A Child's First 1,100 Days are Critical, with guest Geoff Nagle

On this episode of Ready Set Gov, we sit down with Geoff Nagle, President and CEO of the Erikson Institute, to talk about the critical importance of early childhood education, especially in the lives of kids who experience trauma and violence in their communities.

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Q & A with Geoff Nagle

Madeleine Doubek: I'm Madeleine Doubek, Director of Policy and Civic Engagement at the BGA and I'm joined today by Geoffrey Nagel who is President and Chief Executive Officer of the Erikson Institute a leading Chicago force in improving the lives of young children and their families and the nation's premier graduate school in child development. Dr. Nagel is an internationally recognized leader in the early childhood field. He joined Erikson in 2014 after serving as the founding director of the Tulane University Institute of Infant and Early Childhood Mental Health. Welcome to Ready Set Gov!

Geoff Nagle: Thanks so much for having me.

Madeleine Doubek: You have talked a lot and focused a lot at Erikson on a child's first 1100 days as being really the key to almost the rest of their lives. Can you explain to us why that time period is so critical?

Geoff Nagle: Sure. So I love to say that the first 1100 days last forever. Eleven hundred days is essentially the number of days from your birth until your third birthday. So it's the foundation for the rest of your life. And what I really say is that it's the smoking gun for long-term educational achievement and health outcomes. That's where we spend the most money in our society is trying to address education and health. And if you peel it all back, it all goes back to those first three years of life.

Madeleine Doubek: One of the reasons why we wanted to have you on this podcast is because you have quite literally talked about the role of guns in certain communities of Chicago and the detrimental effect they have on children in those communities. Can you explain to everybody what I'm referring to?

Geoff Nagle: Sure. So one of the things we look at at Erikson and people in the early childhood field look at is the adversity that children have to deal with and overcome because we often don't think of children having to deal with stress. We think about children in their carefree life and "oh my gosh" we would all love to be a child again and not have the worries that we have as adults. But of course, children feel stress as well and they come out of the womb stressed out right? They are screaming and crying and the moment they are breathing their first breaths of air. And we have to recognize as adults and not forget that it can be a little stressful. So whether you're just hungry or have a dirty diaper all the way up to feeling scared and afraid or alone that can be really stressful. When you're stressed as an adult or a child you have a stress response system that is going to kick into gear. And so one of the things we're looking at was stressful environments and the proxy for that was murders in Chicago and looking at the large number of murders obviously the city has been plagued with the last few years but we mapped all the murders in 2016 by neighborhood and basically of the 700-800 murders in 2016.

Madeleine Doubek: It was a record year.

Geoff Nagle: I think that was the record year we had a little less in 2017 and I saw in today's paper that it was down, thank goodness, 25% this year. But if you mapped all those, the median number of murders a community had was six all the way up to I think it was around 70 was the high. So we looked at the number of children five and under in those communities that had above the median. And that was almost 100,000 kids. So, 97,000 children lived in a neighborhood that had six or more murders in 2016. And I just know that if there was one murder in my community my neighborhood in Evanston I would never forget that right? We'd be talking about that murder for ten years. I can't even imagine being in an environment where there's a murder every other month, maybe one a month, maybe one every other week. And what kind of environment that creates. And we as adults have to understand you can't not address that with young kids and think, 'oh they're not going to be impacted by that" because they are going to be impacted by that.

Madeleine Doubek: Even I'm a baby? If I'm a baby and I live in one of these neighborhoods where that's happening on the south side or the west side, I'm stressed by that?

