Pathways to Peace and Violence Prevention: The Transformative Power of Children and Families James F. Leckman, MD, PhD Neison Harris Professor of Child Psychiatry, Psychology and Pediatrics

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Disclosures Research funding: NIH (R01, R25, T32), Tourette Syndrome Association, Grifols (formerly Talecris); UNICEF UBS Optimus; The Open Road Alliance Royalties: McGraw Hill, John Wiley & Sons, Oxford University Press Philanthropy: Associates of the Child Study Center, AÇEV, Fetzer Institute, Fondazione Child, Gates Foundation SLIDE 2

Perspective We are all interconnected in our ever changing world Neural Circuits

Cosmic Dark Matter & Energy

Social Networks

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Perspectives "If we are to teach real peace in this world, and if we are to carry on a real war against war, we shall have to begin with the children…. You must be the change you wish to see in the world. —Mahatma Ghandi (1869–1948) There can be no keener revelation of a society’s soul than the way in which it treats its children. Education is the most powerful weapon which you can use to change the world. —Nelson Mandela (1918–2013) SLIDE 4

Exposure to Violence For many children this is sad reality is compounded by the situations of migration, war and conflict and extreme violence to which families are exposed.

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Refugee Crisis - EMERGENCY

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Exposure to Violence Across the Globe The exposure of children to violence is a uniquely traumatic experience that has the potential to profoundly derail the child’s security, health, happiness, and ability to grow and learn — with effects lasting well into adulthood. June 2012 SLIDE 7

Violence can become self perpetuating

June 2012

Sadly, exposure to violence at an early age can be extremely detrimental to a child’s development and is causally related to a broad range of negative outcomes across a lifespan, including major emotional and behavioral problems. Indeed, to varying degrees, violence can become self-perpetuating (Fang & Corso, 2007; Fatori et al., 2013). SLIDE 8

A Question What are some of the reasons violence can become self perpetuating?

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Early Childhood Matters !  In the 1st year of life, the brain grows at the pace of 700-1000 new neural connections per second, a pace that is never achieved again. !  By age 3, a child brain is twice as active as an adult brain. !  It is early life experiences that determine the capacity of the brain – it structure and function. S L I D E 10

Adverse Childhood Experiences Adolescent and adult social behavior are shaped by early experience. Poor nutrition, exposure to violence, neglect, abuse, and other forms of dysfunction in the home before conception, prenatally and through early life can negatively impact brain structure and function, our hormonal (oxytocin – vasopressin), and immune system, and even how our DNA is read and transcribed! These alterations impact sensory systems and neural connections, and stress response circuits.

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Microglia Neuron, 2012

Arnold & Betsholtz, 2013

Microglia are critical for the sculpting of neuronal connectivity in the developing brain. They eliminate excess functional connections between neurons to sculpt neural circuits through synaptic pruning. S L I D E 12

Neural-Immune Cross-Talk

Estes & McAllister, Science, 2016 S L I D E 13

Microglia Microglia are the resident macrophages of the CNS. They also eliminate excess functional connections between neurons to sculpt neuronal circuits during development and throughout adulthood. Understanding how microglia recognize and prune synapses during development is providing insight into the neurobiology of toxic stress. Rakic, 2011 S L I D E 14

Epigenetics The Crucial Importance of the Nature of Early Caregiving Individual differences in parental behavior matter and can be transmitted across generations

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Transformative Potential Parental behavior as a key determinant of behavioral plasticity in the offspring

Parental care

Epigenetic marks

Gene expression

Parenting begets parenting

Francis et al., Science, 1999 S L I D E 16

Epigenetics Epigenetics refers to the study of changes in the regulation of gene activity and expression that are not dependent on gene DNA sequence.

Three Main Components

•  DNA methylation

• 

Histone modifications

•  Alterations of micro-RNA transcription S L I D E 17

Perspective Patterns of early caregiving matter

Parenting begets parenting

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Parenting Begets Parenting Sadly, poor parenting and early exposure to violence are associated with epigenetic alterations that may have negative transgenerational consequences. In contrast, early interventions to strengthen families and reduce violence exposures will likely improve the cognitive and socio-emotional well-being of children and will, in turn, have positive transgenerational consequences. S L I D E 19

The Question What is the best way to prevent violence and build a more peaceful world?

MIT Press, 2014 S L I D E 20

The Answer Invest in Early Child Development Programs that help parents become more responsive to their children and for their children to become more securely attached to them S L I D E 21

Responsive Parenting Responsive Parenting occurs when parents (Mothers and Fathers and other caregivers) do their best to invest in their children and meet their emotional, cognitive, nutritional, and physical needs during gestation and the early years. S L I D E 22

So What Programs Work? Prenatal

first 2 years

Ø  Nurse Family Partnership Ø  Minding the Baby

Pre-School Ø  High/Scope Perry Program, Abecedarian (ABC) Project, Chicago Longitudinal Study Ø  Turkish Programs: Mother Child Education Program (MOCEP), Mother Support Program and the Father Support Program Ø  Supporting Fathers Involvement S L I D E 23

Early Childhood Matters •  A large number of parenting programs have been developed across the globe - ranging from home visitation programs starting during pregnancy to working with groups of parents of preschool children. •  Only a few programs have been rigorously assessed and almost all of these have been in High Income Countries. •  Multi-sectorial partnerships (families, providers, governmental agencies, NGOs) are key to developing sustainable programs of proven value.

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Better Brains and Bodies Early Childhood Programs programs aimed at enhancing responsive parenting can reduce adverse childhood experiences (poor nutrition, neglect, abuse, and other forms of dysfunction in the home) can positively impact brain structure and function, our hormonal and immune systems, and how our DNA is read and transcribed!

