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Critical periods in childhood learning 
Kathy Sylva 
Department of Child Development and Primary Education, Institute of Education, London, UK 
The human baby is bom with 'hard wiring' that loads the baby to pay attention to 
certain things in the environment, especially the communications of canegivers. These 
inborn predispositions are gradually shaped by the environment of the family, a 
'curriculum for babies' which is rich on communication and making sense of the world. 
Day care and nursery education can complement and enhance the child's learning, 
especially if they are of high quality. Research has shown again and again that early 
learning has lasting effects on development although they are rarely irreversible. 
Nature and nurture: an ancient but current debate 
This is one of the oldest and most central debates in science. When 
discussed by a psychologist it concerns whether a child's development is 
governed by a pattern built in at birth or whether it is moulded by 
experiences afterwards. Historically the nativist side to the debate, the 
side which championed nature, was represented by Plato who believed 
that many concepts were innate. On the other side, British 'empiricists' 
such as John Locke insisted that the baby's mind is a blank slate at birth 
and that all knowledge is etched on it by experience. There is now 
widespread agreement that the 'interactionists' have won the day and 
that child development is governed by the interaction of nature and 
nurture. Still there is heated debate about how much of a child's genes 
contribute to the child's eventual intellectual attainment and personal 
style. This paper leaves the topic of genes to other authors in the volume 
while concentrating on what is known about learning in young children, 
especially the power of the environment to shape it. 
Inborn bias and constraints 
pTic/nth! contemporary version of the naturist view focuses on 'inborn 
Department of C/11W biases'. These constraints on development do not consist of Plato's 
Deve/opmentond inborn concepts but rather ways the newborn is 'programmed' to pay 
PnmaryEducation, m o r e attention to some things than to others and to respond in a 
Institute or Education, . . . . .  i n i _ - i L 
20 Bedford Way, particular way to certain objects. For example, Slobin1 proposes that 
LondonWOHOAL, UK babies are born with what he calls 'operating principles' that 
Bnhth Medical Bulletin 1997;53 {No 1).185-197 息Tti. Bnti損hCounall997 
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Fetal and early childhood environment: long-term health implications 
Fig. 1 Five models of 
the relationship between 
maturation and 
environment4.The top 
model show! a purely 
maturational effect' the 
bottom model (induction) 
shows a purely 
environmental effect.The 
other three present 
interactive combinations: 
maintenance, in which 
experience prevents 
lessening of a 
matu rationally 
developed skill; 
facilitation, in which 
experience hastens the 
development of some 
maturational process; 
and attunement, in which 
experience increases the 
level of a skill or 
behaviour above the 
'normal' maturational 
level (from'1). 
Roles of early experience 
High- 
Low- 
High- 
~ Low_ 
| High- 
Q. 
5o 
o 
"o 
5 Low-o 
High- 
Low- 
High- 
Low- 
Maturation 
Maintenance 
Facilitation 
Attunement 
Induction 
/' Experience 
' No experience 
l a ) 
(b) 
(c) 
( d ) 
( e ) 
Onset of experience 
Age 
determine which aspects of the auditory environment they selectively 
attend to and the systematic ways they try to make sense of speech 
sounds. Aspects of the speech environment which babies pay special 
attention to are the beginnings and ends to the human speech stream. 
It's similar in visual perception; psychologists such as Haith2 claim 
that babies have an inborn predisposition to pay special attention to 
movement and to shifts between dark and light. Although such biases 
in perception are inborn starting points for learning, new skills and 
knowledge will be influenced profoundly by experience. However, 
these biases constrain the developmental pathways that are possible3; 
theories of complete plasticity in human nature have not withstood 
scientific test. 
186 Brihih M.dico/ Bu//束hn 1997^3 (No. 1) 
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Critical periods in childhood learning 
How nurture modulates nature 
Understanding of the interaction between nature and nurture has 
become more subtle and powerful. Richard Aslin4 proposes five models 
to describe the potential impact on children's development of the 
childhood environment in which they grow up (see Fig. 1). 
The first model assumes absolutely no environmental effect on the 
developing skill: the second assumes that certain environmental support 
is necessary for the maintenance of a skill or behaviour but that its form 
is innate. In the third model the environment facilitates the earlier or 
later appearance of a skill or behaviour which is programmed by the 
genes. The last two models show a considerable impact of the 
environment. In the fourth model, the environment's shaping leads to 
lasting higher or lower performance. For example, it is known that 
parents who talk to their children have offspring with higher IQs5. 
Finally the fifth model describes skills or behaviours which are shaped 
completely by the child's experiences. Exposing a child to a second 
language is a good example of the fifth model because the environment 
determines all. 
The timing of experience: or 'critical periods' 
The impact of nurture can vary according to its timing. For example, the 
impact of day care on a child may differ according to its occurrence in 
the first year of a child's life or the years right before school6. The best 
known example of a critical period in animal development is that young 
ducks will become imprinted on any moving object in their immediate 
environment at approximately 15 h after hatching. If they do not 
experience a moving object during this critical period they will fail to 
become imprinted at all7. 
The broader concept of a sensitive period in human development has 
supplanted the notion of critical periods. A sensitive period may last for 
months or even years and denotes the time in which the developing child 
is particularly responsive to certain forms of experience or particularly 
hindered by their absence. A good example is the fact that children in the 
period 6-18 months are particularly sensitive to caretaking and that this 
is the time when they must develop their core attachment to their 
parents8. Other periods may be particularly important for intellectual or 
linguistic development, for example the period 12-30 months when 
language develops so rapidly9. 
Bnfah Mtdical Bulletm 1997,53 (No. 1) 187 
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Fetal and early childhood environment: long-term health implications 
The ecology of development 
Until recently, most research on child development concentrated on the 
child's immediate environment, which was the family throughout 
infancy, followed by the school and the peer group. Bronfrenbrenner10 
deplores this tunnel vision and argues forcefully that the child's 
immediate environment is influenced by broad social factors, such as 
cultural beliefs or the distribution of health care. Moreover, even the 
environment of the family is not unidimensional; each child inhabits a 
unique space which is defined by siblings, the age of their parents when 
they were born and a host of other 'ecological factors' which may be 
unique to them or their family. (Imagine the difference between the 
experiences of the first child born to a Pakistani family who later moved 
to Britain and her much younger sibling born 15 years later in a large 
city. It would be impossible to imagine that the 'family' influences on 
these two children were not vastly different.) An understanding of early 
learning and its environment will have to include the social institutions 
related to childcare as well as the family. 
