There is no universal way and ways that might be effective for some are not necessarily effective for others. Having said that, there is the possibility of “corrective emotional experiences” for those with histories of mistreatment and other adversities that have undermined their well-being. Our 5-decade study showed that although many people who suffered adversity in childhood had poor physical and mental health outcomes as adults, a good-sized group did not, so this shows that childhood effects can indeed be reversed. There is research evidence that a good marriage/partnership can be therapeutic; a good experience with a psychologist/counselor/psychiatrist can also be beneficial; and even on-going emotional support of friends and families hold the possibility of healing. Being successful in a job or avocation might also help some. Many of our research participants explained that they had a horizon-expanding experience that showed them it was possible to live life a different way than they had when growing up, and they used their own agency to decide to be different. We wish you good luck.

Thanks for this question, I love it! For researchers, the most important standout research question is always the one you HAVEN'T answered yet. So here is one we are working on now, but we won't know the full answer for a while: Do children who were exposed to toxic lead have any lasting long-term effects, particularly for brain health in late life? The Dunedin Study is ideal for researching this question, because lead was added to gasoline and paints from the 1960's until the 1980's, and they were born in 1972, and lead-tested in 1983. Another ideal feature is that although it is hard to disentangle the effects of lead from the effects of poverty when most children exposed to lead today are very poor, this was not the situation in New Zealand in the 1980's. Dunedin children from both rich and poor homes had blood lead levels then that were far above the levels considered dangerous in America today. We looked at the outcomes of the Dunedin children who had elevated blood lead by age 11, following them to their late forties. They show mild decline in their IQ scores, they have downward social mobility (lower level occupations than their parents), they have more mental health problems, and on MRI brain scans at age 45, they show smaller brain structures, compared to their peers who escaped lead exposure. This means lead's effects a very long-lasting indeed. Following the Dunedin children into the future is important for 2 reasons. First, although lead is banned in North America, is still ubiquitous in Asia and Africa, and children's lead levels are very high in those locations. Second, Americans who were children between 1960 and 1990 (like me), had elevated blood lead that was stored in our bones. As we age, bone minerals, including lead, leave bones and leak out into the bloodstream again, particularly with menopause. So a big research question is whether Dunedin Study children with the highest lead at age 11 will develop the most early memory problems as they continue to age. To me, this is a real stand-out research question, and it illustrates how very important early childhood is for healthy aging!

When it comes to human development, posing either-or questions regarding what matters is a 20th-century way of thinking that should be abandoned now. So, consider the following: parents can enhance children’s ability to cope with stress and adversity, by helping them think through how they might handle troubling situations (e.g., with bullies) and implementing those (via practice at home or reminders), all the while recognizing and accepting how they are feeling. Indeed, in one of the studies reported in our book, it was clear that the problematic effects of bullying did not arise for kids when their parents and even siblings were emotionally supportive to the child. A good relationship can be like an effective vaccine! But it is also the case that genetics likely matter. In fact, there is evidence, including some reported in our book, that some children are, for genetic reasons it seems, less susceptible to the effects of adversity on well-being, broadly conceived. In one of our studies, we tracked people who managed to live for over 40 years without ever being depressed or anxious or having a problem with alcohol or drugs. We found that what set them apart from their less fortunate peers was two things: they had no family history of any mental health problems in their parents, grandparents, aunts or uncles, and also, they had shown very sturdy temperament as a preschool child. These two predictors of resilience involve both genes and environment. That’s perhaps the good news. But there is also emerging evidence that those who do not succumb to adversity—which is really the definition of resilience, the opposite being vulnerability—are also less likely to benefit from support and enrichment. In other words, some children, for seemingly genetic reasons, are more and others less susceptible to both negative and positive environmental effects.

My two sons are grown and went to a Montessori day care/preschool from the age of 2.5 and 3.0 years. If one has the resources, my recommendation would be to delay the onset of child care for a year or so, as it is early, extensive and continuous care--meaning from early in the first year, for 20-30 or more hours per week, until the child starts school--that seems to carry risk for small to modest increases in aggression and disobedience. Selecting a program with fewer kids in a group and more skilled caregivers is almost always a good idea. But if one either doesn't have the freedom to do what I have described or simply doesn't want to, then appreciate that what goes on at home in the family is more important than what goes on in day care. So there would be less reason for any concern if the family is well resourced psychologically, emotionally, educationally and financially. And never forget, while the early years are important, they are by no means everything: Infancy and early childhood experiences, exposures and development are NOT destiny.

