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    Life Sciences

    The Brain Architects – Center on the Developing Child at Harvard University

    Healthy development in the early years provides the building blocks for educational achievement, economic productivity, responsible citizenship, strong communities, and successful parenting of the next generation. By improving children’s environments, relationships, and experiences early in life, society can address many costly problems, including incarceration, homelessness, and the failure to complete high school. But if you’re a parent, caregiver, teacher, or someone who works with children every day, you may be wondering, “Where do I start?!” From brain architecture to toxic stress to serve and return, The Brain Architects, a new podcast from the Center on the Developing Child at Harvard University, will explore what we can do during this incredibly important period to ensure that all children have a strong foundation for future development. Listen to the trailer, and subscribe now!

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    Latest Episodes:
    The Brain Architects Podcast: Extreme Heat & Early Childhood Development: A Discussion on Rising Temperatures and Strategies for Supporting Development and Lifelong Health May 21, 2024
    Show notes

    Contents Podcast Panelists Additional Resources Transcript In April 2024, we hosted a webinar where we explored the science from our latest working paper, Extreme Heat Affects Early Childhood Development and Health. The Center’s Chief Science Officer, Dr. Lindsey Burghardt, joined by Dr. Kari Nadeau, Chair of the Department of Environmental Health at Harvard’s T.H. Chan School of Public Health, brought the latest research and insights from the field to discuss the intersection of heat, early childhood development, and health equity. They also discussed actionable solutions to benefit children, caregivers, and communities now and in the future. The webinar discussion has been adapted for this episode of the Brain Architects podcast. Panelists Lindsey Burghardt, MD, MPH, FAAPChief Science Officer, Center on the Developing Child at Harvard University Kari Nadeau, MD, PhDChair of the Department of Environmental Health, Harvard’s T.H. Chan School of Public Health Rebecca Hansen, MFA (Webinar Host)Director of Communications, Center on the Developing Child at Harvard University Cameron Seymour-Hawkins (Podcast Host)Communications Coordinator, Center on the Developing Child at Harvard University Additional Resources Extreme Heat Affects Early Childhood Development and Health Heat: An Action Guide for Policy Webinar Recording: Extreme Heat and Early Childhood Development Place Matters: The Environment We Create Shapes the Foundations of Healthy Development Place Matters: What Surrounds Us Shapes Us Transcript Cameron Seymour-Hawkins: Welcome to The Brain Architects, a podcast from the Center on the Developing Child at Harvard University. I’m Cameron Seymour-Hawkins, the Center’s Communications Coordinator. Our Center believes that advances in the science of child development provide a powerful source of new ideas that can improve outcomes for children and their caregivers. By sharing the latest science from the field, we hope to help you make that science actionable and apply it in your work in ways that can increase your impact.  In April, we hosted a webinar where we explored the science from our latest working paper, Extreme Heat Affects Early Childhood Development and Health. The Center’s Chief Science Officer, Dr. Lindsey Burghardt, joined by Dr. Kari Nadeau, Chair of the Department of Environmental Health at Harvard’s T.H. Chan School of Public Health, brought the latest research and insights from the field to discuss the intersection of heat, early childhood development, and health equity. They also discussed actionable solutions to benefit children, caregivers, and communities now and in the future. We’re excited to share this conversation on today’s episode of the Brain Architects. Now, without further ado, here’s Rebecca Hansen, the Center’s Director of Communications, who will set the stage for our conversation.  Rebecca Hansen: Hello, everyone, and welcome. We’re very happy to have you all with us for today’s webinar, Extreme Heat and Early Childhood Development: A discussion on rising temperatures and strategies for supporting development and lifelong health. Whether you’re joining us for the first time or have been a regular at our webinars here at the Center on the Developing Child, we are very happy to have you with us today. So, today’s webinar is grounded in the first working paper from the Early Childhood Scientific Council on Equity and the Environment. The council is a multidisciplinary group that synthesizes and communicates about emerging science that can help to improve our understanding of how influences from the broader environment affect early childhood development and also lifelong health. The council’s first working paper, published earlier this year, focuses on the many ways that heat can affect development, including its impact on young children’s biological systems and how it can amplify the effects of systemic inequities. The paper offers strategies to mitigate the impact of extreme temperatures and points toward actionable solutions for cooling the communities where children live, grow, learn, and play. And we look forward to diving into these strategies throughout today’s conversation. So, without further ado, I am going to introduce our panel, starting with a note that while we had hoped to be joined today by Dr. Gaurab Basu, he was unfortunately unable to be here. We do have with us Dr. Lindsey Burghardt, who is Chief Science Officer at the Center on the Developing Child, where she develops and leads the center scientific agenda. She is also founding director of the Early Childhood Scientific Council for Equity and the Environment and leads their efforts to synthesize and communicate about the scientific mechanisms related to how children’s environments shape their development. Dr. Burghardt engages regularly with diverse stakeholders and audiences, with the aim of making the science both accessible and actionable. She is also a practicing primary care pediatrician in the community outside of Boston. Dr. Burghardt is joined today by Dr. Kari Nadeau, who is chair of the Department of Environmental Health, and John Rock, professor of climate and population studies at the Harvard T.H. Chan School of Public Health. Dr. Nadeau is a practicing clinician specializing in allergy, asthma and immunology in children and adults, and she has published over 400 papers, many in the field of climate change and health, for more than 30 years. She has devoted herself to understanding how environmental and genetic factors affect the risk of developing allergies and asthma, especially wildfire induced air pollution. Her laboratory has been studying air pollution and wildfire effects on children and adults, including wildland firefighters. Dr. Nadeau is also a member of the Early Childhood Scientific Council on Equity and the Environment. And we are very happy to have her here with us today. And with that, I will turn it over to Dr. Burghardt to begin our discussion. Lindsey Burghardt: Thanks, Rebecca. I’m so excited for this conversation today. Thrilled to have Kari here with us. I’m just going to start by setting the stage a little bit for why this feels like such a timely and important conversation. And then we’ll dive right in. You know, I think many of us have recognized from our own experiences that temperatures are rising around the world. And, you know, science is confirming we’re having record setting heatwaves that are happening more often and they’re lasting longer than they have ever before. So I think with these increasing temperatures and with the increased frequency of these events, it makes this topic really timely and important because it’s something that’s already affecting kids and their caregivers today. And we know that excessive heat impacts kids development, both in the moment, but also potentially across their lifespan. And the good news is that there’s a lot of solutions that already exist and that communities are putting into effect already with really good results. So we’re going to talk today about how extreme heat affects development, the potential effects in pregnancy and throughout early childhood, and then get into some of those actionable solutions and thinking about how heat works to affect development. We really know that it starts with an understanding that environment influenced all children’s development by shaping the exposures and the experiences that they have. And this developmental environment is really the full range of exposures and experiences that they have in places where they live and learn and play and grow. And so what’s surrounding children is quite literally shaping their biology. But importantly, you know, these experiences and exposures can be positive or they can be negative. So environments can have exposures and experiences that fuel positive development, things like really strong foundational relationships with their caregivers and access to green space and breathing clean air. Or they can be more negative or potentially derail development. So things like extreme heat or breathing toxic air from wildfire smoke. So climate change is coming in and it’s creating and shaping changes to this environment of exposures and experiences. And it’s really important to understand, too, that these effects are not only direct on their biology, like breathing in their toxic wildfire smoke, but they’re also indirect and that things like extreme weather events and flooding can cause displacement that then places enormous stress on caregivers, which then has an important effect on those foundational relationships. And when it comes to climate change, this is just the first in a series of conversation that we’re hoping to have about how climate change is shaping developmental environments. And today we’re going to talk about Heat and, Kari, it’s just so amazing and special to have you join this conversation as just really an expert and really thoughtful thought leader in this space. So thank you. Kari Nadeau: Thank you. I’m so excited to be here. I’m a pediatrician. I’m a parent. I’ve lived and dealt with heat stress myself as well as climate change. So I’m really happy to be here. As the department chair of Environmental Health, we work a lot with climate change in the global environment, and so our health is inextricably related to earth cell and we need to really focus on early development of children. And today, I’ll talk a little bit about how heat, specifically heat stress affects children, because now with climate change here on our planet, every child born today will suffer from at least one severe weather condition associate of climate change and most likely that will be heat. You, I’m sure, all heard on the news that last summer was the hottest summer on record for our earth and unfortunate it will likely be the coolest summer on record for our in the future. So we not only have to talk about solutions today, but we absolutely must talk about how those solutions affect children and pregnant women and how it affects the early development of the child. So I’m excited, Lindsey, for your wonderful seminar today and happy to answer any questions from you as well as from the audience at the end. Lindsey Burghardt: Yeah, Thanks, Kari. And actually, I am going to hopefully intersperse. We’ve got so many amazing questions that really helped to guide how we shaped the discussion today. And one question that I get a lot that came up quite frequently from the audience when it comes to heat is what do we mean? Like when we say extreme heat or excessive heat, What does that mean? How are people thinking about definitions and how do we kind of start from a common understanding? Kari Nadeau: Yeah, that’s a great question. So when we talk about heat, especially in babies that tend to have a lot of extra tissue around, especially with children who are moving around and toddlers who are on the move, typically what we call heat that could affect them physically, mentally, in a in a way that’s not good for their bodies is 85 degrees Fahrenheit. So that’s what people think above, which if you’re exercising and moving a lot, it can actually be a problem for your health. So 85 degrees Fahrenheit is really where we keep the thresholds. Lindsey Burghardt: Yeah, that’s super helpful. And I think, you know, the next question that usually follows is what about places where it’s been warm for quite a while? You know, how do we think about heat differently? You know, if you’re somebody listening in from someplace like Boston, that’s typically more cool and dry. How do we think about Heat and children’s the way that they’re going to experience is increasing temperatures differently or the same as a child who has always lived or whose family has always lived in a place that it’s typically more humid or hot. Kari Nadeau: Right. So as we all know, we grow up in areas of the world with certain cultural habits. And we also make sure that our children are part of those cultural habits as a family. And those are good things. We’re part of that overall environment to take care of the next generation. And with that, for example, in Boston, we tend to have colder weather in New England. But the problem with 85 degrees is if it’s in April versus July, where we’re prepared in July to have warmer weather, people already have their clothes out, their shorts are bathing, suits have pools open. But in April, not so much in the middle of Boston. And so people are used to having colder weather. So therefore, they’re going to dress their children and dress themselves up with warmer type layers of clothing and so that’s a problem because part of dealing with heat physiologically is to evaporate our sweat. And if we can’t evaporate our sweat, especially for babies and toddlers, because they’re not just little adults, they have different ways of evaporating from their skin because they don’t have as much skin surface area. So it’s actually more dangerous for children not to be prepared for these high temperatures in areas of the world that they’re not used to. That, for example, in Switzerland, there were places in the Alps that had absolutely no air conditioning ever. They just didn’t have it because they never thought they need it. And two years ago, they had summer conditions of greater than 100 degrees Fahrenheit and people were not ready. So the children had terrible heat, stress and exhaustion just because people aren’t ready. And so we need to when you think about preparing the rest of the world, you’re right. There are places in the global majority and near the equator that are used to heat, but they’ve already adopted the methods to be able to deal with heat that I’ll talk about later on today, because those are methods that have been central to the ecological knowledge of that community that now we have to be humble and listen to so that we ourselves can take the same steps to protect our children. Lindsey Burghardt: And that makes so much sense too. And thinking about like, you know, we’re used to something in July that we’re not prepared for in April or even in October. And I think in Boston in particular, we experienced this when it came to our schools and our early care and education settings, which by design were made to keep heat in, you know, and are not adapted then to kind of handle those higher temperatures at times of the year where children are more accustomed to spending time inside. So I’m excited to get into that, you know, a little bit later on. So can you talk about, you know, under the skin, how does our body respond, you know, when temperatures increase and how is that different? How is the response different? As you mentioned, it really young children, especially infants who have different physiology. Kari Nadeau: Yeah. So on one side, when we deal with stressors, our body handles stress in some similar ways. So there’s just a certain pathway that when we deal with early life stressors, it’s similar with heat. There are and pathways that are very similar to other stress pathways. So what I like to think about is these types of life stressors that affect children, especially early on. So and the reason we know so much of this biology is because unfortunately animals out in animal husbandry and agriculture have dealt a lot with heat stress and so have their babies. And so we know a lot about mammals and how babies have to deal with heat stress. And so biologically, what will happen, especially even after three exposures of heat waves of 85 to 100 degrees Fahrenheit, where you’re dealing with overheating for more than two days in a row. With that in mind, we’ve seen that these proteins called heat shock proteins, can get activated. And the reason I don’t want you all to have to know the molecular mechanisms here, but the important thing is this it’s real, it’s documented. We’ve documented in animals, we’ve documented it in human babies. Key proteins get activated…

    Full show notes at the publisher

    A Place to Play: Moving Towards Fairness of Place for All Children May 02, 2024
    Show notes

