Prioritize Children to Prevent Violence: On the Shoulders of Giants 2017

In the wake of the horrific mass murder in Las Vegas — an act that is also now painfully familiar — the conversation turns to why it happened and how it could have been prevented. We don’t expect to ever have enough information to give a satisfactory answer.

Guns are central to this tragedy, and we hope that our leaders can come together and address this fact. The problem goes beyond guns to the larger problem of violence in America, which is a public health and social issue that costs our communities dearly — and which we can work to prevent.

We have our heads in the sand. Kids with troubled childhoods will grow out of it, we say; or conversely, they were born that way and can never change. We mistakenly think this child is destined to be a recidivist criminal or that child is destined to be a heartless man lacking compassion.Developmental scientists have accumulated a great body of evidence that points, if not towards what motivated this killer, then towards why so many people grow up to commit acts of violence, great and small. This research offers a prevention approach grounded in cognitive psychology and neuroscience. This approach is also common-sense: how we treat our children when they are young determines how they will treat us when they grow up.

Our combined experience of over 60 years in child psychiatry and psychology leads us to a dismaying conclusion. We know, scientifically, that a child’s experiences in early life have a profound effect on who that child becomes, how he or she becomes wired to respond to other people, and how much empathy for others he or she is able to develop.

And yet this knowledge has not changed how we treat children. The United States government spends more money per year on every other age group than we do on the group of young children. We invest in young children to a much lower level than do most other developed nations in the world. We cannot expect more unless we invest more.

Here is what the research shows: much antisocial and violent behavior in adulthood can be linked back to high levels of cumulative childhood stress and trauma, including physical maltreatment, exposure to violence, disrupted families, and chronic disadvantage. These children are first victims before they become actors in the cycle of violence. Early traumatic experiences form neural connections that endure.

The mechanism that connects these childhood experiences with the adult outcome is an acquired deficit in the function and the volume of brain regions tied to neuro-cognitive processing. In particular, early adverse experiences results in a pattern of decision-making when faced with uncertainty called “defensive processing,” characterized by hyper-vigilance to threat, negative interpretations about the intentions of others, and a quick default to anxiety and anger. When faced with new provocations and challenges, these children become wired to pull the trigger before blinking.

Of course, our first goal must be to protect our young children from trauma so they do not develop these neuro-cognitive patterns. But we can also help struggling children before they become set in this cognitive style and become violent, antisocial adults. Scientists have technologies to teach essential social-emotional skills, cognitive control, and executive function.

Evidence-based programs such as Fast Track and REDI and classroom curricula such as PATHS are based on the simple idea of teaching children to slow down and adjust harmful thought processes through cognitive retraining. The central metaphor is a stoplight: red for calm down; yellow for think it through; green for try your best.

Hundreds of research papers have shown that children who receive early interventions such as these have better outcomes in diverse domains, including substance abuse, arrests for violent crimes, overall well-being, and even civic participation.

Far from being doomed from an early age, at-risk children can be helped to live productive lives. We simply must embrace early childhood intervention as a focus of our practice, our research, and our public policy. Let’s demonstrate our commitment to our children and invest in proven early childhood interventions and in violence prevention research.

Let’s learn more about what makes a person grow up antisocial and violent — and what puts a person on a better path. Then, let’s take those positive steps. Who knows how many tragedies could be averted with a renewed focus on helping children?

At our recent On the Shoulders of Giants symposium, it was suggested that perhaps policy “should be made by scientists rather than politicians.” An audience member responded, “Good luck!” All too often it seems like we in this country need a massive dose of luck to contend with the negative outcomes we see all around us. We contend that research-based early-childhood intervention on a large scale, coupled with compassion and optimism, is much, much better than doing nothing.

Dr. Kenneth Dodge is a member of the National Academy of Medicine and founding director of the Center for Child and Family Policy at Duke University. Dr. Harold Koplewicz is the former director of the Nathan S. Kline Institute for Psychiatric Research and the founder and president of the Child Mind Institute.