Geoff Nagle: Right. So a baby experiences the world through their relationships, through the relationships with their caretakers. And if you as an adult are living in a violent scary community that's going to impact your ability to be calm and relaxed and playful perhaps, you're going to bring that to your relationship with your child. There's no escaping that. They're certainly not aware that that's their environment if they're a baby or infant or a toddler. But it is going to impact their experience in life. Is their experience going to be more limited to indoor play only and less outdoor play because it's not safe to go outside? Is there experience going to be one with the adults in their rooms crying because they're so upset about what's happening outside in their community.? Is it going to be just a more stressful environment because people are concerned and scared and overwhelmed? And what else is happening in the communities where lots of murders are happening. So we just always have to think of the infant and toddler in the context of a relationship with their primary caregivers. Children don't know they're poor but they experience poverty through the stress it creates for the family and the caretakers and their whole environment. So we always have to think of them in the context of relationships.

Madeleine Doubek: And that experience for almost a hundred thousand children from 2016 is going to be with them forever.

Geoff Nagle: Right. They are a part of a community that has a lot of murder going on. We didn't even look at the number of shootings I think there was 700 and some odd murders. But there is like over 4,000 shootings so we didn't map those. So you figure there was a number of shootings on top of the number of actual murders. Just think about what that would be like if that is your environment day in and day out. Yes. That is the environment that is raising them. And we have to be aware that the experiences children have are their education in those first five years. It's not so much rote education of being in the classroom and remember these things and we're going to you know make you memorize the alphabet but it's the experiences so when we think about experience and so much of the way your brain develops is experience-dependent. I always like to say, "what is the language a baby's capable of speaking when they're born." The answer is any language ever known to mankind. But what language or languages will they speak? It will be the ones they experience. Now the area of your brain that has the most connections around language forms that at the age of nine months. So it's kind of like your peak moment of learning language and you think when does a child begin to really start uttering the first few words. It's at nine months of age. That is just a really clear example of how experience is going to impact the way the brain is developing. It doesn't mean you can't learn languages later but you're going to learn that much easier if you're starting from that very early time. So experience and relationships are how children experience the world. That is the name of the game in early childhood.

Madeleine Doubek: What communities are we talking about.? Give us some a geographic reference point.

Geoff Nagle: Yeah there were a lot of communities mainly on the south side but a little south-west. I have a little map here so I'm going to cheat and look at that. The communities with the highest number of murders, unfortunately, were Austin, North Lawndale, and then some of the other communities south and a little bit south-west. So these were communities that had above the median number of murders which was six and the highest number was 87. So you can just imagine a community with 87 homicides. And when those happen you can't think of it just as who was the victim and the victim's family. We can't forget that there are children under 5 that live right near where those crimes happened whether they heard it or not whether they heard the crying and screaming afterward whether they knew the family members who are now devastated by that death. All of that creates an environment for that child that family that is more than just that isolated event. And that's what really have to pay attention to. So what are the preventive services? What are the services that are addressing trauma in children? That is going to manifest itself in some capacity either internalizing where you're bringing those feelings inside to externalizing which would be more of the aggressive behavior: lashing out, the violence, the hitting, those things. That gets the adults attention much more when kids are doing that. But kids can be suffering quietly, internally as well a lot of anxiety depression those types of things. It's hard to just pretend the world is safe when the world is not safe.

Madeleine Doubek: Right. And you feel that. We talk a lot about this violence that has plagued our city for some time now in terms of police response and concerns about policing in our community. And that's one way that government interacts with this problem. But when you talk about 97 thousand plus children, how else ought all of us be responding to help in this situation? And can we?

Geoff Nagle: Right. So it's really about appreciating the trauma that the child is experiencing. The term in the field is really "trauma-informed care." Obviously, that can be a very high-level professional who's you know maybe a mental health professional who's serving that child or family directly but all the way down to the teachers in the classroom that they may have or the child care setting. How does the teacher understand trauma and the way it will manifest in the child. So a lot of times we see children in early childhood settings who have a tough time getting along with others not just sharing because that can be tough for most...

Madeleine Doubek: Adults.

