PAT LEVITT, PH.D.

1. Lessons Learned by a Basic Scientist: How To Succeed in Business (of the Policy World) without really trying • PAT LEVITT, PH.D. • ANNETTE SCHAFFER ESKIND CHAIR, VANDERBILT KENNEDY CENTER FOR RESEARCH ON HUMAN DEVELOPMENT • DIRECTOR, ZILKHA NEUROGENETIC INSTITUTE, KECK SCHOOL OF MEDICINE OF USC, CHAIRMAN, DEPT. CELL & NEUROBIOLOGY, PROVOST PROFESSOR OF NEUROSCIENCE, PSYCHIATRY & PHARMACY • MEMBER, NATIONAL SCIENTIFIC COUNCIL ON THE DEVELOPING CHILD

2. The Mismatch Between Opportunity and Investment Brain's "Malleability" Spending on Health, Education and Welfare 0 3 10 70 Age

3. Rates of Return to Human Development Investment Across all Ages 8 6 Pre-school Programs Return Per $ Invested School 4 R Job Training 2 Pre- School School Post School 0 6 18 Age Carneiro, Heckman, Human Capital Policy, 2003

4. Susan Bales, M.A. The Child Development Challenge: Translating Science for Public Understanding

5. Perceived Public Support is a Strong Influence on Policymaker Behavior “If we could find a way to deal with 70 percent of people that are not the 15 on the left and not the 15 on the right that believe no matter what the information is, they're ready. If we can find a way to get that other 70 percent informed and activated, that would solve a lot of problems right away because I don't care whether you're a right wing politician or a left wing politician, when you go to your primary election [you listen].” “Objectively, you do the right amount of education, do the right amount of meeting and greeting and everything else. That ain't what it's about. It's about where the political will is and how much passion there is around the issue by a wide enough audience that these guys will say this train is going and I don't want to be off the train.” AZ Legislators

6. People are selfish, small-minded, uncaring Or, it’s a cognitive rather than a moral failure – they don’t understand what their responsibility could be Persuasive communications cannot depend on simply putting information in front of people, because when communications is inadequate, people default to the “pictures in their heads” Communications must change the lens through which they see the information When communications is effective, people can see an issue from a different perspective Why doesn’t the Public take responsibility for social problems?

7. How does the public think about a particular social or political issue? What is the public discourse on the issue? How does this dialogue influence and constrain public choices? How can an issue be framed to evoke a different way of thinking, one that illuminates alternative policy choices? The Questions We Ask

8. “Organizing principles that are socially shared and persistent over time, that work symbolically to meaningfully structure the social world.” Reese, Gandy and Grant, Framing Public Life. NJ: Lawrence Erlbaum, 2001. See also: Goffman, E. 1974. Frame Analysis: An Essay on the Organization of Experience. Cambridge: Harvard University Press. Tannen, D. (ed). 1993. Framing in Discourse. New York: Oxford University Press. Frames Are…

9. “We can define framing as the process of culling a few elements of perceived reality and assembling a narrative that highlights connections among them to promote a particular interpretation. Fully developed frames typically perform four functions: problem definition, causal analysis, moral judgment, and remedy promotion”. (Entman, 1993, 2004)

10. Values Visuals Messengers Context Numbers Metaphors Simplifying Models Stories Tone “Finding some familiar element causes us to activate the story that is labeled by that familiar element, and we understand the new story as if it were an exemplar of that old element.” “Understanding means finding a story you already know and saying, ‘Oh yeah, that one.” “Once we have found (the) story, we stop processing.” Roger C. Schank, “Tell Me A Story: Narrative and Intelligence,” Northwestern University Press, 1995. Where We Get Our Cues:Elements of the Frame

11. FrameWorks Research Base:Strategic Frame Analysis™ Voters • 30 focus groups in 15 states • 175 cognitive interviews in 9 states • 500 “talk back” interviews re: simplifying models • Experimental survey with 2,000 registered voters Legislators • 6 focus groups in 3 states • 40 cognitive interviews in 5 states Business leaders • 10 cognitive interviews • Experimental survey with 2,000 business owners Media • Content analysis of 11,000 local news stories

