REVIEW OF THE RESEARCH EVIDENCE ON EARLY CHILD DEVELOPMENT

Tim MooreCentre for Community Child Health

Paper presented at National Meeting on Early Childhood Systems,Melbourne, November, 2002

Our understanding of prenatal and early childhood development continues to growapace. While there is still a great deal to be learned, there is now sufficientaccumulated evidence for us to be able to identify the key characteristics orprinciples of development. This paper presents a list of these characteristics drawnfrom recent authoritative summaries of the research on prenatal and early childhooddevelopment provided by Bateson and Martin (1999), Catherwood (1999), Eliot(1999), Halfon, Shulman and Hochstein (2001), Hertzman (2000), Lerner (1998),McCain and Mustard (1999), Monk, Webb and Nelson (2001), Mustard (2002),Nelson and Bosquet (2000), Rutter (2002a), Siegel (1999), Shonkoff and Phillips(2000), Thompson (2000), Thompson (2001) and Thompson and Nelson (2001).Implications of each of these characteristics or principles for service provision arenoted throughout.

Key features of early childhood development

• Human development is shaped by a dynamic and continuous interactionbetween biology and experience (Anderson, Northam, Hendy and Wrennall,2001; Gottlieb and Halpern, 2002; Rutter, 2002a, 2000b; Shonkoff and Phillips,2000; Siegel, 1999; Sternberg and Grigorenko, 2001; Rutter, 2002; Sameroff andFiese, 2000; Thompson and Nelson, 2001; Yoshikawa and Hsueh, 2001). AsSternberg and Grigorenko (2001) note, genes always have their effect either incorrelation with or in interaction with the environment. Thus, even if attributes areheritable, they can develop very differently in different environments. Siegel (1999) gives the following account of this process:

‘An infant is born with a genetically programmed excess in neurons, and thepostnatal establishment of synaptic connections is determined by both genesand experience. Genes contain the information for the general organization ofthe brain's structure, but experience determines which genes becomeexpressed, how, and when. The expression of genes leads to the productionof proteins that enable neuronal growth and the formation of new synapses.Experience - the activation of specific neural pathways - therefore directlyshapes gene expression and leads to the maintenance, creation, andstrengthening of the connections that form the neural substrate of the mind.Early in life, interpersonal relationships are a primary source of the experiencethat shapes how genes express themselves within the brain.’ (p. 14)

How does experience shape the mind? Experiences can shape not only whatinformation enters the mind, but the way in which the mind develops the abilityto process that information. Thus, ‘each individual's history reflects an

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inseparable blend of how the environment, random events, and the person'stemperament all contribute to the creation of experiences in which adaptationand learning recursively shape the development of the mind’ (Siegel, 1999, p.20).

Different stages of development are more biologically determined than others.Prenatal neurological development in particular occurs largely according to abiologically predetermined template, with any disruptions (whether biological orenvironmental) that occur affecting the formation of the central nervous system.Postnatal neurological development is also prespecified, but to a lesser extent.Disruptions during this period are likely to affect the elaboration and connectivityof the central nervous system (Anderson et al, 2001).

Implication: Developmental psychologists and geneticists should work closelytogether to get a better understanding of how genetic inheritance andenvironment interact to shape development.

• Children affect their environment as well as being affected by it, thereforeplaying an active part in their own development (Siegel, 1999; Shonkoff andPhillips, 2000; Thompson, 2001). The inborn drive to master the environment is abasic feature of human development throughout the life cycle. Moreover, no twochildren share the same environment, and no environment is experienced inexactly the same way by two different children.

‘The development of the mind has been described as having "recursive"features. That is, what an individual's mind presents to the world can reinforcethe very things that are presented. A typical environmental / parental responseto a child's behavioral output may reinforce that behavior. Therefore, the childplays a part in shaping the experiences to which the child's mind must adapt.In this way, behavior itself alters genetic expression, which then createsbehavior. In the end, changes in the organization of brain function, emotionalregulation, and long-term memory are mediated by alterations in neuralstructure. These structural changes are due to the activation or deactivation ofgenes encoding information for protein synthesis. Experience, geneexpression, mental activity, behavior, and continued interactions with theenvironment (experience) are tightly linked in a transactional set of processes.Such is the recursive nature of development and the way in which nature andnurture, genes and experience, are inextricably part of the same process.’(Siegel, 1999, p. 19)

Implication: In providing services to young children, we should recognise theactive role they play in shaping their environment, and their potential role aspartners.

