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These magnetic resonance images (MRIs) of a brain are from a study of twelve young children, with a median age of 14-15 months, who were treated in a South African hospital for infantile malnutrition. The MRI on the left shows various abnormal structural changes associated with the cerebral shrinkage that was present in every child on admission. The image on the right, taken after 90 days of nutritional rehabilitation, shows the anatomical recovery that occurred in the majority of the children.

Source: Gunston, G. D., et al., ‘Reversible cerebral shrinkage in kwashiorkor: an MRI study’, Archives of Disease in Childhood 1992; 67:1030-1032, with permission from BMJ Publishing Group.

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Early brain development: A firestorm of creativity

Have you ever observed an infant watch with heightened anticipation, then squeal with delight as his mother’s face, hidden behind her hands, suddenly appears? During this seemingly simple and repetitive game, something quite dramatic is taking place as thousands of cells in the child’s growing brain respond in a matter of seconds. Some brain cells are ‘turned on’, some existing connections among brain cells are strengthened and new connections are formed.

With brain connections proliferating explosively during the first three years of life, children are discovering new things in virtually every waking moment. At birth, a baby has about 100 billion brain cells. Most of these cells are not connected to each other and cannot function on their own. They must be organized into networks that require trillions of connections or synapses between them.

These connections are miracles of the human body, depending partly on genes and partly on the events of early life. Many kinds of experiences affect how young brains develop, but nothing is more important than early care and nurturing.

A delicate dance

A child’s brain is neither a blank slate waiting for a life story to be written on it nor a hard-wired circuit planned and controlled by implacable genes. From the first cell division, brain development is a delicate dance between genes and the environment. While genes pre-order the sequence of normal development, the quality of that development is shaped by environmental factors that affect both the pregnant and lactating mother and the young infant. Such factors as adequate nutrition, good health, clean water and a safe environment free from violence, abuse, exploitation and discrimination all contribute to how the brain grows and develops.

The uniqueness of the human brain lies not only in its size and complexity but also in the properties that make it extraordinarily interactive with experience. Every touch, movement and emotion is translated into electrical and chemical activity that shifts the genetic momentum forward, subtly modifying the way a child’s brain is wired. Human interactions are as important to the development of brain connections as having food to eat, sounds to hear and light by which to see.

Timing is critical

There are periods in life when the brain is particularly open to new experiences and especially able to take advantage of them. If these sensitive periods pass by without the brain receiving the stimulation for which it is primed, opportunities for various kinds of learning may be substantially reduced.

Exactly how critical ‘critical periods’ are, and how long the windows of opportunity for specific areas of development stay open, is under debate. We know that the human brain is malleable and that its capacity for reorganization continues throughout life and can be enhanced by interventions. But there is wide consensus that during early childhood the brain is taking shape with a speed that will never be again equalled.

Developmental prime time

The brain’s malleability also means that there are times when negative experiences or the absence of good or appropriate stimulation are more likely to have serious and sustained effects. When children do not get the care they need during developmental prime times, or if they experience starvation, abuse or neglect, their brain development may be compromised. Many children living in emergency, displaced or post-conflict situations experience severe trauma and are under exceptional and unresolved stress, conditions that are particularly debilitating for young children. Only a few synapses fire, while the rest of the brain shuts down. At these young ages, a shutdown stalls the motor of development.

Prevention is best

Although it is never too late to intervene to improve the quality of a child’s life, early interventions have the most significant effects on children’s development and learning. Children’s development can be enhanced with appropriate, timely and quality programmes that provide positive experiences for children and support for parents. There are a wide range of successful interventions - helping a young mother and father to understand the newborn’s signals more accurately, for example, reading a story to a group of toddlers, providing home visits to new parents.

Lasting imprints

Early care and nurturing have a decisive and lasting impact on how children grow to adulthood and how they develop their ability to learn and their capacity to regulate their emotions.

While it is certainly possible to develop basic skills later on, it becomes increasingly difficult. Children whose basic needs are not met in infancy and early childhood are often distrustful and have difficulty believing in themselves and in others. Children who do not receive guidance in monitoring or regulating their behaviour during the early years have a greater chance of being anxious, frightened, impulsive and behaviourally disorganized when they reach school.

The brain has remarkable capacities for self-protection and recovery. But the loving care and nurture children receive in their first years — or the lack of these critical experiences — leave lasting imprints on young minds.


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