Geoff Nagle: Yes but also kids at those younger ages. It's about understanding that if a child is not playing well with others, pushing kids away, maybe acting a little more aggressive, can't sit still in their circle time, can't pay attention, and can't get along with others. Is that because the child is A.D.H.D. as we like to label them? Or are they overly stressed internally when they can't turn off their stress response system? So they're always on alert–for good reason–they're always afraid about what's going to happen. So we as adults have to be tuned into the child's behavior and what is the cause of that behavior versus trying to label them trying to remove them from the class because they are disruptive. The child needs help. We can either help them or we can pretend that it's something wrong with the child and remove them. But we're going to have to deal with that later. We are not really good at trying to see the world through a child's eyes and understand what they're experiencing in any given moment to try to really empathize with them and address their fears and concerns in a very empathic way. That's really the challenge and that goes so any adult that is interacting with the child. You really have to just ask the question how is the child experiencing "this" whatever "this" is in that moment. And that may seem like a simple question. If you can A) remember to ask yourself that question and then B) you'll find it hard to really think, "well, how are they experiencing this?" And really put yourself at their level, not just at their eye level but their cognitive level of understanding and appreciating what is going on but that would make a world of difference. That's a lot of what we do at Erikson from graduate school to professional development. We do a lot of those trainings for many different types of professionals and people who interact with children to try to help them understand a child's needs, where a child is coming from, understanding and interpreting behavior, and being able to respond appropriately.

Madeleine Doubek: Is there a role for us as citizens and for our government to play to get more involved in addressing what's happening to the children who are victimized by this violence.

Geoff Nagle: Well I think of it as "is there a role for all of us to play in supporting the development of our children?" All children, not just children who are coming from kind of the most challenging communities although we would provide them even more. So let's take a step back and just say we want our children to reach their full potential whatever that may be. That may mean more resources to different children based on what their challenges are. But I think we have to think about all of our children. So we do that for kids starting, generally speaking, at age 5 with kindergarten and all the way up until they are 18. So we do that very much in a school kind of way. We believe all our kids should go to a school that starts at 5. Now maybe it starts at 4 and we are trying to build more and more Pre-K. All of those things. What I'm saying is, if we were building that system today knowing what we know about child development, we wouldn't start at age 5 and we wouldn't start at age 4 because we know children are learning from the day they are born. And really if we want that child to have a healthy birth outcome we're concerned about that child in utero and all of those issues before the child's ever born. But let's just go with birth to 5 and those years that it's kind of a "catch as catch can." If we are building the system today we would be starting at birth. We would be trying to ensure that they have the right experiences before they had the cognitive ability to be in an educational environment where they're learning in the way that we traditionally think of it in a school setting. So right now we have this five-year-old to 18-year-old system and we're unhappy with that system because of the educational disparities that exist. We're upset with the school system in this country and in Chicago because there are educational disparities.  Well, why aren't schools making sure that all kids are achieving academically? Well, the reality is the disparities exist not because of what the schools are doing it's because of what happens or doesn't happen for the children before they ever get to school. So there are some amazing new research that's come out of Stanford where these Stanford researchers led by Sean Reardon looked at 300 million achievement tests and they mapped out how kids were doing across the country. They standardized all these scores so that you could really see how all the kids were doing. What you see is by and large that the schools are doing exactly what they were designed to do which is educating kids one year at a time. Meaning, if you're in 3rd grade, you want to be at 3rd-grade level. We're going to educate you so that in 4th grade you're the 4th-grade level. If my fifth grader at the 5th-grade level they're moving kids along essentially one year at a time. The problem is the gap that we're upset about at the end of the pipeline was there before third grade. And in reality, the gap is there a kindergarten and really the gaps start emerging by age 2. But when you look at the schools actually his data shows that of the large school districts in this country the 200 largest school districts in the country the district with the highest growth is Chicago Public Schools.

Madeleine Doubek: Wait. Say that again because we live in a community where we're constantly criticizing the Chicago Public Schools.