• Human relationships, and the effects of relationships on relationships, arethe building blocks of healthy development (Nelson, 1996; Shonkoff andPhillips, 2000; Siegel, 1999; Thompson, 2000, 2001). Those that are created inthe earliest years are believed to differ from later relationships in that they areformative and constitute a basic structure within which all meaningfuldevelopment unfolds.

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According to Siegel (1999), different patterns of child-parent attachment areassociated with differing physiological responses, ways of seeing the world, andinterpersonal relationship patterns. The communication of emotion may be theprimary means by which these attachment experiences shape the developingmind. Research suggests that emotion serves as a central organizing processwithin the brain. In this way, an individual's abilities to organise emotions - aproduct, in part, of earlier attachment relationships - directly shapes the ability ofthe mind to integrate experience and to adapt to future stressors.

However, summarising the attachment research, Thompson (2000, 2001)concludes that children vary considerably in the extent to which early attachmentshave an enduring impact on them. Both developmental history of attachment andcurrent circumstances are influential, and their relative influence can vary fordifferent children. Thus, early attachment experiences are important, but they canbe transformed by later experiences. Therefore, attachment has much strongercontemporaneous associations with socioemotional adaptation than it doespredictive relations. Similarly, O’Connor (2002) notes that, although there is evidence of strong linksbetween parent-child relationship quality and children’s well-being, difficultiesremain in drawing causal connections and applying research findings to clinicalsettings.

Implication: We should seek to provide parents and young children with theconditions and support they need to form strong attachments.

• Culture influences every aspect of human development and is reflected inchildrearing beliefs and practices designed to promote healthy adaptation(DeLoache and Gottlieb, 2000; García Coll and Magnuson, 2000; Eckersley,2001; Goodnow, 1999; Kalyanpur and Harry,1999; Lynch and Hanson, 1998;Shonkoff and Phillips, 2000). Culture provides a virtual how-to manual for rearingchildren and establishes role expectations for all members of the immediate andextended family, as well as friends. As DeLoache and Gottleib (2000) state, ‘thechild-rearing customs of any given society, however peculiar or unnatural theymay at first seem to an outsider, make sense when understood within the contextof that society’ (p. 5).

Implication: We need to be wary of judging child-rearing customs that are differentfrom our own as inappropriate or bad for the child.

• The key developmental challenges faced by young children are formingattachments, acquiring self-regulation, developing communication andlearning skills, and learning how to relate to peers (Shonkoff and Phillips,2000; Thompson, 2001). The growth of self-regulation is a cornerstone of earlychildhood development that cuts across all domains of development (Bronson,2000; Keating and Miller, 1999; Shonkoff and Phillips, 2000; Siegel, 1999). Self-regulation includes physiological and behavioral regulations that sustain life (eg.maintenance of body temperature and conversion of food into energy), as well asthose that influence complex behaviors (eg. the capacity to pay attention, express

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feelings, and control impulses). Early regulatory tasks include acquiring day-nightwake-sleep rhythms, and learning to regulate crying. Later regulatory tasksinclude understanding and regulating emotions, and regulating attention andexecutive functioning.

Implication: We should be particularly sensitive to children’s early regulatorydifficulties, and be able to support parents in helping children learn to managetheir own behaviour.

• There is a wide range of individual differences among young children thatmakes it difficult to distinguish normal variations and maturational delaysfrom transient disorders and persistent impairments (Shonkoff and Phillips,2000; Shonkoff, Phillips and Keilty, 2000). All children have built-in capacities toattain developmental goals in multiple ways and under varying conditions. Thus,there are alternative developmental pathways, rather than a single ‘normal’ thishelps explain the distinctive competencies that children develop in diverse culturalcontexts, as well as the different family patterns of interaction that promote theirunfolding.

Implication: Early childhood services should be accepting of and able to cater fora wide range of individual differences in children.

