Early intervention Chow Chun Bong Early life experiences
Early intervention 早期培育 Chow Chun Bong 周鎮邦
"Early life experiences have disproportionate importance in organizing the mature brain and are directly connected to children's optimal development. " B. D. Perry, M. D. from: Incubated in Terror: Neurodevelopmental Factors in the ‘Cycle of Violence’, " Children, Youth and Violence: Searching for Solutions The quality of caring a child receives in the first three years of life is the single most important factor other than genetics influencing that child's development. Paul. D. Steinhauer, M. D, Chair, Voices for Children from: Kaleidoscope Magazine, Hospital for Sick Children "The interest in ‘early education as prevention' is coming from those in industry who are concerned about the quality of the future work force, from families searching for adequate child care, and from private citizens who are concerned about the quality of life. " D. P. Weikart, from: Early Childhood Education and Primary Prevention, Prevention in Human Services
Summary 簡介 ¡ Early child development – From neuron to neighbourhoods兒童的早期發展 ¡ Early intervention 早期干預的成效 ¡ Examples 例子 Down syndrome 唐氏綜合症 VLBW 早產兒
From Neurons to Neighborhoods: The Science of Early Childhood Development 由腦細胞到鄰舍 – 兒童早期發展的科學 Committee on Integrating the Science of Early Childhood Development Board on Children, Youth, and Families Institute of Medicine National Research Council October, 2000
Putting the Study in Context ¡ Explosion of knowledge in neurobiology and the behavioral and social sciences ¡ Marked variations in the social and economic circumstances under which families are raising young children throughout the world ¡ At a time when scientific advances could be used to strengthen early childhood policies and practices, if knowledge is dismissed or ignored children suffer the consequences • 近年在腦神經 科,行為及社會 研究方面得到重 大發展 • 如果不能好好 應用此等成果, 兒童的未來將會 受到影響
CONCLUSIONS 結論
Core Concepts of Development Human development is shaped by a dynamic and continuous interaction between biology and experience. 人類發展是通過生理和經驗不斷互動、互相影響下成長的。 Culture influences every aspect of human development and is reflected in childrearing beliefs and practices designed to promote healthy adaptation. 育兒文化和信念對各方面的成長都有重要的影響. The growth of self-regulation is a cornerstone of early childhood development that cuts across all domains of behavior. 自我調適的成長是兒童成長的碁石 Children are active participants in their own development, reflecting the intrinsic human drive to explore and master one‘s environment. 兒童本身是自己發展的積極參與及推動者. Human relationship‘s and the effect of relationships on relationships, are the building blocks of healthy human development. 人與人之間的相互關係是健康成長的基礎.
¡ The broad range of individual differences among children often makes it difficult to distinguish typical variations and maturational delays from transient disorders and persistent impairments. ¡ The development of young children unfolds along individual development pathways whose trajectories are characterized by continuities and discontinuities, as well as by a series of significant transitions. ¡ The development of young children is shaped by the ongoing interplay among sources of vulnerability and sources of resilience. ¡ The timing of early experiences can matter, but, more often than not, the developing child remains vulnerable to risks and open to protective influences throughout the early years of life and into adulthood. ¡ The course of development can be altered in early childhood effective interventions that change the balance between risk and protection, thereby shifting the odds in favor of more adaptive outcomes.
