Transcriber: Rhonda Jacobs Reviewer: Denise RQ
Frequently, I get asked how I started on the path that I'm on,
and the inspiration.
And perhaps like many of you, there were moments
where my professional work and my personal life came together.
I remember this October day as I was driving our three children
from the grocery store to the pumpkin patch.
And in the back seat were our three-year-old,
our one-and-a-half year old, and our baby.
And as I drove from my Martha Stewart moment at the pumpkin patch,
tears were rolling down my cheeks;
physically and emotionally exhausted living by my own standards of parenting,
these three very closely spaced children.
At the time, I was working on a research project as a statistician
for a home visiting intervention
that was looking at helping women who were using drugs and alcohol during pregnancy
improve their parenting.
I remember one day watching this woman with a three-year-old by her side
push a double stroller over the snow-covered sidewalks of Minneapolis
and convince her three-year-old to walk the two blocks to catch the bus.
Now, I knew my job was impossible,
and I had an attached garage, a supportive spouse, an amazing community,
and a PhD in child development.
I actually used to go to parent education classes,
not telling anybody what my background was,
just so I could have coffee with the ladies.
In fact, I was terrible during parent-child interaction time
because I did not want to play with my children.
(Laughter)
One day one of the women pulled me aside, and she says,
"What do you do? You sound a little bit like my therapist."
(Laughter)
I had been outed in parent education class.
We also have been on a journey in terms of policy, research, and practice.
And I'd like to borrow from an urban legend
to talk about this journey.
It's a day a villager is out walking alongside a river,
and as he's looking at the current seeing the sun glisten upon the water,
he notices something something in the river,
and he realizes it's a child.
And without regard for himself, he jumps into the river,
he pulls that child ashore,
and he calls for another villager to come down to help him.
As she walks down and wraps her sweater around the two of them,
she too notices a child in the river, and jumps in and pulls that child ashore.
Well, they lived in a very prosperous, very generous village,
and soon they had people lined up on lookout
because these children kept coming down the river.
There were folks responsible for taking care of the rescuers,
and the children, and supplies.
Everyone had a job to do.
One day, one of the villagers started walking away from her position.
And they're like, "Hey, where are you going?"
"I'm going to find out why the children are in the river in the first place."
That's actually the journey that we've been on for
about the last 50 years.
Our first vision was that we saw children living in poverty,
particularly those in families relying on welfare,
who were not as well prepared for school
as children coming from more affluent communities,
and so we created Head Start.
In the 80s, we saw the importance of parent-child relationships,
and so we started home visiting as a way of helping improve parent to education
and understanding of their children's cues and signals.
In the 90s, we thought if we got involved with children earlier,
before problems happened, early intervention or prevention,
maybe we could keep those problems from surfacing.
And in the 90s, we got really issue-focused.
So we now have literacy-based, early intervention,
home visiting programs in Head Start.
The problem is part of what we did is we took what we knew
at the wide end of the river, and we just miniaturized it.
A first grade classroom started to look like a pre-school classroom,
started to look like an infant classroom.
So that in this infant classroom,
you have an area for climbing and an area for reading,
as if a baby would know they needed to do those things in two different spots.
The other thing we've done is there's been a major change in the fabric of lives
of families living in poverty, and that was welfare reform.
We now, all of the interventions we've developed previously,
relied on a parent being home for most of the time,
even in communities of poverty.
Now we've said young mothers in poverty need to be working,
and there needs to be a place for those children to go during the day.
But in most communities of poverty, there is no high quality place
for those babies to be, for the families still to be nurtured.
In fact, the Minnesota Children's Defense Fund
reports that children under the age of two have more changes
in who takes care of them during a week than any other age group --
than a six-year-old, than a twelve-year-old.
At a time where relationships are so critical,
children are going from adult to adult to adult.
Now, if you journey with me back down stream,
this well-organized village, this is our special education system.
We are spending all kinds of resources, everybody knows in which line to stand,
which form to fill out, how many minutes to be in that line.
We can't get all the children back to shore
so we've built barges out there in the middle of the river:
our juvenile justice system,
our Level 5 special education system
- that's for the children who have been in the water for so long
that's it's changed the way they move, changed the way they think,
changed the way they interact.
The best we can hope for is to keep them dry.
But we never get back to typical development.
So what's the answer?
What I'd like you to journey with me today, upstream,
and do something really important:
turn 180 degrees and begin to look at the river from the baby's point of view.
The lovely part is that there's this grassy meadow of typical development
right before that child.
