The foundation of children’s development in the first thousand days, the doctor says – 03/09/2022 – Equilíbrio e Saúde

What determines the healthy development of a person? An important part of that answer is the first thousand days or three years of life.

At this crucial time, the foundation for complete cognitive and emotional development is formed from relationships with parents and caregivers and the stimulation that the child receives. Genetics, food, microbiota and environmental stress also come into account.

To identify and predict exactly which factors are in favor of good development and which are risk factors, 15 different research teams from USP (University of Sওo Paulo) have teamed up and created the Germina project, which will monitor 500 babies from three months of life. Three years.

“Our results could even help develop public policy. If we can predict that any children will be at risk, we will be able to offer programs for better development,” said Guilherm Polankzic, associate professor of child and adolescent psychiatry. USP School of Medicine and Project Leader.

The study is still volunteering. Participants will be able to learn in detail about their child’s development, receive guidance if a problem is identified, and learn the results of research, including sequencing children’s genomes. Interested parents can apply through the project website.

What is already known about the importance of the first three years of life for human development? We know that relationships are established primarily with the mother, but also with the father and other caregivers, the basis of how the child interacts with the world at the beginning of life, that is, the basis of how the child receives stimuli. And how safe it feels to work actively in the world.

Previously, scientific literature had a more psychological focus. Today, with neuroscience, we have more and more methods for obtaining brain images and other laboratory measurements, and with this we have come to realize that many skills that will be important later have already begun to develop in the first and second years. Life attention control, language, motor control, emotion control, all these problems start to appear early in life.

In the last two decades, it has become very clear that adults have mental health problems that start in childhood or adolescence. And we see that many problems can start even earlier, sometimes even during pregnancy, such as obesity and cardiovascular risk. We also look at how the brain develops before and after.

And what else does the study want to know? At this stage of life that gap needs to be filled? Those who are trying to predict an ambitious gap will have difficulty developing in the future. Studies show interactions – for example, the child who cries the most is more agitated or has more difficulty with language, but that is not enough for me to say which child will have difficulty with language.

The idea is to get closer. This will be extremely important as it paves the way for prevention strategies. If I could identify earlier, I could offer a program with activities to promote better development.

There are several innovative aspects to this study. One of the most important is how broadly and broadly we look at childhood, and this can only happen because we have researchers from different fields – genetics, nutrition, brain development, pediatrics, psychiatry.

Through this, we will be able to understand how these issues will interact with each other and manage to predict who will develop better and who will have difficulty. Typically, studies evaluate one or two isolated factors.

When we say that a child who is a victim of violence is well-developed in spite of that, we are only looking at violence without considering genetics or nutrition. The idea is to look at all the factors and be able to see how their combination tells you who is going to do better.

Do you want to assess how corporal punishment can affect children’s development? Today, even after the spanking law and further discussion about it, it is still a controversial topic in Brazil. There is now good evidence that the use of physical violence is associated with the development of lifelong anxiety and depression, but we are also conducting a comprehensive assessment of the environment in which the child lives through questionnaires.

We ask about the practice of parenting, the stimulation that the child receives, maternal care and we evaluate the interaction between mother and child. There are standard instruments with ten minutes of footage of the mother communicating with the baby to understand maternal behavior. The environment, including coercive and punitive practices, will actually be assessed.

What happens in the first thousand days of life is marked at the point of influencing what will happen in the future, even though we do not remember this episode? It is identified in the brain, and we have evidence that shows how brain structure, hormonal patterns, and epigenetic markers change from these experiences in the first years of life, leading to skills that are not necessarily so conscious, such as emotion or language control. Development

We know that the amount of words that children come in contact with in the first year greatly affects their language level and we know that two year olds who speak sentences will have a better chance of developing healthy cognition. So these are skills that are not necessarily conscious or accessible in our memory; Basic, the foundation of the brain.

There is a whole brain circuit that is related to fear. Children who are exposed to stressful, neglected situations, where they do not feel cared for, will change this circuit and eventually create anxiety.

The biggest study that shows the strength of these effects is the study of Romanian orphans, which ruthlessly shows how the absence of touch and affection fails children to develop cognitive and mental skills.

About 200,000 children were originally housed in orphanages, without skin contact and affection from other people. They are placed in cribs and placed in bottle bars.

What we saw were very severely developing children, almost autistic, without speaking, without controlling the sphincter. This is one of the most brutal natural experiments that shows the strength of the childhood environment.

AndWhen The child does not come into contact with good causes early in life, but for some reason this scenario changes, what is the possibility of recovering or preserving the damage already done? It depends on the severity of the damage and when it is removed from the hostile environment. In Romania, some researchers have shown that children adopted before the age of two had the same type of brain function as children who were not institutionalized. Nevertheless, over time, emotions can be controlled, and in the first years of life, language can be stimulated at an early age.

What should parents and carers do and should do in these first three years and beyond to ensure good development? One of the most important things for parents and caregivers is to establish a connection with the child and to develop a sensitive and responsive type of care.

That is, by knowing the child you can understand what he is communicating with you, if he is uncomfortable in a certain environment, if he likes a certain person and responds to these needs and wants. This connection is one of the foundations of healthy mental and cognitive development. At the same time, it is important to set boundaries and rules and think about the value that is important to you from an educational point of view.


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Guilharm Polankzik

He is a child and adolescent psychiatrist and professor of psychiatry at the USP School of Medicine. He graduated with a degree in medicine from the Federal University of Rio Grande do Sul and did postdoctoral work at the Institute of Psychiatry, Psychology and Neuroscience at King’s College London (UK) and Duke University (USA).

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