Stopping the next generation of alcoholics before they start

By KIERAN FINNANE
 
We can do something to prevent the next generation of alcoholics from developing and it involves intervening in the earliest years of life: little children need their parents or other care-givers to be interacting and talking with them daily, reading to them, putting them to bed at regular times; they need to be physically active and to have a good playgroup of children of similar age. International research, conducted over many years, has shown that children benefitting from this kind of care in their first years will grow up to be far more resilient to addictions.
 
While to date the People’s Alcohol Action Coalition has focussed almost exclusively on curbing existing heavy drinking, it is starting to turn its attention to prevention. Spokesperson Dr John Boffa says the first three years of life are critical. For many disadvantaged children, by the time they enter school it is too late for the cognitive and emotional development that will help them succeed in education and resist addiction in later life. Without the brain capacity to do well at school, they will most likely drop out at the earliest opportunity, and their impulsivity, poor concentration, lack of self-discipline and self-control will predispose them to develop addictions in adolescence.
 
Dr Boffa recognises that the vast majority of adolescents will experiment with alcohol and drugs, but says the most disadvantaged young people are more likely to indulge in persistent very heavy drinking. In adolescence this causes permanent brain damage which in turn leads to further diminished self-control, spiralling down into full-blown addiction. Dr Boffa says this is what is going on for many Aboriginal heavy drinkers; it is not a genetic predisposition to alcoholism but the result of physiological deterioration that commenced with excessive abuse of alcohol when they were teenagers.
 
In his day job Dr Boffa works for Central Australian Aboriginal Congress. That organisation has published a policy paper on rebuilding family life in Alice Springs and Central Australia. In it they are pushing for a three-pronged approach to turn around the early years of the most disadvantaged children in our community and so divert them from a likely future of under-achievement, unemployment, addiction to alcohol and other drugs and possible criminality.
 
Two parts of the approach are in place: nurse-led home visitation to mothers, both before and after the birth of their babies, and a pre-school preparedness program.
Home visitation has been happening in Alice Springs for the last 18 months and has already led to a significant improvement in birthweight of the children born in that time (a critical developmental factor). Congress wants to see the program extended throughout Central Australia.
A team working on preparing children to enter pre-school started work in February this year, and so far 30 children who otherwise would not have attended pre-school have been enrolled and continue to attend.
 
The remaining part of the approach, not yet the subject of a funding application but that Congress is advocating for, covers the years in between, during which there is important and rapid cognitive and emotional growth that underpins a child’s future development.
“If we wait until age three or four to enroll the most vulnerable children in education, they will enter far behind,” says Congress CEO Stephanie Bell.
 
British researcher Michael Marmot, studying the fates of 17,200 UK babies born in the same week in April 1970, found that the things that made a critical difference to brain development and subsequent life chances, including good health, included: daily one on one interactions and talking with young children, daily reading, going to bed at regular times, being physically active and having a good playgroup of children of similar age.
 
Both the nurse-led home visitation and getting children into pre-school can help to varying degrees achieve these things. The establishment of educational daycare centres could fill in further gaps. The model that Congress is promoting is the “Abecedarian approach” of Professor Joseph Sparling, developed in Carolina, USA.
It involves:-
• “learning games”, where teachers engage daily with one or two children at a time in short interactive sessions;
• “conversational reading” to each child, every day;
• “language prority”, surrounding spontaneous events with adult language; and
• “enriched care-giving” in which teachers encourage children to practice skills like cooperating, counting and colour recognition, during care routines.
 
The day care centres would operate for six hours a day, four days a week, with one teacher for every four children. The teachers do not need to be tertiary-trained. People in the community committed to working with children and who have an acceptable level of literacy could be trained on the job. Congress says 250 children in Alice Springs could benefit from such a program and it would also create local employment.
 
The long term benefits for the children in Prof Sparling’s program have been remarkable:
• fewer risky behaviors at age 18;
• fewer symptoms of depression at age 21;
• healthier life styles. The odds of reporting an active lifestyle in young adulthood were 3.92 times greater for children in the Abecedarian program compared to the control group (children from identical disadvantaged backgrounds who had not had the benefit of the program).
 
“If there was a medicine that produced this odds ratio every child would be on it!” says Ms Bell.