Adelaide_Salisbury__Aug12

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Science-Technology

Published on October 14, 2008

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Investing in the early years: An idea whose time has (finally) arrived : Investing in the early years: An idea whose time has (finally) arrived Early Years Conference Salisbury August 12, 2008 Professor Frank Oberklaid Director, Centre for Community Child Health Royal Children’s Hospital Melbourne The importance of skills in the modern economy : The importance of skills in the modern economy ‘ A large body of research…shows that skill begets skill; that learning begets learning. The earlier the seed is planted and watered, the faster and larger it grows. Environments that do not stimulate the young and fail to cultivate both cognitive and non-cognitive skills place children at an early disadvantage’. (James Heckman, 2006) The importance of skills in the modern economy : The importance of skills in the modern economy ‘Once a child falls behind, he or she is likely to remain behind. Remediation for impoverished early environments become progressively more costly the later it is attempted in the life cycle of the child. The track record for criminal rehabilitation, adult literacy and late teenage public job training programs is remarkably poor…Impoverished early environments are powerful predictors of adult failure on a number of social and economic dimensions.’ (James Heckman, 2006) Ability gaps open early in life : Ability gaps open early in life ‘ Ability gaps between advantaged and other children open up early before schooling begins.Conventional school based policies start too late to completely remedy early deficits, although they can do some good. Children who start ahead keep accelerating past their peers, widening the gap…Early advantages accumulate, so do early disadvantages…The best way to improve the schools is to improve the early environments of the children sent to them.’ (Heckman J. & Masterov DV, 2005) Outline of presentation : Outline of presentation Brain development research Early childhood and the life course The economics of investing in the early years Implications for policy, for communities, and for service managers and providers The research : The research 3 research themes Brain development Life course Economics of human capital formation 3 research disciplines Neuroscience Developmental psychology Economics Multitude of published studies by researchers from varied professional/disciplinary backgrounds What the research tells us : What the research tells us The early years of a child’s life are critical in impacting on a range of outcomes through the life course The environment experienced by a young child literally sculpts the brain and establishes the trajectory for long term cognitive and social-emotional outcomes If we want to improve outcomes in adult life we have to focus on the early years - this has profound implications for public policy Investing in early childhood is a sound economic investment (‘the best investment society can make’) Neuroscience of brain development : Neuroscience of brain development Brain is not mature at birth The brain organises itself through the interaction of genes responding to the local environment - a dance between biology and experience Brain is changed by experiences The quality of the relationships a young child has with caregivers programs social-emotional function Adversity impacts on brain development Nature and nurture : Nature and nurture Genes (nature) provides the substrate for the development of the brain, but after birth nurture is the dominant force Optimal development dependent on good environment - nutrition, good health, nourishing and stimulating parenting Development is the result of complex, dynamic transactions between nature and nurture - between biology and the environment (the transactional model of development) Influencing outcomes : Influencing outcomes Biology - at present state of knowledge we cannot do much to change biology - although we can reduce the risk to the fetus - e.g. avoid substance abuse during pregnancy Environment - there is much we can do to change the environment in which young children grow and develop Brains are built over time : Brains are built over time Brain architecture and skills are built in a hierarchical ‘bottom-up’ sequence Neural circuits that process basic information are wired earlier than those that process more complex information Foundations important - higher level circuits are built on lower level circuits Skills beget skills - the development of higher order skills is much more difficult if the lower level circuits are not wired properly It is biologically and economically more efficient to get things right the first time Human brain development - synapse formation : Human brain development - synapse formation Conception Months Years AGE -6 -3 0 3 6 9 1 4 8 12 16 Sensing Pathways (vision, hearing) Language Higher Cognitive Function C. Nelson, in From Neurons to Neighborhoods, 2000. Brain architecture : Brain architecture The brain is sculpted by early experiences - this determines the development of neural circuits Plasticity of the brain decreases over time and brain circuits stabilise, so it is much harder to alter later There is constant pruning of circuits that are not used - concept of developmental windows or critical periods The importance of relationships : The importance of relationships Nurturing and responsive relationships build healthy brain architecture that provides a strong foundation for learning, behaviour and health The relationships a young child has with their caregiver(s) literally sculpts the brain and determines the development of circuits When protective relationships are not provided, levels of stress hormones increase - this impairs cell growth, interferes with formation of healthy neural circuits, and disrupts brain architecture Adversity : Adversity Research on the biology of stress in early childhood helps explain some of the underlying reasons for differences in learning, behaviour and physical and mental health Any adversity or stress that impacts on the parents may affect their relationship with their young child and thus has the potential to have a negative impact on brain development - e.g. effects of rapid social change Positive stress : Positive stress Moderate and transient stress responses - results in mild increases in stress hormone levels and short lived increases in heart rate Precipitants include the challenges of new people and situations, dealing with frustration, adult limit setting, the pain of a fall or injection Important part of healthy development as it occurs in the context of stable and supportive