The 'pre-adapted' newborn 
To understand how very young babies learn, we must return to nature 
and nurture. Babies' perception of complex patterning provides a good 
example of how the infant's 'wiring' influences what it learns about the 
visual world. Newborns and infants have far more sensory capacity than 
doctors or psychologists have suspected. Babies' motor skills are limited 
for many months and perhaps professionals assumed that sensory skills 
were as well. Although the newborn baby does not have the sensory 
capacities of a 6 month old, most of the basic perceptual skills are 
functioning at some level immediately after birth. The newborn is much 
better at getting information about the world than at acting on it. 
Although newborns cannot judge depth at birth and are clumsy at 
reaching, their behaviour is governed immediately by visual information 
which they process quite efficiently. Babies look at the world in a 
systematic way. Haith2 says 'there are rules babies look by' and adds that 
the rules change with age. At first, visual attention is focused on where 
objects are but a change takes place around 2 months such that attention 
is drawn more to the characteristics of objects rather than their 
location11. The baby moves from a visual strategy for 'finding where 
things are' to one of 'finding out about things'. It's not known whether 
this shift is affected by learning but it is certainly an inborn disposition, 
18 8 British Medical BuH.hn 1997,53 (No 1) 
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Critical periods in childhood learning 
since babies reared in vastly different environments all go through the 
same perceptual shift. 
Most interesting of all, learning concerns the baby's recognition of the 
parents. Walton et at11, showed newborns videos of their own mothers 
contrasted with videos of a woman with similar hair colour, eyes, 
complexion and hair style. Babies of 1-2 days clearly recognised their 
own mothers because they spent significantly more time looking at them. 
Within 2 days, the baby had learned the perceptual features of his/her 
own mother's face, a sure example of learning shaped by inborn rules 
concerning what to pay attention to. 
Developmental changes in thinking and learning 
Jean Piaget13"15 was the first developmental scientist to take seriously the 
interaction of nature and nurture in children's thinking. He began by 
studying what he called 'sensory-motor schemas' in infancy. These were 
part of the baby's biological inheritance and included looking, grasping 
and sucking. Through careful study of his own children, Piaget 
concluded that babies did not take in information in a passive way, as 
a camera might do, but they use environmental information gathered 
from inborn actions such as looking and sucking to construct a model of 
the world. For Piaget, learning is not the passive acquisition of 
information; instead, babies and children actively process information 
entering through the senses and integrate it into representations of 
previous information. This means that children do not receive 
information; they process it in light of what they already know and 
they integrate it with previous knowledge. 
Piaget stressed the fact that children are much more than miniature 
adults with fewer facts at their command. Children perceive and think 
about the world differently, according to developmental stages. Piaget 
investigated the regular sequences children follow as they develop 
concepts. Children all over the world pass cognitive milestones at the 
same age and even make certain mistakes at the same time. For example, 
when children learning English discover the '-ed' rule for the past tense, 
they start to make mistakes they haven't made before. A 3 year old who 
had been regularly heard to say 'I rode my bike' suddenly changed to 'I 
rided', incorrectly generalising a new-found rule to irregular verbs. 
Although grammar varies from language to language, the tendency to 
over-generalise morphological endings appears in all cultures, showing 
again an inborn predisposition to pay attention to beginnings and 
endings in language. 
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Fetal and early childhood environment: long-term health implications 
Piaget's most important notion is that the child is an active participant 
in the development of knowledge and constructs his/her own under-standing. 
At each stage in development, the child adapts to the world by 
using different sorts of mental operations. 
Piaget's stages of mental development in young 
children 
Sensory-motor stage 
During this stage, the infant responds to the world through sensory and 
motor schemes. The infant lives in the here and now, having little 
concept of the future, and does not plan. Piaget argued that the child in 
the period 0-2 years had simple internal representations of the outside 
world. The child lives in and acts on the world but does not reflect on it. 
Although recent research suggests that babies can be planful in searching 
for things and that they may know more about objects than Piaget 
originally thought, most psychologists agree that thinking in the pre-verbal 
child is oriented to the here and now, especially to the child's own 
view of things. 
Pre-operational stage 
During the years 2-6, Piaget claimed that language lifted children's 
thinking to a new level. In this stage, children begin to pretend, to plan 
events in the future and to interrogate their own past experiences in a 
systematic way. Piaget described the thinking of children in this stage 
mostly by things they could not yet do: they were not good at taking the 
points of view of others; they were not good at classifying things into 
hierarchical groupings, and they tended to understand or measure things 
according to appearances rather than underlying mathematical 
principles. 
Concrete operations stage 
At about 6 years of age, children abandon their egocentric and non-logical 
thought as they develop an organised system of scientific and 
mathematical concepts. 
190 Bnhih Mtdical Bulletin 1997,53 (No. 1) 
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Critical periods in childhood learning 
The lasting impact of early learning 
We turn to the evidence which supports the widely held belief that early 
learning in the stages just described has lasting impact. Early learning is 
considered first inside the home and next as it occurs in day care or 
nursery school. 
How the family environment shapes children's learning 
Hundreds of studies have explored the relationship between social 
background and children's intellectual attainment. Broman et alu, 
studied more than 50,000 children born in the US and found, not 
surprisingly, that the average IQ of children rose with both social class 
and maternal education. British studies show the same17-18. The more 
interesting questions concern just how certain parents and families 
create a stimulating and empowering environment. (The influence of 
genes on this topic is discussed elsewhere.) 
Broman et at16 showed clearly that the powerful influence of maternal 
education on children's IQ can be detected after taking into account 
social class; in other words, the mothers with more education had 
children with higher IQs within each social class. How do parents help 
or hinder their children's learning? Bee19 summarises five dimensions of 
family interaction and stimulation which make a difference to children's 
learning. Researchers have found that parents of children with high IQ's 
seem to do the following: 
1. They provide the child with an interesting and complex physical 
environment which includes toys appropriate for the child's 
developmental level20'21. 
