scientific evidence for the importance of …...responsible for basic functions of life, keeping the...
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SCIENTIFIC EVIDENCE FOR THE IMPORTANCE
OF SUPPORTING DEVELOPMENT OF YOUNG
CHILDREN IN LAC
Maureen Samms-Vaughan
Working Group on Education Mtg.
Costa Rica, April 2016
THE LAC REGION
33 countries
15 dependents and/or other
countries
Vary tremendously in
Size
Population
Language
Governance
Economic Development
OUTLINE
A Trajectory of Childhood in LAC
The Biology of Brain Development
Practical Evidence for the Importance of the early years
Intervention Evidence for ECD
The Cross-Sectoral Approach to ECD
ECD successes and Challenges in LAC
A Trajectory of Childhood in LAC: A Second Look
Conclusions : What does this mean for the LAC Region?
A TRAJECTORY OF CHILDHOOD IN LAC
A group of children are born within months of each
other in a town somewhere in the LAC region
At 3 years, they go to the same pre-school in their
town
The teacher finds the children diverse, there are some
striking differences.
WHY ARE THE CHILDREN DIFFERENT?
Were some “born bad?” as we sometimes say? NOT SO
The Science of Early Childhood Development indicates that the first few years of life are critical to children’s health, development and behaviour and set the stage for adult health, education and behaviour
All Children are born wired for feelings and ready to learn.
It is the environment that we have created for them that determines who they become as children AND for many years to come as adults. What is the evidence for this?
THE BIOLOGY OF THE BRAIN
BRAIN GROWTH THROUGHOUT LIFE
The brain grows most rapidly during the EC period
Two thirds (2/3) of brain size is achieved by 21/2 to 3 years
Growth then occurs more slowly until 18 years when adult head size is
reached.
MICRO-LEVEL BRAIN GROWTH I
.
Kolb, U Lethbridge
Average Number of Neurons in the Brain:
100 Billion
Number of Synaptic Connections at Birth:
50 Trillion
Number of Synaptic Connections after a few months
(20 times) :
1,000Trillion
DETAILS OF BRAIN GROWTH
Neurons and connections that you are born with are
responsible for basic functions of life, keeping the heart
beating, breathing etc.
Further increase in complexity of the brain is dependent on
the young child’s experience .
Two types of further brain growth:
Differentiation into specialised brain cells.
Increase in number of synapses
MICRO-LEVEL BRAIN GROWTH II
Maximal brain growth between
birth and 6 years
“Use it or lose it principle”
Synapses or connections that
are not used die away
`Sensitive periods’ in early brain development
Vision
0 1 2 3 7654
High
Low
Years
Habitual ways of responding
Language
Emotional control
Conceptualization
Peer social skills`Numbers’
Hearing
Graph developed by Council for Early Child Development (ref: Nash, 1997; Early Years Study, 1999; Shonkoff, 2000.)