Jay and I answered this question together. What a terrific occupation you have,in perinatal mental health. Like so many “risk factors”, it is critical to understand what the term “risk” implies: increased possibility relative to others (in this case who are not born preterm), but by no means certainty. So what this means is that there are plenty of grounds for offering hope to parents of preterm infants. A very important consideration in realizing this hope will be parenting quality and family support. These early babies can be a real challenge; one of the authors had a premature infant who led him to wonder, honestly, why there wasn’t more child abuse! That is how frustrating it was dealing with this child who cried so easily, proved so difficult to comfort, and had trouble falling and staying asleep. But his parents were glad they “got” him, because they had the necessary resources to cope and not all do. Fascinatingly, there is emerging evidence that these would-be “high-risk” infants may be especially susceptible to the influence of positive parenting, and it may be because they have such sensitive nervous systems that experiences in early life register especially strongly on them. But this means that while they may be more susceptible than others to the benefits of sensitive care, a reason for hope, they also may be more likely to develop problems when their parents' care is less sensitive and supportive. One of our publications looked at the mental health outcomes of low birth weight infants, and we found that they were prone to developing ADHD, but far less prone if their mother was exceptionally warm toward the child. Ultimately, a particular preterm infant’s age, weight and physical health at time of birth are going to matter, but as you will know, the parents' age, maturity, physical health, mental and cognitive health, matters just as much. This means your work supporting parents is essential.

It is rare for a child who behaves and functions in a certain and troubling way not to be able to change/develop at all, and this is especially so the younger the child is--though even older children can change. While there is no guaranteed formula for inducing change--and children are different, with some easier than other when it comes to changing-- consider the following: --reward good behavior with words and deeds, as this is far more effective than punishing bad behavior; --and when it comes to the latter, try to ignore it when it is not too disruptive/problematical, as the attention it evokes can be its own reward, thereby maintaining the problematic behavior; --talk to your child about what s/he is feeling when she is behaving in problematic ways; --let him/her know that those feelings are real and okay, but they don't have to drive behavior; --explore with him/her, if old enough, what might be done to not be so controlled by feelings; --also you can suggest tactics/strategies and help the child implement them; --but these should not be giant steps, but smaller, gradual ones that, over time, can lead to larger improvements. --always let your child know that you love him/her and that if and when you get angry/annoyed it is his/her behavior that is bothering you, not who s/he is. Tell him "it's just like your loving mommy/daddy, but not liking it when they stop you from doing what you want to do or punish you." --look for the good in who they are and how they behave and even how what bothers you might have some hidden benefit (some day?). Good luck.

Evidence often indicates that almost irrespective of the psychological or behavioral phenomenon we are talking about (e.g., IQ, aggression, happiness), genetics account for around 50% of the differences among people. But that doesn’t mean that the remaining 50% is a function of parenting. Instead it would be a function of all types of experience (with parents, at school, with peers, with sibs, at work, shocks to adult health….). So it seems unlikely that effects of parenting per se will be equal to genetics. There is a lot of luck to life, after we grow up and leave our parents’ influence. Having said that, it is important to appreciate an emerging understanding of nature and nurture: For some individuals their genetics appears to make them especially susceptible to parenting and other environmental effects, for good or for ill, whereas for others their genes make them less susceptible. Some people seem genetically impervious to their environments, other are unusually sensitive. So it may be the case that we need to think in terms of the “nature of nurture”, what with nature making some more likely to be affected, either well or badly, by the nurture they experience, including parenting, whereas for others this is less the case. This certainly complicates the question posed.

A core theme of our book is that development continues life long, so the possibility of change most certainly exists, even if it gets more difficult or less likely the older we get. There is plenty of evidence that at least when it comes to risk of physical and chronic illness there are things we can do to lessen the risk, even with high ACE scores—because the past is probabalistically, not deterministically, predictive of our future. In other words, high ACEs do not create inevitable outcomes. Our 4-decade follow up study shows that many participants with a high ACE score in childhood had excellent outcomes by age 45. A good general description of them was that these were people who used the power of their own intelligence, and they invested in making plans for themselves. So what can one do? In general, adopt positive health behaviors by exercising regularly, eating well and not too much, getting sufficient sleep, and perhaps even meditating. At the same time, abandoning negative health behaviors matters a great deal, too, perhaps most importantly, quitting smoking. But reducing alcohol and drug consumption and the feeling and expression of anger can also help. Supportive relationships with others are also health sustaining. We wish you good luck.

