National Framework for Universal Child and Family Health Services

2.2 The importance of the early years

Page last updated: 20 May 2013

In recent years, accelerating bodies of evidence from many disciplines including neuro-science, molecular biology, developmental psychology, and social ecology have demonstrated that the period from conception through the early years of a child’s life provide the foundation for lifelong physical, social and emotional wellbeing. Key points emerging from this evidence are as follows:

  • Research demonstrates that the developing brain is not just genetically determined but contingent on the complex interplay between genes and the environment and that the brain develops most rapidly from conception to about 5-6 years of age [12].
  • Early experiences and interactions contribute to brain ‘wiring’ or structure and capacities. Nurturing, responsive relationships build healthy brain architecture that provides a strong foundation for learning, behaviour and health [12, 13].
  • When protective relationships are not provided, elevated levels of stress disrupt brain architecture [12, 13].
  • Biological events during fetal and early life predispose a child to an elevated risk of physical and mental health problems as an adult [14-18]. Studies indicate for example, that adults who had low birth weight are at increased risk of coronary heart disease, diabetes, hypertension and stroke in adulthood [14-18]. Importantly however, these relationships can be modified by positive patterns of postnatal growth [19].
  • Socioecological perspectives [20] emphasise the importance of understanding the multiple influences on child development. These include the most immediate influence of family, through to peers, school and neighbourhood, as well as, the social and institutional context in which the child lives.
  • The health of the mother, father and other primary carers is crucial for optimising the health and wellbeing of children [21].
  • Neighbourhoods and communities are also important and studies indicate that socioemotional and learning outcomes of children are influenced by the neighbourhood they grow up in [22].
  • There are also strong indications that social changes over recent decades have impacted on maternal wellbeing and have altered family functioning [23]. For example, changes in family composition, alterations in workforce participation particularly for women, and an increasing number of families with complex needs may have resulted in the weakening of protective factors and an increase in risks for children [23].
It is important that support is accessible for all children and their families throughout a child’s development including across key transitions. This is particularly true for vulnerable families. Transition periods such as becoming a parent, early infancy, the toddler years and starting preschool or school represent critical developmental stages for children and families. Each involves multiple social, cognitive, physical and emotional changes. The success of each of these transitions depends on a complex interplay of family, health, legal, cultural, neighbourhood, educational and other influences. Failure to make successful transitions puts children at increased risk for poor outcomes in the present and the future [24-29].

There is a strong economic argument for supporting children and families early. Known benefits accrue to the whole society, through enhanced human capital and capability, increased productivity, greater social inclusion and reduced public expenditure in health, welfare and crime, related to disadvantage over the life course [23]. Much cited benefit-cost ratios from the US suggest that for every dollar invested in services for preschool age children, there will be a $2 to $2.60 return to society [30]. Nobel laureate and economist, Professor James Heckman calculates that taking into account crime savings, education savings, welfare savings and increased taxes due to higher earnings, the economic return is between 15-17% for every dollar [31].