First 1,000 Days – a Critical Time for Children’s Brain Development

Research shows that 80 percent of a child’s brain development occurs within the first 1,000 days of life – making those three years important for lifelong health, learning, and success.

But children are uniquely vulnerable during this period to the negative impacts of toxic stress on both their physical and mental well-being. To address these challenges, M Health Fairview’s expert care teams in the M Health Fairview Birth to Three and Early Childhood Mental Health programs work closely with researchers from the University of Minnesota to transform leading-edge findings into responsive clinical care. Together, specialists across several disciplines identify challenges and partner with families during the first years of a child’s life to reduce the impact of negative or stressful experiences.

The clinical and academic partnership at the heart of these programs will grow even stronger with the opening of the Masonic Institute for the Developing Brain (MIDB) this fall. Most M Health Fairview pediatric behavioral, developmental, and mental healthcare services – including the Birth to Three and Early Childhood Mental Health programs – will move to the new facility. This will create a “one-stop shop” that brings together clinical care, research, and advocacy to prioritize childhood development through leading-edge support.

Discovering how to protect children from early stress

Pediatric Psychologist Maria Kroupina, PhD, who leads the M Health Fairview Birth to Three Program, has seen firsthand the power of collaboration between researchers and clinicians.

The Birth to Three clinic was founded based on leading-edge research in early brain development, including the role of toxic stress and the importance of family dynamics. The first three years are the most rapid period of development in a person’s life, and also when the brain is at its most flexible.

“Our program is designed to bring research into the clinic as quickly as possible,” said Kroupina. “The most up-to-date findings on brain development guide us as we put interventions and assessments together. The Birth to Three Program also furthers scientific understanding by providing firsthand insight back to researchers.”

Kroupina often works with children who were born with complex medical conditions. Long hospital stays, procedures, and disrupted family time can be tough for infants. Young kids can also be negatively affected by an unstable home environment or unsupported relationships. A healthy relationship is expected – and needed – for learning. When this isn’t present, it can harm the brain’s development.

“We’re not always able to predict how toxic stress will affect a child later in life. It could be anxiety or more aggressive behaviors,” said Kroupina. “However, we’ve discovered how to best protect children from these potential impacts of early stress.”

Early intervention helps success at school, home

Kroupina and her team partner closely with a child’s caregivers, educating them on their child’s risks or conditions and effective at-home supports. The Birth to Three program also works closely with the Early Childhood Mental Health Program, led by Psychologist Katie Lingras, MA, PhD.

The Early Childhood Mental Health Program sees children from birth until age 8. It’s able to support patients who started in the Birth to Three Program as they get older, if necessary. This collaboration and continuity in care will be further supported when the two programs come together in the same clinical space at MIDB.

Like Kroupina, Lingras talks about the importance of early intervention for both development and mental health. Working with a caregiver to help them understand their child’s risk or condition can change the way a family approaches the situation at home.

Early intervention also helps a child build self-regulation and communication skills before starting school, setting them on a path of success from the start.

“When families used to come in with behavioral concerns during check-ups, physicians would often recommend that they wait and see before making referrals. For a long time, that was the best advice,” said Lingras. “As we learned more about a child’s early years, it became clear that we could intervene sooner for all different types of conditions. These early interventions can make a big difference in short- and long-term outcomes for kids and their families.”

Lingras added that children’s brains are constantly developing, even into their early twenties. The early years are important, because it’s easier for interventions to work quickly and stick when a child’s brain is more flexible. However, intervention and change are possible at many points. MIDB will work with patients into early adulthood.

Like the Birth to Three Program, the Early Childhood Mental Health Program takes a strong developmental and relationship-based approach in addressing the needs of both children and their caregivers.

“Both of our programs benefit from extensive experience in trauma and adversity. This training underpins the importance of relationships in those early years,” said Lingras. “We’re both psychologists, but we work with a fantastic team of social workers, psychiatrists, nurses, and other folks.”

Expanded clinical, community collaboration for child development

Kroupina hopes the opening of MIDB will further expand collaboration between clinicians and researchers across M Health Fairview’s clinical programs and specialties. Many young children have complex needs, as early stress can impact the brain in a number of ways. Through the new institute, families will have access to multiple leading-edge clinical programs and studies in one location. MIDB will help families put together the best resources to support their child’s early development, and programs will be able to collaborate in providing this support.

In addition to a clinic and research facility, MIDB will house the University of Minnesota’s Institute on Community Integration (ICI), an organization focused on community and policy advocacy for people with disabilities and educational support needs.

“At MIDB, we’ll have the opportunity to be even less siloed. There will be the possibility for more community outreach,” said Lingras. “There’s a huge amount of value in now bringing together expertise from across the university and health system when thinking about new collaborations.”

“The passion for this institute is amazing,” she added. “The donors, our leadership, everyone involved came together to say, ‘We care about the developing brain. We care about emotional and social health.’ That’s an important thing. It sends a message of support to families across the state.”