“Pre-school” years School years
CONCLUSIONS FROM BIOLOGY
The early years of life are important because the interactions that
a young child has with his/her environment determines the
structure of the brain
There are important sensitive periods of brain development
Early experiences determine learning, behaviour and health
Early experiences determine whether a child has a strong or
fragile foundation to go into adulthood with
PRACTICAL EVIDENCE FOR IMPORTANCE
OF EARLY DEVELOPMENT
LANGUAGE AND LEARNING
Early Child Development and Language
Language development starts early:
first 7 months
Sets capability for mastering
multiple languages
Sets literacy and language trajectory
0
600
1200
12 16 20 24 28 32 36
High
Middle
Low
Age - Months
Vocabulary Growth – First 3 Years
B. Hart & T. Risley, Meaningful Differences in Everyday
Experiences of Young American Children, 1995
Vocabulary Word Exposure
Test of Language Development
(TOLD) at Age 9
Can predict a child’s reading score at
age 9 years from vocabulary at 3 years
Correlation between vocabulary growth
at Age 3 and TOLD at Age 9 : 0.74
04-146
READING SCORES BY NO. OF POSSESSIONS IN HOME:
PRE-SCHOOL TO GRADE 3 (JAMAICA)
0
5
10
15
20
25
30
Pre-School Grade I Grade 3
0 to 2
3 to 4
5 to 6
7 to 10
<2.5
Birthweight (kg)
Test S
core
BIRTHWEIGHT AND MATH
1958 Birth Cohort (UK)
09-033
Jefferis et al. 2002
2.5-3.0 3.01-3.5 3.51-4.0 >4.0
-0.4
-0.3
-0.2
-0.1
0
0.1
0.2
LOW BIRTHWEIGHT AND READING
(LA and Cuba)
Birthweight Reading
% Infants % Level 4
Low BW Grade 6
UNICEF 2008 UNESCO 2008
Cuba 5 51
Chile 6 29
Mexico 8 24
Brazil 8 22
Adapted from UNICEF 2008 and UNESCO 2008
Reading Levels: 1 (Low); 4 (High) UNESCO
BIRTHWEIGHT AND SCHOOL SCORES
11-12 YRS (JAMAICA)
Arithemtic Spelling Reading0
10
20
30
40
Arithemtic Spelling Reading
LBW NBW*** ***
***
Samms-Vaughan, 2002*** p< 0.0001
SUMMARY
Children who get exposed to language in the first
few years of life go on to have better reading ability
in later childhood and adulthood
Children of low birth weight, a birth vulnerability
factor, have later learning and behaviour difficulties
PHYSICAL HEALTH
PHYSICAL HEALTH
• Babies born small for age (not premature) have higher physical health risks as adults of:
• Heart disease
• High Blood Pressure
• Type 2 Diabetes
• Obesity
• Vulnerability to Aging
• Babies who are undernourished in the first few years of life have later learning difficulties
ECD Swedish Longitudinal Study and Adult Health
Number of Adverse ECD Circumstances*
Odds - RatiosAdult Health
0 1 2 3 4
General Physical
Circulatory
Mental
1
1
1
1.39
1.56
1.78
1.54
1.53
2.05 3.76
2.91
2.08
10.27
7.76
2.66
* Economic, family size, broken family and family dissention
Lundberg, Soc. Sci. Med, Vol. 36, No. 8, 1993
04-006
MENTAL HEALTH
STRESS AND THE DEVELOPING BRAIN (1)
Stress systems are particularly malleable or “plastic” during the fetal and early childhood periods
Early experiences shape how readily they are activated and how well the responses can be contained and turned off
Stress responses that are activated too frequently or for prolonged periods in the absence of supportive systems (Toxic stress) are damaging to the brain.
STRESS AND THE DEVELOPING BRAIN (2)
Toxic stress (including exposure to violence) during this period affects the developing systems and result in systems that are hyper-reactive or slow to shut down when faced with threats
This leads to increased risk of behavioural and physiological disorders:
- Anxiety & Depression- Alcoholism & Drug Abuse- Cognitive & Memory Impairment- Cardiovascular Disease- Stroke- Diabetes- Infections
IMPACT OF CHILD NEGLECT:
Romanian Orphan Adoption
Children adopted into middle class homes after 8
months in the orphanages show at 11 years in
contrast to children adopted early:
1. Abnormal brain development (small brain, low
metabolic activity, abnormal EEG)
2. Social and cognitive problems (IQ loss)
3. High vulnerability to behavioural problems
(ADHD, aggression, quasi-autism)
Kolb, U Lethbridge
IMPACT OF CHILD ABUSE
Physical damage to brain structure in areas responsible for
thinking (cortex), processing memories and emotions
(hippocampus), and responding to danger (amygdala). These
regions are critical for learning.
The hippocampus becomes smaller with chronic abuse.
Changes in brain chemistry also occur. Increases the production
of the stress hormone cortisol, and neurotransmitters such as
epinephrine, dopamine and serotonin, the chemical messengers in
the brain that affect mood and behavior, leading to depression and
aggression.
Abnormal EEG and seizures.
