Full PreFrontal

Ep. 68: Dr. Elise Davis-McFarland - Unequal Dreams

April 18, 2019 Sucheta Kamath Season 1 Episode 68
Full PreFrontal
Ep. 68: Dr. Elise Davis-McFarland - Unequal Dreams
Chapters
Full PreFrontal
Ep. 68: Dr. Elise Davis-McFarland - Unequal Dreams
Apr 18, 2019 Season 1 Episode 68
Sucheta Kamath

What do Supreme Court Justice Sotomayor, academy award winning actor Leonardo de Caprio, designer Ralph Lauren, and entertainment mogul Jay Z have in common? They all grew up poor. Their success is enviable, but breaking the cycle of poverty is a mammoth task; one that requires educational opportunities that compensate for the disadvantages created by the socio-economic gap, appropriate structural support, and exposure to the larger world. Every young mind has the right to dream big, but not all dreams are destined to become a reality.

On this episode, Elise Davis-McFarland, the Immediate Past President of American Speech-Language Hearing Association (ASHA 2019) and an ASHA Fellow, discusses how poverty is a serious condition and a potential cause of deprivation and educating students from low income families warrants more than just tolerance, but strong cultural competence. Robust Executive Function and self-regulation are essential ingredients for raising independent children, but ongoing environmental stressors and economics adversity can prove to be an obstacle in bringing forth future-ready children.

About Dr. Elise Davis-McFarland
Dr. Elise Davis-McFarland has enjoyed a rewarding career in higher education that includes teaching, development, and leadership of speech-language pathology programs; research; and executive-level college administration. She began her career as a school speech-language pathologist (SLP) in North Carolina where she provided diagnostic and therapeutic services for children in pre- and elementary schools. Following an audiology internship at the VA and Duke Hospitals and graduate study, she joined the faculty of the University of Houston as an assistant professor where she taught graduate courses in language development, childhood language disorders, early literacy development, and assessment and diagnosis of childhood communication disorders.

In Charleston, South Carolina—in the absence of an academic program in her discipline—she took advantage of new experiences, first as vice president of Governmental Affairs for the Charleston Chamber of Commerce and later as Director of Institutional Research at The Citadel. Dr. Davis-McFarland was also elected as a commissioner for the state’s Medicaid program by the South Carolina Legislature. At the Medical University of South Carolina (MUSC), as an associate professor the opportunity to develop and lead the interdisciplinary graduate Communication Sciences and Disorders program in the Department of Rehabilitation Sciences where Occupational and Physical Therapy programs were housed led to a teaching award and to her research at the MUSC hospital. Later, she became Vice President for Student Affairs at Trident College, where she provided executive-level leadership and supported the successful matriculation of students with autism and Asperger’s Syndrome into the college. 

Dr. Davis-McFarland is an ASHA Fellow.  Her service to ASHA includes membership on the Committee on Practice Guidelines for SLPs, the Professional Practices Committee, the Ethics Committee, the Executive Board Subcommittee on Examination Performance, and the Multicultural Issues Board. She was one of ASHA’s representatives on the committee formed by ASHA and the International Association of Physicians in AIDS Care (IAPAC). She chaired the Committee on Honors and was the coordinator for SIG 14. Until her election as ASHA’s president-elect she served on the SLP Advisory Council as a representative from South Carolina, and the SIG 17 Coordinating Committee. She has also been a reviewer for Language, Speech, and Hearing Services in Schools and the African Journal of AIDS Research. Her areas of research and publication include speech and language development in infants and children

Support the show (https://mailchi.mp/7c848462e96f/full-prefrontal-sign-up)

Show Notes Transcript

What do Supreme Court Justice Sotomayor, academy award winning actor Leonardo de Caprio, designer Ralph Lauren, and entertainment mogul Jay Z have in common? They all grew up poor. Their success is enviable, but breaking the cycle of poverty is a mammoth task; one that requires educational opportunities that compensate for the disadvantages created by the socio-economic gap, appropriate structural support, and exposure to the larger world. Every young mind has the right to dream big, but not all dreams are destined to become a reality.

On this episode, Elise Davis-McFarland, the Immediate Past President of American Speech-Language Hearing Association (ASHA 2019) and an ASHA Fellow, discusses how poverty is a serious condition and a potential cause of deprivation and educating students from low income families warrants more than just tolerance, but strong cultural competence. Robust Executive Function and self-regulation are essential ingredients for raising independent children, but ongoing environmental stressors and economics adversity can prove to be an obstacle in bringing forth future-ready children.

