SCIENTIFIC EVIDENCE FOR THE IMPORTANCE

OF SUPPORTING DEVELOPMENT OF YOUNG

CHILDREN IN LAC

Maureen Samms-Vaughan

Working Group on Education Mtg.

Costa Rica, April 2016

THE LAC REGION

33 countries

15 dependents and/or other

countries

Vary tremendously in

Size

Population

Language

Governance

Economic Development

OUTLINE

A Trajectory of Childhood in LAC

The Biology of Brain Development

Practical Evidence for the Importance of the early years

Intervention Evidence for ECD

The Cross-Sectoral Approach to ECD

ECD successes and Challenges in LAC

A Trajectory of Childhood in LAC: A Second Look

Conclusions : What does this mean for the LAC Region?

A TRAJECTORY OF CHILDHOOD IN LAC

A group of children are born within months of each

other in a town somewhere in the LAC region

At 3 years, they go to the same pre-school in their

town

The teacher finds the children diverse, there are some

striking differences.

WHY ARE THE CHILDREN DIFFERENT?

Were some “born bad?” as we sometimes say? NOT SO

The Science of Early Childhood Development indicates that the first few years of life are critical to children’s health, development and behaviour and set the stage for adult health, education and behaviour

All Children are born wired for feelings and ready to learn.

It is the environment that we have created for them that determines who they become as children AND for many years to come as adults. What is the evidence for this?

THE BIOLOGY OF THE BRAIN

BRAIN GROWTH THROUGHOUT LIFE

The brain grows most rapidly during the EC period

Two thirds (2/3) of brain size is achieved by 21/2 to 3 years

Growth then occurs more slowly until 18 years when adult head size is

reached.

MICRO-LEVEL BRAIN GROWTH I

.

Kolb, U Lethbridge

Average Number of Neurons in the Brain:

100 Billion

Number of Synaptic Connections at Birth:

50 Trillion

Number of Synaptic Connections after a few months

(20 times) :

1,000Trillion

DETAILS OF BRAIN GROWTH

Neurons and connections that you are born with are

responsible for basic functions of life, keeping the heart

beating, breathing etc.

Further increase in complexity of the brain is dependent on

the young child’s experience .

Two types of further brain growth:

Differentiation into specialised brain cells.

Increase in number of synapses

MICRO-LEVEL BRAIN GROWTH II

Maximal brain growth between

birth and 6 years

“Use it or lose it principle”

Synapses or connections that

are not used die away

`Sensitive periods’ in early brain development

Vision

0 1 2 3 7654

High

Low

Years

Habitual ways of responding

Language

Emotional control

Conceptualization

Peer social skills`Numbers’

Hearing

Graph developed by Council for Early Child Development (ref: Nash, 1997; Early Years Study, 1999; Shonkoff, 2000.)

“Pre-school” years School years

CONCLUSIONS FROM BIOLOGY

The early years of life are important because the interactions that

a young child has with his/her environment determines the

structure of the brain

There are important sensitive periods of brain development

Early experiences determine learning, behaviour and health

Early experiences determine whether a child has a strong or

fragile foundation to go into adulthood with

PRACTICAL EVIDENCE FOR IMPORTANCE

OF EARLY DEVELOPMENT

LANGUAGE AND LEARNING

Early Child Development and Language

Language development starts early:

first 7 months

Sets capability for mastering

multiple languages

Sets literacy and language trajectory

0

600

1200

12 16 20 24 28 32 36

High

Middle

Low

Age - Months

Vocabulary Growth – First 3 Years

B. Hart & T. Risley, Meaningful Differences in Everyday

Experiences of Young American Children, 1995

Vocabulary Word Exposure

Test of Language Development

(TOLD) at Age 9

Can predict a child’s reading score at

age 9 years from vocabulary at 3 years

Correlation between vocabulary growth

at Age 3 and TOLD at Age 9 : 0.74

04-146

READING SCORES BY NO. OF POSSESSIONS IN HOME:

