Early experiences set the developmental trajectory for lifelong learning and health.

1. Early experiences set the developmental trajectory for lifelong learning and health.

2. Babies are born wired to learn, but they don’t come fully wired. At birth, a baby’s brain contains about 100 billion neurons. Most are not yet connected in networks. Genes provide the blueprint for building the brain’s architecture. However, a child’s early experiences affect how the circuitry actually gets wired. Early neural connections occur at warp speed. Learning is faster, more effortless and more fun than it will ever be again.

3. Brain architecture and developing skills are built “from the bottom up.” Simple circuits and skills provide the foundation for more advanced circuits and skills over time. The early period of brain development is one of both opportunity and vulnerability. Healthy early experiences provide a sturdy neural foundation for all of the learning, health and behavior that follow. Adverse early experiences result in weakened brain architecture and often lead to problems in learning, health and behavior.

4. The developing brain is like a super sponge, rapidly absorbing experiences into its architecture. By age three, 80 percent of neural construction is complete.

5. Early environmental factors and experiences shape the brain’s architecture. They foster or inhibit healthy social, emotional, cognitive and physical development. Caregiver-child interactions Emotional support Sensory stimulation Parents’ education Sense of safety Neurotoxins Nutrition Caregiver health Caregiver stress levels Stability of caregiver relationship Toxic stress Parents’ income Exposure to language/vocabulary Socialization with others

6. Healthy early experiences promote healthy brain development. • Nurturing, secure and predictable relationships with caring and supportive adult caregivers. • Stimulation through positive “serve and return” interactions with those caregivers. • Interactions that foster language development, including exposure to rich vocabulary. • Sense of safety and security, absence of toxic stress.

7. Three Levels of Stress Response Positive Brief increases in heart rate, mild elevations in stress hormone levels. (Examples: Starting a new school, getting a vaccination) Tolerable Serious, temporary stress responses, buffered by protective relationships. (Examples: Frightening injury, natural disaster) Toxic Serious, prolonged elevated stress responses, in the absence of protective relationships. (Examples: Exposure to violence, physical or emotional abuse or neglect, caregiver substance abuse or mental illness)

8. Toxic stress can cause physiological changes that: • Disrupt development of brain circuits and negatively impact brain functioning. • Damage the hippocampus (learning and • memory) and cause permanent brain deficits. • Suppress the body’s immune response system, resulting in vulnerability to infection and chronic health problems.

9. The physiological changes caused by TOXIC STRESSresult in increased rates of adult: SMOKING ALCOHOLISM ISCHEMIC HEART DISEASE DEPRESSION LIVER DISEASE OBESITY HYPERTENSION ANXIETY DISORDER ILLICIT DRUG USE DIABETES CORONARY OBSTRUCTIVE PULMONARY DISEASE

10. Department of Health and Human Services: Centers for Disease Control and Prevention, The ACE Pyramid (2008).

11. Adverse childhood experiences are devastating to Maine– in terms of both social and economic costs. K-12 Special Education $300 million/year Child Mental Health Services $60 million/year Corrections $160 million/year Substance Abuse $900 million/year Domestic Violence $1.0 billion/year

12. A child’s early development is often influenced by his or her parents’ education and income level. Early literacy is one example. 1200 1000 College Educated Parents 800 Working Class Parents Cumulative Vocabulary (Words) 600 Parents in Poverty 400 200 16 mos. 24 mos. 36 mos. Child’s Age (Months) Source: Hart & Risley (1995)

13. Parents’ education and income can substantially impact their children’s well-being in other ways. Children who are born and raised in poverty are more likely to experience: • Hunger and/or inadequate nutrition • Exposure to environmental toxins • Chronic medical conditions • Learning disabilities and developmental delays • Emotional and behavioral problems • Academic difficulties, repeating grades and dropping out • Unwed childbirth in adolescence • Low incomes as adults

14. But it doesn’t have to be this way. Communities can protect at-risk infants and toddlers and support their families through: • Universal access to prenatal and primary health care services; • Home visiting and parenting education & mentoring (facilitating healthy home environments with positive parent-child interactions); • Interventions that target and alleviate the source of parental stress (e.g., extreme poverty, violent relationships, mental illness, substance abuse) and help meet the needs of families and children; and • Affordable, high quality early care & education programs that provide nurturing environments and promote learning.

15. High quality early care and education involves adult caregivers providing young children with individualized, responsive and stimulating learning experiences. These experiences foster intellectual, social and emotional development and lay the foundation for later school success. High quality early care and education features stable and highly skilled staff, a high ratio of adults to children and a language rich, stimulating and safe environment.

