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Kernels for Life:
                              from what we know about prevention science
                              and human development to what we do for
                              children and youth for our futures…

                                 Twitter hashtag: #HCMMB
                                 Slides and publications
                                 http://www.slideshare.net/drdennisembry




    Copyright © 2010, PAXIS Institute, All rights reserved. May be reproduced in whole without charge, provided copyright notice included.

Thursday, November 18, 2010                                                                                                                  1
Thursday, November 18, 2010   2
We must move in the right
                              direction, with all due speed for
                               the next decade—not just for
                               the children of Manitoba, but
                                also as the Inukshuk for the
                                   Western Hemisphere.




Thursday, November 18, 2010                                       3
Thursday, November 18, 2010   4
Thursday, November 18, 2010   5
Thursday, November 18, 2010   6
FREE DOWNLOAD




                 Embry, D. D., & Biglan, A. (2008).
                     Evidence-Based Kernels:
                 Fundamental Units of Behavioral
                 Influence. Clinical Child & Family
                      Psychology Review, 39.

                              Download at:

                   www.pubmed.gov
            Described in the 2009 IOM Report, p. 210

Thursday, November 18, 2010                                            7
Relational
                                Antecedent       Reinforcement            Physiological
                                                                                                     Frame
                                  Kernel             Kernel                  Kernel
                                                                                                     Kernel



                                                                            Changes               Creates verbal
                              Happens BEFORE   Happens AFTER the
                                                                         biochemistry of         relations for the
                                the behavior       behavior
                                                                            behavior                 behavior


                                                                    Embry, D. D., & Biglan, A.
                                                                     (2008). Evidence-Based

                              Four Types of Kernels
                                                                   Kernels: Fundamental Units
                                                                      of Behavioral Influence.
                                                                       Clinical Child & Family
                                                                     Psychology Review, 39.




Thursday, November 18, 2010                                                                                          8
What is a kernel?
                                  Is the smallest unit of scientifically proven behavioral
                                  influence.

                              •   Is indivisible; that is, removing any part makes it inactive.

                                  Produces quick easily measured change that can grow
                                  much bigger change over time.

                                  Can be be used alone OR combined with other kernels
                                  to create new programs, strategies or policies.
                              •   Are the active ingredients of evidence-based programs
                              •   Can be spread by word-of-mouth, by modeling, by non
                                  professionals.
                              •   Can address historic disparities without stigma, in part
                                  because they are also found in cultural wisdom.




Thursday, November 18, 2010                                                                       9
Rapid


Thursday, November 18, 2010           10
Community     Prenatal      Ages 0-2      Ages 3-5
                                 Text         Text           Text          Text




                               Primary    Intermediate   Early Teens   Later Teens

Thursday, November 18, 2010                                                          11
Your take away task for communities and families…
                               List five ideas you can take back to your
                               community or even your own family
                               Explain the benefits of how these five things
                               Ask others to try one or more of these thing
                               Ask them use their social and electronic
                               networks to spread these ideas
                               For the benefit of all children and families in
                               Manitoba




Thursday, November 18, 2010                                                       12
Epigensis revisited Fraser
                                         Mustard’s talk




Thursday, November 18, 2010                                13
Obesity
                               Conduct
                               Disorders


                                                              Homicide &
                                                               Suicide


                                                                                           Early Sex

                                              Early
                                           Pregnancy
                                                       Addictions


                                                                                     Aggression
                                                                           Disease




                               School
                               failure



                              Epigensis results in a risky path or a healthy path
Thursday, November 18, 2010                                                                                      14
Thursday, November 18, 2010   15
Redness, rubor, a response of body tissues to
                                                          injury or irritation; characterized by pain and
                                                          swelling and redness and heat.
                                                          Excitation, excitement, fervor, fervour the state of
                                                          being emotionally aroused and worked up
                                                          Inflaming arousal to violent emotion
                                                          Firing, ignition, kindling, lighting
                                                          the act of setting on fire or catching fire




                              Hypothesis: Evolutionary “inflammatory” processes

Thursday, November 18, 2010                                                                                      16
Threat from parasites,   Threat from humans
                              bacteria, and viruses    who might kill or steal

