Kids First Saskatchewan November 2010
The First ‘R” Relationships:
How Love Builds Brains
Jean Clinton BMus MD FRCP(C)
McMaster University and Children’s Hospital
Department of Psychiatry and Behavioural
Neurosciences
Offord Centre for Child Studies
Kids First Saskatchewan November 2010
Kids First Saskatchewan November 2010
The Wisdom of the Elders

Consider the interest of the next 7
generations when decisions are being
made
Kids First Saskatchewan November 2010
Masai Greeting:
How are the children?
Kids First Saskatchewan November 2010
What is our
VALUES DRIVEN
question and conversation?
Who won the hockey game last
night?? What about those Blue
Jays?
Kids First Saskatchewan November 2010
The Child
“To the doctor, the child is a typhoid patient;
to the playground supervisor, a first
baseman; to the teacher, a learner of
arithmetic. At times, he may be different
things to each of these specialists, but too
rarely is he a whole child to any of them.”
From the 1930 report of
The White House Conference on Children and Youth
Kids First Saskatchewan November 2010
What is the world
we want to see?



What we believe about children informs our view…and our
language.
Child as empty vessel? Or
Child as Powerful ,resourceful, creative co-learner and
creator

Develop normally or function to the best of ability?
Fix the problem…..or promote activity and what can be?

WHAT IS OUR IMAGE OF THE CHILD?

Kids First Saskatchewan November 2010
Adapted from Loris Malaguzzi
How are the Children?
Kids First Saskatchewan November 2010
UNICEF REPORT CARD 2007

“The true measure of a nation’s standing
is how well it attends to its children-their
health and safety, their material security,
their education and socialization, and their
sense of being loved, valued and included
in the families and societies into which
they are born.”
Kids First Saskatchewan November 2010
Unicef Innocenti Report 2007
Unicef Report :Canada







Material Well Being
Health and Safety
Educational Well being
Family and Peer Relationships
Behaviours and Risks
Subjective well being
6
13
2
18
SWEDEN
SWEDEN
BELGIUM
ITALY

17
15
SWEDEN
1
NETHERLANDS 1

12/21





Overall
Unicef Innocenti Report 2007
Kids First Saskatchewan November 2010
1
1
1
1
Reaching For the Top Report.

We are doing poorly compared to other
OECD countries(29 total)
21st in child well being, including mental
health
 22nd in PREVENTABLE childhood injury and
deaths
 27th in childhood obesity

Kids First Saskatchewan November 2010
National Advisor Report March 2008
03-080
The Founder’s Network
Experience-Based Brain Development in
the early years of life sets neurological
and biological pathways that affect:
Health
Learning
Behaviour
Kids First Saskatchewan November 2010
Why do we care about brain?
You are your brain.
BUT
Your brain is not just produced by your genes.
Your brain is sculpted by a lifetime of
experiences . The most important time
in brain development is the first few years
of life.
Kids First Saskatchewan November 2010
Kolb
The Brain Matters
The human brain is the organ responsible
for everything we do. It allows us to
laugh, walk, love, talk.
 For each of us, our brain is a reflection of
our experiences.
 The brain is an environmental organ. It
reflects our environment.

Adapted from Bruce Perry
Kids First Saskatchewan November 2010
Time Magazine from the MEHRI Neuroscience lab
Kids
First Saskatchewan
November
2010
Hamilton
Regional Child
Wefare
Conference September 2010
Nature/ Nurture
No longer a debate
 Environment leaves its mark on our genome
and can modulate future gene expression in a
sometimes heritable fashion
 The study of how environment leaves its
footprint on the genome falls into the domain
of Epigenetics