About Dr. Elise Davis-McFarland
Dr. Elise Davis-McFarland has enjoyed a rewarding career in higher education that includes teaching, development, and leadership of speech-language pathology programs; research; and executive-level college administration. She began her career as a school speech-language pathologist (SLP) in North Carolina where she provided diagnostic and therapeutic services for children in pre- and elementary schools. Following an audiology internship at the VA and Duke Hospitals and graduate study, she joined the faculty of the University of Houston as an assistant professor where she taught graduate courses in language development, childhood language disorders, early literacy development, and assessment and diagnosis of childhood communication disorders.

In Charleston, South Carolina—in the absence of an academic program in her discipline—she took advantage of new experiences, first as vice president of Governmental Affairs for the Charleston Chamber of Commerce and later as Director of Institutional Research at The Citadel. Dr. Davis-McFarland was also elected as a commissioner for the state’s Medicaid program by the South Carolina Legislature. At the Medical University of South Carolina (MUSC), as an associate professor the opportunity to develop and lead the interdisciplinary graduate Communication Sciences and Disorders program in the Department of Rehabilitation Sciences where Occupational and Physical Therapy programs were housed led to a teaching award and to her research at the MUSC hospital. Later, she became Vice President for Student Affairs at Trident College, where she provided executive-level leadership and supported the successful matriculation of students with autism and Asperger’s Syndrome into the college. 

Dr. Davis-McFarland is an ASHA Fellow.  Her service to ASHA includes membership on the Committee on Practice Guidelines for SLPs, the Professional Practices Committee, the Ethics Committee, the Executive Board Subcommittee on Examination Performance, and the Multicultural Issues Board. She was one of ASHA’s representatives on the committee formed by ASHA and the International Association of Physicians in AIDS Care (IAPAC). She chaired the Committee on Honors and was the coordinator for SIG 14. Until her election as ASHA’s president-elect she served on the SLP Advisory Council as a representative from South Carolina, and the SIG 17 Coordinating Committee. She has also been a reviewer for Language, Speech, and Hearing Services in Schools and the African Journal of AIDS Research. Her areas of research and publication include speech and language development in infants and children

Support the show (https://mailchi.mp/7c848462e96f/full-prefrontal-sign-up)

Producer:  Welcome back to Full PreFrontal, where we are exposing the mysteries of executive function. I am here with our host, Sucheta Kamath. She’s going to lead us off by talking about poverty in America as well as sharing information about her upcoming interview. Good morning, my friend, always good to be with you.

Sucheta Kamath:  Great to be with you, Todd. Thank you for teeing me off. Yes. It’s such an interesting topic: does America have poverty? I was born and raised in India and one thing that was very clear ever since I was a child, that there are many, many poor people. How did we know that? Because they were on the streets and they were walking with bare feet and they had no food to eat and it was extremely evident and it was part of everyday life. Every cultural event had some ties to taking care of the poor. I don’t think as a child or even as a young professional prior to leaving India, I was aware that there’s infrastructural problem, policy problem that impacts and keeps poor poor. I also harbored a lot of preconceived notions and I brought in my mindset that why are you poor? Why are you staying poor? Why are you not doing anything about being poor? 

Now, when I came to US, one of my concept about US was this is a first world country, modern country, extremely evolved, and of course, very rich. A rich country will not have poor people. That is not the case and I was devastated to know that. But what was so interesting and that came about for me when I did my first internship in rural-most part of Ohio, where our professor who was – I was in graduate school and he would drive us to these different locations where we would do home visits. One such family that I went to visit where the children, there were four children in the house, all below the ages of 5 and there were no parents in the house. Those children were wondering – there was a baby in the crib but when we arrived one morning to do the language stimulation, there were no adult around. We literally thought that maybe somebody was in the backyard so we walked around without really being very sure. We had a planned visit so we knew we were not trespassing. We had informed the family. But there was no adult.

Literally, this happened within six months of being in US. When I saw the house, the house had no food. It was in a terrible condition. All the children that were playing in the backyard, some of them were eating sticks. Certainly, they look extremely malnourished. From there on, I have become very aware of poverty in America. 