Thursday, November 18, 2010                                                      17
Thursday, November 18, 2010   18
Human Infectious/Biological Threats                       Human Predatory Threats



                                  Evolutionary Adaptive Responses                     Evolutionary Adaptive Responses
                                             (Simplified)                                         (Simplified)
                                                                     Neuro-Hormones

                                                                          Mood
                                                                        Modulators


                                                                       Reward Delay   Intra-Group              Threat Attributional
                              Generalized              Localized        Modulators
                                                                                      Affiliation               Bias (Inflammatory)
                              Inflammatory          Inflammatory                        (Anti-Inflammatory)
                                                                                                                        Out-Group
                              Response                Response           Stress
                                                                        Modulators
                                                                                                           Aggress. (Inflammatory)
                                                                                      Intra-Group
                                                                                      Cooperation             Tit-for-Tat Beh. Bias
                                 Anti-Inflammatory Regulators           Puberty/Sex    (Anti-Inflammatory)
                                                                       Modulators                                    (Inflammatory)




Thursday, November 18, 2010                                                                                                           19
Substance                       Work         Obesity,
              Early           Mental Illness                   Violence                                 Cancer      School
                                                 Abuse                       Problems         etc
              Sex                                                                                                   Failure

                               Mood                              Reward         Executive           Behavioral
                                                 Attention
                              Stability                           Delay         Function           Competencies

                                                                                                   Immune-
          STD’s                Motor                                                                Healing          Special
                               Skills            Multi-Inflammatory Threat Reaction                 Functions           Ed




                                Major Ecologic Causes of the Dual Inflammatory Threats to Children & Youth

                              Physiological      Antecedents         Reinforcement               Verbal Relations




Thursday, November 18, 2010                                                                                                    20
K                                                                              R
                                  Path                                                                           Path



                                                             Evolutionary Path
                                                              of a Child’s Life




                                                                                  Probability of short-life and doubtful
                              Probability of long-life and                              reproductive success
                                reproductive success




Thursday, November 18, 2010                                                                                                21
Obesity
                                Conduct
                                Disorders


                                                                Homicide &
                                                                 Suicide


                                                                                             Early Sex

                                                Early
                                             Pregnancy
                                                         Addictions


                                                                                       Aggression
                                                                             Disease




                                School
                              Disabilities
                                failure



                              R PATH = Risky behaviors or health
Thursday, November 18, 2010                                                                                        22
Physically and                   Successful in
                               emotionally                       life-long
                                 healthy                         learning



                                 Safe and                      Socially engaged
                                  secure       Healthy Child   and responsible
                                                Manitoba




Thursday, November 18, 2010                                                       23
Community     Prenatal      Ages 0-2      Ages 3-5
                                 Text         Text           Text          Text




                               Primary    Intermediate   Early Teens   Later Teens

Thursday, November 18, 2010                                                          24
Coaster and Poster case study for women




Thursday, November 18, 2010                                             25
Do these effect
                                epigensis?




Thursday, November 18, 2010                     26
Antecedent
                      Kernel




           Happens BEFORE
             the behavior




Thursday, November 18, 2010      27
Antecedent
                      Kernel




           Happens BEFORE
             the behavior




Thursday, November 18, 2010      28
Addictions intervention or treatment kernels




Thursday, November 18, 2010                                                  29
Antecedent
           Kernel




                              “Wait for the Timer” for addictions and other issues

Thursday, November 18, 2010                                                          30
Reinforcement
      Kernel




                              “Prize Bowl” for change, recovery & addictions

Thursday, November 18, 2010                                                    31
Reward & Reminder case study on tobacco




Thursday, November 18, 2010                                             32
Thursday, November 18, 2010   33
Thursday, November 18, 2010   34
Reward &
                    Reminder:
                    Logic
                    model




Thursday, November 18, 2010     35
Baseline                    After Reward and Reminder
                                                                                               60%
                                                                                                     Wyoming




                              Percentage of Illegal or Non-Compliant Tobacco Sales to Minors
                                                                                               50%



                                                                                               40%




        Reward &                                                                               30%




        Reminder Impact
                                                                                               20%