    Contents Podcast Panelists Additional Resources Transcript In March 2024, we continued our Place Matters webinar series with our third installment: “A Place to Play: Moving Towards Fairness of Place for All Children.” During the webinar, we explored the power of play in supporting early childhood development, as well as the importance of ensuring that children and caregivers have access to safe green spaces, like parks and playgrounds. Our panel of experts discussed how access to safe, stimulating, and joyful play space is not equally distributed across communities, along with strategies to work toward building a future where all children have a safe place to play. The webinar discussion has been adapted for this episode of the Brain Architects podcast. Panelists Leah Anyanwu (Moderator)Programme Specialist, Children on the Move, Children’s Learning and Development, The LEGO Foundation Cynthia Briscoe BrownAtlanta Board of Education Seat 8 At Large Kathy Hirsh-PasekProfessor of Psychology and Neuroscience, Temple University; Senior Fellow, Brookings Institute Lysa RatlifChief Executive Officer, KABOOM! Le-Quyen VuExecutive Director, Indochinese American Council Melissa Rivard (Webinar Host)Director of Engagement Strategies, Center on the Developing Child at Harvard University Cameron Seymour-Hawkins (Podcast Host)Communications Coordinator, Center on the Developing Child at Harvard University Additional Resources Place Matters: The Environment We Create Shapes the Foundations of Healthy Development Presentation Slides Playful Learning Landscapes KABOOM! Atlanta Community School Parks Initiative LEGO Foundation Indochinese American Council Transcript Cameron Seymour-Hawkins: Welcome to The Brain Architects, a podcast from the Center on the Developing Child at Harvard University. I’m Cameron Seymour-Hawkins, the Center’s Communications Coordinator. Our Center believes that advances in the science of child development provide a powerful source of new ideas that can improve outcomes for children and their caregivers. By sharing the latest science from the field, we hope to help you make that science actionable and apply it in your work in ways that can increase your impact. In March, we continued our Place Matters webinar series with our third installment: “A Place to Play: Moving Towards Fairness of Place for All Children.” During the webinar, we explored how play and a family’s access to safe green spaces, like parks and playgrounds, support early development. Our panel of experts discussed how access to safe, stimulating, and joyful play space is not equally distributed along with strategies to work toward building a future where all children have a safe place to play. We’re excited to share part of this conversation on today’s episode of the Brain Architects podcast. If you’re interested in in seeing some examples of community-led solutions to address gaps in play space equity presented by Lysa Ratliff of KABOOM and Kathy Hirsh-Pasek of Playful Learning Landscapes, we encourage you to head over to our YouTube channel to view the full webinar recording. Now, without further ado, here’s Melissa Rivard, the Center’s Assistant Director of Innovation Strategies, who will set the stage for our conversation. Melissa Rivard: Welcome and thank you all so much for joining us today. It’s really gratifying to have so many of you showing up for this really important topic. So thank you. I’m Melissa Rivard, Assistant Director of Innovation Strategies and I will be your host today. This webinar is part of a series of webinars that the Center on the Developing Child has hosted to examine the ways that a child’s broader environment, including the built and natural environments, as well as the systemic factors that shape them, play a role in shaping child development and health beginning before birth. Our focus today, the importance for all children to have access to stimulating joyful and safe places to play, is prompted by our focus on fairness of place as well as a desire to highlight a long standing collaboration between the Center on the Developing Child and the LEGO Foundation, and our shared belief in both the power of the early years and in the power of play to positively impact lifelong learning and health. Our moderator for the conversation is Leah Anyanwu. Leah is a program specialist at the LEGO Foundation, where she supports the Foundation’s early childhood portfolio with a focus on children displaced due to conflict and climate. Leah is a passionate educator and advocate with over a decade of experience working in education with a focus on early childhood and education systems reform. Along with Leah, we’ll be joined for this discussion by a phenomenal group of panelists who bring a wide range of expertise related to this topic. Kathy Hirsh-Pasek is a professor of psychology at Temple University and a senior fellow at the Brookings Institute. She served as president of the International Congress for Infant Studies, was on the Governing Board of the Society for Research in Child Development and is on the board of 0 to 3. In 2010, Dr. Hirsh-Pasek founded Playful Learning Landscapes with her colleagues, an initiative that reimagines cities and public squares as places with science infused designs that enhance academic and social learning opportunities for young children. And we have Lysa Ratliff, who is CEO of KABOOM!, a national nonprofit that works to end play space inequity. Lysa is a leading national advocate for equitable access to play spaces, has been invited to speak at several White House events and engages with members of federal, state and local public offices advocating for and creating opportunities for kids to play across the nation. We’re also joined by Le-Quyen Vu, who is Executive Director of the Indochinese American Council in Philadelphia, a nonprofit working to empower disadvantaged and minoritized groups and newly arrived refugees and immigrants in their community to achieve social, economic and educational advancement and mobility. And Cynthia Briscoe Brown, a member of the Atlanta Board of Education, Seat 8 at large who’s been instrumental in passing a number of policy initiatives, such as the historic Equity Policy, the Atlanta Community School Parks Initiative and the Atlanta Public Schools Center for Equity and Social Justice. Without further ado, I am so pleased to hand the baton to you, Leah. Leah Anyanwu: Thank you and welcome, everyone. I am so excited to hear from each of our panelists about the critical work connected to play equity and for this conversation, which centers the power of play and the importance of safe and quality play spaces. Our aspiration at the LEGO Foundation is that children become creative, engaged, lifelong learners who thrive in a constantly changing world by experiencing the benefits of learning through play. The scientific evidence around the power of play is clear and growing. In short, play is essential, everyone. Not only is play the best way for children to learn and to thrive, but play builds the foundations of lifelong learning and fosters holistic development. We’re here today because there is so much opportunity for children, families and communities when it comes to play and creating spaces that invite and enhance it at the community level in policy development and in the work that brings each of us to this conversation today. Yet we have a long way to go towards ensuring that the opportunity for quality play is equally accessible to all children, families and communities. To quote the Place Matters paper that Melissa just mentioned, “just as dimensions of the built and natural environment have been designed over time, they can be redesigned to support healthy development.” Throughout our conversation today, we will share insights from research and the field about ways to redesign, to rethink and to rebuild in pursuit of creating environments that support all children’s copy development. Now, without further ado, let’s get started. And I really want to invite Kathy to really focus first on the why. So, Kathy, good to have you here. What does this science tell us about why play matters for children, particularly young children? And how is play connected to learning and what kinds of play and characteristics of play are particularly important? Kathy Hirsch-Pasek: All right. You got it. And thank you so much, Leah. Well, we created Playful Learning Landscapes because we agreed with you Leah and we agreed with the work going on at Harvard that it was time to transform cities and villages and towns into family friendly spaces that were inclusive and that were infused with learning. So what I’m going to share with you today are not really just play spaces. It’s not like going to the playground. They are every day spaces that are infused with the science of learning and social learning that can be built right into the architecture. We build everything that we do on what we call our three part equation. The first thing is that when you go into a city, you need to know who your audience is. You need to be consistent with the cultural beliefs and the community values. So we start there. And then on top of that, we add a series of characteristics that define how human brains learn. And it just so happens that those same characteristics define play and playful learning. You have to be active, not passive, engaged, not distracted. It has to be meaningful. It has to not be disjointed. Has to be socially interactive. It has to change a little each time and be iterative. And finally, it should be joyful. That’s the how of learning how brains learn. And then the science of what children learn is the 6Cs. You know, in a world with AI we need to learn reading and writing and arithmetic, but we need to go beyond it. Can we collaborate and can we communicate well. Do we know our content? Do we have critical thinking? Do we have good–here you go–creative innovation, which is going to be very important. And then we want to know if you have the confidence to give it a try, which helps to feed grit and perseverance. There’s a whole lot of science to back this work up. And that you can use this equation for digital media, for places and for school building in ways that will help kids grow in a playful way. Leah Anyanwu: Thank you, Kathy, for that framing, I want to bring Lysa into the conversation. Lysa, KABOOM!’s mission is to end play space inequity for good. Can you tell us how you define play space inequity and share what you’ve learned about the scope of the issue? And what are you and others doing at the policy level to try to address it? Lysa Ratliff: Sure. The big question and I want to start by thanking Kathy for grounding us in such beautiful space, because what we see through those examples is that we have solutions. We are working against a solvable problem, and for Kaboom! we define play space inequity as a lack of access to and a sense of belonging and which is important. Quality play spaces due to the affect of systemic racism in communities across the country. And for anyone who’s been following the report, the play Place Matters report or the webinars, I would encourage you to go back to Dr. Lightsey-Joseph’s conversation where she laid out the historical policies that we are all trying to navigate today, and for Kaboom! Within that broader context, our focus is centered on kids. We care deeply about our children and we prioritize public space. And so we focus our efforts on play spaces and the surround sound that needs to happen so that kids have more access to and more quality time in play spaces so that they can benefit from all of the things that happen when kids go out and play on quality spaces. What we’ve learned about the scope. There’s just four really big categories that we’ve discovered through some work that we did that was funded by Colorado Health Foundation, and we worked with our partners at NC State and the College of Charleston, where we see those same patterns of inequities that Dr. Lightsey-Joseph was talking about and things like the achievement gap, the access to healthy food and health care coverage, all of those things. They also apply to play spaces. And so the four different areas are 1) distance matters and we hear a lot of conversation around the ten minute walk and the accessibility to play spaces and making sure that it is the easy option and that play spaces are within the communities that we need to work in. The challenge is that low income and communities of color and even rural rural communities are more likely to have limited access to play spaces where they live and learn. This is not just in their community, this is in their schools. There are schools without play spaces at scale and in parks just across the board. There is not easy access to play spaces and public spaces for kids and families to go. So that’s one critical piece. The quality of those spaces is also something that we’re concerned about. And so even when they do have access to places, it tends to be lower quality. It tends to be in communities of color, half the size as in communities that are predominantly white. So there’s less space to be able to play in and there’re worse physical conditions and lower play value. So we all know that kind of repetitive play is important and being able to not just go out there once and play, but time and time again to go out and discover new things is really important. That all has to do with quality. Neighborhood, again, you know, when we’re thinking about inequities, low income and BIPOC communities are more likely to have limited access to play spaces because of neighborhood factors like transportation and personal safety concerns. And so community cohesion and coming together and making sure that the community starts to really bind together as a community through public space will also help us address the barriers to kids going out and play. And then finally, history. You know, I’ll kind of end with this piece with where I started is that our communities are still shaped by racist historical practices like redlining. Our public spaces, our schools are a reminder that not so long ago they were segregated space. People are still alive that lived in segregated space. And I can’t share it here because I don’t have license to the photo. But I would encourage people to look at the Gordon Parks photo from 1956 called Outside Looking In, and it shows a group of young black kids looking through a fence into the most beautiful play space you can imagine. And yet they weren’t allowed to play in it. That residue is still what we’re dealing with today. Those kids in that photo are probably still alive. Some of them are probably still alive today. So we’re not talking about that long ago. So that history that we have inherited is also affecting how we work today . In the fifties, what we were also seeing is infrastructure being developed that went straight through thriving black communities like our highways and freeways, all of this backdrop is really the barriers that we have to make sure that we are acknowledging and problem solving around to make sure that we solve in a way that addresses the systemic issues, but also allows us to work in a systematic way so that our future is better than our past. You talked about policy, or asked about policy. And so to that part of the question, doing so much, so much and we’ve only really leaned into policy and advocacy and government affairs works since like 2019, 2020. And in that time we’ve moved in light years. You know, we think that our policy and advocacy work and the influence that we have there is as important as the spaces we build, because that’s where we’re going to stall and stop the perpetual issue of that historical racism has created in our public space and the allocation of resources. And so in the policy work, we see play space inequity as a historic chall…

    Full show notes at the publisher

    Understanding Racism's Impact on Child Development: Working Towards Fairness of Place in the United States Feb 15, 2024
    Show notes

