Early Childhood Development: Equity and Inclusion

Mary Eming Young, MD, DrPH

Director, Center for Child Development, China Development Research Foundation

16th International Meeting on Early and Preschool Education: Comprehensive

Early Childhood Development, Inclusion, and Attention to Diversity

Monterrey, Mexico | October 12 – 15, 2016

Overview

• World community converging on the importance of ECD.

• What we have learned in the science of ECD

• How are we doing?

• So, what’s next? A sustainable development agenda for all

– Prevention, not remediation – Expand access to and ensure the quality of ECD programs– Build a cadre of practitioners knowledgeable in EHD

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I. ECD AND SDG

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Making the Case

• Children are a common basis for all dimensions of sustainable development. No advances in sustainable development will occur in coming decades without multiple generations contributing to societal improvement. Moreover, beyond sheer survival, children have a right to thrive, develop to their full potential, and live in a sustainable world.

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Making the Case

• The foundations of brain architecture and functioning, and subsequent lifelong developmental potential, are laid down in the early years in a process that is exquisitely sensitive to external influence. Early experiences in the home, in other care settings, and in communities interact with genes to shape the developing nature and quality of the brain’s architecture.

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Benefits of Investment in ECD

• Raising preschool enrollment to 50% in all countries: value US$33 billion with benefit / cost ratio 8 to 18, depending on discount rate (Engle et al., 2011; Behrman & Urzua, 2012)

• US Council of Economic Advisors estimate for the United States (CEA, 2014): benefit-cost ratio of 8.60

• 0-2 parenting program with nutrition supplementation in Jamaica (Walker, Grantham-McGregor et al, 2013; Gertler, Heckman et al., 2013) –20 years later participating children had: – Higher IQ– Reduced anxiety, depression and crime – 50% higher earnings

Source: Hiro Yoshikawa 2015

High Returns from Early Investments

-TAKE ADVANTAGE OF MALLEABILITY

-BUILD STRONG FOUNDATIONS FOR FURTHER LEARNING

-PREVENT EARLY DAMAGE / AVOID

LOSS OF POTENTIAL WHICH CANNOT BE

REMEDIATED

INVEST STRONGLY IN EARLY CHILDHOOD PROGRAMS, EVEN IF PAYOFF IS ONLY 20+ YEARS FROM TODAY

Source: Pedro Carneiro, 2008

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Reasons for investing in early child development

• Dry economic logic – high returns to investing in children

• More so, beyond pure economic reasons, it relates to social linkages- abilities to live with others, to participate in social activities and avoid social disasters (A. Sen), i.e development that improves people’s lives by improving peoples’ capabilities.

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Goal 4 and Target 4.2

• Goal 4: “Ensure Inclusive and Equitable Quality Education and Promote Life-long Learning Opportunities for All”

• 4.2: “By 2030, ensure that all girls and boys have access to quality early childhood development, care and pre-primary education so that they are ready for primary education”

Other SDG targets relevant to ECD • Eradicate extreme poverty for all people (1.1); services for poverty (1.3, 1.4)

• End hunger and ensure access by all people, in particular the poor and people in vulnerable situations, including infants, to safe, nutritious and sufficient food all year round (2.1)

• Reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being (3.4)

• Stunting and wasting in children under 5 years of age (2.2)

• Ensure universal access to sexual and reproductive health-care services… (3.7)

• Achieve universal health coverage (3.8)

• Reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination

• Availability and sustainable management of water and sanitation for all (Goal 6)

• Reduce inequality within and between nationsl (10.2

• Safe resilient and sustainable settlements “for women and children” (11.7)

• Prohibition and elimination of the worst forms of child labour, including…child soldiers, and by 2025 end child labour in all its forms

• End abuse, exploitation and trafficking and all forms of violence against children (16.2); legal identity and birth registration 10

Child rights and inclusion in the SDGs

• Language of the SDGs: All children, not simply targeted to poverty or to child survival

• Examples of protections and rights for groups at the margins: – Build and upgrade education facilities that are child, disability, and

gender sensitive and provide safe, nonviolent, inclusive, and effective learning environments for all (4a)

– End trafficking and sexual and other types of exploitation (5.2)– End early and forced marriage (5.3)

• Links to the General Comment 7 (early childhood) of the Convention on the Rights of the Child and the Convention on the Rights of Persons with Disabilities– Anti-discrimination rights of both parents and young children

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II. SCIENCE OF ECD

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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.

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brain

learning

health

behavior

genes

epigenetics

experience

nurturingnutrition

physicalenvironment

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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.

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Eight (8) Things to Remember about

Child Development 1. Even infants and young children are affected adversely

when significant stresses threaten their family and

caregiving environments.

2. Development is a highly interactive process, and life

outcomes are not determined solely by genes.

3. While attachments to their parents are primary, young

children can also benefit significantly from relationships

with other responsive caregivers both within and outside

the family.

4. A great deal of brain architecture is shaped during the first

three years after birth, but the window of opportunity for its

development does not close on a child’s third birthday.

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Source: Harvard Center on the Developing Child, 2016

Eight (8) Things to Remember about

Child Development

5. Severe neglect appears to be at least as great a threat

to health and development as physical abuse—

possibly even greater.

6. Young children who have been exposed to adversity or

violence do not invariably develop stress-related

disorders or grow up to be violent adults.

7. Simply removing a child from a dangerous

environment will not automatically reverse the negative

impacts of that experience.

8. Resilience requires relationships, not rugged

individualism.