Teicher, 1993, 1998
IMPACT OF ADVERSITY ON BRAIN DEVELOPMENT
SUMMARY
Children who do not have adequate emotional
stimulation or who have negative emotional
stimulation have mental health, learning, memory
and behaviour disorders.
INTERVENTION EVIDENCE :
CAN WE CHANGE CHILDRENS
OUTCOMES BY PROVIDING APPROPRIATE
EARLY ENVIRONMENTS?
OPPORTUNITIES FOR ECD INTERVENTION 1:
HIGH/SCOPE PERRY PRESCHOOL PROJECT, AGE 27 EFFECTS
20%
13%
7%
41%
36%
29%
0% 5% 10% 15% 20% 25% 30% 35% 40% 45%
Never on welfare
as adult
Own home
Earn $2,000 +
monthly
Program group
No-program group
Barnett, W.S. (1996). Lives in the balance: Benefit-cost analysis of the Perry Preschool Program through age 27. Monographs of the High/Scope Educational
Research Foundation. Ypsilanti, MI: High/Scope Press.
PERRY: ECONOMIC RETURN (2002 $)
$8K $65K $173K
$0 $20,000 $40,000 $60,000 $80,000 $100,000 $120,000 $140,000 $160,000 $180,000 $200,000 $220,000 $240,000
Costs
Benefits
Welfare Education EarningsChild Care Crime Preschool
$249,663
$15,386
WHAT MATTERED IN THE US?
Meta-Analysis:Direct Teaching
Other Studies:All children benefit, disadvantaged gain more
Focus—children learn what is taught
Educated, trained, adequately paid staff
Quality, Quality, Quality
DEVELOPMENTAL LEVELS OF STUNTED AND
NON-STUNTED CHILDREN AND BENEFITS OF
INTERVENTIONS
80
85
90
95
100
105
110
115
Baseline 6 mo 12 mo 18 mo 24 mo
DQ
Non-stunted
Both
Stimulated
Supplemented
Control
Grantham-McGregor et al, Lancet 1991
IQ AT AGE 17-18 YEARS
p=.02
p=.02
p=.001
p=.005p=.001
p=.054
62
64
66
68
70
72
74
76
78
80
IQ points
Verbal Performance Full Scale
No stim Stim Non stunted
Walker et al, Lancet 2005
Grade 3 Language Scores
UNESCO, 1998
100 250 300 350 400150 200
Argentina _ _ _ _ _ _ _ _
Brazil _ _ _ _ _ _ _ _ _ _
Chile _ _ _ _ _ _ _ _ _
Cuba _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Mexico _ _ _ _ _ _ _
05-066
Sociocultural
Gradients forLanguageScoresBy Country(UNESCO 1998)
Cuba
Argentina
Brazil
Colombia
Chile
Parents' Education (Years)
1 4 8 12 16200
240
280
320
360
Mexico
Willms & Somers, 2000
SUMMARY :
A quality ECD programme improves children’s educational and behavioural outcomes in the short term and as adults in the long term
Head Start Programme in USA- Higher numeracy levels- Higher literacy levels- Better social skills
ECD has a 17:1 return on investment based on:- Reduced remedial education- Reduced crime and violence- Reduced use of social services
The Mismatch Between Opportunity and Investment
0
2000000
4000000
6000000
8000000
10000000
12000000
Early Childhood Primary Secondary Tertiary
Education levels
Inve
stm
en
t
Brain's Malleability
Government Expenditure
Rates of Return to Human Development Investment Across all Ages
Pre-school Programs
School
Job Training
ReturnPer $Invested
R
2
4
6
8
0 6 18Age
Pre-School School Post School
Adapted from Founders’ Network (Carneiro, Heckman, Human Capital Policy, 2003)
THE CROSS-SECTORAL OR INTER-SECTORAL APPROACH TO ECD:
Experience from Jamaica and Colombia
Physical Health SDG3
Nutrition SDG 2
Nurture
(Socio-Emotional)
SDG3
Stimulation/ Development/
Education SDG 4
Protection SDG16
Public Health
(Water/ Sanitation)
SDG 6
Socio-Economic
Environment
(Standard of Living)
SDG1,8,9,10, 11,17
Physical, Chemical and
Built Environment
SDG 7,12,13,14,15
Preschools
Chaos (Slide from CECD)
