The First R: Relationships and Asset Building

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www.offordcentre.com
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The First R RelationshipsBuilding for
Tomorrow.
Every Child Matters OACRS Conference October 2008

• Jean Clinton BMus MD FRCP(C)
• McMaster Children's Hospital and University
• Council for Early Child Development
• Offord Centre for Child Studies

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The Wisdom of the Elders

• Consider the interest of the next 7 generations
  when decisions are being made

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What is our View of the Child?

• What we believe about children informs our
  viewand our language.
• Child as empty vessel
• Child as Powerful ,resourceful,
• creative co-learner
• Develop normally or function to the best of
  ability?
• Fix the problem,,,or promote activity and what
  can be?

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Unicef Report Canada

• Material Well Being
• Health and Safety
• Educational Well being
• Family and Peer Relationships
• Behaviours and Risks
• Subjective well being
• Overall

• 6 SWEDEN 1
• 13 SWEDEN 1
• 2 BELGIUM 1
• 18 ITALY 1
• 17 SWEDEN 1
• 15 NETHERLANDS 1
• 12/21

Unicef Innocenti Report 2007
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Reaching For the Top Report.

• We are doing poorly compared to other OECD
  countries(29 total)
• 21st in child well being, including mental health
• 22nd in PREVENTABLE childhood injury and deaths
• 27th in childhood obesity

National Advisor Report March 2008
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OECD Report, 2004
Source Starting Strong ll Early Childhood
Education and Care September 2006
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Guiding Principles

• Development of the whole childmany competencies
• The importance of belonging.
• Relationships as central.

Ryan and Powelson 1991
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03-080
The Founders Network
Experience-Based Brain Development in the early
years of life sets neurological and biological
pathways that affect
Health
Learning
Behaviour
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Time Magazine from the MEHRI Neuroscience lab
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The Brain Matters

• The human brain is the organ responsible for
  everything we do. It allows us to laugh, walk,
  love, talk.
• For each of us, our brain is a reflection of our
  experiences.
• The brain is an environmental organ. It reflects
  our environment.

Adapted from Bruce Perry
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Why do we care about brain?
You are your brain.
BUT Your brain is not just produced by your
genes. Your brain is sculpted by a lifetime of
experiences . The most important time in brain
development is the first few years of life.

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Cortical Neuron

• Brain Plasticity
• Connections are
• formed and altered
• by experience

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04-039
Two Neurons
RECIPIENT NEURON
Axon
Synapse
SIGNAL-SENDING NEURON
Dendrite
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But, not done until at least age 20 years
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PLASTICITY

• Babies highly attuned to their environment
• Massive synaptic growth in first two years
• Pruning starts at 8months
• Pruning regulated by emotional interactions with
  caregivers
• From The First Idea Greenspan and Shanker

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The Role of the Primary Caregiver in Early Brain
Growth

• The primary caregiver serves as an external
  brain, regulating and stimulating the babys
  brain
• Dyadic experiences are vital for
• Sensory regulation
• Emotion-regulation
• Self-Regulation
• perceptual, cognitive, communicative and social
  development

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04-212
Sound Vision Smell
Touch Proprioception Taste
Neal Halfon
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01-003
Human Brain Development Language and Cognition
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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04-200
Early Child Development and Language
Starts early first 7 months Sets capability
for mastering multiple languages Sets literacy
and language trajectories
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02-002
Estimated Cumulative Difference in Language
Exposure by 3 Years of Age
Million
50
40
High SES
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Words
Medium SES
20
10
Low SES
0
0
12
24
36
Age of child in months
Hart and Risley, 1995
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02-001
Vocabulary Growth First 3 Years
Vocabulary
1200
High SES
Middle SES
600
Low SES
0
12
16
20
24
28
32
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Age - Months
B. Hart T. Risley, Meaningful Differences in
Everyday Experiences of Young American Children,
1995
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03-079
Vision and Hearing Critical Period
Eye cataracts at birth prevent normal
development of vision neurons in the
occipital cortex (Hubel and Wiesel)
Cochlear defects at birth impair hearing
development (Rauschecker and ODonoghue)
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Brain Cells develop connections over the first 2
years
Then they are sculpted actively for the rest of
your life!
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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.