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Source: Harvard Center on the Developing Child, 2016

Biological Susceptibility to Context

Individual Differences : Neurobiological Sensitivity

to Social Context (vulnerability and resilience)

dandelion child

orchid child

Tom Boyce

Resilience Can Be Strengthened By Supportive Relationships and Skill-Building

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Optimizing Healthy Development

Addressing the factors shaping health

development trajectories over the

lifespan

AgeHalfon, 2015

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III. ECE AND EQUITY

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Source: Wilkinson & Pickett, The Spirit Level, 2009

Index of:

• Life expectancy

• Math & Literacy

• Infant mortality

• Homicides

• Imprisonment

• Teenage births

• Trust

• Obesity

• Mental illness

– incl. drug &

alcohol addiction

• Social mobility

Health and social problems are worse

in more unequal countries

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Ind

ex o

f h

ea

lth

an

d s

ocia

l pro

ble

ms

Healthy Development Disparities by

Race/Ethnicity: U.S. Bruner, C., & Schor, E. (2009)

White Non-Hispanic

Black Non-Hispanic Hispanic

Health Outcomes

Low Birth Weight 7.2% 13.4% 6.8%

Elevated Blood Lead Levels (0-5 year-olds)

2.6% 4.3% 3.1%

6-11 year-olds Overweight 11.8% 19.2% 23.7%

Lack of Regular Source of Care 3.3% 5.8% 24.1%

Incomplete Immunizations (19-35 month-olds)

16.7% 25.5% 21.3%

Education Outcomes

Below Basic 4th Grade Reading 22% 54% 50%

Below Basic 8th Grade Math 18% 53% 45%

Non-completion of High School 21.4% 48.8% 46.8%

Other Outcomes

Children in Poverty 11% 36% 29%

Children in Single-Parent families 23% 65% 36%

Pop. In High Vulnerability Tracts 1.7% 20.3% 25.3%

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Children in the poorest households are lesslikely than children in the richest households to attend early childhood education programmes(3-4 year old children attending early childhood education, comparing top and bottom wealth quintile; UNICEF, 2012)

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Enrollment in Center-Based ECE by Mothers’ Education: LAC Region

(IDB Flagship Report on ECD, Berlinski & Schady, 2015)

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Effects for Specific Groups: Can Quality ECE Increase Equity / Reduce Disparities

in Early Learning?(Rao et al., 2015; Yoshikawa & Kabay, 2015; Yoshikawa, Weiland, Brooks-Gunn, et al., 2013; Engle

et al., 2011)

• Socioeconomic Status: – High-quality preschool provided universally can

benefit both low- and middle-income children, with substantial effects on both groups, but greater impact on children living in or near poverty

• Children of Immigrants– Positive impacts on language and math outcomes as

strong or stronger for dual language learners and children of immigrants

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Levels of Inclusion (applies to different

marginalized groups: children out of family care; migrant, refugee children; Roma)

• 0-3 Services

• Program and Classroom

• Community and Family

• Transitions and continuity: ECE to Primary Schooling

• Governance and policy – local, subnational and national

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Community and Family

• Approaches to outreach and recruitment of marginalized groups

• Teacher and staff training and professional development regarding inclusion – pre-service; in-service

• Involvement of community and family members in local governance of programs

• Community-level access to quality ECE –attention to gaps in access due to rural, remote, indicators of neighborhood disadvantage

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Transitions and Primary Education Experiences

• Sustained exposure to low vs high-quality ECE and basic education in primary school has long-term consequences

• Those without access to ECE may also be at risk of low-quality primary education, late entry, grade repetition, suspension due to behavioral issues, identification as intellectually disabled

• High-quality ECE can reduce grade repetition and special education “tracking” (McCoy et al., 2015 meta-analysis)

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Governance and Policy

• Representation of marginalized groups in local, subnational and national governance

• Political representation can result in positive policy change – at community / local and national levels (with impacts on child health and nutrition strongest when experienced in early childhood – Pathak & Macours, 2014)

• Need for leadership development specific to expertise in ECD practice, policy and research

Source: Hiro Yoshikawa 201631

Lessons regarding ECE and Inclusion

• SDG indicators provide framework for national data collection efforts that disaggregate by ethnicity, majority, and other marginalized groups across ECD relevant indicators

• Data on disproportionate exclusion (access) and “tracking” into lower-quality education, across ECE through primary schooling required

• Quality measures need to assess differential treatment of different groups of children in the classroom

• Child development and learning outcome measures must be culturally appropriate and adapted for home language, cultural norms

• Professional development and training systems can counter differential treatment in classroom practices

• Representation in local, subnational and national governance are critical –facilitated by leadership development opportunities

• Finance mechanisms and costing studies must consider explicitly the costs of NOT addressing exclusion and providing quality ECE and primary schooling for marginalized groups

So

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Two-generation approaches provide opportunities for and meet the needs of children and their parents together.

Integrating a 2Gen Lens

6Ascend at the Aspen Institute • May 2016

Messages for Policymakers

• Start early – begin at birth or before, with effective programs of quality and intensity, and continue on with preschool curricula aligned with curricula of primary school

• Assure quality by providing for professional development of ECD educators and staff.

• To do so, need leaders that are in position of power to understand the importance of investing in young children.

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Conclusion

• Policymakers, working with ECD leaders and practitioners in NGOs and civil society and with families and communities, officials in the education and health sectors and social protections can make strides in ECD by:

– Harnessing existing knowledge about the science of early brain development to build ECD systems that integrate the delivery of childcare, education, and health into comprehensive, cross-silo packages of services for families and children

– Investing in capacity development of leaders, and likewise professionals in all sectors

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