Overcoming Impact of Adversity on Learning
Diego Ramirez, 4, holds a kaleidoscope for his father, Wences Ramirez, in the boy's classroom at Childhaven, a therapeutic day-care center in Seattle. Childhaven is teaching parents and children to play games together to build the children's focus and self-control. The program is part of a larger statewide effort to improve learning and well-being. Nick Adams for Education Week

Poverty, neglect, or family stress can make it especially difficult for young children to develop the self-discipline and habits of mind they will need to succeed in the classroom and beyond. Armed with research and a commitment to the whole child, Washington state has transformed the way its agencies work together and in partnership with researchers to address the effects of early adversity on learning and to help disadvantaged children build resiliency and other so-called executive-function skills they need to learn and grow.

In the process, officials hope to create a national model for rapidly translating new research in fields like cognitive and neuroscience into usable practice.

The Innovation by Design work, launched in 2011 through the Frontiers of Innovation initiative at Harvard University's Center on the Developing Child, focuses on the importance of executive function, the umbrella term researchers give a collection of skills-focus, working memory, decisionmaking, and self-control among them-which have been found to be associated with academic achievement as well as social and career success. Those skills are governed by the prefrontal cortex, the part of the brain just behind the forehead that has been called the "control room." It is one of the areas that sees the most rapid growth in normal child development.

Researchers have found that chronic, sustained stress, such as that caused by neglect, abuse, or deprivation, elevates stress hormones in the brain and weakens the neural foundation of executive-function skills in early childhood. That can cause the children to struggle in school and work, and in adulthood, make it harder to pass those skills on to their own children.

"There's a growing recognition in the research and education communities that beyond the 'three Rs' is the executive function," said Philip A. Fisher, the director of the Stress Neurobiology and Prevention research laboratory at the University of Oregon in Eugene. He is one of more than a dozen researchers working with the initiative. "Without the ability to control yourself, to be flexible and respond to complex rules, no matter how good their math skills, children are going to have a hard time."

Yet this "exploding knowledge base in neuroscience," Mr. Fisher said, so far hasn't provided much insight for teachers and others who work with children on how to repair the damage.

"It's like now we see the landscape, we see these obstacles in the way of learning, and we need to build a bridge or a series of bridges over those obstacles," he said. But when it comes to using the research to help teachers and others who work with children, he said, "the way the message is being crafted tells more about the obstacle than how to get over it."

Harvard University's Center on the Developing Child has established a national network of sites, called the Frontiers of Innovation, to identify targeted practices to build up executive functioning in children and adults who have been exposed to so-called "toxic stress."

Washington was named the first "Innovation by Design" state in 2011 for having the first holistic statewide approach in the Frontiers of Innovation program, according to Dr. Jack P. Shonkoff, the director of Harvard center and one of the nation's foremost experts on the effects of stress on child development. In Washington, it is also often dubbed "one science," a reference to the unifying science of early-childhood development which is used as a prism through which to evaluate policies and build interventions.

"The early-childhood policy and political environment have not made it safe to try new things, but all of our breakthroughs in science come on the shoulders of a long list of things that didn't work," he said. "We have to develop an environment that makes it safe to do that."

Working Across Agencies

Bette Hyde, Washington's early-learning director, along with Social and Health Services Secretary Susan N. Dreyfus, and Rep. Ruth Kagi, the Democratic chairwoman of the House education committee, helped spark the initiative in 2011, after a meeting about the effects of stress on child development at the Harvard center. The officials came back determined to change the way the state worked with children and adults who had been exposed to toxic stress. Washington signed a charter later that year to become the first in the national Frontiers of Innovation network to launch a statewide initiative.

"We gained momentum just in having the right people here at the right time," said Juliet Morrison, the assistant director for quality practice and professional growth for the state's early-learning department.

The state soon after earned a $60 million federal Race to the Top grant to improve its early education system, which operates under a separate Cabinet position from the K-12 education agency. Ms. Morrison and her colleagues culled research on executive function to develop new early education standards for the grant. They are also rolling out online training at six sites this spring.

With help from the Center on the Developing Child, the state paired child-development researchers with local groups interested in testing new ways to repair executive function in students who have experienced adversity.

For example, the Seattle-based Children's Home Society is working with Mr. Fisher to test a video-based coaching program to identify actions that support children's cognitive development during home visits supported by the federal early-childhood education program Early Head Start. The group is using short-turnaround "micro-trials" to test and tweak the intervention.

Childhaven, also in Seattle, is taking a similar approach. The center partnered with neuroscientist Silvia A. Bunge, the director of the Building Blocks of Cognition Laboratory at the University of California, Berkeley, to use games to build preschool students' ability to control impulses, regulate emotions, and respond to changing rules.

"Just performing the activity in a general way isn't enough. A very child-focused classroom isn't enough," said Nell Robinson, Childhaven's parent-skills training manager. "Games are much more specific play repetition. The point is not to learn numbers; that's a side benefit. The point is learning to sit, to wait, and how to approach loss and competition."

