launching a new era in science-based early childhood policy...source: danese, et al. (2008) control...
TRANSCRIPT
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JACK P. SHONKOFF, M.D.
Julius B. Richmond FAMRI Professor of Child Health and Development,
Harvard School of Public Health and Harvard Graduate School of Education.
Professor of Pediatrics, Harvard Medical School and Boston Children’s Hospital.
Director, Center on the Developing Child at Harvard University
Sulzberger Distinguished Lecture | Duke Center for Child and Family Policy Durham, NC | February 4, 2014
Launching a New Era in Science-Based Early Childhood Policy
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Building on a 50-Year Legacy
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Revisiting a 13 Year Old Call to Change the Narrative
Advocates of earlier and more intervention have an obligation to measure their impacts and costs. Skeptics, in turn, must acknowledge the massive scientific evidence that early childhood development is influenced by the environments in which children live.
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Revisiting a 13 Year Old Call to Change the Narrative
Continued ‘winner takes all’conflict between advocates and skeptics serves only to fuel a siege mentality in the early childhood community that undermines critical self-evaluation in the service of short-sighted self-preservation.
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Applying Julius Richmond’s Model for a
Social Change Agenda
Knowledge Base
Political Will
Social Strategy
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Driving Science-Based Innovation that Achieves Breakthrough Outcomes for
Children Facing Adversity
Advances in neuroscience, molecular biology, genomics, and the behavioral and social sciences provide an unprecedented opportunity to catalyze new strategies across multiple sectors to strengthen the foundations of lifelong learning, behavior, and health.
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Experiences Build Brain Architecture
View this video: http://developingchild.harvard.edu/resources/multimedia/videos/
three_core_concepts/brain_architecture/
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The Cumulative Pile Up of Adversity Impairs Development in the First Three Years
Number of Risk Factors Source: Barth, et al. (2008)
Ch
ild
ren
wit
h
Develo
pm
en
tal
Dela
ys
1-2 3 5 4 6 7
20%
40%
60%
80%
100%
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Risk for Adult Heart Disease is Embedded in Adverse Childhood Experiences
Adverse Experiences Source: Dong, et al. (2004)
Od
ds R
ati
o
0 1 2 3 4 5,6 7,8
0.5
1
1.5
2
2.5
3
3.5
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Biological “Memories” Link Maltreatment in Childhood to Greater Risk of Adult Heart Disease
Percent of adults with biological
marker for greater risk of heart disease
Source: Danese, et al. (2008)
Control
10%
20%
40%
30%
50%
Depression (age 32)
Depression (age 32) + Maltreated (as a child)
Maltreated (as a child)
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Toxic Stress Derails Healthy Development
View this video: http://developingchild.harvard.edu/resources/multimedia/videos/
three_core_concepts/toxic_stress/
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Early Life Experiences Are Built Into Our Bodies (For Better or For Worse)
Research on the biology of adversity illustrates how increases in blood pressure, heart rate, blood sugar, stress hormones, and inflammation fuel the “fight or flight response” to deal with acute threat... …but excessive or prolonged activation of stress response systems can lead to long-term disruptions in brain architecture, immune status, metabolic systems, cardiovascular function, and gene expression.
