Dr. Silvia Bartolozzi

In this interview, Dr. Bartolozzi takes us inside the fascinating world of early childhood brain development. She explains how emotions and behavior are shaped in the first years of life, debunks common myths about the developing brain and offers practical advice for parents raising children in today’s fast-paced, screen-filled world. She also highlights key warning signs to watch for and shows how simple, consistent care and interaction can make a lasting difference in a child’s growth and well-being. Enjoy!

From your experience, what are some of the most fascinating aspects of how a child’s brain develops in the early years of life?

I’ve been doing this job (the pediatrician) for 31 years and I’m still amazed by how quickly a child’s brain grows in the first 3 years. Some aspects are a real miracle of nature. It’s as if a small tree were born and within a year, cerebrally, it became a baobab. Interneuronal connections are created in response to environmental stimuli and multiply in the first three years of life. The brain can form millions of synapses per second. It’s a phase of “superplasticity” that will never happen again. That’s why a calm voice, reading, skin-to-skin contact, routine, shared play are all tools that help neural circuits grow. The brain produces many connections, then eliminates the ones that are used less. It’s a natural process that makes it more efficient. Always remember that in the first months of life children “read” the world through the faces and the tone of voice of adults. We talk about psychomotor development precisely because the milestones in the first year are many: they learn to crawl, to walk, to be stable but also to recognize voices and faces, to feel safe, to laugh, to speak, to exchange words and emotions. In short, it’s the miracle of life that begins in the womb but is completed in the environment, in the contact with mother and father and then with others.

In what ways does brain development in children influence their emotional and behavioral growth?

In the early years of life the emotional areas (especially the limbic system made up of the amygdala, hippocampus, cingulate cortex) mature much earlier than the areas responsible for rational control (the prefrontal cortex, responsible for impulse inhibition, planning, cognitive flexibility, managing frustration and understanding consequences). In short, “feeling” develops first and “managing” comes later. This is why a tantrum, an inconsolable cry, an oppositional or explosive behavior are almost never signs of intentional misbehavior or intentional stubbornness but the natural expression of a brain that feels more than it knows how to manage. It’s the adult who, through behavior that calms and gives a sense of safety, must support the child’s behavioral development by modulating their emotional outbursts with consistency and affectionate gestures (a hug is containing) and by creating reassuring routines. So emotional development and behavioral development are tied to brain development, which in turn is tied to interaction with the environment. This shows how the parental role is fundamental for the serenity and balance of children.

What are some common misconceptions people have about the “developing brain”?

Some recurring beliefs need to be dismantled. Here are a few examples:

“The brain is predetermined”: nothing could be more false, the brain is extremely plastic so environment, relationships and routines matter enormously.

“Constant stimulation is better.” : the brain also needs pauses, boredom, rest so we should stop creating an intense weekly schedule for our children that could rival that of a multinational CEO.

Rushing to reach milestones is what leads to judging a child as pathological too quickly during neurological development. Every individual is a reality of their own: individual variations are normal. Some children need more time to reach a milestone (think of crawling, walking, speaking etc). Let’s observe them and let the pediatrician guide us as parents.

“The child behaves like this because they’re acting out on purpose” : it’s generally not intentional, it’s neurological immaturity. It’s up to us to contain them and evaluate how things evolve.

Are there small details that pediatricians notice — maybe a movement, a reaction or a habit — that can reveal a lot about a child’s neurological health?

The pediatrician is an observer, a kind of Sherlock Holmes in search of clues. This is especially true when the child is very young and does not speak. Over the years we learn to assess even small details and to recheck them over time. If they persist, then action is needed. In newborns we immediately try to evaluate reactivity to sounds and the mother’s voice and whether they are easily consoled. Then, over time, we assess the acquisition of certain motor milestones such as the fluidity of movements, grasping, turning, sitting without support, crawling and walking. From the very beginning, eye contact, smiling, and interacting with the environment are important. None of these signals is diagnostic on its own: they are clues, not conclusions.

Children today grow up surrounded by screens, stress and constant stimulation. How do you think this environment is reshaping their brains compared to previous generations?

Once, in the pre-internet era, children played in courtyards and parks. Now reality is virtual and friends are heard or seen through a phone. But language, the sharing of constructive experiences and empathy are fundamental for building a balanced adult. Today, children can no longer get bored, and to avoid hearing them complain, they are usually given a phone in their hand. Greater exposure to fast stimuli and immediate gratifications makes it harder to tolerate frustration and waiting, which will, however, be present in life. There is a risk of creating maladapted individuals. Phones should not be used before the age of 12 and, in any case, should always be monitored by parents and regulated in terms of time. The stimuli provided by the internet should only be limited to the time spent in front of devices and related to age. If we observe this, we will have only positive effects related to the ease with which new knowledge can be acquired and new languages learned, taking full advantage of neural plasticity. That said, I do not see screens as “enemies”: the problem is the quantity and, above all, the replacement of real relationships.

What gives you hope regarding the next generation’s relationship with their own mind and mental health?

A lot, actually: first of all, there is a growing awareness of psychological well-being, and this is only a good thing. There is also more openness in seeking help. Parents themselves are more informed and attentive to mental health. More importance is also given to emotions, critical thinking, and inclusion. Children grow up, on average, more curious and more critical. The increasing awareness of psychological well-being is a huge change compared to the beginning of my career.

How can parents recognize early signs that something might not be right neurologically — and when should they seek medical advice?

We should not be constantly worried, but there are some signals that parents should report to the pediatrician. For the youngest children, “red flags” include low reactivity to faces or sounds, absence of vocalizations after the first months, rigidly asymmetric or overly repetitive movements and difficulty consoling. Later on, concerning signs include loss of previously acquired skills, persistent difficulties with language, highly repetitive behaviors, low interest in the environment and people, marked and persistent irritability and excessive difficulty managing even minor changes.

Let’s also remember that the pediatrician conducts “Health Assessments,” which are scheduled periodic visits designed precisely to monitor the child’s psychophysical development and to highlight critical signs that should be further evaluated by a specialist.