1. First 1000 Days of Life – Window of Opportunity for Brain Development
Sept 10, 2018
Karakoram International University,
Gilgit – Baltistan
Dr. Ghazala Rafique
Aga Khan University

2. Situation of children – Under 5
In low and middle-income countries
43% at risk of not achieving development potential
75 million live in areas affected by conflict, exposed to toxic stress, potentially inhibiting brain cell connections
155 million are stunted, which prevents brain development
25% of 2-4 year olds (in 64 countries) do not have opportunities essential for brain development such as playing, reading and singing
300 million live in areas with toxic air, which can damage their developing brains
Early moments Matter –UNICEF for every child 2017
April 17, 2019

3. Why Early Child Development is Important?
What happens early affects all aspects of a child’s development
First 1,000 days of life have a profound impact on brain development
Nurturing relationships in the early years are critical
Toxic stress has a negative impact on a child’s development
Early interventions are critical for optimal life course outcomes
April 17, 2019

4. The First 1,000 Days of Life = + +
The first 1000 days beginning at the time of conception on to a baby’s second birthday
First
Pregnancy
Year 1
Year 2
1000
270
365
365 = + +
Days
Days
Days
Days
April 17, 2019

5. Brain Development Born with 100 billion brain cells
All the neurons have the same genetic potential
Our brain is Sensitive and Reactive and further development of connections is dependent on stimuli from the sensory pathways
Upto15,000 synaptic connections may be established for each cell
Signals can be sent to other cells at speeds of more than 200 mph
70% of brain development occurs by age 1 and 80% by age 3
April 17, 2019

6. Brain Architecture Builds over Time
Neural Circuits are Wired in a Bottom-Up Sequence (700 synapses formed per second in the early years)
Language
Higher Cognitive Function
Sensory Pathways
(Vision, Hearing)
FIRST FIVE YEARS
Years
Months
April 17, 2019
Source: C.A. Nelson (2000) 6

7. Experience shapes Brain Architecture (overproduction followed by pruning)
Human Brain at Birth
14 Years Old
6 Years Old
April 17, 2019

8. Experiences shape Brain Architecture
VideoExperiencesBuildBrainArchitecture.mp4
April 17, 2019

9. ‘Serve and Return’ Relationship
The interactive influences of genes and experience shape the developing brain
Brain development occurs through the brain’s active engagement in everyday experience
Major ingredient in the developmental process is the ‘Serve and Return’ interactions
April 17, 2019

10. Experience-based brain development
genes
brain
learning
health
epigenetics
behaviour
experience
physical environment
nurturing
nutrition

11. The Plasticity of Brain Architecture Decreases over Time
Brain has more plasticity in early years and its capacity for change decreases with age
Accommodates a wide range of environments and interaction during early years
Early Plasticity makes the brain both more vulnerable to harm and more capable of recovery
Window of opportunity for different type of skills
April 17, 2019

12. `Sensitive Periods’ in Early Brain Development
“Pre-school” years
School years
High
`Numbers’
Peer social skills
Sensitivity
Symbol
Language
Habitual ways of responding
Emotional control
Vision
Hearing
Adapted from Nash, 1997; Early Years Study, 1999; Shonkoff, 2000
Low 1 2 3 4 5 6 7
Years

13. Neglect Impedes Brain Development
Limited exposure to language, touch or social interactions
Emotional or cognitive neglect
Physical Threat
Early, frequent and intense threat
Structural Changes
Lack of brain growth beyond effects of poor nutrition
Neuronal death beyond “pruning”
April 17, 2019

14. Disparities in Early Vocabulary Growth
1200
1000
Children of College Educated
800
Children of Lower Middle Class
Cumulative Vocabulary (Words)
600
Children of Parents in Poverty
400
200
16 mos.
24 mos.
36 mos.
Child’s Age (Months)
Source: Hart & Risley (1995)

15. Stress and Development
Important to development & in the context of stable and supportive relationships
Potentially disruptive, but buffered by supportive relationships & safe environments
Disrupts brain architecture, increases the risk of stress-related physical and mental illness
Positive
Tolerable
Toxic
April 17, 2019

16. Early Childhood Stress Influences Brain Development
April 17, 2019

17. Rates of Return to Human Development Investment Across all Ages
‘Policy makers should invest in young children where the return on investment is stronger than in low-skilled adults’
James Heckman, a Nobel-prize winning economist
April 17, 2019

18. A nation is only as good as its children – let us invest in our future by investing in Early Child Development
April 17, 2019

19. Thank you
April 17, 2019