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On Health, Human Development Potential and the Quality of Life:

Early Social-Emotional and Cognitive Basis for Human Development Potential, and Improved Quality of Life. On Health, Human Development Potential and the Quality of Life: Towards Biological-based Indexes of Human Development Potential for Assessing the Quality of Life IDB-PAHO, May 25, 2007

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On Health, Human Development Potential and the Quality of Life:

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  1. Early Social-Emotional and Cognitive Basis for Human Development Potential, and Improved Quality of Life On Health, Human Development Potential and the Quality of Life: Towards Biological-based Indexes of Human Development Potential for Assessing the Quality of Life IDB-PAHO, May 25, 2007 S. Greenspan, M.D. & C. Breinbauer, M.D., M.P.H. Interdisciplinary Council on Developmental and Learning Disorders (ICDL)

  2. Brain Development Index??“Social-Emotional & Cognitive Development” • The evidence is clear: good nutrition and social, emotional, language and cognitive development are critical for human development and quality of life • We know how to measure early childhood stunting • The next challenge is to develop “internationally comparable and feasible measures of child development” (Grantham-McGreggor et al., 2007)

  3. Traditional Domains of Child Development • Language • Cognitive (IQ) • Social-Emotional • Fine Motor • Gross Motor • Limitations for internationally comparable & feasible measures: • Separate and/or long instruments for each domain • Complex application, expensive • Fragmented approach

  4. Brain Development:Social-Emotional Domain starts early • Newborns show visual preference for faces and rapid face recognition Social Cognition Emotion Recognition Face Perception Eye Gaze Adapted from G. Dawson, 2006

  5. Influence of Social Motivation on Brain Development Brain Development Social Motivation Cortical Specialization and Integration Attention to Social Stimuli Development of Expertise Efficiency (neural speed) Dawson et al., 2005, Developmental Neuropsychology

  6. The role of Emotions on Child Development • Traditionally, language and cognition were thought to be autonomous faculties that develop independent of emotion. • Greenspan & Shanker have demonstrated that language and cognition emerge from, and are inextricably tied to, increasingly complex affect gesturing between a child and his or her caregiver. • Shanker & Greenspan (2007). The Developmental Pathways to pattern Recognition, Joint Attention, Language and Cognition. New Ideas in Psychology, 25:1.

  7. Language Cognitive Socio-emotional Gross motor Fine motor Attention & Regulation Engagement Purposeful Communication Problem Solving Symbolic Ideas Logical, Critical Thinking Multi-Causal, Comparative, and Triangular Thinking Gray-Area Thinking Reflective Thinking Functional , Integrated Social-Emotional , Language & Cognitive Domains Classical Domains

  8. Shared Attention and Regulation Critical link between nutrition and social-emotional development

  9. Engagement and Relating

  10. Purposeful Emotional Interactions

  11. Shared Problem Solving

  12. Emotional Ideas

  13. Greenspan Social-Emotional Growth Chart, PsychCorp 2004 Quicker Progress Slower Progress

  14. Functional Social-Emotional Domains • 1994-1995 National Health Interview Survey on Disability (NHIS-D), NCHS • Simpson, Colpe & Greenspan (2003). Measuring functional developmental delay in infants and young children: prevalence rates from the NHIS-D. Paediatric and Perinatal Epidemiology, 17, 68-80 • Social-Emotional Scale of Bayley Scales of Infant and Toddler Development, third edition • Nancy Bayley (2006) PsychCorp

  15. Measuring Child Development Outcomes through Household SurveysA pilot effort to explore feasibility and methodological challengesInter-American Development Bank, 2005-2006

  16. Measuring Child Development Outcomes • % of children not developing to their fullest potential Purpose? • Gather evidence to inform policy makers of the need for specific country ECD policies & programs, “Evidence for Action” • Add ECD data to infant mortality and nutritional data • “No data, no problem, no action” (A. Solari, 2006)

  17. Comparable Domains & Survey ItemsAge Band: 36-47 months

  18. Preliminary Results from Chile • % of children under 5 years with emerging delays: 29.9% • % of children under 6 years with moderate delays: 11.3% • Delays increase with age, and are more prevalent among boys • 45.5% of boys between 4-5 years old have emerging delays (21.3% of girls between 4-5 years old have emerging delays)

  19. Logistic Regression Analysis: Correlation between Poverty and Children with Emerging Delays Risk of emerging delays increases in children living in households with lower incomes, 53% difference between highest (V) and lowest (I) quintile.

  20. Conclusions • Optimal nutrition and social-emotional development are the basic building blocks for higher level thinking abilities, human development and quality of life. • It is feasible to measure early child development outcomes through household surveys by interviewing their main caretaker, usually the mother. • More work is needed to develop feasible valid, reliable, and internationally comparable measures of early child development.

  21. “Redefining each child’s potential” S. Greenspan, M.D. & C. Breinbauer, M.D., M.P.H, Infant Mental Health Initiative Interdisciplinary Council on Developmental and Learning Disorders, ICDL

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