2. They are emotionally responsive to the child and involved in their 
daily lives. This can be seen in their warm, contingent reactions to the 
child. They smile when the child smiles, talk when the child talks and 
answer the child's questions22"24. 
3. They talk to their child, using language that is accurate and richly 
descriptive5. 
4. They are not excessively restrictive or punitive. Instead they give the 
child room to explore and even to make mistakes21*25. 
5. They have high expectations for their child's learning and emphasise 
achievement, especially educational achievement26. 
Two decades ago, researchers discovered the 'structural' influences on 
children's learning and attainment, e.g. social class, ethnicity or maternal 
Bntit/i MtdKal Bvlhttn 1997;53 (No 1) 191 
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Fetal and early childhood environment: long-term health implications 
T)rp束 of tejt 
IQ 
  Readiness 
Achievement 
- 2 0 
Immediate 1st Year 2nd Year 3+ Years 
Fig. 2 Immediate effects and long-term effects of Head Start on IQ, school readiness and achievement meosures (treatment control 
studies). From McKey alaP7. 
education. Now they have developed techniques involving fine grained 
analysis to specify the activities and objects inside the home which seem 
to make a difference. 
Research on learning in preschool settings 
The American project, Head Start, has received government funding for 
two decades in hopes that it would 'break the cycle of poverty'. Initial 
evaluations seriously underestimated the value of the programme by 
focusing on measures of intelligence as the main outcome. Sadly they 
found that early IQ gains quickly washed out, leaving graduates of Head 
Start no different from control children. 
Recent evaluations have employed sophisticated research methods to 
look at a wide array of child outcomes from early education. In 1985, a 
synthesis of research findings was published27 which combined into a 
single meta-analysis the results of 210 studies evaluating the impact of 
Head Start. To enable comparison amongst the studies, findings were 
converted to statistical 'effect sizes' and comparisons were made across 
different sites and target groups. 
McKey and his colleagues concluded that Head Start had immediate, 
positive effects on children's cognitive ability27. Unfortunately, the 
192 Bnfish Medical Buffctm 1997,53 (No 1) 
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Critical periods in childhood learning 
cognitive gains were no longer apparent after the end of the second year 
at school (see Fig. 2). Head Start also had short-term positive effects on 
children's self-esteem, scholastic achievement, motivation and social 
behaviour, but these advantages also tended to disappear by the end of 
the third year in school. 
The smaller, better controlled studies of the effects of Head Start have 
produced more positive findings. A well designed study by Lee et al28 
compared the outcomes of 969 disadvantaged children who had 
experienced three different pre-school environments; Head Start, some 
other pre-school programme and no pre-school. Large, initial differences 
on a wide range of outcomes were found at school entry, with Head 
Start children lower on almost all measures. After adjusting for initial 
scores (because the Head Start sample were lower), Head Start children 
showed larger gains on measures of social and cognitive functioning 
('readiness for school'20) compared to children in the other two groups. 
It was not surprising that children in Head Start began school with lower 
scores because Head Start children tend to be drawn from families of 
low levels of income and education. Thus, in Lee's study28, Head Start 
was effective in 'closing the gap' but did not succeed in doing so 
completely because its children began at greater levels of disadvantage. 
Notable in Lee's study28, were the large gains made by black children 
in Head Start. In many evaluative studies of pre-school it has been 
shown that pre-school intervention is particularly effective for the most 
economically disadvantaged children29. Black children gained more than 
white children, even when controlling for initial levels of ability. Further, 
black students of below average ability gained more than their 
counterparts of average ability. They concluded that their study 
demonstrates the effectiveness of Head Start: 'not only were those 
students most in need of pre-school experience likely to be in Head Start 
programs, but also that those black students who exhibited the greatest 
cognitive disadvantage at the outset appeared to benefit most from Head 
Start participation' (p. 219). 
There is cause for optimism when examining research on the 
effectiveness of pre-school programmes which are of 'high quality'. A 
group of American researchers carried out a meta-analysis of the effects 
of compensatory education on well resourced, 'quality' programmes. 
They ignored the garden-variety programmes (which included Head 
Start) and focused instead on projects of excellent curricular quality and 
rigorous research design. Lazar et al30 restricted their analysis to 11 
carefully monitored programmes, using a statistical analysis enabling 
researchers to compare effect sizes across many different studies. The 
researchers located approximately 2000 pre-school 'graduates' and their 
matched controls to describe their educational and employment 
histories. In addition they interviewed the youth and their families. 
Bnttth Medical BuHef.n 1997,53 (No 1) 193 
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Fetal and early childhood environment: long-term health implications 
Results from the 11 studies showed that attendance at excellent, 
cognitively oriented pre-school programmes was associated with later 
school competence at the age of 19 and reduced likelihood of assignment 
to 'special' education. Interviews carried out at age 19 showed the 
families of the nursery group to have higher aspirations for their 
children's employment. 
The most carefully controlled of the 11 programmes reviewed by 
Lazar was the Perry Pre-school Project, which became known later as 
High/Scope. This curriculum is of exceptionally high quality, and it 
includes a complex training scheme for staff and sound parent 
participation. The programme has been subjected to careful evaluation 
for almost 30 years and has consistently shown striking results. 
Although an initial IQ advantage for pre-school graduates disappeared 
by secondary school, there were startling differences in outcome between 
the 65 children who attended the half-day educational programme over 
2 years and the control group of 58 children who had remained at home. 
Figure 3 summarises the findings at age 27 when the High/Scope 
'graduates' had: 
 significantly higher monthly earnings at age 27 (29% vs 7% earning 
$2,000 or more per month) 
 significantly higher percentage of home ownership (36% vs 13%) and 
second car ownership (30% vs 13%) 
 a significantly higher level of schooling completed (71% vs 54% 
completing 12th grade or higher) 
 a significantly lower percentage receiving social services at some time 
in the past 10 years (59% vs 80%) 
 significantly fewer arrests by age 27 (7% vs 35% with 5 or more), 
including significantly fewer arrested for crimes of drug taking or 
dealing (7% vs 25%) 
Schweinhart and Weikart31 carried out a cost-benefit analysis which 
showed that for every $1000 that was invested in the pre-school 
programme, at least $7160 (after adjustment for inflation) was returned 
to society. These calculations were based on the financial cost to society 
of juvenile delinquency, remedial education, income support, and 
joblessness  set against the running costs of an excellent pre-school 
programme. 
