Luby Joan L, Rogers Cynthia, McLaughlin Katie A
Department of Psychiatry (Child), Washington University School of Medicine, St. Louis, Missouri.
Department of Psychology, Harvard University, Cambridge, Massachusetts.
Biol Psychiatry Glob Open Sci. 2022 Jul;2(3):233-241. doi: 10.1016/j.bpsgos.2021.10.003. Epub 2021 Oct 21.
Environmental experiences early in life have strong and enduring consequences for cognitive, emotional, and neurobiological development and related physical and mental health trajectories. The powerful influence of early caregiver nurturance and stimulation on promoting positive neurodevelopmental outcomes has been demonstrated across species. These findings elucidate the environmental conditions known to facilitate healthy neurodevelopment and underscore the potential for modifiable psychosocial factors in the environment to be harnessed to inform early preventive interventions to promote health and adaptive development. A framework for early preventive interventions to enhance nurturing and responsive caregiving for implementation during early sensitive periods of brain development delivered within existing health or educational infrastructures is proposed. Emotional development during sensitive periods is an important, under-recognized, and abundantly modifiable predictor of mental and physical health outcomes that warrants investment of resources and integration of interventions into public health infrastructure for children worldwide. Future studies are needed to further clarify whether and when sensitive periods are present for key developmental domains to inform the optimal timing and targets of these interventions. Numerous available empirically supported early interventions may be modified and applied in briefer and more feasible modalities of delivery to broader populations of developing children. As well established in growth and development across species, essential environmental inputs that are particularly important at specified developmental periods facilitate optimal growth trajectories. Such principles hold great potential in application to early child neurodevelopment to facilitate a thriving and resilient human population.
生命早期的环境经历对认知、情感、神经生物学发育以及相关的身心健康轨迹有着强大而持久的影响。早期照料者的养育和刺激对促进积极的神经发育结果的强大影响已在多个物种中得到证实。这些发现阐明了已知有助于健康神经发育的环境条件，并强调了利用环境中可改变的社会心理因素为早期预防性干预提供信息以促进健康和适应性发育的潜力。本文提出了一个早期预防性干预框架，即在大脑发育的早期敏感时期，在现有的卫生或教育基础设施内实施，以加强养育性和反应性照料。敏感时期的情感发育是一个重要的、未得到充分认识且可大量改变的身心健康结果预测因素，值得投入资源并将干预措施纳入全球儿童的公共卫生基础设施。未来需要进一步研究，以明确关键发育领域是否存在以及何时存在敏感时期，从而为这些干预措施的最佳时机和目标提供信息。许多现有的、有实证支持的早期干预措施可以进行修改，并以更简短、更可行的方式应用于更广泛的发育中儿童群体。正如在跨物种的生长和发育中所确立的那样，在特定发育时期特别重要的基本环境输入有助于实现最佳生长轨迹。这些原则在应用于幼儿神经发育方面具有巨大潜力，以促进人类繁荣和适应力。
