Serve and Return: Supporting the Foundation

What is “serve and return”? What does it mean to have a “responsive relationship” with a child? How do responsive relationships support healthy brain development? And what can parents and caregivers do in their day-to-day lives to build these sorts of relationships? This episode of The Brain Architects podcast addresses all these questions and more!

Fortunately, there are many quick, easy, and free ways to create responsive relationships with children of any age. To kick off this episode, Center Director Dr. Jack Shonkoff describes the science behind how these interactions—known as “serve and return”—work.

This is followed by a discussion among a panel of scientists and practitioners including Dr. Phil Fisher, the Philip H. Knight Chair and Professor of Psychology at the University of Oregon, and director of the Center for Translational Neuroscience; Patricia Marinho, founder and CEO of Tempojunto and co-founder of Programa BEM; and Sarah Ryan, director of Life Skills at Julie’s Family Learning Program. The panelists discuss what it looks like to serve and return with children on a daily basis, and how to encourage these interactions.

• Working Paper 1: Young Children Develop in an Environment of Relationships
• Serve & Return Interaction Shapes Brain Circuitry
• 5 Steps for Brain-Building Serve and Return
• How-to Video: 5 Steps for Brain-Building Serve and Return
• Play in Early Childhood: The Role of Play in Any Setting
• Building Babies’ Brains Through Play: Mini Parenting Master Class
• FIND: Filming Interactions to Nurture Development

Articles

• Beecher, Michael D. & Burt, John M. (2004). The role of social interaction in bird song learning. Current Directions in Psychological Science, 13(6), 224-228.
• Kok, R., Thijssen, S., Bakermans-Kranenburg, M. et al. (2015). Normal variation in early parental sensitivity predicts child structural brain development. Journal of the American Academy of Child and Adolescent Psychiatry, 54(10), 824–831.
• Kuhl, P.K., Ramírez, R.R., Bosseler, A., Lin, J.L. & Imada, T. (2014). Infants’ brain responses to speech suggest analysis by synthesis. Proceedings of the National Academy of Sciences. 111(31), 11238-11245.
• Levy, J., Goldstein, A. & Feldman, R. (2019). The neural development of empathy is sensitive to caregiving and early trauma. Nature Communications, 10, 1905.
• Marler, Peter (1970). Birdsong and speech development: Could there be parallels?. American Scientist, 58(6), 669-673.
• Ramírez-Esparza, N., García-Sierra, A. & Kuhl, P.K. (2014). Look who’s talking: Speech style and social context in language input to infants is linked to concurrent and future speech development. In press: Developmental Science, 17(6), 880-91.
• Rifkin-Graboi, A., Kong, L., Sim, L.W. et al. (2015). Maternal sensitivity, infant limbic structure volume and functional connectivity: A preliminary study. Translational Psychiatry, 5, e668.
• Romeo, R.R., Leonard, J.A., Robinson, S.T., et al. (2018). Beyond the 30-million-word gap: Children’s conversational exposure is associated with language-related brain function. Psychological Science, 29(5), 700-710.
• Sethna, V., Pote, I., Wang, S. et al. (2017). Mother–infant interactions and regional brain volumes in infancy: An MRI study. Brain Structure and Function, 222, 2379–2388.
• Yu, C. & Smith, L.B. (2013). Joint attention without gaze following: Human infants and their parents coordinate visual attention to objects through eye-hand coordination. PLoS One, 8(11), e79659.

• The FIND Program

• Tempojunto (in Portuguese)
• Progama BEM (video in Portuguese with English subtitles)

Sally: Welcome to The Brain Architects, a new podcast from The Center on the Developing Child at Harvard University. I’m your host, Sally Pfitzer. Our Center believes that advances in science can provide a powerful source of new ideas that can improve outcomes for children and families. We want to help you apply the science of early childhood development to your everyday interactions with children, and take what you’re hearing from our experts and panels and apply it to your everyday work. In today’s episode, we’re going to dive into the science behind serve and return interactions and we’ll learn how important responsive relationships are to healthy development. Later in the podcast, we’ll incorporate these positive interactions into ordinary moments throughout your day. Here to discuss serve and return is Dr. Jack Shonkoff, who is the professor of Child Health and Development and the director of the Center on the Developing Child at Harvard University. Hey, Jack, we’re so glad to have you back.

