Children, Neighbourhoods and Development

What I want to Talk about…• What is childhood?• Are the “first three years” as important as people are

saying?• Healthy childhood = healthy adult life?• The place of early childhood education in a healthy

life.• The importance of universal access to quality

childcare and Early Childhood Education.

The Concept of Childhood

Before there was childhood…• The ancient world had a limited concept of

“childhood”• In the Middle Ages, a child was an adult when she

could speak English and be understood.• The Renaissance saw the development of a concept of

childhood, tied to the ability to read.• However, childhood as we know it is a very recent

phenomenon.• No universal acceptance of the rights and protections

of childhood

Childhood is an Evolving Concept

• In Human history, childhood is a recent concept

• Greeks had no real world for “child” in the ancient world. They did invent schooling, but children’s lives were precarious.

• In the middle ages, you were an adult when you could speak English well.

What developed to give rise to “Childhood”

• The advent of the printing press and reading.

• A division between those who could read and those who could not.

• Schooling was a necessity.

• Therefore, childhood a necessity-you had to be educated to make your way in the world successfully.

• We live in an economy where education is essential to well being.

Why are the Early Years Important?

• Research has shown that what happens in the early years can have an impact on health outcomes across the lifespan.

• We now know more about child brain development, thanks to new brain scanning technologies.

• We live in a very complex, information based world, making education more important than ever.

• Countries need highly educated, well adjusted citizens in order to compete in the global economy

Developmental Health as the Wealth of Nations

In Ontario, our perspective was changed by the first Early Years Report (The Real Brain Drain) by Margaret McCain and Fraser Mustard.

Early brain development is the key to lifetime health and mental health outcomes.

Brain development is supported by the environment, especially during “critical periods”.

Critical periods are pre-programmed windows of development where the brain is most sensitive to input from the environment.

Therefore, the early environment should be arranged to support critical periods of development.

Everything you wanted to know about Everything you wanted to know about brain development…brain development…

• Newborn has greatest number of neurons it will ever have in its life

• Brain development proceeds by two main mechanisms: white matter growth and pruning.

• Neurons and dendrites are selectively “pruned”.

• Some connections are strengthened and others are lost.

• Pruning periods are critical periods. Use it or lose it.

Successful Early Development = Critical Periods + Environment

• Research shows that early experiences are crucial for brain development, which affects all other developmental areas.

• Children who are exposed to warm environments that provide stimulation as well as manageable activities and challenges are:

• 1) Equipped for the demands of school (cognitive and emotional)

• 2) Better able to bounce back from stress

• 3) Better able to actively participate in their own learning

• 4) Are more satisfied with their lives.

Brain Development and Health Outcome

• Early global factors (e.g., nutrition, stimulation and attachment) can have a profound effect on later health:– Poor frontal lobe development-risky behaviour

– Poor early nutrition/education-increased rate of dementia

– Underweight/premature-Risk of poor behaviour outcomes

– Early deprivations-increased risk later in life due to reduced “cognitive reserve”

How Does Outside Get Inside?:• Early events interact with critical neural• There are two main ways to divert normal

development: Understimulating and Overstressing a child

• Stress chemicals interfere with gene expression during development and cause neuron death or disablement

• Some stress is good because it helps set the child’s “stress response”

• Too much stress sets it too high.

From Neurons to Neighbourhoods

•Fetus

•Potential

•Old Age

•Cognitive Reserve

•Maternal

•Parent/Caregiver

•School

•Neighbourhood

•Nutrition

•Stress/Inflammation

Drugs and Injury

•Brain Life Cycle

•New Brain

Diminishing Return Rates

Where Do Family and Preschool Fit ?

• The family is the primary source of nurturance, and all of the characteristics that make for good development.

• Increasingly, children are spending a significant proportion of their early lives OUTSIDE of the family structure (daycare, homecare, preschool, kindergarten).

• With ECE such a large part of children’s lives…

Integrating ECE and Development

• The ECE centre is a prime factor in child development.

• However, ECE is marginalized in the education system.

• The new focus on health suggests that early education is as much about health and prevention as education.

• This suggests that ECE should be supported to a greater degree than is currently the case.

Preschool Characteristics

Better match between challenges and child’s level of ability or learning style

Play based learning Secure, un-stressful environment Lower child to staff ratio Social inclusion Parental inclusion Identification of early signs of falling behind Greater ECE staff awareness of neurodevelopment

and signs of early risks.

Integration• The best way to make ECE more central is to

integrate ECE with public education and Public Health.

• ECE needs more political attention.• ECE centres should be about “lifelong” learning and

health, not just the first 5 years.• For example, ECE centres could also provide prenatal

classes, drop-in centres for retirees, etc. in order to make it a HUB for human development IN THE COMMUNITY

ECE, Neighbourhoods and Brains

• Children would benefit from ECE centres being integrated into neighbourhoods.

• We need a shift from seeing early education and health promotion as two different things.

• Care should be taken to de-marginalize ECE from mainstream education.

• ECE Centres should be hubs for lifespan needs, not just the needs of toddlers.

• Better connection between ECE curriculum and kindergarten curriculum to maximize “readiness for school”

What Makes a Brain-Friendly ‘Hood?

Risk• Poor access to health

care• Lack of parental

support• Parental stress• Stressful

conditions/neglect• Lack of social

resources• Poor nutrition• Low stimulation

Protective• Parental support• Quality childcare• Nutrition programs• Parenting skills classes• Income support• Building social

cohesion• Violence reduction• Play-centered learning

What we hope…..

Current reality…..

Acknowledgements

• I gratefully acknowledge the support of the Peterborough K.M. Hunter Charitable Foundation, The Canadian Institutes of Health and the Ministry of Health and Long Term Care

• The views expressed in this presentation are the views of the author and do not necessarily reflect the views of the Ontario Ministry of Health and Long Term Care

Resources

• http://www.who.int/social_determinants/resources/ecd_kn_report_07_2007.pdf

• www.futureofchildren.org• Keating & Hertzman (1999) Developmental

health and the wealth of nations. • Sapolsky, R (2003). Why zebras don’t get

ulcers.• Hertzman, Healthier Societies• Early Years study: McCain and Mustard

ST. MICHAEL’S HOSPITALStatement of Affirmation Regarding

Accessible, Welcoming, and Equitable Health Care for All

To acknowledge the needs of the communities we serve, St. Michael’s Hospital reiterates our longstanding commitment to affirm and protect the right to sensitive, secure, respectful health care for all patients, including people living with HIV/AIDS, lesbians and gay men, their partners and families, the poor, and homeless and people living with severe mental illnesses. It is the mission, values, and tradition of St. Michael’s Hospital and those associated with the hospital to provide compassionate care in a welcoming environment, embracing all races, cultures, classes, beliefs, ages, gender, and sexual orientations.

Board Approved 1998