How to Promote & Improve Healthy Brain Development in Children

 Audrey Brewer, MD, MPH, Advanced General Pediatrics and Primary Care, answers common questions about childhood brain development and what families can do to reinforce and support it.

When is brain development most important?

Basic architecture of the brain is an ongoing process that begins before birth and continues into adulthood. More than 80 percent of a child’s brain is formed during the first three years of life, and what they experience in this window can affect how their brain develops.

The brain is most flexible early in life, accommodating a wide range of environments and interactions. Therefore, early life experiences have the capacity to impact the quality of brain architecture, (whether the brain’s foundation becomes sturdy or fragile) directly affecting how a child learns, as well as how the brain may influence their physical and mental health outcomes.

What experiences might negatively influence brain development? 

While experiencing stress is an important part of healthy development, the persistence of stress and life challenges can weaken brain architecture, damaging neurons and connections in the brain. The disruption to brain development that persistent stress and adverse childhood experiences (ACEs) cause can lead to lifelong challenges with learning and subsequently physical and mental health. For young children whose brains are developing, the amount of ACEs they are exposed to is important.

A wide range of childhood adversities can impact brain development, including:

• Threatening events such as abuse, bullying, or disasters
• Ongoing chronic hardships such as poverty (lack of access to healthy and nutritious foods, housing instability)
• Racism, discrimination, neglect (emotional and physical)
• Abuse (physical, emotional and sexual)
• Household dysfunction (mental illness, incarceration of a relative, substance abuse)
• Exposure to community violence
• Lack of educational and economic opportunities

The environment in which we live plays a direct role in a child’s brain development. The quality of the environment – such as community violence, poor or unaffordable housing conditions, lack of educational opportunities and lack of economic opportunities – can all influence the way a child’s brain develops. This is especially true when there are no buffers or protective factors to combat the adversities and toxic stress that a child may experience early in life. These experiences lead to trauma, which disrupts brain architecture.

Early childhood experiences are invaluable. They have the ability to: change the way our genes work, change the way our brains form and function, affect our resilience to toxic stress, affect both cognitive and social-emotional development, and affect health and well-being into adulthood.

How does stress affect child brain development?

There are different forms of stress that we encounter that can impact our health:

• Positive stress: a normal and essential part of healthy development, which can lead to brief increases in heart rate, mild elevations in stress hormone levels (E.g., a child getting a vaccine or the first day of school)
• Tolerable stress: this could include a response to a more severe stressor, but in limited duration. These are often serious, temporary stress responses, buffered by supportive relationships. (E.g., the loss of a loved one or a broken bone)
• Toxic stress: this includes experiencing strong, frequent, and or prolonged adversity, which leads to prolonged activation of stress response systems in the absence of protective relationships. (E.g., the ACEs mentioned above)

When we encounter positive or even tolerable stress in our lives, our bodies respond physiologically with activation in our brain that’s commonly known as the fight or flight response. Typically, they return to their baseline fairly quickly in these situations.

When we experience toxic stress, such as ACEs and unmet needs, our bodies have a strong and prolonged response that does not return to normal, as seen by permanently elevated cortisol levels in the body. The severity and duration of the stress response makes all the difference.

How can parents/caregivers support early brain development? 

Positive, nurturing and responsive parent-child interactions are the antidote to adverse childhood experiences, helping to support brain development. The goal is for children and their families to flourish and thrive despite the adversities they may experience.

Parents/caregivers can support and encourage early brain development when they are feeling well and their physical and mental health needs are fully addressed. If the parents/caregivers are not feeling well, it may become challenging for them to provide the stability, safe and nurturing environments that allow children to grow and develop in the face of adversity.

• Reading regularly to a child stimulates optimal patterns of brain development and strengthens parent-child relationships. Home reading routines have been found to be an important predictor of children’s oral language and socio-emotional skills. In addition, reading regularly stimulates optimal patterns of brain development and strengthens parent-child relationships. (Source: Reach Out & Read)
• Serve and Return Play: when an adult engages with an infant or young child as the child is babbling, makes different gestures or cries and the adult responds in a positive and appropriate manner through eye contact, words or a hug providing a safe, stable and nurturing interaction. It is important to think about these interactions as way that nurture and support the child’s unique personality, sparking the child’s interest to grow and develop.

Can a child’s brain development be improved?

Absolutely. Child brain development can be improved through supporting parent-child relational health and building resiliency. Children are very resilient and can bounce back from adversities when there are positive and protective factors in place. We can harness both the phenomenon of neuroplasticity (our brain’s ability to reorganize itself, physically and functionally, over our whole lifetime) and the concept of resilience (our ability to bounce back) to transform our entire health trajectory. 

We are born with neuroplasticity, and we can develop resilience. Resilience is built through positive social conditions, attunement and secure attachment relationships. Learning how to cope with adversity is an important part of healthy child development. Early relational experiences with engaged and attuned adults have the ability to influence early brain development in a child.

When a child’s stress response system is activated (as recognized by increased heart rate, blood pressure, and stress hormones) within an environment of supportive, nurturing, and positive stable relationships with adults, these physiological effects are buffered and brought back down to baseline, ultimately leading to the development of a healthy stress response system.

If stress response is extreme and long-lasting, and buffering relationships are NOT present or unavailable to the child, the result can be damaged, weakened systems and brain architecture leading to lifelong repercussions. Research suggests that identifying ACEs early, providing interventions to address different ACEs, and ensuring that all children have supportive, safe, stable, and nurturing relationships with at least one adult can interrupt this pathway. Helping children and families to build resiliency and ensuring they have adequate resources and support to do so can influence children’s physical and mental health outcomes.

How are sleep and brain development connected?

Research shows that lack of sleep has been shown to affect brain structure and function, impacting different health outcomes. When a child has limited or insufficient sleep, this can impact the overall structure of the brain in particular areas that are responsible for attention, memory, and inhibition control. If children do not consistently get adequate sleep this can eventually lead to impairment in cognitive functions such as decision making, problem solving, memory function, and learning. In addition, if insufficient sleep persists into later childhood and early adolescence, children may be more likely to have mental and behavioral health challenges such as problems with impulse control, stress, depression, anxiety, aggressive behavior and comprehension.

Did the COVID-19 pandemic impact brain development in young children?

Experiencing extended periods of social isolation during the pandemic impacted our overall well-being. For young children, it disrupted opportunities for them to connect to different sources of safe, stable, and nurturing relationships, which is particularly important if they did not receive these relationships in the home. It also disrupted chances to connect with others in the community. Our limited ability to engage in relational health directly impacted children and parents/caregivers’ ability to build resiliency.

Despite our understanding of early brain development, children continue to grow and learn beyond three years old. Even if a child experiences adversity at a young age, it does not mean that they will develop different physical and mental health disorders in later childhood and into adulthood. Supporting positive relationships that help to build resiliency and hopefully leading to the capacity for children to thrive are crucial.

About the Schreiber Family Center for Early Childhood Health and Wellness

In late 2022, the Schreiber Family Center for Early Childhood Health and Wellness was established as part of Lurie Children’s Patrick M. Magoon Institute for Healthy Communities, the hospital’s hub for all community-focused initiatives. The Schreiber Family Center, which focuses on the most important years of development—birth to age five, brings together the hospital’s experts with community partners to ensure children thrive where they live, learn and play.

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