PRE-SCHOOL TO GRADE 3 (JAMAICA)

0

5

10

15

20

25

30

Pre-School Grade I Grade 3

0 to 2

3 to 4

5 to 6

7 to 10

<2.5

Birthweight (kg)

Test S

core

BIRTHWEIGHT AND MATH

1958 Birth Cohort (UK)

09-033

Jefferis et al. 2002

2.5-3.0 3.01-3.5 3.51-4.0 >4.0

-0.4

-0.3

-0.2

-0.1

0

0.1

0.2

LOW BIRTHWEIGHT AND READING

(LA and Cuba)

Birthweight Reading

% Infants % Level 4

Low BW Grade 6

UNICEF 2008 UNESCO 2008

Cuba 5 51

Chile 6 29

Mexico 8 24

Brazil 8 22

Adapted from UNICEF 2008 and UNESCO 2008

Reading Levels: 1 (Low); 4 (High) UNESCO

BIRTHWEIGHT AND SCHOOL SCORES

11-12 YRS (JAMAICA)

Arithemtic Spelling Reading0

10

20

30

40

Arithemtic Spelling Reading

LBW NBW*** ***

***

Samms-Vaughan, 2002*** p< 0.0001

SUMMARY

Children who get exposed to language in the first

few years of life go on to have better reading ability

in later childhood and adulthood

Children of low birth weight, a birth vulnerability

factor, have later learning and behaviour difficulties

PHYSICAL HEALTH

PHYSICAL HEALTH

• Babies born small for age (not premature) have higher physical health risks as adults of:

• Heart disease

• High Blood Pressure

• Type 2 Diabetes

• Obesity

• Vulnerability to Aging

• Babies who are undernourished in the first few years of life have later learning difficulties

ECD Swedish Longitudinal Study and Adult Health

Number of Adverse ECD Circumstances*

Odds - RatiosAdult Health

0 1 2 3 4

General Physical

Circulatory

Mental

1

1

1

1.39

1.56

1.78

1.54

1.53

2.05 3.76

2.91

2.08

10.27

7.76

2.66

* Economic, family size, broken family and family dissention

Lundberg, Soc. Sci. Med, Vol. 36, No. 8, 1993

04-006

MENTAL HEALTH

STRESS AND THE DEVELOPING BRAIN (1)

Stress systems are particularly malleable or “plastic” during the fetal and early childhood periods

Early experiences shape how readily they are activated and how well the responses can be contained and turned off

Stress responses that are activated too frequently or for prolonged periods in the absence of supportive systems (Toxic stress) are damaging to the brain.

STRESS AND THE DEVELOPING BRAIN (2)

Toxic stress (including exposure to violence) during this period affects the developing systems and result in systems that are hyper-reactive or slow to shut down when faced with threats

This leads to increased risk of behavioural and physiological disorders:

- Anxiety & Depression- Alcoholism & Drug Abuse- Cognitive & Memory Impairment- Cardiovascular Disease- Stroke- Diabetes- Infections

IMPACT OF CHILD NEGLECT:

Romanian Orphan Adoption

Children adopted into middle class homes after 8

months in the orphanages show at 11 years in

contrast to children adopted early:

1. Abnormal brain development (small brain, low

metabolic activity, abnormal EEG)

2. Social and cognitive problems (IQ loss)

3. High vulnerability to behavioural problems

(ADHD, aggression, quasi-autism)

Kolb, U Lethbridge

IMPACT OF CHILD ABUSE

Physical damage to brain structure in areas responsible for

thinking (cortex), processing memories and emotions

(hippocampus), and responding to danger (amygdala). These

regions are critical for learning.

The hippocampus becomes smaller with chronic abuse.

Changes in brain chemistry also occur. Increases the production

of the stress hormone cortisol, and neurotransmitters such as

epinephrine, dopamine and serotonin, the chemical messengers in

the brain that affect mood and behavior, leading to depression and

aggression.

Abnormal EEG and seizures.

