A call for two-generation strategies to achieve “breakthrough” impacts

A portrait of a young Ghanaian mother with her child.
A call for two-generation strategies to achieve “breakthrough” impacts
19 June 2014

Many early childhood programs improve the prospects of poor and disadvantaged children. Many are also cost-effective. But despite 50 years of development, the effects of these programs remain modest and variable. Could working with adults be a stronger way to help their children?

Jack Shonkoff, director of the Center on the Developing Child at Harvard University, and Phil Fisher, from the University of Oregon and the Oregon Social Learning Center, argue that it is time to draw on evidence from biology to design, adapt, and scale up far more effective programs.

Children’s outcomes are strongly affected by their caregivers’ resources and capabilities, but most programs that aim to disrupt cycles of intergenerational poverty and promote the healthy development of vulnerable young children focus on the children, not the adults in their lives.

And this may be one of the reasons, Shonkoff and Fisher explain, that program impacts are often small. When children grow up facing high levels of adversity, “toxic stress” can disrupt their brain development. The longer such stress goes on, the harder it becomes for interventions to prevent or repair the damage done to mental and physical health. In the face of chaotic, abusive, or neglectful situations, interventions that focus on children may not be up to the task.

Now the urgent need is for two-generation strategies that focus on adults and the environment as much as – or more than – they focus on the children. We need “creative new interventions that strengthen the capacity of parents and other caregivers to reduce sources of excessive adversity and to help build effective coping skills in children who experience high levels of stress,” the authors argue.

Three intervention strategies
How would improving caregivers’ capacities improve children’s outcomes? Shonkoff and Fisher offer three “particularly ripe candidates.”

First, improve the executive function and self-regulation skills of parents and childcare providers. Children learn their executive function skills through relationships with adults who have these skills. The abilities to focus, set goals, solve problems, and control impulses are fundamental for everything from doing well in school, to holding a job, to raising children.

Second, strengthen caregiver mental health. Parents and childcare providers who have poor mental health, especially anxiety and depression, have a harder time creating healthy day-to-day interactions with their children.

Third, improve family economic stability. This is perhaps the most important of the three strategies Shonkoff and Fisher propose, given that strong executive function and good mental health are hard to maintain in the midst of financial stress. Adequate and stable income makes it possible for parents to provide good nutrition and quality childcare, and also to avoid stressors like chaotic daily routines and neighborhood violence.

In all three domains – executive function, mental health, and economic security – providing information and informal support will not be enough. Active capacity building is necessary. And in all three domains, building parents’ capacity should not only improve their direct ability to give their children a better environment. It should also improve their employability and their ability to manage other aspects of their daily lives – indirectly improving the environment that children experience.

Why are new two-generation approaches needed?
New approaches to early childhood policy are needed, Shonkoff and Fisher argue, because improvement in the quality and coordination of existing services (although valuable) is not likely to result in “breakthrough” impacts. Even the most widely recognized model programs, such as HighScope Perry Preschool, don’t work for everyone. As they point out, a third of the Perry Preschool intervention group had at least one arrest for an alleged violent offense.

So new approaches are needed to produce larger effects, more consistent effects across diverse groups, and better cost-effectiveness. Two-generation services aren’t themselves a new idea. But new science – from psychology, neurobiology, developmental psychopathology, and prevention science – offers insights that haven’t yet been put to use in designing early childhood programs.

Creating and testing new approaches requires creativity, rapid adaptation, and a willingness to learn from failure. As a result, it also requires a different definition of evidence, Shonkoff and Fisher argue. Experimental trials on existing programs are important, “but they are rarely a source of creative new ideas.” A broader definition of evidence that includes scientific principles from the biological and social sciences, by contrast, lends itself to “evidence-based innovation.”

Finally, to put this into action, securing entrepreneurial funding support is paramount. Investors who understand the potential of risk-taking can support this dynamic process. Such an outlook will lead to a “fast-cycle innovation culture” that consists of short-cycle feedback mechanisms that enhance interventions.

Within an innovation-friendly environment, rethinking two-generational approaches provides a new frontier for evidence-based practice, and furthers the quest for greater impacts.

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Reference:
Shonkoff, J. P., & Fisher, P. A. (2013). Rethinking evidence-based practice and two-generation programs to create the future of early childhood policy. Development and Psychopathology, 25, 1635-1653. doi:10.1017/S0954579413000813

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Links:

Center on the Developing Child at Harvard University : http://developingchild.harvard.edu/

Oregon Social Learning Center : http://www.oslc.org/

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