Jack: Great to be here.

Sally: Today we’re going to dig into this concept of serve and return, so I’m wondering if you could start just telling us a little bit about what serve and return is.

Jack: Serve and return is a very simple phrase that tells us about how important the back and forth interaction is between very young children, actually beginning immediately after birth, and the adults who care for them. Serve and return, as we’re using it now, refers to how parents, or other adults who care for young children, exchange vocalizations. They make sounds, they look at each other. There’s back and forth interaction that occurs naturally between babies, very young children and the adults who care for them. These are things that parents and other caregivers do pretty naturally. Even if you haven’t had a course in child development, we are biologically wired to be engaged in that kind of serve and return interaction because it is necessary for healthy development. If we didn’t do it, if it required a course in child development, millions of years ago we would have become extinct as a species because babies’ brains and young children’s brains wouldn’t have developed in the way they do. It’s the essence of what promotes healthy brain development very early.

Sally: Why is that important for healthy development of a child?

Jack: It’s not simply important, it’s critical, because the brain is wired to expect this kind of back and forth serve and return interaction. It’s really the way the brain builds its circuits, the way the brain develops the capacity for different skills. Here’s a really good example. How do birds learn a song? Very similar to how do humans learn their language, which is speaking. A really elegant experiment was done once. Newly hatched baby songbirds who, at that point, didn’t know their songs. They removed them from the adult songbirds and raised them in cages with very high-fidelity recordings of the song for that songbird. You can guess what the punchline is here. Those birds never learned to sing, ever. Even though they heard the song beautifully, there was no opportunity to practice it and interact and get feedback from the adults.

Sally: That’s so fascinating. I’m imagining, as a listener, my first question might be, am I supposed to engage in this serve and return interaction at all times with children? If I’m busy doing something else, am I missing a really critical moment to build the child’s brain?

Jack: The best general answer is extreme on anything is usually not good. As much as it would be really bad for a baby or a young child to be ignored, most of the time, it is not helpful to be interacted with all of the time. That’s not the real world and children of all ages need some time to process what’s going on by themselves. It’s a balance issue. Is there anybody out there listening to this who don’t want a break at some point from all the nice chatter and interaction? We all need a little bit of a break.

Sally: We all need a break.

Jack: Absolutely.

Sally: Absolutely.

Jack: The important thing is when children are young and they don’t really understand a lot about what’s going on, that is not a time to say, “Well, it doesn’t really matter.”

Sally: Can you give us some examples? Not necessarily of how to serve and return, but how specifically does that serve and return interaction build a strong foundation?

Jack: It actually works in two ways. One is how it helps to shape and model brain connections. The other is the extent to which, if a baby doesn’t get that kind of responsive interaction, it triggers a stress response. The serve and return interaction is both important for its positive, it’s what scientists call experience expectant development, the brain is expecting it, but the other part of it is that because the brain is expecting it, when it doesn’t get it, the stress system gets activated because it’s biologically dangerous for a baby.

Sally: So when it comes to serve and return interactions, how do you know what might be too much, what might be too little?

Jack: Like everything else in development, there’s no one size fits all model for this, but at the end of the day it’s about knowing your baby and knowing your own style and finding a comfortable way of interacting. That fits in a very, very wide range of normal. And I think we also ought to talk about the stresses on parents. Some parents are working full time and have less hours in the day to spend with their child. I think one of the worst phrases we’ve ever imposed on parents is this issue of the importance of quality time in the evening, to make sure you get that quality time and if you’re working all day, well, guess what? There’s probably no time in the 24-hour daily cycle that’s more challenging for everybody than kind of early evening at the end of a long day. Some parents are struggling with a lot of stresses in their lives and there are many parents who are dealing with depression. Postpartum depression is a very real thing. People are overwhelmed by lots of problems. They can have a hard time summoning up the energy. And what, really, people need to understand is you don’t have to spend hours and hours a day with rich interaction. It’s the time you spend together. If there’s very little interaction, then you can’t summon that energy, then it’s really important to get help. But if the time you spend together includes a reasonable amount of positive interaction, you’re there. You don’t have to worry about whether there needs to be more.