Geoff Nagle: We're constantly criticizing them and the reality is they're doing not just a good job they're doing the best job in the country of large school districts. The 200 largest school districts Chicago Public Schools has the best growth of any large school district. So what that means is that children at 3rd grade or scoring below the 2nd grade level and by 8th grade they were almost at the 8th grade level essentially in the five years between 3rd and 8th grade. They had six years of academic growth. So that was the most growth of any large school district in the country. But they didn't close the gap. They just did a better job of accelerating the growth. But the kids who were already doing better also did better because the system is educating the kids well. So, if we want to close the gap, we've got to make sure the gap doesn't open and the gap opens in early childhood. The schools were built to educate the kids essentially one year at a time. They were not built to close achievement gaps that exist before the child ever gets to school. That's asking them to do something that they weren't built to do. It's incumbent upon us the general public "us" to say, "wait, we're not happy with those gaps." It's not the school's fault the schools are doing more than what we've asked them to do. We have to address this by making sure those kids don't have the gaps. So that means a whole lot of supports and services for children and families before those kids get to school. Supports and services are their home visiting programs, their health care, their child care. We don't want to just make everything about "education" because this isn't about teaching the kids an alphabet when they're age two when they can't learn that at that age. It's about making sure they have high quality experiences so they're learning social-emotional skills, executive function, the higher levels of relationships and how to get along with others and be able to sit and attend to tasks. Those are the skills they're going to learn in those first few years so that by the time they get to kindergarten they are "ready for school" even if they haven't learned the letters, the days of the week, the months of the years, the colors. Teachers will tell you they can teach that to a kid easily if the kid is able to get along with others, sit in class, attend to the tasks at hand. The rest is easy. But those are the challenges. If we can make sure the kids get off to the right start by having the right experiences. We're really setting ourselves up for success and this is what I think parents every parent intuitively wants their kid to have great experiences from day one. This isn't counter-intuitive.

Madeleine Doubek: But when it's been drummed into you to do it a different way it is sort of counterintuitive. We're talking about what role can government play. How are we doing with focusing resources where it needs to be focused? Can you talk a little bit about that?

Geoff Nagle: Yeah so Chicago leadership here led by Mayor Emanuel. They totally get the importance of early childhood and they have made investments. They created universal Pre-K. But that was a half-day program and so they've been really committed to making it full-day Pre-K and they have about 45% of the kids the 4-year-olds that are in a city-funded Pre-K program are now in a full-day setting. Their goal is to get that 100%. So that's great but that's the beginning. That's not the end. You can't say, "OK we're doing early childhood because we have a 4-year-old Pre-K program." I think their ambition is to eventually get the 3-year-olds and they want to start there. My fear is that it'll take us 10, 15, 20 years and we'll have just gotten to the 3-year-olds but it still ignores them when they're infants and 1-year-olds and 2-year-olds. So, in New York, their mayor literally made it the cornerstone of his inauguration for his first term. "We're going to have universal Pre-K for 4-year-olds within two years they had universal for 60,000+ 4-year-olds. It was unbelievable that they had accomplished that. They did that, then they set off and said, "OK now we're going to incrementally start for 3-year-olds." You can take big steps when you really make it the priority. I don't mean that as a criticism because there's lots of priorities here. You've got to deal with the crime issue and the long-term solution crime is how we invest in our young children but that's not going to stop the crime that we have today. So, I get that there's competing issues and limited resources. But until we have more than just the mayor saying this is the biggest bang for our buck which the science tells us it is, we're going to make these investments, they're going to pay off, we're going to build the best city in the country. In order to do that, to invest in our people and by investing in our young children we're investing in their families as well. And that's how we're going to make this city the most attractive. That's got to be coming as a message from every corner of our society. It can't just be one person and therefore is scraping together a few dollars here and there to expand the program. Across the country, it's more of that kind of story where you have some states that are doing universal 4-year-old, some doing modified but the name of the game isn't just 4-year-olds, it's how do you build a comprehensive system that really starts at birth to support children and families.

Madeleine Doubek: You're sitting in a city in a state with billions of dollars of unpaid bills and the worst pension debt unfunded liability in the nation. There are all kinds of things pulling and competing for our public officials’ attention. So how do you go about persuading people and the politicians who represent them that this ought to be the priority? That this is the place where they ought to be focused and this is where we're going to get the best return on our investment.

