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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.
Mea
n D
evel
opm
enta
l Qu
otie
nts
(D
Qs)
Control
Supplemented
Stimulated
Child’s Age (Months)
90
100
110
Source: Grantham-McGregor, et al. (1991)
95
105
Developmental Interventions Multiply Impact
12 mos. 18 mos.
Supplemented and stimulated
Baseline 6 mos. 24 mos.
Mea
n D
evel
opm
enta
l Qu
otie
nts
(D
Qs)
Control
Supplemented
Stimulated
Child’s Age (Months)
90
100
110
Source: Grantham-McGregor, et al. (1991)
95
105
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
Brains and Skills are Shaped by the “Serve and Return” Nature of Human Interaction
Brains and Skills are Shaped by the “Serve and Return” Nature of Human Interaction
Brains and Skills are Shaped by the “Serve and Return” Nature of Human Interaction
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
36
Language Skills (Median TVIP Score)
Poorest 25%
Richest 25%
50-75%
Child’s Age (Months)
60
90
Source: Schady and Paxton (2005)
80
100
110
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)
Ch
ildre
n w
ith
D
evel
opm
enta
l D
elay
s
1-2 3 5 4 6 7
20%
40%
60%
80%
100%
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
10%
20%
40%
30%
50%
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.
Positive Brief increases in heart rate,
mild elevations in stress hormone levels.
Three Levels of Stress Response
Toxic Prolonged activation of stress response systems
in the absence of protective relationships.
Tolerable Serious, temporary stress responses, buffered by supportive relationships.
Positive Brief increases in heart rate,
mild elevations in stress hormone levels.
Three Levels of Stress Response
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
Health-Related Behaviors
Educational Achievement & Economic Productivity
Physical & Mental Health
Source: Center on the Developing Child (2010)
Biology of Health and
Development
Foundations of Healthy
Development
Caregiver & Community Capacities
Policy & Program
Levers for Innovation
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
Health-Related Behaviors
Educational Achievement & Economic Productivity
Physical & Mental Health
Outcomes in Lifelong Well-Being
Biological Adaptations
or Disruptions
Foundations of Healthy
Development
Caregiver & Community Capacities
Policy & Program
Levers for Innovation Stable, Responsive
Relationships
Safe, Supportive Environments
Appropriate Nutrition
The Foundations of Healthy Development Influence Biological Responses Over Time
Source: Center on the Developing Child (2010)
Foundations of Healthy Development
Health-Related Behaviors
Educational Achievement & Economic Productivity
Physical & Mental Health
Outcomes in Lifelong Well-Being
Biological Adaptations
or Disruptions
Foundations of Healthy
Development
Caregiver & Community Capacities
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
Source: Center on the Developing Child (2010)
Caregiver and Community Capacities
Health-Related Behaviors
Educational Achievement & Economic Productivity
Physical & Mental Health
Outcomes in Lifelong Well-Being
Biological Adaptations
or Disruptions
Foundations of Healthy
Development
Caregiver & Community Capacities
Policy & Program
Levers for Innovation
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
Source: Center on the Developing Child (2010)
Policy & Program Levers for Innovation
Science Can Inform an Integrated Approach to Early Investment in Healthy Development
Source: Center on the Developing Child (2010)
Policy & Program
Levers for Innovation
Science Can Inform an Integrated Approach to Early Investment in Healthy Development
Source: Center on the Developing Child (2010)
Policy & Program
Levers for Innovation
Caregiver & Community Capacities
Science Can Inform an Integrated Approach to Early Investment in Healthy Development
Source: Center on the Developing Child (2010)
Policy & Program
Levers for Innovation
Caregiver & Community Capacities
Foundations of Healthy
Development
Science Can Inform an Integrated Approach to Early Investment in Healthy Development
Source: Center on the Developing Child (2010)
Policy & Program
Levers for Innovation
Caregiver & Community Capacities
Foundations of Healthy
Development
Biological Adaptations
or Disruptions
Science Can Inform an Integrated Approach to Early Investment in Healthy Development
Source: Center on the Developing Child (2010)
Biological Adaptations
or Disruptions
Foundations of Healthy
Development
Caregiver & Community Capacities
Policy & Program
Levers for Innovation
Science Can Inform an Integrated Approach to Early Investment in Healthy Development
Source: Center on the Developing Child (2010)
Health & Development Across the Lifespan
Preconception Prenatal
Early Childhood
Middle Childhood
Adolescence
Adulthood
Biological Adaptations
or Disruptions
Foundations of Healthy
Development
Caregiver & Community Capacities
Policy & Program
Levers for Innovation
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
1
Generating Hypotheses to Guide New Intervention Strategies
Protection and enrichment for young children require capacity-building for their caregivers
Healthy development requires protection and enrichment Early experiences affect lifelong health and learning
1
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
2
Healthy development requires protection and enrichment Early experiences affect lifelong health and learning
1
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
2
Strong communities reduce sources of toxic stress 3
Healthy development requires protection and enrichment Early experiences affect lifelong health and learning
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
Rules
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)
Birth
Age (Years) 50 70 80
Ski
ll p
rofi
cien
cy
3 5 15 25 30 10
The Opportunity: Circuits for Executive Function Skills Are Located in Brain Regions that Exhibit
an Extended Period of Plasticity
Weintraub, et al., (2011)
Birth
Age (Years) 50 70 80
Ski
ll p
rofi
cien
cy
3 5 15 25 30 10
The Opportunity: Circuits for Executive Function Skills Are Located in Brain Regions that Exhibit
an Extended Period of Plasticity
Weintraub, et al., (2011)
Birth
Age (Years) 50 70 80
Ski
ll p
rofi
cien
cy
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