Social inclusion. What are the roots of social exclusion? Children s development. The neuroscience of brain development

Size: px

Start display at page:

Download "Social inclusion. What are the roots of social exclusion? Children s development. The neuroscience of brain development"

Kory Perry
8 years ago
Views:

1 Engaging all families and children: the role of early childhood education and care in supporting vulnerable children and their families Professor Frank berklaid Director, Royal Children s Hospital Melbourne Mary 11, 2012 Social inclusion A socially inclusive society is one where all individuals have the opportunities, capabilities and resources to participate fully in their community. - Australian Social Inclusion Board What are the roots of social exclusion? Biological and/or environmental Genetic aetiology or vulnerability/predisposition Biological embedding of environmental events (Hertzmann) stress changes genes Starts early influences on the developing brain Consequences throughout the life course and into the next generation Ecology of development (Bronfenbrenner) Children s development Development is the result of complex, ongoing, dynamic transactions between nature and nurture - a dance between biology and experience We cannot do much to change biology - but we can change the environment in which young children grow and develop ptimal development dependent on good environment - nutrition, good health, nourishing and stimulating parenting, etc The neuroscience of brain development 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 Plasticity of the brain decreases over time and brain circuits stabilise, so it is much harder to alter later It is biologically and economically more efficient to get things right the first time utcome The developmental trajectory and life course Risk factors Age

- Australian Social Inclusion Board What are the roots of social exclusion?

2 Risk factors in the child s environment Parents and family: include low parental education, parental mental illness, substance abuse, social isolation, single parent, poverty and its associations - poor housing, difficulty accessing services, stress Community: include quality of and access to services, unhealthy environments, safety concerns, poor transport, no facilities to meet other families (refer to new housing estates) Adversity Any adversity that impacts on the parents or caregivers has the potential to have a negative impact on brain development in the young child and therefore act as a risk factor for optimal health and development, family functioning, and the ability to participate fully in the community. Early adversity Leads to changes in DNA (methylation) Biological embedding of environmental events (Hertzmann) Affects the development of biological systems Immune Cardiovascular Metabolic regulatory What appears to be a social situation is likely to be a neurochemical situation - intergenerational nature of disadvantage and social exclusion The impact of social inequality Psychosocial factors impact on health because of association with frequent/recurrent stress Major impact in early years - affects developing brain and establishment of neural circuits Chronic stress affects the body s physiological systems - including the cardiovascular and immune systems - increasing vulnerability to wide range of diseases and health conditions Double jeopardy - have the least access to supports such as consistent health care, quality childcare and preschool, good schools, and family supports Poverty and child health Less likely to: Be breast fed Be fully immunised Receive well child care Have consistent access to health services More likely to have: Low birth weight Higher incidence of SIDS Higher injury rate Suboptimal growth More frequent hospitalisations Developmental delay Behavioural disorders

(refer to new housing estates) Adversity Any adversity that impacts on the parents or caregivers has the potential to have a negative impact on brain development in the young child and therefore act

3 Nicholson JM, Lucas N, Berthelsen D, et al. J Epidemiol Community Health (2010), doc /jech Australian Early Development Index (AEDI) A population based measure which provides information about children s health and wellbeing 100+ questions covering 5 development domains considered important for success at school Teachers complete the AEDI online for each child in their first year of full-time schooling Results are provided at the postcode, suburb or school level and not interpreted for individual analysis 5 The AEDI measures a child s development in 5 areas: Five AEDI subscales physical health and well-being social competence emotional maturity language and cognitive development communication skills and general knowledge MARIBYRNNG Geographic Area, Victoria 5 km West of Melbourne Key Findings Percentage of children developmentally vulnerable (DV) across Australia by jurisdiction DV 1 domains (%) DV 2 domains (%) Australia New South Wales Victoria Queensland Western Australia South Australia Tasmania Northern Territory Australian Capital Territory Proportion of children vulnerable on one or more domains Prepared by: AEDI National Support Centre, GIS Source: AEDI Communities Data 2005

important for success at school Teachers complete the AEDI online for each child in their first year of full-time schooling Results are provided at the postcode, suburb or school level and not

