Press Room

How a Child's Early Experiences Affect Development
by Dr. Paul D. Steinhauer

Following is the opening plenary speech from Linking Research to Practice – A Canadian Forum, October 25-27, 1998 in Banff, Alberta.

It's a pleasure to have the opportunity to speak to you today. I have five grandchildren who have benefited from really good people providing early childhood care and education and I am so grateful for the quality of care that you and your colleagues are giving to so many of our young children. It is so much more difficult for parents these days without your help.

I have been asked to talk about recent research findings and what they tell us about child development. This presentation will address research in three areas: 1) brain development; 2) attachment research; and 3) readiness to learn.

First let's talk about what we've found over the last 10 or 15 years about how infants' brains develop. When a child is born, the brain is extremely underdeveloped. The most important part of neurological development in the first few years of life is the connecting up of cells to form pathways. Unconnected brain cells have a lot of potential but are not doing anything. We know that 90% of the connecting up is achieved in the first two years of life and that, by the time a child is three, he has twice as many connections as his pediatrician. As he gets older, those connections that are used frequently will flourish; those that are not will gradually deteriorate. By the time he reaches the end of his teenage years, his brain will have as many connections and as much potential as an adult brain. We also know that the connecting process occurs in sequence according to a pattern that is laid out genetically. During sensitive periods, an area of the brain shows heightened sensitivity to stimulation – to too much, too little or the wrong kind of stimulation as well. In that area cells begin to mature and form connections rapidly.

There are windows of opportunity for these sensitive periods. For attachment, the window closes at 18 months; for self-regulation at 24 months; and for syntax at three to four years. Once the window closes, the potential for growth, differentiation and connection is much less. However, that does not mean that no further connections will be made – but to bring about change after windows of opportunity have lowered is fighting biology and like trying to swim upstream against the current. As long as the child receives enough of the right kinds of stimuli at the right time, and not too much of the wrong kinds of stimulation, then ideal connections will be made. So it certainly makes sense to try and have optimal conditions during this sensitive period when connections are being made so easily. We also know that the quality of a child's environment during those sensitive periods is what governs that connecting up process.

I want to talk with you about a few major areas in which brain development is affected by the child's environment. First of all I want to talk about attachment. We often talk about attachment as the result of children being well parented. However, attachment is a two-way process and some babies are born without the ability to give the right kind of attachment cues or to respond to those of their parents appropriately. Several studies have shown that the window of opportunity for attachment lowers around 18 months of age. Therefore, the quality of care children receive in the first 18 months of life is crucial to get them off on the right path with all the benefits that a secure attachment brings. This does not mean that a child who was insecurely attached at the beginning may never be able to recover if he is put in a much more ideal environment. However, once the attachment pattern has been established, it is hard to shift, and most of those who are insecurely attached continue to lack the quality of care that is needed to make a diference.

Another area in the cerebral cortex that is maturing within the first two years is just behind the right eye. It has the capacity to inhibit very strong feelings, such as rage and anxiety and is, therefore, important in helping infants regulate emotions. By about the third year of age, young children should be able to soothe themselves and modulate aggression; otherwise they are in significant danger of having trouble controlling their aggression for the rest of their lives.

We also know that when it comes to vocabulary and cognitive development, babies who are not well stimulated by the age of two do not differ in intelligence from others who have been well stimulated. However, by the age of four or five, one can see as much as a 15-point difference in IQ.

Finally, I want to talk briefly about the situation that is experienced by many of the prisoners in our penitentiaries and also by many of the children who are permanent wards of our Children's Aid Societies because they have grown up in families where they have experienced a mixture of chronic neglect and frequent conflict and violence. In response to this violence, these kids become hypervigilant. While it may be useful to be hypervigilant in a family where you never know when war is going to break out, when you go to school and you're supposed to sit still and pay attention to the teacher and you're busy scanning the environment to see where the next war is going to break out, that hypervigilance certainly stands you in very poor stead. We know that children who grow up in a situation where there is chronic violence have an over development of areas of the mid-brain and of the brain stem that are responsible for intense rage, strong feelings of anxiety and very high levels of impulsivity. And at the same time, the neglect that they experienced leaves them lacking the ability to regulate intense feelings and to solve problems effectively. Also, from growing up in conflict-ridden, violent environments, many of these kids readily see themselves as unworthy victims of assault, unlike the positive self-view that children who are parented under better conditions have.