    Contents Podcast Additional Resources Transcript In December 2023, we continued our Place Matters webinar series with our second installment: “Understanding Racism’s Impact on Child Development: Working Towards Fairness of Place in the United States.” During the webinar, Stephanie Curenton, PhD, Nathaniel Harnett, PhD, Mavis Sanders, PhD, and Natalie Slopen, ScD, discussed their latest research, exploring how racism gets “under the skin” to impact children’s development and how it contributes to unequal access to opportunity in the places where children live, grow, play, and learn. Together, they explored ways to dismantle systemic barriers and work toward solutions that promote healthy child development. The webinar discussion has been adapted for this episode of the Brain Architects podcast. Additional Resources Place Matters: The Environment We Create Shapes the Foundations of Healthy Development Moving Upstream: Confronting Racism to Open Up Children’s Potential Priorities for Child Trends’ Applied Research Agenda on Black Children and Families – Child Trends A Bibliographic Tool on Protective Community Resources for Children and Youth – Child Trends Black Children and Youth Can Benefit From Focused Research on Protective Community Resources – Child Trends Black Adolescents Are More Likely to Flourish in Neighborhoods Featuring Four Key Amenities – Child Trends Transcript Cameron Seymour-Hawkins: Welcome to The Brain Architects, a podcast from the Center on the Developing Child at Harvard University. I’m Cameron Seymour-Hawkins, the Center’s Communications Coordinator.Our Center believes that advances in the science of child development provide a powerful source of new ideas that can improve outcomes for children and their caregivers. By sharing the latest science from the field, we hope to help you make that science actionable and apply it in your work in ways that can increase your impact. In December, we continued our Place Matters webinar series with our second installment: “Understanding Racism’s Impact on Child Development: Working Towards Fairness of Place in the United States.” During the webinar, Doctors Stephanie Curenton, Nathaniel Harnett, Mavis Sanders, and Natalie Slopen, discussed their latest research, exploring how racism gets “under the skin” to impact children’s development and how it contributes to unequal access to opportunity in the places where children live, grow, play, and learn. Together, they explored ways to dismantle systemic barriers and work toward solutions that promote healthy child development. We’re excited to share this conversation on today’s episode of the Brain Architects podcast. Now, without further ado, here’s Tassy Warren, the Center’s Deputy Director and Chief Strategy Officer, who will set the stage for our conversation. Tassy Warren: Hello. Welcome to today’s webinar. Understanding Racism’s Impact on Child Development. Working towards fairness of place in the United States. We’re so excited to bring you into this conversation. Whether you’re joining us for the first time or are a regular to the Center on the Developing Child, thank you for being here today. This webinar is part of our Place Matters Webinar series. The series is designed to expand upon our Center’s recent work on how influences from our environments, particularly the built in natural environments, play a role in shaping early childhood development beginning before birth. Throughout this series, we’re highlighting scientific and community expertise and offering strategies to work towards fairness of place and to create the conditions that will allow all children to thrive. Today’s conversation will explore the intersection between policy, systemic inequalities, racial disparities, and children’s healthy development. We hope that you’ll gain insights that are helpful to you in the work you do in support of children and families. And thank you to everyone who submitted questions when registering for this event. We received hundreds of submitted questions, so we’ll be asking some of those questions in the second half of the conversation. Of course, we will not have time to address all the questions that are submitted or we would be here for days. But we were really intrigued going through all of the questions that were submitted. And we appreciate the thought-provoking ideas that you all brought to mind for us. So we will be thinking about how those questions can inform future conversations. So I am really excited in just a second to hand it over to Dr. Stephanie Curenton, who we are incredibly lucky to have leading this conversation for us today. Dr. Curenton is a professor in the Education Leadership and Policy Studies department at Boston University. Wheelock College of Education and Human Development and is the Director of the Center on the Ecology of Early Development, or CEED. CEED’S research and initiatives serve to inform policies that promote equity and justice for racially and ethnically minoritized children in the context of education, health and community. She is joined today by an outstanding panel of researchers Dr. Nathaniel Harnett, Dr. Mavis Sanders, and Dr. Natalie Slopen. Dr. Harnett is Director of the Neurobiology of Affective and Traumatic Experiences Laboratory at McLean Hospital and an Assistant Professor in Psychiatry at Harvard Medical School. Dr. Harnett’s research is focused on understanding the neurobiological mechanisms that mediate susceptibility to trauma and stress related disorders. Dr. Sanders is a Senior Research Scholar of Black Children and Families at Child Trends, where she leads in applied research agenda that advances racial equity and social justice. Before joining Child Trends in 2021, Dr. Sanders served as a professor of education and affiliate professor in the doctoral program in Language, Literacy and Culture at the University of Maryland, Baltimore County. Dr. Slopen is an Assistant Professor of Social and Behavioral Sciences at Harvard T.H. Chan School of Public Health. Dr. Slopen is a social epidemiologist, and her research focuses on social and contextual factors that shape childhood development and inequities in health. Now, I’ll let Dr. Curenton share more about herself and kick off our conversation. Stephanie Curenton: Hello, everyone. I am honored to be here to moderate this conversation and to represent CEED as well as Boston University. As Tassy was saying, our work at CEED specifically focuses on understanding how racism impacts Black children’s growth and development and ways in which families use their cultural assets and social capital to protect themselves from the harm of racism. And we know that this conversation we’re having today is critically important because racism operates on multiple levels and it impacts young children throughout all levels of their biology, their social development and other ecological systems. And in the prenatal phase and the first years of life, they are the most sensitive developmental period. So it’s really critical to understand how racism exerts its impact on the health and growth of prenatal children and infants and toddlers. As a scholar myself, I’ve been investigating and doing work on the topic of racism in young children’s learning for decades. By the fall of 2024, CEED, along with our partners at Equity Research Action Coalition, will be publishing a special issue for Early Childhood Research Quarterly on this topic, featuring researchers from a variety of disciplines and highlighting the work of several junior scholars. So the scientific evidence is clear, and it’s growing that racism imposes unique and substantial stressors on the daily lives of families and caregivers. And understanding how these stressors affect child health and development provides a compelling framework for understanding and protecting young children. Such frameworks are the Rise Three Model, for which I’m a coauthor with Dr. Iheoma Iruka. It presents new ideas about how communities, policies, programs and funding streams might confront and dismantle inequalities and build a stronger future for all of us. But we’re here today because there is so much opportunity ahead of us at the community level, at the policy level, and in all the work that brings each of us to this conversation today, as the Center on the Developing Child wrote in Their Place Matters paper that was published earlier this year. It says just as dimensions of the built and natural environment have been designed over time, they can be redesigned to support healthy development. So throughout our discussion today, we will share ways to redesign, rethink and advance forward in pursuit of creating environments that are anti-racist and can support all children’s healthy development. And with that, I’m so excited to be moderating this conversation with Nate and Natalie and Mavis. And I’m going to start the conversation with Nate. So, Nate, can you share what you’ve observed in your recent research in early childhood emotional health? Specifically, how have you observed the effects of racism on children’s brain development and how. And how were you able to expose a direct relationship to structural racism in your findings? Nathaniel Harnett: Yes. Thank you so much, Dr. Curenton. And thank you very much for having me. Just to set the stage for answering that question, you know, my lab is really interested in understanding how we identify and prevent the development of things like trauma and stress related disorders. And we know that the stress that people experience during childhood really plays a role in the development of those disorders. And we know that there are these really strong racial disparities between the amount of stress that people are exposed to where Black and other racially, ethically marginalized individuals are exposed to a disproportionate amount of stress. And so what we’ve been trying to do is to understand how the places in which children are growing up is related to the developments in brain structure and function and how that might play a role in later development of PTSD. And so one of the more recent things that we’ve done is we looked at data from this large scale longitudinal study of child development called the Adolescent Brain and Cognitive Development Study. This is a study in about 10 to 12000 kids that started when they were about 9 to 10 years old. We were looking at the volume of gray matter of different brain regions that we know are really important for emotion, learning and memory. These include things like the prefrontal cortex, really important for attention and top down regulation of people’s emotional responses. And then regions like the amygdala and hippocampus, which are really important for expressing that emotional response, that fear response to something stressful. And what we found was that if you look at the brain volume of white children compared to Black children, you see that Black talent show, this decrements in gray matter volume of these different brain regions. But what’s really important is if you look at the environments that they’re growing up in, if you look at the amount of income that Black children have or their parents have, if you look at this thing called the area deprivation index, it’s way of looking at the amount of resources available in these different environments. If you look at the amount of conflict that’s happening in the homes, there really strong racial disparities in all these different areas where Black children are really living in these areas that have much more deprivation, There’s much more conflict in the homes, there’s much lower income across those in all of those things are related to gray matter volume in the study. And so once we go through to address your question of how do we actually expose this direct link, once we go through, we try to normalize these mathematically, when we try to account for all of those, you really don’t see strong racial differences in gray matter volume anymore. This is really important because we also look to see how are the volumes of these regions tied to PTSD symptoms even at nine and ten years old. And so you wouldn’t expect large symptoms of PTSD. You wouldn’t expect many people to reach the level of the disorder. And you don’t see that. But you really still see even at nine and ten differences in the severity of PTSD symptoms, differences in the levels of trauma, exposure at nine, ten years old between white and Black individuals. And once you sort of normalize when you sort of equalize the environment, the places that they’re growing up in, you really see these sort of normalizations of brain volume, too. And so we’re really thinking about how do we address this question that the webinar is about this sort of aspect of place and how that’s really toward kids are growing up so that we can help to alleviate some of these brain differences that we see that are going to have a role in how these individuals develop into the future. Stephanie Curenton: So this is just absolutely fascinating. I was taking copious notes here, and I can’t wait until we get to the question and answer session to talk more. But at this point, though, I want to give Natalie a chance to talk about some of her recent work that is centered on racial disparities in the physical and mental health of young children. So, Natalie, can you tell us about your research and how you’re finding links to inequitable experiences and opportunities, particularly as it relates to inequalities in the places where caregivers are raising their young children? Natalie Slopen: Yes. Thank you so much for having me here and for the opportunity to share the work that I’m doing along with my students. So my research is focused on understanding how inequitable experiences of opportunity for healthy development that are shaped by our systems and structures affect healthy development and contribute to inequities that we see across socioeconomic position as well as across racial and ethnic groups with marginalized, racial and ethnic children from marginalized groups, often displaying worse outcomes early in the life course. And we know that these differences emerge over time. So, you know, health is rooted in childhood. And so it’s really important to understand the systems and structures that are in place very early on affecting children in their families so that we can identify where and how we can intervene. And so I have been working on research across a variety of topics, thinking about what are different systems and structures that children interact with that are relevant to their health in the earliest years of life. And one of the areas very relevant to today’s topic is housing. And one of the areas that I’m interested in is also in neighborhoods. And so I thought I could give an example of a study that I published this past year related to neighborhoods that connects to the topic for today. So this was a study that we published in Pediatrics, and we drew on a large national data source called the Mortality Disparities in American Communities. And what we did is we connected information about over a million children in the United States coming from the American community surveys, linking it to information about the neighborhoods that they were living in. So here we were using a neighborhood measure called the Child Opportunity Index. And then we followed the children were followed with death record data for 11 years. And so what our study found was that residing in neighborhoods with lower opportunity based on this measure of the Child Opportunity Index was associated with increased risk for mortality for children as well as for their parents. And so we felt as though it was important to document the intergenerational consequences of neighborhood settings and the importance of implementing place based policies to reduce the inequities that children experience that will have con…

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    A New Lens on Poverty: Working Towards Fairness of Place in the United States Jan 24, 2024
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    Contents Podcast Panelists Additional Resources Transcript In the fall of 2023, we kicked off our three-part Place Matters webinar series with our first installment: “A New Lens on Poverty: Working Towards Fairness of Place in the United States.” The webinar discussion featured the work of Mona Hanna-Attisha, MD, MPH, FAAP, whose research uncovered the water crisis in Flint, H. Luke Shaefer, PhD, co-author of the new book The Injustice of Place: Uncovering the Legacy of Poverty in America, and their groundbreaking new program, RxKids, an innovative effort to address child poverty and improve health equity. This conversation, moderated by our Chief Science Officer, Lindsey Burghardt, MD, MPH, FAAP, has been adapted for the Brain Architects podcast. Panelists Mona Hanna-Attisha, MD, MPH, FAAPFounding Director, Pediatric Public Health Initiative H. Luke Shaefer, PhDProfessor of Public Policy and Director of Policy Solutions, University of Michigan Lindsey C. Burghardt, MD, MPH, FAAP (Moderator)Chief Science Officer, Center on the Developing Child at Harvard University Rebecca Hansen, MFA (Webinar Host)Director of Communications, Center on the Developing Child at Harvard University Amelia Johnson (Podcast Host)Communications Specialist, Center on the Developing Child at Harvard University Additional Resources Place Matters: The Environment We Create Shapes the Foundations of Healthy Development RxKids The Injustice of Place: Uncovering the Legacy of Poverty in America What the Eyes Don’t See: A Story of Crisis, Resistance, and Hope in an American City Transcript Amelia Johnson: Welcome to The Brain Architects, a podcast from the Center on the Developing Child at Harvard University. I’m Amelia Johnson, the Center’s Communications Specialist. Our Center believes that advances in the science of child development provide a powerful source of new ideas that can improve outcomes for children and their caregivers. By sharing the latest science from the field, we hope to help you make that science actionable and apply it in your work in ways that can increase your impact. In October, we kicked off our three-part Place Matters webinar series with our first installment: “A New Lens on Poverty: Working Towards Fairness of Place in the United States.” During the webinar, Dr. Lindsey Burghardt, our Chief Science Officer, moderated a discussion between Dr. Mona Hanna-Attisha, whose research uncovered the water crisis in Flint, and H. Luke Shaefer, co-author of the new book The Injustice of Place: Uncovering the Legacy of Poverty in America. The resulting explores how the qualities of the places where people live are shaped by historic and current policies, which have created deep disadvantage across many communities with important implications for the health and development of the children who live there. We’re happy to share these insights with you all on today’s episode. Now, without further ado, here’s Rebecca Hansen, the Center’s Director of Communications, who will set the stage with a brief overview of the webinar series. Rebecca Hansen: Alright, hello, everyone. My name is Rebecca Hansen, and I’m the Director of Communications here at the Center on the Developing Child. And I’m very excited to welcome you all to today’s webinar, A New Lens on Poverty: Working Toward Fairness of Place in the United States. This webinar is the first in an ongoing series designed to examine the many ways that a child’s broader environment, including the built and natural environments, as well as the systemic factors that shape those environments, all play a role in shaping early childhood development beginning before birth. In this series, we will explore various environment tool influences from both scientific and community-based perspectives, including strategies to work toward fairness of place and improve existing conditions to allow all children to thrive. I want to thank everyone who submitted questions for our panelists today. We received hundreds of questions, and we will turn to some of those in the second half of the conversation. And with that, I am excited now to hand it over to Dr. Lindsey Burghardt, who is the Chief Science Officer at the Center on the Developing Child and a practicing pediatrician in the community outside of Boston. Lindsey, I will pass it over to you to introduce our panelists and get the conversation started. Lindsey Burghardt: Thanks, Rebecca. And thanks to everybody who took time out of their day to join us here. And before I introduce our fantastic panelists, I’m just going to start by giving some context and some background for our conversation, and then we’ll jump right in. And I think we’ll have a great conversation together today. So earlier this year, the National Scientific Council on the Developing Child published their 16th working paper and they called it Place Matters: The Environment We Create Shapes the Foundation of Healthy Development. And that working paper laid out a framework for how the child-caregiver relationship is critically important and just as important as it’s ever been. But in shaping early childhood development. But that relationship doesn’t exist in isolation. And the places where people live affect what they’re exposed to. And that in turn affects maturing biological systems. And those effects can be positive or they can be negative. And that’s what we mean when we say that Place Matters. So the physical environment that surrounds children, their built environment, their natural environment. Both of those are shaped by human actions, including very intentional decisions around policies that shape the environments where kids live and the quality and the conditions in the environment where children live. They’re not evenly or randomly distributed. They’re shaped by and they’re deeply rooted in public policies and social history that we’ll talk about today. So for many families, both these historical roots, as well as present day policies and decisions being made, are resulting in really an uneven distribution of risk and opportunity in neighborhoods and in the places where families are raising young children. So I am thrilled just completely thrilled to introduce two really special guests who are going to talk more about this today and who are really deeply committed to reshaping children’s environments to support their healthy development. Dr. Mona Hanna-Attisha is a fellow pediatrician. She’s an activist and author. Just an amazing person who leads an innovative program called Rx Kids, which aims to address child poverty and health equity. And it does it through unconditional direct cash payments to residents of Flint, Michigan, during pregnancy and throughout the first year of their child’s life. Our other panelists, Dr. Luke Schafer. among many things, is the Hermann Amalie Kohn Professor of Social Justice and Social Policy at the University of Michigan’s Gerald R Ford School of Public Policy and the inaugural Director of Poverty Solutions. And he’s partnering with Mona to launch Rx Kids. Luke has a new book that came out this summer, The Injustice of Place, and it provides what I think is a really sweeping understanding of extreme poverty in the United States. And it puts a new lens on poverty, I think, because of the unique multidimensional measures, Luke, that you used in the book, as well as the way that you engage the communities when you are conducting research for the book. So Mona and Luke, welcome. I’m really excited to have you here. Mona Hanna-Attisha: Thank you so much for having us. Lindsey Burghardt: So the two of you are working in really close collaboration with the community in Flint to address poverty in really actionable ways. And what I’m hoping today and what we talked about before when we prepared for this webinar was really focusing on the innovative approach to solutions that you guys have taken and so that those who are listening can apply anything that resonates in their own contexts. Sound good? Awesome. All right, let’s do it. So first question for Mona. We have some international listeners and some who may not be as familiar with maybe how your really specific engagement in this area got kicked off and your work related to the Flint water crisis and you really helped to shine a spotlight on a key example of how community disadvantage and underinvestment influence exposures that shape children’s developing systems. Can you talk a little bit about how you became involved in the water crisis in Flint, what you learned and kind of where things stand today? Awesome. Mona Hanna-Attisha: Thank you for that question and thank you for having us. We’re so excited to be here with all of you, almost 500 people to talk about solutions. And in order for us to really move forward and to make a better world for our kiddos, I think we so often have to start by looking back. So I can share a little bit what happened in Flint and my role. And it’s really it really starts by looking even further back. And I think that’s where kind of Luke is an expert in terms of kind of a history that got us to where we are today in terms of disadvantage. But Flint was at one point like a place of prosperity and opportunity. The birth of the UAW, which is in the news right now, that there’s a historic strike in the 1930s that really put Flint on the map. And autoworkers were demanding prosperity, very similar to what they’re demanding right now. And there was Flint kids striking alongside their parents. And there’s a Flint kid that was holding a sign in the 1930s. It said, give us a chance for better food and a better life. And that advocacy, that resistance that enabled really the beginning of the UAW and the birth of the middle class in America. And that started in Flint. And things happened in the environment and investment and public health and education and community schools and, you know, infrastructure, all this stuff that made Flint a place of prosperity, that translated into improved opportunity and improved health for the people that lived there. The history that followed in Flint is not unique to the communities across the nation. It’s a history of disinvestment. Automation. Globalization. Plants closed. Jobs were lost. Exploitation of workers. Systemic racism that made certain neighborhoods specific to African-Americans because of redlining and blockbusting and chronic disinvestment from, you know, state and federal government, which made Flint kind of this a bleeding city with the loss of population. And really every disparity that you can think of. And even before the water crisis that made growing up in Flint toxic like in so many of our communities, a kid in Flint, you know, their life expectancy is, you know, 15 to 20 years less. And a kid in another part of our county, this is once again not unique to Flint, but the census tract that you grow in the place, the environment, the conditions, the history, the geography, the hierarchy all predict how you end up. Flint was near bankrupt, lost democracy was taken over by emergency management. Like so many cities in our state at that time, anti-democratic law pushed through by our gerrymandered legislature, and that took away democracy, accountability and the decision was made to change our water source. It was from the Great Lakes to Flint River water without proper treatment, and that caused corrosive water to flow through our drinking water infrastructure and that corroded our pipes, which had lead in them for a year and a half. The people of Flint, a predominantly poor minority community, were drinking lead laced water. That’s how I got involved as a practicing pediatrician in Flint to do the research to uncover what was happening to our kids and really since then have been on this path to recovery. But it is an emblematic story of what happens when you live in a place that has been chronically disinvested, that does not prioritize the health and development of our children. Literally, the address of our children predicted whether or not they were going to drink poisoned water. So maybe an extreme example of what happens, a consequence of growing up in a certain place, but once again, not unlike so many communities across this nation. Lindsey Burghardt: And, you know, I think for Luke, Flint really represents this example, as Mona articulated so beautifully, of a community that has been disadvantaged in so many ways and the sort of that theme of underinvestment. And Luke, in the book, I was really fascinated when you wrote about this concept and developed this index of deep disadvantage, which is something that I had not heard about before in the context of understanding poverty. So I’m wondering if you can kind of describe the index and share more about how it can deepen our understanding about the circumstances of a community, especially as it pertains to young children. Luke Shaefer: I think that the index really tries to pick up on the themes that both of you have already started describing. One is that when we think about something like poverty, it really is often a matter when we’re really thinking about it’s a matter of compounded disadvantage. So in my field, we often think of poverty as a lack of income, not having enough to meet your basic needs. But I think when we all think about it, we think about income. And that’s clearly really important. But we also think about health. and those vast disparities that Mona was describing, you know, huge differences in life expectancy in fairly small levels of geography. And I think we think about social mobility. So we think about the possibility if you grow up or what are your chances of rising to the middle class. And so the index, the first thing the index really did was try to bring income, poverty, income, health and social mobility into conversation with each other. And it turns out we can learn more about a community. We can actually find communities where poverty is very high, but social mobility is also pretty good. Or communities that have longer or shorter life expectancy than we think. And it just really enriches our understanding and I think gets us closer to what we’re talking about. The second thing that the index does is say it tries to shift the focus from the individual to the community. So Mona described like huge, like decade plus long differences in life expectancy and like small geographic spaces and like, how can we how can we explain that the same is true with social mobility. So there are places in the United States where if you grow up poor, you are just as likely as anyone else to rise to the middle class. And then there are places where if you grew up poor, you’re likely to be poor as an adult as well. So how do we understand those geographic differences? So we brought all of those factors together and put them into a Machine Learning technique called principal component analysis. And we’re able to rank all the counties in the United States in the 500 largest cities on a continuum of disadvantage based on income, health and social mobility and it created a map for us and just to reiterate the evidence from this that support is exactly what both of you were saying. Once we had that map, we started comparing it to other maps and we could see like huge parallels. The most stark one was a map of enslavement in the United States from 1860, where we compared our map of deep disadvantage, a concentration of deep disadvantage to a map of the concentration of enslavement from 1860 and could see not just some correlation, but like really just a high level of correlation between the very gradation of those maps. So that really takes the onus off the individual. How can it be an individual’s fault when communities have been bifurcated and divided in these ways, not just for a decade, not just for a few decades, but well over a century? I think we have to start thinking about solutions in a very different way. Lindsey Burghardt: Than…