Teicher, 1993, 1998

IMPACT OF ADVERSITY ON BRAIN DEVELOPMENT

SUMMARY

Children who do not have adequate emotional

stimulation or who have negative emotional

stimulation have mental health, learning, memory

and behaviour disorders.

INTERVENTION EVIDENCE :

CAN WE CHANGE CHILDRENS

OUTCOMES BY PROVIDING APPROPRIATE

EARLY ENVIRONMENTS?

OPPORTUNITIES FOR ECD INTERVENTION 1:

HIGH/SCOPE PERRY PRESCHOOL PROJECT, AGE 27 EFFECTS

20%

13%

7%

41%

36%

29%

0% 5% 10% 15% 20% 25% 30% 35% 40% 45%

Never on welfare

as adult

Own home

Earn $2,000 +

monthly

Program group

No-program group

Barnett, W.S. (1996). Lives in the balance: Benefit-cost analysis of the Perry Preschool Program through age 27. Monographs of the High/Scope Educational

Research Foundation. Ypsilanti, MI: High/Scope Press.

PERRY: ECONOMIC RETURN (2002 $)

$8K $65K $173K

$0 $20,000 $40,000 $60,000 $80,000 $100,000 $120,000 $140,000 $160,000 $180,000 $200,000 $220,000 $240,000

Costs

Benefits

Welfare Education EarningsChild Care Crime Preschool

$249,663

$15,386

WHAT MATTERED IN THE US?

Meta-Analysis:Direct Teaching

Other Studies:All children benefit, disadvantaged gain more

Focus—children learn what is taught

Educated, trained, adequately paid staff

Quality, Quality, Quality

DEVELOPMENTAL LEVELS OF STUNTED AND

NON-STUNTED CHILDREN AND BENEFITS OF

INTERVENTIONS

80

85

90

95

100

105

110

115

Baseline 6 mo 12 mo 18 mo 24 mo

DQ

Non-stunted

Both

Stimulated

Supplemented

Control

Grantham-McGregor et al, Lancet 1991

IQ AT AGE 17-18 YEARS

p=.02

p=.02

p=.001

p=.005p=.001

p=.054

62

64

66

68

70

72

74

76

78

80

IQ points

Verbal Performance Full Scale

No stim Stim Non stunted

Walker et al, Lancet 2005

Grade 3 Language Scores

UNESCO, 1998

100 250 300 350 400150 200

Argentina _ _ _ _ _ _ _ _

Brazil _ _ _ _ _ _ _ _ _ _

Chile _ _ _ _ _ _ _ _ _

Cuba _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Mexico _ _ _ _ _ _ _

05-066

Sociocultural

Gradients forLanguageScoresBy Country(UNESCO 1998)

Cuba

Argentina

Brazil

Colombia

Chile

Parents' Education (Years)

1 4 8 12 16200

240

280

320

360

Mexico

Willms & Somers, 2000

SUMMARY :

A quality ECD programme improves children’s educational and behavioural outcomes in the short term and as adults in the long term

Head Start Programme in USA- Higher numeracy levels- Higher literacy levels- Better social skills

ECD has a 17:1 return on investment based on:- Reduced remedial education- Reduced crime and violence- Reduced use of social services

The Mismatch Between Opportunity and Investment

0

2000000

4000000

6000000

8000000

10000000

12000000

Early Childhood Primary Secondary Tertiary

Education levels

Inve

stm

en

t

Brain's Malleability

Government Expenditure

Rates of Return to Human Development Investment Across all Ages

Pre-school Programs

School

Job Training

ReturnPer $Invested

R

2

4

6

8

0 6 18Age

Pre-School School Post School

Adapted from Founders’ Network (Carneiro, Heckman, Human Capital Policy, 2003)

THE CROSS-SECTORAL OR INTER-SECTORAL APPROACH TO ECD:

Experience from Jamaica and Colombia

Physical Health SDG3

Nutrition SDG 2

Nurture

(Socio-Emotional)

