Brains Are Strengthened in the First Three Years of Life

by George Halvorson Former Chairman and CEO, Kaiser Permanente 15.01.2014

We have more people in prison in this country [the U.S.] than any other country in the world. On a per capita basis, we imprison more than three times as many people as any other western country. Only Russia comes close to us in the number of prisoners per 1,000 citizens, and we significantly exceed them.

When you look to see who is in our prisons, a couple of facts about who we imprison are glaringly obvious. We imprison far more of our minority citizens than our white citizens. That set of facts is well known.

What isn't well known is another extremely important but almost entirely invisible fact about our prisoners.

They can't read.

Seventy percent of the people in our jails and prisons are either very poor readers or they cannot read at all.

When you look at the young people in our juvenile criminal systems, that number is even higher. Eighty-five percent of those young people either can't read or have very poor reading skills.

We have a court system full of non-readers. If we only imprisoned people who could read, we would have fewer people in jail than any of the western countries who are currently below us in the percentage of people they incarcerate.

That set of facts is not an indictment of our school system. Having so many non-readers is actually not the fault of the schools. We have over a half a million children who drop out of school and the basic reality is that two-thirds of the children who drop out of school also are the children with low reading skills or who have a complete inability to read.

Those two very unfortunate facts are not caused by our schools. Our schools are working very hard to reduce the number of dropouts. The truth is, the key reading problems for those children actually happen before our children who drop out get into our schools. We know, today, that the basic brain functionality that is needed to enable children to read is developed before age five. That learning problem happens before our children get anywhere near our schools.

The first three years of life are key.

The current science can actually predict with a sad level of accuracy by age three who will be able to read and who will not be able to read.

Our schools have an extremely difficult time helping children learn to read whose developmental levels are very low before they even get to kindergarten.

Our prisons also have a very hard time rehabilitating their prisoners and preparing them for a life away from crime if the prisoners can't read. Non-readers usually can't find jobs when they get out of prison, so the non-readers too often end up returning to a life of crime once they are released from the jails. They return to crime because crime is the only economic infrastructure they can enter easily as non-readers.

We need to do a lot better. We are managing in health care today to go upstream in the progression of major diseases to do very effective and very practical interventions that keep people from having heart attacks or strokes. We know that kind of practical, logistical, process-based interventional thinking works to prevent strokes and heart attacks.

We need to use the same kind of upstream, process-based thinking to prevent prison terms and to reduce high school dropouts.

All children can be saved. We should not have all of those failures. The issue that actually functionally impairs reading ability isn't race or ethnicity or even the economic status for each child. The all important issue is whether each child gets the level of stimulation -- reading, talking, and direct adult interaction -- that is needed to stimulate their one- and two- and three-year-old brains.

Modern science is very clear on this issue.

Most brain development and most major brain organization for each child happens in those first three years of life. Science has now taught us how important those very early years are. Every child whom we interact with at that point in their lives in the right ways can have their brains blossom, grow and be strengthened with every day of that direct contact. The first three years of life are the golden years for strengthening the brains of each child. Those years create the learning strength -- and build the vocabularies and the language skills -- for each child.

The best predictor for who will go to jail and who will not go to jail can actually be linked to the number of words in each child's vocabulary when they reach kindergarten.

The kids with a larger vocabulary and a greater number of words when they get to kindergarten tend to read better. The poorly prepared children are 40 percent more likely to get pregnant while in school. The poor readers are also 60 percent more likely to drop out of school, and the poor readers are more than 70 percent more likely to go to jail.

We need to turn that situation around. We need all mothers to know how important those early interventions in those first years of life are for their children. Most mothers do not know the biological science that creates the reality of the very early years development processes within their child's brain. Too many mothers and families and too many people in our communities do not know about those golden years for strengthening each child's brain.

We need all mothers, all families and all communities to know that those opportunities exist. We need to help mothers and families create the interactions that are needed to give their children the best chance of success, the best mental growth, and strong brains.

My conversation tomorrow will explain what some of those support tools are. They are pretty basic. Reading to children in those key early years is a key tool. Speaking directly and frequently to each child and playing with each child daily in those very first years also does very many good things for children and those basic activities for each child lead the list of things that can make brains strong for babies. Not enough mothers and families know that to be true. We need everyone to understand those basic biological facts of life so we can make sure that those tiny babies get the brain strengthening help they each need.

We need to cut the number of kids who go to prison by half. We have managed to cut stroke deaths by half in our care system by going upstream to intervene effectively in the process that ends up with a stroke.

We need to do the exact same thing to reduce the failure rates for our children.

The time to do that work -- for each child -- is now.

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