Askwith Forums – Protecting Brains, Stimulating Minds: The Early Life Roots of Success in School

Askwith Forums – Protecting Brains, Stimulating Minds: The Early Life Roots of Success in School


– I reach out to the broader
community to stimulate conversation, discussion, debate, introduce interesting ideas. The topics are fairly wide ranging, addressing many issues of
importance in education, and this is also a way
for the Harvard community to reach out to the broader community beyond just the walls of this school. And following my instructions carefully, I would like to say please
use hashtag ask with if you want to tweet something
about tonight’s forum, positive or negative. I’ve been given this
wonderful opportunity to speak with you tonight about
kind of early childhood. And I’m going to give you
a little bit of the title, Protecting Brains, Not
Just Stimulating Minds. To kind of look at the
early life roots of success in school and I want to kind
of set a tone for this evening so I’m gonna start with the slides. For those of you who don’t
know Ellen Johnson Sirleaf was the first and I think
maybe still only freely elected leader of an African country. She was the President of
Liberia for many years and also a Nobel Laureate,
won the Nobel Peace Prize. I love this quote from her. “If your dreams do not scare
you, they’re not big enough.” I actually want to kind of
create this as a subtext for my comments this evening and hopefully we’ll have a lively discussion. I’ve been working in the
early childhood field for pretty much most of my career. And I have a kind of a very
strong alliance with this field and where I’ve come to
as the field has evolved, as a loving, nurturing,
supportive, constructive, dissatisfaction with
the magnitude of impacts that we’re having early
in life, addressing what are the roots of what
is certainly the education world is one of our greatest challenges, the disparities in educational achievement and school success related
to income, parent education, racism, exposure to violence,
a lot of adversities. I’m a pediatrician by
training, it’s the same problem in the healthcare system. Disparities related to social
class and race and ethnicity in many of the common
diseases that are not, this has nothing to do
solely with genetics. This has to do with the impact of adversity on people’s lives. And so what I wanted, the mindset
I’d like you to start with this evening is I’m gonna
really kind of walk you through a way of looking at the field,
thinking about the field in a constructive and in a critical way, and asking the question
as why, what if we started to bring in some of the
thinking that is coming from a revolution that’s
going on in science right now, neuroscience and molecular
biology, epigenetics, linked with very deep
knowledge base in behavior and development and the social sciences, the idea being that we
desperately need fresh thinking and new ideas in the
early childhood space. And that’s the context for
my remarks this evening. And the reason for starting with the quote from former president
Johnson Sirleaf is that we need to be, in a
constructive way, not happy with the little statistically
significant bump on an increase in a reading
test or some modest decrease in a gap and we need to
set our sights much higher about dramatically doing
something about leveling the playing field for all
children, very early life before they set foot in school. So, what I’m gonna do is start by taking stock of what we’ve
learned from half a century in the United States of
the struggle to reduce the consequences of poverty and racial inequities in this country. I’m gonna start with the
war on poverty and the great society programs in 1960s, not
because that’s particularly more important than any other
time, but it was the origin of what really the beginnings
of a lot of policies and programs that we still have today. So the point here is we
have 50 years of lessons learned from policies and
programs and it’s a time to take stock and say
what have we learned, what do we know, and where do we go next. So if we go back to the mid
1960s, about 50 years ago, the Civil Rights Movement
was at its height and reaching a peak of intensity
of attention in the country and demonstrations for basic
civil rights in this country were very much in the public eye. That problem has not
been solved in 50 years. There was a substantial
amount of national legislation passed as part of these great
society and war on poverty programs, Medicaid, Medicare,
a variety of important civil rights legislation,
voting acts, housing, discrimination acts, a
variety of other things. This was a time of very
aggressive federal legislation designed to reduce the
burdens of poverty and racism and its effect on our population. Head Start began in the summer of 1965. The best minds in the
country from academia and the most creative public
policy thinkers came together with the strong note of political activism and came up with the
brilliant idea that a six week program in the summer
before starting high school would reduce all of the
inequities of five years of living in poverty
before beginning school. And I say this with respect. I think the people who began
and formulated the ideas for Head Start were,
they were brilliant and but to show how knowledge moves, right. The fact, there wasn’t like I said, let’s do this cheap and dirty. In fact, the federal government
was saying give me more sites, let’s pour money in. And the best thinking of
the day was that if we had six weeks of exposing kids to
book and teaching them letters and making sure they had a
medical check up and went to a dentist and they
had a social worker check to see how things are doing
at home, that we would level the playing field. The program is still
very much with us today. The Job Corps was begun in
the war on poverty days, the Office of Economic
Opportunity to do something about chronic unemployment. Food coupons became known as food stamps and the nutrition programs,
they began at that time. They’re wonderful assistance programs. Before then, neighborhood
health centers were created for the first time to
provide healthcare for people who did not have access to
decent quality medical care. Community action programs
were formed at that time with this notion that providing
resources and allowing communities to take
leadership would be the answer to reducing the impacts of poverty. And there was a lot of activism
in the courts at that time, from the Supreme Court on down. So we have this half a century
legacy of demonstrations on the streets, federal
legislation, programs sending resources to local
communities and to states, a notion of using the
courts as a way to achieve more equity in terms of opportunity. And you can finish, each of
you could finish the paragraph any way you want about so how
far have we come in 50 years. And the answer is, I don’t
have the slide for the glass half full and you
say is the glass half full or the glass is half empty, but clearly the glass is far from full. And the more important
issue, I think for us, is to ask the question
of not so what should we be doing differently, yet. First question should
be what could we learn from what we’ve been doing for 50 years. And then we can kind of
build on what’s successful, what do we know, what have we
learned from what doesn’t work and then where do we go next. And part of the problem is
that we don’t know a lot about what have we learned
from the things that don’t work because the environment
has not made it safe to learn from things that don’t work. So any one of you in the
audience who ever applied for a grant for a program
and were lucky enough to actually at the end of
the year be asked to submit another grant for your program. You know how to write
a proposal that shows that you’re making a difference. Okay, that’s kind of the way it works. And for those of you who would think, gee, it would be great if I could try something and not have to show that
it works but maybe find out what’s working and what’s not. Learn from failure, learn
from disappointment, learn fast, that by the way
is what drives Silicon Valley. That’s what drives biomedical
research in Kendall Square. Any part of society that
is innovating all the time, part of its buzzwords are fail
fast, iterate, keep trying, you’ll never get it right the first time. We can take any example you want. You can take a space
program that took a year to go from the charge to
go to the moon to make it with the crashes and the explosions that took place along the way. You can think about Apple as
a company, it’s, I don’t know, they keep shifting about
which one has the highest capitalization but the
first things out of the box were not, there were many big
failures in the Apple history. All of these big breakthroughs,
Thomas Edison has this wonderful quote of saying
I’ve never failed at anything, but I have found 10,000
things that don’t work. So in the education
field, in human services, and anti-poverty programs
and community action, I look for it all the time. There is no compendium
of things I’ve learned from what didn’t work. It’s always this is what we do, this is what makes a difference, and that’s one of the
biggest stumbling blocks. So I won’t beat this point
into the ground anymore but what I want to do now
is walk you through in a few slides what have we
learned and what do we know about, now specifically I’m
just gonna zero in on the early childhood years and what
do we know about how we can level the playing field
and increase the likelihood of better outcomes for children growing up facing conditions of adversity. So first, let’s look at reading scores. And again, I’m not gonna,
each of these slides could be an hour discussion
but I’m gonna zip through them because I want to kind of put a couple of points on the table. Over the last 50 years,
although these data went up only like 40 years,
reading gaps and test, test gaps in reading tests
have decreased significantly in terms of race, but it’s
still unacceptably high. So we could look at the
decrease in racial gaps in reading scores and one could say, wow, that’s a pretty good reduction
in the gap and I would acknowledge that but I also kind of look and it’s still an unacceptable gap. There should be no gap in
reading scores by race. At the same time, we’ve seen
over the last about 25 years or so the gap by family
income has actually increased, the gap between the top 10th percentile and the bottom 10th percentile. These are data from Sean
Reardon and some other education program on the west coast I
can’t remember the name of that. Stanford, I think, right. We could talk a lot
about what that might be but the point is we have
to solve this problem by race or by income, and
in fact, the gap by income in reading scores right now
is the highest, is as high as the gap was by race in 1968. So we’ve got a lot of work to do on that. This is a good problem
for students who kind of, you know, you come in
and you say well gee, what problems are left to solve? Every problem that’s been
around is left to solve for the last 50 years. You’re not too late. The one thing I hope you all
leave this presentation with is that the answer is not
just to get more money for the things that we’re doing. We need more money for the