                                                                                               10%



        on Access                                                                              0%
                                                                                                     1996   1997   1998   1999   2000    2001   2002   2003   2004   2005   2006   2007
                                                                                               60%
                                                                                                     Wisconsin
                                                                                               50%



                                                                                               40%



                                                                                               30%



                                                                                               20%



                                                                                               10%



                                                                                               0%
                                                                                                     1996   1997   1998   1999   2000    2001   2002   2003   2004   2005   2006   2007


                                                                                                                          Data Source: Synar Report, SAMSA


Thursday, November 18, 2010                                                                                                                                                               36
Reward &
                    Reminder:
                    Impact on
                    prevalence

                                 Source: Youth Risk Behavior Survey (YRBS), Centers for Disease Control




Thursday, November 18, 2010                                                                               37
The Lancet case study on fish consumption




Thursday, November 18, 2010                                              38
Thursday, November 18, 2010   39
Apparent consumption o inoleic acid (% of dietary energy) among
                                                                                                             Australia, Canada, UK and USA for the years 1961–2000


                                                                                                                                                     #"        +651.-:8-       A-0-;-         BC        BD+2




                                                                                                             +,,-./012340567,1840 492:804:/83 -38;
                                                                                                                                                     $

                                                                                                                                                     &

                                                                                                                                                     '




                                                                                                                         <=2/0/.>?@
                                                                                                                                                     (

                                                                                                                                                     %

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                                                                                                                                                          #$(" #$(%   #$'"   #$'% #$&" #$&%    #$$"   #$$% !"""




                                                                                                                                                                                                                   “Risky” Beh.
                                   Evolution                              Neonates                                                                   Breast Milk
                                                                                                                                                                                                                   & Mismatch
                                In the Rife Valley, the                 Successful human                                                        American infants have
                               human brain evolution                   neonates born with                                                        been getting steadily                                                Theory
                                 the result of eating                    60-day supply of                                                       less omega-3 (n3) and                                              Almost all adolescent
                                fish high in omega-3                        omega-3 in                                                           more pro-inflammatory                                               risky behaviors have
                                                                                                                                                omega-6 (n6) in breast                                            now been documented
                               not savannah animals                   subcutaneous fat from
                                                                                                                                                        milk                                                      to be related to low n3
                                                                          mother’s diet
                                                                                                                                                                                                                  and high n6 in US diet
                                 See Broadhurst, Cunnane, &
                              Crawford (1998). Rift Valley lake fish
                                                                        See HIbbeln et al. (2007).Maternal
                                                                      seafood consumption in pregnancy and
                                                                                                                                       See Ailhaud et al. (2006).Temporal                                         change in last 50 years
                                                                                                                                       changes in dietary fats: Role of n6
                              and shellfish provided brain-specific        neurodevelopmental outcomes in                                                                                                           Hibbeln et al. (2006). Healthy intakes of
                                                                                                                                     polyunsaturated fatty acids in excessive
                                          nutrition for                   childhood (ALSPAC study): an                                           adipose tissue                                                    n-3 and n-6 fatty acids: estimations
                                          early Homo                        observational cohort study                                                                                                               considering worldwide diversity.
                                                                                                                                     development and relationship to obesity




Thursday, November 18, 2010                                                                                                                                                                                                                               40
Low maternal omega-3 consumption from
                              seafood and
                                                               34


     Physiological                                             32


        Kernel
                                                               30
                                 Percentage of children with
                               low verbal IQ, WISC-III , 8y




                                                               28                                                 Hibbeln et al, Lancet 2007: 369: 578-585
                                                      UK




                                                               26
                                                                                                                                                  r = 0.97
                                                               24                                                                                 r2 = 0.95
                                                                                                                                                  F=27.2
                                                               22                                                                                 p<0.02.

