it takes a village to raise a child equity from the start
TRANSCRIPT
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It Takes a Village to Raise a ChildEquity from The Start – Part 1
Early Child Development:
Jean M Clinton B.Mus MD FRCP(C)Clinical ProfessorMcMaster University
Zero to Three fellowChild Trauma Academy [email protected]@drjeanforkids
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2
Infant and Early Childhood Mental Health: “It Takes a Village” –Part 2 on December 3rd, 2020 – 1:00pm – 2:00pm
Dr. James ReynoldsDr. Chaya KulkarniDr. Diane Philips
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Why is Early Child Development Important?
It is a Determining Influence on Subsequent
Life Chances and Health
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“Poor social policies, unfair economics and bad politics are killing people on a grand scale.”
Sir Michael Marmot
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Do we need to worry about social determinants of health in Hamilton, in
Ontario, in Canada?
In a word
YES…WE DO
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CODE RED HAMILTON
http://media.metroland.com/thespec.com/statistics_flash
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Families or Society
9
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What Influences
Early Child Development?
The experiences children have in the environments where they grow up, live and learn.
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Which Environments Matter?
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Time Magazine from the MEHRI Neuroscience lab
Watching the Brain Learn!!
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National Scientific Council on the Developing Child (2010). Early Experiences Can Alter Gene Expression and Affect Long-Term Development: Working Paper No. 10. Retrieved from www.developingchild.harvard.edu September 28, 2010.
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What is experience?
Everything that you encounter
both pre- and postnatally aswell as in adulthood…
Examples: sounds, touch, light,
food, thoughts, drugs, injury,
disease…
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Plasticity
• Plasticity: brain’s ability to rearrange the connections between neurons
• Changes that occur in the structure of the brain as result of learning or experience (adaptation)
• High levels of stimulation, numerous learning opportunities, increase in density of neural connections
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From Aitken and Trevarthen16
04-212
Sound
Vision
Smell
Touch
Proprioception
Taste
SERVE AND RETURN
Concept also from Centre on the Developing Child at Harvard University
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The early years of life matter
• because early experiences affect the architecture of the maturing brain.
• As it emerges, the quality of that architecture establishes either a sturdy or a fragile foundation for all of the development and behavior that follows ---
Schonkoff- Frameworks Institute
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Childhood Mental Health Is…
The developing capacity of the child to:• form close and secure adult and peer relationships,• experience, manage and express a full range of emotions• explore the environment and learn –
All in the context of family, community, and culture
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Cohen, Oser & Quigley, 2012 Zero to Three
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USE IT OR LOSE IT !The more a system, or set of brain cells is activated, the more
that system changes in response. The stronger the repetitions the stronger the memory.
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What Does the EDI Measure?
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All Children
Included in Age 5
School Entry Year
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Australia: % vulnerable by SES
35.3
27.6 26.324
18.7
11.2
0
5
10
15
20
25
30
35
40
Bottom
10%
10-25% 25-50% 50-75% 75-90% Top 90%
vulnerable %
%
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Stress …..don’t go NUTS
• Novelty, • Unpredictability, • Threat to the ego, • Sense of loss of control
Dr Sonia Lupien Centre for Studies on Human Stress
http://www.humanstress.ca/
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Stress Pathway and Health
Cortisol – Over Production
Behaviour, depression, type II diabetes,
cardiovascular disease, memory, immune
system function, drug and alcohol addiction
Cortisol – Under Production
Chronic fatigue syndrome, fibromyalgia, immune
system (autoimmune disorders) rheumatoid
arthritis, allergies, asthma
05-212
McEwen 1998
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Life Course Problems Related to
Early Life
2nd
Decade
3rd/4th
Decade
5th/6th
Decade Old Age
• School Failure
• Teen Pregnancy
• Criminality
• Obesity
• Elevated Blood
Pressure
• Depression
• Coronary Heart
Disease
• Diabetes
• Premature
Aging
• Memory Loss
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The Impact of Toxic StressPoverty as an example
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Poverty (and early adversity) is associated with lower cognitive readiness for school
• Attention skills-sustaining attention and following instructions
• Language skills (vocabulary and grammatical understanding)
• Memory skills, (Working memory and memory)Karen Bierman, Ph.D. Penn State University
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The Long Reach of Early Childhood
• The longer children lived in poverty, the higher the measured stress load and lower score on working memory tests
• A plausible contributor to the income-achievement gap is working memory impairment in lower- income adults caused by stress-related damage to the brain during childhood”
Evans and Schamberg PNaS 2009
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Biological embedding occurs when…
• experience gets under the skin and alters human bio-development;
• systematic differences in experience in different social environments lead to different bio-developmental states;
• the differences are stable and long-term;they influence health, well-being, learning, and/or behaviour over the life course.
Biological Embedding
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Precis octaviaWet Season Dry Season
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Agouti “Twin” Sisters
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It does not only occur during basic
fetal development, when cells are
specializing……it can continue after
birth and be influenced by the
broader environment!
What’s new about this?
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Parents change us too…
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Methylation
Dr R Gibb U of Lethbridge
Epigenetics
Is any process that can alter gene activity without
changing the DNA sequence.
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DNA Is Not Destiny The new science of
epigenetics rewrites
the rules of disease,
heredity, and identity.
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Epigenetics of touch
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What are the Adverse Childhood Experiences?
◆Emotional abuse
◆Physical abuse
◆Sexual abuse
◆Emotional neglect
◆Physical neglect
◆Mother treated violently
◆Household use of drugs or alcohol
◆Household mental illness
◆Parental Separation or Divorce
◆Incarcerated household member
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Parenting Stress and Ace’s
• Maternal report of exposure to ACEs during childhood is significantly associated with parental stress, even after controlling for poverty and being at-risk (i.e., clinical sample).
• As John Bowlby (1951)never hesitated to suggest: “a society that values its children must cherish their parents”
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Strategic Insight
The burden of mental health problems and early criminality will be driven by the level of
vulnerability in social-emotional development in the early years.
Thus, our strategy should focus on reducing vulnerability early in life.
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Rates of Return to Human Development
Investment Across all Ages
Pre-school Programs
School
Job Training
Return
Per
$
Invested
R
2
4
6
8
0 6 18Age
Pre-
School School Post School
03-074
Carneiro, Heckman, Human Capital Policy, 2003
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Current System
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What the WHO Commission recommended
Commit to and implement a comprehensive approach to early
life, building on existing child survival programs and extending
interventions in early life to include social/emotional &
language/cognitive development.
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Innovating and Advancing Child
and Youth Mental HealthNovember 23 to December 4
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