things that we’re doing. We need more money for
the things that work, but the answer is not, it is
wrong to say we know exactly what’s to do if we only
get the funding to do it. So these data are taken from
a meta analytic database that was built at our center,
Center on Developing Child. Looking at what have we
learned from, this actually covered 47 years of published
literature on center-based early childhood programs,
anywhere from the beginning at birth up to just before
just before kindergarten age and what do we know about
the impact of these programs. The take home line is we have
terrific unequivocal proof of concept that we know
how to shift the curve, we know how to create
better outcomes for children who receive an intervention,
but the effects are modest. Here’s the story of almost a
half a century of center-based early childhood intervention. If you look at this, the
zero line is no effect. The red indicators are Head Start studies and the blue are other early
care and education programs. The larger circles were a
reflection of sample size, the bigger the sample, the
bigger the sample size. Okay, we start with the
two iconic programs, Perry Preschool in the 1960s and the Abecedarian Project in 1970s, too. Elegantly designed demonstration projects, randomized control trials,
each serving about, 50 kids got the intervention, 50 kids were in the control group. Both very low income and both primarily African American populations. Perry Preschool, we have 40 year followup, first of all the outcomes
just after the program was ended was well over a
standard deviation difference on the kind of standard
developmental tests. Abecedarian also close to a
standard deviation difference. Perry Preschool, we
have a 40 year followup on Perry Preschool, we have
21 year followup on a lot of the educational outcomes and later for some health outcomes. These are the ones that
everyone refers to every time you hear somebody say we
get $9 back for every dollar we invest, that’s Perry Preschool data. We’ve proved that we
can make a difference. And then over the remaining
40 some odd years, this is kind of what it looks like. The affect sizes average
about point three, overall. So we say well what’s that all about? Well, for one thing, when you
have an elegantly designed demonstration project with
high paid teachers and a really well delivered intervention and
Perry Preschool, by the way, was with three to four year
olds, it was a very high quality preschool program,
that also, people don’t talk about this very much, also
the teachers, these very well trained and well paid
teachers, made home visits every week or every other week
and spent at least an hour a week with the mothers going over the things they did with the kids. Maybe it was the home
visiting program for mothers that happened to be attached
to a preschool program. I don’t know. But we talk about it as a
preschool program, which it was. We never mention the fact
that most of our programs now don’t have any intensive
work with the parents. But we quote Perry data
to show why other things are making a difference. It’s remarkable that when you
get to the larger numbers, they’re still showing,
the effects are small, but they’re still
statistically significant and the slightly downward
slope is probably a product of the fact that when you
serve more kids, it’s harder to maintain quality,
especially when you have less well trained teachers and
you don’t pay them as much. And also there’s the counter
factual issue, which is that in the early days, if you
were the treatment group, you got nothing, and now if
you’re in the treatment group, you find another program. So these effects are probably understated. Bottom line here is we
don’t have to ask and answer the question anymore about
whether we can make a difference. We’ve shown over and over
and over again we can make a difference, but as we try to scale this, the difference is relatively small and that’s not good enough. Nothing to be ashamed of unless
we say we have the answer. If we say we know we can
make a difference but we need to make that difference
bigger, then we’ve got a rich and lively and healthy field that is determined to dream big. Dream big, even if it scares
you, ’cause you’re not quite sure yet what we’re gonna do. So what’s been driving all these programs? There’s a wide variety of
home-based and center-based programs but many of the
ones that have been studied have been center-based, except
for some of the home visiting programs that are really
more parent support. We have a conceptual framework
that’s about 50 years old and it’s still pretty sound,
but it has some limitations. And here’s what it looks like. We believe and we have lots
of evidence to indicate that some combination of
providing stimulating, enriched learning experiences for young
children, often in centers, providing education and
support for their parents, assuring access to primary health care, good nutrition, and health
promoting environments will lead to readiness
to succeed in school. And by and large, that
basic model has held up well over time, it’s pretty sound and it sits on a strong knowledge base. But there’s one problem. There’s a part of the
population that is facing significant adversity and
the assumption here is, I put this out as a reasonable hypothesis, that for this part of the
population that’s experiencing significant adversity,
it’s not enough to overcome that adversity by just
providing some rich learning experiences and some
information for the parents. That amount of adversity
kind of has an overwhelming effect that results in
children whose early learning and in many cases, whose
later health is impaired as a result of the impact of significant adversity and stress,
that’s the hypothesis. And for this part of the
population, saying we’ll tweak the curriculum a little bit
more, or we’ll up the ante on giving parents information and support, is not gonna be enough. It’s not just about the curriculum. It’s about the forces in a
child’s life that are interfering with the ability to benefit
from programs and to also benefit from just what’s
provided in the community. It’s not just about programs. So I’m gonna kinda switch. I’m a pediatrician by training. I don’t use medical analogies too much but I couldn’t resist this one. To show you what 50 years
of progress in treating the most common form
of cancer in children, which is acute lymphoblastic leukemia. It is by far the most common
form of cancer in children. In 1964, when Head Start began,
the five year survival rate for AOL was about three percent. What that means is if you
had a diagnosis of that form of leukemia, your chance, only
five percent of the children with that diagnosis lived for five years. 10 years later, the five
year survival rate was 60%. Today, the five year survival
rate is way over 90%. And I’m gonna leave you, I’m
gonna come back to this issue at the end of my talk
and raise some questions about what we can learn from this. Okay, I’m not equating
leukemia to poverty or violence or racism, although some
people could use the metaphor of cancer for the impacts of racism or the impacts of poverty. Let’s leave it at this
point to say that one reason why so much progress was
made is because people were very motivated to
dig deeper and deeper into understanding the underlying causes and the pathogenesis and the
mechanisms of this disease, to have ideas about
what kind of treatments would be most effective. It wasn’t just taking
the first thing you think of and continuing to do that. It was also a relentless
pursuit of increasingly better outcomes and every time so in our field, if we went from 3% to 60%
survival, we’d declare a victory, okay, and move on. That wasn’t good enough. People said no, it’s
gotta, right now it’s 95%, that’s not good enough, it has to be 100%. And not only 100% but then
it’s like what’s the part about the quality of life
during the treatment. The treatment has to be made less toxic. There’s a relentless pursuit
of getting better and better. This is the Ellen Sirleaf Johnson message. Have big dreams, that it’s
not enough to just get a statistically significant
difference on a trial of an intervention but to aim for the highest possible outcomes. But there’s an even more
exciting punchline to this story and I’m saving it to the end. So those of you who leave
early, it’s too bad, you’ll never know, but the
real thing is about leukemia. So Albert Einstein, the
number of quotes that I loved about Einstein over the years
and some of them I found out he never said, but I
think this one he did say. He said the significant problems
we face cannot be solved at the same level of thinking we were at when we created them. Now, we did not create the
problem of poverty and racism and violence when the programs
were started in the 1960s. But we had a concept of
what needed to be done that represented the best
thinking of the time. Nobody should be uneasy or
self-conscious about the fact that some of the things
people thought about back then end up to be like not as
smart as we are right now. If we kept looking back at
what the best people did and say, well gee, we can’t
improve on what they did, that is not the sign of a healthy field. So for me, to show how
healthy this field is, we need to be thinking of
what are we going to be doing 10 years from now. And we will laugh at what we did in 2018. Say I can’t believe we
did that to this thing, because it’s hard to find
out what we could laugh about what we did in 2008 or
1998 or 1988, because a lot of what we’re doing is a
modification and adaptation of what is still basically a
very sound conceptual framework but it’s not enough, it’s not getting us to the promised land. But one of the things we did
create and do a little spoiler alert here, that represented
the way we thought then, that has to change is the way we designed and especially evaluate programs. I’m gonna kind of come to that at the end. We created the way we evaluate
programs back when we started them and the way we were
thinking then is really becoming increasingly obsolete
relative to what 21st century science is telling us. And that’s what I want
to spend most of the time talking about now is how
science that’s rapidly moving, particularly the biological
sciences, should be making us think differently about
how we design and evaluate the programs that we have. This is not going to be a
crash course in neuroscience, molecular biology, and epigenetics. If anybody here, if any
students have been to my class, you’ve heard all this before. This is like one slide with two animations to kind of summarize a
very important concept that is right at the heart
of where 21st century biology is all about. It is opening up the black
box of early learning and lifelong health. We have known for more than
100 years in this country and every country in the world
that there is a social class gradient and that the more
poor you are and the more adversity you experience, the
more likely you are to have problems in school, the more
likely you are to have problems with health and not live as long. And we study that and we
study that and study it in a more elegant way and we describe it, but what this revolution