16. Home visiting involves caring professionals visiting with expectant and new parents. Home visitors help parents access information and resources to nurture and support the healthy physical, cognitive, emotional and social development of their young children.

17. Children who experience high quality early care and education are more likely to: • • have good physical, emotional and mental health, • • have high self esteem, • • have strong speech and language skills, • • succeed academically and attend college, • • have higher earnings as adults, • • own their own homes, and • • contribute to the tax base.

18. And less likely to: • require remedial education and/or drop out of school, • become teen parents, • experience emotional and mental health problems, • engage in criminal behavior as teens and adults, • abuse drugs, and • become dependent on welfare.

19. Early childhood investments yield the highest economic returns.

20. Yet, we invest the least at the time of greatest impact. $60,000 $40,000 $20,000 0 $80,000 Brain Growth Curve Educator Salaries Child’s age 5 10 15 20 Early Ed K-12Higher Ed

21. What do we know about Maine’s youngest children? • There are fewer than 70,000 children under age five — about the populations of Lewiston and Bangor combined. • About 15,000 (21%) live in poverty (below FPL) — the size of Waterville. • Another 20,000 (29%) live in low income families (between 100% - 200% FPL) — the population of Biddeford.

22. What do we know about Maine’s youngest children? • Nine out of 10 young children in Maine whose parents lack a high school degree live in low-income families. • Three-fourths of young children whose parents have only a high school degree live in low-income families. • Almost half of young children in low-income families live with a single parent. Only 14% of other children do.

23. Two-thirds of children under five live in families in which all parents work. Maine lacks adequate high quality care and education to meet the needs of these families. 50 45 40 35 30 Thousands 25 20 15 10 5 0 Slots with Quality Certificates Licensed slots for Children birth-5 Children birth-5 with all parents working

24. Maine’s education “system”: Too many start behind, and most who do, stay behind. Kindergarten About 45% of all students are low-income As many as 40% of all students are not developmentally prepared 4th Grade 43% of low-income students can't read at basic level 19% of non low-income students can't read at basic level 80% low-income and 57% non low-income can't read at proficient level 8th Grade 30% of low-income students can't read at basic level 12% of non low-income students can't read at basic level 76% low-income and 51% non low-income can't read at proficient level High School 52% of 11th graders can't read at proficient level 54% of 11th graders are not proficient in math 20% of students who start 9th grade don't graduate with class College 35% of HS grads don't enroll in college 50% who enroll in community colleges and 20% who enroll in universities require remediation 74% who enroll in community colleges and 52% in universities don't graduate w/in 150% of normal time

25. “By age 5, it is possible to predict, with depressing accuracy, who will complete high school and college and who won’t.” David Brooks “The Biggest Issue” Mr. Brook’s NYT ‘s article summarizes Nobel prize-winning economist Dr. James Heckman’s research (”Schools, Skills and Synapses.”)

26. What happens to high school dropouts? • Many can’t find work, or if they do, they can’t keep it. • Most who are working are earning low pay – on average less than $20,000 a year. • Many engage in non-social behavior. High school dropouts are three and a half times more likely to wind up in jail than graduates. • 54% of adults incarcerated in Maine prisons lack a high school education. This compares to 11% in the general population.

27. Ensuring that all Maine children start to kindergarten ready and able to succeed is an economic imperative! Maine employers find it difficult to fill jobs in many areas. These include health sciences, engineering and information technology.There simply aren't enough highly educated and skilled workers to meet the demand. Unless we take action now, the problem will only worsen. That’s because Maine has an old population, a low birthrate and a high percentage of children born to parents with low education and incomes.

28. Things you can do to make a difference: • Educate yourself! Learn more about the importance of high quality early childhood development. Visit early childhood providers in your community. • Speak out! Educate others about the importance of high quality early childhood development. Explain how our lack of investment is failing not only our children, but our economy as well. • Take action! Share your concerns and ideas with public officials and business leaders. Advocate for increased public and private investment in Maine’s youngest children and their families.

