palate and premature birth, the Centers for Disease Control and Prevention warns.

New research is adding “conduct disorders” to that list of health risks. Mothers who smoked during pregnancy were more likely to have children who had behavioral issues, a new study found.

“The evidence is emerging that smoking in pregnancy and the frequency of smoking in pregnancy is correlated with developmental outcomes after (children) are born,” senior author Gordon Harold, professor of developmental psychopathology at the University of Leicester in England, said to Reuters.

The CDC estimates that 13 percent of women smoked during their last three months of pregnancy. A 2012 survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) showed that an even higher amount, 21.8 percent of white women aged 15 to 44, smoked while pregnant. Black and Hispanic women’s rates lingered around 14.2 and 6.5 percent respectively.

Smoking has already been linked to increased risk of mental health problems for children. A 2011 Pediatrics study found children who had behavioral problems — including learning disabilities, attention deficit hyperactivity disorder (ADHD) and other behavioral and conduct disorders — were more likely to be exposed to secondhand smoke while they were growing up. In addition, kids who had a smoker in the home had a 50 percent increase in having two or three neurobehavioral disorders. However, it was unclear in the Pediatrics study if the moms had smoked through their pregnancy.

For the new research, doctors looked at three studies — the Christchurch Health and Development Study (a long-running study that includes biological and adopted children), the Early Growth and Development Study (an adoption-at-birth study), and the Cardiff IVF Study (an adoption-at-conception study among genetically-related families and genetically-unrelated families) — for data.

The adopted children were included in order to examine the role of genetics versus environment and different parenting styles.

Researchers asked the mothers whether they had smoked cigarettes during pregnancy and how many they smoked per day. They also asked parents and teachers to report any behavioral problems the child exhibited between the ages of four and 10. They then scored the behavior of each child, with 100 being average and a higher number indicating more behavioral problems. Children who were born to biological mothers who did not smoke scored a 99 on average. Children born to biological mothers who smoked 10 or more cigarettes a day scored a 104 on average.

When researchers looked at the data from birth mothers of adoptive children, they saw similar problem patterns in kids whose genetic mothers smoked while pregnant. The same behavioral issues were seen even for mothers who got a donor egg through in vitro fertilization (IVF) and were not genetically-related to the children they gave birth to.

“It’s illuminating the prenatal period as having an ongoing influence on outcomes,” Harold said.

Theodore Slotkin, a professor of pharmacology and cancer biology at the Duke University School of Medicine in Durham, North Carolina, added in anaccompanying editorial published in the same issue that the study just adds more evidence that smoking during pregnancy can only harm the fetus.

“Thus, the conclusion is incontrovertible: Prenatal tobacco smoke exposure contributes significantly to subsequent conduct disorder in the offspring,” he wrote. “Considering the relationship of conduct problems to poor school performance, social isolation, and juvenile and adult incarceration, the negative impact on the affected individuals’ quality of life and, ultimately, on society as whole, cannot be underestimated.”

The study was published in JAMA Psychiatry on July 24.

Stressed out mothers make asthma in children worse

Maternal stress causes asthma in childrenBy Richard Alleyne

Children are more likely to suffer severe asthma if their mothers are stressed, study finds

Angry and irritated mothers or those who try to suppress their emotions can worsen the condition in their offspring, particularly when the children are young.

A year-long study of 223 mothers, investigated what effect their stress levels, coping styles and parenting styles had on their two to 12 year old children who suffered from asthma.

Mothers’ tendencies to reject, dominate, overprotect and indulge their children were assessed by questionnaire, as were their specific kinds of chronic stress and coping styles.

Children over the age of seven suffered worse attacks if their mother was over protective.

But younger children suffered more in the following year if their mother was chronically angry, irritated or suppressed their emotions.

Jun Nagano, of the Kyushu University Institute of Health Science in Japan, said that stressed mothers made children more stressed which increased their suffering from asthma.

He said: “Our results suggest that the mothers of younger children may be advised to pay more attention to the reduction of their own stress.

“Mothers of older children may be encouraged to increase their own wellbeing via proper egocentric and self-defensive activities, being careful to avoid too much interference with their children.”

TV Ratings: A Guide for Parents

While family is the most important influence in a child’s life, media in all its forms, including TV, computers, and other screens, are not far behind. Because media can influence how children think, feel, and behave, the American Academy of Pediatrics (AAP) encourages parents to help their children form healthy media use habits early on.

TV Parental Guidelines

The TV Parental Guidelines (see chart below) rating system was created to help parents choose programs that are suitable for children. The ratings are usually included in local TV listings. Remember that ratings are not used for news programs, which may not be suitable for young children.

All TVs 13 inches or larger made in the United States after 2000 are required by federal law to have a V-chip. The V-chip allows parents to block programs based on ratings or times or to block specific shows.

For more information, go to the FCC Parents’ Place Web site athttp://reboot.fcc.gov/parents.