The early experiences that that baby has are what form the neural synapses,
the connections that are made that lay the foundation
for that child's growth and development.
A mom has her baby in a bouncy seat as she cooks dinner.
She twirls the toy bar.
The baby gets interested in it, gets a little fussy and she's like,
"Oh, I'm stirring the pot."
Baby gets a little more fussy,
she realizes the baby's not going to be distracted, she picks him up,
he calms back down.
It's nothing extraordinary. It's everything ordinary.
Paying attention to the cues and signals,
what the baby's learning about forming relationships, regulating his emotions,
and learning through play and exploration.
Contrast that for a minute to a baby that spends all of his day in a saucer.
His mother and father are diagnosed with schizophrenia.
The best that they can do is keep that baby safe.
But relying on his cues and signals to get fed?
No luck.
Has to do with when the parents remember.
Monitoring who interacts with that baby by virtue of their mental illness,
who comes in and out of that house is unregulated.
Sometimes the baby's bombarded, sometimes left alone.
Those everyday experiences are forming the architecture
of each of those babies' brains.
Now I want to pull back a little bit from something quite so dramatic
and talk about those babies that are beginning to get into the river.
Right on the pebbly shore.
I want to tell you a story about Joe.
Joe's parents were expecting the birth of their second baby,
and they had decided that they wanted to spend the first week
just at home with the new baby -- mom, dad, and the new baby.
And Joe would go with grandma and grandpa who he loved very much,
and they had all kinds of fun things planned.
He had a present a day to open
so he could remember when he was going home.
Joe comes home after the seven days.
He's home with his new baby, his mom, and dad.
That night, in the middle of the night while Joe's asleep,
the baby spikes 105 temperature.
Mom, dad, and the baby are air-vac'ed from their rural community
to a teaching hospital three hours away.
Joe wakes up in the morning to a neighbor.
The next night he's at the aunt and uncle's house.
The next night at another neighbor's house.
The baby's diagnosed with spinal meningitis.
Fortunately, the baby recovered.
Two-and-a-half weeks later, mom, and dad, and the baby come home.
Joe is cranky, irritable, not sleeping through the night,
wants to be held all the time.
Dad's been out of work for three weeks.
Mom has this critically ill baby.
Now, if Joe was running a fever, was cranky, not sleeping through the night
and pulling at his ear, she'd call her family practitioner and say,
"I think Joe has an ear infection. Can I bring him in?"
What does she do in this case, when he's showing symptoms?
Ideally, this has been a family practice or pediatric office
that has been screening for social-emotional health
right along with motor development, with vision,
so that she knows she can call and say,
"I think Joe is having some difficulty. Can somebody get us some help?"
They could be connected with a mental health provider
who probably would see the family two or three times.
They make a plan for Joe in transitions, they'd help them understand,
go ahead and hold him,
because as soon as he knows you're not going to leave anymore,
he won't want to be held anymore.
He's two-and-a-half years old!
Could you have a baby-sitter come over one hour a day
to take care of the baby because we know you're worried about her,
and you just spend an hour with Joe.
A couple of times, Joe's back on the path of typical development.
It's much like an ear infection.
Unfortunately for Joe and his family,
they told me this story when he was five hears old --
he'd been kicked out of two childcare centers.
There was no such help.
It's interesting, with ear infections -- children's anatomy changes
so that they're only vulnerable to ear infections when they're very young.
And we treat it because re-occurring ear infections lead to later hearing loss.
But we don't treat social-emotional problems?
The National Institute of Mental Health estimates that one in four adults
every year has symptoms of mental health problems.
Hmm.
We need to make sure that health is more than growth;
that health includes social-emotional development.
How does that baby go about forming relationships?
How does that baby experience and regulate their emotion?
And how do they learn?
Now, we have some children who are particularly vulnerable to something
that we have been calling "toxic stress."
Three things make up toxic stress.
The first one is deep poverty. The lack of opportunity.
The second one is child maltreatment or neglect.
And the third one is trauma.
Trauma can be witnessing violence.
It can be experiencing an environmental event like a hurricane or a tornado
without a supportive network of adults around that child
to help them understand the experience that they're going through.
The center that I started, "Baby's Space" is in one of these neighborhoods
that has high poverty, extremely high community violence.
In fact, a couple of weeks ago, we were on lock-down at noon
because there was shooting in the neighborhood.
We were running around the building trying to find out
as much information as we could so we could tell the children.
We were able to let them know that there were three men
that were arrested and no one was shot.