Dr Robin Gibb U of Lethbridge
Kids
First Saskatchewan
November
2010
Hamilton
Regional Child
Wefare
Conference September 2010
Children’s Mental Health Is…
Developing the capacity to:
Experience, regulate, and express emotions
• Form close interpersonal relationships
• Explore the environment and learn
•
Child mental health = healthy social and
emotional development.
Zero to Three
Kids First Saskatchewan November 2010
BRAIN PLASTICITY
Connections are
formed and altered
by experience
But, not
done until
at least ageKids First Saskatchewan November 2010
24+years…
19
 Proliferation Migration-
how cells grow
where cells go
 Subtle
changes in the neurotransmittershow the cells communicate
 Many
parts of the brain are affected
Kids First Saskatchewan November 2010
The Hamilton Task Force on FASD 905
527-3823 x267
20
13 weeks
Kids First Saskatchewan November 2010
Kids First Saskatchewan November 2010
Dr Robin Gibb U of Lethbridge
04039
Two Neurons
Axon
RECIPIENT
NEURON
Synapse
SIGNALSENDING
NEURON
Dendrite
Kids First Saskatchewan November 2010
Founders Network
KidsUniversity.
First Saskatchewan
November
2010 C.A. (1999) Change and continuity in neurobehavioral
Graphic courtesy of Center on the Developing Child at Harvard
Originally published
in Nelson,
development: lessons from the study of neurobiology and neural plasticity. Infant Behavior and Development, Volume 22(4) 415-429. Cited in InBrief: The Science
of Early Childhood Development, presentation summary from the National Symposium on Early Childhood Science and Policy, Cambridge, MA, June 2008.
PLASTICITY
Babies highly attuned to their environment
 Massive synaptic growth in first two years
 Pruning starts at 8months
 Pruning regulated by emotional
interactions with caregivers


From “The First Idea” Greenspan and
Shanker
Kids First Saskatchewan November 2010
04-212
SERVE AND RETURN
Sound
Vision
Smell
Touch
Proprioception
Taste
Kids First Saskatchewan November 2010
Neal Halfon
From Aitken and Trevarthen
Kids First
Saskatchewan Law
November
2010
Ontario
Collaborative
Federation
September 2010
27
A Citizen and Competent from Birth
Amazing Talents of the Newborn ;
Johnson & Johnson
Paediatric Institute
Kids First Saskatchewan November 2010
Brain Cells develop connections over the first 2 years
Kids First Saskatchewan November 2010
Then they are sculpted
actively for the rest of your life!
Kids First Saskatchewan November 2010
02-002
Estimated Cumulative Difference in Language
Experiences by 4 Years of Age
Million
50
Professional
40
Working-class
30
20
10
Welfare
0
0
12
24
36
Age of child in months
Kids First Saskatchewan November 2010
48
Cumulative Vocabulary (Words)
Disparities in Early Vocabulary
Growth
1200
600
College
Educated
Parents
Working Class
Parents
Welfare
Parents
200
16 mos.
24 mos.
Child’s Age (Months)
Kids First Saskatchewan November 2010
Source: Hart & Risley (1995) Slide by The National Scientific Council on the Developing Child
36 mos.
‘Sensitive periods’ in earlyBinocular vision
Central auditory system
brain development
Habitual ways of responding
Language
Emotional control
Symbol
Peer social skills
Relative quantity
High
Low
0
1
2
Kids First Saskatchewan November 2010
3
Years
4
5
6
7
Harvard Centre on the Developing Child
Kids First Saskatchewan November 2010
USE IT OR LOSE IT !
The more a system, or set of brain cells is activated, the
more that system changes in response. The stronger
the repetitions the stronger the memory.
Kids First Saskatchewan November 2010
Brain Development
Maturation Occurs from Back to Front
of the Brain
Images of Brain Development in
Healthy Youth (Ages 5 – 20)
Blue represents maturing of brain
areas
Source: Gogtay, Giedd, et al., 2004.Kids First
Copyright © 2004 The National Academy of Sciences, USA
Gogtay, N., Giedd, J.N., et al. (2004)
Dynamic mapping of human cortical development during childhood through early adulthood
Saskatchewan November 2010
Proceedings of the National Academy of Sciences, 101 (21), 8174 – 8179
Brain Plasticity
Incidental Finding in 55 year old man
Kids First Saskatchewan November 2010
Brain Plasticity
Kids First Saskatchewan November 2010
02-066
The Fear Response
Visual Thalamus
Visual
Cortex
Amygdala
Scientific
Kids First Saskatchewan November
2010
American
The Hidden Mind, 2002, Volume 12, Number 1
Hippocampus
Amygdala
Kids First Saskatchewan November 2010
Kids First Saskatchewan November 2010
Stress is NUTS
 Novelty,
 Unpredictability,
 Threat
to the ego,
 Sense of loss of control