30. ENDNOTES • This presentation was developed by Steven Rowe, former Maine Attorney General and passionate advocate for Maine's youngest children. Creative services were provided by Burgess Advertising & Marketing in Portland, Maine. The presentation is available for responsible educational use through the Maine Children's Growth Council. Information contained herein has been collected over a period of time from foremost experts in the field. Careful attention has been given to provide the most current and accurate data and sources. If data is found to be inaccurate, please provide corrected data and source to info@MaineCGC.org. • Slide Number and Source • The statement “Early experiences set the developmental trajectory for lifelong learning and health” summarizes the content and message of the presentation. • “A Science-Based Framework for Early Childhood Policy: Using Evidence to Improve Outcomes in Learning, Behavior, and Health for Vulnerable Children.” Center on the Developing Child at Harvard University (2007).http://www.developingchild.harvard.edu; Shonkoff, J.P. and Phillips, D.A., eds., (2000), From Neurons to Neighborhoods: The Science of Early Childhood Development, National Research Council and Institute of Medicine (National Academy Press, Washington, D.C.). • Shonkoff, J.P. (2010), “Building a New Biodevelopmental Framework to Guide the Future of Early Childhood Policy,” Child Development , 81: 357–367. doi: 10.1111/j.1467-8624.2009.01399.x; “The Science of Early Childhood Development: Closing the Gap Between What We Know and What We Do.” (2007), National Scientific Council on the Developing Child. http://www.developingchild.harvard.edu. • Graph is by Dr. Charles A. Nelson and is contained in Shonkoff, J.P. and Phillips, D.A., eds., (2000), From Neurons to Neighborhoods: The Science of Early Childhood Development, National Research Council and Institute of Medicine (National Academy Press, Washington, D.C.). • From various research including “The Foundations of Lifelong Health Are Built in Early Childhood.” Center on the Developing Child at Harvard University (2010). http://www.developingchild.harvard.edu; and Zeanah, Jr., C.H. (Ed.), Handbook of infant mental health, third edition (New York: Guilford Press, 2009).

31. “A Science-Based Framework for Early Childhood Policy: Using Evidence to Improve Outcomes in Learning, Behavior, and Health for Vulnerable Children.” Center on the Developing Child at Harvard University (2007). http://www.developingchild.harvard.edu; Shonkoff, J.P. and Phillips, D.A., eds., (2000), From Neurons to Neighborhoods: The Science of Early Childhood Development, National Research Council and Institute of Medicine (National Academy Press, Washington, D.C.). • “Toxic Stress Response: The Facts.” Center on the Developing Child at Harvard University. http://www.developingchild.harvard.edu; Middlebrooks JS, Audage NC. “The Effects of Childhood Stress on Health Across the Lifespan.” Centers for Disease Control and Prevention, National Center for Injury Prevention and Control (2008). • “Excessive Stress Disrupts the Architecture of the Developing Brain: Working Paper #3.” National Scientific Council on the Developing Child (2005). http://www.developingchild.harvard.edu. • From the “Adverse Childhood Experiences (ACE) Study”, an ongoing collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente. Led by Co-principal Investigators Robert F. Anda, MD, MS, and Vincent J. Felitti, MD, the ACE Study is perhaps the largest scientific research study of its kind, analyzing the relationship between multiple categories of childhood trauma and health and behavioral outcomes later in life. Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. http://www.cdc.gov/nccdphp/ace/findings.htm. • The ACE Pyramid represents the conceptual framework for the Adverse Childhood Experience (ACE) Study. Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. http://www.cdc.gov/ace/pyramid.htm. • Program expenditures (rounded) from budget data of Maine Departments of Education, Health and Human Services and Corrections, 2010; “Substance Abuse in Maine: What does it cost us?”, Maine Office of Substance Abuse, Jan. 2011; “Victims Costs and Consequences, A New Look,” U.S. Departments of Justice and Health and Human Services, 1996 (national annual costs of domestic violence and sexual assault apportioned to Maine on per capita basis).

32. Graph is from Hart, B., and Risley, T. R., Meaningful Differences in the Everyday Experience of Young American Children (Baltimore, Md.: Paul H. Brookes Publishing Co., 1995). • From various research including Zeanah, Jr., C.H. (Ed.), Handbook of infant mental health, third edition (New York: Guilford Press, 2009); Schweinhart, L. J., Montie, J., Xiang, Z., Barnett, W. S., Belfield, C. R., & Nores, M., Lifetime effects: The HighScope Perry Preschool study through age 40. (Ypsilanti, MI: HighScope Press, 2005); Brooks-Gunn, J. and Duncan, G.J. (1997).“The effects of Poverty on Children.” Future of Children, 7:55–71. • From various research, including materials on the Maine Children’s Growth Council website http://www.mainecgc.org such as “Invest Early in Maine: A Working Plan for Humane Early Childhood Systems,” (2008), Maine Department of Health and Human Services. http://mainecgc.org/Invest%20in%20Maine%202008.pdf. • Ibid. • Ibid. • Heckman, J. J. (2006). “Skill formation and the economics of investing in disadvantaged children.” Science, 312, 1900–1902; Heckman, James. http://www.jec/senate.gov/archive/hearings/06.27.07; Schweinhart, L. J., Montie, J., Xiang, Z., Barnett, W. S., Belfield, C. R., & Nores, M., Lifetime effects: The HighScope Perry Preschool study through age 40. (Ypsilanti, MI: HighScope Press, 2005); Campbell, F. A., Ramey, C. T., Pungello, E. P., Sparling, J., & Miller-Johnson, S. (2002). “Early Childhood Education: Young Adult Outcomes from the Abecedarian Project.” Applied Developmental Science, 6, 42-57. • Ibid. • Graph is from Heckman, J. J. (2006). “Skill formation and the economics of investing in disadvantaged children.” Science, 312, 1900–1902.