• Children with developmental disabilities have the same core needs as otherchildren, and can teach us much about development of children withoutdisabilities (Hodapp, 1998; Lewis, 2003). Children with developmentaldisabilities have the same needs for nurturance, protection from harm,appropriate stimulation, and opportunities to fully participate in family andcommunity life as other children. Children with disabilities are guides tounderstanding typical development: understanding how a particular disabilitychanges the course of development in an individual can help us better understandwhat is involved in normal development There is also increasing evidence of an increasing convergence toward whatLieber, Schwatrz, Sandall, Horn and Wolery (1999) have called ‘a compatiblephilosophy of instruction’ between the early childhood and early childhoodintervention fields. This evidence comes from studies of naturalistic approaches toteaching, effective ways of working with multiply disabled children, parent-childand teacher-child interactions, and longitudinal studies of preschool curricula forat-risk children (Moore, 2001).

Implication: All children stand to benefit from services that are truly inclusive.

• The development of children unfolds along individual pathways whosetrajectories are characterized by continuities and discontinuities, as well asby a series of significant transitions (Lewis, 1997; Shonkoff and Phillips, 2000;Shonkoff, Phillips and Keilty, 2000). Children’s development is affected byunexpected changes in their own states (eg. illness), their families (eg. divorce) ortheir communities (eg. business closures). These can significantly alter thebalance of risk and protective factors in their environments, and potentially disrupttheir individual developmental trajectories, for better or worse.

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In addition, there are significant transitions that children typically face, such ascommencing child care or entering school. These transitional phases, which maybe either smooth or characterized by stress and turmoil, are important periods ofpsychological reorganization. Interventions to ensure that these transitions go assmoothly as possible are indicated.

Implication: We should be ready to provide appropriate support when significantrisk changes occur in the lives of children, as well as during significant normativetransitions.

• Early brain development is characterised by sensitive rather than criticalperiods (Keating and Hertzman, 1999; Thompson, 2001; Thompson and Nelson,2001; Bailey and Symons, 2001). Critical periods are times in growth whencertain input is essential for development. Relatively little early brain developmentis of this kind. Instead, ‘the term sensitive periods is preferred to critical periodsbecause it implies less rigidity in the nature of the formative early experiences,their developmental timing, and their developmental outcomes’ (Thompson, 2001,p. 85). The sensitive periods that have been identified (eg. for languagedevelopment or attachment) may begin abruptly, but typically last a long time andtaper off gradually.

Implication: We should be more concerned about the overall quality of earlyexperience than with the timing of specific influences.

• Brain development is life-long (Rutter, 2002a; Thompson and Nelson, 2001).The most significant period of brain development is actually during the prenatalmonths (Monk, Webb and Nelson, 2001), and significant neurobiologicaldevelopment and learning continues to occur after the early years.

Implication: Crucial as they are, the early childhood years are but one link in thechain of development – ultimately, achieving positive developmental outcomesdepends upon the individual and collective strength of all links in the chain.

• Early experiences can influence later health and developmental outcomesthrough a process of biological embedding whereby experiences areprogrammed into the structure and functioning of biological and behavioralsystems (Halfon and Hochstein, 2002; Hertzman, 1999, 2000; Keating andHertzman, 1999; Repetti, Taylor and Seeman, 2002). Hertzman (2000) explainsthis process thus:

‘Spending one’s early years in an unstimulating, emotionally and physicallyunsupportive environment will affect brain development in adverse ways, andlead to cognitive, social and behavioural delays. The problems that children soaffected will display early in school will lead them to experience much moreacute and chronic stress than others, which will have both physiologic and life-course consequences. Because the central nervous system, which is thecentre of human consciousness, “talks to” the immune, hormone and clottingsystems, systematic differences in the experience of life will increase ordecrease levels of resistance to disease. This will change the long-term

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function of vital organs of the body and lead to socio-economic differentials inmorbidity and mortality. This process, whereby human experience affectshealth over the life course, is called “biological embedding.” ‘

Through the process of biological embedding, systematic differences inpsychosocial / material circumstances, from conception onward, embedthemselves in human biology: gradients in health and well-being are therefore afunction of human development and its interaction with social circumstances.Thus, Repetti, Taylor and Seeman (2002) summarise evidence that what they call‘risky’ family environments are associated with long-term adverse outcomes forboth mental and physical health: ‘Whether the unit of analysis is the shared familyenvironment or the parent-child relationship, comprehensive reviews of theresearch literature associate family relationships that are marked by high levels ofanger and aggression or that are cold, unsupportive, or neglectful, with mentalhealth problems in childhood and adolescence.’ (p. 332)

Implication: We should seek to ensure that children are protected from conditionsand experiences known to have adverse neurological / biological consequences.