Dr Sonia Lupien Centre for Studies on Human Stress
Kids First Saskatchewan November 2010
03-002
Emotional
Stimulus
Amygdala
+
Hippocampus
+
Hypothalamus
-
-
PVN
Cortisol
Cortisol
CRF
PIT
ACTH
Adrenal
Cortex
Kids First Saskatchewan November 2010
LeDoux, Synaptic Self
Amygdala and Hippocampus
Kids First Saskatchewan November 2010
00-058
Cortisol can be bad for the brain
Hippocampus
high sterol levels cause loss of dendrites
and cell death
Frontal brain
attention deficits
Kids First Saskatchewan November 2010
05-212
Limbic HPA Pathway - Stress
Cortisol – Over Production
Behaviour (ADHD, violence), depression,
diabetes, malnutrition, cardiovascular disease,
memory, immune system, drug and alcohol
addiction
Cortisol – Under Production
Chronic fatigue syndrome, fibromyalgia, immune
system (autoimmune disorders) rheumatoid
arthritis, allergies, asthma
Kids First Saskatchewan November 2010
Anterior Cingulate Cortex
Kids First Saskatchewan November 2010
Cortisol & Brain Development
Cortisol affects the parts of the brain that
 regulate stress

store memory

Are involved in planning and executing
complex functions

Are involved in language
Kids First Saskatchewan November 2010
PFC
AMYGDALA
A: Positive emotional state, flow through amygdala to PFC
and better memory test results.
B: Stressed state: No passage of information to PFC & lower
memory testing short and
long-term.
(Hamman,et
al. Cognitive
Kids
First
Saskatchewan
November
2010
Hamilton
Regional Child
Wefare
Conference September 2010
Neuroscience.)
Children’s Stress Pathway

“Children’s number one fear is PUBLIC
HUMILIATION. They will do anything to
belong”.
“If a child is not sure if they are going to
be embarrassed or humiliated they can’t
learn”

Mary Gordon

Kids First Saskatchewan November 2010
Still Face Experiment
Kids First Saskatchewan November 2010
Self-Regulation

SR is the ability to manage emotions and
behaviour independently

Is considered by some to be a central
organizing feature of human development

Most mental illnesses can be thought of as
a problem of self-regulation

Babies learn to self-regulate from their
caregiving experiences
Kids First Saskatchewan November 2010
Self regulation
Kids
First Saskatchewan
November
2010
Hamilton
Regional Child
Wefare
Conference September 2010
Maternal Stress



Affects HPA axis in offspring
Can alter susceptibilty to later
disease/ drug taking
Affects males more than
females
Kids First Saskatchewan November 2010
Maternal style


Mothering has a lifelong influence on health of offspring
Passed on from generation to generation via epigenetics
Kids First Saskatchewan November 2010
05-056
Individual differences in stress reactivity of the adult are
determined by maternal behaviour during infancy
HIGH LG
LOW LG
Development of
Stress Reactivity
Modest Stress
Reactivity
Reduced Risk
for Disease
Increased Stress
Reactivity
Increased Risk for Heart
Disease, Type II Diabetes,
Alcoholism, Affective
Disorders,
Brain Aging, etc.
Kids First Saskatchewan November
2010
M. Szyf
05-057
Is maternal care the mediator of these effects on
hippocampal (GR(17) promoter methylation?
ADOPTION/CROSS FOSTERING STUDIES
Biological Mother
Adoptive Mother
LOW
LOW
HIGH
HIGH
Kids First Saskatchewan November 2010
M. Szyf
05-059
Rats – Gene Methylation
Cytosine-Methylation
1.2
0.8
Licking
Low
0.4
Licking
High
0
Embryo
Day 20
Birth
Pup
Day 6
Day
1
Kids First Saskatchewan November 2010
Age
Weaning
Adult
Day 21
Day 90
M. Szyf
Serotonin Gene, Experience,
and Depression
03-089
Depression
Risk
.70
Age 26
SS
S = Short Allele
L = Long Allele
.50
SL
.30
LL
No Abuse
Moderate Abuse Severe Abuse
Kids First Saskatchewan November 2010
Early Childhood
A. Caspi, Science, 18 July 2003, Vol 301.
Nature/ Nurture
No longer a debate
 Environment leaves its mark on our genome
and can modulate future gene expression in a
sometimes heritable fashion
 The study of how environment leaves its
footprint on the genome falls into the domain
of Epigenetics

Dr Robin Gibb U of Lethbridge
Kids
First Saskatchewan
November
2010
Hamilton
Regional Child
Wefare
Conference September 2010
Perinatal Depression
Kids First Saskatchewan November 2010
Perinatal Depression
For decades the medical profession believed the
increased hormones in pregnancy protected
women from becoming depressed.
 In the late 70's and 80's researchers discovered
that many of the women who experienced
depression after the birth of their child were
depressed in pregnancy.
 Today we know that 10 % of women will
experience depression during pregnancy.