in science is letting us do right now is to ask the
question of how does that happen? What is it about poverty that results in having more trouble in school? Above and beyond what we
know is a problem in terms of unequal access to good
quality schools and well paid teachers and all of that,
but it’s more than that. Because in countries where
there’s universal access to good education or universal
access to good quality healthcare, everybody gets
the same, we still have many of these social class gradients. So there’s something about
adversity that’s at play here. And so this is kind of what
we’re beginning to understand and ignoring this in the education world is ignoring at our peril. I would say you could not
believe in the science behind climate change, you
could say I don’t believe it. Or people have a lot of
different thoughts about it and you could ignore it,
but that doesn’t stop the ice caps from melting
in the North Pole. So we could ignore some of
these insights from science and say they’re not really
relevant to education, but by ignoring them, we’re
missing a very important opportunity to think differently. So here’s a kind of one slide
summary of what’s happening. So basically, the public’s
understanding and most people’s understanding of development
is there’s some combination of like what accounts for
differences in children’s learning their educational
achievement, their health. You know it has something
to do with kind of parents and parenting and genetic differences. And there are stressors and
risk factors in people’s lives and there are supports
and protective factors. And the general census
that all of those things are somehow playing a role
where they all go in to this black box and out of the
other end comes some kids who have strong skills and good behavior and they’re physically and mentally well. And others fail in school and
they have risky behaviors. They have chronic illnesses,
they don’t live as long. And then the answer is well, I don’t know, something happens but we
see it over and over again. And what the science is doing, it is opening up that black box. And the first thing it’s telling
us, very important concept for education, is that
this is not just about the combination of parent influences
and genetic differences and risk factors and protective factors, that these, you can’t, it’s
not a matter of adding them up, it’s not a matter of just
saying we’ll add another risk factor, we’ll kind of
increase parents education. These different variables, these forces, are highly interactive with each other. So the old nature versus nurture debate, how much of this is
genetics, how much of this is the environment, that
was a hot, up to the end of the 20th century, debate in science. It is no longer a debate in science. The human genome project,
the decade of the brain from MIMH in the 1990s kind of put the last nail in the coffin. You can’t separate genetics
from the environment. Every individual is born with
the unique genetic makeup with a unique range of potential, but that genetic makeup doesn’t
really have a significant effect on your outcomes, let’s
just stick with education for this talk, without the
impact of your life experience and the environment in which you live and the relationships that
you have literally affecting whether those genes work
or not and how they work, whether they’re turned on or off. So we are understanding
now at the molecular level, we are, scientists can
tell you that the addition of a particular chemical
to a part of the gene or the structure around
the gene will determine whether that gene makes a
protein or not, which will affect how you deal with stress
and how you can regulate your behavior and so nothing,
the people who kind of want to kind of invoke a notion
of genetic determinism, the kind of, they’re dinosaurs. From a scientific point of view. There’s no such thing. For any of the things we’re
talking about as predominantly genetically determined,
everything is shaped by the environment in which you live. If this was just an audience
of the most crusty, hard nosed unforgiving, uncompromising,
neuroscientists and geneticists, they’d
all be sitting here and say well that’s true,
we all agree with that. People will disagree about the mechanisms, they’ll disagree about all
that stuff that we don’t know but no one disagrees anymore
that you can not separate genetics from experience and experience drives gene expression. I’m gonna go through this on
the next slide very quickly and just because for the
sake of time, trust me, I’m just giving you some
scientific principles that are backed by a lot of
data but I’m not going through the data because I wanna
go through a different kind of data set with you. So here are, in a very
conservative way, not being imaginative, not kind of taking
some science and twisting it for a particular political
agenda or a partisan kind of interest or to
make a case for one program or another, I’m just gonna
tell you what a kind of basic core principles of what 21st
century science is telling us about the early life roots
of success in school. What do we know, three
core scientific principles. The first is that responsive
relations, by the way, well let me just say this and
I’m make my editorial comment. Responsive relationships
and positive experiences build sturdy brain architecture and promote healthy development,
starting in early infancy. Actually, this begins before birth. And the beauty of this is
when science is most powerful is when science says kind of
converges with common sense and what your grandmother
could have told you. You put those three things
together and you know, you’re in business, you’re
absolutely in business. So principle number one,
resting on very hard science is in the early years, it
is about the availability of responsive relationships
that are interactive, that promote a sense of
safety and stability, that promote healthy brain
development, which is essential for early skill development. And this is not about how
much, it starts in the family but it’s not just the family. A lot of other, I mean,
childcare providers, preschool teachers, neighbors, friends. It’s also not about how much
people love their children. Very, very, very few people
wouldn’t give their lives for their children but when
you are dealing with excessive levels of stress every day
in your life and you don’t know whether you’ll have food
on the table the next day or whether you are dealing
with a serious mental illness like depression or whether
you’re dealing with a substance abuse problem or violence in the home, that makes it very difficult
to be consistently responsive on a day to day basis. And it has, I’ll take
whoever in this audience, I won’t ask you to raise your
hand ’cause you don’t know who you are, but the most
competent person in this room who’s ever been a parent of a young child knows that there’s no such
thing as days when you don’t come from work where you
just can not give any time to your child, you’ve just kind of had it. It’s been a bad day, but
if every day was like that, this is not about love,
this is about ability to kind of be engaged. Second is toxic stress,
which is different from I had a bad day, toxic stress is
the unremitting constant activation of the stress
system because of high levels of adversity that are not reduced. Most typically for children
in conditions of serious neglect or chronic abuse. Toxic stress, which is
activation of the stress system. Your blood pressure’s up,
talking about babies now and young children, your
blood pressure’s up, your heart rate is up, your
stress hormones are elevated, your inflammatory system is activated, your blood sugar is
going through the roof. That’s what happens when you’re stressed. That’s what’s going on in your
body when you feel stress. It’s a good thing to have a stress system, that’s what keeps us alive,
it allows us to deal with a threat, just not a good
thing to have that stress system activated most of the time. As one legislator in Kansas said years ago when we were working,
picking out some of the most conservative states to go
and educate policy makers about this science, one very
conservative state legislator in Kansas said that’s like
a 24/7 adrenaline high, that can’t be good for you. That can’t be good for
your health, you bet. It’s not good for your
health and it’s not good for your brain development
on some parts of the brain that are particularly
sensitive to disruption, including things like your
ability to focus your attention and regulate your behavior. Helps us understand how
kids who’ve lived in such circumstances can’t regulate
their behavior and focus their attention are not
kids with poor motivation. They’re kids whose
circuitry for those skills has been disrupted. Doesn’t mean you can’t make it better, but it means it would have
been better to prevent that problem in the first place. So that kind of disruption
affects the brain, it affects other biological systems. Makes it more likely you’re
gonna get heart disease, more likely you’re gonna get diabetes, more likely you’re
gonna have hypertension, more likely you’re gonna have
a substance abuse problem. And we begin to see why
individuals who very early in life have more adversity
statistically end up having more problems,
it’s biologically wearing. It’s weathering, it’s a wear
and tear effect on the body. The third principle is that
the foundations of resilience. What is it that allows
children to overcome adversity? Lots of kids overcome adversity. They’re resilient. Resilience is not
something you’re born with. I mean, you can be
genetically different in terms of some kids go into a
nursery at a hospital with babies who are one day old and look around and speak to the nurses. Some babies are pretty placid
and they’re easy to care for. Some are hellions, they’re
screaming all the time. They’re all healthy, they’re all normal. Some kids are easy, some
kids are hard, some kids are more sensitive, some
kids are less sensitive. All normally developing
kids, we’re wired differently but resilience to overcome
adversity is not something you’re born with that’s
immutable and it’s not something you will yourself to do, okay. It’s a very terrible thing
when we find, we always pick up the examples, see that
kid over there, he came from a very tough situation
and he is overcome it. Look at how he’s kind of doing so well. Everybody else be like that kid. There is no such kid who did
that on his own or her own. Those are kids who had adults
who kind of helped them. Could have been a parent,
it could have been an aunt, it could have been a
grandmother, it could have been a father, it could have been
a neighbor, it could have been anybody but you don’t do it by yourself. And what’s critical early
on, the skills, there’s a lot of attention now to executive
function and self regulation skills, lot of people
are interested in that. This is not instead of
early literacy or numeracy, it’s not instead of language development, but it’s the substruction. These are the skills that
are the building blocks of resiliency and they do not
come in on automatic pilot. They don’t. They come in through what
we can serve and return interactions back and forth. Adults who were responsive
