Psychology in action
Psychology in Action: Finding International Potential in Early Childhood Development
By Amena Hassan
Psychology International (September-October 2007)
by Amena Hassan
APA Office of International Affairs
Earlier this year, the British journal The Lancet published a series of three papers addressing child development in developing countries, focusing specifically on children under the age of 5. The first paper found that over 200 million children across the world do not reach their development potential in the first 5 years of their life, while the second paper addressed the risks underlying the developmental loss, including nutritional deficiencies chronic and substantial enough to cause stunting, iron and iodine deficiencies, inadequate cognitive stimulation, maternal depression, violence exposure, and diseases such as malaria. In the third paper, the authors reviewed strategies to promote child development and prevent developmental loss. They provided guidelines, based on effective early child development programs that had been implemented at scale in developing countries.
One of the authors of the papers, Maureen Black, a pediatric psychologist and APA member from the University of Maryland, gave insight into what the authors were striving to achieve in tackling the questions surrounding global child development. Black, along with two other APA members, Patrice Engle of Cal Poly State University and Ted Wachs of Purdue University, worked with an interdisciplinary steering committee, to organize and write the papers. One of the primary aims was to promote early child development as a critical method to meet the objectives put forth by the United Nation’s Millennium Development Goals to reduce poverty throughout the world. The steering committee approached The Lancet after the journal had published other series on the subjects of child survival and neonatal health and child mortality. The Lancet decided that a series of articles is an effective method of addressing important issues, since this technique attracts more attention than a single paper.
“We assembled three interdisciplinary writing teams of approximately 20 colleagues to write the papers, including economists, nutritionists, psychologists, educators, public health professionals, physicians, anthropologists, and statisticians from universities and international agencies in developing and developed countries," said Black. "The nature and importance of the conclusions we came to in these papers would not have happened if we were all from one discipline because the product would have been too narrow. Finding a common language among colleagues from multiple disciplines comes with its tensions, but there is also a synergy that emerges from interdisciplinary work. Also, the contributions of colleagues from differing countries increased the validity and the appeal of the papers.”
The group functioned through email, conference calls, and meetings in New York and at the Innocenti Center in Florence, Italy with the support of the United Nations Children's Fund (UNICEF) and the Bernard van Leer Foundation. After the papers were published, the group was involved in launches held in London (at the University College London’s Institute for Child Health), Bangladesh, and professional meetings, including the Society for Research in Child Development in Boston, the Pediatric Academic Societies in Toronto, and the Micronutrient Initiative in Istanbul.
The authors’ next initiative will take place at a conference in Bellagio, Italy supported by the Rockefeller Foundation. At the conference, the main focus will be on the third published paper, which spells out guidelines for program implementation and the further research that is needed for adopting early childhood development plans. A specialist in international priority setting from Croatia will also work with the group, while the Society for Research in Child Development (SRCD) will work with the authors to put together an upcoming social policy report.
“Early implementation plans have an impact in a relatively controlled setting, but to move to a more local or regional implementation involves a whole separate set of issues,” said Black. “We have representatives from UNICEF, the World Health Organization (WHO) and the World Bank, because they actually have the power to do something.” She noted that there are also similarities with issues within the United States and in other countries. “We focused on children under the age of 5 because there is so much potential and vulnerability during the early years when brain development is occurring rapidly and nutritional demands are high and 89% of the world’s children under age 5 live in developing countries, with only 3% in the United States. However, there are commonalities between issues in the United States and in developing countries. In the United States, we have children starting school who are already behind in both cognitive and social-emotional development and children who are exposed to micronutrient deficiencies, maternal depression, violence, and few opportunities for early learning. The recommendations we have in the third paper could apply to any of the poorer areas in the US, such as urban Baltimore or other rural areas. They could apply internationally as well as domestically. It’s important to think broadly.” Black also referred to the long-term benefits of early home-based intervention trials conducted among undernourished children in Jamaica by two members of the Steering Committee, Sally Grantham-McGregor and Susan P. Walker. Recent publications in The Lancet and the British Medical Journal have shown beneficial effects of early home-based intervention on cognitive and educational performance and measures of attention, anxiety, depression, and self-esteem.
Presently the largest problem areas for obstacles in child development are in sub-Saharan Africa and South Asia, both of which have some of the largest numbers of disadvantaged children. Extreme poverty partnered with complications from HIV and AIDS in Africa have resulted in scant resources for children. Lack of food, lack of opportunities for early learning, and the ever present existence of infectious diseases are large factors in what Black calls the “derailment” of children in South Asia. Black urges that a broader approach is needed to create a dent in the problem and says that during the implementation of programs it is important to think comprehensively instead of compartmentally.
“In the papers we talked about insuring that children have adequate nutrition and learning opportunities. Often the health system is the only system that reaches children under the age of 3. There are innovative examples from Turkey of incorporating early child development activities into primary health care. In the first 2 to 3 years, early child development programs are primarily home based, and in the later years programs are focused in preschools. In the papers we looked for examples of early child development programs that were integrated into the health and educational sectors, and ensured that children had access to nutrition and learning opportunities early in life. If we can promote early child development, we can prevent developmental loss and enable children to benefit from educational opportunities and to become productive citizens in the future.” Ψ
For more information, or to access the articles mentioned, please visit: http://www.thelancet.com/collections/series/child_development_developing_countries.