At each of its three sites, teachers conduct eight- to 10-week trials, followed by a retest, then tweak the intervention and launch a new trial, a process similar to the "deep-dive, quick-turnaround" cycles now being explored by the U.S. Department of Education.

"It's not how research is usually done," said Vicki Nino Osby, Childhaven's senior vice president. "It's not just taking it out of the lab into the field and plunking it down and saying, 'Here, do this,' but instead working with us. They want to co-create with us."

During a class session earlier this month, 4-year-olds practiced the highly ritualized "roll and play" game. When each child takes a turn, he or she walks to the back of the classroom, then steps onto a small podium while classmates clap. Then the child comes down, catches a large, multicolored foam die tossed by the teacher, and rolls it across the floor. The student then identifies the color that comes up on the die, matches the color to stacks of activity cards, and leads the class in performing the activity—stomping feet five times for an orange counting card, for example, or patting the belly for a purple body-parts card.

Making Strides

That the class can keep all those rules straight after playing the game only a few weeks is an achievement, Ms. Robinson said, because the students are not typically developing 4-year-olds. Nearly all of Childhaven's 250 students, ages 6 months to 6 years, come from backgrounds of trauma or adversity. They are typically referred to the center by the state's child-welfare agency, administrators of the Temporary Aid to Needy Families program, and even adult addiction-support services. While not all the children have specific learning disabilities, all have individualized education plans and are considered at risk of not being on track to start kindergarten at age 5.

"You start with the language of play, but some of these kids have very blunt play; they just line up trucks or put Play-Doh in piles," Ms. Robinson said. "Trauma will reduce their capacity to wait. It's a social contract that you will allow me to take a turn, and social contracts have been broken repeatedly in their world, so they don't know how to wait."

Across town, Washington's Juvenile Rehabilitation Services agency works with children facing very similar difficulties a decade or so down the line. The agency's three institutions serve about 400 teenagers who have committed felonies, and "about 80 percent of the kids we serve have had a [Children's Protective Services] investigation in their past," said Dana Phelps, the executive assistant to the assistant secretary for juvenile-rehabilitation services. "There's just a lot of trauma in these kids' backgrounds."

While the Innovation by Design initiative has so far been focused primarily on improving executive function in young children and their families, the state is also working to rebuild executive function in older students. Now, juvenile-rehabilitation officials are reviewing policies at the agency's three institutional sites and planning a pilot intervention with University of Washington child clinical psychologist Kevin M. King to develop self-regulation skills in at-risk teenagers' through mindfulness meditation.

"We were very excited that people stopped saying, 'Do it by age 5, or there's nothing you can do,' and started saying, 'The brain is very plastic and can change over time,' " Ms. Phelps said. "Great, you're telling us it's not too late, we can still make a difference in these kids' lives to keep them out of prison."

Other agencies are also joining the conversation. The state's K-12 education agency joined the initiative in late November, and its health-care-management administration is discussing ways to train doctors and insurers about health problems associated with childhood trauma.

"We're realizing more and more that it's really going to take a holistic approach," involving researchers and educators, to improve support for children, said Jason Gortney, the program manager for the Frontiers of Innovation program at Children's Home Society of Washington. "That's something we always believed, but it's something we are seeing possibilities to do now that we didn't before."

That "holistic approach" to supporting children and adults exposed to toxic stress is slowly taking shape out of these disparate pilot projects.

"Executive function is a really big piece biologically of school readiness," Ms. Morrison said. "We really wanted to make sure we were talking about it in a way that resonated with people."

Amy Astle-Raaen, the cross-systems coordinator for the Innovation by Design initiative, is also developing a shorter, 20-minute program geared toward other professionals who work with children, such as pediatricians and those who organize benefits to families in need.

"It's a paradigm shift in many ways around implementing services [for families in need], moving from a sense of 'these people make bad choices' to understanding how a lifetime of stresses can impact" multiple generations, Ms. Astle-Raaen said.

"This initiative could be seen as focusing on early childhood, but we're also talking about the lifespan impacts of toxic stress," she said.

Looking Forward

It's not yet certain whether Washington's early connections will be reinforced or wither over the next year. Pilot programs are picking up speed just as Washington transitions from outgoing Democratic Gov. Christine Gregoire, an early advocate of the initiative, to incoming fellow Democratic Gov. Jay Inslee.

Gov. Inslee has voiced general approval of the work, but "there have been so many cuts to state government services. While an initiative like this provides promise and opportunity, there's just a limit to the capacity," said Ms. Astle-Raaen. "Prioritizing the good ideas and figuring out what can take hold at what time will be one of the challenges."

It is already providing a model for other states. A team from Georgia recently visited the state to discuss the initiative, and Harvard's Dr. Shonkoff said the Frontiers of Innovation network is in discussions with three states and the Canadian province of Alberta. Ultimately, Dr. Shonkoff said he hopes to develop a critical mass of states, practitioners, and researchers who can build on the work.

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