In myriad ways, early childhood charts course for life to come

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December 24, 2014

In 1988, the Rev. Robert L. Fulghum published an instantly famous title you’ve heard about, even if you haven’t read the book: ''All I Really Need to Know I Learned in Kindergarten: Uncommon Thoughts on Common Things.'' The collection’s eponymous essay put into wide circulation the idea that the life truths that matter most are absorbed amid the controlled chaos of sandboxes and sing-alongs.

But we’ve also seen a wealth of research in recent years that suggests the very qualities that allow kindergarteners to self-regulate and learn are deeply shaped by the preceding years, when brain circuits are multiplying at rates more commonly associated with bacteria or insects. As the calendar winds to a close, it’s worth taking a quick look back at some of the research from the past year that enlarged our understanding of the ways in which childhood exerts an enduring influence on lifelong health (with no claims to completeness).

Perhaps no research center has done more to explain the emerging science behind the first few years of life than Harvard’s Center on the Developing Child. (The center’s site is a goldmine for journalists seeking overviews on the latest research on topics such as toxic stress and early brain development.)

In recent years, the center’s director, Dr. Jack Shonkoff, has repeatedly spoken out to emphasize the importance of attentive parenting in forming young brains and heading off dangerous stress levels. The policy correlative, Shonkoff argued earlier this year, is a greater investment in programs that build up the life skills and capacities of adult parents and caregivers, on whom so much of a child’s well being depends.

In June, new research from Tulane University helped illustrate what can go wrong when parents are unable to buffer kids from trauma and toxic stress. Dr. Stacy S. Drury published a study that found that the more violence and disruption a kid witnessed, the shorter the length of the chromosomal tips in their DNA, known as telomeres. And girls were more likely to show shorter telomeres – one potential barometer of overall health – than boys. The research suggested that family trauma is registering down to the level of children’s DNA.

This year also saw the continued focus on early language acquisition. Last year, I wrote about research that found wealthier kids were on average about six months ahead of their poorer peers in language skills by age 2. This year, the word gap captured the president’s attention, even as new research suggested that the way in which parents talk to their young kids may matter more than how much they talk. Current efforts to boost kids’ early language exposure, such as Providence Talks, have largely focused on the quantity of words, rather than quality of conversations.

Mum parents may be bad, but an absent parent can be even worse. In August, a new study from UC Irvine sociologist Kristin Turney found that having a parent behind bars “is independently associated with learning disabilities, attention deficit disorder and attention deficit hyperactivity disorder, behavioral or conduct problems, developmental delays and speech or language problems.”

When it comes to disadvantaged children, research shows that high-quality early childhood programs can make a big difference in long-term health. Nobel Laureate James Heckman, a University of Chicago economist, published a big new study in March that found that kids who participated in the Abecedarian preschool project – the program mixed instruction and caregiving with health care and nutrition – had significantly lower risk of cardiovascular and metabolic disease in their mid-30s, compared to the control group.

Heckman followed that study up with “The Jamaican Study” in late May, which found that extremely disadvantaged children who participated in a home visiting program in Jamaica later earned 25 percent more than their peers in the control group.

But such interventions have yet to reach many disadvantaged kids. A huge longitudinal study from John Hopkins researchers, published in book form this summer, tracked nearly 800 Baltimore inner-city kids, from first grade to age 28 or 29. A family’s resources and strength tended to wield a huge influence over a child’s future, with disturbingly little social mobility. Out of 790 kids followed, only 33 moved from a low-income to higher-income bracket, while 19 went in the reverse direction.

In case you missed it

It’s now official — the Children’s Health Study has died before we ever truly knew it. And with it dies the data wonk’s dream of “the most comprehensive study of child health and development in the world,” as Princeton sociology professor Sara McLanahan cast it earlier this year.

Francis S. Collins, director of the National Institutes of Health, announced he was pulling the plug on the ill-fated study – designed to investigate how environmental factors shape children’s health – earlier this month. In June, he’d placed the study on hold until a team of experts could review whether it was still scientifically valid, as well as affordable, given budget constraints. They concluded the study, which would have tracked 100,000 children from the womb to age 21, is “not feasible.”

The study was projected to cost $1.5 billion for the first seven years alone, and Bloomberg reported that the study, which failed expectations during its “Vanguard” pilot phase in recent years, spent “about $1.3 billion since 2007 without it ever really getting off the ground.”

Recommended reading

The December issue of the policy journal Health Affairs is required reading for those on the children’s health beat. My colleague Kellie Schmitt already discussed one study from the issue that found that the ACA’s undefined pediatric essential health benefit has resulted in a patchwork quilt of coverage exclusions in states.

Adverse Childhood Experiences are a hot topic in children’s health these days, but potential solutions to combat the long-term health effects of childhood trauma are far less discussed. Elsewhere in the same issue, Christina Bethell of John Hopkins and colleagues help fill that gap with a study that suggests “building resilience” can help kids succeed in the wake of early traumas.

Check out the full range of articles here.

Photo by Che Rosales via Flickr.