New insights into early childhood development Implications for policy and services

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New insights into early childhood development -
Implications for policy and services

• Professor Frank Oberklaid
• Director, Centre for Community Child Health
• Shaping Quality Outcomes for Australian Children
• CAA and Guild Forum - Canberra
• March 5, 2007

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The Tipping PointMalcolm Gladwell

• The tipping point is that magic moment when
  an idea, trend, or social behavior crosses a
  threshold, tips, and spreads like wildfire.

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Outline of presentation

• Brain development research
• Early childhood and the life course
• The economics of investing in the early years
• Implications for policy, service systems and
  professional practice
• Implications for early childhood services,
  including child care

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Brain development research

• Convergence of research from neurosciences,
  developmental psychology, economics of human
  capital formation
• New imaging techniques
• MRI and fMRI (Functional Magnetic Resonance
  Imaging)
• PET scans (Positron Emission Tomography) - maps
  brain metabolism (uptake of glucose)
• Chemistry and physiology

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Neuroscience of brain development

• Brain is not mature at birth
• Brain is changed by experiences
• The brain organises itself through the
  interaction of genes responding to the local
  environment - a dance between genes and
  experience
• Relationships program social - emotional function
• Adversity impacts on brain development

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Nature and nurture

• Genes (nature) provides the substrate for the
  development of the brain, but after birth nurture
  is the dominant force
• Optimal development dependent on good environment
  - nutrition, good health, nourishing and
  stimulating parenting
• Development is the result of complex, dynamic
  transactions between nature and nurture - between
  biology and the environment

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Influencing outcomes

• Biology - at present state of knowledge we cannot
  do much to change biology - although we can
  reduce the risk to the fetus - e.g. avoid
  substance abuse during pregnancy
• Environment - there is much we can do to change
  the environment in which young children grow and
  develop

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Brains are built over time

• Brain architecture and skills are built in a
  hierarchical bottom-up sequence
• Foundations important - higher level circuits are
  built on lower level circuits
• Skills beget skills - the development of higher
  order skills is much more difficult if the lower
  level circuits are not wired properly
• It is biologically and economically more
  efficient to get things right the first time

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Cortex
Brainstem
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Brain architecture

• The brain is sculpted by early experiences - this
  determines the development of neural circuits
• Plasticity of the brain decreases over time and
  brain circuits stabilise, so it is much harder to
  alter later
• There is constant pruning of circuits that are
  not used - concept of developmental windows or
  critical periods

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The importance of relationships

• Nurturing and responsive relationships build
  healthy brain architecture that provides a strong
  foundation for learning, behaviour and health
• The relationships a young child has with their
  caregiver(s) literally sculpts the brain and
  determines the development of circuits
• When protective relationships are not provided,
  levels of stress hormones increase - this impairs
  cell growth, interferes with formation of healthy
  neural circuits, and disrupts brain architecture
  

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Positive stress

• Moderate and transient stress responses - results
  in mild increases in stress hormone levels and
  short lived increases in heart rate
• Precipitants include the challenges of new people
  and situations, dealing with frustration, adult
  limit setting, the pain of a fall or injection
• Important part of healthy development - occurs in
  the context of stable and supportive relationships

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Tolerable stress

• Stress responses that can disrupt brain
  architecture, but are buffered by supportive
  relationships that facilitate adaptive coping
• Precipitants include death or serious illness of
  a loved one, parent divorce, witnessing a
  frightening event, major trauma or illness,
  natural disaster, homelessness
• Generally time limited, so gives the brain
  opportunity to recover from potentially damaging
  effects

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Toxic stress

• Strong and prolonged activation of bodys stress
  response - absence of buffering protection of
  adult support
• Precipitants include extreme poverty, physical or
  emotional abuse, chronic neglect, severe maternal
  depression, family violence
• Disrupts brain architecture and leads to stress
  management systems that have lower threshold of
  activation - increases risk of stress related
  physical and mental illness

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Adversity

• Research on the biology of stress in early
  childhood helps explain some of the underlying
  reasons for differences in learning, behaviour
  and physical and mental health
• Any adversity or stress that impacts on the
  parents may affect their relationship with their
  young child and thus has the potential to have a
  negative impact on brain development - e.g.
  effects of rapid social change