                                                               20
     Changes                                                   18

  biochemistry of                                              16

     behavior                                                  14

                                                                    0   0.05   0.10   0.15   0.20       0.25   0.30   0.35   0.40   0.45   0.50   0.55 0.60

                                                                                                    -
                                                                           Estimated omega 3 fatty acids from seafood (en %)
                                                                                       Mother at 32 wk gestation




Thursday, November 18, 2010                                                                                                                                   41
Physiological    Mother
                                                    Mother

                                                   concordant

                 Kernel
                              concordant




                                                                exceeds




               Changes
            biochemistry of
               behavior
                                                   Mother
                                                  concordant
                               Mother
                              concordant




                                                               exceeds
                                        exceeds




Thursday, November 18, 2010                                               42
Omega-3 for all pregnant mothers, nursing
                              mothers and weaned infants and toddlers

Thursday, November 18, 2010                                               43
The cost? About $40 per year




Thursday, November 18, 2010                                  44
Why not help our serious at-
                              risk children with omega-3?
                                                                              30%
                                     Percentage with Psychosis at 12 months


                                                                                                          27.5%
                                                                              24%


                                                                              18%


                                                                              12%


                                                                              6%
                                                                                    4.9%
                                                                              0%
                                                                                    Omega-3               Placeo
                                                                                              Psychosis


                              Amminger, G. P., M. R. Schafer, et al. (2010). "Long-Chain {omega}-3 Fatty Acids for Indicated
                              Prevention of Psychotic Disorders: A Randomized, Placebo-Controlled Trial." Arch Gen
                              Psychiatry 67(2): 146-154.
Thursday, November 18, 2010                                                                                                    45
Before Omega 3



                              Omega-3 can improve school
                              grades and success
                                    Omega 3   Placebo
                               7
                                                           These were gains in
                               6
             After Omega 3                                  academics after 3
                               5
                                                               months of
                               4
                                                           exposure to fish oil.
                               3
                               2
                               1
                               0
                              -1
                              -2
                                   Reading    Spelling   See www.durhamtrial.org/



Thursday, November 18, 2010                                                         46
The British and Netherlands Prison Studies




Thursday, November 18, 2010                                                47
Thursday, November 18, 2010   48
Reduce Omega 3 and
                              Micronutrient Brain Deficiency




Thursday, November 18, 2010                                   49
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                              7-.8&6"%)33"*#"#&#9-(+&93)$*.1&):&;-.93-*1<&3-*"69(1&9*#&"11"*=9(&:9>+&9%-#1
                                  Ratio of Disciplinary Incidents Supplementation/Baseline



                                                                                             1.00

                                                                                                                                      2%=;"&CDGKOQ                  5(9%"J)&CFOKFQ
                                                                                             0.75                                       &B&R&OKOOS                      &B&T&*1

                                                                                             0.50

                                                                                                                                                                               Active
                                                                                             0.25                                                                              Placebo


                                                                                               0
                                                                                                         Before supplementation            During supplementation


                                                                                             ?@&39A-3$3&1"%$6-.+&B6-1)*&C&DDE&)0"*%"1&93)*4&FGH&B6-1)*"61&);"6&I&3)*.81&.6"9.3"*.&-*&9&
                                                                                                                          %)3B96"#&.)&I&3)*.81&J91"(-*"K&
                                                                                                                    L"1%8&".&9(K&&M6&N&51+%8-9.6+&HOOH<&FEFPHHCHE




Thursday, November 18, 2010                                                                                                                                                               50
Why not reproduce the rapid
                              results in Manitoba to get a
                              37% reduction in jail violence?
                              It cost the Brits 19¢ per day or $69.35 per year.




Thursday, November 18, 2010                                                       51
Safe Playing Case Study




Thursday, November 18, 2010                             52
A environmental policy
                              case study in reducing
                              early rebelliousness, risk
                              taking and sensation
                              seeking
                              This risk factor can be easily measured in early-childhood, and it
                              predicts lifetime injuries, delinquency, alcohol/drug abuse abuse,
                              and school difficulties.




Thursday, November 18, 2010                                                                        53
Contextual example of such risk

Thursday, November 18, 2010                                     54
Oh,prior prevention efforts in Sweden had resulted
                              in more fatalities…




Thursday, November 18, 2010                                                        55
A book about “me” being a Safe Player




Thursday, November 18, 2010                                           56
Adults defining boundaries of safe play




Thursday, November 18, 2010                                            57
Adults setting timer to watch safe play in child




Thursday, November 18, 2010                                                      58
Parent praising safe play with stickers




Thursday, November 18, 2010                                             59
Study 1 showed preschool intervention alone had short-
                              term benefits

                              Study 2 showed preschool plus parenting intervention had
                              long-term benefits

                              Study 3 showed strategy could be implemented in 35 Head
                              Starts nationally

                              Study 4 showed parents could change child’s behavior from
                              special story workbook

                              Study 5 showed behavior change for over 100 preschoolers,
                              with no adverse effect.

