About a year ago, at one years old, Eden Tobik was found to have a blood lead level of 19. Any amount of lead is harmful to young children; five is the threshold of concern.
Her mother, Casey Tobik, was devastated.
“Shock, guilt, shame, fear, despair, terror, sets in,” said Tobik. “And then you Google it and it gets even worse.”
They didn’t have chipping paint, just an old house in Lakewood, Ohio, with friction surfaces causing lead dust that Eden must have ingested as she crawled around, like any normal toddler.
Eden’s parents took out a loan to make their home lead-safe and were told to give Eden healthy foods and a multivitamin, but other than that doctors had nothing else to offer her.
“It was very much a, ‘This is it. Let’s just watch and wait and see what happens,’ which as a mom, is like the worst thing you can hear from a medical professional because you just feel helpless,” said Tobik.
As Cleveland grapples with efforts to address lead in old housing stock, parents worry about the effect of the toxin on their children. But it’s possible the brain can compensate. One thing that might help? Reading. That’s the approach championed by MetroHealth pediatrician Dr. Robert Needlman.
Needlman said that he’d never tell a parent with a lead poisoned child that it’s hopeless. What he would say is this: “We don’t know in your individual case what that lead may or may not be doing. But what we do know is in every case, if you talk with your child and listen to your child and have conversations and read books together and learn together, your child will be smarter. And have more self-control. And behave better than if you don’t do that.”
The key, said Needlman, is to remove the source of lead exposure and provide a nurturing environment where learning can happen. And he added, one-on-one conversations and interactions promote healthy, strong brain connections.
“Those kinds of conversations cause the brain to grow in positive ways and essentially combat the negative effects of lead,” said Needlman.
While the cellular damage of lead is permanent, Needlman and other experts said the young brain is highly resilient and they believe it can compensate for the loss.
“If one part of it isn't working very well, other parts can take over. And also it’s growing. It’s not finished,” he said.
Needlman said reading offers one of the best ways to help the brain bounce back from lead exposure, which is why he helped start the national Reach Out and Read program where doctors give books to patients and encourage reading.
Looking at pictures, naming objects, hearing and sounding out words, Needlman said, all fire up important connections in the brain.
No Perfect Research
Nothing makes University of Cincinnati researcher Kim Dietrich bristle more than inferring that kids with lead in their systems are a lost cause.
“So the idea, the concept, that children who are exposed to lead early on are a lost generation is completely fallacious,” said Dietrich.
Dietrich was part of a 2015 CDC working group that reviewed the scientific literature on ways to help lead exposed children. He thinks reading is an excellent strategy, given the decades of research that speak to the benefit of reading to children in general.
But Dietrich and others in the field, including Needlman, acknowledge that there isn’t perfect scientific data on its effectiveness yet. It also wouldn’t be ethical to do a perfect study — a researcher couldn’t ask some parents to not read to their lead-exposed children, just so they would have a control group.
Case Western Reserve University’s Rob Fischer is planning a new study to gather some data about programs that get books into the hands of children with lead exposure.
Fischer recently co-authored a study that found high-quality preschool — which would have, in theory, a lot of reading and one-on-one attention — didn’t help lead-poisoned kids catch up to their peers. But there was nuance to their findings.
“We see in the evidence that there are lead exposed children who are on track to kindergarten, and are on track at third grade,” said Fischer. “What's allowing them to overcome that adversity? It’s very possible that something like reading and parental engagement in the child’s life is the success factor that allows that to happen.”
For Casey Tobik, reading is something she would have done anyway, but she’s encouraged by the messages of resiliency.
And at last count, Eden’s lead levels are down to 3.3.