Sally: Thanks Jack, I really loved hearing about serve and return and how it can be important to build responsive relationships in the children in our everyday lives. And when we come back, we’ll have a few experts on serve and return who are joining us for a panel discussion.

Musical interlude

Sally: Here to help us talk through the implications of serve and return, we have Dr. Phil Fisher, who is the Philip H. Knight Chair and Professor of Psychology at the University of Oregon and the Director of the Center for Translational Neuroscience. Hi, Phil.

Phil: Hey, Sally. Great to be here and connect with you.

Sally: Also joining us is Ms. Patricia Marinho, who’s the founder and CEO of Tempojunto, and cofounder of Programa BEM, who’s from Sao Paulo, Brazil. Hey, Patricia.

Patricia: Hi, Sally. What a pleasure to be here with you.

Sally: Also joining us is Ms. Sarah Ryan, who’s the director of Life Skills at Julie’s Family Learning Program here in Boston. Welcome to the podcast, Sarah.

Sarah: Hi, Sally. Thank you so much for having me.

Sally: Okay, let’s go ahead and get started. Sarah, this first question is for you. How have you used the concept of serve and return in your work?

Sarah: I work with young mothers and we have their children actually on site in our childcare center. I have them for one hour every day and we do a parenting or life skills curriculum, so I actually get to teach serve and return and touch on it every single day with them and talk about specific examples: what their child offered, what they offered back, and talk about enhancing or pointing and naming or adding one thing, adding a color, adding a shape.

Sally: How have you seen that impact your families? Does it help them get a better understanding of serve and return interactions or just how their child is developing?

Sarah: Well, I would say all of the above. Then they feel this sense of competence and mastery. My young moms don’t have their high school diplomas. They’re working on those. And they often haven’t thought of themselves as valuable teachers, as competent, as capable, and many of them didn’t receive high quality, consistent serve and return in a nurturing way. So when they realize they can do it and they have every tool they need already to grow their children’s brains and to develop them, it’s really empowering. It’s really exciting to watch parents and the young moms really come alive and then get excited about doing more of it and reporting back what their children do and feeling so much pride in that.

Sally: Right. It’s that positive reinforcement cycle, right? They understand that they actually already have all the skills that they need to do this. And, Phil, that actually reminds me a lot of your work and I’m wondering if you could share a bit about results that maybe you’ve seen–how people, when they start to better understand what serve and return is, how they are better able to interact with their children.

Phil: Sure. I’d be happy to talk about that. First of all, I think the whole concept of serve and return has really had a huge impact in how we communicate about the science of early childhood in the sense that it’s just a really straightforward and vivid way to convey this idea of back and forth interactions being so central. In our own work, one of the things that’s been really essential has been to clarify that the serve and return process is most impactful when it begins with the child. So that is the extent to which the child is exploring the world, is using language or vocalizations and the adult notices the child serve and then returns it. But what’s really transformative, I think it’s pretty clear that we’re pretty hardwired to notice what children are doing and respond, but it can still go beneath the radar for people to have awareness of what they’re doing and that’s why a lot of us, I think, are now gravitating toward techniques like video coaching that can really make it apparent to people how they are participating in the serve and return process and therefore should just do more of it.

Patricia: I’d like to add on something. I think that the word transformative is very powerful in terms of thinking of serve and return. And I’d like to give my testimony as a mom because I think the first encounter that I have with this knowledge of serve and return was thinking about the way I personally act with my kids. It was amazing to see, to really understand the metaphor that the child was ready to explore and I would be the one helping them. I discovered the knowledge of serve and return and decided to apply in my personal life and I found this transformation both in myself and in my relationship with my kids and with my children. So I think this transformation aspect is really very, very powerful.