Bruce Perry MD
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Sensitive periods in early brain development
Binocular vision
Central auditory system
Habitual ways of responding
Language
Emotional control
High
Symbol
Peer social skills
Relative quantity
Sensitivity
Low
0
1
2
3
7
6
5
4
Years
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02-066
The Fear Response
Visual Thalamus
Visual Cortex
Amygdala
Scientific American
The Hidden Mind, 2002, Volume 12, Number 1
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Anterior Cingulate Cortex
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03-002
Emotional Stimulus
Amygdala
Hippocampus
-

-

Hypothalamus PVN
Cortisol
Cortisol
CRF
PIT
ACTH
Adrenal Cortex
LeDoux, Synaptic Self
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Amygdala and Hippocampus
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00-058
Cortisol can be bad for the brain
Hippocampus
high sterol levels cause loss of dendrites
and cell death
Frontal brain
attention deficits
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07-105
Health, Behaviour and Limbic HPA
Pathway Allostasis Allostatic Load (Stress)
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05-212
Limbic HPA Pathway - Stress
Cortisol Over Production Behaviour (ADHD,
violence), depression, diabetes, malnutrition,
cardiovascular disease, memory, immune system,
drug and alcohol addiction Cortisol Under
Production Chronic fatigue syndrome,
fibromyalgia, immune system (autoimmune
disorders) rheumatoid arthritis, allergies,
asthma
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05-213
Limbic HPA Pathway and Sensory Experience in
Early Life
Touch and other experiences in the early period
are critical Rats Mothers licking
pups Monkeys Peer vs mother rearing Humans -
Attachment
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05-046
The Founders Network
Secure Attachment Buffers Cortisol Response to
Threatening Events
Secure Attachment Insecure Attachment
Change in Salivary Cortisol



HIGH
LOW
Fearful Responses to Stimuli
Gunnar (1996).
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Maternal Stress

• Affects HPA axis in offspring
• Can alter susceptibilty to later disease/ drug
  taking
• Affects males more than females

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Parents change us too
Dr Robin Gibb U of Lethbridge
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EPIGENETICS

• Any Functional Change in the Genome that does not
  involve an alteration of sequence.
• Familial transmission of traits vulnerabilities)
  from parent(s) to offspring can occur through a
  nongenomic mechanism of inheritance

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05-056
Individual differences in stress reactivity of
the adult are determined by maternal behaviour
during infancy
HIGH LG
LOW LG
Development of Stress Reactivity
Increased Stress Reactivity Increased Risk for
Heart Disease, Type II Diabetes, Alcoholism,
Affective Disorders, Brain Aging, etc.
Modest Stress Reactivity Reduced Risk for
Disease
M. Szyf
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05-057
Is maternal care the mediator of these effects on
hippocampal (GR(17) promoter methylation?
ADOPTION/CROSS FOSTERING STUDIES
Adoptive Mother
Biological Mother
LOW
LOW
HIGH
HIGH
M. Szyf
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04-144
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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97-044
The Mismatch Between Opportunity and Investment
0
3
10
70
Age
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03-074
Rates of Return to Human Development Investment
Across all Ages
8
6
Pre-school Programs
Return Per Invested
School
4
R
Job Training
2
Pre- School
School
Post School
0
6
18
Age
Carneiro, Heckman, Human Capital Policy, 2003
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Hamilton
Best Start

• Getting it Right at 18 months
• Making it Right for a Lifetime

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04-012
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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Importance of Relationships

• "Human beings of all ages are happiest and able
  to deploy their talents to best advantage" when
  they experience trusted others as "standing
  behind them."
• 
  Bowlby, 1973

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