Marceau, 2008; Apter, Pauls, et al., 1993; Tallal, 1991). The age of onset of MEB disorders is generally earlier in boys than in girls, producing a male predominance of these disorders in prepubertal children. This sex-specific difference in rates of illness reverses following puberty, when the prevalence of disorders is higher in girls.
Developmental neuroscience provides a great deal of knowledge that will increasingly support preventive intervention approaches for MEB disorders. Knowledge is growing about the determinants of mental health in the prenatal and early postnatal periods of brain development; the importance of consistent and nurturing parental care on development of the brain; and the neural systems that support healthy attachment, socialization, adaptive learning, and self-regulation throughout infancy, childhood, and adolescence. All of this knowledge has important implications for interventions that can not only prevent MEB disorders but also actively promote positive, adaptive, prosocial behaviors and well-being. Specific opportunities to support healthy brain and behavioral development and to protect against environmental factors present themselves at distinct developmental stages, when they are most likely to have a beneficial effect.
During the prenatal period and the early years of a child’s life, neurobiological processes establish the potential for healthy development or, in the presence of various risk factors, the potential for the development of significant cognitive, emotional, and behavioral difficulties. Knowledge of these processes informs preventive approaches in a number of ways.
First, as discussed throughout this report, mental and physical health are inseparable, as are brain and physical development. Programs and interventions that support healthy pregnancy are therefore crucial. These can include efforts to ensure adequate and proper nutrition, such as requiring the fortification of foods with folic acid, a universal preventive intervention that has reduced the rates of neural tube defects in the United States by 25-30 percent (Pitkin, 2007). Similarly, reducing exposure to environmental toxins and infections during pregnancy and minimizing obstetrical complications during childbirth can have powerful effects on preventing MEB disorders (see Chapter 6).
Second, this chapter has emphasized the importance of nurturing care for healthy brain development and the lifelong adverse effects that disruptions in this care and exposure to harmful experiences early in life can have on both the development and functioning of the brain. Considerable