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The impact of social change

• Higher divorce rates - more blended families and
  shared custody arrangements
• More single parents
• More families with both parents working - marked
  increases in child care
• Working longer hours - part time/shift and casual
  work
• Job insecurity, unemployment, homelessness
• Increase in poverty and increased social gradient

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Other sources of parental stress

• Child care
• Inflexible work arrangements
• Changed work environment and culture
• Job insecurity
• Market deregulation
• The built environment - parks, roads, access to
  services, isolated from family and friends
• Erosion of social capital - lack of supports

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Disordered brain circuits

• Problems in childhood
• Beginning of pathways to problems later in life
• Evidence that many problems in adult life have
  their origins in pathways that begin in childhood

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Problems in childhood

• Child abuse and neglect
• Vulnerable school readiness
• Poor literacy and school achievement
• Mental health problems - ADHD, conduct disorders,
  aggressive and anti-social behaviour
• Problems of communication and social interaction
• Obesity

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Problems in adult life

• Mental health problems
• Family violence and aggressive/anti-social
  behaviour
• Crime
• Poor literacy
• Welfare dependency
• Substance abuse
• Obesity and its associations

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Implications for policy

• Need for increased government expenditure to
  address these challenges
• But in the long term such policies
• Are not sustainable - there will never be
  sufficient resources
• Are often ineffective - treating established
  problems is difficult (and expensive)
• Better to get it right the first time

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The developmental trajectory and life course
Outcome
Risk factors
Protective factors
Age
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Risk and protective factors
Risk Factors Child Family Community School
Protective Factors Child Family Community School
Outcome
Negative vulnerability
Positive resilience
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Poverty and health (0-3 years)

• Less likely to
• Be breast fed
• Be fully immunised
• Receive well child care
• Have regular and consistent access to health
  services

• More likely to have
• Low birth weight
• Developmental delay
• Higher incidence of SIDS
• Higher injury rate
• Suboptimal growth
• More frequent hospitalisations
• Behavioural disorders

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Double jeopardy for children living in poverty

• Experience most health problems and more likely
  to be unimmunised, but live in unhealthy
  environments and have fragmented access to good
  health care
• Highest risk of academic failure, but attend the
  most disadvantaged schools
• Families experience the most stress but have
  fewest social supports
• Parents have the greatest need of but often have
  greatest difficulty in accessing services

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Vocabulary Growth - First 3 Years
Vocabulary
High SES
1200
Middle SES
600
Low SES
0
12
16
20
24
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Age - Months
B Hart T Risley Meaningful Differences in
Everyday Experiences of Young American Children
1995
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Source National Longitudinal Survey of Children
and Youth, (NLSCY) Cycle 3, 1998-1999
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Literacy As children move from year 3 to year 5,
the disparity among those meeting literacy
standards grows
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So what do we do? What are the answers?

• Need major shift in public policy, focusing not
  just on treatment but also on prevention and
  early intervention (fence on top of cliff rather
  than more ambulances at the bottom)
• There is evidence from successful demonstration
  programs that early intervention works - ie the
  research tells us how to build the fences
• Early childhood education and care (ECEC) is
  central to policy and service initiatives that
  can make a big difference to young children and
  to their life course

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Intervention effects and costs of
social-emotional mental health problems over time
(Bricker)
High
Cost
Intervention effectiveness
Low
Time
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So we now have...

• A good understanding of early influences on the
  brain, childrens development and risk factors
• Research showing that patterns established early
  in life can have long term consequences
• Research demonstrating that early intervention
  programs can significantly improve outcomes later
  in life
• Now add to this the economic/business case for
  investment in early childhood programs

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Cumulative cost and savings
30,000
Cumulative savings
25,000
20,000
Cumulativedollars per child
15,000
10,000
Cumulative cost
5,000
0
0
5
10
15
20
25
30
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40
45
50
55
60
65
Age of child (years)
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Rates of Return to Human Development Investment
Across all Ages
8
Pre-school Programs
6
School
Return per invested
4
R
Job Training
2
Pre-School
School
Post School
0
6
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Age
Pedro Carneiro, James Heckman, Human Capital
Policy, 2003
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• The best investment in economic development that
  government and the private sector can make is in
  the healthy development of children
• Society should adopt the perspective of
• child-development-as-economic-development.
• In our view, the economic case for why we should
  invest in early childhood development is closed.
• Arthur J. Rolnick Senior Vice President and
  Director of Research
• Federal Reserve bank of Minneapolis

