Tag Archives: Epigenetics

Resilience

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She is kind of family in a far-fetched way, this little girl I have known since she was one. At that age, she was hanging on her extremely obese mother, crying out loud when she saw new faces. Her life was chaotic with no structure and the social services were already engaged.

At two I got to see a little more of her because she stayed with her grandmother in a house beside our summer house. Still anxious around new people, she spoke only a few words. Nevertheless, once she got used to us, she was happy to participate in family life: played with pots on the floor, slept in her pushchair on our walks, and sat in our knees.

Of course I worried: is it fair to give her all this love and attention for a few weeks and then disappear from her life once again? But I convinced myself that it’s better with as much love and attention as possible, than indifference. Maybe she would store it somewhere and use it when most needed.

By the third summer her life had become even more chaotic: her parents had divorced, she experienced poverty, moves, and moves again. But preschool had done wonders to her development and I was no longer that worried about her cognitive abilities. She was not afraid of us anymore and for many long summer mornings – when her grandmother was not well enough to get out of bed – she was with us. Our children treated her as a little sister. They told her stories, painted her nails, and took her on discovery walks. More love for her to store for worse times.

The beauty of being able to give, what you yourself have gotten, struck me as I watched my children engage with her. I remembered the Hungarian story of the old woman who found a kid (as in baby deer) with a broken leg and took it home to cure it. Her dog and cat befriended the little animal, just as they themselves once had been taken to heart by the old woman.

Those worse times came for the little girl soon after that third summer. Her mother had committed suicide – luckily on the week when she was with her father. Although the little girl didn’t have to find her mother dead she was taken to the morgue to see her. She was prepared by her hand being put to the porcelain sink in the bathroom to show her how cold her mother would feel like.

With no mother and a father with cognitive difficulties I was sure the social services would opt for out-of-home placement. We would then have some big decisions to make. But rather than doing so, massive supports were planned and put into place, albeit pretty half-heartedly. There was also some family back-up, but most of all, the wondrous preschool personnel, who brushed her teeth, treated her eczema, and had extra clean clothes and breakfast prepared for her.

On this fourth summer she recognised us right away. Apparently she told her grandmother that I had missed her and marched right over to our house. She is now here as much as she can. Says yes to everything: water colouring, swimming, even brushing her teeth. She remembers our bicycle adventure from last year and asks to go again and again. She has all her twenty nails painted by my daughters and chatters on all day long.

She eats anything I put in front of her; we bake berry pies, prepare meat balls, and cut fruit sallads. My son is duly jealous of someone taking on the role of the youngest, but is gentle and kind with her and tries to show off his reading skills.

But the one thing she can’t really do is actually to focus when being read to. Already at four she knows Daddy cannot read so well so of course there is no regular reading at bed-time. But wise as she is she knows that learning is valued in our house. So she asks to be taught to write her name and makes me read out loud all the numbers on the jetty, marking the places for the boats. We find her own number there: “4”. She follows it carefully with her finger.

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I watch her with amazement; where does she get it from? This appetite for life, this sucking in of love and whatever good things life pleases to give her. The odds are terrible: early attachment disorder, poverty, parental loss, intellectual disability in her genes, inadequate home environment in her epigenome.

And yet, something tells me she will make it. Her resilience leaves me in awe and makes me wonder if we as a society are not underutilizing children’s ability to overcome challenges in our efforts to keep them happy and safe.

The Nutcracker – or how experiences get under our skin

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Walking along the shopping street near us we saw several man-high Nutcracker figures in the shop windows as Christmas decorations. They looked exactly as the Nutcracker costume used in the ballet we attended two years ago at the Budapest Opera House. Which is why my 11-year-old daughter started humming away on Tjajkovskij’s Nutcracker on our way home. She hummed the part when the rodents come out at night and try to steal the Nutcracker from the little girl. I remember that made a big impression on her.

Yet, my daughter neither knew which tune she was singing or where it came from. It was her brain that picked up one of its imprinted associations and had a little run about it.

That’s just how we learn – by association. It is a use it or lose it game in children and the younger they are, the more circuits the brain is capable of building up. Brain research in the past decade has clearly delivered its message: the more circuits the child builds up, the faster and broader its thinking goes, and the smarter the child becomes.

By age five the least advantaged children have been exposed to 30 million less words compared to children in the highest socioeconomic groups in Northern America. Consequently, the development of their language skills will differ. The PISA test results reflect this trend: in Australia a difference, equivalent to two-and-a-half years of schooling, separates the scores of students in the highest and lowest socio-economic groups.

But not only does the environment affect children’s brains and learning – it also gets under their skin. In fact, it modifies their genes in ways that we are only beginning to understand.

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Photo: Fanni Sarkadi

I still remember a book my father gave me called The Double Helix, describing the discovery of the structure of our DNA. It was the story of Watson and Crick who were awarded the Nobel Prize for that discovery. I was fascinated: everything was coded in our genes and if only humanity got around to brake the code we would know all about human disease and what our futures might entail.

