Give Me the Child Until He is Seven The Early Roots of Human - - PowerPoint PPT Presentation

Give Me the Child Until He is Seven…

The Early Roots of Human Behavior

Donald A. Barr, M.D., Ph.D. Professor (Teaching) of Pediatrics, and of Education (by Courtesy)

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All types Coronary Artery Disease Hypertension Stroke

Percentage of adults reporting disease

Type of disease

Less than a high school diploma High school diploma or GED\12 Some college Bachelor's degree or higher

Age-adjusted percentages of selected circulatory diseases, by highest level of educational attainment - U.S., 2009

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Compared to those with lower levels of education, adults with higher levels of education:

• Have higher incomes
• Have lower rates of high blood

pressure

• Are less likely to have a stroke
• Are less likely to have diabetes or

kidney disease

And they live longer!

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CONCLUSIONS “A substantial portion of the excess mortality among current smokers between 2000 and 2011 was due to associations with diseases that have not been formally established as caused by smoking.”

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Educational Attainment Health behaviors such as smoking, diet, and lack of exercise Reduced life expectancy and premature death

Educational attainment, health risk behaviors, and preventable deaths in the U.S.

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Missing third factor? Health- related behaviors Well-being as an adult

Or is it this way?

Educational Attainment

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Time perspective

• A psychological construct that describes

how one’s perception or weighing of the past, present, and future influences current decision making

• Thought to represent a subconscious

cognitive response that one uses when making decisions about short-term and long-term actions and goals

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The Marshmallow Study

Done at Bing Pre-School, Stanford

Mischel et al, 1988

“You can play with these toys, and later I’ll give you a reward”

4-year old children – invited into a room of toys to play alone

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“If you play until I come back, you can have two of these.” “If you don’t want to wait, ring this bell, and I’ll come right

• back. Then you’ll get
• ne of these.”

How long will a child wait?

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As adolescents, the children who didn’t ring the bell (i.e., they were able to wait 15 minutes for the larger reward) were:

• More academically and socially

competent

• More verbally fluent
• More rational, attentive, able to plan

ahead

• More able to deal with frustration and

stress

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• As 4-year olds, these children already had

differing time perspectives that offered them differing levels of rewards.

• Their time perspective as 4-year olds was

associated with their personality characteristics and level of academic success as adolescents.

Conclusions:

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Time perspective – 3 sub-scales

(From Zimbardo & Boyd, 1999)

• 1. “Future”

– ‘‘Before making a decision, I weigh the costs against the benefits’’ – ‘‘It upsets me to be late for appointments’’ – ‘‘I believe that a person’s day should be planned ahead each morning.’’

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Time perspective – 3 sub-scales

• 2. “Present – fatalistic”

– ‘‘Since whatever will be, it does not really matter what I do’’ – ‘‘Fate determines much in my life’’ – ‘‘You can’t really plan for the future because things change so much.’’

• 3. “Present – hedonistic”

– ‘‘I take risks to put excitement in my life’’ – ‘‘I try to live my life as fully as possible, one day at a time.’’

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“If you wait until I come back, you can have two of these.” “If you don’t want to wait, ring the bell and I’ll come right back. Then you’ll get one of these.”

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In college students, how are these scales associated with personal characteristics and academic performance?

Zimbardo and Boyd study of several hundred college students in California

Future Present - Fatalistic

Academic Performance Aggressive/ Impulsive

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Is Time Perspective Associated With Socio-Economic Status?

From Guthrie et al – 2009

(solid line = direct correlation; dashed line = inverse correlation)

Future Present - Fatalistic Education

• study of more than 500 adults recruited from hair salons

and barber shops in a suburb of Washington, DC.

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• Eager
• Energetic
• Fun-loving
• Intelligent
• Sensible
• Willing

What about the role of personality traits in affecting patterns of behavior?

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• Cheerful
• Confident
• Hard-working
• Helpful
• Likeable
• Reliable

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“The list that follows contains all the words descriptive of personality or personal behavior… included in Webster’s New International

Dictionary…Our list contains 17,953 words,

• r 4½% of the total

English vocabulary.” Allport, GW, Odbert HS. Psychological Monographs 1936 47(1)

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Moving to fewer trait clusters in the digital age

The “Big Five”

• I. Extraversion
• II. Agreeableness
• III. Conscientiousness
• IV. Emotional stability
• vs. Neuroticism
• V. Openness

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Summary of personality traits as assessed using the Big Five

“These five dimensions represent personality at the broadest level of abstraction, and each dimension summarizes a large number of distinct, more specific personality characteristics.”

• Oliver John and Sanjay Srivastava, 1999

“When factored jointly with personality variables, measures of cognitive ability typically form a distinct sixth factor.”

