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Influence of Experiences From Birth to 5 Years of Age on Emotional and Psychological Health

Influence of Experiences From Birth to 5 Years of Age on Emotional and Psychological Health When they are born, they can still be perfect. You haven't made any mistakes yet.—Steve Martin, Parenthood The angst that reverberates in the character of Gil Buckman is not unfamiliar to many parents. Children enter this world sentient, to be sure, but otherwise, at least in parents' minds, entirely undifferentiated, with seemingly limitless potential. When we chose the time from birth to 5 years of age as a critical period of development for our theme issue, we did so hoping to attract articles that advanced the science of early life experience—articles that provided key, actionable evidence of how we can manipulate the early environment of children and make a tangible difference in their health. We clearly succeeded. What have we learned? The birth weight of twin pairs appears to have important effects on later development, with larger twins having more conduct problems than the smaller infant of the pair.1 Exposure to drugs and toxins during pregnancy and their effect on the developing fetus have long been of concern, and better understanding of these effects is one of the main driving forces behind the National Children's Study. Smoking during pregnancy has been shown to have myriad effects on infants and children; to these, we can now add sleep problems that persist throughout childhood.2 For therapeutic agents, mothers and their physicians must balance the risk of the drugs against the risks—to both mother and child—of untreated disease. Oberlander and colleagues3 demonstrate that a third factor must be considered, namely, the child's genotype, which can have a moderating influence on the effects of maternal illness. Another exposure that some would also classify as toxic to infants and young children is television. The obesity “epidemic” affecting children throughout the world has been ascribed, in part, to the effects of television on decreased physical activity and snacking while watching.4,5 Pagani and colleagues6 show the harmful effects of each hour of television watched during the preschool years on classroom engagement and compare it with achievement in grade 4. The first experimental study of infant entertainment conducted in naturalistic settings found no evidence that entertainment designed for infants can increase a child's language development7 despite the claims of some producers of baby videos as well as a suggestion that earlier viewing might delay language, confirming prior studies.8,9 Finally, articles in this issue advance our understanding of why low socioeconomic status has such detrimental effects on health. The worse cardiovascular health of overweight children from poor neighborhoods10 may be due to impaired reactivity and recovery from acute stress related to the high levels of chronic stress these individuals experience throughout childhood.11 Caution needs to be emphasized in any interventions in children, and these interventions must be based on compelling evidence before being widely implemented. Screening of school children for attention-deficit/hyperactivity disorder would seem, initially, to be worthwhile. However, Sayal and colleagues12 demonstrated that school screening offered no benefit to the children, and risks the harm of labeling children with a disorder. What is especially gratifying is that articles in this issue show how changes in the environment can positively affect children. Nurse visitation programs for at-risk children show benefits, even 12 years later, both to the children who have less substance abuse, less internalizing of problems such as anxiety and depression, and better school performance13 as well as to their mothers, who also report less involvement with substance abuse and longer relationships with their partners.13 Perhaps the most vulnerable children in any society are those who are abused, orphaned, or in foster care. The nature of the environment in which society places these children can have enormous effects on the physical and emotional health of these children. Placing children involved with the child welfare system into foster care can lower the amount of stress the children experience, as measured by their diurnal cortisol secretion, compared with leaving them in the homes of their birth