Just before leaving this, I want to emphasize once more that windows of opportunity do not close completely. Change can still occur after the window of opportunity closes; however, fighting biology is extremely difficult.

Despite the fact that during the first three years, children's brains are most malleable and most responsive to the environment, society spends very little on them. We wait until they get really messed up – and then we spend much more – and achieve much less – as we try to cope with the damage.

Now, I want to talk about what happens when children are exposed to severe, frequent and chronic maltreatment. What will happen is that they have a disruption in the development of their capacity to regulate their feelings. As a result of this they will have a shift in their tone: they will be much more negative, they won't smile as much, they will be more sullen and withdrawn; they will not attract as many people as buoyant children do. They will have less of the positive, the enthusiasm, the energy. Along with that they are going to show signs of increased arousal. That arousal will take many different forms.

The first result of their increased arousal is that these kids show a lot of aggression, a great deal of frustration and they are very poor at dealing with their frustration. In addition, they are far less compliant than other children; they also have less self-control and are constantly being disruptive. That is the aggressive cluster of behaviours that comes out of their increased arousal. Another cluster of behaviours are the hypervigilant behaviours which can help a kid develop a typical Attention Deficit Disorder pattern B hyperactivity, distractibility and decrease in attention span.

A third pattern resulting from increased arousal is a lack of empathy for others. As you people know, when one child cries, it is usually upsetting to other children because normally children have the capacity for empathy – but children who have been chronically maltreated lack that capacity. They are far more likely to become aroused and aggressive, and to show rage and fear. Also, they are more responsive when adults are upset: they become very stressed, are more likely to become aggressive and more likely to try to intervene to break things up. They also show a great deal more fear of adult anger.

I've been talking about some of the changes in the way an infant’s ability to regulate their feelings develops as a result of chronic maltreatment in a bad family situation – but there are also secondary reactions. The inability to regulate their feelings will affect their other attachment relationships. It will also seriously interfere with their peer relationships as they get older, and how they learn when they get into school. I would like to look very briefly at some of these secondary effects of that failure, that lack of capacity for self-soothing, for self-regulation, at an early age.

Those kids who have been physically abused will show a lot of verbal aggression and disruptive behaviour that will get in the way of their forming successful relationships. Those children who have been neglected but not abused will often actively withdraw from relationships with other children. It is as though they have learned not to trust people and so other children also become people not to trust, rather than people to reach out to. In their 1995 article, Cicchetti and Toth pulled together beautifully about thirty studies on this topic.1

Children who experience a combination of neglect and abuse become more aggressive and more avoiding of contact – they often end up as angry loners. And by the way, the pattern of being an angry loner in kindergarten is a stronger predictor of how those children are going to behave in adolescence than is the kind of peers they hang out with just before they hit adolescence.

If you look at how they do in school, children who have been exposed to different types of abuse show different patterns of behaviour. The neglected children are the ones who have the most difficult time learning in school. They just don't seem able to get it. That's because, due to the neglect, they don't have the same level of cognitive development that other children have. The physically abused children are much more likely to present behaviour problems and will also show some difficulty with learning as well, but their real incapacity to understand is not as high as the degree of their disruptiveness. On the other hand, the outstanding feature in school of children who have been sexually abused is that they just never seem to stop trying to get the approval of the teacher. This dependency on the approval of the teacher is probably the predominant feature that they show. But as you know, many children have not just been physically abused, just neglected or just sexually abused: they have often experienced a number of these abuses and will show a mixture of these symptoms.

In contrast, the child whose caregivers are there for him in home care and day care, sufficiently near, responsive and attuned, will feel secure, loved and confident. You're likely to have a playful, smiling, exploratory and sociable child. I know temperament comes into this too, but certainly the more difficult the temperament, the more important the quality of care is, because it’s so much easier to care for a temperamentally easy child. It is with the difficult child that the quality of care received makes such an enormous difference in helping that child settle down, become more easily accessible and live more easily with herself and with others. If the caregiver responds to the difficulty in the child's temperament with rejection, abandonment or frustration, then those difficulties will be exaggerated in the child's temperament.

On the other hand, if the child does not have consistent attachment figures or a secure attachment, he's likely to respond through insecurity – with fear, anxiety and defensiveness. He may also show an exaggeration of attachment behaviours that, instead of drawing others to him, are likely to turn others off and/or push them away.

