II Workshop Internacional - Evaluation Early Human Development

Second Annual Workshop of Fundacao Maria Cecilia Souto Vidigal (1st presentation)

Sao Paulo, Brazil

Evaluation of Early Human Development

By J. Fraser Mustard The Founders’ Network Founding Chairman Council for Early Child Development October 3, 2008

Presentation Socioeconomic gradients in health and literacy.

Experience-based brain development in the early years and the effects on health, learning, and behaviour.

Early human development – outcome measures.

Success by Ten

97-044

The Mismatch Between Opportunity and Investment Brain's "Malleability" Spending on Health, Education and Welfare

0

3

10

Age

70

03-076

CIAR - History Population Health Human Development

Experience-based Brain and Biological Development

91-068

Cumulative Mortality

U.K. CIVIL SERVICE Mortality - All Causes 16

Other

12

Clerical Professional/ Executive

8

4 Administrative 0 0

2

4

6

Year of Follow-up

8

10

Socioeconomic Gradients for Adult Document Literacy Scores (16 to 65)

06-114

Mean Scores

350 310 Intern’l Mean

U.S. 270

Canada Australia

230

Sweden Finland

190

Chile 0 3

5

7

9

11

13

15

Parents’ Education (years)

17

19 OECD, 2000

04-147

Life Expectancy & Literacy Life Expectancy at Birth

80 78 76 74 72 70 0

20

40

60

Percent at Levels 1 and 2

80

100 OECD

Health Gradients

06-008

AGES

Health Status

2.25

13 - 17 9 - 12 4-8 0-3

2.00

1.75

1.5

8

9

Income

10

11

National Health Interview Survey (1986 – 1995) in Case, 2002

03-080

Experience-Based Brain development in the early years of life sets neurological and biological pathways that affect throughout life:

Health Learning (literacy) Behaviour

08-039

Why do we care about brains?

You are your brain.

BUT Your brain is not just produced by your genes.

Your brain is sculpted by a lifetime of experiences. The most important time in brain development is the first few years of life.

Kolb, U Lethbridge

08-026

What is experience?

Everything that you encounter both pre- and postnatally as well as in adulthood‌ Examples: sounds, touch, vision, smell, food, thoughts, drugs, injury, disease‌ Kolb, U Lethbridge

Does Experience have the Same Effects on Brain Development at Different Times in Life?

08-029

No !

There are qualitative differences at different stages of life.

There is something fundamentally different prenatally vs infancy vs juvenile vs adult.

One difference is gene expression.

Kolb, U Lethbridge

04-039

Two Neurons Axon

RECIPIENT NEURON

Synapse

SIGNALSENDING NEURON

Dendrite

03-079

Vision and Hearing Critical Period Eye cataracts at birth prevent normal development of vision neurons in the occipital cortex (Hubel and Wiesel)

Cochlear defects at birth impair hearing development (Rauschecker and O’Donoghue)

07-123

Brain Pathways “Higher levels of brain circuits depend on precise, reliable information from lower levels in order to accomplish their function.

Sensitive periods for development of lower level circuits ends early in life.

High level circuits remain plastic for a longer period.�

Knudsen 2004

01-003

Human Brain Development – Language and Cognition

Language Sensing Pathways (vision, hearing)

-6

-3

3 0 Months

6

9

Higher Cognitive Function

1

4

8 12 Years

16

AGE C. Nelson, in From Neurons to Neighborhoods, 2000.

04-200

Early Child Development and Language Starts early – first 7 months

Sets capability for mastering multiple languages Sets literacy and language trajectories

02-001

Vocabulary Growth – First 3 Years

Vocabulary 1200

High SES Middle SES

600

Low SES

0

12

16

20 24 28 32 36 B. Hart & T. Risley, Meaningful Differences in Everyday Age - Months Experiences of Young American Children, 1995

04-146

Test of Language Development (TOLD) at Age 9 Correlation between vocabulary growth at Age 3 and TOLD at Age 9.

