Early Child Development

An Overview

MENA WorkshopMay 27, 2008

Mary Eming Young, MD DRPHHDN CY

World Bank

Competition for Talents in the 21st CenturyEducation vs. Learning – Expected Abilities

Industrial

• Special skills

• Planning & implementation

• Navigating the bureaucracy

• Following the heritage

Blue collars

Post-industrial

• Communications

• Teamwork

• Human relations

• Problem-solving

• Design & innovation

• Personal responsibility

• Self-management

• Ethics, values, principles

Knowledge workersSource: Cheng, Kai-ming, Education versus Learning: the Post-Industrial Challenge, presentation at the World Bank Human Development Forum, 2006

Literacy Level by Income

0

10

20

30

40

50

60

70

80

90

100

0 5000 10000 15000 20000 25000

GDP per capita (thousands)

Lite

racy (

%)

Cuba

Baharain

Yemen

Iraq

IranUAE

Oman

Jordan

Lebanon

Morocco

Egypt

Qatar

Tunisia

Djibouti

Saudi Arabia

Algeria

LibyaKuw ait

Education: ECD in the Mediterranean

Palestine

SyriaEgypt

Morocco

Albania

Jordan

Lebanon

Algeria

Macedonia

Romania

Tunisia

Bulgaria

Libya

Croatia

Kuwait

Bahrain

Malta

Cyprus

Slovenia

UAE

Greece

Qatar

Israel

SpainItaly

France

Turkey

Iran

YemenIraq Oman

Saudi Arabia0

20

40

60

80

100

120

0 5 10 15 20 25 30 35

Countries ranked by GDP per capita (US$ PPP)

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Source: PIRLS 2006 International Report

Reading Achievement at the 4th Grade

PIRLS 2006

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How Does ECD Relate to the Workforce?Early Child Development (ECD) =

Learning, Behavior, and Health

Experience-based brain development in early life

(including in the uterus) can set trajectories for:

• Learning,

• Behavior, and

• Health

that are difficult to change later in life.

Why Do We Care about Brains?

You are your brain.

BUT

Your brain is not just produced by your

genes.

Your brain is sculpted by a lifetime of

experiences. And, the most important

time in brain development is the first

few years of life.

Kolb, U Lethbridge

08-039

Findings from Neuroscience: Early Experiences

Shape…

Brain architecture

Neurochemistry

Gene expression

Cognitive

+

Emotional

+

Social Behavior

Prerequisite

for economic

productivity

in adulthood

0 1 4 8 12 16

AGE

SensingPathways

(vision, hearing)

LanguageHigherCognitive Function

3 6 9-3-6

Months Years

C. Nelson, in From Neurons to Neighborhoods, 2000

Window of Opportunity - ECD

Differences on child development outcomes

between poor and non poor children manifest

early

Source: Paxson & Shady, 2005

Vocabulary Scores by SES Quartiles

in 36 to 72 month old Children in Ecuador

Literacy and Vocabulary Growth – First 3 Years

High SES

Middle SES

Low SES

1200

600

012 16 20 24 26 32 36

Vocabulary

Age (Months)Source: B.Hart & T. Risley. Meaningful Differences in Everyday Experiences of Young American Children, 1995.

Children Who Start Behind Stay Behind

Academic Abilities of Entering Kindergartners by Family Income

Source: Schulman, K., and W. S. Barnett. 2005. The Benefits of Prekindergarten for Middle-Income Children. NIEER Policy

Report. New Brunswick, N.J.: National Institute for Early Education Research, Rutgers, The State University of New Jersey.

12

Benefits of ECD Programs for High

Risk Children

• Higher Employment

• Higher High school completions

• Less Crime

• Less Teenage pregnancies

• Less Drug use

Challenges.. Where does ECD fit in?…where cross-sector policies/programs are

essential to human capital development

Age

24

18

14

5

0

He

alt

h a

nd

N

utr

itio

n

Ed

uca

tio

n

So

cia

l P

rote

cti

on

Early Child Development(Health/Nutrition, School Readiness, Parenting)

Youth Development(School-to-work, Second-chance programs,

Risky behaviors, participation, crime and violence)

10

Do we know what to do?