and engaged the children and model these kind of self regulation executive function skills. Which means the adults who
are caring for children have to have them and have
to be able to use them, which is why so many children
early care and education programs, so pick, think about. It’s not just single
parents with low education, it’s think about poor quality childcare. One person with a limited
education, paid very little, who herself has, didn’t
have an opportunity early on to develop really strong
executive function skills and now you’re asked to
take care of 10 toddlers. Eight hours a day. And kind of manage their
behavior and create a good learning environment for them. This whole blame game
issue has to kind of, we’ve got to get beyond
that because we’ve got a lot of people who are working
very hard to provide good environments for children
under tough circumstances but we are not providing
the resources and supports for people who are often put
in really tough situations like managing a whole bunch of kids. Parents, the best parents,
they only have two and three kids, have a hard time
getting through the day. This is not easy. Okay, so what I want to do now is shift to so what’s coming out of
the pipeline, the frontiers of neuroscience and molecular
biology and epigenetics and this kind of revolution in science. There are three areas of
very active investigation right now that are so
ripe for fresh thinking in the early childhood world. To begin to answer the question
of what should we be doing differently, where can
we find some new ideas, how can we try some new strategies. I’ll throw three out for you
and give you some examples. The first is there is a huge
amount of work being done producing new insights about
this notion of decreasing plasticity over time and critical periods in the development of the brain. Critical periods being the
time when the brain is making particular circuits and is
most open to the influence of positive experiences
to build strong circuits and most open to negative
experience disruptions. This kind of insights
about what we’re knowing and finding out about critical
periods could catalyze fresh thinking about the
timing and the nature of interventions across the life cycle. There’s a difference
between a one year old and a three year old and a four
year old and a five year old and starting early doesn’t
mean anything relative to how much more, we could
pinpoint timing for different kinds of functions and
I’ll show you some of those in a minute or two. Probably, from my
perspective, the biggest area of investigation right now
that is really changing the way we think about gene
environment interaction that is just begging to be
used by the early childhood field is research on how stress affects individuals differently. Okay, so some of you know about this. This is differential
sensitivity to the environment. We need to throw out the term vulnerable. We use the term vulnerable
to say children in certain kinds of environments are not doing well. So there are many children
in environments that are under a lot of stress
who do remarkably well and there are many families
who do a remarkably good job raising their kids under
very tough circumstances. There are some kids who
are particularly struggling in tough environments and it’s not just about the environment. We know we have increasing
knowledge base now that some kids are
constitutionally more sensitive to the environment than others. It’s built into their genes. But the interesting thing
about that is these kids who are most sensitive to
the environment, in difficult adverse environments,
have tremendous problems. And in highly responsive
stable environments, they are among the most talented
and gifted kids we have because they are so
sensitive to the environment so that they are more creative,
they are more artistic, they are more productive,
in a good environment and they’re much more at
risk in a poor environment. And by the way, if you think
that all an intervention is or program is some other
dimension of the environment, it’s beginning to tee up
this notion that we shouldn’t expect children to respond
the same way to interventions. Some children who are more
sensitive to the environment will do better with an
intervention than children who are less sensitive to the environment. The intervention may have
less of an effect on them. Actually it originated in
I think Norway or Sweden, I don’t know the word in that
language, but the concept here was orchid children
and dandelion children. Dandelions will grow
anywhere under a variety of circumstances, orchids
require very carefully controlled environment
with the right humidity and the right temperature
and if you have the right environment, I’m not a big fan of orchids, but for some people say you
get the most beautiful flowers. And if it’s the wrong temperature
or not enough humidity, they wither and they die
and it’s about sensitivity to the environment. Clearly, there are children who are more sensitive to the environment. What it means is our interventions
have to be a portfolio of strategies that are matched to different needs of children. This is the biological
underpinnings of the interesting personalized learning right now. Children have different needs
and it’s independent of just, it’s built in to their
constitution as how they respond to the environment. A very important area of research. And the third area where
we’re actually doing a lot of work in our centers, Center
on the Developing Child, is the emerging availability
of new measures. Measures biological and
behavioral measures of stress and resilience in young children, that I’m gonna tell you
more about in a few minutes. Measures that are acceptable
to parents and that are modifiable by interventions. Will just kind of open up a
whole new range of opportunities to actually find out
early on the short term whether what we’re doing
is reducing stress effects and whether it’s building resilience. We currently have no capacity to do that and when new measurement
becomes available, it’s a game changer. So let me just give you
some examples of these three areas that I mentioned
and how they are waiting, just standing here waiting
for the early childhood arena to use them to think about
what we might do differently. So we know, we know very
well, that there are sensitive periods in development in
different parts of the brain. The critical periods are not the same for different parts of the brain. Generally speaking, sensory
pathways evolve first and then kind of the fundamentals
of language primarily related to speech, speech
sounds, on differentiation of reception and reproduction. And then the beginning of
higher cognitive function which extends out over a
much longer period of time. So different parts of the
brain have different sensitive and critical periods when
their circuits are being made. At birth, the brain has most of its cells but relatively few of its circuits. It makes its circuits over
time and those circuits are shaped by experience. Well, so, in this country,
most of the policy discussions, most of the public funding,
and when the early childhood period comes up, is about
pre-K for four year olds. That’s where most of the money’s going. People are saying we need
to start early, let’s invest in pre-K for four year olds. You can’t argue with
the fact that pre-K is, you can’t say it’s not earlier than K. That’s good. Four is earlier than five, that’s good. So this is not an
anti-pre-K, anti-focus on, but from a brain
development point of view, particularly for adversity,
it’s earlier than what we usually did, it’s not remotely early. Because for example, this
shaded area is just the first 12 months of a life. And the area where already
circuits are being developed and connections are being
pruned and critical periods are moving away and its
too late to do anything about those circuits, you have to kind of build on that later. What I want to particularly
draw your attention to is increasing evidence now that the circuitry for the foundations of
attention, the ability to focus your attention and sustain your attention, we can see differences based
on exposure to adversity as early as two months of age. Two month olds in highly
chaotic, poorly regulated environments have more trouble
focusing their attention than two months old who are in pretty regular
predictable environments. To say let’s start at four,
and that’s early, is fine for a lot of kids, but
it’s actually for the most, the kids who are at the
most at risk in the toughest environments, it’s like four
years too late to get in early. It’s not too late to
make a difference later, it’s never too late to make things better. It’s too late for them to be as good as they would have been
if we had started earlier. Another thing that’s really
very powerful, this is coming from animal data, where a lot
of the brain research comes. This is from studies of rodents. This notion, this is looking
at the critical period for the normal development
of fear circuitry in the mass of how the different parts of
the brain, for those of you who know, the connections
between the amygdala and the prefrontal cortex,
eventually, where the basic fear circuitry is, in the
presence of significant adversity, in this case,
separating baby rodents, baby rats, from their
mothers, that adversity shifted the critical period. The critical period opened
earlier and closed sooner. So we have, and this is one
example of increasing numbers of studies showing that
adversity actually accelerates development in terms of critical periods. Biology always has a reason for things. All biology cares about is
keeping you alive long enough to reproduce, that’s evolution. What your life’s gonna be like later, it’s not something biology cares about. Just want you to reproduce
because if you don’t, then you become extinct,
that’s why species that don’t go extinct, they don’t
extinct because they adapted to figure out how to stay
alive long enough to reproduce. But the message here is
that once again, children in the most adverse circumstances
are not only missing opportunities early on
for us to get things right and help build the building
blocks of resilience, but in the face of high
adversity, it’s actually working against us, the
window is closing faster. While we’re twiddling our
thumbs and saying well not much happens until you’re three or four or we’re not gonna get involved. So this is a cry out for
we have got to be doing some more things earlier
for children facing the greatest adversity with
missing that critical window. Now, next, go to the variation issue. So this is the differential
sensitivity to contacts concept. So every one of you has seen,
we have seen more variations on these graphs in our life
than probably anything else. This is the kind of social
class gradient in whatever. The higher the SES index,
the better the language development, visuospatial
development, memory, cognitive, it goes on and on and on. This is the, some slopes are
steeper, some are flatter, but this is the universal phenomenon. And we make a lot of this,
this is population level data and we organize a lot of
our programs around this. But you know, the time has
come what 21st century science is saying is okay, a statute
of limitations is now over for focusing on the slope,
