Frontiers of Innovation/Best Starts for Kids WebinarJune 27, 2018

Three Science Concepts That Can Help Us Think Differently About Early Childhood

Programs and Solutions

@HarvardCenter

Al RaceChief Knowledge Officer

Center on the Developing Child

Melissa RivardSenior Project Manager

Center on the Developing Child

Holly Schindler, Ph.D.Assistant ProfessorUniversity of Washington

Jason GortneyDirector of InnovationChildren’s Home Society of Washington

SupportiveExperiences

Advances in Science Are Opening Up the Black Box of Disparities in Learning, Health, and Development

Effective learning, adaptive behavior, lifelong health and well-being

School failure, risky behaviors, chronic illness, shorter lifespan

Black Box

Parents

Genes

NegativeExperiences

ACEs Family Life

Peers Habits/Choices

Social Determinants

Schools

Advances in Science Are Opening Up the Black Box of Disparities in Learning, Health, and Development

Effective learning, adaptive behavior, lifelong health and well-being

School failure, risky behaviors, chronic illness, shorter lifespan

SupportiveExperiences

Parents

Genes

NegativeExperiences

Responsive Relationships and Positive Experiences Build Sturdy Brain Architecture1

Brains’ Ability to Change Decreases Over Time

Source: Levitt, P. (2009)

Birth 10 20 30

Physiological “Effort”Required to Enhance Neural Connections

Normal Brain Plasticity Influenced by Experience

Age (Years)

40 50 60 70 80

“Serve and Return” Interaction Shapes Brains and Builds Skills

Toxic Stress Disrupts the Development of Brain Architecture and Other Systems2

Number of Risk Factors Source: Barth, et al. (2008)

Ch

ildre

n w

ith

D

evel

opm

enta

l D

elay

s

1-2 3 54 6 7

20%

40%

60%

80%

100%

Significant Adversity Impairs Development in the First Three Years

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)

How ACEs, Trauma, and Toxic Stress Intersect

Poor Life Course

OutcomesACEs 1995 Kaiser-CDC Study

ACEs + Community & Systemic Adversity

Toxic Stress

Trauma(psychological manifestation)

Trauma-Informed

Care

Building Skills to Mitigate Stress

Reducing Sources of

Stress

Therapeutic Interventions

A Spectrum of Responses

Core Capabilities for School, Work, and Life Are Built Over Time Through Practice

An “Air Traffic Control System” for the Brain

Executive function and self-regulation are a foundational set of capacities that help us: • focus and sustain attention• set goals, make plans, and

monitor actions• make decisions and solve

problems• follow rules, control impulses,

and delay gratification

Emotions

Error Processing

Reaction and ResponsesUse of

RulesRisk/Reward Decisions

Behavioral Control

Working Memory

After infancy, two major spurts in skill development: ages 3-5 and 15-25

3

How Excessive Stress Affects the Development and Use of Core Capabilities

Faith and cultural

traditions

Increasing sense of mastery

Strengthening adaptive skills

Responsive relationships

Resilience Can Be Strengthened by Supportive Relationships and Skill-Building

Supportive community

services

3 Design Principles to Improve Outcomes for Children and Families

Reduce Sources of Stress

Strengthen Core Life Skills

Build Responsive

Relationships

ChildrenHealthy

Development & Educational Achievement

AdultsResponsive

Caregiving & Economic Stability

Using the Principles as a New Lens for Interventions

Is one of the principles a specific target of your intervention?

How does your intervention affect one or more of the principles?

Can you measure the impact of your intervention on one or more of the principles?

Building a New Definition of an Evidence-Based Program

0

Current ApproachSignificant mean effect earns evidence-based status

What We Should AskWhy did this work so well for these children and families?

Why did this work so poorly for these children and families?

0

Scale effective strategies for similar subgroups

Design and test new approaches for these subgroups

Build a suite of programs and policies across sectors that matches different strategies to different resources,

needs, and outcomes

Building a New Definition of an Evidence-Based Program

Asking the Right Questions When Measuring Impact

Rather than asking if a program works on average, we need to be asking:• What about it works?• How does it work?• For whom does it work, and for whom does it not work?• In what contexts does it work?

(Adapted from Everett Rogers, Diffusion of Innovations, 2003)

Basic quality issues that must be addressed

Meeting standards and increasing access

Generating and testing new ideas across sectors

Adapting and scaling the most promising new strategies

Delivering state of the art

Any Healthy Field Requires a Full Spectrum of Approaches to Move Forward

www.developingchild.harvard.edu@HarvardCenter

Some questions to think about for your proposal

How do the activities you propose relate to the three principles?

Will your activities help to…

…reduce sources of stress that affect families?

…strengthen relationships between adults and children?

…strengthen relationships between the adults in children’s lives?

…strengthen adults’ core life skills?

…develop young children’s core life skills?

Reducing Sources of Stress

• Helping families identify stressors

• Providing linguistically and culturally relevant services

• Being a trusted source of child development information for parents

• Helping families connect to resources

• Providing needed resources

• Making it easier to use services

• Providing fun activities

• Helping families with translation/interpretation needs

• Helping families plan and set goals for a better future

Examples

Strengthening Responsive Relationships Between Adults and Children

• Modeling positive interactions

• Coaching parents/caregivers on positive interactions

• Connecting parents to infant mental health services

• Educating parents about responsive caregiving

• Providing space and time for parents and children to interact

• Providing fun activities for parents and children to do together

Examples

Strengthening Responsive Relationships Between the Adults in Children’s Lives

• Offering opportunities for parents to connect with each other

• Providing coaching on conflict resolution

• Helping families set shared goals to work on together

• Providing relationship coaching

• Encouraging caring, consistent relationships between program staff and families

• Helping parents develop a supportive social network

Examples

Strengthening Core Life Skills in Adults

• Helping families develop household routines

• Providing coaching on goal setting and achievement

• Helping families learn to navigate systems

• Teaching stress management skills

• Teaching healthy communication skills

• Providing or linking to behavioral health services

• Helping parents develop safety and self-care plans

Examples

Develop Young Children’s Core Life Skills

• Providing a safe, stable, predictable environment for children to learn, play and explore

• Playing games with children

• Engaging in serve and return interactions

• Giving children opportunities to practice focus and self-control

• Helping children make connections between their experiences

• Helping children learn to communicate their thoughts and feelings

Examples