Towards an Integrated System of Early Child Development Programs

1
Towards an Integrated System of Early Child
Development Programs
2004 Annual Meeting European Society for Social
Pediatrics
Montreal, Quebec
By J. Fraser Mustard Founding President, CIAR
September 23, 2004
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03-072
CIAR
The Canadian Institute for Advanced Research
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03-073
CIAR Programs
Population Health Human Development Economic
Growth
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04-033
Early Child Development and Human Development
Unacceptable gap between what we know and what we
do
Why?
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04-152
WHAT DO WE KNOW?
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What Do We Know?
The Biology of Brain Development
Conditions of early life affect the
differentiation and function of billions of
neurons in the brain. This early experience sets
up the pathways (connections) among the different
centres in the brain.
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Experience-Based Brain Development in the early
years of life sets neurological and biological
pathways that affect health and well-being
throughout life
Health
Learning
Behaviour
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The brain is a pathway by which experiences get
under the skin to affect health, learning and
behaviour.
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Why the Gap?
Lack of understanding Social/Cultural Profession
al silos Failure to integrate knowledge about
ECD and human development Cost of quality ECD
programs
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NEUROSCIENCE
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Experience and Brain Development
Stimuli in early life switch on genetic pathways
that differentiate neuron function sensitive
periods
Stimuli affect the formation of
the connections (synapses)
among the billions of neurons
From studies in humans, monkeys and rats
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Brain Pathway and Plasticity in Early Years
1. Hypothalamus pituitary adrenal axis
- regulation of cortisol
memory, diabetes, heart disease,
cognition, behaviour
2. Autonomic nervous system
blood pressure, respiration
3. Sensing pathways (vision, sound, touch etc.)
cognition, language, literacy etc.
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01-023
Genes and Brain Stimulation
in the dance of life, genes and environment
are absolutely inextricable partners. On the one
hand, genes supply the rough blueprint for the
brain. Then stimulation from the environment,
whether its light impinging on the retina or a
mothers voice on the auditory nerve, turns genes
on and off, fine-tuning those brain structures
both before and after birth.
Hyman, S., States of Mind, New York John
Wiley, 1999
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03-089
Serotonin Gene, Experience, and Depression Age 26
Depression Risk
.70
SS
S Short Allele L Long Allele
.50
SL
LL
.30
No Abuse
Moderate Abuse
Severe Abuse
Early Childhood
A. Caspi, Science, 18 July 2003, Vol 301.
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Epigenetics Gene Expression
An intermediate process that imprints dynamic
environmental experiences on the fixed genome
resulting, in stable alterations in phenotype.
I. Weaver et al., Nature Neuroscience, June 2004.
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Epigenetics and Brain Plasticity
Experience and methylation of DNA Imprints
environmental experiences on the fixed
genome Maternal behaviour affects DNA
methylation Can be transmitted to offspring
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Summary Brain Plasticity
Sensing pathways set in early life
Vision Hearing Touch
HPA Pathway (stress) set in early life
(HPA-Immune Pathway)
Hippocampus - Memory
Plasticity sustained throughout life Affected by
HPA Pathway
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Human Brain Development Synapse Formation
Language
Sensing
Pathways
Higher
(vision, hearing)
Cognitive Function
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0
1
4
8
12
16
3
6
-3
-6
Months
Years
Conception
AGE
C. Nelson, in From Neurons to Neighborhoods, 2000.
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HEALTH
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The Brain and Health
From the time of the ancient Greeks to the 20th
century, it was accepted that the mind can affect
illness. The new thrust of the biosciences and
the new treatments for disease have recently
caused us to have less interest in the mind-body
interaction and disease.
Esther Sternberg (NIH)
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Swedish Longitudinal Study ECD and Adult Health
Number of Adverse ECD Circumstances
1
2
4
0
3
Adult Health
Odds - Ratios
General Physical
1
1.39
1.54
2.08
2.66
1
1.56
1.53
2.91
7.76
Circulatory
Mental
1
1.78
2.05
3.76
10.27
Economic, family size, broken family and family
dissention
Lundberg, Soc. Sci. Med, Vol. 36, No. 8, 1993
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00-076
Socio-Economic Factors Life Cycle and Health
In Utero - Barker et al
Early Years - Power and Hertzman
Adult Life - Marmot et al
Biological embedding in the early years
influences health risks in adult life
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Health Problems Related to Early Life
and Brain Development
Coronary Heart Disease Non-insulin Dependent
Diabetes Obesity Blood Pressure Aging and
Memory Loss Mental Health (depression)
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"Follow up through life of successive
samples of birth has pointed to the
crucial influence of early life on
subsequent mental and physical health
and development."
Acheson, Donald -
Independent Inquiry into
,1998
Inequalities in Health
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Socio-Economic Gradients in Health, Learning and
Behaviour
Can be steep or shallow (no threshold) At the
lowest SES position, many still do well in
respect to health, education and learning Not
simply a poverty question Is a social
issue Cohesion trust
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Socio-Economic Gradient and Mortality Men UK
140
120
SMR
100
SMR Standardized Mortality Ratios
80
60
I
V
IV
III
II
Social Class
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BEHAVIOUR
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"Longitudinal studies show most seriously
antisocial adolescents and adults who had
behavior problems during childhood showed as
antisocial behavior when they enter the school
systems."
Tremblay, R
. - Developmental Health and the
Wealth of Nations, 1999
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"The origin of these behavior problems can be
traced back to fetal development and infancy.
High quality care-giving support during the
first three years reduces the seriousness
of behavior problems."
. - Developmental Health and the
Tremblay, R
Wealth of Nations, 1999
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02-008
Maltreatment at an early age can
have enduring negative effects on
a child's brain development and
function.
Martin Teicher
Scientific American, 2002
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"The aftermath can appear as
depression, anxiety, suicidal thoughts or
post-traumatic stress - or as aggression,
impulsiveness, delinquency, hyperactivity
or substance abuse."
Martin Teicher
Scientific American, 2002
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Substance Abuse and Childhood Abuse
Odds Ratios for Drug
and Alcohol Use
Exposure to
Drugs
Alcohol
Child Abuse

