By Jim Dwyer
May 3, 2016
The human brain begins as a neural tube that develops five weeks after conception. Years later, it is fully formed. On Tuesday, experts in neuroscience, genetics and social work met in Manhattan to talk about what can happen to it along the way, and what emerging research tells us about how children who seem broken can be made whole.
Officially, the meeting was called Poverty, the Brain and Mental Health. It could have been called This Is Your Brain on Poverty. Or: Don’t Give Up on Little Kids.
For some children, living in poverty is like playing football without a helmet; everyday life causes social concussions. The developing brain gets hammered not by linebackers, but by the stresses often present in homes where people are poor. Brute force is not required to cause physical changes in the brain, emerging science shows.
“There’s no doubt that the field of public health has been slow to embrace much of this research and insight,” Dr. Mary T. Bassett, New York City’s health commissioner, said. “A lot more work has been committed to helping infants survive early death. Less has been done to truly help them thrive.”
How does stress reshape the brain?
It sets off the release of a hormone called cortisol, essential to the “fight or flight” response, and critical to a child’s healthy development, Dr. Bassett said.
Some children are exposed to multiple, chronic stresses: neglect, abuse, maternal depression, parental discord, crime and other domestic dysfunctions. In response, cortisol levels rise and stay high, said Margaret Crotty, executive director of the Partnership With Children and an organizer of the meeting. One analogy: like revving a car engine too fast, for too long.
Too much cortisol changes two parts of the brain, Ms. Crotty said: “One is your prefrontal lobe in the front of your brain. That’s how you develop executive functions — negotiating with people, telling the difference between good and bad, thinking about the consequences of your actions, your social behaviors in a classroom. Literally, how you behave.”
The other area, she said, is the hippocampus, deeper in the brain, which is central to creating memories of fact. “The things you can declare and verbalize,” Ms. Crotty said. “Pretty important to school.”
Her organization provides social services in the city’s schools. “You’d be amazed at how many kids are suffering from not having an alarm clock,” she said. “In one of our schools, 47 percent of the kids are living in shelters within walking distances of the schools. There was one child who was consistently late and finally just stopped coming to school. We went there; what was happening? Well, the mother’s cellphone was stolen, and she couldn’t afford to get another one. Who’s she going to tell that to?”
Two decades ago, doctors and researchers in California studied the effects of home lives that included abuse, neglect and dysfunction in childhood on the health of 17,421 adults. It was called the Adverse Childhood Experiencesstudy; the stress factors were called Aces. The more factors children had, the more likely that disease and mental health problems would emerge when they were adults. It is considered a landmark piece of research, and its findings have stood up, Dr. Bassett said.
Research in the field of epigenetics, the study of how genes and the environment interact, has explained some of the responses that cause trouble, said Dr. Frances Champagne, an associate professor of psychology at Columbia University. Early-life stress turns on genes that overreact to stress.
At the same time, Dr. Champagne said, “those genes that help us, to buffer us, from the effects of stress are epigenetically silenced.”
She and others said in the meeting, which was held at the American Museum of Natural History, that evidence showed the brain’s ability to adapt meant that children and even older people were not doomed by biology and environment. Dr. Bassett said stresses were risk factors, and that city policies like universal prekindergarten were based on research that showed they did not have to define a child’s future.
Outside the home, children can build resilience by forming caring, consistent relationships with adults, Ms. Crotty said. “That’s how your cortisol levels drop,” she added.
Renée Wilson-Simmons, director of the National Center for Children in Poverty at Columbia’s Mailman School of Public Health, said a proverb could sum up the wisdom in the research.
“Work the clay,” she said, “while it’s soft.”