SDG3

Stimulation/ Development/

Education SDG 4

Protection SDG16

Public Health

(Water/ Sanitation)

SDG 6

Socio-Economic

Environment

(Standard of Living)

SDG1,8,9,10, 11,17

Physical, Chemical and

Built Environment

SDG 7,12,13,14,15

Preschools

Chaos (Slide from CECD)

Child care

Parenting centres

Children’s mental health centres

Kindergartens

Local school authorities

Public health

Munici-palities

Community

servicesParks &

recreation

Early interventionHealth Social

servicesEducation Family

support

ECC:Policy

frameworkand NSP

Early intervention

Coherence (Slide adapted from CECD)

Positive Child Outcomes

Family support

Education

Health

Social services

CROSS-SECTORAL ECD APPROACH: JAMAICA I

DEVELOPING THE STRATEGY

Establishment of a co-ordinating cross-sectoral agency (2003)

Development of the vision

Identification of existing resources, information sources and gaps

Conduct of studies to fill information gaps

Consultation with all stakeholders

Development of cross-sectoral Strategic Plan, including costing

Development of Implementation, Monitoring and Evaluation

Strategies

Development of Financing Strategies

EARLY CHILDHOOD DEVELOPMENT SECTOR

STRATEGY MAP – OCTOBER 2007

Natio

nal im

pact

Cu

stom

er

satis

factio

n

Key p

roce

sses

Work

ing e

nviro

nm

en

t

I1. Critical thinking,

socially competent,

healthy children

ready for life

I2. Fathers, mothers, guardians

are involved and satisfied with

services provided to their

children

I2. Parents are

informed, educated,

involved and

supported in meeting

early childhood

development needs

I1. Our children’s

special needs are

taken care of

IP1:

Effective

parenting

education

and

support

IP2:

Effective

preventive

health care

IP3:

Effective

screening,

diagnosis

and

intervention

for “at risk”

IP4: Safe

learner

centred

well-

maintained

EC

facilities

LG1: The sector and sector

agencies are achieveing targets

and are governed by

frameworks that promote

achieving results in a

consultative environment

LG2:

Timely clear and current information

to support evidence based decision

making

IP5:

Effective

curriculum

delivery by

trained early

childhood

practitioners

CROSS-SECTORAL ECD APPROACH: COLUMBIA I

Established an ECD Commission (Comisión Intersectorial de Atención Integral

en Primera Infancia- CIPI)

Reports to nation’s Parliament (True Cross-Sectoral Approach!!!)

Developed a national multi-sectoral Strategy for ECD (De Cero a Siempre)

through the following mechanisms:

Establishment of a multi-sector committee and multi-sector governance

arrangements to support coordination of the Commission's work across sectors

and levels of government;

Development of tools for strategy implementation

Operations Manual for local level implementation of the Strategy

Framework for the design of a Monitoring and Evaluation (M&E) system;

CROSS-SECTORAL ECD APPROACH: COLUMBIA II

Promotion of accountability through the development of quality standards

for ECD Centers and the design of a municipal-level tracking tool for ECD

services;

International benchmarking (SABER-ECD) and sharing best practices, which

assisted officials in assessing Colombia’s ECD policies and provided

recommendations for moving forward; and

South-South Knowledge Exchange: Chile to Colombia; Colombia to Bolivia

and Nicaragua

ECD SUCCESSES AND CHALLENGES:

LAC REGION

ENROLMENT OF CHILDREN 0-2 YRS. IN

DAY-CARE

PRE-SCHOOL ENROLMENT BY REGION

1999-2015

(UNESCO, GMR 2015)

OVERVIEW OF ECD SERVICES IN LAC: FINDINGS I

In depth review of 42 publicly funded programmes for children 0-3 in 19

countries in LAC

34 (85%) were centre based, 5 (15%) were parenting programmes.