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    Place Matters Sep 20, 2023
    Show notes

    Contents Podcast Panelists Additional Resources Transcript In June, we hosted a webinar about our latest Working Paper, Place Matters: The Environment We Create Shapes the Foundations of Healthy Development, which examines how a wide range of conditions in the places where children live, grow, play, and learn can shape how children develop. The paper examines the many ways in which the built and natural environment surrounding a child can affect their development, emphasizes how the latest science can help deepen our understanding, and points towards promising opportunities to re-design environments so that all children can grow up in homes and neighborhoods free of hazards and rich with opportunity. Corey Zimmerman, our Chief Program Officer, moderated a discussion around these themes between Dr. Lindsey Burghardt (Chief Science Officer) and Dr. Dominique Lightsey-Joseph (Director of Equity, Diversity, Inclusion and Belonging Strategy) which has been adapted for this episode of the Brain Architects podcast. Panelists Tassy Warren, EdM (Podcast Host)Deputy Director and Chief Strategy Officer, Center on the Developing Child at Harvard University Corey Zimmerman, EdM (Moderator)Chief Program Officer, Center on the Developing Child at Harvard University Lindsey C. Burghardt, MD, MPH, FAAPChief Science Officer, Center on the Developing Child at Harvard University Dominique Lightsey-Joseph, EdD, EdMDirector of Equity, Diversity, Inclusion and Belonging (EDIB) Strategy, Center on the Developing Child at Harvard University Additional Resources Place Matters: The Environment We Create Shapes the Foundations of Healthy Development Place Matters: An Action Guide for Policy Place Matters: What Surrounds Us Shapes Us Child Opportunity Index (COI) Healthy School Environments – US Environmental Protection Agency Transcript Tassy Warren: Welcome to The Brain Architects, a podcast from the Center on the Developing Child at Harvard University. I’m Tassy Warren, the Center’s Deputy Director and Chief Strategy Officer. Our Center believes that advances in the science of child development provide a powerful source of new ideas that can improve outcomes for children and their caregivers. By sharing the latest science from the field, we hope to help you make that science actionable and apply it in your work in ways that can increase your impact. In June, we hosted a webinar about our latest Working Paper, Place Matters: The Environment We Create Shapes the Foundations of Healthy Development, which examines how a wide range of conditions in the places where children live, grow, play, and learn can shape how childre During the webinar, Corey Zimmerman, our Chief Program Officer, moderated a discussion around these themes between Dr. Lindsey Burghardt (Chief Science Officer) and Dr. Dominique Lightsey-Joseph (Director of Equity, Diversity, Inclusion and Belonging Strategy) which we’re happy to share with you all on today’s episode. To access the full Working Paper and related publications, please visit our website at developingchild.harvard.edu. Now, without further ado, here’s Corey Zimmerman. Corey Zimmerman: Hi, everybody. Welcome. I’m Corey Zimmerman. I’m the Chief Program Officer here at the Center on the Developing Child, and today we’re going to be discussing a paper, the name of it is Place Matters: The Environment We Create Shapes the Foundation of Healthy Development. This paper was written by our National Scientific Council on Developing Child and was released earlier this year in March. We see this webinar as an opportunity to begin to understand a broader frame for thinking about what influences early childhood development, the role that inequity plays in influencing the environment children are in, and third, some early thoughts on new actors or sectors that might be called upon given this broader frame, to be able to join us in our collective effort to improve outcomes for all children and their families. Okay. With that, let’s get started. It is my pleasure to introduce you to my two colleagues, Dr. Lindsey Burghardt, who is the Chief Science Officer here at the Center on the Developing Child. And then second, Dr. Dominique Lightsey-Joseph, who is our Director of Equity, Diversity, Inclusion and Belonging Strategy here at the Center. Okay. So we’re going to start with a brief overview of the Working Paper, Place Matters from Dr. Burghardt. Lindsey Burghardt: Thank you again, Corey, for that introduction. And thanks to all of you today who took time out of your day to join us and to hear about this new working paper from the National Scientific Council. So the overall focus of this paper is really to broaden the frame of how we’re talking about early childhood development and health. And we’re going to look upstream today and consider all the different factors that influence how kids develop. So we all experience this continuous influx and flow of influences from our environments, and they begin before birth right in the earliest days of the prenatal period, and they continue throughout our lives. And these influences include the environments of relationships and those environments–that environment of relationships–is just as important as it’s ever been. And children also experience exposures and influences from the physical environment that surrounds them and their caregivers. So particularly the built and natural environments. And there are a really wide range of conditions in places where children live, learn, play and grow, and all these conditions have the ability to get under the skin and affect the developing brain and also other biological systems. So the immune system, the microbiome and the metabolic system, among others. And beginning before birth, these environmental conditions are shaping how children develop and that, in turn, has the ability to shape their lifelong physical and mental health. So the built and natural environments and the systemic factors that shape them, like policies that influence where people are able to live and how resources are distributed, interact with each other and they interact with a child’s social environment in really deeply interconnected ways. So this is really what we mean when we say that place matters. So every environment is infused with a combination of influences, and these influences can have positive or negative effects on health and development. And it’s also really important to recognize that level of exposure to risk and access to opportunity for children are not distributed equally. So in 2004, the National Scientific Council on the Developing Child described the effects of early life experiences on the developing brain and its first working paper called Young Children Develop in an Environment of Relationships. And over the two decades that followed, this concept really helped to make the case for caregiver-child relationships is sort of the active ingredient in how environments can influence the architecture of the developing brain. So the environment of relationships includes the presence of responsive relationships, the presence of significant stress and adversity, caregiver well-being, social connectedness, community support, faith and cultural traditions. And so more recently as our understanding of how early the early origins of health and disease have advanced, we’ve also really started to understand how early experiences affect multiple developing biological systems beyond the brain. So thinking about the immune system, the metabolic system, the respiratory system, and actually how these systems are interacting with each other and shaping each other as well as the brain. So the environment of relationships again, is just as important as it’s ever been, but these environments–that environment or relationship–it doesn’t exist in isolation; it exists in the context of is much broader environments that include the built and natural environments that surround children. Exposures from the natural and the built environments also directly shape the development of biological systems inside the body, and they interact with adult-child relationships in a really deeply interconnected way. And these exposures can be positive or negative, and they can include things like air quality and temperature that children breathe, the purity and availability of their water supply, their ability to access safe green space and healthy housing and whether or not they’re exposed to things like environmental toxicants. So we can take the example of lead is one that many people are familiar with. So lead is one factor in the built environment that connects to safe and healthy housing, connects to clean water supply and to exposure to toxicants. And we’ve known now for a really long time that lead is harmful to children’s development, particularly in the prenatal period and in the earliest years. And lead is still a challenge for a lot of families that today that are still dealing with this and the ongoing situations in Flint and in Jackson speak really clearly to this issue. So the presence of lead in children’s drinking water directly influences and affects their development, and it also shapes the environment that their caregivers are in with the burden and stress that it puts on them. So if there’s lead in the water supply, caregivers often have to seek out alternatives, and it’s typically at a cost, they may need to find in time for additional doctor’s visits and follow up. And all this can cause stress on them, and that can impact their ability to be in a caregiving relationship. So when we look at an environment, one that provides lots of positive influences is more likely to support children’s healthy development, and just as an environment that provides or imposes more negative influences is going to be more likely to result in disease and in poor health outcomes. So let’s widen the frame one level further, because there’s also these really broad systemic influences that play quite a powerful role in shaping the environments our children live. So these systemic influences are going to shape children’s development directly and they’re going to shape them indirectly through their influence on a child’s environment of relationships and their built and natural environments. And these influences include things like current and historic public policies, systemic racism and intergenerational poverty, among others. So it’s really important to acknowledge that conditions in our built and natural environments are not experienced equally among children. They vary widely and the adverse effects of systemic racism in particular have deep historical roots whose impacts continue to the present day and many present-day policies continue to perpetuate these inequities and their ongoing effects. So there’s an example that we’re going to dive deeper into a little bit later on in redlining. And redlining strongly influences where many children of color live today. And although this practice is now illegal, it has modern day implications like the home appraisal process that continues to shape the environment where young children grow. So increasingly, data that has been provided that shows deep analysis of these differences at the community level. And there’s one that’s provided by the Childhood Opportunity Index, or COI, that’s cited in the working paper. And then we’ll again talk in more detail later on. But the COI demonstrates that in the United States, neighborhood opportunity is highly segregated by race with black and Hispanic children having access to significantly less neighborhood opportunity than white children. So let’s shift a little bit now to talk about the timing, which is so important. Well, it’s really clear now that it’s not just our genetics and it’s not just our environment, that influence health and development. It’s both. And the influence that our genes and our environment have on our health is also really depends on the time during which we have certain experiences or exposures. And people differ in their sensitivity to influences from their environment at different points throughout their life course. And children’s biological systems in particular have different periods when they’re really sensitive and more sensitive to various environmental exposures and influences, even within the same biological system. So one example is the developing microbiome in our gut, which is very sensitive to influence from the built and natural environments around the time of birth and in the first few years of life. So in general, the sensitivity of the brain and the other biological systems that we’ve talked about is typically greater in the prenatal period than it is in early childhood. And in general, young children are more sensitive to influences from their environment than older children who are in turn more sensitive than adolescents. And in general, adolescence will be more sensitive than adults to many environmental exposures, and this is really important when we consider the importance and the impact of environmental exposures because of a greater sensitivity in early childhood. When an exposure happens during a fetal development or in early childhood, it’s going to have a very different impact and potential effects than if that same exposure happened later in life. So when we think about it, actually the first place where a child’s development is affected by place is the intrauterine environment during pregnancy. And during fetal development,immature biological systems are developing a very, extremely fast pace and their development is powerfully shaped by the environment around them. And these systems read the conditions in the womb as predictors of what they’re going to encounter after birth, and they sort of adapt accordingly. And so because these systems are still differentiating, they’re still becoming specialized and figuring out what they’re going to be, the exposures can result in really different outcomes depending on the time during development when they occur. And we can take a look here at the example of air pollution. So air pollutants can be absorbed in a variety of ways and can cause problems in developing organs and entire organ systems. But the nature and the severity of any potential effects will be different depending on the time during childhood and during development when the exposure occurs. So, for example, in the prenatal period, exposure to air pollution is associated with things like adverse birth outcomes in prematurity and in low birth weight. And in early childhood exposure to air pollution is a known risk factor for a variety of health effects, including asthma and children who are exposed to higher rates of outdoor air pollution during the first year of life may have diminished functional lung capacity as teenagers. So this is only one example of how the nature and the extent of an exposure that occurs very early in life may not even be fully apparent for years or even decades later. So let’s talk a little bit about climate. So climate and our changing climate is a really important factor in how children experience place. So we’ve talk today about how environment shape development and health, and we’ve discussed that what surrounds us quite literally shapes us. So let’s go back to thinking really broadly about what’s surrounding and shaping children in their environment. We talked about the quality and the temperature of the air that they breathe, the purity and availability of their water supply, their ability to access safe and healthy housing, their ability to access nutritious foods and the quality and density of the buildings in their neighborhoods. So climate is modifying the environment where these kids are living in a number of ways, it’s increasing the temperature of the air that’s surrounding them and making that air less pure. And it’s altering the availability and purity of the water supply, and that’s making housi…