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Magnitude of Effects of Center-Based Early Childhood Education By Year of Intervention
Source: Leak, et al. (2011)
Averag
e E
ffect
Siz
e
Calendar Year of Study
1960 1970 1980 1990 2000 2010
-0.5
.5
1.5
0
1
Abbott
Preschool
Program Abecedarian Project
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The Foundations of School Success are Strengthened by Building Caregiver Capabilities,
Not Simply by Giving Parents Information
Source: Grindal, et al. (under review)
Eff
ect
Siz
e
Cognitive Skills
.2
.4
.6
Pre-Academic Skills
.1
.3
.5 with modeling/practice for parents
Average Impacts of 88 Early Childhood Education Programs (1960-2007)
without modeling/practice for parents
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Enhance quality and take effective models to scale
Increasing the Impact of Current Investments Requires Three Strategies
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Enhance quality and take effective models to scale
Build strong systems for coordinated service delivery and data management
Increasing the Impact of Current Investments Requires Three Strategies
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Enhance quality and take effective models to scale
Build strong systems for coordinated service delivery and data management
Formulate enhanced theories of change, test new ideas, and learn from interventions that don’t work
Increasing the Impact of Current Investments Requires Three Strategies
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Stimulating Experiences, Parenting Education, Sound Nutrition, Primary Medical Care, and Health-Promoting Environments
Readiness to Succeed in School
Current Conceptual Framework Guiding Early Childhood Policy and Practice
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Significant Adversity
Stimulating Experiences, Parenting Education, Sound Nutrition, Primary Medical Care, and Health-Promoting Environments
Impaired Development
Current Conceptual Framework Guiding Early Childhood Policy and Practice
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Creating a New Paradigm for Policy and Practice Across Sectors
Early experiences affect lifelong health and learning
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Creating a New Paradigm for Policy and Practice Across Sectors
Healthy development requires protection and enrichment
Early experiences affect lifelong health and learning
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1
Generating Hypotheses to Guide New Intervention Strategies
Protection and enrichment for young children require:
Healthy development requires protection and enrichment
Early experiences affect lifelong health and learning
Strengthening adult capabilities that are the common foundations of effective parenting, economic self-sufficiency, and responsible citizenship
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1
Generating Hypotheses to Guide New Intervention Strategies
Protection and enrichment for young children require:
2 Reducing community sources of toxic effects on healthy development
Healthy development requires protection and enrichment
Early experiences affect lifelong health and learning
Strengthening adult capabilities that are the common foundations of effective parenting, economic self-sufficiency, and responsible citizenship
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Emotions
Skill Building for Parenting and Economic Self-Sufficiency Points to the Foundational Role of Executive Function and Self-Regulation Skills
These core dimensions of adult competence include the ability to focus and sustain attention, set goals and make plans, follow rules, solve problems, monitor actions, defer gratification, and control impulses.
Error Processing
Reaction and Responses
Use of Rules
Risk/Reward Decisions
Behavioral Control
Working Memory
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Building Blocks for Early Learning
Self Control — filter thoughts and impulses to resist temptations and distractions
Mental flexibility — adjust to changed demands, priorities, or perspectives
Working Memory — hold and manipulate information in our heads over short periods of time
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What These Skills Look Like in Adults
Self Control — filter thoughts and impulses to resist temptations and distractions
Mental Flexibility — adjust to changed demands, priorities, or perspectives
Working Memory — hold and manipulate information in our heads over short periods of time
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The Challenge: The Ability to Change Brains and Behavior Decreases Over Time
Source: Levitt (2009)
Birth 10 20 30
Physiological “Effort” Required to Modify Neural Connections
Normal Brain Plasticity Influenced by Experience
Age (Years)
40 50 60 70
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The Opportunity: Circuits for Executive Function Skills Are Located in Brain Regions that Exhibit
an Extended Period of Plasticity
Source: Weintraub, et al. (2011)
Birth
Age (Years)
50 70 80
Skil
l p
ro
ficie
ncy
3 5 15 25 30 10
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A Humble Proposal for a Bold New Strategy
Create an aspirational vision for the 21st century by defining best practice as a starting point, not a solution. Move beyond battles over statistically significant but small magnitude effects on multiple measures, and seek breakthrough impacts on key outcomes. Embrace constructive dissatisfaction with the status quo and build an R&D platform to catalyze innovation. Recognize that the risks of trying new strategies that don’t work pale next to the risks of not being bold enough to seek substantially larger impacts.
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The Compelling Need to Design and Test Enhanced Theories of Change
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Special Thanks for the Collective Knowledge and Contributions of the Following
Remarkable Groups
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www.developingchild.harvard.edu