Total Environment Assessment Model for Early Child Development

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Introduction and Overview In summary, past frameworks have been critical in developing understandings of social determinants of health, and each has strengths and omissions. team-ecd builds on and improves upon previous models for explaining ecd and conditions that are nurturant for children. By expanding the environmental spheres that are included, challenging the notion of strict hierarichy between environments, adding temporal components, and holding successful ecd as its central goal, team-ecd offers the strongest means thus far of understanding (and therefore acting upon) social determinants of early child development. Evidentiary Base for team-ecd team-ecd also draws on a large body of literature and expertise in order to document the features of environments that are most nurturant for children (see also appendix A). The evidentiary base, as well as interpretation of the body of evidence used in this volume is derived from three primary sources: peer-reviewed scientific literature, reports from governments, international agencies, and civil society groups, and international experts in the field of ecd (including the csdh, Knowledge Network of ecd, which itself is representative in both international and inter-sectoral terms). One irreconcilable factor is the imbalance in availability of information from each of these three sources across resource-rich and resource-poor nations. The preponderance of scientific literature arises from studies conducted in resource-rich nations, while evidence from resource-poor nations is largely contained in governmental and agency reports. Notwithstanding this issue, the evidence-based multiple-sourced approach ensures that the conclusions and recommendations of this report are borne out of the perspectives of a diverse array of stakeholders and broadly applicable to societies throughout the world. Certainly, there are facets of ecd that are ‘context-specific’ (for example, cultural practices and norms), but from this body of evidence, one can glean key aspects of ecd that hold true in all cultures and in all societies. In addition, team-ecd provides a flexible means of integrating ideas of nurturance which may only be locally-relevant with those which are universal - for all children in all places. Universal Principles of ecd There are several principles which are universally characteristics of ecd; they are consistently upheld irrespective of society, and a child and family’s place within that society. First, the early years of life are marked by the most rapid development, especially of the central nervous system (cns). Second, there are a number of sensitive or ‘critical periods’ in the development of the human brain that occur almost exclusively during this time period. For each of these critical periods, specific regions (and therefore specific functions) of the brain undergo crucial growth and formation. Third, the environmental conditions to which children are exposed in the earliest years literally “sculpt” the developing brain. The more ‘nurturant’ the physical, social, and economic environments of children during the early years, the greater the chances for successful development of the growing child. Fourth, the development occuring during this time provides the essential building blocks for a lifetime of success in many domains of life, including economic, social, and physical well-being. Certainly people continue to develop beyond the early years, however science has demonstrated that healthy early child development—which again (for the sake of emphasis) includes the physical, social/emotional, and language/cognitive domains of development, each equally important - is fundamental to health, success, and happiness not only for the duration of childhood, but throughout the life course. As such, the environmental conditions to which children are exposed in the earliest years of development are consequential over the entire life course. Fifth, and related to the preceding point, the pervasive socioeconomic inequities in adult health outcomes (and many other markers of well-being) have roots in socioeconomic inequities in ecd. That is, during 14
Family, Cultural, Economic, & Social Environment, Gender Roles, Family Health Status and Dwelling Environment Total Environment Assessment Model for Early Child Development the earlierst years of life, differences in the extent of nurturance provided by children’s environmental conditions lead to differences in ecd outcomes; the effects of these early inequities last for a lifetime, and translate into inequities in health in later childhood, adolescence, and in adulthood. In sum, the socioeconomic environment is a fundamental determinant of ecd and, in turn, ecd is a determinant of health and well-being across the balance of the life course. Primary Principles of team-ecd Rooted in these universalities, team-ecd is based on three underlying principles: 1) Early Child Development—physical, social/emotional, and language/cognitive—is the result of interactions between children’s biological factors and the environments in which children are embedded. 2) Successful ecd occurs when environmental conditions—physical, social, and economic —demonstrate characteristics that are known to be ‘nurturant’ for children. 3) Using an equity-based approach to provide nurturant environments for all children will lead to equity of Early Child Development and equity in well-being throughout the life course. team-ecd: Organizational Overview Figure 1 provides the heuristic depiction of team-ecd. team-ecd is organized by interacting and interdependent ‘spheres of influence.’ They include the individual sphere (which is the central sphere in the model and reflects the child itself, including her/his biological characteristics), the family and dwelling sphere, the residential community sphere, the relational community sphere, the ecd services sphere, the regional environmental sphere, the national environmental sphere, and the global environmental sphere. Each chapter in this study is devoted to describing one of these spheres of influence in terms of the aspects of each—physical, Introduction and Overview figure 1: team-ecd schematic Global Ecological, Corporate/Economic, Policy, Political and Social Environments Civil Society Regional Health Status, Ecological, Economic, Policy, Political & Social Environments Residential Community Health Status and Cultural, Economic, Service & Social Environments National Health Status, Ecological, Economic, Policy, Political & Social Environments Individual Brain and Biological Development ecd Programmes and Services Genetics, Age, Sex, Gender Institutional / Historical Time Relational Community (Tribe, Religion, etc.) Health Status, Gender Socialization, Cultural Environment and Socioeconomic Status & Resources 15
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