The effects of day care on children's outcomes 
Most research studies have looked at the effects of day care on children's 
emotional adjustment, especially their attachment to their mothers32-33. 
194 Bnhsh AWica/ Bulletin 1997,53 (No 1) 
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Critical periods in childhood learning 
Fig. 3 High/Scope 
Perry Pre-ichool Study, 
from Schweinhart and 
Weikart31. 
High/Scope Perry Preschool Study: 
Outcomes at age 27 
High School Grades 
Five or more arrests 
$2000+ Eamings/Mtri 
Soc Serv since 18 
Own a House 
20 40 60 
Percentage 
I Programme 
 No programme 
80 100 
Several American scholars claim that early entrance into day care, before 
the age of 1 year, is detrimental to children's emotional development6, 
but others claim that early entry to day care will not harm children 
whose parental attachments are secure34. The debate rages on. 
Research from Sweden tells a very different story; Andersson35 found 
day care experience gave children a better start in school. He examined 
the development of 128 children who attended well resourced 
neighbourhood day care centres. Progress was monitored from the 
children's first year in day care to the age of 13. No developmental 
disadvantage was found in the day care group compared to children who 
had stayed at home. In fact, the highest performance in school tests and 
the best emotional adjustment was found in the children who had 
experienced the MOST day care, even before the age of 1 year. 
Why do Swedish children appear to benefit from attendance at child 
care centres when some American studies suggest that day care 
attendance may lead to poor social and emotional adjustment? Perhaps 
the answer lies in different social policies, with Sweden offering highly 
subsidised day care to families from all walks of life and the US offering 
private lower-quality care. 
Howe36 studied 80 children in deliberately contrasting care in the US. 
Half were enrolled in excellent centres and half in poor ones. 'High 
quality' centres were characterised by the following: (i) stable child care 
arrangements such that children interacted with just a few primary 
caregivers in any one day; (ii) low staff turnover so that children were 
cared for by the same individuals over several years; (iii) good staff 
training in child development; and (iv) low staff:child ratios, e.g. from 
0-12 months the ratio was 1:3, from 1-3 years the ratio was 1:4, and 
from 4-6 years the ratio was 1:8-12. 
Bnfufc AWica/BuH.hn 1997,53 (No 1) 195 
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Fetal and early childhood environment: long-term health implications 
In Howe's research, outcomes were controlled for family background 
and individual differences, factors that might affect development as well 
as the quality of care36. After controlling for these, children enrolled in 
the higher quality centres still did better in primary school on both 
educational and social measures. The picture was different in the low 
quality centres, with children doing particularly poorly at school when 
they had been enrolled in lower quality centres before their first 
birthdays when they entered primary school. These 'early entry' children 
were distractible, low in task orientation and had considerable difficulty 
getting on with peers. 
Research in both the US and Sweden shows clearly that day care, 
when of high quality, does not harm children's development and may 
enhance children's learning. There have now been many studies 
confirming the fact that the higher the quality of day care, the better 
the learning outcomes for children37"40. 
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39 Philips D, McCartney K, Scarr S. Child-care quality and children's social development. Dev 
Psychol 1987, 23: 537-43 
40 Schhecker E, White DR, Jacobs E. The role of day care quality in the prediction of children's 
vocabulary. Can] Behav Sci 1991; 23- 12-24 
British Medical Buffahn 199743 (No 1) 197 
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Critical period

  • 1. Critical periods in childhood learning Kathy Sylva Department of Child Development and Primary Education, Institute of Education, London, UK The human baby is bom with 'hard wiring' that loads the baby to pay attention to certain things in the environment, especially the communications of canegivers. These inborn predispositions are gradually shaped by the environment of the family, a 'curriculum for babies' which is rich on communication and making sense of the world. Day care and nursery education can complement and enhance the child's learning, especially if they are of high quality. Research has shown again and again that early learning has lasting effects on development although they are rarely irreversible. Nature and nurture: an ancient but current debate This is one of the oldest and most central debates in science. When discussed by a psychologist it concerns whether a child's development is governed by a pattern built in at birth or whether it is moulded by experiences afterwards. Historically the nativist side to the debate, the side which championed nature, was represented by Plato who believed that many concepts were innate. On the other side, British 'empiricists' such as John Locke insisted that the baby's mind is a blank slate at birth and that all knowledge is etched on it by experience. There is now widespread agreement that the 'interactionists' have won the day and that child development is governed by the interaction of nature and nurture. Still there is heated debate about how much of a child's genes contribute to the child's eventual intellectual attainment and personal style. This paper leaves the topic of genes to other authors in the volume while concentrating on what is known about learning in young children, especially the power of the environment to shape it. Inborn bias and constraints pTic/nth! contemporary version of the naturist view focuses on 'inborn Department of C/11W biases'. These constraints on development do not consist of Plato's Deve/opmentond inborn concepts but rather ways the newborn is 'programmed' to pay PnmaryEducation, m o r e attention to some things than to others and to respond in a Institute or Education, . . . . . i n i _ - i L 20 Bedford Way, particular way to certain objects. For example, Slobin1 proposes that LondonWOHOAL, UK babies are born with what he calls 'operating principles' that Bnhth Medical Bulletin 1997;53 {No 1).185-197 息Tti. Bnti損hCounall997 Downloaded from http://bmb.oxfordjournals.org/ by guest on September 19, 2014