Panel Conclusions 結論 ¡ The traditional nature versus nurture debate is simplistic and scientifically obsolete ¡ Environmental influences clearly affect brain development, beginning well before birth and continuing long into adulthood ¡ Early intervention programs can improve the odds for vulnerable children, but those that work are rarely simple, inexpensive, or easy to implement 傳統的先天對後天的 理論己不合時宜。 後天環境明顯影晌腦 部展 – 早在胎兒時期 開始直致成年。 早期訓練可以改善高 危兒童的機會,但通 常都是複雜,昂貴和 不易實施的。
Panel Conclusions 結論 ¡ How young children feel is as important as how they think, particularly with regard to their readiness for school ¡ Healthy early development depends on nurturing and dependable relationships ¡ Culture influences all aspects of early development through child-rearing beliefs and practices n幼兒的感覺和思 考同樣重要 n 健康的早期發 展依賴培育和穩 定可靠的關係 n 文化會透過育 兒信念和行動影 響兒童各方面的 發展
Panel Conclusions 結論 ¡ There is little scientific evidence that special “stimulation” activities, above and beyond normal growthpromoting experiences, lead to “advanced” brain development in early childhood ¡ Substantial scientific evidence indicates that poor nutrition, specific infections, environmental neurotoxins, drug exposures, and chronic stress can harm the developing brain ¡ Significant parent mental health problems, substance abuse, and family violence impose heavy developmental burdens on young children n全無證據顯示”特殊 刺激”活動可促進腦部 發展 n很多證據顯示營養不 良,特別感染,藥物和 長期受壓可以傷害腦部 發展 n父/母患有精神病,濫 用藥物和家庭暴力對兒 童發展有嚴重傷害
A CRITICAL PERSPECTIVE ON THE SCIENCE OF EARLY CHILDHOOD INTERVENTION
Essential Features of Effective Interventions 有效干預的特質 ¡ Individualization of service delivery ¡ Quality of program implementation Provider knowledge, skills, and relationship with the family ¡ Family-centered, community-based, coordinated orientation Timing, intensity, and duration of intervention n個人的 n優質的 n員 的知識,技巧 和與家庭的關係 n以家庭為中心,基 於社區和協調的 n時刻,密度和時間
Persistent Challenges Facing The Field of Early Childhood Intervention 早期培育的挑戰 ¡ Increasing access and ¡ ¡ ¡ participation Ensuring greater quality control Defining and achieving cultural competence Identifying and responding to the special needs of distinctive subgroups Influencing and assessing the impacts of post-intervention environments Reducing fragmentation and strengthening the service infrastructure Assessing costs and making choices among early childhood investments n更多的參與 n文化的保育 n適當回應特殊需要 n質素的保持 n改善干預後家庭周遭 環境 n減少服務分割和加強 服務的機能 n效益評估及多樣化
How do children develop? 兒童如何發展 ¡ To encourage children’s best ¡ ¡ development, we need to understand the various ways they grow. Children‘s physical development includes learning large muscle skills like jumping and running, and small muscle skills like cutting and pasting. Intellectual development involves children‘s increasing ability to think and solve problems Emotional development is about learning to experience, identify, express and control feelings. Social development means learning how to relate to others §體能發展 – 大肌肉 : 跑 , 跳. 小肌肉 : 剪 , 貼 §智能發展 – 學習思 考和如何解決問題. §情緒發展 -學習 , 體驗, 認知 , 表達和 控制感覺 §社交發展 -學習如 何與人相處.
What do children need for healthy development? 健康成長的原素 ¡ To thrive, children need a healthy physical start, enough to eat, and warmth and affection. 。 ¡ To help their intellectual development they need a safe and stimulating environment where they can play, learn and explore. ¡ They need encouragement and guidance from adults. §健康的開始 – 食物,溫暖和愛 護 §安全,多采多 姿的環境去學習, 遊玩,探索。 § 鼓勵,輔導。
Why are the early years so important? 早年經驗的重要性 ¡ The earlier children experience good care, the longer their developmental gains last. ¡ Early childhood experiences have powerful effects on the development of children‘s physical and emotional abilities and influence their abilities in math, logic, language and music. New research indicates that infant brain development during the first years of life depends on that infant’s environmental experience. ¡ The brain develops according to the quantity and quality of the stimuli it receives Daily exercise increases nerve connections in the brain. This makes it easier for children to learn. ¡ 早期培育對長期發展 非常重要 ¡ 早期經驗對兒童的各 種能力發展有重要影 響 ¡ 兒童腦部的發展和他 們的早年經驗有重要 關係 ¡ 腦部發展依賴早年經 歷的質量和質素 ¡ 每天運動增加腦部聯 系,增強學習能力
早年經驗的重要性 ¡ development when it is especially ¡ ¡ 學習臨界 增加小孩的詞彙 從小教導數學理念 可增加長大後的數 學技巧 音樂培訓可爭強小 孩思考和做決定的 能力 早年形成的行為模 式將持久很難改變 open to certain kinds of learning. ¡ The more words a child hears by age two, the larger his/her ¡ vocabulary will grow. Research indicates that toddlers ¡ taught simple math ideas, like bigger or smaller, and more or less, do better in math when they are older. Early music lessons help develop skills which later improve a child’s ability to think things through and ¡ make decisions. The brain continues to develop and mature in many areas, but patterns of behaviour and emotional response set in the early years are very difficult to change or make up ¡ for in other ways.
