A Beacon of Hope

Although research reveals that it is never too late to learn, the plasticity of the brain is greatest from birth to about three years of age - the period when the most rapid brain development occurs. As many as 700 synapses per second are formed in the early years.

Economic analysis indicates that appropriate investments in support of the families of these young children or the use of proven interventions for the children will result in the greatest return on investment if measured over a lifetime, according to advocates at The Urban Child Institute (TUCI).

The Institute is the brainchild of Eugene V. Cashman, CEO, and Henry G. Herrod, MD, the Senior Fellow at TUCI, a pediatric allergist/immunologist and former dean of the college of medicine at UTHSC. The Urban Child Institute has evolved from its original focus on women and children, including domestic violence, child abuse, substance abuse and teenage pregnancy under the auspices of the an organization known as LHS.

Cashman and Herrod were discouraged that little had changed following several years of devoting considerable resources with no enduring improvement apparent, despite efforts spent battling the issues.  They turned to the science of developmental neurobiology and outcomes of interventions in the early years of child development – the landmark HighScope Educational Research Foundation studies.

With rich community resources including the department of neuroscience at UTHSC, Le Bonheur, St. Jude, the University of Memphis, and others, they were convinced that optimal early brain development was where they needed to focus. The organization was renamed The Urban Child Institute in 2004 and the mission of channeling resources to benefit children, especially from conception to three years when the brain undergoes rapid development, was set in motion.

That was seven years ago.  Fast forward to May, 2011.

Though it seems intuitive that children need stimulation from the time of birth, not every child receives the stimulation necessary to nurture optimal brain development. The nerve cells develop connections (synapses) with other neurons; these connections produce the networks that engender learning, memory, and thought.

Earliest messages have the greatest impact. Infants are stimulated through touching, gazing, talking, loving, singing and facial expressions. Whether the message is positive or negative is key; studies have demonstrated that children with ‘professional parents’ hear six positive statements for every one negative according to TUCI’s The Data Book 2010.

In pursuit of stated goals, Herrod enumerated four of TUCI’s current initiatives to promote and accomplish its mission:

• The creation of an annual data book, which is an effort to collect data on children and youth in Memphis and Shelby County and put it all in one place.
• Disseminating the message to parents, professionals, policy makers, and other philanthropic organizations about the importance of early childhood development.
• A close, working relationship with the Neighborhood Christian Center (NCC) service organization.
• The CANDLE project (Conditions Affecting Neurocognition Development and Learning in Early Childhood)

The data book is compiled from multiple sources of the latest research, reports and surveys, both local and national, on children in the U.S. and Memphis and Shelby County including the DHHS, the U.S. Census Bureau, the CDC, Memphis City Schools, Porter Leath’s Early Headstart program, the Early Childhood Development Public Opinion Poll and other sources. The purpose is to present the information in a comprehensive manner that is useful in extrapolating information that might not appear as meaningful on its own.

Getting the message to parents, professionals (defined as college educated), policy makers and philanthropic organizations seems to be a no-brainer, yet, as women have increasingly joined the workforce, some children do not spend as much time with their mothers/parents/ siblings as a generation or two ago, according to Herrod. More children are in settings (childcare) that may not stimulate their brains or expose them to experiences that were considered common years ago.

“’Talk, touch, read, and play’ is the mantra that TUCI promotes,” said Herrod, reflecting the way babies learn and react to stimulation as their brains develop. This may not be at the forefront since other needs supersede family time, especially financial needs for mothers who are also heads of the household.

The Neighborhood Christian Center (NCC) is a 32-year-old service organization founded by JoeAnn Ballard, PhD, originally responding to basic needs, such as food, shelter, and clothing. Several years ago, Ballard questioned how many lives were actually being changed as a result of the NCC’s efforts and discussed her thoughts with Cashman and Herrod. The leadership of the two organizations which now includes Ephie Johnson as the president/CEO of the NCC, dovetailed in their core beliefs that early childhood was where the resources should be directed by TUCI and that the NCC was the ideal conduit for getting the message out.