• Early experiences are linked to later developmental outcomes in severaldifferent over-lapping ways (Barker, 1992; 1998; Ben-Shlomo and Kuh 2002;Halfon and Hochstein, 2002; Hertzman, 2000; Najman, 2002).

Najman (2001) contrasts two theories of how environments and experiences caninfluence health and developmental outcomes: the foetal progamming theory andthe life-course theory. – The foetal programming theory (the so-called Barker hypothesis) argues that

critical experiences / exposures early in gestation can have life-long healthconsequences

– The life course theory argues that health outcomes are a product of theaccumulation of experiences / exposures over time – it is the duration andintensity of these exposures that is critical

Najman suggests that these are not necessarily contradictory but interact with oneanother to produce particular outcomes.

In a similar vein, Halfon and Hochstein (2002) discuss health development interms of macropathways and micropathways:- Macropathways involve interactions between environmental risk and protective

factors that are often correlated (eg. poverty, geographic proximity, physicalenvironment, limited social capital) and that cumulatively influence lifestyle,physical activity, and food consumption. These in turn mediate the effects ofsocial, economic, and cultural environments on short- and long-term healthand well-being.

- Micropathways involve metabolic and neuroendocrine regulatory processesthat translate information from social relationships, environmental exposures,and historical events into biological information that alters the functioning of

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biological processes – a process that Keating and Hertzman (1999) callbiological embedding.

Hertzman (2000) describes the development of child in terms of three processes:latent effects, pathway effects, and cumulative effects.- Latent effects involve specific biological or developmental experiences in

pregnancy or early infancy that can program the function of a number of organsystems, and influence adult physical health (the Barker hypothesis)

- Pathway effects involve other early life experiences that act to set individualsonto life trajectories that, in turn, affect health, well-being and competenceover time.

- Cumulative effects involve the accumulation of advantage or disadvantageover time, based upon the duration and intensity of exposure to a variety ofrisk factors.

Implication: We need to be concerned both about prenatal nutrition and well-being, as well as children’s ongoing environmental conditions and experiences.

• Human development is shaped by the ongoing interplay among sources ofvulnerability or risk and sources of resilience or protection (Cashmore,2001; Durlak, 1998; Halfon and Hochstein, 2002; Homel, Elias and Hay, 2001;Kelly and Barnard, 2000; Luthar, Cicchetti and Becker, 2001; Rutter, 2002a;Sameroff and Fiese, 2000; Shonkoff and Phillips, 2000; Shonkoff, Phillips andKeilty, 2000; Thompson, 2001; Waller, 2001; Werner, 2000). Individualdevelopmental pathways throughout the life cycle are influenced by interactionsamong risk factors that increase the probability of a poor outcome and protectivefactors that increase the probability of a positive outcome. Risk factors may befound within the individual (e.g., a temperamental difficulty, a chromosomalabnormality), the family (e.g., poverty, family violence), or the community (eg.social isolation, lack of infrastructure). Protective factors also may beconstitutional (e.g., good health, physical attractiveness), familial (e.g., lovingparents, effective behaviour management), or community-based (eg., strongsocial networks, safe neighbourhoods).

Risk and protective factors are multiplicative rather than additive in their effects(Sameroff, Seifer, Barocas, Zax and Greenspan, 1987; Dunst and Trivette, 1994).The cumulative burden of multiple risk factors is associated with greaterdevelopmental vulnerability, while the cumulative buffer of multiple protectivefactors is associated with greater developmental resilience. Thus, the totalnumber of risk factors in a child's life is a better predictor of developmentaloutcomes than the specific nature of those factors. The double burden of bothbiological and environmental risk produces an unusually high level of vulnerability.