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• I think we will have to go further and be
  pre-emptive in conditioning the public,
  particularly the grey-haired part, to accept that
  policy must be forward looking and directed to
  ensuring a vigorous Australian society 20 years
  hence. This will mean giving priority to
  tomorrows working-age population, rather than
  satisfying the demands of yesterdays.
• Reserve Bank Governor Ian Macfarlane
• November 2003
• (as quoted in The Age, May 13, 2006)

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Implications of the science of early childhood

• Parents and families
• Communities and the built environment
• Child care
• Education
• Child protection system
• Services
• Business
• Media
• An expanded view of building infrastructure

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Communities and the built environment

• Community can be effective buffer against stress
• Create child friendly communities
• Access to services - e.g. childrens centres
• Child oriented workplaces, organisations,
  community settings - child care, schools,
  libraries, parks, transport, pubs, pools,
  shopping facilities
• Social connectedness
• Child care centres are an important part of this
  network

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Child care

• Early learning environment - not child minding
• Universal access to everyone, especially
  disadvantaged - cost and availability should not
  be a barrier
• Quality vital - staff ratios, physical amenities,
  and especially expertise of caregivers
• Need radical rethink of training, pay and
  conditions, and career structure of child care
  workers
• Parental choices, supported by leave provisions

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Rethinking child care

• Refocus child care based on three sets of
  relationships
• With children - training and quality of services
• With parents - health promotion and early
  detection of problems
• With community - child care as platform

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Refocusing child care - relationships with
children

• Brain development research
• Relationships with caregivers program brain
  development
• Experiences in early years influence
  developmental trajectory and life course
• Expertise of providers and quality of child care
  services is critical

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Refocusing child care -relationships with parents

• Modelling for parents
• Credible advice and guidance on child
  development, behaviour and health
• Early detection of problems and risk factors
• Referral to community agencies and professionals

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Refocusing child care -relationships with
community

• Reconceptualise child care as an early learning
  environment and platform
• Establish links with other providers and service
  systems - MCH (community) nurses GPs preschools
• Develop links with community agencies and
  resources - libraries service organisations

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What is needed - macro?

• Public policy which promotes accessibility and
  affordability
• Understanding that child care is nor simply child
  minding
• Investment in training and professional
  development
• Commitment to quality - can we afford not to have
  high quality environments for young children?
• Seeing the potential of child care as platform
  - source of information and modelling for
  parents, hub of community network of early
  childhood services, opportunity for early
  detection and referral

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What is needed - micro?

• Expanded and strengthened quality framework
  (NCAC)
• Training/education and upskilling of staff
• Resource materials for staff and parents
• Facilitating dialogue and establishing true
  partnerships between between staff and parents
• Establishing links with other professionals and
  community agencies - begin with mapping
  exercise

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Business

• Will understand the importance of early childhood
  - concerned less with the cost of programs and
  services but rather the return on investment
• Business sector has two parallel sets of
  interests
• Macro level (broad economic) skilled and
  educated workforce, social capital, international
  competitiveness, preservation of democratic
  institutions and fair society
• Micro level (workplace) attraction and retention
  of skilled staff, productivity, work life balance

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Media

• Important role to play
• Desperately need a more sophisticated approach to
  major issues of our time - very superficial level
  of debate in mainstream media - eg child care,
  education
• Early childhood issues beginning to move from
  womens pages and parenting magazines to
  financial pages
• Need media to focus more on translation and
  dissemination of the research

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Building infrastructure - human capital

• The implications of this rapidly evolving
  science for human capital formation are striking.
  The workplace of the 21st century will favor
  individuals with intellectual flexibility, strong
  problem solving skills, emotional resilience, and
  the capacity to work well with others in a
  continuously changing and highly competitive
  economic environment. In this context, the
  personal and societal burdens of diminished
  capacity will be formidable, and the need to
  maximize human potential will be greater than
  ever before.
• - Knudsen EI, Heckman JJ, Cameron JL, Shonkoff
  JP (2006)
• Proceedings of National Academy of Sciences

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Conclusion

• Promoting the healthy development of children is
  both an ethical imperative and a critical
  economic and social investment
• Our agenda for the 21st century has to be the
  application of science to policy and practice -
  to close the gap between what we know and what we
  do.

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• frank.oberklaid_at_rch.org.au
• www.rch.org.au/ccch