we have to start focusing on the distribution and the variation. Look at that variability. Look at how not tightly around the the slope line these data points are. There’s huge variation. There are a lot of kids
in low income families who are doing better on
any of these dimensions than kids in high income families. And there are kids in high
income families who are having more problems than kids
in low income families. But if you average it out
on a population basis, we see this gradient and not
disregarding the importance of the gradient, but that
gradient has run its course. It’s getting us no where. To kind of talk about categorizing
kids by family income, by race, by ethnicity, by social class, we see these gradients, the issue is to understand variability,
to understand that the kids who are doing well don’t need services, they need a better environment to live in but that’s not to say we
shouldn’t care about that because we sure should. But there’s no, the
children and their families are actually doing quite
well and there are some who are really in trouble and
it’s about the variability. And this variability
gets even more dangerous when we start bringing biology in. Many of you know about
this study, Kim Noble and her colleagues,
this got a lot of press and the Washington Post
and the New York Times and a lot of the tabloids
and a lot of the TV shows, this is the stuff where the headline was poverty shrinks children’s brains. Okay, children growing up in
poverty have smaller brains. They have less gray matter. They have less surface area. This is what happens when
you have, you can start measuring things so these
are kind of fMRI studies, other neuroimaging studies,
that have begun to show structural differences in
brains based on, most of them have been focusing on
family income and poverty. But look at this. The story here is variability. You can see, it’s down. Do we have a pointer here? No. So you can see down at
the left, there’s this dip where, on average, below
a certain income level, children had, were found
on average, to have less cortical surface area,
reflecting the consequences of the significant
disruption of adversity. It’s real, it’s real as a
phenomenon, as an observation on a population basis. But it’s not the kind
of thing that you put on individual children and
say this is where you are on the SES gradient,
your brain is shrinking, or poverty caused that. Because there’s so much
variability, there are kids living in poverty who had higher
cortical surface areas than kids in families
with $250,000 incomes. So we have got to at least,
now this is, this is not a universally accepted
thing, this is my taking advantage of having the
podium, so I’m preaching to you based on strong science. We are going no where if we’re
gonna continue to subgroup kids by income, family
income, by parent education, and by race and ethnicity
and exposure to violence. As population level risk factors, yes. But as kind of figuring out
what to do to help improve the lives of children
facing adversity, no. That’s an inadequate way to
be categorizing kids anymore. And the other way to look at
that is if we’ve been doing that for 50 years, where’s it gotten us? It’s gotten us to kind of
solidify in this notion of demographic risk factors
that label kids and that kind of assign them to one group or another. On a population basis,
on an individual basis, it just doesn’t work anymore. At least, personal opinion, based on good scientific evidence, not everybody would agree with that. But when you introduce
biology, then you get it, which is where a lot
of this stuff is coming with brain imaging now, we
get very close to a very dangerous ugly history of
how biology has been used to stigmatize marginalized groups. Particularly communities
of color, where people have used biology, there’s a long history of the exploitation and
oppression and stigmatization of marginalized groups with biology. It’s hard to find any time
where biology did any good. For people it was always
done in a nasty way. So that’s something that
we watch out for very, very carefully but there’s
important insights that could actually help us move the
needle in terms of being much more effective in
the way we individualize providing what children need. So this gets to the issue of new measures of stress and resilience,
which are being developed right now and our center is
kind of taking the lead on that. I want to give you an example of what, so there’s, these are all
things that can be done in a pediatrician’s office. The child with, you know, it’s
a little webbing you can put on a child’s head, the
parents get a kick out of it. The kids don’t mind and
you can, in two minutes, in an office setting, you
can get a full scale EEG recording, watch the
activity in the brain. The one on the right is on a tablet. This is attention task
with a camera that records eye tracking movements and
in two or three minutes, you can measure differences
in attention, the ability to focus, and track as
early as two months of age. And the middle picture’s
designed to say there are things you can measure in the urine
that we’re testing right now that have never been
tested in young children that have been tested a lot
in adults that will tell you what the level of oxidative
stress is on a total body level with a simple thing you can
measure in a few drops of urine. Oxidative stress, I
mean, every public hears about things like antioxidants. You think like oh, you take these special multivitamins and antioxidants. Blueberries are a good
source of antioxidants. It’s because oxidation and
oxidative stress is one of the biological consequences
of excessive stress activation and it’s
associated with greater risk for a variety of diseases,
so it’s good to know if you’re showing evidence
of oxidative stress. Never been measured before
routinely in young children. We’re trying to find out
whether that would be helpful. So let me kind of share with
you some very preliminary data but before I do that, tell you who’s developing these measures. We have a network funded
by the JPB Foundation that is made up of a
dream team of scientists, some here at Harvard, and
five other universities that are collaborating. We have an equal number of
practicing pediatricians working in community
settings who are particularly interested in developing
new strategies that could be employed in the healthcare
setting to kind of address the needs of children,
young children and families who are experiencing significant adversity other than just reassuring
the parents that everything will be fine and making
referrals to programs without necessarily knowing what
people are going to do for very young children. And also an equal number
of community leaders. This is not an advisory
group, this is kind of equal partnership among
scientists, pediatricians and community leaders. The community leaders are, five
of the six community leaders are from communities of
color and they were picked for the following reason. They were picked because
they are deeply concerned about the lack of progress,
particularly in figuring out what to do about the high
rates of stress related disease in poor communities, particularly
hypertension, diabetes, heart disease, which are much higher rates in poor communities and
communities of color. One of the community leaders said to us I’m sick of seeing my
friends have heart attacks in their 40’s and I want
you to figure out how to prevent this from our child
having this happen to him. And they were picked because
their interest in that and because of their deep
distrust of bringing biology into this, so this is the
opposite of kind of rubber stamp group, this is the group
that kind of will make sure that not only will the science
be strong, the pediatricians will make sure this is something
that can feasibly be done as part of routine care. The community leaders, some
of whom are parents themselves right now, will make sure
that this is empowering for families and not something that will be stigmatized or undermining. We started out, we had some
focus groups when we began, one of the community leaders
is a woman who had a deep long history with child
protective services. She had two of her children taken away. They’ve been reunited, she’s
kind of turned her life around, she leads a big advocacy
program for families in the child welfare
system in Washington State. She put a focus group
together of parents to kind of as part of our initial exploration
about how would parents feel about us measuring kind of evidence of stress effects in their kids. 100% of the parents who
are actively involved with child welfare said
over my dead body will I let you get any of the
information from my child. It will be used against me. People will use it to take our child away. So we take the science and
the implementation challenges very seriously here. The choice is either to not
do it and better to not do it than to do it in a way that’s harmful. But the opportunity and
the need to figure out how to do this right in
a way that is empowering for parents to work with
pediatricians when their children are very young to address stress effects. The alternative is what we
have no way to measure them. And so we generalize by
income or by education. And we have no way to
measure on the short term whether what we’re doing is
reducing these stress effects. So the stakes are high,
it has to be done right. This is an example of how nothing’s easy, but that can’t stop us from figuring out how can we be better. And I will tell you, this is
something I’m heavily invested in this but I would prefer not
to have any of these measures than to have them
measures that are harmful. So this is an important part of the measurement development process. So I give you an example of
what the possibilities are. These are early pilot data. Actually just based on 100 kids. 50 here in Boston, Chuck
Nelson’s lab working with a practice at children’s hospital, and 50 out in LA in a community setting. So more stressors in the
family’s life is reported by the mothers on a stress
events scale were associated with lower EEG power at two months of age. Mothers who reported more
stress at the third trimester of their pregnancy and
in the first two months of the child’s life had children
whose EEG power was lower than mothers who reported less stress. Now, again, there’s scatter. See, individual differences,
but indication that we can see as early as two
months of age that the stress in the family is being experienced by the child biologically. A measure of isoprostanes in
the urine, which is a measure of oxidative stress, babies
who had higher levels of isoprostane in the
urine at two months of age had a slower growth in
the power of their EEG from two months to six months of age. Again, indicating an effect
of this total body stress kind of on EEG power. We’ve also seen preliminary
data, as I mentioned before, of differences in the
ability to pay attention. Now this is the most important
thing you need to take from this, these are not irrevocable. This is not irrevocable biological damage. This is like a lead test, this
is like a hematocrit to see if you have anemia, this
is kind of having ways of screening for things that