33. Salary figures are rounded. Average annual salary of $27,000 for teachers in accredited child care centers and $21,300 for teachers in non-accredited centers from Maine Child Care Workforce Climate Report & Market Rate Analysis, prepared for the Early Childhood Division of the Maine Department of Health and Human Services by Digital Research, Inc., 2008; Average annual salary of $46,106 for public school teachers in Maine is from Rankings of the States 2010 and Estimates of School Statistics 2011, NEA Research, Dec. 2010; Average annual associate professor salary is composite of average annual salaries for associate professors at University of Maine at Orono, University of Southern Maine and other University of Maine System undergraduate universities. These figures are $75,400, $72,700 and $57,000, respectively, and are from the University of Maine System 2009 Compensation Report. Brain development curve approximates curve from D. Purves, Body and Brain, Harvard University Press, 1998. The curve shows the percentage of total brain growth by age. • Extrapolated and rounded from 2010 U.S. Census data for Maine; and “Annual Social and Economic Supplement of the Current Population Survey 2010”, National Center for Children in Poverty, Maine Early Childhood Profile. • Ibid. • Data provided in 2004 by the Office of Child and Family Services, Maine Department of Health and Human Services. Although data is not recent, similar shortages continue to exist. (Data is being updated for 2011.) • “Low income” is defined as income at or below 185% of Federal Poverty Level (FPL) for purposes of this chart. The percentage of students who arrive at kindergarten developmentally unprepared (40%) is an estimate based on data from a number of states that have universal standardized kindergarten assessments (the percentages range from 33% to 50%). It is also based on the opinions of many Maine school teachers and administrators. (Note: here is no standardized kindergarten readiness assessment used in Maine schools.) The approximate percentage of kindergarteners who are low income (45%) is based on the fact that 44% of Maine K–12 students qualify for the federal free or reduced lunch program (eligibility up to 185% of FPL) as well as the fact that 50% of Maine children under age 6 live at or below 200% of FPL (National Center for Children in Poverty, 2009.) 4th and 8th grade reading statistics are from U.S. Dept. of Education National Assessment of Educational Progress (NAEP) results, 2011. 12th grade reading and math statistics are from 2009-2010 Maine High School Assessments. High school graduation rate is from Maine Department of Education, 2009. Percentage of high school graduates enrolling in college and percentages of college enrollees graduating within 150% of normal time are from Indicators of Higher Education Attainment in Maine, prepared for Maine Compact on Higher Education by Mitchell Institute, Aug. 2010. Percentages of college students taking remedial courses are rounded from data provided by Maine Community College System and University of Maine System, 2011.

34. David Brooks, “The Biggest Issue” summarizing Nobel prize-winning economist James Heckman’s research in ”Schools, Skills and Synapses.” http/www.nytimes.com/2008/07/29/opinion/29Brooks.htm. “The High Cost of High School Dropouts,” November 2011 Issue Brief, Alliance for Excellent Education; Educational and Correctional Populations, Harlow, C.W. (2003), U.S. Department of Justice, Bureau of Justice Statistics; Maine Crime & Justice Data Book (2008), University of Southern Maine Muskie School of Public Service, Justice Policy Program; 2005-2009 American Community Survey 5-Year Estimates, U.S. Census Bureau. http://factfinder.census.gov/. From various sources including news reports in Bangor Daily News , Lewiston Sun Journal and Portland Press Herald; conversations with numerous Maine business leaders; Kaiser Family Foundation State Health Facts, http://www.statehealthfacts.org; 2005-2009 American Community Survey 5-Year Estimates, U.S. Census Bureau. http://factfinder.census.gov/; “Annual Social and Economic Supplement of the Current Population Survey 2010”, National Center for Children in Poverty, Maine Early Childhood Profile. These suggested actions are not exclusive. Neither are they new. For years, experts (to include noted economists, physicians and business leaders) have called for increased public and private investments in early childhood development. Yet, there continues to be a lack of public appreciation regarding the value of these investments.