  • 2. Fetal and early childhood environment: long-term health implications Fig. 1 Five models of the relationship between maturation and environment4.The top model show! a purely maturational effect' the bottom model (induction) shows a purely environmental effect.The other three present interactive combinations: maintenance, in which experience prevents lessening of a matu rationally developed skill; facilitation, in which experience hastens the development of some maturational process; and attunement, in which experience increases the level of a skill or behaviour above the 'normal' maturational level (from'1). Roles of early experience High- Low- High- ~ Low_ | High- Q. 5o o "o 5 Low-o High- Low- High- Low- Maturation Maintenance Facilitation Attunement Induction /' Experience ' No experience l a ) (b) (c) ( d ) ( e ) Onset of experience Age determine which aspects of the auditory environment they selectively attend to and the systematic ways they try to make sense of speech sounds. Aspects of the speech environment which babies pay special attention to are the beginnings and ends to the human speech stream. It's similar in visual perception; psychologists such as Haith2 claim that babies have an inborn predisposition to pay special attention to movement and to shifts between dark and light. Although such biases in perception are inborn starting points for learning, new skills and knowledge will be influenced profoundly by experience. However, these biases constrain the developmental pathways that are possible3; theories of complete plasticity in human nature have not withstood scientific test. 186 Brihih M.dico/ Bu//束hn 1997^3 (No. 1) Downloaded from http://bmb.oxfordjournals.org/ by guest on September 19, 2014
  • 3. Critical periods in childhood learning How nurture modulates nature Understanding of the interaction between nature and nurture has become more subtle and powerful. Richard Aslin4 proposes five models to describe the potential impact on children's development of the childhood environment in which they grow up (see Fig. 1). The first model assumes absolutely no environmental effect on the developing skill: the second assumes that certain environmental support is necessary for the maintenance of a skill or behaviour but that its form is innate. In the third model the environment facilitates the earlier or later appearance of a skill or behaviour which is programmed by the genes. The last two models show a considerable impact of the environment. In the fourth model, the environment's shaping leads to lasting higher or lower performance. For example, it is known that parents who talk to their children have offspring with higher IQs5. Finally the fifth model describes skills or behaviours which are shaped completely by the child's experiences. Exposing a child to a second language is a good example of the fifth model because the environment determines all. The timing of experience: or 'critical periods' The impact of nurture can vary according to its timing. For example, the impact of day care on a child may differ according to its occurrence in the first year of a child's life or the years right before school6. The best known example of a critical period in animal development is that young ducks will become imprinted on any moving object in their immediate environment at approximately 15 h after hatching. If they do not experience a moving object during this critical period they will fail to become imprinted at all7. The broader concept of a sensitive period in human development has supplanted the notion of critical periods. A sensitive period may last for months or even years and denotes the time in which the developing child is particularly responsive to certain forms of experience or particularly hindered by their absence. A good example is the fact that children in the period 6-18 months are particularly sensitive to caretaking and that this is the time when they must develop their core attachment to their parents8. Other periods may be particularly important for intellectual or linguistic development, for example the period 12-30 months when language develops so rapidly9. Bnfah Mtdical Bulletm 1997,53 (No. 1) 187 Downloaded from http://bmb.oxfordjournals.org/ by guest on September 19, 2014
  • 4. Fetal and early childhood environment: long-term health implications The ecology of development Until recently, most research on child development concentrated on the child's immediate environment, which was the family throughout infancy, followed by the school and the peer group. Bronfrenbrenner10 deplores this tunnel vision and argues forcefully that the child's immediate environment is influenced by broad social factors, such as cultural beliefs or the distribution of health care. Moreover, even the environment of the family is not unidimensional; each child inhabits a unique space which is defined by siblings, the age of their parents when they were born and a host of other 'ecological factors' which may be unique to them or their family. (Imagine the difference between the experiences of the first child born to a Pakistani family who later moved to Britain and her much younger sibling born 15 years later in a large city. It would be impossible to imagine that the 'family' influences on these two children were not vastly different.) An understanding of early learning and its environment will have to include the social institutions related to childcare as well as the family. The 'pre-adapted' newborn To understand how very young babies learn, we must return to nature and nurture. Babies' perception of complex patterning provides a good example of how the infant's 'wiring' influences what it learns about the visual world. Newborns and infants have far more sensory capacity than doctors or psychologists have suspected. Babies' motor skills are limited for many months and perhaps professionals assumed that sensory skills were as well. Although the newborn baby does not have the sensory capacities of a 6 month old, most of the basic perceptual skills are functioning at some level immediately after birth. The newborn is much better at getting information about the world than at acting on it. Although newborns cannot judge depth at birth and are clumsy at reaching, their behaviour is governed immediately by visual information which they process quite efficiently. Babies look at the world in a systematic way. Haith2 says 'there are rules babies look by' and adds that the rules change with age. At first, visual attention is focused on where objects are but a change takes place around 2 months such that attention is drawn more to the characteristics of objects rather than their location11. The baby moves from a visual strategy for 'finding where things are' to one of 'finding out about things'. It's not known whether this shift is affected by learning but it is certainly an inborn disposition, 18 8 British Medical BuH.hn 1997,53 (No 1) Downloaded from http://bmb.oxfordjournals.org/ by guest on September 19, 2014
  • 5. Critical periods in childhood learning since babies reared in vastly different environments all go through the same perceptual shift. Most interesting of all, learning concerns the baby's recognition of the parents. Walton et at11, showed newborns videos of their own mothers contrasted with videos of a woman with similar hair colour, eyes, complexion and hair style. Babies of 1-2 days clearly recognised their own mothers because they spent significantly more time looking at them. Within 2 days, the baby had learned the perceptual features of his/her own mother's face, a sure example of learning shaped by inborn rules concerning what to pay attention to. Developmental changes in thinking and learning Jean Piaget13"15 was the first developmental scientist to take seriously the interaction of nature and nurture in children's thinking. He began by studying what he called 'sensory-motor schemas' in infancy. These were part of the baby's biological inheritance and included looking, grasping and sucking. Through careful study of his own children, Piaget concluded that babies did not take in information in a passive way, as a camera might do, but they use environmental information gathered from inborn actions such as looking and sucking to construct a model of the world. For Piaget, learning