This document discusses the importance of infant mental health. It provides three key reasons:
1) Fetal programming - environmental inputs during sensitive periods of development can program biological systems, impacting health for life. Studies like the Dutch Famine Study show this.
2) Attachment - the relationship between infant and caregiver impacts development. Disruptions to attachment can harm social and emotional growth.
3) Therapy - early intervention can treat mental health issues in infants and young children to prevent problems down the line. The Adverse Childhood Experiences Study shows a strong link between childhood trauma and later health risks. Investing in infants and young children through programs that support caregiver-child relationships can promote wellbeing and human capital
3. Fetal or Developmental Programming:
“…biological systems adapt to input from the
environment during especially sensitive
periods of development; furthermore, the
malleability of biological systems to adjust to
environmental input is developmentally
constrained, so that systems that adapt to
environments early in life do not readapt to
subsequent changes in the environment…”
p. 674, O’Connor, 2003
4. Consider the nightmare of the
“Hungerwinter” of 1944
• Dutch under German occupation
• Sudden starvation
• 20,000 people die
• What happens to pregnant
women?
http://www.pnas.org/content/107/39/16757.full.pdf+html
9. Fetal Nutrient demand
Maternoplacental nutrient supply
• Nutrient availability
• Placental function and transfer
• Uteroplacental blood flow
Fetal adaptations (e.g., re-programming)
If demand is > maternoplacental supply
Then alterations how key organs function
Disease and Disability—YEARS later!
10. Anne Murphy Paul @ TED
What we learn before we’re born
http://www.ted.com/talks/annie_murphy_paul_what_we_learn_before_we_re_born.html
11. The Adverse Childhood Experiences (ACEs)
Study
• The largest study of its kind ever done: ~18,000
participants.
• Examined the health and social effects of adverse
childhood experiences over the lifespan.
• Conducted by a group at Kaiser Permanente, a large
HMO
For more on the Adverse Childhood Experiences Study, see:
http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=DetailsSearch&term=adverse+childhood+experiences+study
16. Adverse Childhood Events and
Adult Substance Abuse
Self-Report: Alcoholism Self-Report: Illicit Drug Use
Dube et al, 2002, 2005
17. Cumulative ACEs Increase the Risk of
Negative Outcomes
14
Attempted
suicide
12 Injected drug
use
Alcohol problem
10 Illicit drug use
Depressed
8 Chronic
bronchitis
50+ sex
partners
6 STDs
Poor Self-rated
health
4 Current Smoker
Cancer
2 Severe obesity
0
0 1 2 3 4+
18. ACE Studies Summary of Findings
• Adverse Childhood Experiences are very
common.
• ACEs are strong predictors of later health risks.
19. ACE Studies Summary of Findings
This combination makes ACEs one of the
leading, if not the leading, determinant of the
health and social well-being of our nation.
20. Felitti’s General Model-Trauma Effects
Early
Death
Disease &
Disability
Adoption of Health
Risk Behavior
Social, Emotional, &
Cognitive Impairment
Adverse Childhood
Experienced
21. James Heckman and the Question of
When to Intervene….
• Nobel prize winning economist who teaches at
U-Chicago
• Focus is on human capital and on policy that
promotes this commodity
• See: www.heckmanequation.org
