Leveraging Science to Strengthen the Foundations of Lifelong … · 2017-08-18 · Brains are built...

Leveraging Science to Strengthen the Foundations of Lifelong Learning,

Behavior and Health through Innovations in Policy and Practice

James Cairns Project Director, Global Children’s Initiative Center on the Developing Child Harvard University

CORE Group Webinar April 2, 2014

The Foundation of a Healthy and Sustainable Society is Built in

Early Childhood Early development provides the building blocks for educational achievement, economic productivity, responsible citizenship, lifelong health, strong communities, and successful parenting of the next generation.

The Foundation of a Healthy and Sustainable Society is Built in

Early Childhood Early development provides the building blocks for educational achievement, economic productivity, responsible citizenship, lifelong health, strong communities, and successful parenting of the next generation. Attention to early development can multiply the impact of investments in many different sectors, including health, education, nutrition, protection, and economic empowerment.

Baseline 6 mos. 24 mos.

Control

Supplemented

Stimulated

Child’s Age (Months)

Source: Grantham-McGregor, et al. (1991)

Developmental Interventions Multiply Impact

12 mos. 18 mos.

Supplemented and stimulated

Baseline 6 mos. 24 mos.

Control

Supplemented

Stimulated

Source: Grantham-McGregor, et al. (1991)

Developmental Interventions Multiply Impact

12 mos. 18 mos.

Supplemented and stimulated

Non-stunted

PART 1: CORE SCIENTIFIC CONCEPTS

Brains are built over time, starting in the earliest years of life. Simple skills come first; more complex skills build on top of them.

Brain Architecture Supports Lifelong Learning, Behavior, and Health

Cognitive, emotional, and social capabilities are inextricably intertwined throughout the life course. A strong foundation in the early years improves the odds for positive outcomes and a weak foundation increases the odds of later difficulties.

Neural Circuits are Wired in a Bottom-Up Sequence

FIRST YEAR

-8 -7 -6 -5 -4 -3 -2 -1 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Birth (Months) (Years)

Sensory Pathways (Vision, Hearing)

Language Higher Cognitive Function

Source: C.A. Nelson (2000)

Brains and Skills are Shaped by the “Serve and Return” Nature of Human Interaction

The Ability to Change Brains Decreases Over Time

Source: Levitt (2009)

Birth 10 20 30

Normal Brain Plasticity Influenced by Experience

Age (Years)

40 50 60 70

The Ability to Change Brains Decreases Over Time

Source: Levitt (2009)

Birth 10 20 30

Physiological “Effort” Required to Enhance Neural Connections

Normal Brain Plasticity Influenced by Experience

Age (Years)

40 50 60 70

Barriers to Educational Achievement Emerge Before School Begins

Language Skills (Median TVIP Score)

Poorest 25%

Richest 25%

50-75%

Source: Schady and Paxton (2005)

42 48 54 60 66 72

70 25-50%

Significant Adversity Impairs Development in the First Three Years

Number of Risk Factors Source: Barth, et al. (2008)

1-2 3 5 4 6 7

Biological “Memories” Link Maltreatment in Childhood to Greater Risk of Adult Heart Disease

Percent of adults with biological

marker for greater risk of heart disease

Source: Danese, et al. (2008)

Control

Depression (age 32)

Depression (age 32) + Maltreated (as a child)

Maltreated (as a child)

Research on the biology of stress illustrates how increases in heart rate, blood pressure, serum glucose, stress hormones, and inflammatory cytokines fuel the “fight or flight response” to deal with acute threat...

…but excessive or prolonged activation of stress response systems can lead to long-term disruptions in brain architecture, immune status, metabolic systems, and cardiovascular function.

Early Life Experiences Are Built Into Our Bodies (For Better or For Worse)

Positive Brief increases in heart rate,

mild elevations in stress hormone levels.

Three Levels of Stress Response

Tolerable Serious, temporary stress responses, buffered by supportive relationships.

Toxic Prolonged activation of stress response systems

in the absence of protective relationships.

Tolerable Serious, temporary stress responses, buffered by supportive relationships.

Learning how to cope with moderate, short-lived stress can build a healthy stress response system.

Relationships Buffer the Effects of Stress

Toxic stress—when the body’s stress response system is activated excessively—can weaken developing brain architecture.