The reason we are even talking about this topic is because the guest I have is a very special person. We are going to talk about developing brain, developing language skills, developing self-regulation, and getting prepared to manage life. And particularly if you come from such a disadvantaged background, how does that affect your capacity to enter the world and compete with the world for resources and secure your place and find success for yourself. America particularly has perpetuated this myth for its citizen that pull yourself by the bootstraps and everything will be fine. 

Here we have a most a most amazing guest, her name is Elise Davis-McFarland. She is a ASHA fellow, American Speech and Hearing Association fellow which is a highest honor bestowed upon the most accomplished leader clinician. She is also immediate past president where she was the president last year and I have had the privilege and joy watching her direct and guide my community of professionals. She has a career in higher education that includes teaching, development, and leadership of speech and language pathology programs, research and executive level college administration. Her area of research and publication include speech language pathology, development in infants, and children with HIV-AIDS, multi-cultural issues in language assessment, literacy development, and pediatric dysphasia. 

Dr. Davis-McFarland’s interest in international practice led to a Rotary faculty fellowship to teach speech and language pathology at the Medical University of South Africa. She was also able to collaborate with speech language pathologists and physicians at Baragwanath Hospital in Johannesburg, South Africa on communication assessment and treatment of children with HIV-AIDS. 

Her interest in global issues in the speech and language pathology profession continues and is reflected in her service as a member of American speech and hearing associations ad hoc committee for technical support to the Ministry of Health in Guyana. Dr. Davis-McFarland has received several awards for her leadership and her contributions to higher education. 

Welcome, Elise, to the show. I am so delighted to have you.

Elise Davis-McFarland:  Well, thank you very much. I am very pleased to be with you, Sucheta.

Sucheta:  Before we get started about the topic that I have in mind for us to talk about, can I ask you a question about your own executive function skills and how would you describe your own executive function? As an SLP who works with language development in children and particularly in low socio-economic background, how have you benefited from your self-knowledge in the way you have impacted your treatment?

Elise:  Well, I think that’s a very interesting question. I think I have some strengths in terms of executive function but I also have some things that are not so strong. One of the things that I’ve done in my own practices and especially with children from low socio-economic backgrounds is to try to determine where their strengths and weaknesses might be and really work on those areas where they may not be so strong especially if it is affecting their oral communication or their literacy development. 

One of my strengths is that I tend to be very organized but I think one of my weaknesses is I also have some of my impulsivity. And although I’m aware of that, since I’m aware of that, I work hard to not be overcome by that. But when I see that in children, especially who are from poor backgrounds, that is one of the things that I really try to work with them on because it’s one of the things that can stand in the way of learning. It can also get them in a lot of trouble in terms of their behavior within the school system as well as in terms of their home and community environment. 

Sucheta:  Great. I have one more question about that, about your own executive function. I have been asking this of all the experts I have had. How do you describe your attention skills and do you multitask? Here we are in a profession where we help people develop skills and self-knowledge and I find that there’s so much demand on our own abilities to manage our own selves and attention seems to be the most fragile system when it comes to executive functions. What do you notice about your attention?

Elise:  I have to work on that. In certain situations, I can be easily distracted but I’m aware of that. Especially in professional situations, learning situations in particular for me, listening to a lecture is a situation especially if there are other people around in which I can really be distracted but I know that about myself and so I work hard to be able to direct my attention and maintain my attention.

And when I’m working with children who are highly distracted, I try very hard to help them develop skills or to be aware of that and help them to develop their own attention skills.

Sucheta:  Got it. My first question is, I would love for you to define poverty for us. What does poverty in America look like? 

Elise:  There are lots of different definitions of poverty. In terms of, first of all, income, number of people in the family on and on. But one of the things I always like to say is, we know poverty when we see it. and we certainly know poverty if we experience it. But one of the things that I like to point out is the difference, that there are different types of poverty. There is situational poverty. I think that what’s going on with the furlough of Federal employees may lead to a good example of that.

Situational poverty usually occurs as a result of some rather catastrophic event, a divorce or illness or the death of a person who is the breadwinner of the family. All of a sudden, income is lost and people who may have had a middle class or even higher existence no longer have the financial stability that they did. And so that is what we call situational poverty. 

What we see is that even though people may be without financial resources, they maintain their perspective and their values, the perspective and values that they had when they did have more financial resources. That’s one type of poverty. 

