Putting Science to Action

Transcription

1 Putting Science to Action Mary Eming Young, MD, DrPH International Consultant, Global Health and Child Development Senior Advisor, Center on the Developing Child, Harvard University Co-leader, Early Childhood Initiative, HCEO, Institute for New Economic Thinking, University of Chicago Senior Fellow, China Development Research Foundation Co-leader, Early Childhood Interventions, HCEOInstitute for New Economic ThinkingUniversity of ChicagoSenior FellowChina Development Research Foundatio st International Symposium on Early Childhood Development Quito, Ecuador January 28-30, 2014

2 Dr. Mustard s Call to Action We now have the science and what we urgently need is to get on with it to do more and do better in translating that science into action.

3 Outline What we have learned in the science of ECD How we can close the gap between what we know and what we do in ECD

4 Children s early development is the foundation of human capital formation and of successful societies Nobel Laureates of Economics Tinbergen Fogel Sen Heckman

5 1. THE BRAIN S ARCHITECTURE DEPENDS ON EXPERIENCE

6 genes epigenetics experience brain learning behavior health physical environment nurturing nutrition

7 Experience build brain architecture Stimuli switch on genetic pathways that differentiate the functions of billions of neurons Stimuli affect the formation of the trillion of connections (synapses) among the billions of neurons.

8 Methylation DNA Genetics and Epigenetics Nucleus MicroRNA RNA Cytoplasm Cell Messenger RNA Ribosome Protein F.Mustard, Founders Network

9 2. SKILLS BEGET SKILLS

10 Neural Circuits are Wired in a Bottom-Up Sequence Sensory Pathways (Vision, Hearing) Language Higher Cognitive Function FIRST YEAR Birth (Months) (Years) Source: C.A. Nelson (2000) Slide by Center on the Developing Child, Harvard University

11 Cumulative Vocabulary (Words) Disparities in Early Vocabulary Growth 1200 Talkative families College Educated Parents Working Class Parents Welfare Parents Moderate talkative families Not talkative Families 16 mos. 24 mos. 36 mos. Child s Age (Months) Source: Hart & Risley (1995) Slide by The National Scientific Council on the Developing Child

12 Barriers to Educational Achievement Emerge Before School Begins 110 Richest 25% Language Skills (Median TVIP Score) % % 60 Poorest 25% Child s Age (Months) Source: Schady and Paxton (2005) Slide by Center on the Developing Child, Harvard University

13 3. SERVE AND RETURN

14 Brain development is dependent on interaction Sound Vision Smell Touch Proprioception Taste Source: Founders Network

15 Effect of touch

16 4. PAY NOW OR PAY LATER

17 The Ability to Change Brains Decreases Over Time Normal Brain Plasticity Influenced by Experience Physiological Effort Required to Enhance Neural Connections Birth Age (Years) Source: Levitt (2009) Slide by Center on the Developing Child, Harvard University

18 Profound Deprivation Affects Brain Power Positive Relationships Extreme Neglect Source: C.A. Nelson (2008); Marshall, Fox & BEIP (2004). Slide by Center on the Developing Child, Harvard University

19 Kaiser Permanente ACE Study (Adverse Early Childhood Experience) Ischemic heart disease Blood pressure Obesity Drug and alcohol addiction Depression Suicide Source: Founders Network

20 Children with Developmental Delays Significant Adversity Impairs Development in the First Three Years 100% 80% 60% 40% 20% Number of Risk Factors Source: Barth, et al. (2008)

21 Odds Ratio Risk Factors for Adult Depression are Embedded in Adverse Childhood Experiences Adverse Experiences Source: Chapman et al, 2004

22 Risk Factors for Adult Substance Abuse are Embedded in Adverse Childhood Experiences Self-Report: Alcoholism Self-Report: Illicit Drugs % 14 % Adverse Experiences Source: Dube et al, 2002 Source: Dube et al, 2005

23 Odds Ratio Risk Factors for Adult Heart Disease are Embedded in Adverse Childhood Experiences ,6 7,8 Adverse Experiences Source: Dong, et al. (2004)

24 Biological Memories Link Maltreatment in Childhood to Greater Risk of Adult Heart Disease 50% Percent of adults with biological marker for greater risk of heart disease 40% 30% 20% 10% Source: Danese et al. (2008) Control Depression (age 32) Maltreated (as a child) Depression (age 32) + Maltreated (as a child)

25 READY FOR ACTION

26 Strategies to Improve healthy development and improve school readiness trajectories Lack of support services Family discord School readiness-socioemotional, physical, cognitive and language function Readiness to Learn Poverty Preschool Appropriate discipline Reading to child Lower trajectory lower function Parent s Education Emotional Awareness Birth Late Infancy Late Toddler 6 mo 12mo 18mo 24mos 3yr 4yr 5 yr Early infancy Early Toddler Preschool Adapted from Halton N, McLearn K. Families with children under 3. What we know and implications for Results and Policy. In Halton, McLearn and Shuster eds. Child Rearing in America. Challenges Facing Parents and Young Children. New York, Cambridge University Press

27 Summary Intervene early, often, and effectively. Allocate sufficient resources. Ensure relevant training. New generation competent in the understanding of human development Monitor and evaluate. Measure child development outcomes.

28 Creating a New Paradigm for Early Childhood Policy and Practice Early experiences affect lifelong health and learning Healthy development requires protection and enrichment

29 Generating Hypotheses to Guide New Intervention Strategies Early experiences affect lifelong health and learning Healthy development requires protection and enrichment 1 Protection and enrichment for young children require capacity-building for adults 2 Improved parenting skills also enhance employability and economic stability 3 Strong neighborhoods reduce the burdens of adversity