More than Just Stimulating Minds

The importance of early years experience on the developing brain and children's developmental trajectories is a message the science community has long sent – and it's a message that has been well received by policy and practice over the past decade. Indeed, the upsurge in pre-school provision such as Head Start in the US and Sure Start in the UK indicates the importance placed on early years by policy makers.

Early years education represents an important step forward in thinking. But if such provision is to generate real reductions in achievement gaps between deprived children and their better-off counterparts, such endeavors will need to go further than providing educational stimulation to these young children – they will also need to protect their developing brains.

This was the message conveyed by Jack Shonkoff, the director of the Center on the Developing Child at Harvard University, in a recent Science article. More than four decades of evaluation have generated ample evidence that early years programs targeting disadvantaged children do work. These interventions can indeed improve educational achievement, lifelong health and economic prosperity. However, this provision is far from a panacea, producing, at best, only modest effects.

Shonkoff claims this modest impact may be improved if early years programs enhance their focus on stimulating children and educating parents – by adding interventions to prevent, reduce or mitigate the impact of toxic stress on the developing brain.

"Toxic stress" comes from home environments that burden children with adversity, the result of which is an over-activation of the stress response system. Chronic over-stimulation of this system impairs how developing brain circuitry matures, from a remarkably early age.

Recurrent, high levels of stress affect the developing circuits in the brain regions of the hippocampus and amygdala, which can lead to emotional problems such as anxiety. Advances in neurobiology have shown the connection between poor wiring in these systems and later problems in the development of the pre-frontal cortex, which is the area of the brain responsible for cognitive abilities. Therefore, if the foundations of brain development are poorly laid, the later cognitive structures will also be shaky. The chain runs from early adversity, through emotional problems, to impaired cognitive functions such as poor memory, poor mental flexibility, and poor control of inhibitions – all of which culminates in poor educational and employment outcomes.

In the real world, this brain development chain means that disadvantaged children often enter pre-school with more emotional difficulties, disruptive behaviors, and learning difficulties associated with impaired functioning. Focusing these children's education exclusively on cognitive and linguistic skills will go only a little way toward mitigating their neurobiological problems, Shonkoff claims.

Instead, collaboration between scientists, practitioners and policy makers could set out a new and more effective intervention agenda, Shonkoff suggests. This new agenda would need, as he puts it, an "enhanced theory of change," which would use leaning from neurobiology to guide intervention. This new approach would provide a two-pronged attack, making greater use of protective interventions to help children, their parents, and their carers cope with stress, as well as providing the cognitive-linguistic stimulation these children need to catch up.

For instance, parenting has been a point of intervention for many programs. Shonkoff suggests that simply providing information and advice to parents does not go far enough. Future parenting support needs to include efforts to improve parents' mental health and cognitive skills such as self-regulation. These interventions with vulnerable parents could begin as early as pregnancy in order to improve the stability of children's environments, which in turn protects children's developing brains. While evidence has shown that mental health and self-regulation interventions can work with adults, the effectiveness for children of enhancing their mother's stress-buffering skills remains under-researched territory.

Shonkoff also points to research indicating that many staff who provide early years care and education have high levels of depression, limited education, and constrained work experience, along with other indications of burn out. These highly stressed staff may be passing along their stress to the children in their care. Similar to interventions with high-risk parents, professional development should seek to improve the emotional and regulatory capacity of these service providers, improving the stability of children's out-of-home environment, and in turn reducing the risk that toxic stress will damage young children's developing brains.

Interventions that build adult caregivers' capacity to reduce or prevent disruption in the developing brains of children can, especially for parents, start protecting children right from birth. Indeed, starting early is crucial, Shonkoff argues. While "early years" preschool provision for under-4s is a good start, "age 4 cannot be characterized as ‘early' with respect to brain development," he says. "For children in adverse environments, four years of inaction in the face of repeated threats to developing brain architecture are difficult to justify."

This article was originally published by Prevention Action.