if you detect them early, you can do something about it and prevent the consequences later. There’s nothing about these
measures that suggests kind of permanent kind of
biological determinism. That we could not know about
that, we could not know which kids is showing stress
effects and which aren’t. And then we’re left with
either saying, well, these kids are young and
they don’t really know what’s going on and we’ll
wait until they can talk. Or you can say well, we’ll
just categorize by income or parent education, assume
that the kids in low income families are having stress
effects and the kids in higher income families are not. But this is an opportunity
to learn and this is why this has to be owned by
parents and pediatricians. It’s not something that
professionals do to families and the families have to live with it. But it’s a way also to be
able to measure, to have some power and control on the
parents of my child, I’m dealing with a lot of stress, this
is experienced to my child. We’re gonna work together
to figure out how we can intervene and this is basically
where the parent’s role becomes very important. To put all this together and
I just want to kind of close and then we’ll open this
up for discussion is that the biology of adversity,
the biology of adversity which is that excessive stress activation can result in both biological
and behavioral changes, not just elevation of things
you can measure in the urine or saliva but effects on attention. We have an executive function
self regulation scale that we’re working on that
starts at two years of age and actually goes down in
some new things, we’re trying down to as low as one year of age. ‘Cause these parts, these
self regulation executive function skills in the part of
the brain that is exquisitely sensitive to elevated stress hormones. So this is, you would
expect that it’s parallel. This basic biology suggests
how do we take it all, put it together, and what
do we say to the practice community and what do we
say to the policy community other than we’ve got a lot
of interesting biological things going on. So we’ve been working hard
and we’ve been working with policy makers and
practitioners to think about what kind of simple
design principles could be extracted from this science
that would help on a policy level and a practice level
to strengthen the impacts of what we’re doing right
now, above and beyond looking at the curriculum,
kind of looking at the credentials of the
teacher, looking at kind of whether we’re providing the
right learning experiences. And there are three. So we’ve tested these,
they’re grounded in strong scientific thinking, we
tested them with policy makers and practitioners to see if
they were relevant and useful and shaped them so that
they would be very relevant. So there are three design
principles that translate this science to what should we do. And the first is, and you
should be surprised by none of these because they’re coming from what I’ve been talking about. So the first is to basically
have every program ask of itself and every policy
maker ask of a policy or delivery system that is
being funded is how is this program building responsive
relationships between the young child and the
adults who care for them. So for a childcare program
or an early care education program where the parents
drop the child off at the beginning of the
day and pick the child up at the end of the day, there
are two ways to look at this. One is how are we building
responsive relationships between the staff and the child. How are the staff engaged
in responsive relationships? This is where adult child
ratios become important. How many kids can you, in a
day, engage with responsively? But also for children who
are particularly struggling with some of their executive
function self regulation skills since the home
environment still remains accountable for a major part
of the variants and outcomes and for those children
who are really struggling, having a program that
just has the parents drop the kid off in the morning
and pick the kid up at the end of the day is
not attending to the issue of how is it strengthening
responsive relationships. And for anybody who
says yeah, but you know, you can’t expect a center-based
program to do that, my response would be the
program you keep citing all the time is the one that has the
biggest payback is the program that once a week went in
and worked with the parents on those relationships, that’s
the Perry Preschool Program. So we could say we can’t afford to do that and it’s too difficult,
but then maybe that’s why we’re not getting as good
outcomes as we used to get and not getting good outcomes is not good. So the second issue is
strengthening core life skills. Particularly for this
audience, so this is, I will be the last one to in any way
undermine the importance of early language facilitation,
early literacy experiences, reading to children, the
importance of the language environment, numeracy, all those things. This is not instead of. But certainly for children
who are experiencing significant adversity, if
their underlying core skills of self regulation executive
function are disrupted, it will compromise
their ability to benefit from literacy experiences. Giving parents books and urging
them to read to their child when life, on a daily
basis, is completely chaotic because of the absence of resources and depression or mental illness
is kind of, or substance abuse problem or violence in
the family, to kind of say well we took care of
that, we gave out books and we urged people to
read to their kids and talk to their kids, no, that’s not
good enough because the skills don’t come in automatically. They require a kind of scaffolding. And again, the staff in programs
need to have those skills and they need to be able to scaffold those skills in the children. There’s a lot of very good
work going on right here at the ed school in that area. And then the third, which
is the one that we tend to bemoan when we sit
in the education world, we bemoan it and we
blame the outside world, is reducing external sources of stress. So we usually say, we say
well what can an education program do about the
stresses in a community. So our best, we say well,
this is beyond our control. But the science says that’s
not good enough anymore. It’s not that you can
expect a school to by itself know what to do for community violence, but you can’t expect
better outcomes for kids unless we do do something about that and that’s kind of on a community basis. So if you put all these together, they kind of, they have a
fair amount of face validity but the real question is not
whether we understand this or not, but how do we do it. So for 50 years in this field,
Head Start was predicated on active parent engagement when it began. So parent involvement,
parent engagement, parent interactions with the kids
was a new idea in 1965. It actually wasn’t even new then. And for 50 years, we’ve
been having conferences about how do we improve
parent engagement in programs. Well, it’s not good enough
to just identify it. We’ve got to figure out new
strategies about how to do it. But it’s all of these things
together and they’re very interactive, it’s not
that they’re separated one from the other. When they work or when
we’re making progress in each of those areas, what
we end up doing is promoting healthier development for the children and better educational achievement. Those are the active ingredients,
the design principles, that come out of good scientific thinking. At the same time, it’s not
just about the children. It’s about helping adults
who are struggling to engage in responsive caregiving, to
read their children’s cues, to be able to provide that
reciprocal serve and return interaction and also the
absence of economic stability is a huge stressor and the
schools are not going to do something about this on their own. But these core skills that
you need to create a well regulated home environment
for good child rearing, they’re also the same core
skills you need to get a job, to be able to become
economically self-sufficient. So there’s a lot of talk
about two generation programs right now, that was a
new idea 50 years ago. It’s not a new idea
today, it’s still around. But mostly we talk about
interagency agreements and how to get programs core located. What the science is saying is
it’s actually one science here the science of what’s necessary
to create a well regulated home environment, those
skills are the same skills you need to get a job. The same skills you need
to be a contributing member of a community, these
are these core skills of executive function and self regulation. So I’m coming back to
the leukemia contrast. So these two trajectories,
and again, I am not equating leukemia with poverty,
but I want to say for you the last point I want
to make, which is really the radical change, it has to happen about how we evaluate programs. So what would you think if
I told you that for the last 25 years, these dramatic
increases in survival for leukemia came at a time when there
wasn’t one single new treatment for leukemia developed, not one. So what’s that all about? What it’s all about is
people started to realize that there were subtypes
of leukemia and different treatments are effective for
different kinds of leukemia. Different combinations of
chemotherapy and radiation and whatever they were doing. So if they had, so what
happened was they took the same interventions they’ve had
for 25 years and started to stratify risk and match
different types based on the genetics of the tumor and
some of the differences in the kids and went from 60, 70% to 95%. So if they’re, if the answer
for leukemia is, you say, what’s the best treatment for
leukemia and the answer is, well I don’t know, I gotta
find out first which kind of leukemia do you have. So if there isn’t one
treatment for leukemia, why are we still asking
what is the best program for kids living in poverty? What is the best program for
kids who are experiencing the scourge of racism and
violence in their community? How could we be saying that
when progress in another area came from understanding
that there are differential dimensions of a problem that
require differential response? So this is the last thing
I want to leave you with is that we are not,
okay, personal opinion. Everything I’ve said that’s
science is real, I’m not making this up and I’m not putting
a spin on it, but there are, now I’m gonna give you my
personal opinion based on very strong science of how
we are dead in the water on all of the things we’re
doing to reduce inequities and disparities and outcomes
if we continue to use the same criteria for what we call an evidence based program. Everybody wants evidence based programs. There is no national
association for the prevention of evidence based programs. Everybody wants them
and here’s how we do it. We evaluate an intervention. At its best, a randomized control trial. Maybe a quasi-experimental design. Maybe something a little bit weaker. And the red horizontal
zero line means no impact. So what we do is we
calculate the mean difference between a treatment and control group. And if we find a statistically
significant difference on some outcome, we have met the criteria for an evidence based program. I went back and checked this,