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    IDEAS Framework Toolkit Jul 11, 2023
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    Contents Podcast Panelists Additional Resources Transcript In April, we hosted a webinar about the recently released IDEAS Impact Framework Toolkit—a free online resource designed to help innovators in the field of early childhood build improved programs and products that are positioned to achieve greater impact in their communities. During the webinar, we provided an overview of the site and had the opportunity to hear from two organizations in the field about how they leveraged the toolkit and its resources to shape their work: Valley Settlement and Raising a Reader. This episode of the Brain Architects podcast features highlights from the webinar. If you’re interested in hearing a full walk through of the toolkit by the Director of our Pediatric Innovation Initiative, Dr. Melanie Berry, please head over to our YouTube channel to view the full webinar recording. Panelists Aeshna Badruzzaman, PhD (Moderator)Senior Project Manager for Instructional Design, Center on the Developing Child at Harvard University Melanie Berry, PsyDDirector of the Pediatric Innovation Initiative, Center on the Developing Child at Harvard University Sally Boughton, MNMDirector of Development & Communications at Valley Settlement Andres Garcia Lopez, EdM, MBASenior Project Manager, Center on the Developing Child at Harvard University Karla ReyesProgram Manager of El Busesito Mobile Preschool Program at Valley Settlement Michelle Sioson HymanSenior Vice President, Programs and Partnerships at Raising a Reader Corey Zimmerman, EdM (Podcast Host)Chief Program Officer, Center on the Developing Child at Harvard University Additional Resources IDEAS Framework Toolkit Valley Settlement Raising a Reader Transcript Corey Zimmerman: Welcome to the Brain Architects, a podcast from the Center on the Developing Child at Harvard University. I’m Corey Zimmerman, the Center’s Chief Program Officer. Our Center believes that advances in the science of child development provide a powerful source of new ideas that can improve outcomes for children and their caregivers. By sharing the latest science from the field, we hope to help you make that science actionable, and apply it in your work in ways that can increase your impact. With that goal in mind, the Center recently released the IDEAS Impact Framework Toolkit—a free online resource designed to help innovators in the field of early childhood build improved programs and products that are positioned to achieve greater impact in their communities. The Toolkit is self-guided, self-paced, and provides a structured and flexible approach that facilitates program development, evaluation, and fast-cycle iteration, including resources to help teams develop and investigate a clear and precise Theory of Change. In April, we hosted a webinar about the toolkit, where we provided an overview of the site and had the opportunity to hear from teams at several organizations in the field about how they leveraged the toolkit and its resources to shape their work. We’re excited to share those discussions with you here on this episode of the Brain Architects podcast. If you’re interested in hearing a full walk through of the toolkit, by the Director of our Pediatric Innovation Initiative, Dr. Melanie Berry, please head over to our YouTube channel to view the full webinar recording. You’ll also hear from Dr. Melanie Berry during the Q&A portion. The full IDEAS toolkit we’ll be talking about today can be found at ideas.developingchild.harvard.edu. And now, without further ado, here’s Dr. Aeshna Badruzzaman, the Center’s Senior Project Manager for Instructional Design and the moderator for our panel discussion. Aeshna Badruzzaman: Hello, everyone. Welcome. My name is Dr. Aeshna Badruzzaman. I am a Senior Project Manager for Instructional Design at the Center on the Developing Child at Harvard University or HCDC, and I’m part of the development team of the IDEAS Impact Framework Toolkit. And today, I’ll be your host. So, you may hear me come off mute, and help guide presenters, and I’ll be facilitating our question and answer period. So, we are so pleased to be talking to you today about this resource. The IDEAS Impact Framework was born out of more than a decade of the Frontiers of Innovation Initiative or FOI. And some of you may have been partners in that effort. So, while our team no longer offers live training on the framework, we are so excited to be introducing it to you as a free open access resource. And we really hope that this format is going to help make IDEAS accessible to innovators in the field of early childhood development moving forward. The framework was developed in partnership with the University of Washington College of Education, and the University of Oregon Center for Translational Neuroscience. With support from the Gates Foundation, The Lego Foundation, Porticus and the Hemera Foundation. I encourage you to check out our history and acknowledgments page of the toolkit for more information about our various collaborations and supporters throughout time as well. Now I’ll go ahead and introduce our first set of speakers from folks at Valley Settlement. We have with us Karla Reyes, who is the program manager of the El Busesito mobile preschool program at Valley Settlement, which is a nonprofit that works to create opportunities for the Latino community in the Aspen to Parachute region of Colorado. Karla joined Valley Settlement in March 2015, as a preschool teacher for El Busesito until June 2021 when she took on a leadership role. And we also have Sally Boughton who is the Director of Development and Communications at Valley Settlement, a nonprofit again, serving the rural Aspen to Parachute region Colorado with six to generation programs designed by and for local Latina immigrant families. And Sally has been with Valley Settlement for over five years and began managing the organization’s evaluation function in 2021. Thank you so much Karla and Sally look forward to hearing from you. Karla Reyes: Good afternoon, everyone. Thank you for inviting us to share our work with you all and how we have used the framework. I’m going to talk a little bit about it, we’ll see the program and how I kind of started. The idea that it will succeed though began in 2011. We had two bilingual and bicultural community organizers, who met one on one with about 300 families from the Aspen to Parachute region of Colorado. And they learned about their lives and the barriers that they faced within our community. One of the findings from the initial listening tour was that only 1% of Latino children in our community were enrolled in preschool. We also learned that three of the biggest barriers for families to participate in preschool programs were language, cost and transportation resulting in lack of access. Now we have all this information. And we started thinking creatively of different ways that we could bring more access to preschool education to our community. I have also seen those one of the first two generation programs that we launched in Valley Settlement to address the needs of preschool education. And throughout the years Valley Settlement has continued to learn, evolve and co-design programming to respond to community needs. Now, our program has four mobile preschool buses that have been retrofitted into small preschool classrooms. We have two teachers on the bus, and we serve eight children at a time, we provide families with about five to 10 hours of free preschool education. We have about 96 children that we serve annually between 40 to 50 children graduating at the end of the school year and moving on to kindergarten. And currently right now we serve different five different neighborhoods within our community. And we strive to build close relationships with families. So, our program really is designed to meet families at where they are, are at and start breaking down those barriers. We host family nights; we have home visits with our families. We have parent teacher conferences; we have different ways that families can volunteer within our program. We provide a lot of materials for families to use that home so that they can do home activities and homework packets with their students. And we really try to engage with the families. So, each one of our teachers speak Spanish, is bilingual and bicultural. So, this really allows that bond and that relationship to build with each one of our families. I’m going to hand it off to Sally Boughton, and she’s going to talk a little bit more about how we’ve used the framework. Sally Boughton: Thanks, Karla. So, several years ago, we started working with the team at Frontiers of Innovation to refine and evolve our evaluation practices. This work included creating theories of change for each of our programs, researching and recommending observational assessments to measure participant progress towards our program targets and outcomes, and creating implementation guides for our programs to detail the critical components of our work and ensure that future staff can implement programs with fidelity, while still continuing to listen to and evolve alongside families. Since the early days of our programming, Valley Settlement has invested in evaluation to measure understand and strengthen the changes that children and families create in their lives through our programming. Working with the team at FOI really brought this to the next level. Over the last few years, we’ve been working to be more inclusive and participatory in our evaluation process. So now our entire staff gathers for three days every summer, in what I call an evaluation retreat, where we review our annual program data as a team and then try to answer those questions ¿qué? ¿por qué? ¿Y ahora qué? or as the toolkit outlines: What does the data say? Why? Why might the data say this? Or what does that mean? And finally, now what do we do to tweak or change in our evaluation approach or in our programming, based on what we see in the data? Our teams then create action plans to outline those changes that they want to make. We’re usually tweaking one or more program components for the upcoming year. On day two of the retreat, teams then go in and refine and evolve their theories of change. So, we really see that theory of change as a living document that breathes and grows alongside our programming. They identify what targets and outcomes they’re interested in measuring for the coming program year. And then after that evaluation retreat, we work together with our evaluation consultant to refine our measurement tools. And then I always try to call out and highlight that I am in the minority of Valley Settlements. Our staff are largely of the community that we work with. Most of our staff are immigrants or children of immigrants, many have grown up in this community, or immigrated to the community as adults with young children. And so, they have those shared lived experiences with the participants in our programs. And many of our staff have actually been former participants in our programs. Having the entire team participate in this process is incredibly valuable. It really places the experts in the work our staff in the evaluator seat, and we gained so much more by having that inclusive, participatory process. And we’re really so grateful to have our work shared in the online toolkit because, you know, I am not an expert in the IDEAS framework by any means. And that’s kind of the whole point is that it’s very usable, you can go in, you can click through this toolkit, you can see how it all is structured and works. And it just makes for a really kind of manageable, useful process that you can engage in. Thanks so much. Aeshna: Thank you, Karla, and Sally, really appreciate you taking the time to share your experiences with us. Now we’ll hear from folks from Raising a Reader. So Raising A Reader supports families to build, practice and grow reading routines at home. Their award-winning evidence-based program helps caring adults set their children up for success by creating shared reading routines, fostering social emotional learning, healthy family relationships and learning skills needed to thrive in school and beyond. And first, we’ll hear from Michelle Sioson Hyman, who is Senior Vice President, program and partnerships. And in her role, Michelle is responsible for overseeing program development, growth and impact. And then we’ll hear from Andres Garcia Lopez, who is a Senior Project Manager at the Center on the Developing Child. And in his role, he’s coached many early childhood development entrepreneurs, including Raising a Reader in developing strategies to maintain their science-based impact, while scaling their ventures. Welcome Michelle and Andreas. Michelle Sioson Hyman: Thank you so much for having me. I’ll start with a brief overview of Raising a Reader and how we’ve used the framework and then fundraising, engaging some conversation. So Raising a Reader is a national family engagement and early literacy organization through our network of affiliates and partners across 34 states and both rural and urban communities. We engage and support parents and the other caring adults in children’s lives help strengthen the bonds with their children, while building critical early reading and social emotional skills. So along with our award winning multicultural and multilingual book collection, we provide easy to use materials and guides that are really designed to make the most of that shared reading time in the home. So our work really does begin though, with partnering with local agencies who become members of our affiliate network, a community of practice in which we can share best practices and build connections. And we provide professional development, technical assistance and capacity building support to this network of affiliates and partners, who really work across the intersection of systems, supporting children and families at the various points throughout their educational and developmental journey. So that’s, you know, in ECD, K, 12, Health and Human Services. And we’re really able to meet families in the spaces and places where they are involved in how the framework has really impacted our work was that we were introduced to Andres. And the framework is a really critical inflection point in our history. So we’re over 23 years old and Raising a Reader had 39 independent evaluation that prove the success of our Classic Red Bookbag Program and its impact on improving and sustaining home literacy environments. But one thing that we realized through our work with Andres was that there were critical aspects to our work that we weren’t capturing in our theory of change. And just maybe I’ll stop there, and then we can chat. Does that work? Andres Garcia Lopez: Sounds good. That works. Michelle. Thanks so much for that overview. And I’m so excited to be part of this panel, and it’s an honor to share it with you, Michelle, and with the Valley Settlement team. So I’ll just add a few things. I was working with Michelle as part of a fellowship that the Center partners with the Promise Venture Studio. And as was mentioned before, the theory of change on the IDEAS framework really helps you think about what are the key ingredients that my organization in my program works on or provides to families and or maybe two partners that get to the targets that that move the needle towards my outcomes. One thing that was different about Raising a Reader was that they weren’t with partners. So I wanted to mention that sometimes the IDEAS framework can be, and the theory of change could be flexible, and adaptable to meet your needs. Originally, there are three columns in the theory of change. But we’re working with Michelle, we thought we should have an extra column because they wanted to look at how working with partners and affiliate organizations, what their strategy is that was doing racing, a reader was gett…

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    Building Resilience Through Play Feb 22, 2022
    Show notes