The other type of poverty is what we call generational poverty. That is the poverty that most people think about or think of when we talk about poverty. Those are people who for several generations have been without financial resources. We know that there appears to be a culture that goes – a culture and a perspective and a way of viewing the world that goes with or comes along with situational poverty.

Situational poverty and generational poverty tend to be people who don’t have financial resources but in many instances for very different reasons and who bring to that experience very different world perspectives.

Sucheta:  Yeah. I have now had three experts on this podcast who study children particularly development of children and their brains if they grow up from underprivileged backgrounds and that is one of the things that has gotten me interested in this topic to understand because a classroom is made of children from all backgrounds. There may not be visible signs of somebody coming from poverty unless they are on lunch program. But that too, the teachers may not be fully aware of.

I’m glad that you talked about the culture and the belief system that goes with these two conditions because it also influences the way either you seek help or either the way you relate to outsiders and the way you adapt or coat-switch. Is that fair to say?

Elise:  I think you can be but I live in a community here in Charleston, South Carolina. You said that there are all different kinds or children from all different backgrounds in a classroom. That isn’t always the case. I live in a place where if you give me the ZIP code, I can pretty much tell you the composition of classrooms in that area in terms of ethnicity, in terms of financial background, in terms of a lot of things that help define us in this society. That tends to be one of the issues that we see with children who are growing up in low socio-economic communities and homes. That is a lack of diversity in terms of the people that they associate with, the people that are in their community, the people that they meet, on and on.

Sucheta:  What are the effects of poverty on development of the whole child and communication in particular? Because poverty doesn’t happen in isolation. There are a lot of things that go with poverty, right?

Elise:  That is very true. One of the things that we need to be aware of at the very beginning is that children who are born into poverty are also very vulnerable to poor nutrition, poor medical care, environments that are unsafe. There are several things that we need to be aware of in terms of these children’s development and in terms of their exposure within the homes of the communities that they live in.

A lot of them start out at a deficit in terms of their development because of the things that come along with poverty, the things that children need that these children may not have in terms of nutrition, medical care, many other things.

Sucheta:  When a child enters school, there’s lot of research that I read about that the child entering kindergarten with lot of disadvantages because simply from the background he or she comes from that, as you mentioned, just exposure to the language part and the exposure to that discipline or self-control. And unfortunately, a lot of these children receive punitive treatment because of their lack of impulse control, their executive function at that level is simply like managing their attention or holding back or cooperating in the classroom or listening to instructions or sitting still even. That itself creates such a tremendous disadvantage because they are often punished for not having these skills.

Elise:  That’s true. A lot of these children do not come to school prepared to be able to take on the culture of the school. They may not have a lot of direction or a lot of experience with just sitting still and listening. They may have been exposed to television where they are able to watch what they – enjoy what they’re watching but not necessarily sit there for 30 minutes watching the television. They may be up and down, in and out, or whatever.

The culture of education, the culture of the classroom is one of the things that these children may not be prepared for. We know that about 40% of children who come from a poverty background are not prepared for kindergarten. They don’t know the process. They don’t know the routine necessarily. And for some of them especially if they have executive function deficits, it may be difficult for them to get into the routine, to remember the routine, to think purposefully about the routine or even understand why it is that that they’re being required to do what they’re being asked to do.

Sucheta:  Yeah. I think one important point that you made is that not be able to think purposefully and it’s probably often met with surprise by the teacher who’s instructing. I will tell you, all the presentations I do particularly in public schools and I say who is the hardest child to teach and 99% of the time teachers say the one who doesn’t pay attention. They believe paying attention is something that is a matter of will and they don’t look at it as a matter of skill. Do you have any thoughts about that?

Elise:  Well, I think that’s a good distinction to make. Skill versus will. But some of that is related to parenting styles and what it is that children learn in the home. In many instances, parents from low socio-economic backgrounds believe in what we refer to as natural growth. They think that their responsibility, what they need to do, is to provide nourishment, provide a home, keep their child safe. They don’t necessarily see themselves as “the first teachers.” They think that children learn pretty naturally in terms of what they need to know, in terms of being acculturated. But they don’t necessarily see themselves as being the person who has to “teach” a child in order for the child to be successful. They think that teaching begins when the child gets to school. If they keep the child nourished, safe, and provide a home for them, then they have done what it is that they should do, what they know to do.