0.74

07-105

Health, Behaviour and Limbic HPA Pathway

Allostasis & Allostatic Load (Stress)

03-002

Emotional Stimulus

Amygdala

+

+

Hippocampus

Hypothalamus

-

-

PVN

Cortisol

Cortisol CRF

PIT ACTH

Adrenal Cortex LeDoux, Synaptic Self

05-212

Limbic HPA Pathway - Stress Cortisol – Over Production Behaviour, depression, diabetes, malnutrition, cardiovascular disease, memory, immune system, drug and alcohol addiction

Cortisol – Under Production Chronic fatigue syndrome, fibromyalgia, immune system (autoimmune disorders) rheumatoid arthritis, allergies, asthma

08-109

Epigenetics – Regulation of Normal Gene Function Nature and Nurture Epigenetics

MicroRNAs

Chuang & Jones, Pediatric Research, 2007.

05-059

Rats – Gene Methylation

Cytosine-Methylation

1.2

0.8

Licking Low

0.4

Licking High 0

Embryo

Birth

Pup

Weaning

Adult

Day 20

Day 1

Day 6

Day 21

Day 90

Age

M. Szyf

Serotonin Transporter Gene Experience in Early Life Depression 03-089 Age 26

Depression Risk .70

S = Short Allele L = Long Allele

SS

.50

SL

.30

LL No Abuse

Moderate Abuse Severe Abuse

Early Childhood

A. Caspi, Science, 18 July 2003, Vol 301.

07-001 Experience and Brain Architecture and Function Early

Affects gene expression and neural pathways

Shapes emotion, regulates temperament and social development Shapes perceptual and cognitive ability Shapes physical and mental health and behaviour in adult life

Shapes physical activity (e.g. skiing, swimming, etc.)

Shapes language and literacy capability

EARLY BRAIN and HUMAN DEVELOPMENT Outcome Measures a) Neurobiology - Cortisol – Epigenetics – Imaging b) Brain functions – Population-based

Pregnancy Age 0 - 18 months

Age 0 – 5/6 years - EDI

EDI is a crude macro measure of early brain development

03-085

Early Development Instrument (EDI) Physical health, activity, and well-being

Social knowledge and competence Emotional health/maturity

Language and cognitive development Communication skills and general knowledge

08-124

Physical Health, Physical Activity and Well-being This is a measure of brain development in connection with how it affects physical health, physical activity, coordination and well-being.

08-125

Social Competence Social competence includes ability to get along with others, respect for adults, self confidence, ability to control own behaviour, follow routines and capable of pro-social behaviour.

08-126

Emotional Maturity Emotional maturity includes the ability to reflect before acting, the ability to concentrate, and is often helpful to other children.

08-127

Language and Cognitive Development

This includes interest in books, reading and writing, rudimentary mathematics, ability to count and recognize numbers and geometric shapes.

08-128

Communication and General Knowledge

This includes communication skills such as telling a story, and having knowledge about the world around them, and being able to communicate with children and adults.

08-129

EDI Vulnerable Children

Score in the bottom 10% of any of the five assessments.

Canada – EDI Children 5-6 yrs

07-026

% Vulnerable

30

20

10

0

Q1

Q2

Q3 SES - Income

Q4

Adapted from NLSCY/UEY 1999-2000; EDI 1999-2000

NLSCY

Vulnerable Children Aged 4 to 6 – 07-085

07-080 07-080

Prevalence of Vulnerable Children

Ontario - NLSCY 1994-1998 40 30 1996 1994

20

1998

10 0

-1.5 -1.0 -0.5 0.0

0.5

1.0

Socioeconomic Status

1.5

08-130

British Columbia by District District

% vulnerable on one test

Kootenay W. Vancouver Kootenay Lake Boundary Richmond Vancouver Prince Rupert

13.3 14.1 18.1 18.6 26.7 37.9 39.6

Families’ Income 58,000 90,000 45,000 43,000 58,000 51,000 55,000

Australia – AEDI Children 5-6 yrs.