0 1.0 1.0
1 2.7 2.0
2 2.9 4.0
3 3.6 4.9

4 4.7 7.4
Scale 0 none

4 intense
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LEARNING
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Levels of Literacy A Reflection of ECD
Level 1
indicates persons with very poor skills.
Level 2
people can deal with material that is simple
Level 3
is considered a suitable minimum for coping with
the demands of everyday life
Level 4 and 5
describe people who demonstrate command of
higher-order processing skills
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Document Literacy
1994 1998, Ages 16 to 55
Level 1 and 2 Level 4 and 5

Sweden
23
34
Canada
42
23
Australia
43
17
United States
48
18
Chile
85
3
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00-085
Literacy Gradients
Mean scores
350
Document
Literacy Scores
330
310
290
International
Sweden
Mean
270
250
Netherlands
230
Canada
210
190
Chile
170
0
5
10
15
20
Parents Education (years)
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02-001
Literacy Early Vocabulary Growth
1200
High SES
Middle SES
Cumulative Vocabulary
600
Low SES
0
12
16
20
24
28
32
36
Age - Months
B. Hart T. Risley, Meaningful Differences in
Everyday Experiences of Young American Children,
1995
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Test of Language Development (TOLD) at Age 9
Correlation between vocabulary growth at Age 3
and TOLD at Age 9.
0.74
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Life Expectancy Literacy
80
78
76
Life Expectancy at Birth (yrs)
74
72
70
60
40
100
20
0
80
Percent at Literacy Levels 1 and 2
OECD
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99-097
Winnipeg
Education and Death
All Cause Mortality (Deaths / 1000)
Education Level
Q1 Q2 Q3 Q4 Q5
least
most
1996
8.83
7.53
7.26
6.88
5.99
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Early Learning and Criminal Behaviour
Significant correlation with registered
criminality (teenage) appeared for language
development at 6, 18, and 24 months
Journal of Abnormal
Stattin, H. et al -
102 369, 1993
Psychology
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VULNERABLE CHILDREN
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Vulnerable Children Aged 4 to 6 NLSCY 1998
40
30
Ontario
Prevalence of Vulnerable Children
20
Rest of Canada
10

