title: Issues in the timing of integrated early interventions: contributions from nutrition, neuroscience, and psychological research.
abstract: A central issue when designing multidimensional biological and psychosocial interventions for children who are exposed to multiple developmental risks is identification of the age period(s) in which such interventions will have the strongest and longest lasting effects (sensitive periods). In this paper, we review nutritional, neuroscientific, and psychological evidence on this issue. Nutritional evidence is used to identify nutrient-sensitive periods of age-linked dimensions of brain development, with specific reference to iron deficiency. Neuroscience evidence is used to assess the importance of timing of exposures to environmental stressors for maintaining neural, neuroendocrine, and immune systems integrity. Psychological evidence illustrates the sensitivity of cognitive and social-emotional development to contextual risk and protective influences encountered at different ages. Evidence reviewed documents that the early years of life are a sensitive period when biological or psychosocial interventions or exposure to risk or protective contextual influences can produce unique long-term influences upon human brain, neuroendocrine, and cognitive or psychosocial development. However, the evidence does not identify the early years as the sole sensitive time period within which to have a significant influence upon development. Choice of age(s) to initiate interventions should be based on what outcomes are targeted and what interventions are used.
authors.affiliation: Department of Psychological Sciences, Purdue University, West Lafayette, Indiana.
authors.forename: Theodore D
authors.initials: TD
authors.lastname: Wachs
authors.affiliation: Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota.
authors.forename: Michael
authors.initials: M
authors.lastname: Georgieff
authors.affiliation: Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology, The Rockefeller University, New York, New York.
authors.forename: Sarah
authors.initials: S
authors.lastname: Cusick
authors.affiliation: Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology, The Rockefeller University, New York, New York.
authors.forename: Bruce S
authors.initials: BS
authors.lastname: McEwen
mesh_terms: D000367:Age Factors; D001921:Brain / Q000254:growth & development; D002657:Child Development; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D019033:Delivery of Health Care, Integrated; D018479:Early Intervention, Educational / Q000379:methods*; D061345:Early Medical Intervention / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D000090463:Iron Deficiencies; D019266:Iron, Dietary / Q000008:administration & dosage; D013312:Stress, Physiological
chemical_list: D019266:Iron, Dietary
keywords: brain; developmental risk; early intervention; iron deficiency; sensitive periods; stress