Building a Foundation for Achievement How Early Experiences Shape Brain Architecture and the Skills We Need to Thrive AL RACE Deputy Director Director, Communications and Public Engagement Center on the Developing Child at Harvard University NCSL Early Learning Fellows Denver, CO May 1, 2013
The Foundation of a Successful Society is Built in Early Childhood Strong Communities Healthy Economy Successful Parenting of Next Generation Educational Achievement Economic Productivity Responsible Citizenship Lifelong Health
Experiences Build Brain Architecture
The Ability to Change Brains Decreases Over Time Normal Brain Plasticity Influenced by Experience Physiological Effort Required to Enhance Neural Connections Birth 10 20 30 40 50 60 70 Age (Years) Source: Levitt (2009)
Serve and Return Interaction Builds Brain Architecture
Barriers to Educational Achievement Emerge at a Very Young Age Cumulative Vocabulary (Words) 1200 1000 800 600 400 200 College Educated Parents Working Class Parents Welfare Parents 16 mos. 24 mos. 36 mos. Child s Age (Months) Source: Hart & Risley (1995)
Significant Adversity Impairs Development in the First Three Years Children with Developmental Delays 100% 80% 60% 40% 20% 1-2 3 4 5 6 7 Number of Risk Factors Source: Barth, et al. (2008)
Toxic Stress Derails Healthy Development
The Biology of Adversity: Three Levels of Stress Positive Brief increases in heart rate, mild elevations in stress hormone levels. Tolerable Serious, temporary stress responses, buffered by supportive relationships. Toxic Prolonged activation of stress response systems in the absence of protective relationships.
Profound Neglect Can Reduce Brain Power Positive Relationships Extreme Neglect Source: C.A. Nelson (2008); Marshall, Fox & BEIP (2004).
Neglect Can Be a Greater Threat to Development than Abuse More likely to have anxiety, depression, personality disorders More academic problems and special education referrals Lower IQ, poorer reading skills, less likely to graduate high school Poorer responses to frustrating situations Creativity Confidence/Assertiveness N o Maltreatment Verbal Abuse Physical Abuse Neglect N o Maltreatment Verbal Abuse Physical Abuse Neglect Source: Egeland, et al. (1983)
Neglect is the Most Prevalent Form of Child Maltreatment Neglect Physical Abuse Sexual Abuse Psychological Maltreatment 20% 40% 60% 80% Source: U.S. Department of Health and Human Services (2010b).
Risk Factors for Adult Depression are Embedded in Adverse Childhood Experiences 5 Odds Ratio 4 3 2 1 0 1 2 3 4 5+ ACEs Source: Chapman et al, 2004
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)
Chronic Diseases Associated With Childhood Adversity Dominate U.S. Health Care Costs Five of Top Ten Diagnoses for Direct Health Expenditures = $335 billion $100 billion Cancer #3 $72 billion Annual Cost $80 billion $60 billion $40 billion $46 billion $47 billon $72 billion $74 billion $96 billion $20 billion Diabetes #8 Hypertension #7 Mental Disorders #4 Trauma-Related Disorders #2 Heart Disease #1 Source: Agency for Healthcare Research and Quality (2008)
Early Childhood Policy and Practice: The Current Model Significant Adversity Readiness to Succeed in School Impaired Development Parenting Education, Sound Nutrition, Stimulating Experiences, and Health-Promoting Environments
Science Points to the Need to Balance Enrichment, Prevention, and Protection Significant Adversity Address Sources and Effects of Toxic Stress Healthy Developmental Trajectory Supportive Relationships, Stimulating Experiences, and Health-Promoting Environments
Sources of Toxic Stress in Young Children U.S. Children Ages 2-5 (per 1,000) 75 130 136 Maltreatment Postpartum Depression Parental Substance Abuse Source: Finkelhor et al. (2005) Source: O-Hara & Swain (1996) Source: SAMHSA (2009)
Instability Disrupts the Stress Response System But Relationships Reverse the Effect.5 Morning Cortisol Levels.45.4.35 Therapeutic Foster Care Typical (Community Control Group) Standard Foster Care 2 4 6 8 10 12 Months in Foster Care Source: Fisher, Stoolmiller & Gunnar (2007)
The Brain Architecture of Memory and Learning
The Brain Architecture of Anxiety and Fear
Higher Childhood [Mystery Skill] Predicts Less Adult Crime 50% 40% Adult Criminal Convictions 30% 20% 10% 1 Low 2 3 4 Childhood [Mystery Skill] 5 High Source: Moffitt, et al. (2011)
Higher Childhood [Mystery Skill] Predicts Better Adult Health 0.4 0.2 Adult Health Outcomes 0 Poor Physical Health Index - 0.2 Substance Dependence Index - 0.4 1 2 3 4 5 Low High Childhood [Mystery Skill] Source: Moffitt, et al. (2011)
Higher Childhood Self-Control Predicts Greater Adult Wealth 0.4 0.2 Socioeconomic Status Adult Wealth Outcomes 0 Income - 0.2-0.4 1 2 3 4 5 Low High Childhood Self-Control Source: Moffitt, et al. (2011)
The Pencil Tap Test Source: Blair, C. (2012)
What Are Essential Skills for Success?