¡ Sensitive parenting—not educational toys or Mozart CDs— provides the essential catalysts for early intellectual growth. ¡ Language enables children to put their developing ideas and concepts into words they can share with others, and language revolutionizes thought by giving children access to the concepts, ideas, and values of other people. ¡ Nothing focuses a young child’s attention on what other people are thinking or feeling more than the realization that a conflict must be resolved ¡ The irreducible core of the environment during early development is people ¡ 對幼兒的成長最重 要不是玩具或音樂, 最重要的是關切和 愛護的親子養育 ¡ 語言可幫助孩子把 思考和理念表達出 來。語言亦可幫助 孩子理解他人的理 念。 ¡ 糾紛對孩子有嚴重 影響。要適當解決 糾紛。 ¡ 家庭成員是兒童成 長的核心。
Need for Comparable Attention to Cognitive, Emotional and Social Developmental Needs 同樣重視思維,情緒和社交發展 ¡ Early childhood programs must balance the focus on cognition and literacy skills with comparable attention to the emotional and social development of all children, including those with special needs ¡ Greater commitments must be made to address significant developmental disabilities, including serious mental health problems, in young children by establishing clear linkages among primary health care, early education programs, and early childhood intervention services • 早期培育計劃必須平 衡思考、讀算技巧和 情緒、社交發展的培 訓,這對有特殊需要 者尤為重要 • 必須重視有嚴重傷殘 幼兒的問題(尤其患有 行為/精神問題) – 使得 基本醫療、早期教育 和早期教育服務有緊 密聯系。
What are the effects of high quality child care? 高質素幼兒培育的好處 ¡ High quality child care and early childhood education can improve children’s chances for success in later life. ¡ The care that children receive in the early years influences whether or not they will succeed when they begin school. ¡ Children who do not get good care when their parents are not available have decreased language and social skills. ¡ Readiness to learn in kindergarten is the best indicator that children will do well in school. The care that children receive helps them to: understand use language 明白和應用語言 control aggression 控制情緒 play and work with other children 交朋結友 accept adult direction 接受意見 focus attention and do things independently. 集中精神,獨立做事
Why should we care that all children get the best care? ¡ The social and learning skills children need for success in school and work begin to develop in early childhood ¡ Several studies show that good preschool programs can improve how children do in school, especially children who face such disadvantages as poverty, poor housing and food, parents with mental illness or other problems. ¡ Good early child care can reduce later anti-social behaviour, delinquency and crime. Recent research links troublemaking behaviour in young boys with later anti-social behaviour. It has found that good early education programs have a strong, long-term impact on decreasing anti-social behaviour in teenage boys. ¡ 很多社交,學習技 巧在兒童早年時期 已經開始發展 ¡ 優質的學前教育可 促進學習能力 ¡ 良好的早年培育可 減少青少年期的反 叛和犯罪行為
Why is high quality child care a good investment? ¡ The benefits from early childhood care and education programs far exceed their cost. ¡ A four year Swedish study found that children entering daycare at an early age did a number of important learning and social tasks significantly better than children who were older when they started daycare. ¡ Money spent on Head Start early education programs in the United States has decreased the need for spending on special education, welfare, teen pregnancy, delinquency and crime. ¡早期培育的成效遠 超過它的成本 ¡一瑞典研究證明幼 兒教育可增強學習 能力 ¡美國研究也顯示幼 兒教育可減少特殊 教育及其他的經費
Programme design 成功的設計 積極專業; 早期開始; 高質素 – 幼兒對老師比例, 課程; 父母的參與; 以兒童為中心 ¡ Intensity of service ¡ Onset and duration ¡ Quality - program quality depends on small group sizes, high ratios of staff to children, trained and well-supervised teachers, and developmentally appropriate curricula. ¡ Child focused and involving parents
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