• Robert McRae and Oliver John, 1992

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• data set gathered between 1959 and 1967 on

>2,500 elementary school children in Hawaii

• contacted 963 of the individuals in the original

study, now 40-50 years old

• Children rated higher on conscientiousness

– less likely to be smokers as adults – more likely to rate their overall health status as better

Forty Years On: Teachers’ Assessments of Children’s Personality Traits Predict Self-Reported Health Behaviors and Outcomes at Midlife

Sarah E. Hampson, Lewis R. Goldberg, et al.

Health Psychology, 2006; 25(1)

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Childhood conscientiousness and longevity: Health behaviors and cause of death

Friedman, H. S., et al. 1995. Journal of Personality and Social Psychology 68(4)

• In the 1920s, Louis Terman began following

more than 1,500 children in California schools

• As one of their measures, they assessed

children’s conscientiousness

• Followed subjects into adulthood

– Many the subjects had died

• Strong association between

conscientiousness as a child and subsequent length of life

– Lower rates of smoking explained part of this difference

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Time Perspective

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Personality Traits

Health- related behaviors Well-being as an adult Educational Attainment Childhood Adolescence What is the role of cognitive development in affecting patterns of behavior and educational attainment?

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1) Working memory: “combines the temporary storage and manipulation of information in the service of cognition.” 2) Executive control: “the capacity to focus attention, to divide attention between two or more tasks, and to control access to long- term memory”

The hippocampus has two main functions:

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Emotionally significant experiences tend to be well remembered, and the amygdala has a pivotal role in this process. But the efficient encoding of emotional memories can become maladaptive — severe stress often turns them into a source of chronic anxiety.

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Stress hormones and stress-activated neurotransmitters enhance the consolidation of memory for emotionally arousing experiences through actions involving the amygdala.

However, stress and emotional arousal not only induce strong memories of new information: they can also impair our remembering through amygdala interactions with

• ther brain regions.

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The amygdala, through its projections to other brain regions, also has an important modulatory role in regulating stress hormone effects on other memory functions, such as retrieval and working memory.

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Stress exposure can induce amygdala activation to create a brain state that on the one hand promotes the long-term storage of memories of emotionally arousing events and thus preserves significant information, but on the other hand impairs memory retrieval and working memory.

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Reduced Long-Term Memory Formation and Retrieval

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“The neural circuits for dealing with stress are particularly malleable (or ‘plastic’) during the fetal and early childhood periods…Toxic stress during this early period can affect developing brain circuits and hormonal systems in a way that leads to poorly controlled stress response systems that will be overly reactive or slow to shut down when faced with threats throughout the lifespan.’’

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The Harvard study identified three types of stress a child may experience:

• Positive stress – e.g., getting an

immunization

– an important part of the normal developmental process, enables a sense of mastery

• Tolerable stress – e.g., death of a loved one;

a frightening accident

– generally occur over limited time periods, in the context of ongoing, supportive relationships with adults

• Toxic stress – e.g., child abuse (emotional or

physical)

– Stressful events that are chronic, uncontrollable, and/or experienced without children having access to support from caring adults

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Low Family Income Hippo- campal Volume Hostile Parenting Style Stressful Life Events Luby et al 2013

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Graphed anxiety level and amygdala volume Children exposed to high levels of stress during infancy and early childhood tended to have an

• ver-active

amygdala and an under-active hippocampus

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Recall that one of the principal functions of the hippocampus is in regulating Executive Control:

• “a group of skills that helps

us to focus on multiple streams of information at the same time, monitor errors, make decisions in light of available information, revise plans as necessary, and resist the urge to let frustration lead to hasty actions.”

Principal components

• Working memory
• Inhibitory control
• Cognitive or mental

flexibility

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Low Family Income Hippocampal Volume Hostile Parenting Style Stressful Life Events

Results from Luby et al. “The Effects of Poverty on

Childhood Brain Development” JAMA Pediatrics 2013;167(12)

Executive Control Cognitive Ability

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Family SES

Parental Education Parental Occupation Family Income

Study of 60 kindergarten African American children in Philadelphia, half low SES, half middle SES

Executive Function Language Visual cognition Visuospatial skills Memory

Neurocognitive Correlates of Socioeconomic Status in Kindergarten Children

• K. G. Noble, et al. Developmental Science 2005

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Family SES

Parental Education Parental Occupation Family Income

Study of 168 first- grade children in New York City, diverse racially and by SES

Executive Function Language Visuospatial skills Memory

Socioeconomic gradients predict individual differences in neurocognitive abilities

• K. G. Noble, et al. Developmental Science 2007

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An Integrative View of School Functioning: Transactions Between Self-Regulation, School Engagement, and Teacher–Child Relationship Quality

X.A. Portilla et al Child Development 2014; 85(5)

• 338 children entering kindergarten
• Measured child characteristics

– Impulsivity and inattention – School engagement – Academic competence

• Measured conflict in the teacher-child

relationship, as reported by the teacher

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Impulsivity and inattention

Entry into kindergarten End of kindergarten First Grade

Conflict with teacher School engagement Academic competence Conflict with teacher Male gender

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Association between perceived discrimination and racial/ethnic disparities in problem behaviors among preadolescent youths.