And so this idea of sitting still and paying attention may not be something that is necessarily taught in the home, at least not in the way that is expected at school. But then, when we travel, one of the things that I always look at is the relationship between parents and the children that they are traveling with. It’s not unusual to see parents sitting on the floor of the airport waiting room teaching their children, reading them books, pointing to things in the book, asking the child to point to things or identify things, and asking the child questions about the story that they’re reading. They are actively teaching and that is what they intend to do. But there are parents who don’t have that perspective, who didn’t grow up that way and don’t have that kind of understanding of that aspect of helping their child to develop.

Sucheta:  I think you have shared something very, very important that I don’t think any speaker before you has mentioned and my listeners are not used to this idea, this aspect of parenting style that parents will come with this idea or attitude that “I am not your first teacher” or “I’m not even a teacher. I’m a parent.” The teaching begins when you enter school and that itself can create a great disadvantage, I can see. 

Also, I think the second part that you mentioned which is so integral to that parenting style as you mentioned is believe in natural growth. That means let nature take its course and I’m not facilitating or enhancing or adding to it but you can observe everything that’s around you and that should be good enough to contribute to your progress.

Of course, I see every parent from middle class or upper-middle class is so concerted in their effort and using techniques including Einstein-whatever that thing that came out which doesn’t work. They went and bought those CDs first thing as it hit the market. They are using things whether they are proven to be effective or not and the child is exposed to it for sure.

I’m hearing you describe these genuine incredible disadvantages that are embedded in coming from low socio-economic background and that is so often underestimated and misunderstood, so to speak. I know this is a little bit of a sidebar but what kind of effort needs to go into making people even aware of such disadvantages because they’re often discussed in such a sterile way and it’s not something even a classroom teacher is made aware of, I feel.

Elise:  Well, I think obviously we have to share information with people who are teaching these children, who are coming into contact with children from these backgrounds. But one of my interests has been in teaching parents and giving parents the information that they need in order to be able to see themselves as teachers. The importance of making sure that their children have books, making sure that they understand that the language of the classroom is different from the language that children get within the community and in the home, and making parents aware of the language differences, making them aware of the relationship between oral language and learning to read, helping them to be able to identify in their children signs that this child’s speech and language may not be developing as it should. Or that the child may be at risk from not being able to learn to read as quickly or as easily as other children.

I think that the real emphasis that is important is on parent education and helping them to understand what it is they can do and the value of what they can do in terms of enhancing their children’s preparation for school and learning. 

Sucheta:  In your experience when these measures are taken, how do they look? What does it look like programmatically when we train the parents or educate them? Geoffrey Canada’s work, who’s from New York City, comes to mind about when mothers, when they are pregnant, they are brought in to receive this education regarding exposure to words. That has shown incredible impact.

I’m sure you’re familiar with programs that really show impact of such approach. Can you share some of those programs if you know? 

Elise:  Well, you know, Head Start is one of the things that comes readily to mind. And the fact that there’s a lot of parents teaching and a lot of parent training that goes on in Head Start. But I think the language that you use in many instances can be very important in terms of helping parents understand and accept what it is that you want to share with them. 

One of the things that I say to parents all the time is, speaking well and reading well will help your child achieve the life that you say you want for her. Or learning this, learning what I’m going to be talking to you about today is going to help your child win much more often. And so I think that when you explain to parents what it is that they need to do and the benefit of that, that you’re much more likely to convince them, that this is something that they need to do. It’s not that you’re presenting anything that is difficult for them to do or that they’re not capable of doing. It’s a matter of their understanding, the importance of it and what the benefit of it will be.

Sucheta:  While we’re on this subject, one important thing about culturally speaking, particularly in America, poverty affects African-American students more than anyone else, hence, its impact particularly there are a lot of myths around that in terms of their skills and abilities. Can you talk a little bit about some of these relationship between these two factors?

Elise:  Between poverty and?

Sucheta:  Poverty and exposure to a certain skill development particularly in African-American families. 

Elise:  Well, there are a lot of myths and some of them come from our own profession. Studies that have been done, looking at the language of children or parents, households, from those socio-economic backgrounds. Very often, they come from a deficit perspective which is very untrue. Children who are poor are just like other children, exposed to the language of their environment and their community. You don’t go into communities where people don’t talk. People talk. Regardless of the amount of money that they make, they talk. Children here, folk talking and what they learn is what they hear. 