    Contents Podcast Panelists Additional Resources Transcript These days, resilience is needed more than ever, and one simple, underrecognized way of supporting healthy and resilient child development is as old as humanity itself: play. Far from frivolous, play contributes to sturdy brain architecture, the foundations of lifelong health, and the building blocks of resilience, yet its importance is often overlooked. In this podcast, Dr. Jack Shonkoff explains the role of play in supporting resilience and five experts share their ideas and personal stories about applying the science of play in homes, communities, and crisis environments around the world. Panelists Andres Bustamante, Assistant Professor, University of California Irvine School of Education Laura Huerta Migus, Deputy Director, Office of Museum Services at Institute for Museum and Library Services Lynneth Solis, Researcher and lecturer at the Harvard Graduate School of Education Erum Mariam, Executive Director, BRAC Institute of Educational Development, BRAC University Michael Yogman, Pediatrician, Harvard Medical School, Cambridge Hospital Additional Resources Resources from the Center on the Developing Child Video: Play in Early Childhood: The Role of Play in Any Setting Video: How-to: 5 Steps for Brain-Building Serve and Return Handout: 5 Steps for Brain-Building Serve and Return Video: Building Babies’ Brains Through Play: Mini Parenting Master Class (from UNICEF) Report: Three Principles to Improve Outcomes for Children and Families InBrief: The Science of Resilience Resources from Our Guests Panel Learning to Cope through Play UCI STEM Learning Lab Playful Learning Landscapes Understanding the Social Wellbeing Impacts of the Nation’s Libraries and Museums Play in Humanitarian Settings 5 Takeaways from Supporting Refugee Parents to Help Children Learn and Thrive During Covid-19 BRAC Humanitarian Play Lab: when playing becomes healing BRAC: ECD and Play “I try to take their pain away through play”: A healing experiment in Rohingya refugee camps (Quartz: membership required) Prescription for Play The Power of Play: A Pediatric Role in Enhancing Development in Young Children Preventing Childhood Toxic Stress: Partnering with Families and Communities to Promote Relational Health Transcript Sally Pfitzer, host: Welcome to the Brain Architects, a podcast from the Center on the Developing Child at Harvard University. I’m your host, Sally Pfitzer. Our Center believes that advances in science can provide a powerful source of new ideas that can improve outcomes for children and families. We want to help you apply the science of early childhood development to your everyday interactions with children and take what you’re hearing from our experts and panels and apply it to your everyday work. So in today’s episode, we’re going to get serious about the topic of play. For children, play is a fundamental building block of child development, but its role in supporting resilience is often overlooked. And after the past few years, we surely need resilience now more than ever! For me, as a former preschool teacher, I’m especially excited about this episode and speaking with today’s experts, because I’ve seen first-hand how important play is for young children’s development. But what can science tell us about it? And what can be done to support more play in everyday life, even in crisis contexts? In this podcast, we’ll dive into the science of play and resilience, and then we’ll explore how people are using that knowledge to support child development around the world. To explain the science, we’ll start with Dr. Jack Shonkoff, Professor of Child Health and Development and the Director of the Center on the Developing Child at Harvard University. So Jack, what do we mean by resilience and what do we know about how people develop it? Jack Shonkoff: What we mean by resilience is that we’re talking about the ability to do well, the ability to cope, the ability to overcome hardship, or adversity, or threat to your well-being. So the key about resilience is it doesn’t occur in a vacuum. Resilience is something that you actively build, and you build it in the context of relationships in an environment that helps you learn how to cope with challenges, cope with stress, cope with hardships. And it starts very early. It starts in infancy. And infants need to have some sense of participation in that. But also, you don’t do it totally on your own. You need the support and the security, when you’re a baby, of adults who basically help provide a manageable environment in which you can learn resilience. So, if stresses and threats are overwhelming, they can overwhelm the system. And you don’t really get a chance to build resilience. If every time something happens that challenges you, somebody jumps in to protect you, that’s not good for you either because you have to build that yourself. So the environment has a lot to do with how you develop resilience and skills, but so does your own activity on the environment, your own sense of being a player rather than just a receiver. But no two children are the same, even children in the same family, growing up in the same environment. From birth, children differ in how adaptable they are. If you go into a newborn nursery in a hospital, the nurses who work there can tell you about how those babies are all different from each other. Some kids are just more easygoing, constitutionally. Some kids roll with the flow, a little bit easier than others. So in a sense, we don’t all start off with the same way of reacting to stress or hardship. Sally: That’s great. And thinking about how resilience is built, are there specific building blocks that you need to think about? In this case, could you talk a little bit more about how play might support those building blocks? Jack: Play, by definition, is an interactive process or a kind of self-directed process. It’s not by chance that all children, regardless of where they live in the history of the species, use play as a way to develop skills. It’s the way children learn to master their environment. And they learn to try things out. They test things. They test limits. It’s driven by curiosity, and it’s driven by an inborn drive to master the environment. And if you think about what resilience is all about, resilience is mastering your environment. It’s building the skills to be able to cope, building the skills to have strategies, to deal with your own reactions, be able to have some control over what’s going on around you. And none of that would develop as well as it does if you depended on just being taught how to be resilient. No. Your ability, your natural ability to play, is one of the most important strategies that we have developmentally to build resilience in the face of adversity. Sally: So, what is the science that underlines this connection between healthy development and how play supports it? Jack: God, there are mountains of science that help us to understand the process of development. And three principles, three concepts, just continue to stand out among all of the research, evidence, and knowledge we have about development. And they are the keys to healthy development. The first is the importance of supportive relationships. Children develop in an environment of relationships. So, supportive relationships are critically important for healthy development. The second is the need to reduce significant sources of stress—not eliminate stress, but reduce stress, so it’s manageable. And then the third is building core skills, the kinds of skills that are needed for just about anything that we’re expected to do at any point in our life. So these are the core skills that are the building blocks of learning, and behavior, and good health. And if we put those three things together—supportive relationships, reducing sources of stress, and building core skills—they are essential for us to understand not only how resilience develops over time, but also what an important role play occupies in that process. Particularly in a young child, there is this sense of trying to figure out what the world is all about. So core skill development, which is essential for building resilience, is very much tied into the ability to learn actively through play and through interaction with others. There has been so much research done on resilience in a variety of circumstances, trying to understand what is it that explains how some children overcome adversity and do well in spite of hardship and threats. The one thing that comes out in just about every single study is whenever there’s evidence of resilience, you can always identify at least one very important relationship that was critical to the development of resilience. Very often, it’s a parent. It doesn’t have to be a parent. It can be another member of the family. It doesn’t have to be a family member. It could be a neighbor. It could be a preschool teacher. It could be a child care provider. It could be a coach. It doesn’t really matter who it is. It certainly doesn’t have to be a blood relative, but there has to be at least one relationship that basically provides a scaffold in which children develop the skills to be able to cope themselves. That’s the ultimate answer to the question of, can you build your own resilience? The answer is for all the studies that have ever been done, no, you can’t. You can’t become resilient yourself. You can’t will yourself to be resilient. You have to be able to be supported by at least one nurturing relationship. If we look across the incredible range of experiences and conditions that children grow up in, the principles remain the same. Children are all busy actively mastering their environment, regardless of what that environment is. The challenge is to understand what’s individually different about each child and what is the nature of the environment in which the child is living. And everything else is just figuring that out based on basic principles of what science tells us about development. Sally: So Jack, you spoke earlier about how play helps build resilience. I’m wondering if you could you give us an example of what that might look like at different ages—for example, what would it look like for an infant? Jack: What play is about is early on, beginning in the earliest of infancy, really, shortly after birth, is if you think about what babies do, and once babies become attuned to the people who are caring for them, it’s the kind of thing that gets everybody all excited—the eye contact, the beginning of a smile, the cooing, and the vocalizations, and all that stuff that elicits back and forth, serve and return interaction between very young infants and adults. The vocalizing back and forth, the smiling, the looking around and then looking at the same thing, and then handing something, and grabbing it, and giving it back. And, all of those very simple interactions early on are playful interactions. And then, as you move out of the very earliest of infancy and get into the second half of the first year, when babies become more mobile, and they’re rolling over, and then they’re crawling, being able to reach for things, and grab things. You find the right balance between allowing the child some room to do things in a protected environment and also initiating some things with you. So you initiate interactions. You respond to interactions. You let a child move around. You put stuff out on the floor for a child to play with. And sometimes, hopefully, you leave the child alone in a safe place and let the child explore. All of this, a lot of people may not think of that as play. They may think of play as more organized kinds of activities. But that is the beginning of play. It’s the beginning of active learning, discovery, curiosity, trying things, learning from what happens when you do something, action and reaction, all that stuff. And then, as you get older and you start to play more organized games, play peekaboo, play Simon Says with a child that’s a little bit older, play all these kinds of games that have rules attached to them, rules about taking turns, rules about following instructions, all of this, board games as kids get older, and then as they get into the school age years, organized games, sports, more challenging board games, again, now most people would say, oh, yeah, that’s like play. That’s what play is all about. But it started much earlier, and it started with the foundation that was all about discovery, creativity, exploration, learning. In the best of all worlds, play doesn’t end until you die, because play is a way of thinking and engaging with the world. Play is one of the most important vehicles for having some sense of mastery and control over the world that you live in, which is getting us very close to the definition of what resilience is all about. It’s not being able to just deal with predictable things that you’re expecting and you’re prepared to cope with, but being able to deal with anything that life sends your way. Sally: Could you talk a little bit more about how play might actually support health? What are we learning from our current research? Jack: This is a really important question and a really important expansion of how we think about play. It’s easy to understand that most of the conversation and most of the thinking about play for the last, let’s say, last 20 years as we’ve been learning more and more about the science of early development is it naturally connects to learning and behavior. It was very brain-focused. But it’s not just the brain that’s developing. It’s the immune system and metabolic systems. Just like the brain is experience-dependent, the immune system is experience-dependent. It’s learning about different bacteria and viruses that are out there and it’s exposed to. And as a result of that, the immune system is building resistance to those infections early on and preparing you for better physical health. And the same thing with metabolic systems. A well-regulated environment every day is affecting all of these systems. And a dysregulated environment or a highly stressed environment, as it affects the immune system, can cause increased inflammation, which is part of the stress response. And early behavioral regulation, it leads to more health-promoting adult behaviors, less likely to engage in risk-taking behaviors, less likely to engage in addictive behaviors, problems with smoking, problems with alcohol, problems with risky physical activities that get you into trouble. So the link with play—there’s no question that somewhere down the road over the next 10 to 20 years, we will all have an understanding that playful learning and the role of play in building resilience is as much about physical and mental health as it is about early learning and school achievement. Sally: You’ve given us so much to think about, as always, Jack! Thanks so much for your time and being here with us today. When we come back, our panel is going to give us some examples of how they’re putting that science into action. Musical interlude Sally: Okay, so we’ve learned a bit about how play affects our biology. Let’s bring it out of the lab now, and into our daily lives. Most of us think about play happening in child care and on playgrounds, but play can honestly happen anywhere! In our next segment, I’m so excited to talk to our panel members, who have lots of examples to share. Joining us on today’s podcast, we have Andres Bustamante, who is an assistant professor in human development in context at the University of California Irvine. Thanks for being here today. Andres Bustamente: Thank you, Sally. It’s such a pleasure to be here. Sally: Also on today’s podcast, we have Lynneth Solis, who’s a researcher and lecturer at the Harvard Graduate School of Education. It’s so nice to talk to you today, Lynneth. Lynneth Solis: Thank you, Sally. It’s a pleasure to be here. Sally: And also o…

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    COVID-19 Special Edition: Mental Health Vital Signs Jun 16, 2021
    Show notes