parents.14 Even more striking are the results of a randomized controlled trial15 of children living in institutional settings in Bucharest that emphasized the need for early placement of abandoned children in home-based care. Taken together, the research in this issue has clear implications: early experiences matter, and changes in those experiences are achievable and pay dividends. This research needs to be translated into action. In the new austerity that has been spawned by the national fiscal crisis, states are cutting back broadly on services. In many cases, children are being hit the hardest. Given the importance of early childhood experiences on the entire life course, we can only hope that the people who make decisions about where monies are saved are mindful of the effect those decisions can have. Correspondence: Dr Christakis, Center for Child Health, Behavior, and Development, Seattle Children's Hospital Research Institute, 1100 Olive Way, Ste 500, Mailstop 8-1, Seattle, WA 98101 (dimitri.christakis@seattlechildrens.org). Financial Disclosure: None reported. References 1. Mankuta DGoldner IKnafo A Intertwin birth weight differences and conduct problems in early childhood. Arch Pediatr Adolesc Med 2010;164 (5) 457- 461Google ScholarCrossref 2. Stone KCLaGasse LLLester BM et al. Sleep problems in children with prenatal substance exposure: the Maternal Lifestyle Study. Arch Pediatr Adolesc Med 2010;164 (5) 452- 456Google ScholarCrossref 3. Oberlander TFPapsdorf MBrain UMMisri SRoss CGrunau RE Prenatal effects of selective serotonin reuptake inhibitor antidepressants, serotonin transporter promoter genotype (SLC6A4), and maternal mood on child behavior at 3 years of age. Arch Pediatr Adolesc Med 2010;164 (5) 444- 451Google ScholarCrossref 4. Robinson TN Reducing children's television viewing to prevent obesity: a randomized controlled trial. JAMA 1999;282 (16) 1561- 1567PubMedGoogle ScholarCrossref 5. Wiecha JLPeterson KELudwig DSKim JSobol AGortmaker SL When children eat what they watch: impact of television viewing on dietary intake in youth. Arch Pediatr Adolesc Med 2006;160 (4) 436- 442PubMedGoogle ScholarCrossref 6. Pagani LSFitzpatrick CBarnett TADubow E Prospective associations between early childhood television exposure and academic, psychosocial, and physical well-being by middle childhood. Arch Pediatr Adolesc Med 2010;164 (5) 425- 431Google ScholarCrossref 7. Richert RARobb MBFender JGWartella E Word learning from baby videos. Arch Pediatr Adolesc Med 2010;164 (5) 432- 437Google ScholarCrossref 8. Christakis DAGilkerson JRichards JA et al. Audible television and decreased adult words, infant vocalizations, and conversational turns: a population-based study. Arch Pediatr Adolesc Med 2009;163 (6) 554- 558Google ScholarCrossref 9. Zimmerman FJChristakis DAMeltzoff AN Associations between media viewing and language development in children under age 2 years. J Pediatr 2007;151 (4) 364- 368PubMedGoogle ScholarCrossref 10. Singh TPEvans S Socioeconomic position and heart rate recovery after maximal exercise in children. Arch Pediatr Adolesc Med 2010;164 (5) 479- 484Google Scholar 11. Chen E Digging deeper: understanding the biological mechanisms that connect low socioeconomic status to poor health. Arch Pediatr Adolesc Med 2010;164 (5) 495- 496Google ScholarCrossref 12. Sayal KOwen VWhite KMerrell CTymms PTaylor E Impact of early school-based screening and intervention programs for ADHD on children's outcomes and access to services: follow-up of a school-based trial at age 10 years. Arch Pediatr Adolesc Med 2010;164 (5) 462- 469Google ScholarCrossref 13. Olds DLKitzman HJCole RE et al. Enduring effects of prenatal and infancy home visiting by nurses on maternal life course and government spending: follow-up of a randomized trial among children at age 12 years. Arch Pediatr Adolesc Med 2010;164 (5) 419- 424PubMedGoogle ScholarCrossref 14. Bernard KButzin-Dozier ZRittenhouse JDozier M Cortisol production patterns in young children living with birth parents vs children placed in foster care following involvement of Child Protective Services. Arch Pediatr Adolesc Med 2010;164 (5) 438- 443Google ScholarCrossref 15. Bos KJZeanah CH JrSmyke ATFox NANelson CA III Stereotypies in children with a history of early institutional care. Arch Pediatr Adolesc Med 2010;164 (5) 406- 411Google ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Pediatrics & Adolescent Medicine American Medical Association