12. Fate Free will Parents Genes Environment What the Public Sees Regarding Child Development: The Black Box Successful child Black Box Unsuccessful child

13. Very Complicated Something about the brain Only for scientists Everything matters We turned out OK Momma knows best Bad parents Private not public issue Self-made Child Family Bubble Development is automatic Discipline = focus Stress is good for you Leave it alone Schools Hurried Child Fancy Parents Flash cards in cribs Opportunity Children = future Begins in school Safety Community = Predator Control and contain Physical = Focus

14. Families are Responsible “I think one parent at least in the first five years until they get to school ought to be at home because that sets the tone for the kids.” (Virginia man) “I think they absorb. Through three and five -- I know my son absorbs just everything that came around him. (New Jersey woman) Individuals are Responsible “The parents are so protective now compared to what they were 20, 30, 40 years ago…I did a lot of things on my own. When we played sports, there was no parental involvement. We didn't have to be ferried, driven to a place where we played. We were independent… I think this holds back the development of children.” (Boston man) Safety is the Main Concern “I guess you’re looking for clean and safe facilities, and the right number of staff per children, and you’re looking for activities that help the children grow intellectually rather than make sure they stand in line and be quiet.” (Virginia woman) ECD Focus Groups Default

15. Predominance of stories on crime and health In health stories, the dominant frame is child safety (e.g., seat belts) Only 13% of stories address systemic issues Only 3% look at development Dominant frame is “the imperiled child” or child as “precious object” UCLA Center for Communications and Community, Content analysis of local news, 11,000 stories, July 2000, 3 affiliates in 6 cities How the Media Frames Child Issues

16. Advocates Kids are very complex Everything counts Children are made for learning Infants become persons at a very early age The brain is not developed at birth Parenting is difficult Parents are teachers Parents are students Trained coaches are needed for parents All parents are good Parents are experts Experts "The ability to inhibit a response one is all set to perform, sometimes called effortful control, has been of special interest to researchers who seek to understand how individual differences in children's tendencies to respond to stressful or exciting events affect the growth of emotion regulation. Effortful control is one component of a larger set of inhibitory competencies, termed 'executive functions', discussed later..." N2N Veterans of Perceptions and Messaging

17. People have minimal access to a working model of child development. When considered at all, it is a closed private system. There are strong entrenched frames that get in the way of development: family autonomy, safety, individualism. The reframes currently in use – school readiness, etc. -- are not yielding the desired result. Some reframes – future, prosperity – have potential to move public opinion in right direction and prime school readiness for them. What Do We Know?

18. The Central Causal Story Emotional Development Social Development Interaction Brain Architecture Cognitive Development

19. The Core Story Child development is a foundation for community development and economic development, as capable children become the foundation of a prosperous and sustainable society (Prosperity). The basic architecture of the brain is constructed through an ongoing process that begins before birth and continues into adulthood (Brain Architecture). Brains are built from the bottom up (Skill Begets Skill). Interaction of genes and experience shapes the developing brain and relationships are the active ingredient in this Serve and Return process (Serve and Return).

20. Cognitive, emotional, and social capacities are inextricably intertwined, and learning, behavior and physical and mental health are inter-related over the life course (Can’t Do One). Toxic stress damages the developing brain and leads to problems in learning, behavior, and increased susceptibility to physical and mental illness over time (Toxic Stress). Brain plasticity and the ability to change behavior decrease over time and getting it right early is less costly, to society and individuals, than trying to fix it later (Pay Now).

21. To explain the science in such a way that it….. Redirects attention away from the default positions…. By identifying values and explanations that make the societal, not individual goals, obvious …… And by creating Simplifying Models that serve to explain how development works….. And explain the consequences of inaction….. And can be shown to attach to policy thinking The Reframing Challenge

22. A kind of metaphorical frame that both captures the essence of a scientific concept, and has a high capacity for spreading through a population. An explanation that reduces a complex problem to a simple, concrete analogy or metaphor contributes to understanding by helping people organize information into a clear picture in their heads, including facts and ideas previously learned but not organized in a coherent way. Once this analogical picture has been formed, it becomes the basis for new reasoning about the topic. See Dorothy Holland & Naomi Quinn, Cultural Models in Language and Thought, Cambridge University Press, 1987. What are Simplifying Models?

