Early Experience and the Life Path.

This book should be required reading for all mental health professionals. Drawing on their 40 years of work and reviewing a wide body of research, British psychologists and researchers Ann and Alan Clarke argue that the presumed permanent adverse effects of experience as an infant can have unwarranted negative influences on mental health practices and policy. This belief in the special or even overwhelming long-term effects of early adversity is deeply embedded in our culture and reflected in popular literature and journalism as well as some professional schools of thought. Interestingly, the Clarkes refer to a similar publication in 1976, Early Experience: Myth and Evidence with contributions from Bronfenbrenner, Kadushin, Kagan, Rutter and Tizard, which, they believed, contained overwhelming evidence for their conclusion that children could recover from earlier deprivation. Continuing to monitor the research and literature in this field, however, they concluded that another review of the evidence was necessary. The Clarkes state that early experience is a first step on a long and complex path through life. By itself, this first step does not determine a child’s future and may in fact, have little long-term influence. Biological, psychosocial, transactional and chance factors all play a part and have an impact throughout a person’s lifetime. There is no known adversity from which at least some children have recovered if moved to a more positive environment. Early experiences, either negative or positive, may be reinforced and perpetuated by transactional experiences leading to a chain of good or bad events. After discussing the difficulties of extrapolating from longitudinal studies, the authors accent the continuities and changes in long-term development and note that early characteristics, such as IQ and personality traits, are poorly correlated with adult equivalents. They point out that many highly competent and mature adults have survived an extremely troubled and confusing childhood, and that many bright and successful children fail to fulfil their earlier promise. The chapter on children rescued from very severe adversity documents considerable improvement in young children from concentration camps and orphanages who were placed in adoption or foster homes and some intriguing case examples illustrate their arguments. One is of identical twin boys whose mother died shortly after birth. They were cared for by a social agency for a year, fostered by an aunt for 6 months, and then returned to their father. His new wife kept the twins locked in the cellar for the next five and a half years. Discovered at age seven, they were very small, lacked speech and suffered from rickets. Doctors confidently predicted permanent physical and mental handicap. But after special schooling and adoption by exceptionally dedicated women they became adults who appear normal, stable and enjoy warm relationships. One is a technical training instructor, the other a computer technician. The chapter on outcomes in children who were removed from situations of less severe adversity or received interventions such as the Headstart Program summarises much interesting research. For instance, studies of children placed in foster care indicate, “The outcome is generally much better than professional prejudice suggests. ” In a final chapter, where possible contrary evidence is sought, Rutter’s recent research on a large cohort of children who were adopted from Romanian orphanages is examined. These infants were in appalling conditions. There was no personalised caregiving, little or no stimulation, few if any playthings, and most were confined to their cribs. They were fed with gruel from propped up bottles. It comes as no surprise that children who were subjected to these conditions for more than six months were less likely to make the very substantial gains documented in younger adoptees. The authors maintain a scholarly and dispassionate approach throughout, carefully examining the evidence for various theories and propositions. While they provide some historical background about the belief in the monumental importance of infant experiences, they offer no suggestions about its current persistence. This reviewer wonders whether the current state of the world will further this belief. It appears to reflect an understandable wish to simplify an otherwise scary and unpredictable world and provide an infant with a permanent protective amulet against the slings and arrows of later misfortune.