Without caring adults to buffer children, toxic stress associated with extreme poverty, neglect, abuse, or severe maternal depression can have long-term consequences for learning, behavior, and both physical and mental health.

PART 2: A MODEL FOR APPLYING SCIENCE TO POLICY AND

PROGRAMS

Health & Development Across the Lifespan

Preconception Prenatal

Early Childhood

Middle Childhood

Adolescence

Adulthood

Source: Center on the Developing Child (2010)

Biology of Health and

Development

Foundations of Healthy

Development

Caregiver & Community Capacities

Policy & Program

Levers for Innovation

Advances in Science Can Help Construct a

Logic Model to Guide Early Childhood Policy

Long-Term Outcomes

Health-Related Behaviors

Educational Achievement & Economic Productivity

Physical & Mental Health

Long-Term Outcomes

Biology of Health and

Development

Policy & Program

Biology of Health, Learning, and Behavior

Biological Embedding

During Sensitive Periods

Cumulative Effects Over Time

Gene-Environment Interaction

Physiological Adaptations & Disruptions

Early Experiences Are Built Into the Body Through Complex Physiological Pathways

Outcomes in Lifelong Well-Being

Biological Adaptations

or Disruptions

Development

Policy & Program

Levers for Innovation Stable, Responsive

Relationships

Safe, Supportive Environments

Appropriate Nutrition

The Foundations of Healthy Development Influence Biological Responses Over Time

Foundations of Healthy Development

or Disruptions

Development

Policy & Program

Levers for Innovation Time and Commitment

Financial, Psychological, and Institutional Resources

Skills and Knowledge

Caregiver and Community Capacities Affect the Strength of the Foundations

Caregiver and Community Capacities

or Disruptions

Development

Policy & Program

Primary Health Care Public Health Child Care & Early Education Child Protection and Social Welfare Economic and Community Development Private Sector Actions

The Developmental Needs of Young Children Can Be Addressed Across Multiple Sectors

Policy & Program Levers for Innovation

Science Can Inform an Integrated Approach to Early Investment in Healthy Development

Policy & Program

Development

Policy & Program

Development

or Disruptions

Development

Policy & Program

Health & Development Across the Lifespan

Preconception Prenatal

Early Childhood

Middle Childhood

Adolescence

Adulthood

or Disruptions

Development

Policy & Program

PART 3: AN INNOVATION AGENDA FOR

EARLY CHILDHOOD

Child Survival, Basic Health Care, Sound Nutrition, Nurture and Stimulation, and Health-Promoting Environments

Healthy Development

Current Framework Guiding Early Childhood Health and Development

Significant Adversity

Child Survival, Basic Health Care, Sound Nutrition, Nurture and Stimulation, and Health-Promoting Environments

Impaired Development

Current Framework Guiding Early Childhood Health and Development

Using 21st Century Science to Change the Narrative for Policy and Practice Across Sectors

Early experiences affect lifelong health and learning

Using 21st Century Science to Change the Narrative for Policy and Practice Across Sectors

Healthy development requires protection and enrichment Early experiences affect lifelong health and learning

Generating Hypotheses to Guide New Intervention Strategies

Protection and enrichment for young children require capacity-building for their caregivers

Improved parenting skills also enhance employability and economic stability

Strong communities reduce sources of toxic stress 3

Emotions

Skill Building for Both Parenting and Employability Points to the Foundational Role

of the Brain’s “Air Traffic Control System”

These core capacities in “executive functioning” and “self-regulation” include the ability to focus and sustain attention, set goals and make plans, follow rules, solve problems, monitor actions, defer gratification, and control impulses.

Error Processing

Reaction and Responses Use of

Risk/Reward Decisions

Behavioral Control

Working Memory

The Opportunity: Circuits for Executive Function Skills Are Located in Brain Regions that Exhibit

an Extended Period of Plasticity

Weintraub, et al., (2011)

Age (Years) 50 70 80

3 5 15 25 30 10

How can the science be used to incorporate development into current work in order to magnify impact in policies and programs?

Creating a Science-based Agenda to Improve Child Outcomes

How can the science be used to incorporate development into current work in order to magnify impact in policies and programs?

How can child-oriented actors in the international development community work together in new ways that lead to better outcomes for children facing adversity?

Creating a Science-based Agenda to Improve Child Outcomes

www.developingchild.harvard.edu

Leveraging Science to Strengthen the Foundations of Lifelong … · 2017-08-18 · Brains are built...

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