23. “the heart is a pump” “the eye is a camera” “the cell is a factory” “the kidney is a waste filter” “photosynthesis is like baking bread” “an electric circuit is like a water conduit” “the brain is a computer” Glynn et al. (1995), Teaching Science With Analogies: A Strategy For Constructing Knowledge, Learning Science in The Schools: Research Reforming Practice Analogies in the Science Classroom

24. Simplifying Model for ECD: Brain Architecture The early years of life matter because early experiences affect the architecture of the maturing brain. As it emerges, the quality of that architecture establishes either a sturdy or a fragile foundation for all of the development and behavior that follows --- and getting things right the first time is easier than trying to fix them later.

25. Early Experiences Influence Brain Architecture and Function

26. Extreme Early Experiences Can Dramatically Disrupt Brain Architecture 50 days: exposed to early noise 16 days 50 days Source: Chang & Merzenich (2003)

27. Exposure to PCBs During Development Can Disrupt Brain Architecture control PCB developmental exposure Source: Kennet et al. (2006)

28. 400 subjects passers-by in public settings (roughly 80) ads placed in local web sites (roughly 120) graduate and undergraduate students (roughly 100) help from local business leaders (Texas Program for Society and Health, James Baker Institute, Rice University) (roughly 100) broad diversity in terms of gender, ethnicity, age, and educational background; parents and nonparents Brain Architecture Model TestingRecruitment and Sample

29. Q: How does growing up in poverty affect a child’s school readiness? A: I would say in a lot of cases, I wouldn’t say in all cases, growing up in poverty would hinder them, but I guess in some cases it would hinder them, sort of being ready to get to school as knowing, I guess maybe kids who are not in poverty growing up do you have an advantage, as far as they probably know a little more when they do start school than children who are raised in poverty. Q: How does growing up in poverty affect brain architecture? A: I believe because you’re stressed a lot because you have a lot of stress; usually parents that do not make a lot of money are usually under a lot of stress, so that makes the child be under stress as well, also that would affect I guess the growth of the brain. Comparative Frame Effects

30. Interaction as Serve and Return Experts are learning more and more about how interactions with other people affect the development of babies’ brains. It turns out that healthy development of brain architecture depends a lot on a kind of interaction experts call Serve and Return, based on an analogy from games like tennis and volleyball. Serve and Return happens when young children instinctively reach out for interaction, through babbling, facial expressions, words, gestures, cries, etc. and adults respond by getting in sync and doing the same kind of babbling, gesturing, and so forth. Another important aspect of Serve and Return is that it works best with adults who are familiar to the child, like familiar partners. Young children need many of these interactions per day, since they are so critical development, and have effects on everything from the chemicals in the brain to physical structures and connections there.

31. Secure Relationships Calm Children’s Stress Hormone Response .3 Increase in Cortisol .2 .1 0 Secure Insecure Attachment Relationship -.1 Source: Nachmias et al. (1996)

32. Sensitive Care Calms Children’s Stress Hormone Response in Parent’s Absence .3 Increase in Cortisol .2 .1 0 High Low Sensitivity/Responsiveness of Caregiver -.1 Source: Nachmias et al. (1996)

33. Experience Affects Stress Response for a Lifetime! Stress Response Restraint Time Source: Meaney et al. (200?)

34. How is the influence of early experience maintained for a lifetime? In part, through ‘epigenetics’….. and it’s is really powerful

35. Early Experiences Can Transmit Across Generations Maternal diet change during pregnancy causes changes to offspring’sfur color, obesity, and cancer riskin genetically identical mice. Source: Jirtle & Skinner (2007)

36. CH3 CH3 CH3 CH3 Glucocorticoid receptor gene How Experience Influences Genes Stress Response Restraint Time Source: Meaney et al. (200?)