Kids First Saskatchewan November 2010

Perinatal psychiatric disorders are a
leading cause of maternal morbidity and
mortality

Parental mental illness may pose the first
adverse life event for a child

Depression transmits across the
generations
Kids First Saskatchewan November 2010
Perinatal Depression: Prevalence
Depression is among the most common
of health disorders in women (1 in 4
lifetime)
 10% during pregnancy
 12-16% postpartum
 It is a recurrent disorder

Kids First Saskatchewan November 2010
The Problem:
Under-Detection & UnderTreatment
The diagnosis is made in only 0.8% of
childbearing women
 Most receive inadequate treatment
 Compliance

 substantial maternal/infant morbidity
Kids First Saskatchewan November 2010
Edinburgh Postnatal Depression Scale
Brief, easy to use screening instrument
comprising 10 questions
 Can improve the awareness of healthcare
providers and aid in the early detection of
postpartum depression

Kids First Saskatchewan November 2010
Risks Of Untreated Depression
During Pregnancy: The Mother









Postpartum depression
Exposure to additional medication
Drug, alcohol, tobacco use
Poor self-care, nutrition, sleep
Noncompliance with prenatal care
Obstetrical complications
Pre-eclampsia
Negative effect on bonding
Suicide
Kids First Saskatchewan November 2010
Prenatal and Postpartum
Depression in Dads

A recent study by James Paulson and Sharnail
Bazemore from the Virginia Medical School,
Norfolk, VA, published in the Journal of the
American Medical Association, throws new light
on this interesting issue. Notes:
http://www.ncbi.nlm.nih.gov/pubmed/20483973

Kids First Saskatchewan November 2010
Paternal Depression

the average rate of paternal depression in the
antenatal period (during pregnancy) was
abour 10% but increased to about 25%
during the 3 to 6-month postpartum period
(after birth).
Kids First Saskatchewan November 2010
Paternal Depression

it is important to also be wary of mood
disorders in expecting and new fathers
(especially if the mother has mood
problems), but these mood disorders in
fathers may need to be addressed.
Kids First Saskatchewan November 2010
Impact on child
paternal depression may have substantial
emotional, behavioral and developmental
effects on the infant.
 prevention, screening and interventions
for depression should likely be focused on
the couple rather than on the individual
parent.

Kids First Saskatchewan November 2010
Kids First Saskatchewan November 2010
What is Attachment?
Kids First Saskatchewan November 2010
What is Attachment?
An affectional bond or tie between an infant
and his/her mother figure
Kids First Saskatchewan November 2010
What is Attachment?
Bowlby’s Attachment Theory
proximity-maintaining behaviours
 for protection
 in balance with exploration system
 “secure base”

“Attachment & Loss” (1969)
Kids First Saskatchewan November 2010
Internal Working Models

Early relationship experiences create
internal representations of the self in
relation to the attachment figure and the
world

Influence expectations of significant
others
(Bowlby, 1988)
Kids First Saskatchewan November 2010
What is not attachment?

Other parental roles:
 Teacher
 Playmate
 Physical
caregiver
(Bowlby, 1988)
Kids First Saskatchewan November 2010
Ainsworth’s
Strange Situation Procedure
Mary Ainsworth (1978)
 Laboratory measure of attachment based
on internal working model theory
 i.e., infant’s attachment strategy is
based on expectation of how the caregiver
is likely to behave

Kids First Saskatchewan November 2010
Ainsworth’s
Strange Situation Procedure







Infant & Mother
(stranger enters) infant, mother, stranger
(mother leaves) infant, stranger
(mother returns, stranger leaves) infant & mother
(FIRST REUNION)
(mother leaves) infant alone
(stranger returns) infant & stranger
(mother returns) infant & mother (SECOND REUNION)
(Ainsworth et al., 1978)
Kids First Saskatchewan November 2010
Video
Kids First Saskatchewan November 2010
Attachment Classifications

Secure



Insecure – Avoidant



Ignores or avoids mother upon reunion
History of predictably unavailable or unresponsive caregiving
Insecure – Resistant



Settles easily with mother upon reunion
History of consistently responsive caregiving
Difficulty settling upon reunion
History of inconsistent, unpredictable caregiving
Insecure – Disorganized


Odd behaviour, confusion, fear upon reunion
History of abuse/neglect
Kids First Saskatchewan November 2010
Developmental Implications of
Insecure Attachment

Increased





Social withdrawal
Aggression towards peers
Parent-child conflict
Behaviour problems
Decreased
Persistence with challenging tasks
Cognitive problem-solving competence
 Mental health
 Physical health


Kids First Saskatchewan November 2010
What Influences Attachment?

