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The New York Times

A Novel Effort to See How Poverty Affects Young Brains

New monthly payments in the pandemic relief package have the potential to lift millions of American children out of poverty. Some scientists believe the payments could change children’s lives even more fundamentally — via their brains. It is well established that growing up in poverty correlates with disparities in educational achievement, health and employment. But an emerging branch of neuroscience asks how poverty affects the developing brain. Sign up for The Morning newsletter from the New York Times Over the past 15 years, dozens of studies have found that children raised in meager circumstances have subtle brain differences compared with children from families of higher means. On average, the surface area of the brain’s outer layer of cells is smaller, especially in areas relating to language and impulse control, as is the volume of a structure called the hippocampus, which is responsible for learning and memory. These differences do not reflect inherited or inborn traits, research suggests, but rather the circumstances in which the children grew up. Researchers have speculated that specific aspects of poverty — subpar nutrition, elevated stress levels, low-quality education — might influence brain and cognitive development. But almost all the work to date is correlational. And although those factors may be at play to various degrees for different families, poverty is their common root. A continuing study called Baby’s First Years, started in 2018, aims to determine whether reducing poverty can itself promote healthy brain development. “None of us thinks income is the only answer,” said Dr. Kimberly Noble, a neuroscientist and pediatrician at Columbia University who is co-leading the work. “But with Baby’s First Years, we are moving past correlation to test whether reducing poverty directly causes changes in children’s cognitive, emotional and brain development.” Noble and her collaborators are examining the effects of giving poor families cash payments in amounts that wound up being comparable to those the Biden administration will distribute as part of an expanded child tax credit. The researchers randomly assigned 1,000 mothers with newborns living in poverty in New York City, New Orleans, the Twin Cities metro region and Omaha, Nebraska, to receive a debit card every month holding either $20 or $333 that the families could use as they wished. (The Biden plan will provide $300 monthly per child up to age 6, and $250 for children 6-17.) The study tracks cognitive development and brain activity in children over several years using a noninvasive tool called mobile EEG, which measures brain wave patterns using a wearable cap of 20 electrodes. The study also tracks the mothers’ financial and employment status, maternal health measures such as stress hormone levels, and child care use. In qualitative interviews, the researchers probe how the money affects the family, and with the mothers’ consent, they follow how they spend it. The study aimed to collect brain activity data from children at age 1 and age 3 in home visits, and researchers managed to obtain the first set of data for around two-thirds of the children before the pandemic struck. Because home visits are still untenable, they extended the study to age 4 and will be collecting the second set of brain data next year instead of this year. The pandemic, as well as the two stimulus payments most Americans received this past year, undoubtedly affected participating families in different ways, as will this year’s stimulus checks and the new monthly payments. But because the study is randomized, the researchers nonetheless expect to be able to assess the impact of the cash gift, Noble said. Baby’s First Years is seen as an audacious effort to prove, through a randomized trial, a causal link between poverty reduction and brain development. “It is definitely one of the first, if not the first” study in this developing field to have direct policy implications, said Martha Farah, a cognitive neuroscientist at the University of Pennsylvania and director of the Center for Neuroscience and Society who studies poverty and the brain. Farah concedes, however, that social scientists and policymakers often discount the relevance of brain data. “Are there actionable insights we get by bringing neuroscience to bear, or are people just being snowed by pretty brain images and impressive-sounding words from neuroscience? It’s an important question,” she said. Skeptics abound. James Heckman, a Nobel Prize-winning economist at the University of Chicago who studies inequality and social mobility, said he did not see “even a hint that a policy would come out of it, other than to say, yes, there’s an imprint of a better economic life.” “And it still remains a question what the actual mechanism is” through which giving parents cash helps children’s brains, he said, adding that targeting such a mechanism directly might be both cheaper and more effective. Samuel Hammond, director of poverty and welfare policy at the Niskanen Center, who worked on a child allowance proposal by Sen. Mitt Romney, agrees that tracking the source of any observed cognitive benefits is tricky. “I have trouble disentangling the interventions that actually help the most,” he said. For example, policy experts debate whether certain child care programs directly benefit a child’s brain or simply free up her caregiver to get a job and increase the family’s income, he said. Yet that is exactly why providing disadvantaged families with cash might be the most potent way to test the link to brain development, Noble said. “It’s quite possible that the particular pathways to children’s outcomes differ across families,” she said. “So by empowering families to use the money as they see fit, it doesn’t presuppose a particular pathway or mechanism that leads to differences in child development.” Neuroscience has a track record for transforming societal thinking and influencing policy. Research showing that the brain continues to mature past adolescence and into a person’s mid-20s has reshaped policies relating to juvenile justice. In another example, research on brain and cognitive development in children who grew up in Romanian orphanages from the mid-1960s into the 1990s changed policy on institutionalization and foster care, in Romania and worldwide, said Charles Nelson, a neuroscientist at Harvard and Boston Children’s Hospital who co-led that work. Those studies demonstrated that deprivation and neglect diminish IQ and hinder psychological development in children who remain institutionalized past age 2, and that institutionalization profoundly affects brain development, dampening electrical activity and reducing brain size. But that work also underscores how consumers of research, policymakers among them, are prone to give more weight to brain data than to other findings, as other studies show. When Nelson presents these findings to government or development agency officials, “I think they find it the strongest ammunition to implement policy changes,” he said. “It is a very powerful visual, more so than if we said, well, they have lower IQs, or their attachment isn’t as strong.” (He is an adviser for Baby’s First Years.) The vividness of such data is not necessarily bad, Noble said. “If we find differences and the brain data make those differences more compelling to stakeholders, then that’s important to include,” she said. Moreover, brain data provides valuable information in its own right, particularly in infants and young children, for whom behavioral tests of cognition are often inaccurate or impossible to conduct, she said. Brain differences also tend to be detectable earlier than behavioral ones, she said. The field may simply be too young to clock its contributions to policy, Farah said. But increasing understanding of how specific brain circuits are affected by poverty, along with better tools for gauging such circuits, may yield science-based interventions that get taken up at a policy level, she said. Meanwhile, Baby’s First Years hopes to address a broader question that is already relevant at the policy level: whether cash aid to parents helps their children’s brains develop in a way that helps them for a lifetime. This article originally appeared in The New York Times. © 2021 The New York Times Company