Let's start helping Walla Walla's children very early


Most of us have the deep intuition that our youths are our future. We also know, especially from the business paradigm, that the earlier and larger the investment in a given enterprise the greater the later reward.

The expression "getting in on the ground floor" is part of our collective cultural wisdom.

As a society we've been focused on education as a path to improvement of the individual and society.

Even though we understood that the sooner one starts this education, the better, we have recently had some hard science published to show just how important that principle is and just how early the start needs to be.

I have been increasingly interested in youth issues for the past 15 years. My interest was boosted by the second Children's Forum that Dick Cook organized in 2000. The keynote speaker was Robin Karr-Morse. The title of her book, "Ghosts from the Nursery....Tracing the Roots of Violence," says it all.

As a keenly observant social worker, she came to the opinion that, for a rough approximation, an experienced obstetrical nurse could stand at the door of the hospital as the 2-day-old infants were discharged and predict, "that one's OK, that one's going to be fine, that one's in trouble, that one's in deep trouble" with a remarkable degree of accuracy.

The nurse could tell by the interaction of the mother and baby observed over 48 hours and the support systems surrounding the pair, as evidenced by the visitors, what the long-term outlook was likely to be.

There is a growing body of scientific literature that increasingly "proves" the cause/effect relationship between earliest experiences and later adverse outcomes. I put "proves" in quotes because certainty of the cause/effect relationship is crucial if drastic action is to be based on that understanding, and establishing such relationships with sufficient certainty is difficult.

I'll cite two of the studies with which I am most familiar.

Martin Teicher wrote an article published in Scientific American, November 2001, titled, "Scars that Won't Heal...The Neurobiology of Child Abuse." In it, he examines the most extreme end of the spectrum, overt catastrophic child abuse, and shows through CT scans, MRIs and PET scans that the brain anatomy is clearly altered by age 5, and that these changes are lasting and associated with sociopathic personalities.

The second example of this emerging science, which helps establish this cause/effect relationship, is the Adverse Childhood Experiences study done by the Center for Disease Control in Atlanta now being presented to our nation. Several efforts are being made to familiarize everyone in our community with that study and its profound results.

The Children's Resiliency Initiative, led by Mark Brown and Teri Barila, is using it as a major tool to educate our community.

In brief, a scoring system was established to give a numerical value to adverse childhood experience such as loss of a parent, for example, by death, abandonment, or divorce, parent incarceration, drug abuse, unemployment, physical or sexual abuse, etc.

A similar scale was established for adult adverse outcomes such as drug/alcohol abuse, unemployment, divorce, early chronic illness, disability, accidents, suicide.

In the scientific world, the "gold standard" for proof of cause/effect relationship is the double blind, placebo-controlled, cross-over study. Obviously we cannot do this with humans.

When the data of this retrospective adverse childhood experience, or ACE, study was collected and displayed in a graph format plotting ACE scores against adverse adult outcomes, the result was an extraordinarily near perfect 45 degree, straight-line relationship.

A little bit of ACE correlated with a little bit of "badness" in adult life, and a lot correlated with a lot. Any scientist, especially one conducting a drug testing study, would immediately recognize that picture or graph and exclaim, "That's a perfect dose/response curve!"

In medicine we often accept that as one of the most "iron clad" proofs of a cause/effect relationship absent the previously mentioned "gold standard" experiments.

In my judgment, we now have sufficient proof to begin to consider how society can reorder its priorities and apply its creativity and imagination to bring our newborn babies into our community in the best way possible.

There are some early indications of what might be the mechanism underlying this cause/effect relationship.

In brief, there is evidence that chaos, such as might occur when a baby doesn't know if crying will result in soothing or feeding or a slap, causes an outpouring of stress hormones in the body such as adrenaline and cortisol.

When these hormones bathe the developing infant brain, profound changes in the anatomy or "hardwiring" of that brain take place.

The chronic "fight or flight" state produces permanent brain changes.

Using a computer analogy, we used to think these early adverse experiences were making bad software that could, with enough therapy and intervention, be reprogrammed.

I think recent evidence supports the concept that, at least in the more extreme cases, the problem is an altered hardware that no amount of intervention can correct.

I certainly do not advocate "giving up" on someone who needs help. I am suggesting that when society allocates resources, it makes sense to spend them as early as possible.

Another part of our collective cultural wisdom is represented by the familiar advertisement featuring the mechanic urging us to get the oil changed in our car with the warning, "You can pay me now, or you can pay me later."

The "later" bill is vastly greater when one considers the wasted life and the injury to society that damaged individual ofter causes, to say nothing of the costs of incarceration.

In the state of Washington, we are fortunate to have forward-thinking leaders who have been advocating improvements in children's earliest experiences. Mona Locke got "Thrive by Five" started and Gov. Gregoire has kept the ball rolling.

In our Valley, the Early Learning Coalition is working to make real progress in this area.

Just like Karr-Morse, we are all starting to recognize that working with the 3- to 5-age group so that they are ready for kindergarten is a worthwhile and necessary endeavor, but the game may already be over by age 3!

What does all this mean for our community?

We need to do a major revision of our priorities. Instead of spending a massive amount of money and energy on incarceration (vastly more than any other in the world), a fraction of those resources should be redirected at the birth to age 3 situation.

Once the problem is well recognized and characterized, the creativity of our caring people will be mobilized if we, as a society, have the will to redirect our resources.

Being a believer in the mentoring model in practice by Friends of Children of Walla Walla, I'm drawn to the Home Team program of Children's Home Society that matches older couples in a supporting relationship with younger parents.

Travel and technology have badly damaged the extended family in most communities.

We must deliberately create an extended community where little or none exists.

The wisdom, "It takes a village to raise a child," is one valuable concept aboriginal cultures have taught us.

While we are learning more about what is important in early development, we can apply more carefully what we do know.

One of the most important techniques I know of is to read to your children beginning, perhaps, in utero!

Yes, there is emerging evidence that learning begins during the last trimester, and the expectant mother who tells her baby stories before it is born is far from wasting her time.

The Early Learning Center is exploring ways to improve information for parents and learn how to better support them.

Quality, affordable child care has been identified as a need in our Valley.

This situation will take generations to correct, but the sooner we start to apply what we do know, the sooner we will start producing fewer sociopaths.

Dr. Karl Eckhardt, an anesthesiologist, is a member of the Board of Directors of Friends of Children of Walla Walla.


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