in the regulations, in HHS, and in the Department
of Education federally. The federal definition of
an evidence-based program is a program that is one study
showed a significant impact on a child outcome or some
other outcome on one study. And that’s what you need to
be an evidence-based program. What we have to start doing is
to say, instead we should say why did it work so well for
these children and families? Why did it work so poorly for
these children and families? Because once we figure that,
if we figure out who it works for, we can start scaling
for the kids for whom it’s making a big impact and
go back to the drawing board and think about what to do
differently for the others. And at the end of the day,
we don’t keep searching for the Holy Grail of the
best program, we have a suite of programs and policies
across sectors, education, health, human services, that
match different strategies to different resources,
needs, and outcomes. That’s the secret to the leukemia success. That’s what the science is
telling us about learning. This is the message behind
personalized learning and this is what every
teacher knows and every person who works in a program, they
say at the end of the day, I know I’m making a
difference in some cases, and making a difference less. And we stay with this
completely dysfunctional praying at the altar of
evidence-based programs that are defined by somebody
found something once on a study and therefore we call this an evidence based program. So this is my kind of final
take home message for you and then let’s open this up for questions. Steven Johnson, if you’re
interested in innovation, I recommend this book. Steven Johnson, he’s a
very talented scholar who has written a lot on
innovation and this is an interesting historical
overview of kind of innovation and how it’s evolved. He said encouragement does not necessarily lead to creativity. Collisions do. The collisions that happen
when different fields of expertise converge
in some shared physical or intellectual space. That’s where the true sparks fly. If we just hunker down, you
know, this is the silo issue. Talk about a cliche, talk
about something that everybody complains about and no
one does anything about. If you just hunker down and
have educators try to figure out how to improve programs,
have people in healthcare systems try to figure out
how to reduce disparities, and have neuroscientists
and molecular biologists sit in their laboratories
and figure out all the things that we know about how the
outside gets into your body, then we have much less of a
chance to kind of breakthrough thinkings and if we create
spaces where people do more than just have a conference,
give presentations to each other, say that was
interesting and walk off, where people actually
work together in bringing these kind of very different perspectives. And the most distant the perspectives are, if people are interested in
the problem, the more likely it is that something is gonna happen. So we hear a lot of
people talk about, well, you know, people outside
of the education system don’t really understand
the education system. They can’t really bring anything in. And then one business person
comes in, throwing the system, and everybody says I told
you so and we’ll never let anyone else in again. The same thing goes in healthcare. So the answer to this is there
is a rich and rapidly growing science out there that
is transforming medicine, it’s transforming the
way we treat disease, the same science should
be transforming the way we prevent disease, the
way we promote health, and the way we promote early learning. That’s my kind of call to action. That’s going back to what Ellen
Johnson Sirleaf had to say. We have got to dream
big, we can’t just think about how do we tweak programs. We can’t afford another
10, 20, 30, 40, 50 years of kind of little
incremental improvements. This is our website for our center. If you’re interested in this,
we have a lot of material there of translating complicated
science for nonscientists. I think we should just open
this up for conversation. I’m sorry I ran over a little
bit longer on the presentation but we still have time for
questions and comments, so I welcome you to come
to the mic and let’s talk. So thank you. (audience applauding) I’ve also learned to be
patient, so I’ll wait. Actually, if you could identify yourself, that would be great. So why don’t we start, either one. If you want to line up if
others want to talk, please do. – Hi, my name is Rachel. I am coming at you with
a couple questions. One is, as a young child, you
brought up the temporal lobe there, I did not realize,
as a child, that I only had one functional hippocampus. After the cells started
becoming difficult, we had to remove it, we caught
it just before it became astrocytoma versus glioma or
the other way around, sorry. But I wonder, often, this
has been a really recent development where seizures that
I thought were panic attacks became the more dramatic noticeable stuff. I’m finding myself wondering,
we realized that a head injury I got when I was two years
old got that started. I find myself constantly
wondering if I had known that issue existed, if we
had caught it when I was two, would I have had a different
perspective on life. It was the correlation
causation thing there. Something kind of interesting,
would I be standing among you at fancy pants
Harvard if I had thought, oh, I only have one hippocampus. – Right, right. So thank you. Thank you for the
comment and the question. So you’re a great example of
some of the core principles that are really important
for everybody to understand. The biology and the brain. So biology is always set
up to get things right. Because nothing about biology
that wants to go off track. It’s our life experiences
that knock us off track. Or sometimes a medical problem
or something can increase the risk of going off track. But whether it’s something
internal like some kind of medical problem or
whether it’s external sources of stress, you’re a
good example of the fact that obviously there have
been tremendous accommodations and adjustments that your
brain has made, right? Exhibit A. It’s like there are no
perfect brains anywhere. There’s never been a perfect brain in the history of the world. Every one of us has parts of our brain that work better than others. I’m not minimizing the
fact that there can be significant disruptions
of brain development. But biology is trying to get back on track if it gets off track. Programs, if they’re
designed appropriately, will help facilitate the process
of getting back on track. Not going around biology
but facilitating it. And the question of how
different would your life be if people had found that
out, I can ask everyone in the audience to pick
anything in your life and say how different would
your life be if you had. I’ll just, I’ll go to
the trivial with myself. I have a February birthday
and when all the kids in my cohort started
kindergarten, I was too young to start kindergarten, so I
had no preschool experiences. I grew up in Brooklyn,
New York and I hung out on the streets with my friends and stuff. So I didn’t start, I
actually had no preschool and I had no kindergarten
and when it was time next year for me to go
to school, I started in the first grade because
I was always the youngest in my class and I always
felt younger than I was. So what if I had had a
birthday a few months earlier? What if I had a year of kindergarten before I went to first grade? What about kids who had serious illnesses that kind of hospitalized
them for long periods? What about kids who are malnourished? The list goes on and on and on. The answer is that
everything’s set up to try to get back on track. When it goes off track,
we do everything we can to try to get it back on track. And I can’t answer the
question of how your life would have been different
but you’re a wonderful example of how adaptive
the brain is and thank you for kind of telling us. – You touched on the other
subject that I had in mind and reading some of your
work, you talk about some of the very common things
that children go through, sleeping, eating, playing. I’m joining you guys as a
play advocate, a play worker, who works very specifically
on under a biased perspective that that is kind of the
black box, letting children work this stuff out on their
own while we’re not watching. And so I’d like to hear
more a little bit about if any study has been done more
on the neurons and what’s going on on an EEG when
a child is playing. – Yeah, let me give a brief
answer to that so we can get to other people, I would
say that be wary of anything where somebody says there
was a study that showed. There’s a study that
showed almost anything that you would want to show. The knowledge base is, what’s
the accumulated knowledge that we have from lots of study
over long periods of time. The other thing about
neuroimaging, so there’s a study that showed that some
part of the brain lit up when kids were playing. Well sure, anything that
kids are doing like that, something’s lighting up in the brain. We didn’t have the
capacity to see it before, now we can see it. It doesn’t tell us
necessarily anything different because now we know which
part of the brain it is. Because that’s not gonna
necessarily determine what you’re going to do. So think of all the
neuroimaging as a urine analysis is to the kidney, right. It just tells you yeah, this
stuff is going on in the brain. So I think for purposes of
programming, kind of play based interventions, I think we
have much more to be gained and learned from what we
observe and learn about play than to kind of find some
play center in the brain and think that we know
something more important. It’s not minimizing the brain
stuff, it’s just saying, it’s just telling us where
in the brain it’s happening. So thanks. Thank you. – Hi, I’m Pamela Humphrey,
I’ve been involved in the ed school on the dean’s leadership council for a number of years. And I have a question for you. To what extent, when we talk
about the impact on children and the engagement of
families, relationships, and what have you, is the
change in societal norms being looked at as a, and
the impact that it has had. So there as a time when
most kids came home to a parent at home, a mother
usually, and two career households weren’t as
common as they are today. And all those things, now
we have more single family households than we used to
and you talk about stressors and dual careers, that’s stressors. But those are sacred cows,
to not sort of mess with, but to what extent, I often
believe that if you don’t identify the problem, doesn’t
make it bad but if you don’t identify the problem, the
outcomes, and it’s really tough to dig down and finding solutions. So to what extent is that
part of that conversation when you study brain
development and what have you? And the other thing is
the impact of screen time on children’s brain development,
which is a huge big deal and it’s not gonna go away
and it’s gonna get worse because it’s changing
children’s brain circuitry and not in good ways. – These are very important questions. The simple answer is
just to say that, again, the central part of biology