is not the passive acquisition of information; instead, babies and children actively process information entering through the senses and integrate it into representations of previous information. This means that children do not receive information; they process it in light of what they already know and they integrate it with previous knowledge. Piaget stressed the fact that children are much more than miniature adults with fewer facts at their command. Children perceive and think about the world differently, according to developmental stages. Piaget investigated the regular sequences children follow as they develop concepts. Children all over the world pass cognitive milestones at the same age and even make certain mistakes at the same time. For example, when children learning English discover the '-ed' rule for the past tense, they start to make mistakes they haven't made before. A 3 year old who had been regularly heard to say 'I rode my bike' suddenly changed to 'I rided', incorrectly generalising a new-found rule to irregular verbs. Although grammar varies from language to language, the tendency to over-generalise morphological endings appears in all cultures, showing again an inborn predisposition to pay attention to beginnings and endings in language. Bnhi/i Mtdical Bulletin 1997^3 (No 1) 189 Downloaded from http://bmb.oxfordjournals.org/ by guest on September 19, 2014
  • 6. Fetal and early childhood environment: long-term health implications Piaget's most important notion is that the child is an active participant in the development of knowledge and constructs his/her own under-standing. At each stage in development, the child adapts to the world by using different sorts of mental operations. Piaget's stages of mental development in young children Sensory-motor stage During this stage, the infant responds to the world through sensory and motor schemes. The infant lives in the here and now, having little concept of the future, and does not plan. Piaget argued that the child in the period 0-2 years had simple internal representations of the outside world. The child lives in and acts on the world but does not reflect on it. Although recent research suggests that babies can be planful in searching for things and that they may know more about objects than Piaget originally thought, most psychologists agree that thinking in the pre-verbal child is oriented to the here and now, especially to the child's own view of things. Pre-operational stage During the years 2-6, Piaget claimed that language lifted children's thinking to a new level. In this stage, children begin to pretend, to plan events in the future and to interrogate their own past experiences in a systematic way. Piaget described the thinking of children in this stage mostly by things they could not yet do: they were not good at taking the points of view of others; they were not good at classifying things into hierarchical groupings, and they tended to understand or measure things according to appearances rather than underlying mathematical principles. Concrete operations stage At about 6 years of age, children abandon their egocentric and non-logical thought as they develop an organised system of scientific and mathematical concepts. 190 Bnhih Mtdical Bulletin 1997,53 (No. 1) Downloaded from http://bmb.oxfordjournals.org/ by guest on September 19, 2014
  • 7. Critical periods in childhood learning The lasting impact of early learning We turn to the evidence which supports the widely held belief that early learning in the stages just described has lasting impact. Early learning is considered first inside the home and next as it occurs in day care or nursery school. How the family environment shapes children's learning Hundreds of studies have explored the relationship between social background and children's intellectual attainment. Broman et alu, studied more than 50,000 children born in the US and found, not surprisingly, that the average IQ of children rose with both social class and maternal education. British studies show the same17-18. The more interesting questions concern just how certain parents and families create a stimulating and empowering environment. (The influence of genes on this topic is discussed elsewhere.) Broman et at16 showed clearly that the powerful influence of maternal education on children's IQ can be detected after taking into account social class; in other words, the mothers with more education had children with higher IQs within each social class. How do parents help or hinder their children's learning? Bee19 summarises five dimensions of family interaction and stimulation which make a difference to children's learning. Researchers have found that parents of children with high IQ's seem to do the following: 1. They provide the child with an interesting and complex physical environment which includes toys appropriate for the child's developmental level20'21. 2. They are emotionally responsive to the child and involved in their daily lives. This can be seen in their warm, contingent reactions to the child. They smile when the child smiles, talk when the child talks and answer the child's questions22"24. 3. They talk to their child, using language that is accurate and richly descriptive5. 4. They are not excessively restrictive or punitive. Instead they give the child room to explore and even to make mistakes21*25. 5. They have high expectations for their child's learning and emphasise achievement, especially educational achievement26. Two decades ago, researchers discovered the 'structural' influences on children's learning and attainment, e.g. social class, ethnicity or maternal Bntit/i MtdKal Bvlhttn 1997;53 (No 1) 191 Downloaded from http://bmb.oxfordjournals.org/ by guest on September 19, 2014
  • 8. Fetal and early childhood environment: long-term health implications T)rp束 of tejt IQ Readiness Achievement - 2 0 Immediate 1st Year 2nd Year 3+ Years Fig. 2 Immediate effects and long-term effects of Head Start on IQ, school readiness and achievement meosures (treatment control studies). From McKey alaP7. education. Now they have developed techniques involving fine grained analysis to specify the activities and objects inside the home which seem to make a difference. Research on learning in preschool settings The American project, Head Start, has received government funding for two decades in hopes that it would 'break the cycle of poverty'. Initial evaluations seriously underestimated the value of the programme by focusing on measures of intelligence as the main outcome. Sadly they found that early IQ gains quickly washed out, leaving graduates of Head Start no different from control children. Recent evaluations have employed sophisticated research methods to look at a wide array of child outcomes from early education. In 1985, a synthesis of research findings was published27 which combined into a single meta-analysis the results of 210 studies evaluating the impact of Head Start. To enable comparison amongst the studies, findings were converted to statistical 'effect sizes' and comparisons were made across different sites and target groups. McKey and his colleagues concluded that Head Start had immediate, positive effects on children's cognitive ability27. Unfortunately, the 192 Bnfish Medical Buffctm 1997,53 (No 1) Downloaded from http://bmb.oxfordjournals.org/ by guest on September 19, 2014
