Making and Keeping Connections Jean M Clinton B.Mus MD FRCP(C) McMaster University and Children’s Hospital Voices for Children October

The Health and creativity of a community is renewed each generation through its children. The family, community, or society that understands and values its children thrives---the society that does not is destined to fail

UNICEF REPORT CARD 2007 “The true measure of a nation’s standing is how well it attends to its children-their health and safety, their material security, their education and socialization, and their sense of being loved, valued and included in the families and societies into which they are born.” Unicef Innocenti Report 2007

Canada  Material Well Being  Health and Safety  Educational Well being  Family and Peer Relationships  Behaviours and Risks  Subjective well being  Overall  6 SWEDEN 1  13 SWEDEN 1  2 BELGIUM 1  18 ITALY 1  17 SWEDEN 1  15 NETHERLANDS 1  12/21 Unicef Innocenti Report 2007

The Long Reach of Early Childhood Early Years Study 2 CHAPTER 1

Experience Experiences in early life activate gene expression and result in the formation of critical pathways and processes.

Adult-child interaction SoundVisionTouchSmellProprioceptionTaste

‘Sensitive periods’ in early brain development Binocular vision High Low Years Habitual ways of responding Language Emotional control Symbol Peer social skills Relative quantity Central auditory system CECD

Epigenetics Each person has an individualized genetic code. To be expressed, it must be activated. Genes need nurturing.

High School Diploma by Level of Aggression at Age NeverLowHighChronic Level of Aggression 75.8% % 62.5% 27.5% 3.3%

It takes a Child to Raise a Village EYS2 Chapter 2

Families Families are the basic social units of human societies.

Monitoring development Longitudinal surveys & birth cohort studies allow researchers & policy makers to monitor children ’ s development.

Receptive Vocabulary, Age 5 (NLSCY, ) Source: Thomas, 2006

¼ of children  ¼ of Canada ’ s children between birth to age 6 are experiencing some learning or behavioural difficulty.

Social Risk Index  9 comprehensive indicators of social risk  those with rate higher than the national average = contributing to the overall risk  zero (0), indicating no social risk  nine (9) indicating the highest risk

S4 Student Performance by SES Group Language Arts Standards Test 2001/02 Pass/Fail rates of test writers 17/18 year olds who should have written N= N=349 N=36 N=402 N=192

How are Children Doing? Chapter 3

The EDI has Predictive Validity! (more than we want) # of Vulnerabilities % Failing the FSA % Not ‘Successful’ Numeracy Reading (EDI) (Grade 4)

Year Floreat47.22%14.3% Wembley47.11% 11.8% AEDI S.Australia Decrease in the % of vulnerable children as a result of improved ECD in South Australia

CHAOS EYS2 Chapter 4

Top level: Early intervention Health Social services Education Family support Provincial/state

Local school authorities Public health Munici- palities Community services Parks and recreation Local authority Local authority Middle level:

Bottom level: Early identification and intervention Kindergarten Public Health Family supports Community programs Child care

Preschools Local school authorities Public health Munici- palities Community services Parks & recreation Early intervention Health Social services Education Family support Chaos Child care Parenting centres Children’s mental health centres Kindergartens

Thinking big, starting small ECD: the 1 st tier of human development Start in local communities

Thinking big … starting small Communities need more than opportunities to create a collective vision; they need the mandate & resources to realize it.

Investing in Early Childhood Development Chapter 6

Early Child Development & Parenting Centres Parental participation Resources for families Full-day, full-year options Nutrition Problem- based play Pre- and post-natal supports

Sources: Karoly et al. (1998), Masse & Barnett (2002), Reynolds et al. (2002), Schweinhart et al. (2004) Exceptional Returns on Investment: Long-Term Benefit-Cost Ratios for Four Exemplary ECD Programs Up to 16% rate of return on investment in ECD, compared to the highly touted 6% rate of return of the U.S. stock market ( ) Sources: Lynch (2004), Rolnick & Grunewald (2003)

Rates of Return to Human Development Investment Across all Ages Pre-school Programs School Job Training Return Per $ Invested R Age Pre- School Post School Carneiro, Heckman, Human Capital Policy, 2003

OECD Report, 2004 Source: Starting Strong ll: Early Childhood Education and Care; September 2006

Importance of Relationships " Human beings of all ages are happiest and able to deploy their talents to best advantage" when they experience trusted others as "standing behind them." Bowlby, 1973 Bowlby, 1973

Our Biological Unit of Survival “The Clan” We are WIRED to connect. We are unavoidably inter-dependant on each other We are unavoidably inter-dependant on each other YET YET.

The Relational Landscape is changing. Children have fewer emotional, social and cognitive interactions with fewer people

POVERTY OF RELATIONSHIPS The compartmentalizing of our culture has resulted in material wealth yet poverty of social and emotional opportunity. Modernity’s Paradox Hertzman and Keating

Robert Putnam-Bowling Alone Social Capital Social Capital “Defined as a resource-that stems from participation in certain social networks-that possess specific characteristics-which open up access to resources of varying value.

Collective Efficacy  A fusion of shared willingness of residents to intervene and social trust, shared sense of common values and a sense of engagement and ownership of public space.”  CE was found to affect crime rates more than factors typically associated with crime like poverty, unemployment or discrimination. Resulted in dramatically lower crime rates among communities with similar demographics. DR Felton Earls DR Felton Earls

Broken Windows or Collective Efficacy  Physical and social disorder in a neighbourhood lead to increased crime, if one broken window or aggressive squeegee man is allowed to remain in a neighbourhood, bigger acts of disorderly behaviour will follow.

In the year of our Lord 2007  Bowling Alone  National Family Dinner Day  Spending more time studies….  If not our culture, then whose? CLINTON

Individual Brain and Biological Development, Genetics, Age, Sex Family, Cultural, Economic, & Social Environment Family Health Status and Dwelling Environment Residential Community Health Status and Cultural, Economic, Service & Social Environments Regional Health Status and Ecological, Economic, Policy, Political & Social Environments National Health Status, Ecological, Economic, Policy, Political & Social Environments Global Ecological, Corporate/Economic, Policy, Political & Social Environments Civil Society ECD Services and Programs Relational Community (Tribe, Religion, etc.) Health Status, Cultural Environment and Socioeconomic Status & Resources Institutional/historical time

Many things we need can wait. The child cannot. Now is the time his bones are being formed, his blood is being made, his mind is being developed. To him we cannot say tomorrow, his name is today. ~Gabriela Mistral