1. Why Early Childhood Investment Matters Welcoming Remarks Jason Eberhart-Phillips, MD, MPH Kansas State Health Officer Kansas Birth to Five Administrator’s Conference September 29, 2009

2. Brains are Built on Early Experiences Neural growth is unbelievably rapid in young kids –700 new neural connections every second! –Sensory pathways peak first, then early language and higher cognitive functions But developmental gaps start to emerge early

3. Brain Growth Thrives on Interaction Normal brain development depends on a ‘serve and return’ relationship with loving caregivers –Young children reach out, interact with adults through babbling, facial expressions and gestures –Adults respond with similar vocalizing and gesturing When this is absent, or it is unreliable or inappropriate, the brain’s architecture doesn’t form properly ─ Disparities in learning ─ Problems with behavior

4. The Brain’s Capacity for Change This capacity is lifelong, but it decreases with age –The brain is most flexible or ‘plastic’ early in life –With time the wiring is less capable of reorganizing, of adapting to new or unexpected challenges –As we age it takes more effort to think in new ways Early plasticity means it is easier to influence a baby’s developing brain than to rewire circuits later in life

5. It’s All One in the Developing Brain Social, emotional, cognitive capabilities are intertwined –The brain is a highly integrated organ –Emotional well-being, social competence and emerging cognitive abilities are all highly inter-related –And each aspect depends on the others for the growth of healthy neural architecture Early adversity disrupts this

6. The Lasting Effects of Early Adversity Adult Depression As adverse events pile up, so does the risk of lifelong disease – both physical and mental Five or more early childhood adverse factors –Increase the risk of adult heart disease 2-fold –Increase the risk of adult depression 5-fold Similar impacts on alcoholism and drug abuse Adult Depression Adult Heart Disease

7. Stress and the Developing Brain The body’s stress response is life-preserving –But it was never meant to be activated continuously Stress hormones are helpful in the short-term –But chronically they damage the developing brain –They disrupt circuits in the hippocampus, destroying brain cells Chronic stress in early childhood – without the buffering protection of adult support – is toxic to the developing brain

8. Three Kinds of Stress Positive Stress – part of everyday life –First day at childcare, being told you have to nap Tolerable Stress – serious but temporary –An illness, or a disaster, with an adult seeing it through Toxic Stress – the stress response is always on

9. Early Experience is Built into Us For better or worse, unrelenting toxic stress from risk factors such as –Recurrent child abuse –Chronic neglect –Family violence –Paternal substance abuse –Severe maternal depression –Extreme poverty Leads to disruptions in learning and memory, as well as health-damaging behaviors and adult lifestyles that undermine health and well-being

10. Keys to Healthy Brain Development Supportive adult relationships –Doesn’t have to be parents Positive learning experiences –Should balance emotional, social, cognitive and language development –We can make up for deficiencies in the home environment Rapid responses for children and families who face multiple adverse risk factors

11. Policy Implications As a society, we have to give much more attention to early childhood –Better pay, more support for early childhood professionals –A more skilled workforce with the needed expertise to counter effects of adversity –More investment in science, in best practices – a stronger emphasis on quality There is ample $ to do this!

12. The Returns on Investment are Huge The science of brain development makes a moral case for action unavoidable, but investment in early childhood programs also wise economically –Early childhood adversity is costly to society –Costs include lower earnings throughout life, a higher propensity to commit crime, much poorer health –These are expensive Supporting families yields enormous returns on each dollar invested ─ Taking advantage of their brain plasticity

13. How We are Getting to Our Goal Strong, visionary, relentless advocacy for early childhood issues through KDHE, KSDE and their partners statewide –Creative, science-based problem solving in a time of constrained resources –Willingness to take risks, take a stand, build new coalitions –Reaching out to private sector partners who care about kids –Appeals to those in positions of power for a lasting legacy

14. www.kdheks.gov To Protect the Health and Environment of all Kansans by Promoting Responsible Choices Thank You For Listening!