Thus, the experiences that greet children in their human and physicalsurroundings can either enhance or inhibit the unfolding of their inborn potentialThompson, 2001).

The term resilience has often been used to describe the ability of some people tosurvive adverse experiences unscathed (Luthar and Cicchetti, 2001: Luthar,

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Cicchetti and Becker, 2001; Masten, 2001; Rutter, 2000a; Waller, 2001; Werner,2000), although term is somewhat problematic. After reviewing current resiliencetheory and research, Rutter (2000) concludes that resilience is not aunidimensional construct that can be summarised succinctly. What is clear is thatit is not an individual trait or characteristic, but a process or range of processes,although we know little about the mechanisms whereby risk factors lead toparticular outcomes in particular people. There is also evidence that growing up inadverse conditions does not inevitably damage individuals or thwart development(Rutter, 2000), and that resilience is a normal adaptive feature of development(Masten, 2001):

‘The great threats to human development are those that jeopardize thesystems underlying these adaptive processes, including brain developmentand cognition, caregiver-child relationships, regulation of emotion andbehavior, and the motivation for learning and engaging in the environment.’(Masten, 2001, p. 234)

Implication: We need a coordinated systemic strategy to minimise the occurrenceof child, family and community risk factors, and to promote the availability ofprotective factors in the lives of young children and their families.

• The timing of early experiences can matter, but, more often than not, thedeveloping child remains vulnerable to risks and open to protectiveinfluences throughout the early years of life and into adulthood (Lewis, 1997;Shonkoff and Phillips, 2000; Shonkoff, Phillips and Keilty, 2000). However,neurodevelopmental plasticity varies inversely with maturation: there is a greatercapacity for alternative developmental adaptations in the early childhood periodthan in the later years.

Some of the evidence from brain research has been understood to indicate thatthe first two or three years of life are critically important neurologically and shapedevelopment for life (Kotulak, 1996; Shore, 1997). In the light of the sometimesmisleading publicity regarding the early years, efforts have been made to clarifywhat we can justifiably conclude from the developmental and neurologicalresearch literature regarding the nature of early childhood development (Bruer,1999; Elkind, 1999; Kagan, 1998, 2000; Shonkoff and Phillips, 2000; Rutter,2002a; Thompson and Nelson, 2001) and the significance of the early years(Bailey and Symons, 2001; Lewis, 1997; Shonkoff and Phillips, 2000).

The consensus is that what happens in the early years does not finally determinewhat happens later in life, but is crucial nevertheless. The Committee on theIntegrating the Science of Early Childhood (Shonkoff and Phillips, 2000)concluded its consideration of the relative importance of the early years thus:

A fundamental paradox exists and is unavoidable: development in the earlyyears is both highly robust and highly vulnerable. Although there have beenlong-standing debates about how much the early years really matter in thelarger scheme of lifelong development, our conclusion is unequivocal: whathappens during the first months and years of life matter a lot, not because this

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period of development provides an indelible blueprint for adult well-being, butbecause it sets either a sturdy or a fragile stage for what follows.

Implication: We must be careful not to claim too much for the early years, but wemust also be sure not to claim too little.

• Development is multiply determined, with both direct and indirect factorswithin and outside the child contributing to particular outcomes (Cicchettiand Rogosch, 1997; Durlak, 1998; Halfon and Hochstein, 2002). Developmentreflects the complementary principles identified by van Bertalanffy (1968) ofequifinality (multiple causal factors can lead to any particular outcome) andmultifinality (any particular risk factor can lead to multiple outcomes). In terms ofchild development, this means that many different risk or protective factors canlead to any particular developmental outcome, and particular risk or protectivefactors can lead to many different developmental outcomes. Implication: A wide range of risk and protective factors interact to produce a widerange of outcomes – and interventions must address all of these if they are tohave a sustained effect.

