Primary prevention in child psychiatry: The transformative power of children & families

Father bonds with his newborn baby.
Father bonds with his newborn baby. © Dreamstime Images

Introduction

In the video learning tools below, Yale Professor, James F. Leckman provides a synopsis of responsive parenting and the epigenetic, neurobiological and clinical evidence supporting the well-being of children and families as an agent of change for sustainable peace. He posits that a strong case can be made for the field of child psychiatry to invest more in primary prevention. 

He briefly reviews the importance of early child development in setting the stage for an individual’s mental, emotional and physical well-being. His discussions include few key concepts including resilience, and turns to the substantial body of data concerning the long-term impact of adverse childhood experiences on the development of the brain. He follows with reviews of the promise of early parent-child interventions and their potential to improve the child’s cognitive and socio-emotional skills as well as to reduce violence in families and communities for generations to come in a highly cost-effective manner. He concludes the presentations by highlighting the promise of various international efforts underway.

Webinar (Eng) | Primary prevention in child psychiatry: The transformative power of children & families (1:00:32)

Courtesy of the Brain Behavior Research Foundation’s ‘Meet the Scientist’ Webinar Series

Webinar key concepts

  1. Bio-psycho-social ecosystems. The minds and bodies of children are shaped by their day-to-day interactions with parents, relatives, peers, teachers and other members of their community. Critical developmental periods: In the 1st year of life, the brain grows at the pace of 700-1000 new neural connections per second, a pace that is never achieved again;  by age 3, a child’s brain is twice as active as an adult brain; it is the early life experiences that determine the capacity of the brain – its structure and function.

  2. Attachment. Early in life, children form emotional attachments to familiar caregivers. When these caregivers are sensitive and responsive to the child’s needs, the caregivers provide a secure base from which the child can explore the world.

  3. Responsive parenting. Occurs when mothers, fathers and caregivers do their best to invest in their children and meet their emotional, cognitive, nutritional and physical needs during gestation and the early years.

  4. Adverse Childhood Experiences (ACEs). Across the globe, the exposure of children to violence is a uniquely traumatic experience that has the potential to profoundly derail the child’s security, health, happiness and ability to grow and learn - with effects lasting well into adulthood.

  5. Parenting begets parenting. There is a growing body of scientific literature that indicates that one crucially important predictor of parenting behavior is how parents were parented themselves. Violence can become self-perpetuating from generation to generation.

  6. Resilience. Although early childhood adversity and poor parenting can set the stage for a vicious cycle to develop leading to the intergenerational transmission of poor parenting, it is important to emphasize that in many cases, parents who experienced adversity as a child, including physical abuse, will NOT adopt the same pattern of behavior with their child.

Video (Eng) | The transformative power of responsive parenting (15:48)

Take home messages

  1. Early Child Development programs aimed at enhancing responsive parenting can reduce adverse childhood experiences (poor nutrition, ACEs) and can positively impact brain structure and function, our hormonal and immune systems, and even how our DNA is read and transcribed!

  2. Multi-sectoral partnerships (families, providers, researchers, government agencies, NGOs) are key to developing sustainable programs of proven value.

  3. Economic benefits also support the value to society of parent-child interventions in the early preschool years.

  4. The future is now. It is time to take action to make our world a better place for our children and for future generations. 


ContributorJames F. Leckman, M.D., Ph.D., serves as ECPC Executive Committee Member. He is Neison Harris Professor in the Child Study Center and Professor of Pediatrics at the Yale School of Medicine.


Relevant information

  1. Bolby, J. (1982). Attachment and loss. Vol. 1. Attachment. New York, NY: Basic Books.

  2. Bernard van Leer FND. (2014). Responsive parenting: A strategy to prevent violence. Issue 122. The Hague, The Netherlands: Bernard van Leer FND.

  3. Campbell, F. et al. (2014). Early childhood investments substantially boost adult health. Science; 343(6178):1475-85.

  4. Carter, S., & Porges, S. (Nov 2014). Peptide Pathways to Peace. In J. Leckman, C. Panter-Brick, R. Salah (Eds.), Pathways to peace: The transformative power of children and families (pp. 43-64). Cambridge, MA: MIT Press.

  5. Epstein, K. et al. (2015). More than one way to get there: Pathways of change in coparenting conflict after a preventive intervention. Family Process; 54(4):610-8.

  6. Fry, D. (Nov 2014). Group Identity as an Obstacle and Catalyst of Peace. In J. Leckman, C. Panter-Brick, R. Salah (Eds.), Pathways to peace: The transformative power of children and families (pp. 79-92). Cambridge, MA: MIT Press.

  7. Keverne, E. (Nov 2014). Epigenetics: Significance of the Gene-Environment Interface for Brain Development.  In J. Leckman, C. Panter-Brick, R. Salah (Eds.), Pathways to peace: The transformative power of children and families (pp. 65-77). Cambridge, MA: MIT Press.

  8. Listenbee, R., et al. (2012). Defending childhood: Protect, heal, thrive. Report of the Attorney General’s National Task Force on Children Exposed to Violence. 

  9. Olds, D. L. (2011). Evidentiary foundations of nurse-family partnership. Nurse-Family Partnership.

  10. Morgan, B., Sunar, D., Carter, S., Leckman, J., Fry, D., Keverne, E., Kolassa, I-T., Kumsta, R., & Olds, D. (Nov 2014). Human Biological Development and Peace: Genes, Brains, Safety, and Justice. In J. Leckman, C. Panter-Brick, R. Salah (Eds.), Pathways to peace: The transformative power of children and families (pp. 95-128). Cambridge, MA: MIT Press.

  11. Panter-Brick, C, & Leckman, JF. (2013). Editorial commentary: Resilience in child development–interconnected pathways to wellbeing. Journal of Child Psychology and Psychiatry, 54 (4), 333-336.

  12. Sadler, L., Slade, A., Close, N., et al. (2013). Minding the baby: Enhancing reflectiveness to improve early health and relationship outcomes in an interdisciplinary home-visiting program. Infant Mental Health Journal; 34(5).

  13. Science AAAS. (2014). Special issue: Parenting. Vol 345, Issue 6198. 

  14. World Health Organization. (2013). Preventing violence: Evaluating outcomes of parenting programs. WHO.

Relevant links

  1. Brain Behavior Research Foundation

  2. The Carolina Abecedarian (ABC) Project 

  3. Chicago Longitudinal Study

  4. The Heckman Equation

  5. HighScope Perry Preschool Study

  6. Minding the Baby

  7. Mother Child Education Foundation (AÇEV)

  8. Nurse Family Partnership

  9. Supporting Father Involvement 

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