    The devastating toll of the pandemic has underscored the critical importance of connecting what science is telling us to the lived experiences of people and communities. In March of 2020, we recorded episodes exploring the impact the coronavirus pandemic could have on child development. Now, a year later, we wanted to continue these conversations and discuss what we’ve learned, what needs to change, and where we go from here. Contents Podcast Speakers Additional Resources Transcript In the final episode in this special series, host Sally Pfitzer speaks with Dr. Nancy Rotter, a pediatric psychologist and the Director of Psychology in Child and Adolescent Psychiatry, Ambulatory Care Division at Massachusetts General Hospital. They discuss how the pandemic changed conversations around mental health, why we need to integrate mental health into the context of overall health, and what caregivers can do to help children prepare for the lessening of restrictions and the return to school. Subscribe below via your podcast platform of choice to receive all new episodes as soon as they’re released. Speakers Sally Pfitzer, Podcast Host Dr. Nancy Rotter, Pediatric Psychologist and Director of Psychology, Child and Adolescent Psychiatry, Ambulatory Care Division at Massachusetts General Hospital; Assistant Professor, Harvard Medical School Additional Resources Resources from the Center on the Developing Child The Brain Architects Podcast: COVID-19 Special Edition: Mental Health in a Locked-Down World Q&A: The Coronavirus Pandemic: Mental Health One Year Later Re-Envisioning, Not Just Rebuilding: Looking Ahead to a Post-COVID-19 World Working Paper 15: Connecting the Brain to the Rest of the Body: Early Childhood Development and Lifelong Health Are Deeply Intertwined InBrief: Connecting the Brain to the Rest of the Body A Guide to COVID-19 and Early Childhood Development Resources Resources recommended by Dr. Nancy Rotter Interim Guidance on Supporting the Emotional and Behavioral Health Needs of Children, Adolescents and Families During the COVID-19 Pandemic Mothers—and fathers—report mental, physical health declines Mental Health Impact of the COVID-19 Pandemic: An Update Depression and anxiety in pregnancy during COVID-19: A rapid review and meta-analysis COVID-19’s Disproportionate Effects on Children of Color Will Challenge the Next Generation A Guide to Mental Health Resources for COVID-19 How to Talk to Your Children About the Coronavirus (COVID-19) Preparing Children for When Their Parents Return to Work National Alliance on Mental Health: Mental Health By the Numbers Transcript Sally: Welcome to The Brain Architects, a podcast from the Center on the Developing Child at Harvard University. I’m your host Sally Pfitzer. In March of 2020, we recorded episodes exploring the impact the coronavirus pandemic could have on child development. You may remember we discussed the importance of self-care for caregivers, and the importance of physical distancing, not social distancing.  And now a year later, we wanted to continue those conversations and discuss what we’ve learned, what needs to change, and where we go from here. Joining us on today’s podcast, we have Dr. Nancy Rotter. She’s a pediatric psychologist and the Director of Psychology in Child and Adolescent Psychiatry, Ambulatory Care Division, at Mass General Hospital. Thanks so much for being with us today, Nancy. Dr. Rotter: Thanks for having me, Sally. Sally: So, the pandemic has made conversations about mental health more common and perhaps even less stigmatized. How do we make sure that this perspective and these conversations continue even as vaccines become available and restrictions are lessened? Dr. Rotter: You know, I agree that there has been some shifting over time in terms of awareness and acknowledgement about mental health and specifically children’s mental health. I think the pandemic has really raised these conversations to a higher level. I think that there’s certainly been comfort in talking about heightened distress that people have experienced due to the pandemic secondary to the many stressors that families have experienced. I think about things like loss of typical childcare support, like daycare, in-person school, or even grandparents caring for children, unemployment or shifts to having to work at home, social isolation. And I think all of these things are widely understood as contributing to how people are coping and to mental health. I think sometimes people find it easier to describe experiences of anxiety and depression in the context of stress and the stress perhaps experienced by the pandemic. You might not hear those words as much. You might hear things that sound less stigmatizing—that people might talk a lot about stress or isolation or fatigue, rather than referring to specific mental health conditions themselves. I do think that it might be a good direction to go in to think about how we can acknowledge mental health conditions as an aspect of overall health so that we can increasingly talk about things like depression or anxiety or substance use disorders in the same way that we speak about diabetes or heart disease. Shifting towards a more specific and accurate language for mental health conditions can really make a difference. because I think if we do so we can really add clarity for diagnoses, which then result in leading to more effective evidence-based treatments to treat these illnesses. Again, thinking about these like we do other health conditions. I think the continued progress, to kind of get to the other part of your question, towards the de-stigmatization of mental health conditions will really require increased and ongoing discussions about emotional health, and to have this happen in schools, in the media, within families, and certainly when children go to see their pediatrician. I think that pediatricians more and more are providing mental health screenings at routine exams, asking developmentally based questions to both parents and children or adolescents to screen for things that are concerning—anxiety, depression, suicidality, substance use disorders. And I kind of like the idea of thinking of that type of screening as mental health vital signs. And for me, that fits with the concept that when you go to your pediatrician or you go to your doctor, there’s always vital signs. They take your heart rate and your blood pressure, and it seems to me that using that kind of language really is helpful and is something that’s understandable to everyone and can help to really de-stigmatize the concept of mental health. And I do hope that we continue to work in the direction of integration of mental health into the context of overall health. Sally: Yeah, absolutely. So many important points, and I especially love that idea of the vital signs. Nancy, from your perspective, has the pandemic exposed any weaknesses in our mental health care systems, particularly for young children? And how should we take those into consideration as we move forward? Dr. Rotter: I would describe the primary challenges in our mental health care system for young children as twofold. The first relates to access to mental health care and the second is for increased need for prevention and early intervention services. While thinking about the importance of mental health care for children, I think it’s really important to be aware of some of the prevalence rates. For example, 50% of all life-time mental illness begins by age 14 and 75% begins by age 24. So, it’s very clear that making sure that we are keeping an eye on and assessing children and adolescents is key. I have to say that the pandemic has impacted access to mental health care in somewhat of a complicated way. On the one hand, unfortunately, there’s been an increased need for mental health services for everyone, and specifically for children, and the need has really outstripped the availability of services. This has occurred in the setting of overall improved ability to access care via telehealth. Telehealth, through both the use of video and telephone visits has improved access in many ways. Families who struggle with transportation, that don’t have the time, that have financial limitations—it’s allowed them to access behavioral health care more readily. However, this is further complicated as telehealth access has not been equitable. Black, Latino, and non-English speaking patients, and patients living in communities hardest hit by the pandemic demonstrate consistently lower rates of use and access to video-enabled technology. And while overall access to care has been a problem during the pandemic and it’s not easily solved, there’s been some hopeful news in Massachusetts. Effective January 1st of this year, the state legislature passed a bill requiring insurers to pay for services conducted by either telephone or by video technology at the same rate of reimbursement that they cover in-person visits. And I do think that’s really going to make a difference. That isn’t going to solve our immediate problem of access during the pandemic, but hopefully that knowing that that’s going to be an option down the road that that will allow for additional ways that we can help people. In terms of prevention and early intervention, I think addressing the mental health needs of young children when they present with mild symptoms—like sleep or feeding, or toileting, anxiety or behavioral issues—sometimes might not get identified until they reach a level that really requires urgent intervention. However, preventative and early intervention when the initial or the mild symptom becomes apparent can be extremely useful, and my thinking is that it can be improved by having mental health professionals in the clinic, with the pediatricians so that there’s behavioral health care integration. And that way, making services available in the context of the yearly pediatric checkup, which families typically come to, that there would be screening and opportunity for intervention when families are coming every year or even for other visits. In my work at MGH, in pediatric behavioral medicine, we’ve been very successful at embedding psychologists in specialty medical clinics like gastroenterology and diabetes and food allergy, which is where I work. Sometimes, for example in food allergy, I will meet with a family where a child is very anxious about having a blood test. And so, I can—at a minimum—meet with the child then and if they’re not ready to do a blood test that day with intervention, that now they know me and they can come back a couple of times to see me and I can help prepare them for that. And so, catching families where they’re going to get their medical care and being able to help them in that context is really important and really useful. This is something that has been established in many primary care clinics and hospitals across the country. The idea is to really think about a variety of services that might best meet the needs of the family by offering some in-clinic consultation, some brief treatment, access to parenting groups, and potentially digital health interventions in addition to the more traditional therapy and medication treatments that we all know about. Sally: I really love this idea of integration. In particular, at the Center, we talk a lot about the need for responsive relationships and I hear a lot of what you’re saying there is that if you’re able to build those responsive relationships early with kids, you have a better chance at allowing them to benefit from your services if they know you better. Dr. Rotter: Absolutely. And you know, one of the other statistics that I think is so powerful is that when referrals are made by anyone—by physicians or pediatricians—to a mental health professional, approximately 50% of those do not follow through. And so, by having someone actually live in the clinic to meet the family—sometimes even what we call as a warm hand-off—where they just are introduced, they get to see a face and a name, and there’s a connection that can really reduce the gap we have sometimes when they’re referrals that don’t make it to the referral source. Sally: So, in a Q&A for Mass General Hospital on preparing children for when their parents return to work, you said, and I’ll quote you here, “Parents may experience their own anxiety about having children return to daycare due to the worries about COVID and may inadvertently send signals to children about their own anxiety.” Could you give us some ideas on how we can support caregivers during this adjustment period? Dr. Rotter: Absolutely, in supporting parents and caregivers, it’s important to be aware that they may have their own mental health needs and perhaps had mental health issues prior to the pandemic. The toll that the pandemic has had on caregivers and parents has been tremendous. Caregivers have been required to step into roles that they were neither trained to do nor prepared for, such as becoming teachers to their children, providing full-time childcare while at the same time working a full-time job or perhaps coping with stress of unemployment or the loss of loved ones. Self-care strategies can range from taking a few minutes to read an email from a friend, a section of the paper. Additionally, self-care can come in the form of family activities, creating scavenger hunts or obstacle courses for children, or even coming up with healthy cooking projects can combine self-care with family time. And I think that sometimes there are things that we might do that are really self-care that we may not consider self-care. They might be small, or they might be small and done every day and even that sense of routine can provide a break, can provide some comfort, and can provide some predictability. I think we’ve all been dealing with the lack of predictability in quite a profound way during the pandemic. And I’m not sure that’s going to change quickly as things open up in different pieces and in different ways. Sally: I really appreciate that lens on the caregiver, and I wonder if you could talk a little bit more about how caregivers can ease their children back into normal life, while at the same time remaining cognizant of the stressors of this past year. And if you could speak specifically to infants and toddlers, I think their fears are sometimes a little less obvious to us. Dr. Rotter: Absolutely, young children may exhibit distress through behavioral changes or shifts in their typical functioning, which can include sleep, eating, toileting, anxiety, tantrums, or increased irritability. And it’s hard to know when that happens what that could be a function of. It’s really important that if there are changes—abrupt changes or unusual changes in a child’s functioning—it’s really important to seek out consultation from your child’s pediatrician in order to rule out any underlying medical issues as a first step. And if at that point in conversation with the pediatrician, the belief is that perhaps what is being experienced by the child are indicators of stress or anxiety, that’s a time where a referral to a mental health professional from your pediatrician can be very helpful. Many children and families are currently adjusting to the increased amount of time children are spending in-school and/or activities that were not happening during the pandemic restrictions. It’s typical and expected for infants and toddlers to experience discomfort when separating from their parents or caregivers, and this may in fact be exacerbated by the extended period of time they spent at home during the pandemic with parents or caregivers. So, it’s helpful to have a plan in mind. For older children, maybe toddlers, talking with them about familiar school activities that they may remember from when they were in school in the past, such as things that they played with or listening to stories, can help them prepare for their n…

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    COVID-19 Special Edition: Building from Strengths: Post-Pandemic Partnerships in Health Care Jun 10, 2021
    Show notes

    The devastating toll of the pandemic has underscored the critical importance of connecting what science is telling us to the lived experiences of people and communities. In March of 2020, we recorded episodes exploring the impact the coronavirus pandemic could have on child development. Now, a year later, we wanted to continue these conversations and discuss what we’ve learned, what needs to change, and where we go from here. Contents Podcast Speakers Additional Resources Transcript In the third episode in this 4-part special series, host Sally Pfitzer speaks with Dr. Renée Boynton-Jarrett, the founding Director of Vital Village Networks at Boston Medical Center and an Associate Professor of Pediatrics at Boston University School of Medicine. They discuss the cost of failing to address structural inequities with sustainable and comprehensive policy changes, the vital role community leaders played during the pandemic, and why health care systems need to demonstrate trustworthiness. The next and final episode of this special podcast series will focus on the pandemic’s impact on the mental health system. Subscribe below via your podcast platform of choice to receive all new episodes as soon as they’re released. Speakers Sally Pfitzer, Podcast Host Dr. Renée Boynton-Jarrett, Founding Director of Vital Village Networks at Boston Medical Center and Associate Professor of Pediatrics at Boston University School of Medicine Additional Resources Vital Village Networks The Brain Architects Podcast: COVID-19 Special Edition: Creating Communities of Opportunity Thinking About Racial Disparities in COVID-19 Impacts Through a Science-Informed, Early Childhood Lens Early Childhood Adversity, Toxic Stress, and the Impacts of Racism on the Foundations of Health Brief: Moving Upstream: Confronting Racism to Open Up Children’s Potential Infographic: How Racism Can Affect Child Development Re-Envisioning, Not Just Rebuilding: Looking Ahead to a Post-COVID-19 World Working Paper 15: Connecting the Brain to the Rest of the Body: Early Childhood Development and Lifelong Health Are Deeply Intertwined InBrief: Connecting the Brain to the Rest of the Body A Guide to COVID-19 and Early Childhood Development Transcript Sally: Welcome to The Brain Architects, a podcast from the Center on the Developing Child at Harvard University. I’m your host Sally Pfitzer. In March of 2020, we recorded episodes exploring the impact the coronavirus pandemic could have on child development. You may remember we discussed the importance of self-care for caregivers, and the importance of physical distancing, not social distancing.  And now a year later, we wanted to continue those conversations and discuss what we’ve learned, what needs to change, and where we go from here. On today’s podcast, we have Dr. Renée Boynton-Jarrett, who is the founding Director of Vital Village Networks at Boston Medical Center and an Associate Professor of Pediatrics at Boston University School of Medicine. So good to have you with us, Renée. Dr. Boynton-Jarrett: Delighted to be here. Thank you, Sally. Sally: Renée, in March of 2020, we spoke with Dr. David Williams, who explained that many of the disparities that we saw in the early stages of the pandemic were predictable and the result of longstanding social policies and systemic racism. From your perspective, as an expert in the field, in the past year, what have we learned about these disparities? Dr. Boynton-Jarrett: I think what Dr. Williams shared is absolutely correct. What we saw happen with the COVID-19 pandemic is it took advantage of the existing inequities and just widened those. So actually, our existing structural racism created a broader opportunity for the pandemic to disparately impact the lives, the well-being, and the health of communities of color and communities that are disproportionately impacted by structural racism. And so, I think one of the things that we have learned or relearned is the tremendous cost of failing to truly address structural inequities with sustainable and comprehensive policy changes. And as importantly, because we know structural racism is around these interconnected systems and institutions, but there are also these ideologies, mindsets, ways of thinking and being. And if we think about it, those ideologies and mindsets about who’s okay just to remain at risk, to not have the luxury of physical distancing, to not have the luxury of having water to wash hands and do the hygienic practices. We’ve learned that we also have mindsets that truly impact the way in which we view humanity and human dignity and human rights, and that this pandemic has completely taken advantage of the ways in which those mindsets, ideologies, and systems create structures of inequities. Sally: Could you give us some examples of what changes you think need to happen in the field, particularly how communities and neighborhoods could help? Dr. Boynton-Jarrett: Yeah. I think your question actually hits on where I see the biggest opportunity for change. So, one of the things we saw happen over and over during the pandemic is in the absence of plans. Strategic plans and responses are being created in real time, and often those decisions—whether they were decisions being made about how vaccines would roll out, whether they were decisions being made about what economic supports and resources will come to families, or what will happen with early care and education, childcare, school—we saw time and time again decisions being made that were not being made with true engagement. Not just engagement of communities, but engagement of community leadership. So really, in partnership with, in conversation with. Those who were closest to the inequities—experiencing them most directly—were not being engaged or brought to the table. And time and time again, we also saw that the ideas, the wisdom, the strategies that were actually happening within communities were thoughtful, were creative, were real-time responsive. And actually, when we begin to get behind them, we see more protection happening for communities. So, we also saw tremendous community leadership, and in the absence of that leadership, I think that we would have all fared much worse in this pandemic. Sally: Just anecdotally, I’ve seen that even in some of the work we’ve done at the Center too, and often finding that bringing in members of the community actively from the beginning of projects has been the thing that has made those projects so much more successful. Could you tell us more about your work at Vital Village Networks? Dr. Boynton-Jarrett: So, Vital Village Networks is based at Boston Medical Center. We promote child well-being and address structural and systemic inequities and systems of care and education in early childhood by doing a couple of things. We really work around establishing sustainable, authentic, and equitable partnerships between caregivers, parents, and community residents and community-based organizations and cross sector institutions—health care, education, advocacy, social service. In this work, we all really focus on expanding leadership trajectories and pathways for community leaders, and that can be through trainings and certifications and expanded opportunities. But we also really think about how do we work to build capacity and enhance existing community-driven solutions? So, how do we build capacity within a community to promote well-being? And often, that involves helping institutions and organizations within the community work with community leaders in a different way and we use a model called co-design. So, how do we create and design things together? We really work to think about what builds equitable partnerships. What creates a table for truly equitable participation? A lot of approaches to community engagement and community work begin with the deficit lens. They begin with the idea that there’s a problem in the community, and we have a solution, we want to bring the solution. Well, that starting point actually makes it very hard to partner equitably with communities. Because if you think about—even if you were going to pick someone for a team, would you pick someone or something that you had only framed in terms of their weaknesses? Parents don’t do that with their children, right? We all have our strengths and weaknesses. Parents are really good at framing the strengths and uplifting the strengths and building upon the strengths of their children, but we don’t do that with community engagement. We often view a problem and that’s our primary way of understanding a community, and that really creates an imbalance in power from the very beginning. Also, who gets to ask the questions? Who gets to design the evaluation? What type of technology do you need to participate virtually? So, all of these things create barriers for equitable partnerships. With co-design, we really begin first by understanding that there are solutions that already exist within communities and if we’re not aware of those solutions, it’s because we’re not seeing them, not because they don’t exist. So really beginning by recognizing, appreciating, and valuing the strengths and the wisdom and solutions within communities, which creates a much more level playing field for partnership. The second piece is how do we plan? How do we design together? So, how can we disrupt tools and strategies that bias someone based on their training or education? And how do we create opportunities to design things together that are centered around the diversity of people in the room? And that’s also a particular invitation that no one is at the table only as an expert, but everyone is at the table, both with their expertise and their gifts, as well as as learners. And so, creating that mutuality, that ability for us to be in both roles, all of those factors really lead to the ability to partner with communities and not on behalf of. Sally: Why do you think there’s a disconnect between health systems and the families they’re supposed to serve? I’m thinking particularly here about the COVID vaccine in relation to this. Dr. Boynton-Jarrett: What I would share is I think we’ve had a disproportionate focus on distrust about the vaccine. So, when we think about it, when we actually look at the real data that we have, actually the vast majority of people who have been surveyed or interviewed in communities of color are along a continuum of interest in the vaccine, and/or very interested in getting the vaccine or have already received it. So, a very, very small percentage that has said, you know an absolute no. So, that is a strong signal that people are seeking an opportunity to have their questions answered, to have a conversation, and to engage around the vaccine. Also, what I think we haven’t focused on enough is how do health care institutions demonstrate trustworthiness? So, we want people to trust the vaccine, and that it’s good for their health. And we have like this, I think an overemphasis or an over expectation that what we’re hearing from people is that they don’t trust the vaccine. What we may be hearing from people that we haven’t focused on enough is how do institutions demonstrate that they are trustworthy—that they’re going to share updated information about concerns, or warnings, or emerging complications, or side effects? That they are going to offer the vaccine in settings where you will be able to get your questions answered. That you will have opportunities to hear from other people who have received the vaccine. And so, what I think that we need to really focus on is also taking a hard look from a lot of current and historical lessons at the ways in which, you know, despite what might be well intentioned efforts, systemic racism truly exists within our institutions, including our health care institution. And how that is experienced for people is sometimes that the institution does not appear to be trustworthy, because time and time again needs are not being heard or listened to or responded to with dignity. If we are expecting that we can change people’s minds to make them do what it is we’d like them to do, again, that only serves to reinforce, “I’m not wanting to hear your concern. I’m wanting you to follow my guidance, my advice in a system that you have not been invited to help design what this experience would look like.” So, that’s why we’re seeing so much success of vaccines that are being administered at faith-based institutions in partnerships with the faith-based community. That’s why we’re seeing so much success with providers of color that are creating safe and brave spaces for people to learn about, talk about, and discuss the vaccine. And in our work with Vital Village Networks, we’ve had what I would just consider—led by community members—we’ve had love conversations. Conversations that aren’t so much about all of the details, but are just creating a space for people to be honest about any fears they may have, or anxieties that they may have. And time and time again, they connect to what you have learned throughout your life around untrustworthy medical institutions that have demonstrated that time and time again. So, we must do a better job and a different job of demonstrating trustworthiness. Sally: I really appreciate that response. I’m your host Sally Pfitzer. The Brain Architects is a product of the Center on the Developing Child at Harvard University. You can find us at developingchild.harvard.edu. We’re also on Twitter @HarvardCenter, Facebook @CenterDevelopingChild, Instagram @developingchildharvard, and LinkedIn: Center on the Developing Child at Harvard University. Brandi Thomas is our producer. Dominic Mathurin is our audio editor. Our music is Brain Power by Mila from freemusicarchive.org. This podcast was recorded at my dining room table. Header photo by Christina Morillo from Pexels