37. Important to development & in the context of stable and supportive relationships Potentially disruptive, but buffered by supportive relationships & safe environments Disrupts brain architecture, increases the risk of stress-related physical and mental illness Early Childhood Stress Influences Developmental Outcomes Positive Tolerable Toxic

38. Source: Pollok & Kistler (2002)

39. Extreme Neglect Diminishes Brain Power 3-5 Hz 6-9 Hz 10-18 Hz Institutionalized NeverInstitutionalized Source: C. Nelson (2008)

40. Persistent Stress Changes Brain Architecture Typical - neuron with many connections Normal Chronic stress Neuron damaged by toxic stress – fewer connections Prefrontal Cortex and Hippocampus Source: C. Nelson (2008) Bock et al Cer Cort 15:802 (2005)

41. Research Says that Remediation and Prevention ARE Possible

42. Early Intervention Remediates Early Adversity % Time Spent Self-Comforting Surrogate mother at 2 months 40% No surrogate mother Surrogate mother at 1 month 30% 20% 10% Normal 9 1 3 5 7 11 13 Monkey’s Age (months) Source: Knudsen et al. (2006)

43. Delayed Intervention Harms Development Bucharest Early Intervention Program Tested at 3 1/2 Years Old Tested at 4 1/2 Years Old 100 IQ/DQ (Mean) “normal” range 90 “normal” range 80 70 60 0-18 18-24 24-30 30+ 0-18 18-24 24-30 30+ Age of placement in foster care (months) Source: Nelson et al. (2007)

44. “I think what really gets me from the study is that it could actually have a chemical or biological or some sort of impact on the child’s brain. … Behavior is one thing, and attitude and personality is one thing, but if it can really negatively impact … the chemistry and the makeup of the brain – you can damage that that early – that’s really serious. That’s more than just having a bad personality, that’s really screwing up a kid.” Talk Back Informant Effects on Salience

45. Potential Advantages Unifies scientists’ messages Makes science understandable to public Easily remembered, and repeated Can teach about ECD without distorting Questions Remaining What must you include? But does it elevate policy thinking and preferences? Are all models equal? Does it overcome resistance to investment? What Have We Built?

46. The Core Story Framing Experiment Prosperity Pay Now Can’t Do One Skill Begets Skill Evaluation Science Brain Architecture Effectiveness Factors 1100/4000 subjects, June 2007

47. Frame Effects from Experimental Survey June 2007: Exposure to any part of the core story enhances policy support Can’t Do One has the greatest effect Prosperity/Pay Now has next greatest effect Men and people who placed a low priority on child well-being were most affected Models are most powerful when aligned with principles, not asymmetric Conventional wisdom about frame effects should be questioned: business leaders responded more robustly to a developmental frame than a “just the facts” frame Effects of Core Story

48. If our society is to prosper in the future, we will need to make sure that all children have the opportunity to develop intellectually, socially and If emotionally. VALUE But science tells us that many children’s futures are undermined when stress damages the early brain architecture. That stress may result from family tensions over a lost job or death in the family. That stress makes babies’ brains release a chemical that stunts cell growth.SCIENCE When communities make family mental health services available so that early interventions can take place, they put in place a preventive system that catches children before they fall. SOLUTION Putting It All Together….

49. Closing the Gap – Using What We Know To Inform What We Do Factors that Influence Policy Decisions Strategies to Affect Public Policy • Develop simplifying frames of factors that • impact child development • (Drugs; Toxic Stress; Nutrition; Genes; Relationships) Public/Media Perception (free will; legality; excesses) PRENATAL & EARLY CHILDHOOD PROGRAMS What Science Tells Us (maternal health; fetal:maternal interactions; environment of relationshps brain architecture & chemistry) • Develop key working partnerships • (National Conference of State Legislatures; • Childhood-Focused Private Foundations) • Engage scientists in providing impartial testimony– • (“What science tells us”; “Just the facts”) • Scientists must do more work with print and video media – • (Tell a core story) Policy Makers (public perception; family bubble; child welfare)

50. Legislative successes….it’s personal!