One of the disadvantages that we find in terms of children from lower socio-economic backgrounds is that they haven’t necessarily heard the language of the classroom or the language of education or people are not asking them the kinds of questions that teachers are going to be asking them when they get to school and there’s a presentation of information and they ask the child to, “Tell me what’s the same about this and tell me what’s different” or “Look at the cover of this book. What do you think is going to happen in the story?” No one has talked to them like that before and so it may take a while and some doing and some teaching for them to be able to understand that language and what it is that is required of them.

Sucheta:  It’s so important to understand the development of language because it, in essence, impacts development of executive function. We have this key important skill or maybe a process built into our brain which is self-talk. One of the best ways to self-regulate is to activate that self-talk.

What are the reasons we should really understand the relationship of developing language in these children who have experienced disadvantage and its impact on executive function? 

Elise:  I think you make a really good point especially about self-talk. Because that can be a great regulator. It can also be a great adjunct for or support for learning. And so the child is asked the question and he/she needs to be able to say through self-talk, ideation, whatever, What is it that’s being asked? What have I learned? What is it that the teacher is likely to want me to say here? What do I know about this situation? What do I know about what the teacher is asking? All of this, I call it internal talk. That’s what I talk to children about. Internal talk. Being able to use your mind to ask questions.

It’s also very important in terms of behavior regulation. I often tell children, “Before you act, someone has done something to you. Before you act, you may need to ask yourself, ‘What is the cost for me? Am I going to be able to win in every --’” and I don’t use the word “in every aspect” but what I’m telling them to think about, I tell them to ask, “Am I going to be able to win all round? Am I going to be able to win with the teacher, with the child that I might do something to with the principal, with my mom? Will I win all around or is this a situation in which I probably don’t need to do what I’m thinking about doing?”

I really try to help children be able to understand that and reason through it and understand the benefit of being able to use internal talk, to reason through situations, both in terms of learning and in terms of behavior regulation.

Sucheta:  Yeah. I think you just explained this. You hit the nail on its head, that when you see these skills present, those are the kids who are going to activate their own thinking before they go out and do it. Those are the kids that teachers are going to describe as independent, self-regulated, and kids who can become good peers for the classroom students. 

Elise:  Exactly. I talk to children in terms of winning. This is what you need to do in order to win. By that, I mean be successful but in terms of their language, this is what you need to do to be able to win. This is what you need to be able to do to win all around. This is what you need to be able to do to win for yourself so that you’ll feel good about this. 

Sucheta:  Now, what do we know about assessing communication development and disorders in children from poverty background?

Elise:  Well, we know more and more every day. One of the things that we do know is that we don’t necessarily need to depend completely or too much on standardized language measures because we know that they’re not a great measure of language in children who come from nonpoverty backgrounds but they certainly don’t appear to be very helpful in terms of helping us understand deficits in children from low socio-economic backgrounds. 

What we want to know with these children, with any children is whether or not they have the potential to learn. A standardized test doesn’t tell you that. We really need to go to more process-dependent or dynamic approaches to assessment with these children. Because we can get a language sample. We can hang out with a child for an our or two. We can go on to a classroom and observe and then go out on the playground and have a pretty good idea of the child’s oral language and how that child uses language and in what circumstance.

But what we want to know, what we really need to know is whether or not this child has the potential to learn. What I refer to as a higher register of language.

Sucheta:  I’m so sorry. What does that mean? Can you explain a little bit more about --

Elise:  Well, the different registers – Ruby Powel, who was one of my mentors says that there are different registers of language. There is the language that we memorize: The Lord’s Prayer, The 23rd Psalm, whatever. There’s a language between people who are intimate. And then there is the language of the classroom. There is the language of professional interaction. That is being able to use “is” verbing, being able to have subject-verb agreement. The kinds of things that really mark a person as being a good user of language, someone who knows that language. That’s what we want to know. That is, does this child have the potential to be able to learn that register – I call it that, register of language. In order to know that, we’ve got test that child in ways that are different than what we usually find in standardized measures. 

Sucheta:  Got it. It sounds like to me, one has to be extremely knowledgeable and also recognize that this test that I used to evaluate are standardized or they were designed for children from maybe middle class and those rules or observations may not apply to children from poverty and so hence the tools and techniques need to be adapted a little bit.