0
-1.5
-1.0
-0.5
0.0
0.5
1.0
1.5
Socioeconomic Status
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01-053
Odds - Ratio for Children's (0-5)
Cognitive and Behaviour Problems
Behaviour
Cognitive
Parenting (vs good)
Authoritarian
1.53
2.01
Permissive
1.23
1.80
Inadequate
1.85
2.14
Parents Read to Child
0.92
0.96
Local Support
0.93
1.00
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Improving Gradients for Document Literacy Scores
410
Canada
390
370
Sweden
350
330
Mean scores
310
Today
290
Future
270
250
230
0
5
10
15
20
Parents Education (years)
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Evidence That You Can Raise the Learning Bar
Observational Studies Randomized
Trials National Longitudinal Studies
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Romanian Orphanage Study
Adopted Canadian Homes
lt 4 months
8 to 53 months
IQ low
IQ normal
poor attachment
good attachment
serious behaviour
few behaviour
problems
problems
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Evening Cortisol Levels Increase with
Months of Orphanage Rearing
-0.2
-0.4
-0.6
Log10 Salivary Cortisol
-0.8
linear trendline
-1
-1.2
0
10
20
30
40
50
Months of Orphanage Rearing
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Intervention Studies
Grantham-McGregor Abecedarian Ypsilanti Osborn
and Milbank Bergmann France AKDN Madrassa
Program Other (World Bank Report)
Compatible with biological and animal studies
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WISC Verbal Scores Age 8 Low Birth Weight
Children in ECD Centres (Ages 1 to 3)
Low Birth Weight
16
All
14
Very Low
12
Low
10
8
6
4
2
0
-2
Intention to
350 Days or
400 Days or
Treat
Less in Centre
More in Centre
Hill, Brooks-Gunn, Waldfogel. Dev. Psychol. 2003
July.
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Abecedarian Study Reading
Effect Size
Primary Grades
Preschool
Preschool Primary Grades
1.2
0.8
0.4
0
Age 8
Age 12
Age 15
Age 21
Age at Testing
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Critical Factors in Early Child Development (ECD)
Experience-Based Brain Development Healthy
Environment Sound Nutrition Clean
Water Prevention of Illness Avoidance of
Toxic Substances
(alcohol, drugs, lead, smoking, etc.)
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Social Factors Influencing ECD
Parenting and work Role of women in
society Weakening of intergenerational
support Income disparity Population migration
and pluralism
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ECD and Experience-Based Brain Development
parent-oriented
child-oriented
1
2
3
4
5
6
- 0
age
Components of Early Childhood Development and
Parenting Centres
Universal available, accessible, affordable and
optional
Parental and non-parental care
Parent- and child-oriented
Quality early child development environments
Responsive relationships and parent involvement
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Parental and Non-Parental Care
Problem-based play Parents should be involved in
ECD centres Parents learn by doing in the
centres Labour market policies facilitate parent
involvement in ECD centres
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Pre- and Post-Natal Supports
Public health, family physicians and
developmental paediatricians Advice in respect
to nutrition, vaccination and hazards Community
resources and services Service programs for
children linked to ECD centres
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Staffing ECD Centres
1 staff for 3 infants and toddlers (parent
involvement) aged 0 to 3 1 staff plus parents
for 6-8 children aged 3 to 6
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Barriers to Implementing ECDP Programs

• Economics
• Lack of understanding (public and professional)
• The state as a nanny
• No commitment to equality
• 5. Dumb men, stupid choices

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Public Policy ECD-P Centres
Universal and accessible Centres should be
community-based and linked to primary
schools Childrens Services linked to
centres Well-educated and trained
staff Parenting and labour market
policies Outcome accountability
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OUTCOME MEASURES
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Outcome Measures Early Development Instrument
(EDI)
Physical health and well-being
Social knowledge and competence

Emotional health/maturity
Language and cognitive development
Communication skills and general
knowledge
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Percentage of Children in Kindergarten Scoring in
Bottom 10 by District - Vancouver
34.5
15
27.5
8.5
21.5
EDI, February 2000
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Percentage Grade 4 Students Below Numeracy
Expectations
0-11
12-22
23-34
35-46
47-58
Source Ministry of Education
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Canadian Government
Child Tax Benefit National Child
Benefit Maternity and Parental Leave for one
year Funding to provinces and territories for
ECD - QUAD
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Quebec
Minister Responsible for Children Support for
integrated community ECD programs Increased
support for ECD staff Parent involvement
required
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Other Provinces and Territories
Ministers Responsible for Children Programs not
integrated All but Quebec do not adequately
support non-parental care
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Integrated - ECD
Social
Equality
Education
Health
Capital
Economic
Growth
Human Development
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From Early Child Development

To
Human Development
World Bank Report, 2002
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www.founders.net
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References
References

• From Early Child Development to Human
  Development. Editor Mary Eming Young, World
  Bank, Washington, 2000.
• Synaptic Self How Our Brains Become Who We Are.
  Joseph LeDoux, Viking Penguin, New York, 2003.
• The End of Stress As We Know It. Bruce McEwen,
  Joseph Henry Press, Washington, 2002.
• Developmental Health and the Wealth of Nations.
  Editors Daniel P. Keating, Clyde Hertzman, The
  Guilford Press, New York, 1999.
• From Neurons to Neighborhoods. The Science of
  Early Child Development. Editors Jack P.
  Shonkoff and Deborah A. Phillips, National
  Academy Press, Washington, 2000.
• Early Years Study, Final Report Reversing the
  Real Brain Drain. Hon. Margaret Norrie McCain and
  J. Fraser Mustard, Publications Ontario,
  Toronto,1999.
• Vulnerable Children. Editor J. Douglas Willms,
  University of Alberta Press, Edmonton, 2002.
• Readiness to Learn at School. Magdalena Janus and
  Dan Offord, In Isuma (Canadian Journal of Policy
  Research) Vol. 1, No. 2, 2000.
• Why are some people healthy and others not?
  Editors Robert G. Evans et al, Aldine De
  Gruyter, New York, 1994.
• The Early Years Study Three Years Later. Hon.
  Margaret Norrie McCain and J. Fraser Mustard, The
  Founders Network, 2002.