2 purely nutrition programmes were excluded

37 (93%) were in LA, 3 (7%) were in the Caribbean Parenting programmes

were reviewed in 4 countries and child care (centre based) in 15

Programme heterogeneity; Large small scale

Community and institutional

Funding variable; impacts quality

Fewer parenting programmes which predominate in rural areas

Movement away from community services to institutional

OVERVIEW OF ECD SERVICES IN LAC: FINDINGS II

Many programmes not comprehensive; nutrition often not included

Inadequate teaching models

Inadequately trained and poorly paid staff

Inadequate and poorly monitored standards

High child to caregiver ratios

High cost for quality programmes

CRITERIA FOR TARGETTING OF ECD

CENTRE-BASED PROGRAMMES IN LAC

SABER ECD ASSESSMENTS LAC

VIOLENT CHILD DISCIPLINE

Children experiencing some type of violent child discipline in the month preceding the

survey% children between ages 2 and 4. (*)

Source: MICS except Haiti (DHS)

Violent child discipline methods in the household are very widespread in the region.

Two out of every three children between 2 and 4 regularly experience some kind of

violent discipline (psychological aggression or corporal punishment) in the home.

69

10 20 30 40 50 60 70 80 90

Cuba

Panama

Costa Rica

Uruguay

El Salvador

Rep.Dominicana

Saint Lucia

Belize

Guyana

Argentina

T&T

Barbados

Jamaica

Haiti

Suriname

Media Regional

CORPORAL PUNISHMENT

Corporal punishment is generalized in the region (1 of every 2 children are suffering from it).

5% of the under-5s are victims of severe physical punishment. Children living in the Caribbean

are more likely to be victims of physical punishment than those living in other sub-regions.

Children experiencing corporal punishment in the month preceding the survey% of children between 2 and 4 years. (*)

556

10 20 30 40 50 60 70 80

Cuba

Panama

Uruguay

Costa Rica

Rep.Dominicana

Saint Lucia

Argentina

El Salvador

T&T

Guyana

Belize

Suriname

Barbados

Jamaica

Haiti

Media Regional

cualquiera

severo

Source: MICS excepto Haiti (DHS)

Any

Severe

NON-VIOLENT DISCIPLINE

Children experiencing exclusively non-violent discipline in the month preceding the survey . (*)

Children under 5 subject only to non-violent disciplinary measures are a minority in LAC: on

average only 2 out of every 10 for the LAC countries with available information. Costa Rica,

Uruguay, Panama and Cuba are where the exclusive use of non-violent methods is most

common, tripling the figures from the countries of the Caribbean.

Source: MICS except Haiti (DHS)

21

0 5 10 15 20 25 30 35 40

Suriname

Haiti

Jamaica

Barbados

Saint Lucia

Rep.Dom.

T&T

Guyana

Argentina

Belize

El Salvador

Panama

Cuba

Uruguay

Costa Rica

Media Regional

A TRAJECTORY OF LAC CHILDHOOD :

A SECOND LOOK

Let us look again at those challenging pre-school children:

Did we provide their parents or caregivers with the supports they

needed to promote their development particularly 0-3 yrs?

Did we ensure their early childhood centres were of the highest quality

through appropriate standards?

Did any of the more challenging children have child or social protection

challenges that were missed?

Were any of them of low birth weight or did they have any other physical

health challenges?

Did we identify and provide intervention for early developmental or

behavioural disorders / disabilities?

CONCLUSIONS I

Inadequate attention to the early years results in

immediate consequences of children who fail to reach

academic, socio-emotional and health potential, and who

therefore become a challenge to society.

Inadequate attention to the early years results in long

term consequences of adults who fail to reach

educational and social potential

CONCLUSIONS IIThere is economic advantage to addressing the needs of young

children

LAC countries must address the needs of young children

comprehensively if we are to impact current problems of violence,

low academic attainment and low productivity

Our greatest challenges are in addressing needs of the 0-3 year

olds, social protection (poverty), child protection (violence), and

the needs of rural and minority children and those with disabilities.

CONCLUSIONS III

This is best done through a cross-sectoral approach

Our LAC children are depending on us to get it right for

them. They cannot do it themselves.