From Neurons
to Neighborhoods

An Update

WORKSHOP SUMMARY

Committee on From Neurons to Neighborhoods: Anniversary Workshop
Board on Children, Youth, and Families
Steve Olson, Rapporteur

INSTITUTE OF MEDICINE AND
NATIONAL RESEARCH COUNCIL

OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS
Washington, D.C.

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Committee on From Neurons to Neighborhoods: Anniversary Workshop Board on Children, Youth, and Families Steve Olson, Rapporteur

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THE NATIONAL ACADEMIES PRESS • 500 Fifth Street, NW • Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Govern- ing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineer- ing, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropri- ate balance. This project was supported by IOM Healthy Kids Communication Campaign. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project. International Standard Book Number-13: 978-0-309-20978-6 International Standard Book Number-10: 0-309-20978-1 Additional copies of this report are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313, http://www.nap.edu. For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu. Copyright 2012 by the National Academy of Sciences. All rights reserved. Printed in the United States of America Suggested citation: IOM (Institute of Medicine) and NRC (National Research Council). 2012. From Neurons to Neighborhoods: An Update: Workshop Summary. Washington, DC: The National Academies Press.

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The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Acad- emy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding en- gineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineer- ing programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is presi- dent of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Insti- tute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sci- ences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council. www.national-academies.org

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COMMITTEE ON FROM NEURONS TO NEIGHBORHOODS: ANNIVERSARY WORKSHOP JACK P. SHONKOFF (Chair), Director, Center on the Developing Child, Harvard University HUDA AKIL, Co-Director, The Molecular & Behavioral Neuroscience Institute, University of Michigan DEBBIE I. CHANG, Senior Vice President and Executive Director, Nemours Health and Prevention Services, Newark, DE BERNARD GUYER, Zanvyl Kreiger Professor of Children’s Health Emeritus, Bloomberg School of Public Health, Johns Hopkins University RUTH MASSINGA, CEO, Emerita, Casey Family Programs, Seattle, WA BRUCE S. McEWEN, Alfred E. Mirsky Professor, Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology, Rockefeller University, New York, NY PAMELA MORRIS, Professor of Psychology and Social Intervention, The Steinhart School of Culture, Education & Human Development, New York University DEBORAH A. PHILLIPS, Professor, Department of Psychology, Georgetown University IOM Staff ROSEMARY CHALK, Study Director WENDY KEENAN, Program Associate v

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Reviewers This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this report: Duane Alexander, National Institutes of Health O. Marion Burton, University of South Carolina P. Lindsay Chase-Landsale, Northwestern University Sarah L. Friedman, CNA Corp. Lonnie R. Sherrod, Society for Research in Child Development Ross A. Thompson, University of California, Davis Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before its release. The review of this report was overseen by Jeanne Brooks-Gunn, Columbia University. Appointed by the National Research Council and vii

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viii REVIEWERS Institute of Medicine, she was responsible for making certain that an in- dependent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully con- sidered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.

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Contents Preface xi 1 From Neurons to Neighborhoods: Reflections on Four Themes 1 2 Research Issues in Early Childhood Development 9 Nature, Nurture, and the Research Agenda at NICHD, Alan Guttmacher, 10 The Role of Stress in Physical and Mental Health, Bruce McEwen, 14 What We Have Learned about Learning, Deborah Stipek, 19 3 Policy Issues in Early Childhood Development 25 The Federal Policy Environment, Joan Lombardi, 26 A Global Perspective, Mary Eming Young, 31 Creating the Future of Early Childhood Policy and Practice, Jack P. Shonkoff, 35 4 Final Remarks 43 References 45 Appendixes A Original Committee Membership and Charge 47 B Workshop Agenda and Participants 49 ix

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Preface The original study From Neurons to Neighborhoods: The Science of Early Childhood Development was released at a press conference in the Washington, DC, headquarters of the National Academy of Sciences on October 3, 2000 (see Appendix A for the original committee membership and statement of task). For weeks before the event, study director Deborah Phillips and I, along with members of the Committee on Integrating the Science of Early Childhood Development, had been preparing diligently and hoping that our report would garner significant media coverage and have a major impact on policy makers. However, when the report was finally released, the findings of a 6-year investigation into President Bill Clinton’s involvement in the Whitewater case were delivered to the Congress—and our carefully constructed announcement fell off the public’s radar screen. I’ll never forget the words of Vanee Vines, the National Academies’ press officer, who worked with us on the report and put our disappoint- ment into a broader perspective. “This report is not a breaking news story,” she said. “You have to give people time to read it carefully and digest its content. I promise you that this report will have legs.” More than a decade later, those words have held up well. From Neu- rons to Neighborhoods, the product of a 2.5-year study, has indeed had legs. Moreover—to extend the metaphor—it stood up and ran on those legs. It called for a fundamental reexamination of the nation’s response to the needs of young children and families, drawing upon a wealth of scientific knowledge that had emerged in recent decades. The study shaped policy agendas and intervention efforts at national, state, and local levels. It captured a gratifying level of attention in the United States and around xi