An Air Traffic Control System in the Brain Executive functioning is a group of skills that help us to focus on multiple streams of information at the same time, set goals and make plans, make decisions in light of available information, revise plans, and resist hasty actions. Ø A key biological foundation of school readiness as well as outcomes in health and employability
Three Types of Executive Function Skills Inhibitory Control filter thoughts and impulses to resist temptations and distractions Working Memory hold and manipulate information in our heads over short periods of time Mental flexibility adjust to changed demands, priorities, or perspectives
What Do These Skills Look Like in Adults? Inhibitory Control filter thoughts and impulses to resist temptations and distractions Working Memory hold and manipulate information in our heads over short periods of time Mental Flexibility adjust to changed demands, priorities, or perspectives
How Does Executive Function Develop?
Circuits for Executive Function Skills Are Located in Brain Regions that Exhibit an Extended Period of Plasticity Skill proficiency Birth 3 5 10 15 25 30 Age (Years) 50 70 80 Weintraub, et al., (2011)
How Executive Function Is Being Applied Across Multiple Agencies in WA Economic Services Administration WorkFirst assessment redesign Juvenile Rehabilitation Administration Building adolescent executive function through mindfulness training Training for Managers mid-level managers in Economic Services, Vocational Rehabilitation, Children s Administration, Aging & Disability Services Medicaid Incorporate EF information into contractually obligated training for managed care organizations Public Health Tobacco cessation program Consultation with local health jurisdictions
WA Department of Early Learning Professional Development Pilot Sites Guidelines, online modules, coaching, learning communities Assessment Consultation with researchers on using NIH Toolbox EF assessment tools Childhaven (therapeutic child care) and Children s Home Society (Head Start, EHS, home visiting, foster care) Co-creation and weekly collaboration with researchers: initial focus on games Building EF capacities in children and caregivers combined with strategies for reducing toxic stress in families
WA Early Learning Guidelines Working memory Remember and follow directions in one or two steps. 3-4 years Listen to others and respond in a group discussion for a short period. Remember what was said and gain information through listening. 4-5 years http://www.del.wa.gov/development/guidelines/
WA Early Learning Guidelines Inhibitory Control Enjoy turn-taking games with caregivers and may direct adult in his or her role. 16-36 months Will sometimes turn down a treat now if a better treat will be available later (one cookie now or two cookies later). 3-4 years http://www.del.wa.gov/development/guidelines/
WA Early Learning Guidelines Cognitive/Mental Flexibility Adjust behavior to different settings (such as using an outdoor or an indoor voice), sometimes with reminders. 4-5 years Begin to enjoy games like Simon Says, where a child has to adjust behavior in response to changing rules. 4-5 years http://www.del.wa.gov/development/guidelines/
DEL Professional Development Module http://www.deltraining.com/courses/ Executive_Function/content-frame.htm
What Is Inhibitory Control?
How Can Early Learning Practitioners Support its Development?
Supporting the Development of EF Skills Supporters Strategies Capacities Parents, Caregivers, Teachers & Other Professionals Support Model Engage Be Reliable Guide Protect Environments Safe Creative Explorable Stable >Economically >Emotionally Address external causes of stress Teach & use stress coping techniques Foster social interaction Encourage physical exercise Progressively increase complexity Practice, practice, practice Source: Diamond, et al. (2011) Working Memory Flexibility Self-control Skills Remember Filter Focus Plan Monitor Adjust Resist Persevere Life Course Outcomes Learning & Work ü Follow multi-step instructions ü Avoid distractions ü Plan & execute ü Manage long-term assignments ü Adjust to new rules ü Seek alternate solutions Behavior ü Teamwork ü Leadership ü Foresight ü Goal-directed ü Aware of self & others ü Adaptable Health ü Stress Reduction ü Nutrition & Exercise ü Resist Pressure to Take Risks
www.developingchild.harvard.edu
How Executive Function Is Being Applied Across Multiple Agencies in WA Economic Services Administration WorkFirst assessment redesign Juvenile Rehabilitation Administration Building adolescent executive function through mindfulness training Training for Managers mid-level managers in Economic Services, Vocational Rehabilitation, Children s Administration, Aging & Disability Services Medicaid Incorporate EF information into contractually obligated training for managed care organizations Public Health Tobacco cessation program Consultation with local health jurisdictions