Sally: Yeah. And it picks up on what both Sarah and Phil were saying that once parents have the opportunity to see how serve and return can actually be building their child’s brains and be building that positive relationship, it’s self-perpetuating. You want to do more and more of it. Right? Sarah, I’m wondering if you could speak a little bit to if there’s an adult that might be in your program who says, “I actually never really experienced this serve and return interaction with my own parent and now I’m expected to engage with it with my child and it feels overwhelming and maybe it’s a science concept that I don’t really want to dig into too much.” What would you say to that parent to increase that interaction between them and their child?

Sarah: You know, I have had women who say, “That wasn’t my experience at all. I was not to be heard,” or, “My parents were busy working to provide and we didn’t have that.” They want something different. And I really just start with their strengths. I very often have seen them with their children and so I will bring up an example and point that out and then they sort of take it from there. They very consistently expand upon that and how great that moment was or what happened next or what preceded that before I happened upon them. And then we go from there. They feel the success, they feel the relationship and they want more of that. So, really, it’s not difficult to get folks to lean into that as powerful and as meaningful.

Sally: Absolutely. Patricia, have you seen similar interactions with the mom’s that you work with?

Patricia: As Jack said, we are biologically wired to serve and return. So when we just start to pay attention to what we’re doing and see the lights in the eye of the kid when we are interacting with them and the pleasure that you feel when you are responding to them, so whenever the family has the opportunity to lead that, they want more. We can help people find back the pleasure of being a parent. We spent so much time talking about the struggles and how hard it is. And it is something hard. It’s an art to raise a kid. But when we help parents go through the route of finding the pleasure of being a parent, and for instance, in my field of work, we work a lot with play and we put play as a center place in terms of making parents really have back and forth interactions with the kids and everything we do in terms of play, everybody ends up smiling. So whenever we can close the gap between the concept and something that makes people’s lives better, it’s almost always easily understood and applied.

Sally: So I’m imagining as a listener something that might come up might be someone saying, “Well, I’d love to be doing the serve and return interaction all the time. I want to build the strongest brain and the best foundation for my child, but I’m also extremely busy and I’m juggling so many different things throughout the course of my day.” Could any of you respond to what if you’re a busy parent, how can you make sure that you’re increasing the serve and return opportunities or finding ways to look for this in your everyday lives?

Phil: I’m happy to talk a little bit about that. First and foremost, serve and return is a process that can happen in seconds. It’s not an idea that you need to set aside an hour or two per day, so any opportunity to notice what the child’s doing. Think about it in terms of how are they serving and how you can return the serve is going to benefit the child in the long run. I think that’s probably one of the most important things to think of. The other is that serve and return happens in the context of everyday things that are going on in people’s lives. So whether it’s mealtime or whether it’s time where you’re getting into the car or driving somewhere, if the child is with you at the grocery store. So it’s not about like, “Do this for a certain amount of time every day.” It’s just when you have the opportunity to do it, these are moments that are really building healthy brain architecture.

Patricia: I love to use the expression, “Playful parenting,” to describe an attitude that we can have in our daily lives so that we can really enjoy all this moments that Phil just described that happens all the time. So you spend some time with your kid, maybe it’s not so much, it’s not enough or it’s not all the time that you’d like to have, but instead of complaining about the lack of time, because we would all be doing that and we have the playful parenting as a concept, you’ll see that you can really find joyfulness and you can enjoy every minute you have with your kid, if you are in the right frame of mind.

Sarah: I would just like to add something that Patricia mentioned: playful parenting. My parents always identified that they want a good relationship with their children, so this is a simple way to teach them. The serve and return interaction teaches them a way, a concrete way to start developing a relationship that is back and forth, that will develop and evolve into the children’s teenage years and adolescence and it’s going to be this continuous back and forth. The relationship starts now, and I tell my parents, “Your children are babies, but you want them to talk to you when they’re teenagers about what’s going on in their lives and that back and forth starts right here. You’re already starting that relationships with them.” They want to be able to have their children come to them and talk to them.

Sally: I noticed we’ve been using the term parent a lot in these conversations and, Phil, I’m wondering does this have to be a parent that’s doing the serve and return interaction?