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xii PREFACE the world and has helped to foster a highly dynamic and increasingly visible science of early childhood development. It contributed to a growing public understanding of the foundational importance of the early childhood years and has stimulated a global conversation about the unmet needs of millions of young children. Ten years later, on October 27-28, 2010, the Board on Children, Youth, and Families of the Institute of Medicine (IOM) and National Research Council (NRC), which shepherded the creation of From Neurons to Neigh- borhoods, held a 2-day workshop in Washington, DC, to review and com- memorate a decade of advances related to the mission of the report. The workshop began with a series of highly interactive breakout sessions in which experts in early childhood development examined the four organiz- ing themes of the original report and identified both measurable progress and remaining challenges; a summary of the themes and the conclusions of the breakout sessions appear in Chapter 1. A celebratory dinner on the evening of the first day brought together many of the people involved in the original funding, writing, and dissemination of the report to reflect on the reasons for its influence and to discuss future directions for the science of early childhood development and its application. The next day, six speakers chosen for their diverse perspectives on early childhood research and policy issues discussed how to build on the accomplishments of the past decade and to launch the next era in early childhood science, policy, and practice. Their perspectives, which are summarized in Chapters 2 and 3, are just illustrative of the many that could have been discussed at the workshop. Their talks provided a lively cross-section of reflections on the importance of the report and on future research and policy directions. My closing re- marks at the workshop are summarized in the final chapter of this report. From its inception, From Neurons to Neighborhoods has been driven by the proposition that there is a single, integrated science of early child- hood development despite the extent to which it is carved up and divided among a diversity of professional disciplines, policy sectors, and service delivery systems. While much work still remains to be done toward this goal, one of the report’s chief contributions was to identify that common base of knowledge on which researchers, educators, health care providers, courts, policy makers, civic leaders, and many other constituencies have been able to build. The presentations at the 2010 workshop demonstrate both the promise of this integrated science and the rich diversity of contri- butions to that science. Perhaps the most rewarding source of gratification for the authoring committee is the extent to which From Neurons to Neighborhoods has helped transform the public discourse about young children. As stated on the last page of the report, our aim was to “mobilize the best available knowledge (and promote its continued growth) in order to move beyond

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xiii PREFACE simple questions about whether environments and early experiences make a difference.” These concluding thoughts ended with a challenge “to answer questions about how to enhance the quality of those environments and ex- periences in an effort to promote the health and development of young chil- dren.” As we take stock of what has been accomplished since those words were written, it is clear that significant progress has been made in answering the “why” question, while much remains to be done to answer questions that begin with “what, how, and what’s next?” In this context, many of the toughest challenges today are variations on themes that were identified by the committee and articulated in the report more than a decade ago. As the date for this anniversary celebration approached, I reread the acknowledgments section of the report and counted 123 people who con- tributed to its creation—far too many to thank individually again by name. That said, several key people deserve special mention beyond the 17 ex- traordinary members of the original study committee. Deborah Phillips was an inspiring and indefatigable study director who guided the report from its earliest conception through its writing, publication, and release. Much of the report’s success should be credited to her extraordinary efforts. The 13 members of the IOM-NRC review committee provided us with a formi- dable stack of comments and suggestions that greatly improved the report, and our editors—Eugenia Grohman and Christine McShane—scrutinized every word of the manuscript before it was sent to the printer. The anniversary event, From Neurons to Neighborhoods: Ten Years Later, was organized by Rosemary Chalk, the director of the Board on Children, Youth, and Families. Pamella Atayi, Reine Homawoo, Wendy Keenan, and Rachel Pittluck provided valuable assistance in organizing and running the event. Steve Olson wrote the summary, working from a transcript generated by Caset Associates, Ltd. One of the most valuable pieces of advice that the Committee on Inte- grating the Science of Early Childhood Development received very early in the writing of From Neurons to Neighborhoods was that it should try to help build the knowledge base that would be needed 10 years in the future, not just address the pressing issues of the day. The content and energy dis- played at the anniversary gathering for From Neurons to Neighborhoods indicate that the committee successfully embraced this advice. The past decade has seen immense progress, and the prospect of future advances in the domains of science, policy, and practice is even more exciting. The reas- suring message that followed our less than auspicious release was prophetic. The science of early childhood development does indeed have legs! Jack P. Shonkoff, Chair Committee on From Neurons to Neighborhoods: Anniversary Workshop

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