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    COVID-19 Special Edition: Superheroes of Pediatric Care: Moving Beyond the Challenges of COVID-19 Jun 02, 2021
    Show notes

    The devastating toll of the pandemic has underscored the critical importance of connecting what science is telling us to the lived experiences of people and communities. In March of 2020, we recorded episodes exploring the impact the coronavirus pandemic could have on child development. Now, a year later, we wanted to continue these conversations and discuss what we’ve learned, what needs to change, and where we go from here. Contents Podcast Speakers Additional Resources Transcript In the second episode in this 4-part special series, host Sally Pfitzer speaks with Dr. Rahil Briggs, National Director of ZERO TO THREE’s HealthySteps program. They discuss the potential impact of the pandemic on infant and toddler development, how an overstressed pediatric health care system responded, and the importance of overcoming equity challenges and public fears to resume well-child visits. Upcoming episodes of this series will feature expert speakers reflecting on the longstanding social policies and systemic racism that resulted in the pandemic disparately impacting communities of color, and the pandemic’s impact on the mental health system. The experts will discuss how we can take what we learned over the past year and make meaningful changes that will improve outcomes for children and families. Listen to the first episode of this series, where Center Director, Jack P. Shonkoff, M.D. discusses what COVID-19 revealed about the needs of caregivers with young children or during pregnancy. Subscribe below via your podcast platform of choice to receive all new episodes as soon as they’re released. Speakers Sally Pfitzer, Podcast Host Dr. Rahil Briggs, National Director of ZERO TO THREE’s HealthySteps Program Additional Resources Resources from the Center on the Developing Child Re-Envisioning, Not Just Rebuilding: Looking Ahead to a Post-COVID-19 World The Brain Architects: COVID-19 Special Edition: Self-Care Isn’t Selfish Working Paper 15: Connecting the Brain to the Rest of the Body: Early Childhood Development and Lifelong Health Are Deeply Intertwined InBrief: Connecting the Brain to the Rest of the Body A Guide to COVID-19 and Early Childhood Development Resources recommended by Dr. Rahil Briggs Psychology Today: What Parents of Babies and Toddlers Need Right Now American Academy of Pediatrics: A superhero moment HealthySteps: Caring for Yourself and Young Children During the Coronavirus (COVID-19) Crisis ZERO to THREE: Tips for Families: Coronavirus Rapid Assessment of Pandemic Impact on Development (RAPID) – Early Childhood USA Today: Opening ‘so many doors for families’: COVID-19 underscores the importance of wraparound care for new moms and children Early Childhood Depression May Impact Brain Development in Later Years Brazelton Touchpoints Center ZERO TO THREE: Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood and official DC:0-5 Training for advanced infant and early childhood mental health professionals Transcript Sally: Welcome to The Brain Architects, a podcast from the Center on the Developing Child at Harvard University. I’m your host Sally Pfitzer. In March of 2020, we recorded episodes exploring the impact the coronavirus pandemic could have on child development. You may remember we discussed the importance of self-care for caregivers, and the importance of physical distancing, not social distancing.  And now a year later, we wanted to continue those conversations and discuss what we’ve learned, what needs to change, and where we go from here. Joining us on today’s podcast is Dr. Rahil Briggs, National Director of ZERO TO THREE’s HealthySteps program. Rahil, thanks so much for being here with us today and just for timing, I’m going to jump right into our first question. What can we tell parents and caregivers about the potential effects the pandemic lifestyle changes could have on development, particularly on infants and toddlers? Dr. Briggs: Thank you Sally, and thanks for having me. I know this question is on a lot of people’s minds. We’re a year into this and what’s been the effect? For some of these kids, it’s half of their life that they’ve lived within the COVID pandemic. But for parents of babies and toddlers, I think we mostly have really good news. Because they are learning through serve and return interactions, it doesn’t need to occur in one particular kind of learning environment or even a specific variety of environments for them to continuously be learning. So, parents can rest assured that babies and toddlers who are having that regular interaction with their primary caregivers in loving, supportive, nurturing ways with all sorts of serve and return moments all day long are still learning a lot. So, reading books, singing, playing music, just observing what’s going on around them. We often talk about—you know nobody expects that you’re going to put your life on hold and read 20 books to your kids every hour, but can you just comment on what you’re doing as you’re cooking dinner? Now I’m putting the water in the pot, and now I’m putting the rice in, and let’s watch it boil—and just really narrating or sportscasting that day. I’ll say it again and again and again, you know, it’s about really taking care of oneself—avoiding toxic stress, bringing in mindfulness if you can. And I don’t mean that we all become yogis and meditate every day. That is not realistic right now. We’re trying to juggle 12 different things every minute. It’s about self-care of adults. Self-care is not selfish as we’ve discussed before. Reducing that caregiver stress will reduce baby and toddler stress, and when babies and toddlers are less stressed, they learn better just like us, right? We learn better when we’re less stressed and it’s exactly the same for them. And of course, if there’s one thing we’ve all learned in this last year, it’s that stress can’t be avoided per se, but it’s about regulating. And so, for parents and caregivers it’s about self-regulating or asking for help. And when you do those things, either self-regulate or ask for help, you model really important social-emotional skill that babies will eventually learn through that example. Sally: Rahil, I really appreciate that connection you just made between the health of caregivers and the health of children. I think it’s something that can easily be overlooked, especially with everything going on. And I’m wondering, are there concrete examples of things that caregivers should look out for? Something that might indicate that their child has been negatively impacted by the uncertainty and chaos surrounding the pandemic? Dr. Briggs: Sure, so we know that the difference between a one-year-old and a two-year-old say in developmental terms is pretty remarkable. It’s quite different than the difference between a 33-year-old and a 34-year-old, for example. And so, developmental regression is something that you might look at and you might look for. So, is a child who used to be toilet-trained now going back to having accidents or asking for diapers? Or a child who used to be, you know, fully weaned from a bottle, or breastfeeding or a pacifier, suddenly going back in that direction? Those can be signs of them just saying like “Hey, this is all a bit overwhelming for me right now and I want to go back to a place where things are a little bit easier, and I get a lot more soothing and a lot more care.” From some of the wonderful work of people like Joan Luby and others, we know that preschool age children can be unfortunately depressed. They can be reliably diagnosed with depression, meaning that a number of different professionals would agree: “yes, this looks like depression.” And not too unlike ourselves in the adult phase of life, you know. It could be impacting sleep, diet, interest in everyday things. So, I would say that’s a great time to really reach out to your pediatrician and say, “This is what I’m seeing. Does this feel like the new normal and just what I should expect because of how we’ve all been? Or does this feel like something that needs a little bit more attention?” And so, any prolonged or substantial changes might be something to bring to a pediatrician. We know that lots of families have been worried about going to the pediatrician. I saw just this week, the American Academy of Pediatrics has put out a new call that parents are superheroes when they bring their children to the pediatrician to get up to date on vaccinations, but it’s also those times to ask those questions and really double-check like is this okay? Is this something to be expected? Or is this something to be worried about? Sally: So, the pediatric system, like many had to adapt rapidly to the pandemic. What do you think has worked well and what has not worked well? Dr. Briggs: So, talk about superheroes. When I think about my colleagues in pediatric care at Montefiore and around the country and all through healthcare, the lengths to which people have gone to support families is remarkable. We’ve heard about just pediatric practices, sort of turning themselves inside out and becoming one-stop-shops for families—diapers, formula, and the like. So, just gratitude to everyone in pediatric healthcare. They’ve been stressed, to say the least, and so that pediatric system has had to get retooled to serve adult patients. There have been some children’s hospitals where full floors have become adult-focused out of need, and of course, as people have gotten sick or been less available, we’ve seen that as well. So, the pediatric system was stressed to say the least. We saw and we continue to see dips in well-child visits. We see dips in vaccinations—not COVID, but all those other diseases that we have these wonderfully evidence-based vaccinations for—and it’s around the country. We’ve also heard about pediatric practices closing, just not being able to stay open for business because the volume was down or because the workforce issues. There’s been a slow rebound on all of these points, but I’d say we’re not quite back yet to pre-pandemic levels and so that means that families are missing out. They’re missing out on that really important care that happens at the pediatric office. If we don’t reverse this and quickly, that will be concerning. I think about it, especially from an equity lens. When all babies and toddlers have a strong start, and when they can get that start through a partnership through a high performing pediatric practice, the entire country is better, right? Pediatric primary care is like the only setting we have in this country that almost universally reaches all babies, all toddlers, and their families no matter what your income is, no matter, you know where you’re living. So, I’d say some of the transitions we saw, you know, as folks got to recognize that this new normal was going to be around for a lot longer than they had anticipated. We saw our HealthySteps practices really adhere to the guidance that was put out by the American Academy of Pediatrics and by the CDC. And so, for many practices that meant postponing visits for older kids and only seeing kids birth to age 2 in person. That was some early American Academy of Pediatrics guidance. Some practices experimented with drive through vaccinations, others went fully remote and started seeing families virtually. Telehealth in pediatrics is not quite as seamless as it may be for us in the adult world, right? That was a really big adjustment for people. I think it’ll be here to stay in some form, but lest you think it’s easy, try to imagine a baby or a toddler on the other side of that telehealth visit and telling them, “please sit there for the next three minutes and don’t move and show me the inside of your wrist.” Right? It’s like “uhh no.” So, not always the most compliant. You know, but for a lot of folks, for families and providers, seeing their patients virtually was better than not seeing them at all. Again, though, I think about equity here. And so many of those inequities that we saw pre-COVID are still relevant. Perhaps more relevant than ever, and they really come to light when we think about telehealth and folks who don’t have multiple computers in the home and the one that they do have is needed for the school-age child to do online schooling. They don’t have unlimited Internet access or cell phone data. And then, when we close the public spaces, previous options like using a computer at the library or the like aren’t really feasible. We’ve heard from our practices in rural areas that broadband access is a huge issue. This was again pre-COVID, and that affects telehealth and of course, remote learning for older children and work. As we become vaccinated, many of us, you know, practices are mostly back to in-person with the safety precautions that they need, which is really promising. And I would say we’ve all learned a lot. We’ve learned we are more flexible than we knew we could be, and we have been reminded about the inequities that existed pre-COVID because they have been magnified. My real hope is that we renew a focus on changes that really last for families—committed to health, well-being, school readiness of all babies and toddlers. Our work at HealthySteps continues with I’d say even more urgency than we had earlier. And hopefully, the world and the community at large can join us with really that mission to give all babies and all toddlers that incredibly strong start. Sally: Yeah, you started talking about this a little bit, but I’m curious when families are really stressed and they’re starting to say like, “Well, a well-child visit might be something that I can skip because there’s so much going on and I’m worried about exposure.” What would you say to those families and how would you kind of help them think through what that might mean? Dr. Briggs: It’s a great question. In terms of skipping well-child visits, we have data that suggests that there are negative outcomes when you skip well-child visits. So, what are some things that can happen? Well, developmental delays can go undiagnosed, and we all know that the earlier we catch those developmental delays and the earlier that we provide evidence-based treatment, the better the outcome for children, sometimes erasing what was a delay in only just a year. We also know about the incredibly lifesaving importance of vaccinations. We all are pretty well, you know, the number of people who can talk about what an mRNA vaccination does these days is remarkable and hopefully they remember that we’ve got vaccinations for lots of other really life-threatening diseases, and it’s critical—early childhood is the moment when you’re getting vaccinated, right? Almost every visit there’s some combination of vaccinations. They’re just so important. Growth is an obvious one. Not everybody has a perfect infant scale at home, and so being able to make sure that babies are gaining back that early birth weight and then gaining weight at the rate we would expect really has significant implications for development and well-being overall. So, it’s really one of those visits that feels pretty darn worth it to mask up, to call ahead about safety protocols, and to know that each and every one of those health care providers is going in there every day just as worried about their own health and well-being and that of their families and wouldn’t do anything to put their patients in danger. Sally: You always make me feel better when I talk to you, Rahil. I love those concrete examples too, I think that’ll be really helpful. I’m your host, Sally Pfitzer. The Brain Architects is a product of the Center on the Developing child at Harvard University. You can find us at developingchild.harvard.edu. We’re also on Twitter @HarvardCenter, Facebook @CenterDevelopingChild, Instagram @developingchildharvard, and LinkedIn: Center on the Developing Child at Harvard University. Brandi Thomas is our producer. Dominic Mathuri…

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