Closing the Science-Policy Gap

A Conversation with Pediatrician Jack P. Shonkoff

The second group, the Research Network on Early Experience and Brain Development, was a multi-year effort involving leading neuroscientists and child development experts, some of whom also served on the NRC/IOM committee. For the last five years, with core support from the John D. and Catherine T. MacArthur Foundation, this body has conducted wide-ranging research on the effects of early experience on brain development and behavior. The Network asks—and seeks to answer—the compelling question of how this expanding knowledge base can influence the decisions our society makes about supporting the health and development of young children. When the efforts of the NRC/IOM committee concluded with the publication of its landmark report in 2000, Shonkoff, who chaired that effort, and his colleagues were determined to see that their intensive investment of time and energy yielded something more than a weighty report collecting dust on bookshelves. Instead, they agreed, their work must open a new chapter focused on translating and communicating the science of early childhood development into informed public policy that best serves the needs of the nation’s children and families.

From Pediatrics to Policy

Shonkoff’s path from idealistic young pediatrician to academic leader and Council founder is an interesting, if atypical, one. He entered college with plans for a career in medicine, but his longtime fascination with the nexus between politics and social change led him to choose a government studies major over the conventional science route. Medical school soon followed, as did a residency in pediatrics. “I haven’t given up on the idea that a powerful way to change the world is to make it better for kids,” he explains.

His first clinical experience—as a young physician in a community health center in the South Bronx—served up a sobering dose of reality. “I learned quickly that all of the things I was trained to do in medical school prepared me for the easy part of being a pediatrician,” he says. “The real problems these kids were facing extended far beyond the walls of the hospital and the clinic, and were much harder to solve.”

Subsequent fellowship work focused on the evaluation and management of children with developmental disabilities reinforced Shonkoff’s view that children’s health needs are closely intertwined with the broader circumstances of their daily lives. Early interventions that addressed poverty, substandard education, mental health challenges, and the wellbeing of parents and caregivers—that is, the large constellation of factors that threaten child health and development—would appear to offer the greatest chance of success for the youngsters he saw daily, he thought. But, too often, these problems were seen as separate and distinct by the experts responsible for addressing them: the medical practitioners didn’t talk to the research scientists, and neither group talked to the people who make or implement public policies that affect young patients like his.

That realization, Shonkoff says today, profoundly molded his thinking several years later when he was tapped to help launch a new Board on Children, Youth, and Families at the National Academy of Sciences in Washington, DC. At the group’s first meeting in 1993, he proposed a panel study on early childhood development that would bring together diverse constituencies invested in the wellbeing of children—bridging the worlds of science, policy, and practice—to share their knowledge and articulate an integrated agenda. “I had lived professionally in all of those worlds, and it was clear to me that these highly compartmentalized pieces of the policy and practice pie were all guided by the same underlying knowledge base,” he recalls. “I therefore put on the table the idea that this newly established Board should sponsor a study to demonstrate that there is a single science of early childhood development, not different sciences related to early care and education, poverty, disability, mental heath, and child maltreatment, among others ”—a revolutionary proposition at the time.

Despite initial concerns among some Board members that the proposed project was too ambitious, Shonkoff’s idea would eventually gain steam. His persistence and singleminded vision paid off when the Clinton White House agreed to host a high-profile conference on Early Childhood Development and Learning in 1997, attracting widespread attention—and much-needed financial support—for research in the field.

Before long, the Board on Children, Youth, and Families raised sufficient funds to launch the study committee Shonkoff would soon chair, and From Neurons to Neighborhoods began to take shape.

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