On your mark, get set, go. Off they race, the children of America, into our collective future. The end point of this particular race is a healthy, happy and productive adulthood. So here's the question: Are the odds equal that anyone who puts in the effort will reach that finish line?
Basic Training Starts Here
The premise of a certain 2012 presidential platform (you decide which one) appears to be this: Life is an even playing field. As long as we try hard enough we all equally thrive. It's as if the secret to success is effort alone, and if you're not successful you're just not trying hard enough.
Research in child development contradicts this idea entirely. By the age of five, environmental experiences often handicap a child throughout a lifetime. Does effort matter? Absolutely, but countless factors affect the cognitive and emotional development of young children long before they make their own active choices about how to live.
The United States will never be the 'land of opportunity' for everyone without addressing this reality. Thankfully, many of these hurdles can be eliminated through interventions both compassionate and cost effective. To tackle these inequalities, some basic necessities of early childhood include:
A safe and stable home environment
The concept of 'toxic stress' may seem vague, but from a medical point of view excess stress has a significant impact on development. As outlined in a 2012 American Academy of Pediatrics statement, prolonged, excessive stress stacks the odds against children. Early adversity affects the entire body, from the brain through the immune system and even influences which of our genes express themselves. Too much stress can cause lifelong impairments in both physical and mental health and, as the authors state, "many adult diseases are, in fact, developmental disorders that begin early in life."
Making sure children are well fed and have health care is a start. Being undernourished or chronically ill affects an adult's capacities in daily life profoundly, children even more so. Additionally, programs that educate at-risk parents about supporting their children's development are impactful. Down the road, people who have received appropriate services while young are more likely to be reasonably settled when they have children -- and then their kids are better off. Adults who grew up in stable environments are more likely to be doing well in general, and less likely to require ongoing medical attention, mental health care or financial support from the government.
The average low-income child has heard thirty million fewer words than peers by the age of three years, and this pre-school vocabulary score predicts language ability at age nine. Falling behind in these skills puts youth at high risk for school failure. School failure itself places children further in jeopardy of unemployment, underemployment, poor health choices and other difficulties.
Further compounding their disadvantage, these children exhibit a 'knowledge deficit' which stems from decreased exposure to general information about the world. Limited content knowledge affects reading comprehension and related abilities, as understanding text relies on the reader's own background knowledge. One study showed poor readers who were baseball fans tested better for comprehension on a baseball passage than more skilled readers with little interest in the topic. While the more advanced readers could read the words, they didn't have the context to sort out jargon like 'a 6-4-3 double play.' Reading comprehension correlates with academic achievement, and also success after schooling ends; home and school based programs can help address the gap.
The types of schools we create matter greatly, as well. A strong education starts with reasonably sized classrooms run by well-trained teachers. Children with mental health concerns, ADHD, autism or learning disabilities typically need services to keep up academically; these interventions are often unavailable or underfunded in low-income neighborhoods. Quality schools, developmental services, and mental health care head off long term problems for not only individuals, but the community. Without intervention, these same children are less likely to become healthy and independent adults.
- The opportunity to learn through play
Free play is a foundation for later cognitive, communication and social skills. It also encourages emotional resilience and creativity. While you might think all children get an equal chance to play, many don't. Poverty interferes with play at home, at school and after school. Educating parents about the importance of free play and creating both community and school-based environments that facilitate it promote long-term development.
Team in Training
Failing to emphasize these early childhood services fails society as a whole. It perpetuates problems such as early school drop-out, teen pregnancy, substance abuse and many other issues exacerbated by unstable childhoods. Investing in children at an early age even saves money over the years; without early intervention, we pay almost exponentially when adults later struggle. A RAND study, for example, suggested a minimum near two-to-one return for every dollar spent on early childhood services, and potentially as high as seventeen to one.
Eliminating early childhood programs turns a blind eye to the stark reality that life is not, in fact, a level playing field. Children need healthy nutrition and health care to grow. They need to be raised in nurturing, mentally engaging environments that encourage activities like imaginative play and reading. They require appropriate schools and stimulating after school experiences. Without intervention, these same kids often end up having children similarly at risk and the cycle continues.
When society abandons children before age five, we leave them adrift for a lifetime. Only through a concrete and prolonged investment in early childhood do we truly create an opportunity for all individuals to thrive. As the American Academy of Pediatrics states,"a vital and productive society with a prosperous and sustainable future is built on a foundation of healthy child development." Any plan that cuts or eliminates early childhood services fails not only our children but our communal desire for a successful and stable society.
Follow Mark Bertin, M.D. on Twitter: www.twitter.com/markbertinmd