Early Child Development – Outcome Measures · Centre of Excellence for Early Childhood...
Transcript of Early Child Development – Outcome Measures · Centre of Excellence for Early Childhood...
By J. Fraser MustardFounding President, CIAR
April 26, 2006
Early Child Development –Outcome Measures
Measuring Early Child Development
Vaudreuil, Quebec
Centre of Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006
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CIAR Programs
Population Health
Human Development
Economic Growth
Centre of Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006
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HealthLearningBehaviour
Experience-Based Brain Development in the early years of life sets neurological and biological pathways that affect:
Centre of Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006
Population OutcomesSES Gradients
Health – physical and mental
Literacy – language
Behaviour
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Centre of Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006
Can be steep or shallow [No threshold]
At the lowest SES position, many still do well inrespect to health, education and learning
Not simply a socioeconomic question
Is a social environment issue
Is a community support issue
Gradients98-032
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NEUROSCIENCE
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The Hostage Brain , Bruce S. McEwen and Harold M. Schmeck, Jr., 1994.Centre of Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006
SIGNAL-SENDING NEURON
RECIPIENT NEURON
Synapse
Dendrite
Axon
Two Neurons04-039
Centre of Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006
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Experience and Brain Development
Stimuli in early life switch on genetic pathways that differentiate neuron function – critical and sensitive periods.
From studies in humans, monkeys and rats
Stimuli affect the formation of the connections (synapses) among the billions of neurons (sensitive periods).The brain pathways that affect literacy, behaviour, and health form early.
Centre of Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006
0 1 4 8 12 16
AGE
Human Brain Development –Synapse Formation
SensingPathways
(vision, hearing)
LanguageHigherCognitive Function
3 6 9-3-6Months Years
C. Nelson, in From Neurons to Neighborhoods, 2000.
Con
c ept
ion
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Centre of Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006
03-012 Synaptic Density
Rethinking the Brain, Families and Work Institute, Rima Shore, 1997.
At Birth 6 Years Old 14 Years Old
Centre of Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006
EmotionalStimulus
PIT
Cortisol CortisolCRF
ACTH
Amygdala Hippocampus
AdrenalCortex
HypothalamusPVN
+ + - -
LeDoux, Synaptic Self
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Centre of Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006
Limbic HPA Pathway - Stress
Cortisol – Over ProductionBehaviour, 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
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Epigenetics and Brain Plasticity
Experience and methylation of DNA
Imprints environmental experiences on the fixed genome
Maternal behaviour affects DNA methylation
Can be transmitted to offspring
Centre of Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006
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Serotonin Gene, Experience,and Depression
Age 26
No Abuse Moderate Abuse Severe Abuse
.30
.50
.70
A. Caspi, Science, 18 July 2003, Vol 301.
Depression Risk
LL
SS
SL
S = Short Allele L = Long Allele
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HEALTH
Centre of Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006
Swedish Longitudinal Study – ECD 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
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Health Problems Related to Early Life
Coronary Heart DiseaseNon-insulin Dependent DiabetesObesityBlood PressureAging and Memory LossMental Health (depression)
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"Follow up through life of successive samples of birth has pointed to the crucial influence of early life on subsequent mental and physical health and development."
Acheson, Donald -,1998
Independent Inquiry intoInequalities in Health
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BEHAVIOUR
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Stress Pathway and Sensory Stimuli
Touch in the Early Period is Critical
Rats – Mothers licking pups
Monkeys – Peer vs mother rearing
Humans - Attachment
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Martin TeicherScientific American, 2002
"The aftermath … can appear as depression, anxiety, suicidal thoughts or post-traumatic stress - or as aggression, impulsiveness, delinquency, hyperactivity or substance abuse."
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Substance Abuse and Childhood Abuse
0 1.0 1.01 2.7 2.02 2.9 4.03 3.6 4.94+ 4.7 7.4
Exposure to Child Abuse *
Odds Ratios for Drug and Alcohol Use
Drugs Alcohol
Scale: 0 none4 intense
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Significant correlation with registeredcriminality (teenage) appeared for languagedevelopment at 6, 18, and 24 months
Early Brain Development and Criminal Behaviour
Stattin, H. et al -Journal of Abnormal 102; 369, 1993Psychology
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LITERACY
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Centre of Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006
Early Child Development –Language and Health
Starts early – first 12 months
Sets capability for mastering multiple languages
Sets literacy and language trajectoryShares neural pathways influencing health
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01-040 Levels of Literacy:A Reflection of ECD
Level 1:
Level 2:
Level 3:
Level 4 and 5:
indicates persons with very poor skills.
people can deal with material thatis simple
is considered a suitable minimum forcoping with the demands of everyday life
describe people who demonstratecommand of higher-order processing skills
Centre of Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006
0 1 2-1-2
MNABSK
QC
ON BCNS
PENB
NF
socioeconomic status
0
0.5
1
-0.5
Literacy and SES Gradients for Youth by Province 1994
literacyscore
(adjusted)
J. Douglas Willms, "Literacy Skills of Canadian Youth"Atlantic Centre for Policy Reseach in Education, Universityof New Brunswick, October 21, 1996. Prepared for Statistics Canada.