To start with,• better nutrition,

• essential mother and child care, and

• early sustained sensory and social stimulation

Program Options:• Delivery of services to young

children

• Education and support of parents

• training and support of caregivers/paraprofessionals

• Sensitization of the public, through the mass media, to the value of ECD

• Promoting and strengthening community-based activities

0 1 2 3 4 5 6

parent-oriented

child-oriented

Source of Brain Stimulation

age

Components of Early Childhood Development and Parenting Centers:

ECD & care (parental and non-parental) arrangements

Play-based learning

Resources

Prenatal & postnatal supports

Nutrition programs

Implement an Overall ECD Strategy

Intervene early, often, and effectively

Allocate sufficient resources

Ensure relevant trainingEnhance the next generation’s competency for

understanding human development

Build systems, not just projectsEmphasize equity, sustainability, and population health

Monitor and evaluate

Measure child development outcomes

ECD Menu of Options

ECD interventions include:

• Delivering services to children birth to age 6

• Training caregivers and educating parents

• Building public awareness and strengthening

demand

Children Ready

for Success

Compliance with

standards and ongoing

technical support

Monitoring

and Improvement

Programs

Program Standards and Early

Learning and Development

Guidelines

Programs

that meet Standards

Workforce

Development

To consumers, public

and private sector

Engagement &

Outreach

Health, Nutrition, Mental

Health, Disability Services

Parenting and Family

Support

Comprehensive

Services

Early Childhood Development System

Across programs and

connected to other

systems

Coordinated Governance

And Financing

Core competencies

Access to Training and

Higher Education,

Credentialing

Adapted from the State Early Childhood Policy

Technical Assistance Network, J.Lombardi,

2007

World Bank ECD Portfolio in MENA Region

World Bank supported ECD Projects in

MENA region:

• Yemen – Child Development Project

• Jordan - Knowledge for the Economy

• Egypt – Early Enhancement Project

World Bank Cumulative Lending for ECD

More than $1.7 billion over 17 years

By Region 1990–2007 (in US$ million)

LAC

50%

AFR

9%

ECA

2%

MENA

7%

EAP

3%

SAR

29%

How Are Other Nations Improving Their

Children’s Outcomes?

Child Development Program in Singapore

Inter-Ministerial Committee

Health, Education, Community Development, Youth and Sports

Overall policy directions & funding, Service guidelines & Coordination,

and Professional standards

Director, Child Development Program

Ministry of Health

Child Development Unit

National Healthcare Group

Child Development Unit

Singapore Health Services

Cuba ECD Programs: Initial Link

Strong National Institutions

Formal Sector

Local Capacity

Non Formal Sector

Pregnancy Childcare Centers Preschool ProgramsParent Programs(0 years) (0 to 5 years) (5 – 6 years)

French ECD System

1. Emphasis on very young children

2. Voluntary, free preschool

3. More for those with less (Educational

Priority Areas (ZEP)

4. Integration of all children

5. Quality standards and accountability

6. Highly trained and well-paid teachers

7. Secure funding and infrastructure

Public and Private Partnerships

New Zealand

• Centers must comply with minimum

licensing standards.

• Bulk funding: per-child funding based on a

sliding scale.

• Demand-side financing: seed fund to

develop services through grants, offer loans

to ECD teachers, and supplement incomes to

pay for ECD fees.