We had to give them that information
so they knew they were safe to go out to play.
Imagine being five years old, and the thing you have to worry about
is if there's a shooter outside
that could hurt you or somebody that you love.
In the same community, a dad was murdered last year.
Four children in the family,
but an entire community that found out that your dad could be murdered.
So what's the solution?
For us, it was about creating a child development center
from the baby's point of view
that really took social-emotional health as the critical factor.
I want to tell you about the second day of childcare for Tamara.
Tamara was wheeled into the room.
Dad signed her in and walked out.
She sat in the stroller.
She's 11 months old.
Did she want out of the stroller?
Picked her up, set her down.
Nothing.
At 11 months old, she's telling us what she expects from the world.
Nothing.
Dad was telling us
what he expected from Tamara and from the rest of us.
Couple of days later, we have a teacher sitting right next to her
as mom's leaving.
Mom's leaving the door.
The teacher has the baby's arm, waving to the mom.
"Bye mom. See you later," the teacher says.
But Tamara's head is turned this way, and mom is leaving this way.
And mom walks out and goes, "She doesn't care about me."
Now, I have an 11-month-old baby
that is showing no indication that her parent is important,
and a parent who believes she is not.
I have to tell you, in a typical childcare center,
this is a dream baby.
She doesn't care when she gets fed.
She never complains.
She plays with whatever's in front of her.
In our center, red flags are going up all over.
We have a baby who is in the water,
and parents who do not know how to connect with that baby.
We also know, based on research,
that children in mildly stressful situations --
so they brought two-year-olds with their parent,
and they brought in a clown.
Now, two-year-olds and clowns don't go together very well.
That's what researchers do.
They bring in things kids don't like, and they watch and see what happens.
(Laughter)
But these researchers knew a couple of more things.
They knew whether or not the children had a secure reliable partner
in the parent that was with them,
or like Tamara, had a parent that was unavailable,
inconsistently available,
or not really there to support the child and partner.
They also were neurobiological researchers
so they were particularly interested in stress responses.
Now, you may hear a lot about cortisol because it's so easy for us to measure.
Cortisol is that fight-or-flight,
saber-tooth tiger, run!-extra boost that we get
in emergency situations.
Interestingly, if children, as the clown is there --
all the children look the same.
I cannot eyeball who has a secure relationship
as we say in attachment research or has an insecure relationship.
Y'all look the same.
But something different is happening on the neurobiological level.
The children with a secure parent, a partner in the stress: no change.
The children who do not have a reliable partner
are kicking in your own cortisol system.
Fight or flight; saber-tooth tiger; run!
You're two years old.
You're not even old enough to know saber-tooth tigers don't exist.
But your body's reacting as though it does.
Interestingly, if we look at math achievement later on,
children who have secure early relationships with their parents
do better in math than the children who did not.
Now there's no difference in ability, it's in achievement.
Why?
Because if I have a trusted partner,
and I know that when I get stuck on a math problem,
I can turn to my neighbor and say, "Hey could you help me with this?"
Versus, if I've never had a trusted partner,
and I get stuck on a math problem,
my body is going, "Saber-tooth tiger! Saber-tooth tiger!"
And I never get the help I need.
So, by bringing innovation from the baby's point of view,
this is what it looked like for Tamara.
Couple of months later,
we're still doing wave and talk for the baby,
but this time after mom left, Tamara re-traced mom's steps,
put her hands up on the door, turned around,
and fell completely apart.
She was crying.
We were thrilled.
Finally, what had been capped was able to bubble up.
Four months later, this was what it looks like.
Mom's hanging out in the childcare room
because we have partnered mom with a parent educator
in the same way we partnered Tamara with a teacher.
We found out domestic violence was happening in the house.
Now, for Tamara, shutting down was a great survival strategy,
terrible developmental strategy.
The family now has a safety plan in place.
Dad is out of the home. Things are better.
Mom's working on her job, and the teachers know about that.
Now Tamara brings a book over to mom.
They read the book together.
Mom goes to leave. Tamara follows her.
They give each other three kisses good-bye.
And Tamara holds her arms up for the teacher to hold her.
In four months, she went from the river to the solid ground
where she stays today.
The distance is so short here.
We have the capability of changing the fabric of lives of families
which then changes the response of the community
when we begin to look at success from the baby's point of view.
We have the opportunity. We have the knowledge.
We just need to bring it to our most vulnerable children
and invest in them early.
Thank you very much.
(Applause)