Mother







Responsiveness
Her own childhood experiences
Personality
Depression
Stress – parenting, life events
Marital satisfaction, social support
Infant



Unique characteristics
Reactivity to environment and people
Special needs (e.g., premature, developmentally delayed)
Kids First Saskatchewan November 2010
What’s a parent to do?

Get peer support!

Get rid of the “ghosts in the nursery”
family, friends, join a group or early years centre
-
-get counseling (family doctor, local infant development program,
hospital or mental health centre, or Employee Assistance Program)


Education
books (e.g., Sears, Leach)
videos (e.g., A Simple Gift)
- home study (e.g., the Parent Kit)
courses (e.g., Right from the Start)
Have fun!
Kids First Saskatchewan November 2010
-
Developmental Implications of
Insecure Attachment

Increased





Social withdrawal
Aggression towards peers
Parent-child conflict
Behaviour problems
Decreased
Persistence with challenging tasks
Cognitive problem-solving competence
 Mental health
 Physical health


Kids First Saskatchewan November 2010
TEMPERAMENT
“A child’s first and most natural way
of reacting to the world around him”
Kids First Saskatchewan November 2010
Thomas and Chess
TEMPERAMENT
INTENSITY
How strong are your child’s emotional
reactions?Does he laugh and cry loudly
and energetically or softly and mildly?
PERSISTENCE
If your child is involved in an activity and
you tell her to stop,does she stop easily
or fight to continue?
Kids First Saskatchewan November 2010
Raising
your Spirited Child: Mary Sheedy Kurcinka
SENSITIVITY
How aware is your child of slight
noises,emotions and differences in
temperature,taste and texture? Does he
react easily to certain foods,tags in
clothing,irritating noises,or your stress?
PERCEPTIVENESS
Does your child notice people,
colors,noises, and objects around
her?Does she frequently forget to do what
you asked because something else has
caught her attention?
Kids First Saskatchewan November 2010
Raising your Spirited Child: Mary Sheedy Kurcinka
ADAPTABILITY
How quickly does your child adapt to changes in
his schedule or routine? How does he cope with
surprises?
REGULARITY
Is your child quite regular about eating
times,sleeping times,amount of sleep needed, and
other bodily functions?
ENERGY
Is your child always on the move and busy or
quiet and quiescent? Does he need to run, jump,
and use his whole body in order to feel good?
Raising your Spirited Child: Mary Sheedy Kurcinka
Kids First Saskatchewan November 2010
FIRST REACTION
What is your child’s first reaction when
she is asked to meet people, try a new
activity or idea,or go someplace new?
MOOD
How much of the time does your child feel
happy and content compared with
serious, analytical, or cranky?
Kids First Saskatchewan November 2010
TEMPERAMENT CONSTELLATIONS
EASY
DIFFICULT
SLOW TO WARM
Kids First Saskatchewan November 2010
GOODNESS OF FIT
Healthy functioning and development
occurs when there is a goodness of fit
(compatibility) between the capacities and
characteristics of the individual and the
demands and expectations of the
environment.
Kids First Saskatchewan November 2010
Thomas and Chess
TODDLERS CREED