South Australia – Coordinated Early

Childhood Policies

• Legislative reform to integrate Education Act

and Children’s Services Acts

• Creating a Birth through Age 17, Education

and Childhood Development System

• Government collect child development

outcome (EDI) data across state every 3 years

ECD Policy - Trends

Among selected OECD countries:

• Integrated care and education of young children

• Emphasis on universal access to care and education

• Targeting of children who are poor, disadvantaged or at risk

• Substantial public investment in ECD

• Attention to quality

• Expansion of the supply of early interventions to young children under 3

Effective Interventions

No one size or design meets

the needs of all children

• Innovative designs are comprehensive, developmentally appropriate, and of sufficient duration and intensity.

• Effective interventions complement other health and education efforts, reflect a society’s culture and values, and target areas of most need.

Colombia: Community Welfare Homes

A home based child care/nutrition program introduced in the early 1980s

Targets extremely poor 1 million <7 yrs

Supported by ICBF and financed ear-marked payroll taxes (3%)

Mothers receive a loan/grant to upgrade their homes and training

Source: Londono, Beatriz and Tatiana Romero Rey 2007: Colombia Challenges in Country Level

Monitoring. In Proceedings of Symposium of ECD Priority for Sustained Economic Growth (in press)

Bolivia: Integrated Child Development Project

Full time home-based daycare, nutritional and educational services

Poor children ages 6m to 6 yrs in urban areas

Local women trained

Loans/grants ($500) to upgrade facilities

Source: UNICEF Bolivia

Community-based ECD programs

being implemented worldwide

MENA: Yemen

Africa: Kenya, Uganda,

Eritrea, Guinea Bissau, Senegal,

Malawi, Ghana, …

ECA: Kosovo, Macedonia, Albania, Turkey, Bulgaria, …

East/ South Asia: India,

Philippines, Indonesia,

China, Nepal, Bangladesh, Vietnam

Lessons Learned :

Community-based ECD programs

Quality services:

Sufficient intensity and duration – longer exposure

Direct contact with children beginning early in life (birth onwards)

Involve parents and provide parent education

Integrated within a comprehensive package of social, nutrition, and educational services for the child

Lessons Learned:

Community-based ECD programs

Community ownership – culturally relevant and designed to address local needs

Develop local capacity – training of community mothers

Use of local resources (facilities)

Evaluate and monitor progress on child outcomes

Messages for Policymakers

• Child Development – early experience shapes brain architecture, determines all future learning,

behavior and health outcomes later in life

• Effective -

• Cost Efficiency - save money in the long run because they prevent problems before they start and reduce later needs for special education and other remedial measures.

• Economics -the need for different skill sets in the

21st century.

Looking into the Future…

challenges

1. Implement an overall ECD strategy

2. Monitoring effectiveness of programs with outcome measures of child development

Child Development Outcomes – A Schematic

Building monitoring systems

Collecting population-based child outcome data

Early Development Instrument (EDI) –

A Population-based Measurement Tool

• Incorporates the most recent evidence on early brain

development

• Is a macro assessment of children’s early development

• Is a population-based measure, not used for individual

screening or diagnosis

• Has been tested and is being adapted for use in

industrialized and developing countries

• EDI results (at ages 5-6): They are predictive of later

school performance at grade 4; the EDI vulnerability index

correlates very highly with later failing at grade 4 testing.

Brain Growth

Rates of Return to Investment

in Human Capital

Preschool SchoolPost School

Preschool Programs

Schooling

Job Training

Age0

Brain Growth and Rates of Return

Source: Heckman & Carneiro Human Social Policy, 2003, RAND, Benefits and Costs of Early-Childhood Interventions, A

Documented Briefing, Lynn A. Karoly, Susan S. Everingham, Jill Hoube, Rebecca Kilburn, C. Peter Rydell, Matthew

Sanders, Peter W. Greenwood, April, 1997

Optimal Investment Levels

Preschool SchoolPost School

Age0

Optimal vs. Actual Investment

Cumulative Public Investment

Source: Heckman & Carneiro Human Social Policy, 2003, Voices for America and the Child and Family Policy Center.

Early Learning Left out An Examination of Public Investment in Education and Development by Child Age, 2004