07-027

% Vulnerable

40

30

20

10

Q1

Q2

Q3 Q4 SES - Income

Q5

Q6

06-060

Proportion of Vulnerable Children Age 5, Perth - AEDI Suburb Canningvale Thornlie Huntingdale Gosnells Langford Maddington

SES 5 4 4 3 2 1

Vulnerability 1 test 2 tests 17.6 17.8 20.0 27.6 39.3 46.9

7.8 10.9 8.4 10.0 19.6 29.7 Adapted from

Brinkman, 2006

07-063

AEDI Results - SA % Vulnerable on 1 or more Test Roxby Downs Port Augusta

15.6 43.1

Ingle Farm Salisbury East

32.5 16.9

Alberton Croydon Park Seaton

10.5 43.3 50.0

06-149

Vancouver EDI Reading # of EDI Vulnerabilities

0 1 2-3 4-5

% Failing Grade 4

13.6 26.7 29.5 48.4

% Not Passing Grade 4

17.8 33.9 43.1 68.3

Hertzman, HELP, 2006

06-148

Vancouver EDI Numeracy # of Vulnerabilities

% Failing Grade 4

% Not Passing Grade 4

0 1 2-3 4-5

7.5 11.8 18.7 27.5

12.3 22.2 33.8 55.6

Hertzman, HELP, 2006

Math Scores, Ages 5-14

08-089

standardised mathematics score

(High SES) 2

0 median s -2

5

6

8

10

12

14

Students’s age

NZ Council for Educational Research

Math Scores, Ages 5-14

08-090

(Low SES)

standardised mathematics score

2

0

medians

-2

-4

5

6

8

10

12

14

student's age

NZ Council for Educational Research

07-204

Decrease in the % of vulnerable children in middle class districts as a result of improved ECD in Western Australia

Year District

2003 2006 Vulnerable on one test

Floreat

47.22%

14.3%

Wembley

47.11%

11.8% AEDI

06-001

Success by Ten Early Child Development Intervene early Intervene often

Intervene effectively Ludwig and Sawhill, Brookings Institution

08-031

A “Natural� Experiment: Romanian Orphans Adopted

Children adopted after 8 months of age 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) Kolb, U Lethbridge

08-010

Romania – BEIP Project The cognitive outcome of children who remained in the orphanages was markedly below that of non orphanage children and children taken out of the orphanage and placed in foster care.

Nelson et al. 2007. Science, v. 318

04-153

Abecedarian Study – Reading Effect Size 1.2

Primary Grades

Preschool

Preschool & Primary Grades

0.8

0.4

0

Age 8

Age 12

Age 15

Age at Testing

Age 21

Rates of Return to Human Development Investment Across all Ages 8

6

Pre-school Programs

Return Per $ Invested 4

School R

Job Training

2 PreSchool

0

6

School

Post School

18

Age

03-074

WHO – Marmot Commission on Social Determinants of Health

08-113

Chapter 5 – Equity from the Start Recommendation 5.2: Governments build universal coverage of a comprehensive package of quality early child development programmes and services for children, mothers, and other caregivers, regardless of ability to pay.

01-050

The principle of free education for school-age children is already entrenched throughout the rich world; there would be nothing incongruous about extending it further down the age range.

The Economist, pg 16, July 18, 1998

01-039

www.founders.net To download this presentation, go to: Slides - Slide Shows

References Mustard, J.F. Early child development and experience-based brain development: the scientific underpinnings of the importance of early child development. Washington: The Brookings Institution. 2006. Available at: www.founders.net McCain, M.N., J.F. Mustard and S. Shanker. Early Years Study 2: Putting Science into Action. Toronto: Council for Early Child Development. 2007. www.councilecd.ca Mustard, J.F. Investing in the Early Years: Closing the gap between what we know and what we do. Adelaide: State of South Australia. 2008. www.thinkers.sa.gov.au Mustard, J.F. Literacy: Passport to Prosperity. Council of Ministers of Education, Canada. Pan-Canadian Interactive Literacy Forum. 2008. http://literacy.cmec.ca/