Now I want to talk about what having a secure attachment can do for a child, because having had a secure attachment as a preschooler is one of the strongest predictors of the child being able to deal well with stress. A child with a secure attachment develops a basic trust. He knows that if he does need them, the people who are supposed to provide that care will be there for him. As a result of that basic trust he will have the capacity for empathy, but he will also have expectations that others will be good and friendly until proven otherwise, which will help greatly in the development of social skills and will give him a basic tone of optimism and a willingness to turn to others when he's in trouble. Second, having had a secure attachment gives a child that knowledge, comfort and confidence to go out and explore what is new and unknown in the world. Third, having had a secure attachment is the first and most important source of self-esteem. A fourth thing that comes out of having a secure attachment is the capacity for self-soothing. A good attachment is also a major factor necessary for cognitive development.

To say a child has an insecure attachment is not saying that that child already has a disorder; having an insecure attachment is a risk factor for difficulties later on. It is a sign that things are not going well and that his vulnerability is increased, but it does not mean that he already has a significant problem. And when looking at why some children develop problems of one sort or another, you have to take into account four factors: characteristics of the child; family adversity; attachment; and parenting style.

What sort of strengths and weaknesses does the child have? Is he or is he not attractive, healthy, potentially bright? Does he have a predisposition toward any form of mental illness? What kind of temperament does the child have (e.g., laid back, uptight)? Depending on the nature of the child, that child will be easier or harder for adults to attach to.

How much stress does the family have to cope with on an ongoing basis? Stress can come from unresolved attachment problems that the mother and the father have from their childhoods. It can result from tensions between the partners or it can result from the tension of having to bring up a child without the help of anyone else 24 hours a day, seven days a week. It can depend upon the kinds of tensions that come from living in an environment which is becoming harder and harder – with the cutting back of welfare, low-income housing, social services, education services and mental health services. Today’s families are not affluent and they have more stress with which to cope and fewer resources to back them up. And then we must consider that some parents are just born teachers, just as some child and youth workers or child care providers are intuitively good teachers, while there are others who aren't very good at teaching at all.

If you put all these factors together you see why it is that some kids turn out just fine whereas others don't develop in the ways we’d like to see them develop. But what we would really like to avoid is what we often see in some of our most disturbed children where all their energies that should be focused on forming relationships with other people are being focused in just the other direction. What we’re learning through all this early child development research is that even two years may be too long to leave a child in an unsupported situation – because by then the horse may already have left the barn before we’ve had a chance to close the barn door.

Now I want to shift a little and talk with you a bit about marital harmony. What does having two parents who like each other, respect each other and cooperate with each other do for children? If the two partners can get along they can probably solve problems as they arise and, as a result, the children in that family are far likelier to have a consistent set of expectations in terms of rules and follow-through. That kind of parenting is more likely to help children develop better impulse control than if they grow up in a family where parents are not able to agree, have different expectations and sabotage each other. If there is marital harmony, it is less likely that there will be the chronic conflict and violence in the family that one might find in a family in which there is chronic conflict. As a result, you're far less likely to have children who have cognitive disorders, problems controlling aggression and who lack the capacity for empathy. Finally, if you have parents who can get along, you are less likely to have marital breakdown and thus have situations of children living in poverty and father abandonment.

Generally speaking, the types of parenting that seem to be most successful in developing successful kids is what has been called “authoritative parenting” by Dianne Baumrind at the University of Berkeley.2 Authoritative parenting has a number of characteristics. First, the parents are emotionally involved and attuned and, therefore, have the capacity to recognize the needs of their infant and respond to him or her without their own needs getting in the way. As a result, that increases the number of secure attachments and also sets up parent-child reciprocity. As children get older, if there is reciprocity, they know that their parents are not just trying to get them to do what the parents want. If they know that the parents are also there to try to help them enjoy life, then they're more likely to respond positively to reasonable parental requests. The child who does not grow up with parent-child reciprocity, the child who never gets the feeling that the parent is there to nurture them – that child is far more likely to become oppositional and respond defiantly to even the most reasonable requests.

