Leveraging Science to Strengthen the Foundations of Lifelong Learning,

Behavior, and Health

JACK P. SHONKOFF, M.D. Julius B. Richmond FAMRI Professor of Child Health and DevelopmentProfessor of Pediatrics and Director, Center on the Developing ChildHarvard University

São Paulo Early Childhood Development ConferenceSão Paulo, Brazil | May 6, 2014

The Foundation of a Successful Society is Built in Early Childhood

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

Advances in neuroscience, molecular biology, epigenetics, and the behavioral and social sciences could be leveraged to catalyze more effective policies and practices across multiple sectors.

Genes and Experiences Interact to Build Brain Architecture

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

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%

The Cumulative Pile Up of Adversity Impairs Development in the First Three Years

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

Ch

ild

ren

wit

h

Develo

pm

en

tal D

ela

ys

1-2 3 54 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)

Toxic Stress Derails Healthy Development

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

Stable and supportive relationships, language-rich environments, and mutually responsive, “serve and return” interactions with adults promote healthy brain architecture and adaptive regulatory systems.

Excessive or prolonged activation of stress response systems and reduced availability of the buffering protection of supportive relationships can weaken brain architecture and disrupt the development of other organ systems.

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

Enhance quality and take effective models to scale

Build strong systems for coordinated service delivery and data management

Formulate enhanced theories of change, test new ideas, and learn from interventions that don’t achieve sufficiently larger impacts

Increasing the Returns on Current Investments Requires Three Strategies

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

Healthy development requires both protection and enrichment

Early experiences affect both lifelong health and learning

1

Generating Hypotheses to Guide the Design and Testing of 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

EmotionsEmotions

Skill Building for Parenting and Economic Self-Sufficiency Points to the Foundational Role of Executive Function and Self-Regulation Skills

These core dimensions of adult competence include the ability to focus and sustain attention; set goals, make plans, and monitor actions; make decisions and solve problems; follow rules, control impulses, and defer gratification.

Error Error ProcessingProcessing

Reaction Reaction and and ResponsesResponses

Use of Use of RulesRules

Risk/Reward Risk/Reward DecisionsDecisions

Behavioral Behavioral ControlControl

Working Working MemoryMemory

The Development of Executive Function Skills Begins in Early Childhood and

Extends into the Early Adult Years

Source: Weintraub, et al. (2011)

Birth

Age (Years)

50 70 80

Skill p

rofi

cie

ncy

3 5 15 25 3010

ECE only: no parent involvement

Analysis of Parent Involvement in Early Childhood Programs Illustrates Challenges and Opportunities

Source: Grindal, et al. (under review)

Eff

ect

Siz

e

Cognitive Skills

.2

.4

.6

Pre-Academic Skills

.1

.3

.5

Average Impacts of 88 Early Childhood Education Programs (1960-2007)

ECE + modeling/practice for parents

ECE + passive parent education

Crafting a New Framework for Intergenerational Investment

If we really want to achieve breakthrough outcomes for children facing significant adversity, then we have to transform the lives of the adults who care for them.

www.developingchild.harvard.edu