• The development of health and well-being is a population phenomenonrather than a purely individual affair, and social gradient effects areimplicated in a wide range of health and developmental outcomes (Keatingand Hertzman 1999; Halfon and Hochstein, 2002; Hertzman, 2000; Najman,2001). According to Keating and Hertzman (1999), there is a strong associationbetween the health of a population and the size of the social distance betweenmembers of the population; they call this the gradient effect: In societies thathave sharp social and economic differences among individuals in the population,the overall level of health and well-being is lower than in societies where thesedifferences are less pronounced. Differences in equity of income distribution isone of the principal determinants of differing health status among wealthysocieties.

This gradient effect applies not only for physical and mental health but also for awide range of other developmental outcomes, including behavioural adjustment(Tremblay, 1999), literacy (Willms, 1999), and mathematics achievement (Case,Griffin and Kelly, 1999). The gradient effect applies to children as well as adults(Brooks-Gunn et al, 1999) and seems to hold equally well whether we look atdifferences in current social status or in the social status of the family of origin.These social status effects appear to be quite persistent, are evident at birth, andhave effects that show up into old age.

Summarising the evidence for the social origins of variations in health and well-being, Najman (2001) concludes that, ‘Whether we compare groups within asociety, across national borders, or over time, the findings are similar: healthvaries and reflects different social, economic and political realities’ (p. 73). Halfonand Hochstein (2002) state that

‘Our view of disease causation and predisease pathways has also broadened,as it has become clear that health risks are created and maintained by socialsystems and that the magnitude of those risks is largely a function of

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socioeconomic disparities and psychosocial gradients ….Accordingly, ourefforts to reduce health disparities can no longer be confined only to providingbetter access and more resources to address the needs of the underserved.We now understand that we must address the underlying social factors thatdetermine these health disparities, including differences in income,employment benefits, and even the very quality of family and socialrelationships.’ (p. 435)

Implication: We must address the underlying social factors that determinedevelopmental health disparities, including differences in income andemployment.

• While we know much about the risk factors that compromise developmentand the protective factors that buffer these risks, we know relatively littleabout what experiences positively promote development (Shonkoff andPhillips, 2000; Thompson and Nelson, 2001). According to Thompson and Nelson(2001), the early experiences essential to brain development are largelyunknown. Existing data on early human brain development offer little insight intothe relative influence of genetic guidance and experiential exposure for most brainregions or into the types and timing of experiences that are most influential.While the neurological evidence clearly suggests that careful attention should bepaid to ensuring that young children are protected from biological insults andnegative social experiences, it does not necessarily tell us much about what weshould be doing (as opposed to what we shouldn’t be doing). Thus, Kagan (2000)suggests that ‘at the present time, there remains an enormous gap between whathas been discovered about the brain and mind, which is significant and worthy ofcelebration, and the relevant implications for educational practice.’

What we know about is ‘good enough’ parenting, rather than parenting or earlystimulation that can speed up development. There are dangers in trying to pushyoung children’s development along (Elkind, 1987, 1999).

Nevertheless, a number of attempts have been made to identify the keyexperiences that children need to promote their general development (Brazeltonand Greenspan, 2000; Greenspan and Lewis, 1999; Guralnick, 1997, 1998;Ramey and Ramey, 1992, 1999: Shonkoff and Phillips, 2000). Synthesising thesestatements suggests that we can best promote children’s development byproviding them with:

- close and ongoing caring relationships with parents or caregivers - adults who recognise and are responsive to the particular child’s needs,

feelings and interests- protection from harms that children fear and from threats of which they may be

unaware- clear behavioural limits and expectations that are consistently and benignly

maintained- opportunities and support for children to learn new skills and capabilities that

are within their reach

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- opportunities for children to develop social skills through regular contact with arange of adults and other children

- opportunities and support for children to learn how to resolve conflict withothers cooperatively

- stable and supportive communities that are accepting of a different familiesand cultures

Implications: We should be clear about what constitutes ‘good enough’ parenting,and wary of programs or strategies that claim to be able to able to speed updevelopment.

• There is no one right way to bring up children. This follows from a number ofthe principles already noted – that it is possible for children follow differentdevelopmental paths to the same goal, that children grow up successfully in arange of different cultures with diverse values and child-rearing practices, and thatwhat children need is ‘good enough’ parenting. This does not mean that allparenting practices are beneficial for children: we know what conditions andexperiences are definitely detrimental to development, and must protect childrenaccordingly. However, once this condition is met, there is a considerable degreeof leeway in parenting practices. Implications: While we should be sure to protect children from adverse conditionsand experiences, we need to be accepting of ‘good enough’ parenting in its manyforms.