Geoff Nagle: Yeah. The politicians and policymakers love to tell you that they're going to you know run government like a business and they're going to spend their dollars in the most efficient use of those dollars. And you know we have a Nobel Prize-winning economist at the University of Chicago, Jim Heckman, who will tell you that the most efficient use of our public dollars is money spent for young children and earlier in life you spend it on them, the bigger return on the investment. The largest return on investment of any social service program you can have. We know from the science it's the highest ROI. We know from the science what we need to do to support kids to get the outcomes that we want to see for kids. So, it is a question of aligning those facts with the reality on the ground. And there are all the competing reasons, "we can't afford it, we can't afford it, we can't afford it." But somehow, we always do afford the things that we say are a priority. If we want to lure business in like we just put tons of money on the table for Amazon right? We had the Foxconn in Wisconsin. We saw Wisconsin say, "we will spend 3 billion dollars to create 13,000 jobs." Well, divide 13,000 jobs into the 3 billion dollars and you get 250,000 dollars of 220,000 dollars per job. So, we're willing to spend 220,000 dollars to create a job. What are we willing to spend for our children? Clearly, the money is there when we decide it's there. As a country, the United States compared to other developed countries spends 0.3% of our GDP on our youngest kids. The average developed country spends about 0.7% of their GDP so twice as much. The highest country, Iceland, spends 1.8% of their GDP. So that's like six times as much. The only developed country that spends less on their young children than the United States is Turkey. We're way an outlier in terms of what we're willing to invest. What we're doing compared to what we know actually are the best investments. There's a huge gap there and until we hold the politicians and leaders accountable that will continue. We just had the Federal Government say we're going to not just cut taxes but we're going to invest more than 300 billion additional dollars into the military. And that was even more than President Trump had asked for. We got an extra $2.9 billion for young kids. A doubling of what goes to childcare. So instead of 15 %  of the kids who are eligible getting served maybe, we'll get to 30%. But there was clearly the money there. We're willing to spend $300 billion for war machines but not invest in our people. So these are major decisions. At Erikson, we've developed some leadership programs for our current leaders where we put them through a six-day training on just the science and the facts and the information around where the best investments go. We've done one cohort of that and it's called the McCormick Foundation Executive Fellows. It's a huge success.

Madeleine Doubek: So, who goes through that program?

Geoff Nagle: So, these are state representatives, state senators, judges, board of ed superintendents, civic leaders, aldermen, and any type of community leader. We're trying to build that awareness. We're trying to educate and empower the leaders because this is an urgent issue right. Eleven hundred days from the time of birth to the third birthday. That's the time we want to build that foundation. You only get one chance to do that. So, we need everyone to understand that that's where we need to focus. And that's how we're going to change.

Madeleine Doubek: We need to fill in our own gaps.

Geoff Nagle: We do. Well said.

Madeleine Doubek: If I'm listening to this and I'm getting angry about this situation right now because what you're saying is very frustrating. What can I do about it?

Geoff Nagle: Well I think we all need to demand solutions. We can't just say, "oh, I guess we can't afford it." In 1960, one of the most lethal killers of children was acute lymphoblastic leukemia. If you got that diagnosis as a kid in the 1960s your chances of survival was like 10%. Today that's over 90%. The elderly who were poor, 30% of the elderly were poor in the 60s. We said no we don't want that. Today less than 9% are poor. We can solve the problems if we decide that these are problems we need to solve. We the People need to decide, "this must be solved." It's on us to demand that from our leaders and to put leaders in power who are going to respond to that demand. I think we should all be empowered to take this information and act and demand. That's what we have to do.

Madeleine Doubek: All right. Fascinating stuff, Geoff. Thank you so much for being with us today on Ready Set Gov.

Geoff Nagle: Great to be here. Thanks for having me, Madeleine.

Madeleine Doubek: My pleasure.