relationships Tolerable stress : Tolerable stress Stress responses that can disrupt brain architecture, but are buffered by supportive relationships that facilitate adaptive coping Precipitants include death or serious illness of a loved one, parent divorce, witnessing a frightening event, major trauma or illness, a natural disaster, homelessness Generally time limited, so gives the brain opportunity to recover from potentially damaging effects Toxic stress : Toxic stress Strong and prolonged activation of body’s stress response in absence of buffering protection of adult support Precipitants include extreme poverty, physical or emotional abuse, chronic neglect, severe maternal depression, substance abuse, family violence Disrupts developing brain architecture and leads to lower threshold of activation of stress management systems - can lead to life long problems in learning, behaviour, and both physical and mental health Disordered brain circuits… : Disordered brain circuits… Problems in childhood Beginning of pathways to problems later in life Evidence that many problems in adult life have their origins in pathways that begin in childhood Worrying problems in childhood : Worrying problems in childhood Child abuse and neglect School readiness - many children vulnerable Poor literacy and school achievement Mental health problems - ADHD, conduct disorders, aggressive and anti-social behaviour Obesity Even more worrying problems in adult life : Even more worrying problems in adult life Mental health problems Family violence and aggressive/anti-social behaviour Crime Poor literacy - skills shortages Welfare dependency Substance abuse Obesity and its associations The developmental trajectory and life course : The developmental trajectory and life course Outcome Age Risk factors Protective factors Risk and protective factors : Risk and protective factors Child Parents Parenting style Family environment Community and cultural School Life events Risk and protective factors : Risk and protective factors Risk Factors Child Family Community School Protective Factors Child Family Community School Outcome Negative vulnerability Positive resilience Poverty and health (0-3 years) : Poverty and health (0-3 years) Less likely to: Be breast fed Be fully immunised Receive well child care Have regular and consistent access to health services More likely to have: Low birth weight Developmental delay Higher incidence of SIDS Higher injury rate Suboptimal growth More frequent hospitalisations Behavioural disorders Vocabulary growth - first 3 years : Vocabulary growth - first 3 years Vocabulary Age - Months 1200 600 0 12 16 20 24 28 32 36 High SES Middle SES Low SES B Hart & T Risley 1995 Literacy As children move from year 3 to year 5, the disparity among those meeting literacy standards grows : Literacy As children move from year 3 to year 5, the disparity among those meeting literacy standards grows ‘Double jeopardy’ for children living in poverty : ‘Double jeopardy’ for children living in poverty Experience most health problems and more likely to be unimmunised, but live in unhealthy environments and have fragmented access to good health care Highest risk of academic failure, but attend the most disadvantaged schools Families experience the most stress but have fewest social supports Parents have the greatest need of but often have greatest difficulty in accessing services So what can we do? What are the answers? : So what can we do? What are the answers? Need major shift in public policy, focusing not just on treatment but also on prevention and early intervention (fence on top of cliff rather than more ambulances at the bottom) There is evidence from successful demonstration programs that early intervention works - ie the research tells us how to build the fences Making a difference : Making a difference Address risk factors and emerging difficulties before they become entrenched problems Goal is to diminish or remove risk factors and strengthen protective factors, so improving chances of good outcome The earlier the better - more leverage in younger years Intervention effects and costs of social-emotional mental health problems over time (Bricker) : Intervention effects and costs of social-emotional mental health problems over time (Bricker) Time High Low Cost Intervention effectiveness So we now have... : So we now have... A good understanding of early influences on the brain, children’s development and risk factors Research showing that patterns established early in life can have long term consequences Research demonstrating that early intervention programs can significantly improve outcomes later in life Now add to this the economic/business case for investment in early childhood programs… Rates of return to human development - Investment across all ages : Rates of return to human development - Investment across all ages 6 8 4 2 0 Return Per $ Invested Age R 6 Pre-School School Post School Pre-school Programs School Job Training 18 Pedro Carneiro, James Heckman, Human Capital Policy, 2003 Cost benefit analysis : Cost benefit analysis ‘In contrast to …significant benefits from model preschool interventions, later remediation efforts have been shown to be consistently less effective. School age remedial programs…have a poor record of success. Similarly public job training programs, adult literacy services, prisoner rehabilitation services…have yielded low economic returns. Such investments are purely political and not supported by any worthwhile research.’ - Knudsen EI, Heckman JJ, Cameron JL, Shonkoff JP (2006) Proceedings of National Academy of Sciences :  The best investment in economic development that government and the private sector can make is in the healthy development of children… Society should adopt the perspective of ‘child-development-as-economic-development.’ ‘In our view, the economic case for why we should invest in early childhood development is closed.’ Arthur J. Rolnick Senior Vice President and Director of Research Federal Reserve bank of Minneapolis Implications for policy : Implications for policy Positive relationships and quality learning experiences are pivotal to brain development - this promotes cognitive, language, social and emotional development Resources need to be focused on providing parent information, family support, and high quality early learning and care settings for ALL children - ‘universal services’ Targeted services for ‘at risk’ children and families - can improve outcomes by reducing disruptions of the developing nervous system The research is clear that attempts at later remediation are less effective (and cost effective) than prevention Implications of the science of early childhood : Implications of the science of early childhood Parents and families Communities and the built environment Child care Education Child protection system Services Business Media An expanded view of building infrastructure Parents and families : Parents and families Information about child’s health, development and behaviour - what to expect and what to do - ‘responsive’ parenting Support parents as individuals Address personal issues - relationships, financial stresses, ill-health, housing, depression Family friendly workplaces - leave provisions Security of employment Communities and the built environment : Communities and the built environment Community can be effective buffer against stress Create child friendly communities Access to services - eg children’s centres Child oriented workplaces, organisations, community settings - child care, schools, libraries, parks, transport, pools, shopping facilities… Social connectedness Child care : Child care Early learning environment - not child minding Universal access to everyone, especially disadvantaged - cost and availability should not be a barrier Quality vital - staff ratios, physical amenities, and especially expertise of caregivers Parental choices, supported by leave provisions Education : Education Education begins at birth, not when children start school - remove distinction between child care and preschool Match early learning facilities to needs of children and families Major investment in physical facilities and re-design of teacher education Schools as core social centres linked closely with their communities Slide 45: MARIBYRNONG Geographic Area, Victoria 5 km West of Melbourne Prepared by: AEDI National Support Centre, GIS Source: AEDI Communities Data 2005 Proportion of children vulnerable on one or more domains Slide 46: MARIBYRNONG Geographic Area, Victoria 5 km West of Melbourne Prepared by: AEDI National Support Centre, GIS Source: AEDI Communities Data 2005 Proportion of children vulnerable on two or more domains Standard school model : Standard school model Governance Curriculum & teaching New school model : New school model Curriculum & teaching Governance Address barriers to learning Barriers to learning - 3 groups : Barriers to learning - 3 groups No barriers to learning - will do well regardless Subtle to moderate barriers to learning and school success - may elude early detection, and intervention often delayed until problems entrenched and difficult to treat Severe barriers - generally have access to special services What are the barriers to learning? : What are the barriers to learning? Biological and/or environmental Developmental weaknesses - language, memory, visual-motor integration, etc Attentional and behavioural problems Poor environmental circumstances in the early years Breaking down the barriers : Breaking down the barriers Improve ‘school readiness’ (children ready for school; schools ready for children; communities that support early childhood learning) Bring the community into the school - schools as community hubs Linked services Early learning (child care) centres and preschools Family drop in centres Increase the presence of adults in the school (ESL classes, parenting, computer literacy, etc) Child protection system : Child protection system Highest risk segment of early childhood and parent population Services should reflect needs of children rather than families (or the legal system) Virtually all families need ongoing, intensive (early) intervention Virtually all children need referral to early intervention and early education services Need strong links between welfare system and early intervention system Services : Services Need to be reconfigured to meet contemporary needs of families Need true universal access with no social gradient Improved coordination/integration and co-location (children’s hubs, ‘one stop shop’) Greater flexibility - different models that are responsive to diversity of needs Decentralisd - organised at community (as opposed to central) level Community based services : Community based services If concerns or risk factors : If concerns or risk factors Linked services : Linked services Mobilizing the community : Mobilizing the community Family support Old approach : Old approach The needs of the individual child are addressed in isolation Resources allocated only when problems become severe enough to warrant attention Policies are focused on fixing individual deficits Policy criteria - dollar amounts allocated Services delivered in narrow departmental silos New approach : New approach Whole of government approach - broadbanding of services Flexibility of services and improved coordination at local community level Increased community and consumer participation Prevention and early intervention focus Focus on outcomes Innovative funding and accountability arrangements Business : Business Will understand the importance of early childhood - concerned less with the cost of programs and services but rather the return on investment Business sector has two parallel sets of interests Macro level (broad economic): skilled and educated workforce, social capital, international competitiveness, preservation of democratic institutions and a fair society Micro level (workplace): attraction and retention of skilled staff, productivity, work life balance Media : Media Important role to play Desperately need a more sophisticated approach to children’s issues - very superficial level of debate in mainstream media - eg child care, education Early childhood issues beginning to move from women’s pages and parenting magazines to financial pages Building infrastructure - human capital : Building infrastructure - human capital ‘The implications of this rapidly evolving science for human capital formation are striking. The workplace of the 21st century will favor individuals with intellectual flexibility, strong problem solving skills, emotional resilience, and the capacity to work well with others in a continuously changing and highly competitive economic environment. In this context, the personal and societal burdens of diminished capacity will be formidable, and the need to maximize human potential will be greater than ever before.’ - Knudsen EI, Heckman JJ, Cameron JL, Shonkoff JP (2006) Proceedings of National Academy of Sciences The knowledge gap : The knowledge gap Major challenge is to close the gap between what we know and what we do Conclusion : Conclusion Promoting the healthy development of children is both an ethical imperative and a critical economic and social investment Our agenda for the 21st century is the application of science to policy and practice - to close the gap between what we know and what we do. Slide 66: frank.oberklaid@rch.org.au www.rch.org/ccch

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