  • 9. Critical periods in childhood learning cognitive gains were no longer apparent after the end of the second year at school (see Fig. 2). Head Start also had short-term positive effects on children's self-esteem, scholastic achievement, motivation and social behaviour, but these advantages also tended to disappear by the end of the third year in school. The smaller, better controlled studies of the effects of Head Start have produced more positive findings. A well designed study by Lee et al28 compared the outcomes of 969 disadvantaged children who had experienced three different pre-school environments; Head Start, some other pre-school programme and no pre-school. Large, initial differences on a wide range of outcomes were found at school entry, with Head Start children lower on almost all measures. After adjusting for initial scores (because the Head Start sample were lower), Head Start children showed larger gains on measures of social and cognitive functioning ('readiness for school'20) compared to children in the other two groups. It was not surprising that children in Head Start began school with lower scores because Head Start children tend to be drawn from families of low levels of income and education. Thus, in Lee's study28, Head Start was effective in 'closing the gap' but did not succeed in doing so completely because its children began at greater levels of disadvantage. Notable in Lee's study28, were the large gains made by black children in Head Start. In many evaluative studies of pre-school it has been shown that pre-school intervention is particularly effective for the most economically disadvantaged children29. Black children gained more than white children, even when controlling for initial levels of ability. Further, black students of below average ability gained more than their counterparts of average ability. They concluded that their study demonstrates the effectiveness of Head Start: 'not only were those students most in need of pre-school experience likely to be in Head Start programs, but also that those black students who exhibited the greatest cognitive disadvantage at the outset appeared to benefit most from Head Start participation' (p. 219). There is cause for optimism when examining research on the effectiveness of pre-school programmes which are of 'high quality'. A group of American researchers carried out a meta-analysis of the effects of compensatory education on well resourced, 'quality' programmes. They ignored the garden-variety programmes (which included Head Start) and focused instead on projects of excellent curricular quality and rigorous research design. Lazar et al30 restricted their analysis to 11 carefully monitored programmes, using a statistical analysis enabling researchers to compare effect sizes across many different studies. The researchers located approximately 2000 pre-school 'graduates' and their matched controls to describe their educational and employment histories. In addition they interviewed the youth and their families. Bnttth Medical BuHef.n 1997,53 (No 1) 193 Downloaded from http://bmb.oxfordjournals.org/ by guest on September 19, 2014
  • 10. Fetal and early childhood environment: long-term health implications Results from the 11 studies showed that attendance at excellent, cognitively oriented pre-school programmes was associated with later school competence at the age of 19 and reduced likelihood of assignment to 'special' education. Interviews carried out at age 19 showed the families of the nursery group to have higher aspirations for their children's employment. The most carefully controlled of the 11 programmes reviewed by Lazar was the Perry Pre-school Project, which became known later as High/Scope. This curriculum is of exceptionally high quality, and it includes a complex training scheme for staff and sound parent participation. The programme has been subjected to careful evaluation for almost 30 years and has consistently shown striking results. Although an initial IQ advantage for pre-school graduates disappeared by secondary school, there were startling differences in outcome between the 65 children who attended the half-day educational programme over 2 years and the control group of 58 children who had remained at home. Figure 3 summarises the findings at age 27 when the High/Scope 'graduates' had: significantly higher monthly earnings at age 27 (29% vs 7% earning $2,000 or more per month) significantly higher percentage of home ownership (36% vs 13%) and second car ownership (30% vs 13%) a significantly higher level of schooling completed (71% vs 54% completing 12th grade or higher) a significantly lower percentage receiving social services at some time in the past 10 years (59% vs 80%) significantly fewer arrests by age 27 (7% vs 35% with 5 or more), including significantly fewer arrested for crimes of drug taking or dealing (7% vs 25%) Schweinhart and Weikart31 carried out a cost-benefit analysis which showed that for every $1000 that was invested in the pre-school programme, at least $7160 (after adjustment for inflation) was returned to society. These calculations were based on the financial cost to society of juvenile delinquency, remedial education, income support, and joblessness set against the running costs of an excellent pre-school programme. The effects of day care on children's outcomes Most research studies have looked at the effects of day care on children's emotional adjustment, especially their attachment to their mothers32-33. 194 Bnhsh AWica/ Bulletin 1997,53 (No 1) Downloaded from http://bmb.oxfordjournals.org/ by guest on September 19, 2014
  • 11. Critical periods in childhood learning Fig. 3 High/Scope Perry Pre-ichool Study, from Schweinhart and Weikart31. High/Scope Perry Preschool Study: Outcomes at age 27 High School Grades Five or more arrests $2000+ Eamings/Mtri Soc Serv since 18 Own a House 20 40 60 Percentage I Programme No programme 80 100 Several American scholars claim that early entrance into day care, before the age of 1 year, is detrimental to children's emotional development6, but others claim that early entry to day care will not harm children whose parental attachments are secure34. The debate rages on. Research from Sweden tells a very different story; Andersson35 found day care experience gave children a better start in school. He examined the development of 128 children who attended well resourced neighbourhood day care centres. Progress was monitored from the children's first year in day care to the age of 13. No developmental disadvantage was found in the day care group compared to children who had stayed at home. In fact, the highest performance in school tests and the best emotional adjustment was found in the children who had experienced the MOST day care, even before the age of 1 year. Why do Swedish children appear to benefit from attendance at child care centres when some American studies suggest that day care attendance may lead to poor social and emotional adjustment? Perhaps the answer lies in different social policies, with Sweden offering highly subsidised day care to families from all walks of life and the US offering private lower-quality care. Howe36 studied 80 children in deliberately contrasting care in the US. Half were enrolled in excellent centres and half in poor ones. 'High quality' centres were characterised by the following: (i) stable child care arrangements such that children interacted with just a few primary caregivers in any one day; (ii) low staff turnover so that children were cared for by the same individuals over several years; (iii) good staff training in child development; and (iv) low staff:child ratios, e.g. from 0-12 months the ratio was 1:3, from 1-3 years the ratio was 1:4, and from 4-6 years the ratio was 1:8-12. Bnfufc AWica/BuH.hn 1997,53 (No 1) 195 Downloaded from http://bmb.oxfordjournals.org/ by guest on September 19, 2014