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Oxytocin System Oxytocin and vasopressin are synthesized and released from the hypothalamus, and are key elements in the neurobiology of affiliation. OT is also produced in the heart, thymus, GI tract, & reproductive organs. Peripheral measures of OT are individually stable and associated with dyadic parent-child relationships

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Better Brains and Bodies From Generation to Generation… Oxytocin system interacts with the reward, stress response, sensory, and reproductive pathways Rilling & Young, Science, 2014 S L I D E 27

Parent-Child Bonding

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Parent-Child Bonding

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Stress Response

Bonding

CorticotropinReleasing Factor (CRF) Cortisol Oxytocin

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A Sad Reality

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A Sad Reality Sadly, the media’s tendency to report and track frightening events often magnifies and reinforces this tendency. As a result, members of ‘other’ groups are regarded with a negative bias of suspicion and fear based solely on their ethnic, religious, racial, or national identity. This evolutionarily conserved tendency is intensified during conflict and can be difficult to counteract. S L I D E 32

The Media Matters

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Early Childhood Matters

June 2012 Wessels et al., 2013 S L I D E 34

Moving Forward •  Ernst Strüngmann Forum •  Early Childhood Peace Consortium •  UN’s 2030 Sustainable Development Goals - THE LANCET series on ECD •  The need for us to take action at global, national, and local levels S L I D E 35

Ernst Strüngmann Forum

MIT Press, 2014

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Early Childhood Peace Consortium

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Early Childhood Peace Consortium The launch of Early Childhood Peace Consortium in September 2013 at the UN in New York brought together over 140 partners from multiple sectors (including civil society, the social and mass media (Sesame Workshop), government officials, multi and bilateral agencies, as well as practitioners and academia), agencies and countries to “create a legacy of sustained peace drawing on the transformative power of early child development” S L I D E 38

The UN’s 2030 SDGs & ECD

October 2016

September 2015

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The UN’s 2030 SDGs & ECD ECD: the foundation of sustainable development

September 2015

Goal 1: Eradicate poverty Early childhood development interventions increase adult productivity and income, and reduce inequities. Goal 2: End hunger and improve nutritionInterventions to promote nurturing care help to improve young children’s growth and development. S L I D E 40

The UN’s 2030 SDGs & ECD ECD: the foundation of sustainable development

September 2015

Goal 3: Ensure healthy livesSupporting ECD increases quality of home care practices, protects against stress, and reduces risks of chronic disease and improves mental ill health in adulthood. Goal 4: Ensure lifelong learning - Early stimulation increases duration of schooling, school performance, and adult income. S L I D E 41

The UN’s 2030 SDGs & ECD ECD: the foundation of sustainable development

September 2015

Goal 5: Achieve gender equality ECD interventions improve motivation and opportunities for learning for girls, so that they can benefit equally from schooling and enter the job market Goal 10: Reduce inequality in and among countries - Early childhood stimulation and food supplementation will enable children living in extreme poverty, to attain outcomes similar to their peers. S L I D E 42

The UN’s 2030 SDGs & ECD ECD: the foundation of sustainable development

September 2015

Goal 16: Promote peaceful societies - Children who are well nourished and secure have enhanced coping strategies, even in conditions of severe adversity. Goal 17: Strengthen the means of implementation - ECD interventions have the potential to strengthen coordination across sectors to achieve common health, social, and economic goals, and to bring together civil society and governmental partners. S L I D E 43

Take Home Message • Children’s early development requires

Nurturing Care - responsive caregiving, opportunities for early learning as well as efforts to ensure the health, nutrition, and the security and safety of the child. • Coordination, monitoring, and evaluation are needed across sectors to ensure that high quality ECD services are available throughout early childhood and primary school, up to the age of 8 years. S L I D E 44

Take Home Message We need to take action to make our world a better place for our children and for future generations Next steps include a commitment to refine, adapt, and implement in a sustainable fashion responsive parenting programs of proven value across the globe S L I D E 45

Take Home Message Action at global, national, and local levels is needed to increase political commitment to and investment in early childhood development. Journalists and the media can play a crucial role in communicating with policy-makers and society as a whole! S L I D E 46

Thank you ! S L I D E 47

Theory of Change Peace-relevant ECD Sectoral Policies & Institutional Competencies Peacebuilding -informed ECD policies & Highquality Programs with equitable design and implementation

Redistribution, Recognition, Representation, Reconciliation

Peace-relevant skills

Option 5 for visual

Strengthened

Social Cohesion vertical & horizontal

Child & family levels

Holistic Child & Family Development Physical & mental health, safety, nutrition, growth, learning,

Increased & Sustainable Opportunities for Economic Development

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Next Steps - Lebanon Goal: To reduce violence through the promotion of harmonious family relationships in refugee camps and other fragile settings Setting: In Lebanon alone, nearly 230,000 Palestinians live in refugee camps. Conditions in the camps lead to increased harsh punishment, negative intra-family relationships and violence in homes and communities. Adverse effects of this environment are particularly profound for children. Partners: In refugee camps, a local NGO, Arab Resource Collective is implementing the MOCEP 25-week curriculum program for mothers of children (4-6 years of age) focusing on strengthening child well-being and family relationships. S L I D E 49

Next Steps - Brazil National Initiative to Prevent Violence in Brazil through early Parent-Child Interventions and Programs for Street Children: •  •  •  •  •  • 

Minding the Baby Expanded Janelas de Oportunidade Equilibrium Project São Paulo Carinhosa Project Mother & Father Support Programs AÇEV replication (Gates Foundation)

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