With NCC’s 78 church affiliate network, the information from TUCI is disseminated to its population, which is grossly underserved and in need of guidance concerning the importance of early brain development. Herrod gives the bulk of the credit to Ballard, presently the senior advisor to the president & CEO of NCC and a consultant to TUCI, and to Johnson for making this organizational ‘marriage’ work.

“If we could begin to make a difference with the young mothers and their children within a big organization (NCC) and its affiliates, it was felt that, rather than reaching hundreds of people, thousands could be targeted,” added Herrod,

“and we could take this message to scale throughout Shelby County.”

The CANDLE project, funded by TUCI in the department of preventive medicine at UTHSC, is a longitudinal study enrolling 1,500 women during their second trimester of pregnancy and then following them and their children during the first three years of life. The women enrolled reflect the socio-demographic picture of Shelby County, and have delivered their infants at St. Francis, Baptist, Methodist, and The MED.

Multiple contacts are made with mother and child over the course of the study, including clinic, home and phone visits, said Herrod. “The moms and kids will be given a battery of tests, including cognitive tests, collections of placental tissue, blood, and urine, and genetic analysis of tissue will be performed.  “We will also test (with confidential, non-identifiers) for kindergarten readiness, which is a good predictor of how well kids will do in school,” said Herrod.

Collaborators for the study include Emory, Vanderbilt, the University of Southern California, the University of North Carolina, UAB and the Rand Corporation. “We expect to get some useful information relating to what may account for the differences (influencing brain development) we find,” added Herrod.

Herrod recounted numerous studies that demonstrate causal factors that influence differences in children’s learning and reading improvement over time. One study showed that by the time children of ‘professional parents’ are four years old, they have heard about 45 million words; Children who live in poverty have heard about 13 million words. 

Similarly, studies show that children whose parents engage them in activities in the summertime visiting museums, reading, and going on vacation continue learning, as opposed to children with neither parent at home during the summer, who tend to lose ground when stimulating activities are not accessible.

Most people take for granted experiences they had as children – but many children in the city have never seen a lake, or animals in the wild, like a turtle or a raccoon, seen wild flowers, or visited a museum. “Those positive experiences affect brain development,” said Herrod.

Herrod noted many factors that affect learning – genetics, stress, nutrition, adverse experiences; “I think the role of stress ends up being the common pathway for a whole host of things. As you think about the neighborhood, food insecurity, financial insecurity, the pressure that leads people to change homes/residences in the early years – all of these things create a stress factor that is huge for children. …It is clear from animal studies that stress has an effect on neuron development.”

One study cited by Herrod, the Adverse Childhood Experience study (ACE) conducted by the CDC and Kaiser Permanente, identified 10 factors that can alter an individual’s behavior when they occur in childhood, leading to health consequences: emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, violent treatment of the mother, household substance abuse, household mental illness, parental separation or divorce, or an incarcerated household member. The greater the number of adverse experiences a child is exposed to, the greater the risk of developing behaviors (e.g. smoking, substance abuse, sexual promiscuity) that may lead to major health problems such as diabetes, cardiovascular disease, or severe depression. 

Herrod indicated that the key concept they would like for physicians and professionals to be aware of is that, “The biggest return on investment in terms of human capital is in the early years. You get improvement if you do pre-schooling, job training, and scholarship, but the biggest ‘bang for the buck’ is in the early years.”

“For people who try to be realistic about what we can do in our communities, for every dollar invested, there was a $17 dollar return according to the HighScope study. That was following the kids who had high quality intervention in the first couple years of life. Now they are in their 40’s. The right kind of interventions in early childhood have lifelong impact,” stated Herrod.

Negative aspects affecting early brain development are tempered with positive aspects. The bad news: “adverse childhood experiences can last a lifetime.” The good news: positive interventions can mitigate the negative effects.

“And preventive intervention is even better,” said Herrod.

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