Second, it really helps if the parents show cognitive involvement with the child. The type of involvement will depend on the age of the child. With young children this might mean talking and reading to them. As the child gets older, the sort of cognitive involvement that counts is when parents allow and encourage the child to express his/her thoughts or feelings and put them into words. When parents allow that child to negotiate with them it increases the social competence of both girls and boys; on boys it has the particular effect of reducing their aggressiveness in the community. Because they are allowed to know that their needs are taken seriously in the family, they have less of a need to feel resentful and to display that resentment out in the community. In girls, it has the effect of increasing their confidence and self-assertiveness.

Finally, children need to be confronted by their parents and caregivers because absolute, unconditional acceptance of a child, regardless of how he behaves, is a recipe for an isolated, miserable, dependent, socially unacceptable child. It is through confrontation that parents and caregivers pass on their values and those of society to children. However, the way the child is confronted makes an enormous difference. If they are confronted in ways that are violent or shameful, the child will be so demoralized by the feelings that are conjured up that he will not learn anything from the experience. But if confrontation is done in a firm, matter-of-fact but loving way, then the child is likely to learn to change his behaviour to protect his relationship with his parents. The child will learn nothing from a violent approach. The more violence the child is exposed to under the guise of discipline, the more violent he or she will be as an adolescent.

Now let me talk a little bit about readiness to learn. We are hearing more and more about children's readiness to learn and development. Readiness to learn is a measure of cognitive, emotional and social abilities as they enter kindergarten. However, if we just stress the cognitive and forget the ability to get along with other children and the teacher, then we are really going to be doing children a disservice. Readiness to learn is a great outcome measure of populations of children, but it is not nearly as reliable about individual children.

I worry that as we develop this concept of readiness to learn that people will start using it as if it were an absolute indicator of an individual child. And I worry that overly stressed teachers and schools may take the attitude, “He is not ready to learn so what do you expect of us?" Rather, the attitude should be, “If this child is not ready to learn, what can we do to make this child more ready to learn."

We can increase the quality of readiness to learn at just about every stage through a child's lifetime. If we can have better supports, especially for high-risk mothers during pregnancy, fewer children will be born with very low birth weight and with brain damage that will compromise their development. If we can offer better services through effective home visiting to young mothers who are without funds and at risk of having trouble raising their children adequately, their children will be more ready to learn. If we can offer good parent resource programs so that parents can get the support and guidance they need in order to do a good job from the beginning, the children will benefit. If we can combine all those with quality preschool experiences and early childhood care and education, our children will be ready to learn in the sense of having the best start.

The table below shows the effects of high and poor quality early childhood care and education.3 If you look at the qualities involved in readiness to learn, they are almost identical to what children get from exposure to high quality early childhood care and education. They are almost directly opposite to what children get when exposed to poor quality early childhood care and education. Children who happen to have the opportunity of good day care or home care will have greatly increased their ability to level the playing field, thus giving them a chance to compete with children whose parents were better able to prepare them for school.

Effects of High- vs. Poor-quality Early Child Care and Education

(Source: Bertrand, 1993)

At this point, I would not be honest with you if I didn't say that all the services in the world – by themselves – are not what this nation needs. We need changes in six main areas of society if we are going to bring up a healthier, more productive, competent generation of children. We need changes in our families, businesses, communities and mainstream services, such as child care centres and schools. We also need changes in our specialized services; we need to get more of the highly specialized professionals out of their own clinics and hospitals and into areas in the community where children are actually present. We also need changes in government.

When it comes to families, we need to get more fathers involved in parenting when their children of either sex are young. Fathers are more likely to get involved with boys, particularly when they are ready to get into sports activities. We need to get fathers involved earlier. Every study we have seen shows that when both parents are working, as is the case in most families today, the bulk of the housework and the bulk of the parenting falls on the mothers. Never have parents spent as little time with their kids as they do today. So, if we are going to increase parenting time, we are not going to do so by putting more stress on mothers. We need to get fathers more involved with their kids.

We have to do something about the workplace. We need more family-oriented workplaces. Supervisors need to be sensitive to the family needs of workers. A number of studies have shown that in a family-friendly workplace you have less absenteeism, less lateness and higher productivity. But what that doesn't take into account is something that has become quite fashionable in the last few years – laying off a certain percentage of your workforce saying that you have to do it in order to keep the business going, and then expecting your remaining employees to work overtime. Working overtime is energy and time taken away from parenting.

