TEDMED speaker and pediatric endocrinologist Louise Greenspan has been a co-investigator in a uniquely comprehensive longitudinal North American study following young girls through puberty. We asked her to design a fantasy health intervention with unlimited resources. Here’s her vision:
We all know the expression, ”It takes a village to raise a child.” My fantasy intervention is based on that concept, however it expands on what the village is and what it provides. Today’s industrialized societies have fractured the extended family, resulting in most parents not having support from their own elders in raising their children. Many young parents don’t have the basic knowledge they need to support their growing families in healthy ways. While concepts about child rearing naturally change between generations, there is still a lot to be learned from those who have gone before us.
I’d love to support an intervention that provides education and assistance to families beginning from the moment they find out they are pregnant. The idea would be to start with pregnant mothers, by providing nutritional education and enhanced psychological and educational support, regardless of socioeconomic status. This education would take place in classes with members of the neighborhood who are also pregnant, thus building community.
After delivery, new parents would be encouraged to breastfeed and learn how to nurture their babies by visiting health workers who could come into the home. As the children grow, these home health workers would provide assistance and education to parents on how to feed their children, how to support their developing brains, and also how to discipline them. This way, parents could learn the facts they need to know, as well as start to develop a healthy authoritative approach to setting limits with their children. These trained workers would be available for parents to turn to for advice, to supplement the way some of us were once able to turn to our mothers and grandmothers for advice (but with the latest in knowledge and skills). The health workers would also set up support groups for families who live near each other or hold groups and classes as well.
At age 3, all children would be offered high quality preschool with a healthy lunch provided for all, and the parental support and education could continue, informed by these community schools. Parents would learn how to deal effectively with the challenges presented by their ‘threenagers’ and other toddler challenges. At entry to elementary school, the support and education would be augmented so that it would also be provided directly to the children themselves while also continuing with their families. All kids would have weekly lessons in cooking and healthy eating, and be active participants in growing and preparing healthy food at their school as part of the curriculum. Parents and guardians would participate in sessions about how to feed their children healthfully, assist their children educationally, as well as continue to be given tools about how to effectively parent their children.
Health Education would be taught to the children directly, starting in kindergarten with practical life skills, including cooking. In the early grades, the education might focus on the importance of eating a healthy balanced diet and on getting enough physical activity and sleep. As the children age, lessons would include classes on their body and health, with puberty education starting in third grade, separate from sex education, which could start in sixth grade. In third and fourth grade, children would learn about puberty and the body changes that will start and happen to everyone over the next few years. In middle school, kids would continue to discuss puberty, but would now have discussions about sex and sexuality. In high school, these topics would be discussed in more depth. The lessons learned about cooking, healthy eating, and exercise would continue throughout these years. There would also be age-appropriate mindfulness-based stress-reduction education through all of the grades, with an emphasis on this in high school. Parenting assistance and education throughout these years would reinforce these concepts and would perhaps also focus on how to enforce healthy sleep habits and limitations on screen time. The outcomes examined in this intervention would include rates of childhood obesity, early puberty, and psychological and educational diagnoses issues across the socioeconomic spectrum.
Could an intervention like this help reduce childhood health care disparities? Could it reduce parental stress and anxiety? Might it lead to more teens heading to college, thus reducing educational disparities? It is my dream to be able to study the effects of such a holistic, longitudinal, health education intervention. My hunch is that it could be game-changing.
Louise Greenspan is co-author of the The New Puberty: How to Navigate Early Development in Today’s Girls. Learn more by watching her TEDMED talk, “Weighing the causes of early puberty.”