and all this stuff is going on early in life, the brain
is reading the environment and preparing to adapt to
whatever environment it is. I mean, humans are the
most adaptable species. We live in all kinds of
context, cultural differences, they’re all about different
context in which the brain is learning the rules and
learning what’s necessary. There’s no question that
we can make a long list of things that are making it
much harder to raise young children in this environment
compared to 20 years ago. On the other hand, there have
been hundreds of years ago in deep poverty in the
middle ages, I can’t imagine it was easier than it is
to kind of juggle a job as a single parent. The thing is all we know is,
and anybody who’s observed this, I mean clearly it’s
easier for two people to share the responsibility than one. And clearly we live in an environment that we can minimally control, right. If it’s changing, in the
20th century, when we had nature versus nurture, that
was code for well if it’s genetic, we can’t do
anything about it but if it’s the environment, we can fix it. Ironically, pretty soon it
may be well, if it’s genetic, we can manipulate the genes. If it’s the environment, there’s
nothing we can do about it. So I think the issue is it’s a reality. I mean, the world is changing
but the world has always been changing and since we’re
still here as a species, the answer is we’ve
somehow managed to adapt. Have we paid a price for that? Yeah. Do we have, as people live
longer, they have more stress related diseases, right. I think the answer, the dilemma
here is that if society’s changing, if the context
is changing, if the world is changing so rapidly, humans will adapt. They’ll be a price that we’ll
pay but we can’t kind of wish that the world were different. The other thing about the
early childhood programs is the gold standard for
evaluating success used to be high school graduation,
that was the thing. And high school graduation
got you a full time job that could support a family 25 years ago. High school graduation
doesn’t get you that anymore. So actually not only is life
getting harder, arguably, but the goal posts have been moved about how much education you need. So I think that’s a matter
of just dealing with reality we can’t change the world. But biology is doing
everything it can to adapt. Screen time, the simplest
answer is, I’m not an expert on that so I think I
shouldn’t give an opinion and it’s one of the
good things to end here, unless someone wants to
talk afterwards, fine. But I think it’s very dangerous
for anybody to give a talk like this and never say
I don’t know in response to a question so you can
trust that what I say to the other things is I
at least have some basis. It’s very controversial, I think. I don’t really know. The one thing we can say
that we should worry about is interacting with a screen
when you’re very young. We know that the brain needs
responsive interactions but when they start creating social robots that kind of respond to you, I don’t know. I don’t know. But we need to find out
because there’s concern about a lot of things that
people do with screens. So we’ll go here and then there. – Hello, I’m Cindy. First of all, I would thank
you for a very stimulating presentation, I feel my brain
has already been stimulated for some development, so that’s
why I’m asking a question. I actually have lots of
questions but I would like to stick to one for now. You mentioned actually for
the variability of the effects of either intervention
or stress or adversity on children and there’s a
very wide spectrum of effects. So I wonder has your center
or other centers or any other group of scholars have focused
on looking specifically on the top of the minority,
let’s say the minority of the group of children or
maybe adults who actually successfully overcame the
adversity and they made it to the top, just focusing
on the very specific top of the minority. – So our center’s 12 years old. So it’s not enough time to
follow the kids we’ve been looking at until they’re old. But what I will say is there’s
an extensive knowledge base, extensive literature on
resilience in multiple contexts. Resilience in the face of
poverty, in the face of war, in the face of illness in the family. A wide range that are all
geared to ask that question of how do we understand
that group at the top who beat all the odds. And across all of these areas
of research, biological, social sciences, the one
thing that is consistent is that there’s always a
relationship that was providing the protection and the
scaffolding that allowed an individual to overcome adversity. So I would say extracting
from that, if you asked about what do we know about top
five percent or whatever, you never say 100% of anything,
but there will be very few up there who kind of somehow
miraculously got there on their own without tremendous
support from somebody. The other interesting
things that are associated, usually having some sense of
faith, religion seems to be, religiosity seems to be
associated with resilience. Certain kind of temperamental
qualities, some kids are just more adaptable
but the relationship thing just totally overwhelms everything else as the most common thing you see. Getting away from this
thing of somehow grit, you know, some kid who will
just will himself or herself to overcome, there’s no good
scientific evidence for that. – [Cindy] Okay, so we
need to look more into it. Okay, thank you. – Okay, yeah. You get two questions for
the two people at the mic. – I’m Helen, this is Lily. This question from both of us. And I really appreciate
you sharing about insights on especially the age between
zero to three, three to seven. In Chinese language there’s
a saying when you look at someone who is three
years old, you can see how they turn out as adult. When you look at someone
who’s seven years old, you can pretty much figure
out how they turn out when they’re old. So I just wondering about
the mindfulness learning for children’s emotional control
for the child development. Because a lot of times, even
adults, or grandparents, they always like to
have quick conversation, not a deep conversation and
I’m wondering how can we model that as parents and
as grandparents to kind of modify that environment,
emotionally, so child can see how adults engage in deep
conversation and have that mindfulness in the environment,
not being controlled by or possessed by materials
or by a need and very orderly environment but more in control
of everyone’s own emotions and how they solve problems effectively. I was with my family in Europe
and Asia and we went there and lived there for a while
and realized there is totally a difference, sometimes
opposite, experience in different parts of the
world and how do you integrate that together once we’ve come
back and the daycare here and I was the homeschool
environment, I just want to get all these pieces together. – Yeah, no, that’s a great question. It actually gives me a chance
to go back to something I said earlier that a lot of
what we know about kind of basic concepts of brain
development come from human and non-human studies,
and a lot from studies of different animals and
these basic principles are kind of biology and
one of the core concepts that come out of that is
how environment shapes gene expression and shapes brain circuits. So this is actually the
kind of neuroscience answer to cultural context. If you ask neuroscientists about culture, they kind of deer in the headlights. It’s not, they don’t study that. But what they do understand
and tell us is that those basic concepts
are actually the biology of what we mean by how there
are no kind of universals independent of cultural
context that when we look at development, science
has nothing to say about what’s the best culture
in which children grow up and the way culture plays a
role early on in development is how parents respond to
and shape their children’s behavior and what they consider
to be the most important things that drive their
child rearing beliefs and their child rearing practices. I mean, the one that’s most
studied in this country is a real outlier is this
focus on individualism as opposed to kind of
being part of a community. – [Helen] And that’s a problem. – Yeah, well it’s a problem
when you’re in a multicultural environment, so it’s a
problem when you move from one culture to another
but from the brain’s point of view, the brain’s trying
to figure out the culture. The brain’s trying to figure
out what do you need to know, how do you need to behave,
what’s the way to kind of be engaged and successful
in a cultural context. That’s strong biological sense
and the one thing we do know about humans over the history
of our species is that humans have adapted in a wide
variety of cultural contexts, a wide variety of kind
of physical environments. So we have a lot of adaptability,
a lot of plasticity, but actually even certainly
some of this happens during pregnancy, the brain
is reading the environment. If there’s calorie deprivation
and starvation during pregnancy, the brain is
reading that it can sped the metabolic systems learn
how to conserve calories ’cause there’s not gonna be enough to eat. And if you get born and
you’re in an environment of abundance, you’re more
likely to be obese because your metabolic systems been
adapting to not enough to eat. So it’s all about reading
the environment and trying to be adaptive to that environment. And cultural differences get
manifested in how parents raise their children and
kind of what they value, what they reinforce, and
that’s, it’s the same principle but it looks very different
from culture to culture in terms of what the behaviors are. And I can’t resist your point
about the predictability age three and age seven, so
Jerry Kagen, who some of you may know is a very
distinguished psychologist here at Harvard who
retired several years ago. When asked about the
issue of predictability, what’s the best way to predict
development in 18 years of age and he said
study somebody carefully a day before his 18th birthday. (audience laughing) I think predictability is very hard. The brain is averaging out. It’s assuming that what
it’s dealing with is what it will always deal with and
if the environment changes or the demands change, then
the brain has to readjust. And how sturdy the
foundation is makes it harder or easier to readjust. So culture is a critical part of this. Culture is the environment,
it’s the context. – [Helen] Thank you. So do you recommend kids
before seven years old live in different countries
for their own development? – I’m sorry, I missed that. – [Helen] Do you recommend
kids live in different countries early on in? – I have no specific recommendation
one way or the other. Thank you. Maybe one last question
or people want to go. It’s actually after the hour. Maybe we should stop. I’ll be glad to answer your question. I shouldn’t be keeping people
afterwards, it’s five after so thank you very much. (audience applauding)

3 thoughts on “Askwith Forums – Protecting Brains, Stimulating Minds: The Early Life Roots of Success in School

  1. Thanks very much indeed. Ashok Varma M.D. San Francisco 💐❤️🇺🇸🇺🇸🇺🇸🇺🇸🇺🇸

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