Phil: The idea of what serve and return can really involve is that it’s an adult in the process of returning a child’s serves and those can be exploration, but they can also be that the child’s upset or crying. It’s really any adult with whom the child has a meaningful relationship where the serve and return process is so critical. So you can think about this in terms of other adults in the family, whether it’s a cousin of the parent or whether it’s a grandparent. It can be foster or adoptive parents, for sure. And it can also be, and this is extremely important, it can also be in childcare and preschool settings. That adults who are the child’s educator or teacher can be ones that are instrumentally involved in returning children’s serves. So it’s really any adult with whom the child has a meaningful relationship where that serve and return process is going to be especially beneficial.

Sally: Great. Up next our panelists are going to answer some of your social media questions.

Musical interlude

Sally: Now we’re going to open it up to some of our social media followers who submitted questions to the Center. I will start with this question to you, Patricia. This is a social media question from light.annika from Instagram and they ask, “Is serve and return better for infants and toddlers or can it also work with older kids?”

Patricia: It can definitely work with older kids because the basics of it is understanding there is a person and establishing communication. So when you start from your kid, your infant, paying attention to what they’re looking at, their serve and return is based on that. Later on, you will be a better listener to your older kid, your teen kid, and you’ll be a person that will make sure that you listen first and speak later because you understand there is a communication process.

Sally: Here’s another one from light.annika and, Phil, I’d like to address this one to you. “Should I explain to a baby everything we do and see?”

Phil: It’s absolutely not necessary to explain to a baby everything we do and see. In fact, a very young baby isn’t going to have the capacity to understand everything that is seen and done. It’s really a question of noticing what the child is doing and then responding. And you can respond either by using words to respond, to name what the child is expressing or looking at. Or you can also use other kinds of acknowledgement. Some of them can be just nodding your head or saying, “Um-hmm,” things that help them to understand that you see them and you hear them and you understand what they’re focused on.

Sally: It’s all the stuff I’m doing right now that you guys can’t see. I’m nodding and acknowledging and I’m returning your serves, I promise.

Phil: We can tell that you’re listening by your response.

Sally: Excellent.

Phil: And the other thing I want to put in as a really important note here is that parents often are interested in understanding this idea of if a child is focused on one thing and then they shift their attention to another, if the serve and return process involves following the child’s lead and kind of going from the end of one thing to another, is that what you should always be doing? Or are there times when it’s helpful to kind of encourage the child to stay at what they’re focused on? The concept of serve and return is really built around the idea of following what it is that the child is doing and I think especially for children under age three, this idea that there’s a point at which they’ve had enough of focusing on a particular task and that their attention shifts to something else is really critical. And that one of the things that parents can do that’s most helpful is to just wait and see what the child is doing and follow their attention from one thing to another. As children get older it may be possible to direct their attention back to something that’s a task at hand, that is important to focus on. Whether it’s eating or something else that might be important to have sustained attention. This idea of noticing what the child’s doing, mapping onto their serve and then returning their serve doesn’t mean that all day, every day parents should just be following what the child’s doing. There are plenty of times when you’re needing to leave the house, the child has to be put in their car seat, you’re walking across the street where it’s not up to the child to do what they want to do. The adult really has to be the one who’s determining what’s happening and that’s just fine. There’s in no way an effort to say, “Only do what your child wants to do.” It’s more about, as we’ve all been saying, noticing the situations where you have the opportunity to let the child lead, to notice what they’re doing and then to return their serve that are particularly helpful for brain development.

Sally: Here’s another one. This is from ellemeez from Instagram. Sarah, I’ll address this one to you. She asks, “I have two little boys who are almost four years apart. What’s the best way I can engage them both?”

Sarah: Sure. There’s some things that are just so universal. What is important to you? What do you have fun doing? What do your children have fun doing? And following them. So if you have a dance party in your house, this is good for everybody. If you are enthusiastic when somebody starts to dance and then everybody’s dancing. If you take what the older child is capable of doing and let them start the serve and return with the younger child, the younger child is always so much more interested in whatever the older child is doing than with the parent is doing, most of the time. Anytime you can have that magical moment where the older child is engaged with the younger child and they’re both leading the way and back and forth and then the parents just hop in occasionally in that. There’s so many natural moments to let the older child engage the younger child.