Child care
Parenting centres
Children’s mental health centres
Kindergartens
Local school authorities
Public health
Munici-palities
Community
servicesParks &
recreation
Early interventionHealth Social
servicesEducation Family
support
ECC:Policy
frameworkand NSP
Early intervention
Coherence (Slide adapted from CECD)
Positive Child Outcomes
Family support
Education
Health
Social services
CROSS-SECTORAL ECD APPROACH: JAMAICA I
DEVELOPING THE STRATEGY
Establishment of a co-ordinating cross-sectoral agency (2003)
Development of the vision
Identification of existing resources, information sources and gaps
Conduct of studies to fill information gaps
Consultation with all stakeholders
Development of cross-sectoral Strategic Plan, including costing
Development of Implementation, Monitoring and Evaluation
Strategies
Development of Financing Strategies
EARLY CHILDHOOD DEVELOPMENT SECTOR
STRATEGY MAP – OCTOBER 2007
Natio
nal im
pact
Cu
stom
er
satis
factio
n
Key p
roce
sses
Work
ing e
nviro
nm
en
t
I1. Critical thinking,
socially competent,
healthy children
ready for life
I2. Fathers, mothers, guardians
are involved and satisfied with
services provided to their
children
I2. Parents are
informed, educated,
involved and
supported in meeting
early childhood
development needs
I1. Our children’s
special needs are
taken care of
IP1:
Effective
parenting
education
and
support
IP2:
Effective
preventive
health care
IP3:
Effective
screening,
diagnosis
and
intervention
for “at risk”
IP4: Safe
learner
centred
well-
maintained
EC
facilities
LG1: The sector and sector
agencies are achieveing targets
and are governed by
frameworks that promote
achieving results in a
consultative environment
LG2:
Timely clear and current information
to support evidence based decision
making
IP5:
Effective
curriculum
delivery by
trained early
childhood
practitioners
CROSS-SECTORAL ECD APPROACH: COLUMBIA I
Established an ECD Commission (Comisión Intersectorial de Atención Integral
en Primera Infancia- CIPI)
Reports to nation’s Parliament (True Cross-Sectoral Approach!!!)
Developed a national multi-sectoral Strategy for ECD (De Cero a Siempre)
through the following mechanisms:
Establishment of a multi-sector committee and multi-sector governance
arrangements to support coordination of the Commission's work across sectors
and levels of government;
Development of tools for strategy implementation
Operations Manual for local level implementation of the Strategy
Framework for the design of a Monitoring and Evaluation (M&E) system;
CROSS-SECTORAL ECD APPROACH: COLUMBIA II
Promotion of accountability through the development of quality standards
for ECD Centers and the design of a municipal-level tracking tool for ECD
services;
International benchmarking (SABER-ECD) and sharing best practices, which
assisted officials in assessing Colombia’s ECD policies and provided
recommendations for moving forward; and
South-South Knowledge Exchange: Chile to Colombia; Colombia to Bolivia
and Nicaragua
ECD SUCCESSES AND CHALLENGES:
LAC REGION
ENROLMENT OF CHILDREN 0-2 YRS. IN
DAY-CARE
PRE-SCHOOL ENROLMENT BY REGION
1999-2015
(UNESCO, GMR 2015)
OVERVIEW OF ECD SERVICES IN LAC: FINDINGS I
In depth review of 42 publicly funded programmes for children 0-3 in 19
countries in LAC
34 (85%) were centre based, 5 (15%) were parenting programmes.