Somehow we have to get across to our friends, colleagues, relatives and neighbours in the business community, that there's more than just the bottom line. If you are going to be a good businessperson and a good citizen then you have to start thinking about your responsibility to the community and to bringing up those children who are going to be your future employees, your future customers.

Now I want to talk about society. I grew up in the 40s in a Toronto where we children used to play hockey on the streets and when the street lights went out, somebody – my parents, somebody else's parents or a neighbour who did not have children – would tell us to go home. All adults in the neighbourhood took some responsibility for the well-being of the children in the community.

In contrast, a couple of years ago at a meeting I attended, a woman came in very late and somewhat distressed. She had been driving in one of the wealthier Toronto neighbourhoods and had seen a four-year-old child riding a tricycle in the middle of the road. She stopped her car, got out, and lead the child off the road and onto the sidewalk. She went down on her knees and told the child, “You could have been killed…" at which point the mother who had been watching came out of the house and said, “Get away from my child or I'm going to call the police!"

I think these two stories are indicative of the changes that we have seen in society. The first story reflects a society in which people share common beliefs and values. When everybody knows that they have similar beliefs and values, there is trust – and communication with others becomes easy. Strangers are not enemies. The African proverb that sums up that civic society is “It takes a whole village to raise a child." On the other hand, the other type of society (where there are no common values or beliefs) leads to fragmentation and polarization. Strangers – particularly if they look different – are seen as a threat or undesirable until proven otherwise. In this country to date, we only come together when faced with a major crisis, like the ice storm. Such uncivic societies are characterized by the proverb "When the water-hole shrivels, the animals get meaner."

I really think that there has been a major shift in Canadian society away from the civic toward the uncivic. Therefore, we have to do what we can to rebuild the social fabric that has been eroded over the past few decades. Incredible generosity is out there, but we need to somehow open that door and invite more of those people to give what they can give to help society as a whole.

We need a major shift in thinking of government at all levels. If we keep on advocating for children effectively and vigorously, we can possibly get even some of the least humane governments to do better for children than they have done before. Governments are pleased these days to say, "We are going to turn this over to the community." But a community that has lost its infrastructure can't take over overnight what governments have been doing for decades.

Governments hear a lot from the people who don't like their spending on social policy. They don't hear nearly as much from those people who are interested in providing the kinds of social networks and supports that can help families who are at risk to get the resources that will help them do a good job of raising their children. So we have to be more vocal, and not just when we're speaking about our own areas. If you people advocate for child care – and I'm not suggesting that you not do that – at the same time, advocate for better education and for better health services. Persuade your colleagues in education and in health to advocate for child care. I think that this combined effort will be far better than if each person just advocates for his or her own little piece of the pie.

It used to be that governments did not even notice children. Now governments notice children and even talk about them. We have to get to the point where governments do not just talk about doing what's right for children, but will give it the highest priority. There is nothing more important, as the people in Western Europe and Scandinavia know well, than the well-being of our present generation of children. We in North America have taken the attitude that children are the responsibility, not of the state, but of parents. And if the parents don't do well, we turn our noses down on both the children and on the parents.

We have an active role to play getting the general public as well as people in the professions to know what to ask governments 4..We must get informed and stand up in community meetings at all levels and make contact with elected politicians on a regular basis – to let them know that there is a community of people out there who care just as much about what's happening to the nation's children as what's happening to the nation's economy. They're both important, but our children should be our nation’s most important interest. Our children are our future.

Paul Steinhauer, MD, FRPC (C) [deceased] was professor of psychiatry and public health at the University of Toronto, staff psychiatrist at the Hospital for Sick Children and chair of the steering committee of the Sparrow Lake Alliance. This presentation and others from Linking Research to Practice – A Canadian Forum have been published by the CCCF.

Endnotes
1. Cicchetti, D. & Toth, S.L. (1995). "A Developmental Psycho Pathology Perspective on Child Abuse and Neglect." Journal of the American Academy of Child and Adolescent Psychiatry 34, 541-565.
2. Baumrind, D. (1989). "Rearing Competent Children." In W. Damon (Ed), Child Development Today and Tomorrow. San Francisco: Jossey-Bass.
3. Bertrand, J. (1993). Employers, Unions and Child Care. Toronto: Ontario Coalition for Better Child Care.
4. For help on this, visit the website of the Sparrow Lake Alliance: www.sparrowlake.org.