Patricia: I want to say something else about this question. When she says that the best way I can engage with them both, there’s for me something behind that is investing some time to understand your kids, who they really are and what they like. Sometimes we forget to do that, to not come up with our own ideas of how to engage them. But just to work with the things that they like to do and if you know that it’s not that hard to engage them.

Sally: That was a really great conversation and I just really want to thank all of you for your time being here and for giving us your expertise on these topics. And up next, Dr. Jack Shonkoff will be here to debunk another early childhood development myth.

Musical interlude

Sally: We’re back with Dr. Jack Shonkoff. We’ve been talking a lot today about the need for active engagement between child and a caregiver in that serve and return interaction that you were sharing and it sort of reminded me of that expression that we often hear people use in our line of work, where people will say things like “babies are sponges” or that “their brains are always absorbing,” but from what we heard today, that doesn’t seem to be a correct analogy.

Jack: I’m really glad you use that analogy, Sally, because we do talk about babies as sponges a lot. From a scientific point of view, sponges is probably not the best way to describe babies because a sponge kind of sits there and passively absorbs what’s coming. What’s different about serve and return is that the baby is, or any young child, is an active agent of that interaction. It’s not just passively absorbing, it’s also serving. It’s feeding into that interaction and that’s the key difference. So we are not passive sponges, even though we soak up everything around us. We are active agents in our own development.

Sally: We are not passive sponges. That’s the sound clip I’ll take away from this.

Jack: Parents who buy educational videos for babies like classical music or show you beautiful art, that that’s been studied and it’s been found that it has no effect on children. Why? It’s only one-way. There’s no serve and return. You’re just passively listening. That’s not how kids learn to talk. A lot of research on language development shows us that at birth the brain is capable of learning and speaking any language in the world fluently. And in the beginning it’s listening. It’s kind of listening to all that chatter going on around. It’s beginning to differentiate sounds. By 9 to 12 months of age, research is very clear that children are already losing the ability to differentiate sounds in languages they’ve never heard. The brain is pruning away that ability and focusing on just the language it’s heard. So whether it’s language development, whether it’s learning about cause and effect, whether it’s learning just about everything in the world, it’s the back and forth interaction, studied in animals, studied in humans, that comes out to the simple term of serve and return. You can’t just feed information into a baby’s brain. You have to engage in an active back and forth serve and return interaction where the baby is playing a role and the adult is playing a role and you influence each other. That’s how healthy brain development happens. That’s serve and return.

Sally: Thanks, Jack. Another myth busted. Up next, how do we add serve and return interactions to our already busy lives?

Musical interlude

Sally: We’ll leave you with some really simple ways to get started with incorporating serve and return into your everyday lives. And it can be as easy as playing peek-a-boo or where’s baby, a game where there’s back and forth between you and a child.” Or you can just take a few seconds to notice what a baby or toddler is looking at and then talk to them about it. So, for example, if you’re looking at a toy, you can say something like “That’s a ball” Or a doll, or a block—whatever you’re looking at, it’s just important that you’re sharing the attention. And then you would describe it in words. You might say something like “it’s round and green.” You’d wait for their reaction and then you’ll share that interaction back and forth. So if you’re not used to talking through everything with a baby, don’t worry. It does get easier with practice. And even these really simple steps are making amazing connections in a child’s brain. I’d like to, once again, thank our guests, Dr. Phil Fisher, Ms. Patricia Marinho, and Ms. Sarah Ryan and Dr. Jack Shonkoff. I’m your host Sally Pfitzer and we’ll see you next time. The Brain Architects is a product of the Center on the Developing Child at Harvard University. You can find us at developingchild.harvard.edu, where we’ll post any resources that were discussed in this episode. We’re also on Twitter at Harvard Center, Facebook at Center Developing Child, and Instagram at Developing Child Harvard. Brandi Thomas, Charley Gibney, and Kristen Holmstrand are our producers. Bridgette Cyr is our audio editor. Our music is Brain Power by Mela from freemusicarchive.org. The podcast is recorded at PRX Podcast Garage in Allston, Massachusetts.