Caring for early childhood is critical

Posted Nov. 29, 2010, at 8:07 p.m.

There’s a reason we were all born with fat heads, and it’s not so we qualify to be Fox News commentators before we are out of diapers. We need those disproportionately hefty heads because the human brain is the fastest-growing thing in the body for the first eight years of life.

It makes some sense, then, that if we are looking for a good place to invest, we should look at the developing brains of our young. Opportunities that pay off well for the long haul do not get any better than the pile of progressively networked neurons that help make us who we are.

That’s why parents should give quality time together to their children for Christmas instead of video games, and why states should invest in infants and children as a matter of good economic policy. And that’s why, as Maine and other states struggle in 2011 to balance their state budgets, the impact of cuts on early childhood de-velopment should be a lens through which potential cuts are examined. Indeed, as we disinvest in social and health programs through massive state budget cuts in these tight times, we should consider spending more — not less — of the money that remains on this and other areas where the social payback for money spent has the biggest bang for the buck.

A rapidly growing body of evidence suggests that community and government investment in early childhood interventions such as good parenting support, early access to health care and early child development programs can save more money down the road. Returns on investment in the form of reduced crime, reduced special education needs, lower health costs, lower social welfare costs, a more productive workforce, etc., may be as high as $9 for every $1 invested in good, proven child development support programs. (For more information, see the website of the Harvard University Center for the Developing Child at www.developingchild.harvard.edu.)

For this to make sense we need a brief seminar in brain development, which will not be painful. The human brain is forming about 700 new connections per minute between its cells during the early years of life, when most of the connection wiring gets done. In general, the more connected our cells are, the smarter and more functional we are. The higher cognitive functions of the brain are largely wired by age 6. Language is largely wired in by 12 months of age.

All of this means everything that messes with the brain in those early years — malnutrition, stress, abuse, lack of attention and good stimulation, lack of a loving and safe environment, etc. — can mess up brain wiring, normal brain cell gene expression and other crucial areas of the brain development. Then we live with the faulty wiring repercussions for the rest of our lives.

That is why so-called Adverse Childhood Experiences (or ACEs — loss of a parent, abuse of parent or child in the home, mental illness in a parent, substance abuse in the home, and five other adverse experiences) during our early years increase the risk that we will struggle socially, mentally or physically as adults. Every added ACE a child suffers increases the risk of difficulty holding a job, of getting pregnant as a teenager, of committing a crime, of getting hooked on alcohol or pills, of smoking cigarettes or of developing mental illness and other chronic diseases. (Calculate your own ACE score at www.acestudy.org/files/ACE_Score_Calculator.pdf.)

Bottom line: The child’s brain is plastic waiting to be molded by parents and communities. Handled one way, chances are good the molding produces a functional adult who can make his or her own way in society, and be a contributor. Molding another way it is much more likely to produce a dysfunctional adolescent or adult who will struggle to make his or her way in society, and is much more likely to be expensive for the rest of us.

As Maine and other states gear up after November elections to plow state budgets’ roads clear of the snow of accumulating deficits, they need to avoid plowing the interests of our youngest children into the ditch. A life put there at an early age may never get back on track.

Erik Steele, D.O., a physician in Bangor, is chief medical officer of Eastern Maine Healthcare Systems.

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