• Bogart et al. American Journal of Public Health 2013;103(6).
• Study of 5119 fifth graders in Birmingham,

Alabama; Los Angeles County, California; and Houston, Texas.

• Examined the relationships of perceived

racial/ethnic discrimination and race/ ethnicity to problem behaviors, controlling for SES (parents education, household income, single-parent household.

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Differences in problem behaviors between Black students and White students

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Conclusions From these Studies

• Children raised in lower SES families,

especially those who experience racial discrimination, experience more stress in the critical period from birth through entering school

• Children who experience more stress

throughout this period develop weaker cognitive functioning and decreased impulse control

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Upon entering kindergarten :

• Lower SES children exhibit weaker

language skills, executive control, and

• ther cognitive functions
• Lower SES children (especially boys)

exhibit more impulsivity and inattention, resulting in conflict with the teacher and decreased engagement in school

• By first grade, lower SES children

demonstrate lower academic competence, and continued conflict with the teacher.

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When they become adolescents, children from lower SES families:

• Are more likely to smoke;
• Are more likely to have poor dietary

behavior;

• Are less likely to get regular exercise
• Less likely to attend college or graduate

from college

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We Can Do Better — Improving the Health of the American People.

Stephen A. Schroeder. New England Journal of Medicine 2007; 357(12): 1221-28.

“The single greatest

• pportunity to improve

health and reduce premature deaths lies in personal behavior.”

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Genetics Behavior

Psychological Environment Social Environment

Well-Being

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Genetics Psychological Environment Social Environment Behavior Education Adult Behavior Well-Being

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http://www.acestudy.org/

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“The Adverse Childhood Experiences (ACE) Study is

• ne of the largest investigations ever conducted to

assess associations between childhood maltreatment and later-life health and well-being.”

“It is critical to understand how some of the worst health and social problems in our nation can arise as a consequence of adverse childhood experiences.”

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“By far, the largest proportion of the burden of disease due to ACEs arises from the cumulative effect of chronic exposure to multiple adversities whose lifelong consequences may often start to become apparent only many years after exposure.” – Anda et al. American Journal of Preventive

Medicine 2010 39: 95

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Relationship Of Childhood Abuse and Household Dysfunction To Many of the Leading Causes of Death In Adults – The Adverse Childhood Experiences (ACE) Study.

• Felitti, V. J., et al. American Journal of Preventive Medicine 1998; 14:245
• Surveyed 9500 adults (mean age 56),

as part of a regular health assessment at Kaiser-Permanente, regarding their childhood exposure to ACE’s

• Compared frequency of reported

ACE’s with health status as an adult

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Those had experienced more ACE’s had a substantially increased risk for:

• Alcoholism
• Drug abuse
• Depression
• Smoking
• Obesity
• Heart disease
• Cancer
• Chronic lung disease
• Liver disease

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Is best time to intervene before ACE’s have happened?

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The Carolina Abecedarian Project

http://abc.fpg.unc.edu

• Enrolled the families of 104 newborn infants

living in the Chapel Hill area of North Carolina

• Families were identified as high risk based on

poverty, maternal age/education, family structure

• Children randomized at birth, with half of the

children receiving intensive social and educational support birth to age five

• Included full time, year round professional day

care for five days per week

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References:

• Campbell, FA, et el. Developmental Psychology 2001;

37(2): 231

• Campbell, FA, et al. Applied Developmental Science

2001; 6(1): 42

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The Role of Home-Visiting Programs In Preventing Child Abuse And Neglect

Howard, K. S., & Brooks-Gunn, J. 2009 The Future of Children 2009;19: 119

• Reviewed the outcomes from a range of

home-visitor programs, mostly targeting children born into families at risk for abuse

• r other adverse parenting behaviors.
• “Evidence is mounting that these

programs can positively alter parenting practices and, to a lesser extent, children’s cognitive development.”

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The Role of Preschool Home-Visiting Programs In Improving Children's Developmental And Health Outcomes

American Academy of Pediatrics, Council on Community Pediatrics

Pediatrics 2009; 123: 598

“Home-visiting programs offer a mechanism for ensuring that at-risk families have social support, linkage with public and private community services, and ongoing health, developmental, and safety education. “When these services are part of a system of high- quality well-child care linked or integrated with the pediatric medical home, they have the potential to mitigate health and developmental outcome disparities.”

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“AAP is committed to leveraging science to inform the development of innovative strategies to reduce the precipitants of toxic stress in young children and to mitigate their negative effects on the course of development and health across the life span.”

Pediatrics January 2012

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Academic Medicine February 2015

“Thus, the determinants of health are best conceptualized as biosocial phenomena, in which health and disease emerge through the interaction between biology and the social environment.”

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