Through the human genome project the code was indeed described almost down to the last gene, just so that we would discover that things are not that simple. Genes can be turned on and off in a number of ways, interacting with each other and the environment – a phenomenon called epigenetics.

Through the chemical process of methylation, our DNA becomes modified as a result of environmental exposure. This means that molecules bind to the DNA, affecting its structure and the way it “acts” within the cell environment. The discovery of epigenetic processes marks a new era of genetics, as significant as the description of the double helix.

An example of what happens is demonstrated in a study of adults with posttraumatic stress disorder where those who have been exposed to childhood maltreatment showed specific epigenetic modifications to their DNA, very dissimilar to persons traumatised later in life. A recent study of twins suggests that not even twins share the same epigenetic programming: some pairs were already different in their methylation patterns at birth, some were similar, but became more different, while some followed the expected pattern of further increasing similarities over time.

Although the pathways through which epigenetic programming happens are not fully understood, if genes required for brain development do not activate as they should, the effects will be visible. MRI scans of the brains of children who have been exposed to poverty show less white and grey matter as well as less hippocampal volumes. The hippocampus is involved in associative memory and is very stress sensitive.

Now here comes the Christmas gift: effects of poverty on the hippocampus were mediated by parental care. Supportiveness decreased the effect, whereas hostility increased it. Thus, caring parents will always make a difference for their children in the face of adversity.

In terms of public policy this means that all children should be exposed to a loving and supportive environment, adequate stimulation, and a little Tjajkovskij to fend off delinquency…

It’s not fair

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Although our six-year-old has to practice handwriting and using scissors a bit more to produce neater results he knows and uses the term “fine motor skills”. He reads in three languages on grade levels higher then his own.

He could learn to read because he can focus his attention on a certain task and persist until he is done. Sometimes when we play chess and I am ready to give up he’ll tell me: “No, mommy, we’re not done yet, you need to keep thinking!” He gets along well with his peers and makes new friends easily. Although he sometimes bites his older sisters when he is furious, he has the self-control not to use that behaviour at prep. He knows he is loved and is capable of extending his love to others. These skills are essential for children’s academic and social development.

What is not fair is that these vital building stones of human development – focused attention, self-regulation, and a healthy sense of self-worth – are not equally distributed among children. Some enjoy the effects of a nurturing environment, whereas others fall behind early on.

By age five there is a 30 million word-gap between children who belong to the highest and the lowest socioeconomic groups in society in Northern America. So the least advantaged children have been exposed to 30 million less words by their immediate environment, and consequently, the development of their impressive and expressive language skills will lag behind.  Differences in focused attention are huge because the brain is an organ where the rule is use it or lose it.

In countries with no access to universal early childhood education services the social gap – and with it, lost potential – is enormous. In Scandinavia, the preschools serve as a compensatory mechanism and are especially useful for children coming from disadvantaged families. The U.S. has launched a number of successful programs for early childhood education for low-income families, such as Early Head Start. Australia has got some catching up to do in this area!

The excellent book From Neurons to Neighborhoods (Shonkoff and Phillips, eds, 2000) summarises evidence from neuroscience, child development research, and molecular genetics. They shatter the controversy of “nature versus nurture” as a cause of developmental differences by presenting strong evidence that it is both. They make the case that no society can allow itself not to do everything in their might to provide safe, healthy, nurturing, and developing environments to all children.

The importance of the equal distribution of these commodities is described in a book I refer to as our ”bible”: Developmental health and the wealth of nations, edited by Daniel Keating and Clyde Hertzman, 1999. There is a Latin proverb: Nomen est omen – your name predicts what you might become. Hertzman can be translated to The Man of Heart and it is exactly what Clyde was.

I met him at his favourite breakfast place in Vancouver and he generously shared his experiences with me. He stressed the importance of speaking a language that politicians will understand and be able to act upon. Clyde Hertzman died recently, but if you want to see a truly inspiring video where he explains the complex issue of environmental effects on brain development in a simple way, do watch him speak here.
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So what is not fair is that our son is fast asleep in his bed after a dinner with his family and a story read to him, while other children never get a chance to experience that. The tragedy is that so much of the ingredients of suboptimal development, such as insecure attachment, prenatal environmental hazards, chronic life stress, violent relationships, economic disadvantage, and low academic achievement seem to be “inherited” from one generation to the next.

The good news is that even if you are not in a position to make a difference for many children you can always be a significant adult in the life of at least one child – and I don’t mean your own. Children are wired for interaction and learning. So extend your love and attention to a child who needs it: read a story, show them affection, tell them everyone is good at something and the trick is only to find out at what. Show them they are worth loving for just whom they are. That will oil their brain wires for learning and experiencing.

If you are in a position to make a difference: do your part in making high quality early education accessible, affordable, and equitable.