Influence of Experiences From Birth to 5 Years of Age on Emotional and Psychological Health

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References (16)

Publisher
American Medical Association
Copyright
Copyright © 2010 American Medical Association. All Rights Reserved.
ISSN
1072-4710
eISSN
1538-3628
DOI
10.1001/archpediatrics.2010.67
Publisher site
See Article on Publisher Site

Abstract

When they are born, they can still be perfect. You haven't made any mistakes yet.—Steve Martin, Parenthood The angst that reverberates in the character of Gil Buckman is not unfamiliar to many parents. Children enter this world sentient, to be sure, but otherwise, at least in parents' minds, entirely undifferentiated, with seemingly limitless potential. When we chose the time from birth to 5 years of age as a critical period of development for our theme issue, we did so hoping to attract articles that advanced the science of early life experience—articles that provided key, actionable evidence of how we can manipulate the early environment of children and make a tangible difference in their health. We clearly succeeded. What have we learned? The birth weight of twin pairs appears to have important effects on later development, with larger twins having more conduct problems than the smaller infant of the pair.1 Exposure to drugs and toxins during pregnancy and their effect on the developing fetus have long been of concern, and better understanding of these effects is one of the main driving forces behind the National Children's Study. Smoking during pregnancy has been shown to have myriad effects on infants and children; to these, we can now add sleep problems that persist throughout childhood.2 For therapeutic agents, mothers and their physicians must balance the risk of the drugs against the risks—to both mother and child—of untreated disease. Oberlander and colleagues3 demonstrate that a third factor must be considered, namely, the child's genotype, which can have a moderating influence on the effects of maternal illness. Another exposure that some would also classify as toxic to infants and young children is television. The obesity “epidemic” affecting children throughout the world has been ascribed, in part, to the effects of television on decreased physical activity and snacking while watching.4,5 Pagani and colleagues6 show the harmful effects of each hour of television watched during the preschool years on classroom engagement and compare it with achievement in grade 4. The first experimental study of infant entertainment conducted in naturalistic settings found no evidence that entertainment designed for infants can increase a child's language development7 despite the claims of some producers of baby videos as well as a suggestion that earlier viewing might delay language, confirming prior studies.8,9 Finally, articles in this issue advance our understanding of why low socioeconomic status has such detrimental effects on health. The worse cardiovascular health of overweight children from poor neighborhoods10 may be due to impaired reactivity and recovery from acute stress related to the high levels of chronic stress these individuals experience throughout childhood.11 Caution needs to be emphasized in any interventions in children, and these interventions must be based on compelling evidence before being widely implemented. Screening of school children for attention-deficit/hyperactivity disorder would seem, initially, to be worthwhile. However, Sayal and colleagues12 demonstrated that school screening offered no benefit to the children, and risks the harm of labeling children with a disorder. What is especially gratifying is that articles in this issue show how changes in the environment can positively affect children. Nurse visitation programs for at-risk children show benefits, even 12 years later, both to the children who have less substance abuse, less internalizing of problems such as anxiety and depression, and better school performance13 as well as to their mothers, who also report less involvement with substance abuse and longer relationships with their partners.13 Perhaps the most vulnerable children in any society are those who are abused, orphaned, or in foster care. The nature of the environment in which society places these children can have enormous effects on the physical and emotional health of these children. Placing children involved with the child welfare system into foster care can lower the amount of stress the children experience, as measured by their diurnal cortisol secretion, compared with leaving