4 Socio-economic disadvantage AEDI Domain comparison vulnerability by SEIFA N=261,000 Domain Vulnerability by SEIFA 14 Percent vulnerable Physical health and Wellbeing Social Competance Emotional Maturity Language and Cognitive Development Communication Skills and General Knowledge Centre for Community SEIFA Child Index Health of Relative Disadvantage 4 Most 3 Least Disadvantaged disadvantaged Centre for Community Child SEIFA Health A comparison of NAPLAN scores for low SES and all students Relationship between social background and achievement in PISA 2007 reading per cent 6% 4% 2% 0% NAPLAN scaled score 2009 year 3 NAPLAN Victoria All Low SES* * "low SES" defined as occupation of parent is machine operator, hospitality staff, assistant, labourer or related worker, or not in paid work in last 12 months Average score in reading Finland 475 Australia PISA Index of social background Social advantage Impact of poor literacy Poor school performance, low self esteem and reduced adult life chances Generally lower employment and social outcomes Higher rates of welfare dependence, high risk behaviours and teenage parenting Poor health literacy and increased risk of poor health outcomes Ability gaps open early in life Ability gaps between advantaged and other children open up early before schooling begins.conventional school based policies start too late to completely remedy early deficits, although they can do some good. Children who start ahead keep accelerating past their peers, widening the gap Early advantages accumulate, so do early disadvantages The best way to improve the schools is to improve the early environments of the children sent to them. (Heckman J. & Masterov DV, 2005)

disadvantaged Centre for Community Child SEIFA Health A comparison of NAPLAN scores for low SES and all students Relationship between social background and achievement in PISA 2007 reading 600 575

5 The Adverse Childhood Events (ACE) Study (N=17,000) San Diego Kaiser Health Plan Retrospective study of adult patients Reviewed adverse events in early childhood Adverse events included Parental divorce Parental mental health problems Parental alcohol or drug abuse Physical/sexual abuse/neglect If ACE score more than 4, then Smoking: x 2 Alcoholism: x 7 Cancer: x 2 Heart disease: x 2 Ch. lung disease: x 4 Attempted suicide: x12 I/V drug use (men): x 46 * Compared to ACE score of 0 Adult problems with roots in early childhood Mental health problems Family violence and anti-social behaviour Crime Poor literacy Chronic unemployment and welfare dependency Substance abuse besity Cardiovascular disease Diabetes For every complex problem there is a simple solution, and it s usually wrong. - HL Mencken High Cost Complex social issues cannot be dealt with merely by interventions with children or by strengthening families or by building community capacity. Policy needs an integrated focus on all 3 elements: children, families and communities. Intervention effectiveness - A. Hayes, M Gray, AIFS, 2008 Low Time Intervention effects and costs of social-emotional mental health problems over time (Bricker)

2 Ch. lung disease: x 4 Attempted suicide: x12 I/V drug use (men): x 46 * Compared to ACE score of 0 Adult problems with roots in early childhood Mental health problems Family violence and

6 P P U L A T I N Low Developmental risk High P P U L A T I N Low Developmental risk High Effort is devoted to identifying and managing the high risk group Effort is devoted to reducing the risk amongst the entire population Terminology Child care Early learning and care Early childhood education and care Child development centres Child and family centres What is the best term? What term is going to help change outmoded community perceptions? Child care a platform for social inclusion Universal access (?) Community based Non-stigmatising Soft entry point to child and family services Increasing policy attention in Australia Young children as a level to begin to tackle entrenched disadvantage, build community capacity, better coordinate services, etc 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 Refocusing child care - relationships with children Quality of child care is critical expertise of staff, ratios, group sizes etc Brain development research Relationship with caregivers programs brain development Experiences in early years influence developmental trajectory and life course

What term is going to help change outmoded community perceptions? Child care a platform for social inclusion Universal access (?

7 Refocusing child care relationships with parents Refocusing child care relationships with community Modelling for parents Support for families Provision of credible advice and guidance on child development, behaviour and health Early identification of problems and risk factors Early referral to community agencies and professionals Reconceptualise child care as an early learning environment and platform Establish links with other professionals and service systems - MCH (community) nurses; GPs; preschools Develop links with community agencies and resources - libraries; service organisations Map community service and referral networks Sustainable solutions (Dr. Julius Richmond) 1. Knowledge base 2. Political will 3. Social strategy

early learning environment and platform Establish links with other professionals and service systems - MCH (community) nurses; GPs; preschools Develop links with community agencies and

The Core Story of Human Development 2.0

The Core Story of Human Development 2.0 Megan R. Gunnar, Ph.D. Regents Professor and Distinguished McKnight University Professor Director, Institute of Child Development Institute of Child Development