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Chile
Canada
Netherlands
Sweden
170
190
210
230
250
270
290
310
330
350
0 5 10 15 20
InternationalMean
Mean scores
Parents’ Education (years)
SocioeconomicGradients forDocumentLiteracy Scores
OECDCentre of Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006
Life Expectancy & Literacy
70
78
76
74
72
80
200 40 60 10080Percent at Literacy Levels 1 and 2
Centre of Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006
Life
Exp
ecta
ncy
at B
irth
(yrs
)
OECD
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Literacy Levels for the Total Population – USA
0
5
10
15
20
25
30
35
1 2 3 4 5
Perc
ent
Level NALS, p. 17, 2002
Prose
Document
Quantitative
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Literacy Levels by Physical, Mental or Other Health Conditions – USA (Quantitative)
0
10
20
30
40
50
60
1 2 3 4 5
Perc
ent
Level NALS, p. 44, 2002
Health Problems
Mental or Emotional Problems
Long-term Illness
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Percentages of Adults in Poverty, by Literacy Level – USA (Prose)
0 10 20 30 40 50
5
4
3
2
1
Percent
Leve
l
NALS, p. 61, 2002
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Human Studies
Observational studies
Cross-sectional studies
Longitudinal studies
Interventions
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Romanian Adoption Project – B.C.Scores at 10.5 Years
CB EA LA
IQ 108 99 85
Language Score 106 99 88
Behaviour 13% 9% 43%
CB - Canadian BornEA - Early Adopted (within 4 months)LA - Late Adopted (8 months or later) L. Le Mare
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-1.2
-1
-0.8
-0.6
-0.4
-0.2
0 10 20 30 40 50
Months of Orphanage Rearing
Log1
0 S
aliv
ary
Cor
tisol
*linear trendline
Evening Cortisol Levels Increase withMonths of Orphanage Rearing *
Centre of Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006
1958 British Birth CohortAge 45
Cortisol pathway response in adults correlates with quality of ECD.
Children with poor math skills at 7-16 years have dysfunctional cortisol secretion patterns at age 45.
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Power and HertzmanCentre of Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006
Abecedarian Study – Reading
Age 8 Age 12 Age 15 Age 21Age at Testing
0
1.2
0.8
0.4
Effect Size PrimaryGrades
Preschool Preschool &Primary Grades
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EARLY CHILD DEVELOPMENT
PROGRAMS
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Early Child Developmentand Parenting Centres
Offer from conception to school entry
Role of health professionals
Learn parenting by doing
Provide non-parental care
Link to Children’s Services as needed
Integrate with primary schools
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OUTCOMEMEASURES
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-1.5 -1.0 -0.5 0.0 0.5 1.0 1.5Socioeconomic Status
0
10
20
30
40
Vulnerable Children Aged 4 to 6 –NLSCY 1998
Rest of Canada
Ontario
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Prevalence of Vulnerable
Children
Centre of Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006
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Physical health and well-being
Communication skills and generalknowledge
Social knowledge and competence
Emotional health/maturity
Language and cognitive development
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Measures of Early Child Development (EDI)
Predict learning (populations)
Predict behaviour (populations)
Physical and mental health
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Percentage of Children in Kindergarten Scoringin Bottom 10% by District - Vancouver
EDI, February 2000
15%
8.5%
21.5%
27.5%
34.5%
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Centre of Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006
EDI Results – Vancouver Districts
District Income EDI Results$ % scoring in bottom 10%
1 12,000-24,000 34.5
2 24,000-37,000 27.53 37,000-49,000 21.54 49,000-62,000 15.05 62,000-74,000 8.5
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Centre of Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006
Vancouver Grade 4 and Grade 7 Tests
Proportion of children failing to meet Grade 4 and Grade 7 test standards correlates strongly with proportion of children vulnerable on the EDI index at time of school entry.
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Earlier Development Measures
18 Months (family physicians and Public Health)
Salivary sterols
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Integrated Population Data RecordBritish Columbia and Manitoba
Pregnancy
Birth and infancy
Development (ECD)
Education
Adult health and well-being
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Heckman
• Adverse family environments promote adult failure.
• Major economic and social problems can be traced to low levels of skill and ability in the population.
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Integrated - ECD
Human Development
EconomicGrowth
Education Health SocialCapital Equality
Van der Gaag, World BankCentre of Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006
Human Evolution and the Continuing Evolution of Civilizations
Improve health and well-being of populations.
Improve ability and competence of populations.
Establishing sustainable, tolerant, pluralistic, societies.
Equity in literacy and income.
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www.founders.net
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Centre of Excellence for Early Childhood Development, Vaudreuil (Québec) April 26-28, 2006