Elise:  That is true. But even now as our knowledge has progressed, most test developers are including a more diverse mixture of children in their standardization population. But even with that, there is more that we need to know. That’s why I think process-dependent measures and dynamic approaches are much better in terms of getting a really good look at what it is this child has the potential to be able to do.

Sucheta:  Wonderful. Now, how do we go about helping these children or what do some of the strategies look like that can apply to development of these children so that they can master language and develop literacy skills?

Elise:  Well, it’s not really that different in terms of what we do. I don’t think that income makes a big difference. The most important thing is knowing what it is the child needs, and then we teach. We teach them the language that they need. If it is verbing, we bombard them with examples of “Johnny is going to store. He and his mother are walking down the street.” We do pictures. We do video. We do audio. We do everything that we can to expose the child to the models that they need and then providing the opportunities for them to be able to use that language. 

The other thing that I think is very important and I worked with 1st and 2nd graders, that I’ve said to them, “You know, the language that you’re going to use in school may be different a little bit than what you learn at home. But you dress differently to go to church than you do to go play baseball.” And so we use language in different situations, in different ways so that they understand that there may be a way to talk in this situation in a different way in another situation.

Sucheta:  Fabulous. Do you have a success story where you saw incredible change and I’m sure that’s why you and I keep coming back to do what we do.

Elise:  It is. It is. Most of my success, I think, has been when I’m first of all able to work with moms, the parents, and then with the children and then with the child, let me say, and to be able from time to time to bring the parent in on what I’m doing and in some with the child and explaining to her what it is I’m doing and why. Sometimes, she may come to where we are whether that’s Head Start or the school but in situations in which that’s not possible, I’ll go to them. Because another thing is I want to see the home. I want to see where this child lives. I want to see how the environment is structured. I want to see what they have in the home. And so I’m always pleased to be able to go into a child’s home. 

But one of my experience has been with working with a child over a period of years. The child came to kindergarten totally unequipped to sit still and attend, oral language was not at the level of a 4-year-old that it should be. This is just a child who couldn’t carry on a conversation with you. I followed that child, worked with him over a period of time and then other clinicians have worked with him also. But he is in the 6th grade now. 

We had a poetry workshop. That is something that I like to do with children because it allows them to have a lot of free expression. It allows them to talk. It allows them to write. But he now writes almost lyrical poetry. His literacy skills have improved significantly. His writing has and his oral language. But he’s really become very interested in poetry and I give credit for that to the fact that we have worked with language, that he has had an opportunity to work with speech and language so much over the years that it really has become his friend.

Sucheta:  Beautiful. As we close, Elise, can you just comment on one question that I often get particularly not from families or teachers but more so leaders in the community that I interact with who are very much interested in seeing progress that community makes? One of the things that they are stumped by this connection that the 3rd grade reading is determinant of number of prisons that are built, somehow policies need to be centered around that. Do you have any comment about how to conceptualize that 3rd grade reading readiness and mastery and why does that predict a failure in academic or post-academic success?

Elise:  Well, I think it does because kindergarten or 1st grade to 3rd grade, we’re learning to read. After that, you have to be able to read in order to learn. Children who are not able to read, drop out or in many instances, they drop or they become behavior problems and they’re put out. Here in my community, if you can get a child to high school, he/she is likely to graduate. Most of our children who drop out do so between the 6th, 7th, and 8th grades in middle school because the press or literacy is so great at that point. 

We also know from research that was done with the TOEL Language Assessment that 67% of men in prison were at least one standard deviation below the norm for oral language. We have prisons that are full of people who do not have facility with the register of language that they needed to have in order to learn or to become professionally successful. It’s very important.

Now, one of the things that I also say is that these children that we’re losing are children who have not had intervention. Because the children who do have intervention are the children that were able to say and able to help them continue to learn and be successful which is one of the reasons that early screening and intervention becomes so, so important. 

Sucheta:  Thank you for such a great discussion and coming on the show today. This is a topic very close to my heart. I don’t think I myself was aware of the impact of the work that you do as well as its importance in parent training as much as I became aware today. I’m very grateful for your wisdom and your time. Once again, thank you for being here today with me. 

Elise:  Thank you so much, Sucheta.

Producer:  Alright. That’s all the time we have for today. On behalf of our host Sucheta Kamath, our guest, Dr. Elise Davis-McFarland and all of us at Cerebral Matters, thanks for listening today. We look forward to seeing you again right here next week on Full PreFrontal.