Presented at the "First International Conference" of CRN Child Science Exchange Program in Asia held in Shanghai, China, March 4-5, 2017.

Brain Development is a Lifetime Project

Brain development is a continuous process taking place through life. The brain size of a newborn baby is a quarter that of an adult. It increases to 80% of adult size when the child is three years old and 90% at five. All the life-time supply of neurons in our brain are already in place at birth. When you see a newborn baby, the wired-up (connection rate) of the neural circuitry may be 25%. It reaches 75% in the first year and is 90% by three. Here I want to remind you that a fetus can hear the mother's voice. How would her sadness, crying or joy affect its brain connections in utero?

First, I would talk about the "sensitive period" of infant's brain development. This is also sometimes called the "window of opportunity." During this period, the brain development of a child is particularly rapid allowing him to learn with better results with less effort. For example, I went to an English school when I was five and can speak it fluently like a native speaker. I only started learning to read Chinese at nine and it was one subject I always struggled with. I learnt Japanese when I was 30 but even now I cannot speak it well. Language acquisition actually does have its "sensitive period."

I hope teachers involved in early childhood education make serious efforts to identify children who are hard of hearing and who squint and send them for assessment (for squint - before six months of age). Children born with crossed or "lazy" eyes should be seen by an eye specialist for management before six months of age. Otherwise they will fail to develop full visual acuity and depth perception in the course of their lifetime.

The second brain development period is the critical period. Language acquisition is affected by the impact of the two sides of the brain. Language depends on personal verbal input. The right and left brain need to work together to acquire language. If children are not taught words before the age of seven, their future language development (pronunciation, fluency and grammar) will be severely affected. Learning then proceeds more slowly up to adolescence and the critical period ends at the age of 12. Therefore, if you begin to learn a language after the age of 12, you may have already lost a golden opportunity for native fluency. When children learn a language, the first stage is to stabilize the mother tongue, and then to start the second language. If a second language is taught early enough, the brain can switch between languages easily. Whether it is their mother tongue or English, children can convert two different languages naturally and easily. Therefore, I hope that we can have children start learning a second language as early as possible because learning after the age of 12 presents them with considerable challenges with lots of difficulties.

Second, I want to emphasize a screening factor, that is, a "toxic environment," in fact, a "bad environment." There are some children who grow up in a terrible environment, in some cases because of their parent being a single parent, or being neglected or abused. Childhood experiences not only affect the performance of these children, but also may determine the expression and repression of children's genes (epigenetics). For instance, if children below the age of three have suffered major trauma, their development may be adversely affected by the modified expression of some genes. Therefore, early childhood experiences are very important. Not only does it have a lasting impact on people's lifelong learning and behavior, it also has a great impact on human health. For example, I want to tell you about a 74-year-old depressed woman who cried in my clinic. She said she wanted her life back. Her parents were married very young because of the war, without love. When she was very young she was told she was picked up from the trash bin. In school she was told her father was useless and she was frequently beaten and spanked. Although she became a good teacher, her toxic childhood had left her with psychological, marital and chronic health problems. She said she wanted her life back.

A "bad environment" also includes the use of illegal drugs, commonly known as "addiction." One out of every 20 persons use illegal drugs, which means 230 million people are using illegal drugs. A lot of people are taking drugs and also smoking. In fact, these people have not received a good social education, they belong to a group who suffer from "social illiteracy." Considering pregnant minors, 16 million women aged 15-19 become pregnant per year and it accounts for about 11% of the world's newborns. With respect to divorce rate, Belgium is the highest, up to 71% of all marriages, the United States 53%, Europe 55% as a whole. In the past 45 years, the suicide rate has increased by 60%, Japan ranked 17th, South Korea was second. This is what I think is a reflection of "social (skills) illiteracy." I would also like to address "food illiteracy." I think the people here are quite healthy, not particularly fat, but it is not the case in Malaysia. Chinese people's BMI (obesity index) is not bad. Overall, 25% of people at the age of 40 are obese. It is because they do not pay sufficient attention to their diet and healthy lifestyle. When a child is obese by the age of 4 years, he/she has a very high risk of becoming an obese adult. Preschool educators must help to inculcate healthy eating habits and lifestyle to prevent childhood obesity.

Education - A Lifetime of Brain Skills

Aristotle said that the purpose of education is to ensure a sound mind and a sound body. In this process, we must consider physical and mental health.

First, let me talk about music training and physical exercise. Music training can promote the development of the brain and it affects multiple senses. A child who learns to play an instrument before the age of seven can promote the development of the brain by increasing neural circuit connectivity. Music can help us relax and feel better, so it can be used to treat alzheimer, dementia or depression. Music has a great power to heal. I hope children can gain access to music education as early as possible.

It is also important to have regular physical exercise. We need to find children's favorite sports in the early years of childhood, such as swimming, running, martial arts or football so that they will do these physical exercises as a regular routine. It is preferable to introduce this before the age of seven. Once they grow up to be inactive teenagers, they will almost always say "No" when you try to get them be more active. Therefore, preschool educators must have the children participate in regular physical exercise as a lifetime choice.

In addition, the impact of social media on the child is considerable. Nowadays a lot of children watch TV for excessive periods of time. In experimental models, rats subjected to excessive stimulation display hyperactivity and abnormal risk taking behavior. Of course, people and rats are different, but the negative impact on children sitting in front of the TV for prolonged periods and having excessive social media exposure can be considerable. Adults have to be there to explain and to interact with the children while they watch TV programs.

If I were the Minister of Education, I would recommend providing a different type of education, to include emotional, music, survival skills, swimming, first aid, sex and relationship education and so on. Educators should explore all aspects of the child's natural talents and not just "label" a child according to his academic performance. We all know that Albert Einstein was a genius. However, when he was six years old, his teacher said he was stupid, that his brain reaction was too slow, and that he was not sociable, always daydreaming. The teacher told his parents to take him out of school and thereafter he did his studying at home, where he became the genius we know today. When Thomas Edison (who invented the electric light bulb) was small, his teacher said he was stupid and simply could not learn new things. Sir Winston Churchill, the British Prime Minister, was often punished by his teacher in school, who said he was too lazy. Tom Cruise was a child with "reading and writing obstacles" (dyslexia).

In fact, in many of these cases there was no problem with the children. The key is whether we adults can find the right way to help them. The teacher should think about whether he/she understands the child, the environment, family and what happened to him/her in his past. He should ask the child with compassion: "What happened to you?" instead of asking: "What is wrong with you?" This way of thinking is very important!

Educators should avoid sticking labels on children "stupid," "lazy" and "unlikely to succeed"! They might be embarrassed later when the child proves them wrong! Rather they should get to know every child so that early intervention can break the long-term effects of neglect or abuse or toxic environments. At risk children include those of single parents, unwanted pregnancy or those with drug or social problems etc.

Therefore, I often tell my medical students, the most important thing about being a good doctor is not how much he knows, but how much he cares about his patients. Expert knowledge is of course important, but what is more important is whether we can trust the doctor and whether we feel that the doctor is concerned about us or not. Even if you graduated from an international brand-name school, it means nothing if you do not care about the child. By wholeheartedly caring about children, the children, especially preschool children, can feel and be aware of your concern. Teachers should understand the child's mental state in-depth, listen to their true inner feelings, to maximize the promotion of the child's development.