  • 12. Fetal and early childhood environment: long-term health implications In Howe's research, outcomes were controlled for family background and individual differences, factors that might affect development as well as the quality of care36. After controlling for these, children enrolled in the higher quality centres still did better in primary school on both educational and social measures. The picture was different in the low quality centres, with children doing particularly poorly at school when they had been enrolled in lower quality centres before their first birthdays when they entered primary school. These 'early entry' children were distractible, low in task orientation and had considerable difficulty getting on with peers. Research in both the US and Sweden shows clearly that day care, when of high quality, does not harm children's development and may enhance children's learning. There have now been many studies confirming the fact that the higher the quality of day care, the better the learning outcomes for children37"40. References 1 Slobin DI. Crosshnguistic evidence for the language-making capacity In: Slobin DI (Ed) The Crosshnguistic Study of Language Acquisition Vol. 2. Theoretical Issues. Hillsdale, NJ: Erlbaum, 1985; 1157-256 2 Haith MM. Rules that Babies Look By. Hillsdale, NJ: Erlbaum, 1980 3 Campbell RL, Bickhard M H. Types of constraints on development: an interactivist approach. Dev Rev 1992; 12: 311-38 4 Ashn RN Experiential influences and sensitive periods in perceptual development: a unified model. In Aslin RN, Alberts JR, Petersen MR (Eds) Development of Perception- Psychobtoiogical Perspectives, Vol. 2 The Visual System New York: Academic Press, 1981, 45-93 5 Sigman M, Neumann C, Carter E, Cattle DJ, D'Souza S, Bwibo N. Home interactions and the development of Embu toddlers in Kenya Child Dev 1988; 59 1251-61 6 Belsky J. The 'effects' of infant day care reconsidered. Early Child Res Q 1988; 3: 235-72 7 Hess EH. 'Imprinting' in a natural laboratory Set Am 1972; 227: 2431 8 McGurk H, Caplan M, Hennessy E, Moss P. Controversy, theory and social context in contemporary day care research. / Child Psychol Psychiatry 1993; 34: 3-23 9 Tamis-LeMonda C, Bornstein MH. Is there a 'sensitive period' in human mental development? In: Bornstein MH (Ed) Sensitive Periods in Development: Interdisciplinary Perspectives Hillsdale, NJ: Erlbaum, 1987; 163-82 10 Bronfenbrenner U. Ecological systems theory. Ann Child Dev 1989; 6. 187-249 11 Bronson GW. Infant differences in rate of visual encoding. Child Dev 1991; 62: 445 12 Walton GE, Bower NJA, Bower TGR. Recognition of familiar faces by newboms Infant Behav Dev 1992; 15: 265-9 13 Piaget J. The Origins of Intelligence in Children. New York: International Universities Press, 1952 14 Piaget J. Piaget's theory. In: Mussen PH (Ed) Carmichael's Manual of Child Psychology Vol. 1, 3rd edn. New York: Wiley, 1970; 703-32 15 Piaget J. The Development of Thought: Equilibration of Cognitive Structures. New York: Viking Press, 1977 16 Broman SH, Nichols PL, Kennedy WA Preschool IQ: Prenatal and early development correlates Hillsdale, NJ: Erlbaum, 1975 196 Bntith M*d*al Bulltbn 1997,53 (No. 1) Downloaded from http://bmb.oxfordjournals.org/ by guest on September 19, 2014
  • 13. Critical periods in childhood learning 17 Douglas J The Home and the School. London: MacGibbon and Kee, 1964 18 Osborn AF, Millbank JE. The effects of early education: A report from the Child Health. Contemporary Issues in the Early Years. Paul Chapman Educational Series, 1992 19 Bee H. The Developing Child. New York: Harper Collins, 1995 20 Caldwell B. All day kindergarten: assumptions, precautions and overgeneralisanons. Early Child Res Q 1970; 4: 261-6 21 Bradley RH, Caldwell BM, Rock SL et al. Home environment and cognitive development in the first 3 years of life a collaborative study involving six sites and three ethnic groups in North America. Dev Psychol 1989; 25: 217-35 22 Barnard KE, Hammond MA, Booth CL, Bee HL, Mitchell SK, Spieker SJ. Measurement and meaning of parent-child interaction. In: Morrison JJ, Lord C, Keating DP (Eds). Applied Developmental Psychology. San Diego- Academic Press, 1989; vol. 3; 40-81 23 Bradley RH, Caldwell BM. 174 children: a study of the relationship between home environment and cognitive structure during the first five years. In: Gottfried AW (Ed) Home Environment and Early Cognitive Development: Longitudinal Research. New York: Academic Press, 1984; 5-56 24 Lewis MD. Early socioemononal predictors of cognitive competence at 4 years. Dev Psychol 1993; 29. 1036-45 25 Olson SL, Bates JE, Kaskie B Caregiver-infant interaction antecedents of children's school-age cognitive ability. Memll Palmer Q 1992; 38: 309-30 26 Entwistle DR, Alexander KL. Beginning school math competence: minority and majority comparisons. Child Dev 1990; 61: 454-71 27 McKey RH, Condelli L, Granson H, Barrett B, McConkey C, Plantz M. The impact of Head Start on children, families and communities (final report of the Head Start Evaluation, Synthesis and Utilization Project). Washington, DC: CSR 1985 28 Lee V, Brooks-Gunn J, Schnur E. Does Head Start work? A one-year follow-up comparison of disadvantaged children attending Head Start, no pre-school, and other pre-school programmes. Dev Psychol 1988; 24: 210-22 29 Zigler EF. Formal schooling for four-year-olds? Am Psychol 1987; 42: 254-60 30 Lazar I, Darlington R. The lasting effects of early education: a report from the consortium for longitudinal studies / Soc Res Child Dev 1982, 47: 195 31 Schweinhart LJ, Weikart DP. A summary of significant benefits: The High/Scope Perry Pre- School Study through age 27. High Scope, 1993 32 Clarke-Stewart A. The social ecology of early childhood. In: Eisenberg N (Ed) Contemporary Topics in Developmental Psychology. New York: Wiley, 1988; 292-318 33 Kagan J, Kearsley R, Zelazo P. Infancy: Its Place in Human Development. Cambridge, MA: Harvard University Press, 1978 34 NICHD Infant child care and attachment security: results of the NICHD study of early child care Paper presented at International Conference in Infant Studies Providence, RI, April 1996 35 Andersson B. Effects of day-care on cognitive and socioemononal competence of thirteen-year-old Swedish children Child Dev 1992; 60: 857-86 36 Howe C Can the age of entry into child care and the quality of care predict adjustment in kindergarten? Dev Psychol 1990; 26: 292-303 37 McCartney K. Effect of quality of day care environment on children's language development. Dev Psychol 1984; 20: 244-60 38 McCartney K, Scarr S, Phillips D, Grajek S. Day care as intervention: comparisons of varying quality programs. / Appl Dev Psychol 1985; 6- 247-60 39 Philips D, McCartney K, Scarr S. Child-care quality and children's social development. Dev Psychol 1987, 23: 537-43 40 Schhecker E, White DR, Jacobs E. The role of day care quality in the prediction of children's vocabulary. Can] Behav Sci 1991; 23- 12-24 British Medical Buffahn 199743 (No 1) 197 Downloaded from http://bmb.oxfordjournals.org/ by guest on September 19, 2014