• The course of development can be altered in early childhood by effectiveinterventions that change the balance between risk and protection, therebyshifting the odds in favor of more adaptive outcomes (Albee and Gullotta,1997; Barnett, 1998; Guralnick, 1997, 1998; Karoly et al., 1998; Mustard, 2002;Pfieffer and Reddy, 2001; Shonkoff and Phillips, 2000; Zigler and Styfco, 2001).What we have learned from research and practice is that carefully designed andimplemented interventions and programs can make a significant positivedifference to the lives of young children and their families, especially those whoare at risk. This is the conclusion reached by the Committee on Integrating theScience of Early Childhood Development (Shonkoff and Phillips, 2000):

‘In the final analysis, there is considerable evidence to support the notion thatmodel programs that deliver carefully designed interventions with well-definedgoals can affect both parenting behavior and the developmental trajectories ofchildren whose life course is threatened by socioeconomic disadvantage, familydisruption, or diagnosed disability. Programs that combine child-focusededucational activities with explicit attention to parent-child interaction patternsand relationship building appear to have the greatest impacts. In contrast,services that are supported by more modest budgets and based on genericsupport, often without a clear delineation of intervention strategies matcheddirectly to measurable objectives appear to be less effective for families facingsignificant risk.’ (p. 379)

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Implications: We need to draw on this accumulated knowledge to identify the keyfeatures of effective intervention, and we need to integrate our intervention effortsto ensure that they are maximally effective and reach all children and families.

General implications

The evidence just summarised has general implications for research and servicedelivery.

With regard to research, it is apparent that research efforts are not well integrated,and are therefore limited in the kinds of conclusions they can draw. Research done inparallel or related fields (such as mental health or child protection or early childhoodintervention) does not connect, and we therefore struggle to develop a unifyingpicture or model of development. In response to this situation, several authoritieshave recently called for those in related fields of practice and research, includingdevelopmental psychology, developmental psychopathology, psychiatry, sociologyand social work, molecular and quantitative genetics, and environmental studies, towork much more closely together (Nelson, Bloom, Cameron, Amaral, Dahl and Pine,2002; Rutter, 2002a, 2000b; Siegel, 1999).

With regard to service delivery, a similar picture emerges. Government departmentsas well as various institutes and service agencies have responded to the evidenceregarding early child development and early childhood intervention with a plethora ofinitiatives and programs. These have addressed such issues as depression andsuicide (Commonwealth Department of Health and Aged Care, 2000), crime(National Crime Prevention, 1999), domestic violence, drug usage, and many others.However, they have done so within the parameters of their individual departmentsand service briefs, usually without reference to other related departments or servicesthat are involved with the same target population or have responsibility for some keyresource. The effect of this has been to replicate the ‘silo effect’ that bedevilsgovernment service delivery. Yet the evidence from child development researchclearly indicates that the factors that help or hinder child development are closelyintertwined and that interventions need to be integrated and address the commonunderlying factors influencing development. As Halfon and Hochstein (2002) havewritten in the context of health promotion,

‘To understand the origins and effects of these health disparities, we increasinglyrely on an analysis of biological, psychological, socioeconomic, cultural, andphysical environments and their impact on the health of both individuals andpopulations … Because research on health disparities has demonstrated theeffect of many determinants interacting in various contexts at developmentallysensitive points, we need an integrated conceptual model to translate evidenceinto policies, practices, and health systems.’ (p. 435)

The hunt is on for the human services equivalent of a theory of everything.

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CONTACT DETAILS

Dr. Tim Moore Senior Research Fellow Centre for Community Child Health, Royal Children’s Hospital, Flemington Road, Parkville, Victoria 3053 Phone: (03) 9345 5040 Fax: (03) 9345 5900 Email: mooret@cryptic.rch.unimelb.edu.au

Projects / EC Systems National Meeting 2002 / Child dev evidence revised 3.12.02