Early Childhood Intervention

When listening to Professor Frank Oberklaid talking about the ‘brain architecture being built in an hierarchical ‘bottom up’ sequence’, at the DI conference in Sofia, last month, I was struck by the methaphor he used. I have been using phrases like ‘the foundation of the brain’ and ‘when you build on a foundation with holes in it, the building won’t stand’ to explain the effects of institutionalisation on children for years now, but I had never heard anyone else use ‘architectural terms.’

It has happened regularly that when I make the point that the foundation of a child’s brain is completed around age 10, and that after that the child can build on that foundation, but cannot make changes to the foundation itself anymore, I encounter arguments that after all the brain is very plastic and it has an amazing ability to recover and adapt. It is true that the brain has an amazing ability to recover and adapt, throughout life. However, there are limits to what is possible. Your leg also has an amazing ability to heal and recover from injury, but if you cut the leg off, it is not going to grow back.

During the conference both Professor Oberklaid and Dr Charles Nelson pointed out that the plasticity of the brain decreases over time and that it is harder to change anything later on. Or as Dr Nelson said, in some domains change remains possible – for example we can learn a new language at an advanced age – throughout life, while in other domains it is not. And even where change remains possible, it requires far more effort to accomplish it later on, so it becomes harder.

This is why Professor Oberklaid made the case for Early Childhood Development (ECD) support. Because, he stated, the earlier the intervention, the lower the cost and the higher the effectiveness.

He explained that the relationships that a child has with the adults around him, sculpt his brain. And that the lack of attachment opportunities and stable relationships in institutional care form a major source of stress for children. Through the ‘biological embedding of environmental events’ (quote from Herzmann), toxic stress is seen in children who have been institutionalised from an early age.

Professor Oberklaid emphasised that ECD support cannot be fragmented. To be effective it has to be integrated and multi-sectored, including education, health, nutrition, child protection and social protection. By providing ECD the removal of children from their family can often be prevented. And the relationships that professionals have with the parents have a big impact on the quality of the ECD of the child.

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