them in the homes of their birth parents.14 Even more striking are the results of a randomized controlled trial15 of children living in institutional settings in Bucharest that emphasized the need for early placement of abandoned children in home-based care. Taken together, the research in this issue has clear implications: early experiences matter, and changes in those experiences are achievable and pay dividends. This research needs to be translated into action. In the new austerity that has been spawned by the national fiscal crisis, states are cutting back broadly on services. In many cases, children are being hit the hardest. Given the importance of early childhood experiences on the entire life course, we can only hope that the people who make decisions about where monies are saved are mindful of the effect those decisions can have. Correspondence: Dr Christakis, Center for Child Health, Behavior, and Development, Seattle Children's Hospital Research Institute, 1100 Olive Way, Ste 500, Mailstop 8-1, Seattle, WA 98101 (dimitri.christakis@seattlechildrens.org). Financial Disclosure: None reported. References 1. Mankuta DGoldner IKnafo A Intertwin birth weight differences and conduct problems in early childhood. Arch Pediatr Adolesc Med 2010;164 (5) 457- 461Google ScholarCrossref 2. Stone KCLaGasse LLLester BM et al. Sleep problems in children with prenatal substance exposure: the Maternal Lifestyle Study. Arch Pediatr Adolesc Med 2010;164 (5) 452- 456Google ScholarCrossref 3. Oberlander TFPapsdorf MBrain UMMisri SRoss CGrunau RE Prenatal effects of selective serotonin reuptake inhibitor antidepressants, serotonin transporter promoter genotype (SLC6A4), and maternal mood on child behavior at 3 years of age. Arch Pediatr Adolesc Med 2010;164 (5) 444- 451Google ScholarCrossref 4. Robinson TN Reducing children's television viewing to prevent obesity: a randomized controlled trial. JAMA 1999;282 (16) 1561- 1567PubMedGoogle ScholarCrossref 5. Wiecha JLPeterson KELudwig DSKim JSobol AGortmaker SL When children eat what they watch: impact of television viewing on dietary intake in youth. Arch Pediatr Adolesc Med 2006;160 (4) 436- 442PubMedGoogle ScholarCrossref 6. Pagani LSFitzpatrick CBarnett TADubow E Prospective associations between early childhood television exposure and academic, psychosocial, and physical well-being by middle childhood. Arch Pediatr Adolesc Med 2010;164 (5) 425- 431Google ScholarCrossref 7. Richert RARobb MBFender JGWartella E Word learning from baby videos. Arch Pediatr Adolesc Med 2010;164 (5) 432- 437Google ScholarCrossref 8. Christakis DAGilkerson JRichards JA et al. Audible television and decreased adult words, infant vocalizations, and conversational turns: a population-based study. Arch Pediatr Adolesc Med 2009;163 (6) 554- 558Google ScholarCrossref 9. Zimmerman FJChristakis DAMeltzoff AN Associations between media viewing and language development in children under age 2 years. J Pediatr 2007;151 (4) 364- 368PubMedGoogle ScholarCrossref 10. Singh TPEvans S Socioeconomic position and heart rate recovery after maximal exercise in children. Arch Pediatr Adolesc Med 2010;164 (5) 479- 484Google Scholar 11. Chen E Digging deeper: understanding the biological mechanisms that connect low socioeconomic status to poor health. Arch Pediatr Adolesc Med 2010;164 (5) 495- 496Google ScholarCrossref 12. Sayal KOwen VWhite KMerrell CTymms PTaylor E Impact of early school-based screening and intervention programs for ADHD on children's outcomes and access to services: follow-up of a school-based trial at age 10 years. Arch Pediatr Adolesc Med 2010;164 (5) 462- 469Google ScholarCrossref 13. Olds DLKitzman HJCole RE et al. Enduring effects of prenatal and infancy home visiting by nurses on maternal life course and government spending: follow-up of a randomized trial among children at age 12 years. Arch Pediatr Adolesc Med 2010;164 (5) 419- 424PubMedGoogle ScholarCrossref 14. Bernard KButzin-Dozier ZRittenhouse JDozier M Cortisol production patterns in young children living with birth parents vs children placed in foster care following involvement of Child Protective Services. Arch Pediatr Adolesc Med 2010;164 (5) 438- 443Google ScholarCrossref 15. Bos KJZeanah CH JrSmyke ATFox NANelson CA III Stereotypies in children with a history of early institutional care. Arch Pediatr Adolesc Med 2010;164 (5) 406- 411Google ScholarCrossref

Journal

Archives of Pediatrics & Adolescent MedicineAmerican Medical Association

Published: May 3, 2010

Keywords: emotions,mental health,birth

There are no references for this article.