This is a challenging issue, with several competing concerns, including the desire to keep families together, the desire to protect the child, and the recognition that there are risks with waiting too long to separate child from parents and/or terminate parental rights, as well as not waiting long enough. So each and every case is different. The more troubled parents are, perhaps with alcohol and/or drug problems for which they won't seek treatment or stick with it, the more severe the and long-standing the mistreatment, the more severe parents' mental health problems, again perhaps resistant to treatment, then I think it makes sense to take children from parents; and the sooner the better. But except in truly extreme cases, intervention efforts should be tried, but reality should not be confused with hopes/dreams. If it doesn't work, don't keep believing that it eventually will.

It is by no means unusual, indeed virtually typical, for adolescents to engage in delinquent-related norm and rule breaking. This can take the form of drinking too much alcohol, taking a car out for a drive without permission, shoplifting, vandalism and a host of other problematic behaviors. And most adolescents grow out of this. The young people who grow out of delinquency fastest are the ones who had good grades at school and warm family bonds before they began getting into trouble. But there are those whom we can identify—but still imperfectly—who will go into a life of crime. While we can predict accurately their increased “risk”, a probability statement, we cannot say for certain that this risk will be realized in any particular case for any individual child. What to look for? As we make clear in our book, the factors that strongly increase the risk of a life of crime are limited cognitive abilities, especially limited verbal skills, and difficulties controlling behavior in early childhood, perhaps reflecting underlying neurobiological problems, along with an unsupportive family environment. And it is when the troublesome behavior of being disruptive, aggressive, overactive, and with a limited ability to focus attention continue through the middle-childhood years, that adolescent trouble making is much more likely to persist into the adult years, including serious adult criminal behavior. All this speaks to the importance of early intervention—because the longer the liabilities outlined continue, the harder it has proven to be to significantly modify development. An antisocial lifestyle can become like a snowball rolling downhill, picking up more snow on the way, and gaining momentum until it is very difficult to turn or stop.

Your question is important, and dear to my scientific heart, but it asks about two of the aspects of human development that are the very most difficult to study properly. To study prenatal domestic violence well, one needs to recruit large numbers of women while they are pregnant, and interview them about domestic violence. But pregnant women today are busy, and reluctant to sign up for research, and researchers must overcome mothers' fear that their baby might be taken away if they reveal domestic violence going on at home. To study inter-generational trauma, researchers must recruit not only women, but their child, and its grandparents too, to take part in interviews and assessments. Getting three generations is a big challenge. As a result, many scientific papers purport to study these questions, but if you look closely the research is often not very well done. Domestic violence has been a key aspect of our work, including intimate partner violence between a mother and her partner(s), and neglect and abuse of that mother's child. We have been able to interview Dunedin Study members (and their partners) about their experiences of intimate partner violence, when they were aged 21, 26, 32, 38, and 45. At age 21, violence between partners was not unusual, it was very common, but by age 45, very few study members are now left who are still experiencing violence at home, though those seem to be more serious cases. Many have carried violence with them from partner to partner, over the years. The most surprising finding we had was that women and men in their twenties and thirties took part in intimate violence about equally, even in the most seriously involved couples who had used police, battered women's shelters, and hospital emergency treatment. This finding was not welcomed by the feminist community at the time, but it has since been confirmed in studies from many different countries. However, we did find that the women in a violent relationship, and not the men, ended up developing diagnoseable mental disorders. This year we reported that Dunedin women in long-term violent relationships have actually aged faster biologically than other women in the study. What about intergenerational effects? Our Environmental Risk Study of 2,200 children born in the 1990's in Britain focused very intensely on the effects of domestic violence on young children. We worked hard to earn the trust of these mothers. We found mothers' intimate partner violence was concentrated in the same families as child abuse and neglect, these problems seem to co-occur very often. In some families, the father was so antisocial that the mothers' and children's lives improved if the father was absent, everyone's mental health improved, even though the family had less money coming in after the father left. So far, there is no good news, put simply, it is not good for children to be exposed to any violence at home, ever, period. We have reported that the children's mental health, physical health, social health, and academic health all suffered. What we are looking forward to now is following up these British E-Risk children into their late 20's and 30's as they have their own babies. Some will sadly repeat their bad childhoods, but I have no doubt that many will choose to be different and better. It will be terrific for our scientific team to learn from how they make their decisions.