If I want it ,it’s mine
If I give it to you, and change my mind
later, it’s mine
If I had it a little while ago, it’s mine
If it’s mine it will never belong to
anyone else, no matter what.
If we are building something together,
all the pieces are mine.
If it looks like mine, it is mine
If it breaks, it’s yours
Kids First Saskatchewan November 2010
00-046
Evening Cortisol Levels Increase with
Months of Orphanage Rearing *
-0.2
-0.4
-0.6
-0.8
*linear trendline
-1
-1.2
0
10
20
30
40
Kids First
November 2010Rearing
Months
ofSaskatchewan
Orphanage
50
05-046
The Founders’ Network
Secure Attachment Buffers
Cortisol Response to Threatening Events
Change in Salivary Cortisol
0.35
0.3
0.25
Secure Attachment
Insecure Attachment
0.2
0.15
0.1
0.05
0
-0.05
-0.1
HIGH
LOW
Kids First Saskatchewan November 2010
Fearful Responses to Stimuli
Gunnar (1996).
02-050
Development and Cortisol Levels
1.3
Low SES
Medium SES
High SES
1.1
0.9
0.7
0.5
6
8
Age
Kids First Saskatchewan November 2010
10
05-047
Children in Poorer Quality Childcare
Show Rises in Cortisol Over the Day
Quality of Childcare
2.0
1.0
0.0
-1.0
-0.4
-0.2
0.0
Kids First Saskatchewan November 2010
Rise in Cortisol
0.2
0.4
Dettling (2000).
05-063
Averaged Cortisol (log10)
Daycare Quality & Cortisol Levels
(Individual
Needs)
0.6
Unsatisfactory
0.5
High Quality
Satisfactory
0.4
AM
Kids First Saskatchewan
November 2010
Time
of Sampling
PM
Sims et al. 2005.
05-064
Averaged Cortisol (log10)
Daycare Quality & Cortisol Levels
(Treat
Equitably)
0.6
Unsatisfactory
0.5
High Quality
Satisfactory
0.4
AM
Kids First Saskatchewan
November 2010
Time
of Sampling
PM
Sims et al. 2005.
00-045
Cortisol Levels in Romanian Adopted
Children 6 Years Post Adoption
Adopted < 4 months
in orphanage
Adopted > 8 months
in orphanage
Canadian Control
1
0.8
0.6
0.4
0.2
0
AM
Noon
Kids First Saskatchewan November 2010
PM
Dr Megan Gunnar
Social Relationships control cortisol levels
in infants and young children.
 Children with secure attachments to their
caregivers show stable cortisol levels.
 The key ingredient to buffering stress is
sensitive, responsive, individualized care.
 It’s not separation from parents, but the
experience in child care that triggers their
stress responses.

Kids First Saskatchewan November 2010
Research on Quality
Treating children with respect
Developing relationships with
families
Ensuring programmes focus on
children feeling safe
“
Kids First Saskatchewan November 2010
Hutchins and SIMS 2000
Research on Quality
 Meeting
the individual needs of children
 Ensuring
staff remain in their positions
long enough to be able to develop and
maintain relationships with children
All of these dimensions of quality are
fundamental to developing and
maintaining strong relationships between
caregivers and children “(Hutchins &
Sims, 2000).
“
Kids First Saskatchewan November 2010
Floor Time
Stanley Greenspan’s Model
Functional Emotional Scale
Kids First Saskatchewan November 2010
Rates of Return to Human Development
03-074
Investment Across all Ages
8
6
Pre-school Programs
Return
Per
$
4
Invested
School
R
Job Training
2
PreSchool
0
6
School
Post School
Kids First Saskatchewan November 2010
18
Age
Carneiro, Heckman, Human Capital Policy, 2003
97-044
The Mismatch Between Opportunity
and Investment
Brain's "Malleability"
Spending on Health,
Education and Welfare
0
3
10
Age
Kids First Saskatchewan November 2010
70
Impact on Health
Kids First Saskatchewan November 2010
04-006
ECD Swedish Longitudinal Study and Adult Health
Number of Adverse ECD Circumstances*
0
Adult Health
1
2
3
4
Odds - Ratios
General Physical
1
1.39
1.54
2.08
2.66
Circulatory
1
1.56
1.53
2.91
7.76
Mental
1
1.78
2.05
3.76 10.27
* Economic, family size, broken family and family dissention
Kids First Saskatchewan November 2010
Lundberg, Soc. Sci. Med, Vol. 36, No. 8, 1993
Life Course Problems Related to
Early Life
2nd
Decade
• School Failure
3rd/4th
Decade
• Obesity
5th/6th
Decade
Old Age
• Coronary Heart • Premature
Disease
Aging
• Teen Pregnancy • Elevated Blood
Pressure
• Diabetes
• Criminality
• Depression
Kids First Saskatchewan November 2010
• Memory Loss
Risk Factors for Adult Heart Disease are
Embedded in Adverse Childhood
Experiences
Odds Ratio
3.5
3
2.5
2
1.5
1
0.5
0
1
2
3
4
5,6
7,8
Kids First Saskatchewan November 2010
ACEs
Source: Dong et al, 2004
Kids First Saskatchewan November 2010
SCENARIOS

What we THINK….

Affects what we FEEL…

Affects how we ACT….
Kids First Saskatchewan November 2010
112
“The Power of One”
Collected all together is
Massive
Kids First Saskatchewan November 2010
Kids First Saskatchewan November 2010