Expecting To Fail


June 23, 1991|By GEORGE F. WILL

Cambridge, Mass. -- Dr. T. Berry Brazelton is from Texas -- central Texas -- and sounds it. But he lives hard by Harvard Yard, on a street with a fine New England name -- Hawthorne St. -- in a clapboard house painted a mustardy yellow popular in New England.

He is from a region fond of gregariousness, but is married to a Lowell. She remembers walking, when a young girl, with her father, a Boston Brahmin, who did not acknowledge a cousin when they passed. When she asked why, her father explained: "He knows that I know him."

Dr. Brazelton put his foot down when she wanted to cut their wedding cake using her family's ancestral sword that had been used in the Civil War against the side on which his ancestors fought.

Dr. Brazelton, now 70, knows the enduring nature of America's regional and cultural differences. Perhaps that has equipped him for what has become his calling, that of calling attention to the differences that Americans least like to contemplate -- those of class.

He is a pediatrician at Harvard Medical School and Children's Hospital Medical Center in Boston, and he is a member of the National Commission on Children, which will issue its report this week. In assessing the condition of America's children, the report cannot avoid the subject of class.

Dr. Brazelton's interest in class has made him a physicist of childhood. Physicists refer to the "escape velocity" of particles circling in an orbit. Some particles spin, or outside intervention causes them to spin, free from the prison of orbit onto their own long trajectory. Society's challenge is to give poor children outward velocity from the orbit that imprisons them.

Dr. Brazelton believes that the propensity of a child to flourish is established very early. The crucial variable is the child's expectation that the world will be consistently interested, supportive and encouraging.

Absence of the propensity to flourish can be "read" in the behavioral language of even a nine-month-old. Doctors, says Dr. Brazelton, must be taught to read that language in such simple activities as elementary play with blocks. The grim message of some play is that the babies expect to fail for the rest of their lives.

Handed two blocks, a baby that is at ease in the world -- a baby probably already accustomed to the praise of interested adults -- will manipulate the blocks vigorously, dropping one to see who retrieves it and looking bright-eyed at any observing adult, expecting praise. A baby who expects to fail will have a more limited repertory of play -- limited, Dr. Brazelton says, "by the realization that no one will care."

Poor children sense and acquire the helplessness of their parents -- or, more likely, of a single parent. In 1988, the last year for which figures are available, 26 percent of all American babies were born to single women, up from 18 percent in 1980. Sixty-three percent of all black babies were born to single women. The figures for Hispanics and whites were 34 and 18 percent, respectively. Single women are 50 percent more likely than married women to have low-birth weight babies. Such babies have reduced chances of a healthy life.

In these numbers there is a strong correlation with class: Single mothers are more apt to be poor.

We now know how, using early intervention, to raise, by age three, the IQ of infants as much as 13 points. That can be the difference between social competence and failure. Such an increase in IQ points can be achieved even in infants whose neurological systems have been disorganized by the mother's ingestion of alcohol or other damaging drugs.

The brute fact is that the best predictor of a baby's prospects is socioeconomic status. And in the 1980s, among children the chance of being poor rose from 16.4 to 19.6 percent, while among senior citizens it fell from 15.2 to 11.4 percent.

Poverty is a public health problem and treatment must begin with the new family, often just a mother and child. Parents (or parent) and baby must be treated as a single patient, medically and socially.

But, says Dr. Brazelton, there are three impediments to this. One is fiscal, one cultural and one pertains to the sociology of his profession.

Early intervention in dysfunctional families is labor-intensive and hence expensive. It also is intrusive, and violates a cultural value -- the self-sufficiency of the family unit. Furthermore, the medical profession is increasingly science-intensive and specialized. It is neglecting the art of imparting "escape velocity" through the practice of medicine as a "family friendly" art.

So for starters, Dr. Brazelton's message is: Physicians, heal yourselves.

George Will is a syndicated columnist. Ernest B. Furgurson, whose column usually appears in this space, is on vacation.

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