2 purely nutrition programmes were excluded
37 (93%) were in LA, 3 (7%) were in the Caribbean Parenting programmes
were reviewed in 4 countries and child care (centre based) in 15
Programme heterogeneity; Large small scale
Community and institutional
Funding variable; impacts quality
Fewer parenting programmes which predominate in rural areas
Movement away from community services to institutional
OVERVIEW OF ECD SERVICES IN LAC: FINDINGS II
Many programmes not comprehensive; nutrition often not included
Inadequate teaching models
Inadequately trained and poorly paid staff
Inadequate and poorly monitored standards
High child to caregiver ratios
High cost for quality programmes
CRITERIA FOR TARGETTING OF ECD
CENTRE-BASED PROGRAMMES IN LAC
SABER ECD ASSESSMENTS LAC
VIOLENT CHILD DISCIPLINE
Children experiencing some type of violent child discipline in the month preceding the
survey% children between ages 2 and 4. (*)
Source: MICS except Haiti (DHS)
Violent child discipline methods in the household are very widespread in the region.
Two out of every three children between 2 and 4 regularly experience some kind of
violent discipline (psychological aggression or corporal punishment) in the home.
69
10 20 30 40 50 60 70 80 90
Cuba
Panama
Costa Rica
Uruguay
El Salvador
Rep.Dominicana
Saint Lucia
Belize
Guyana
Argentina
T&T
Barbados
Jamaica
Haiti
Suriname
Media Regional
CORPORAL PUNISHMENT
Corporal punishment is generalized in the region (1 of every 2 children are suffering from it).
5% of the under-5s are victims of severe physical punishment. Children living in the Caribbean
are more likely to be victims of physical punishment than those living in other sub-regions.
Children experiencing corporal punishment in the month preceding the survey% of children between 2 and 4 years. (*)
556
10 20 30 40 50 60 70 80
Cuba
Panama
Uruguay
Costa Rica
Rep.Dominicana
Saint Lucia
Argentina
El Salvador
T&T
Guyana
Belize
Suriname
Barbados
Jamaica
Haiti
Media Regional
cualquiera
severo
Source: MICS excepto Haiti (DHS)
Any
Severe
NON-VIOLENT DISCIPLINE
Children experiencing exclusively non-violent discipline in the month preceding the survey . (*)
Children under 5 subject only to non-violent disciplinary measures are a minority in LAC: on
average only 2 out of every 10 for the LAC countries with available information. Costa Rica,
Uruguay, Panama and Cuba are where the exclusive use of non-violent methods is most
common, tripling the figures from the countries of the Caribbean.
Source: MICS except Haiti (DHS)
21
0 5 10 15 20 25 30 35 40
Suriname
Haiti
Jamaica
Barbados
Saint Lucia
Rep.Dom.
T&T
Guyana
Argentina
Belize
El Salvador
Panama
Cuba
Uruguay
Costa Rica
Media Regional
A TRAJECTORY OF LAC CHILDHOOD :
A SECOND LOOK
Let us look again at those challenging pre-school children:
Did we provide their parents or caregivers with the supports they
needed to promote their development particularly 0-3 yrs?
Did we ensure their early childhood centres were of the highest quality
through appropriate standards?
Did any of the more challenging children have child or social protection
challenges that were missed?
Were any of them of low birth weight or did they have any other physical
health challenges?
Did we identify and provide intervention for early developmental or
behavioural disorders / disabilities?
CONCLUSIONS I
Inadequate attention to the early years results in
immediate consequences of children who fail to reach
academic, socio-emotional and health potential, and who
therefore become a challenge to society.
Inadequate attention to the early years results in long
term consequences of adults who fail to reach
educational and social potential
CONCLUSIONS IIThere is economic advantage to addressing the needs of young
children
LAC countries must address the needs of young children
comprehensively if we are to impact current problems of violence,
low academic attainment and low productivity
Our greatest challenges are in addressing needs of the 0-3 year
olds, social protection (poverty), child protection (violence), and
the needs of rural and minority children and those with disabilities.
CONCLUSIONS III
This is best done through a cross-sectoral approach
Our LAC children are depending on us to get it right for
them. They cannot do it themselves.