                              Study 6 showed effort could be successful in a 3-city
                              multiple baseline in New Zealand

                              Study 7 is national campaign, adopted by 50% of New
                              Zealand families

                              Study 8 replicates city results in US




Thursday, November 18, 2010                                                               60
Kernels and 4-P’s used in multi-city/national
                              Safe Playing campaign
                               Proclamations in cities and nationally
                               Endorsements/Sponsorships by prestige organizations AND businesses
                               Media models of adoption by high-status people
                               Media models showing rapid results/benefits
                               Public posting of rates of adoption/use
                               Competitions between cities on adoptions

                               Placement in supermarket or other easy venues
                               Price free after filling out Safe Playing Promise (with address, etc.)
                               Promotion for every family who wants their child to be safe
                               Product promises child will be safer in two weeks when steps followed




Thursday, November 18, 2010                                                                            61
Why not distribute specially
                              constructed books for
                              parents with young children…
                                Reduce dangerous,
                                impulsive, disturbing
                                behavior quickly?
                                Increase social-
                                competence quickly?
                                Improve school
                                readiness quickly?




            Embry, D. D. and L. Peters (1985). A three-city evaluation of the diffusion of a pedestrian-safety
            injury control intervention. R. S. Division, New Zealand Ministry of Transport, Wellington, NZ.
Thursday, November 18, 2010                                                                                      62
Good Behavior Game Case Study




Thursday, November 18, 2010                                   63
Why not turn about the lives of high risk primary
                              grade children using a teacher invented procedure?




Muriel Saunders,
  the teacher




Thursday, November 18, 2010                                                        64
Her invention immediately increases time to learn

Thursday, November 18, 2010                                                       65
Why not turn about the lives of high risk primary
                              grade children using a teacher invented procedure?

Thursday, November 18, 2010                                                        66
Thursday, November 18, 2010   67
Community reinforcement case study




Thursday, November 18, 2010                                        68
PeaceBuilders School-Community Reinforcement Study

                                Positive   Peer-to-Peer     Social
                              Home Notes      Notes       Competence    Violence




Thursday, November 18, 2010                                                        69
Injury Prevention Study Using Positive Reinforcement
                                60%

                                50%            Change in
                                40%
                                            Nurses’ Office
                                          Visits from Year to
                                30%
                                                   Year
                                20%

                                10%

                                  0%

                                -10%

                                -20%
                                              All Visits        Injury Viists   Non-Injuries     Fighting Injuries   Non-Fighting Injuries

                                          Control/Wait List     Intervention




                              Krug, E. G., N. D. Brener, et al. (1997). "The impact of an elementary school-based violence prevention program on
                                              visits to the school nurse." American Journal of Preventive Medicine 13(6): 459-463.
Thursday, November 18, 2010                                                                                                                        70
Prevention Store




                                         Prevention Science Meets
                                                 Retail Consumers
                              Dennis D. Embry, Ph.D., Society for Prevention Research, Denver, June, 2010




Thursday, November 18, 2010                                                                                 71
If kernels are so good…

Thursday, November 18, 2010                             72
How have kernels evolved?
                              The first (almost certainly antecedents) were selected by
                              consequence for immediate reinforcement of food, protection, etc.
                              Early tools come to mind as examples.
                              The second (physiological) probably also arouse by selection by
                              consequences by providing relief from physical or emotional
                              distress.
                              The third (relational frames) arouse with invention of oral and
                              written language, selected by consequences to protect against
                              danger from other humans or natural harm.
                              The forth (contingent reinforcement) arouse with invention of oral
                              and written language, selected by consequences for social
                              advantage within groups and survival advantage of kin.




Thursday, November 18, 2010                                                                        73
Using kernels to build
                                            population-level change…
                                                 Problem
                                                            Kernel
                                                             #1                 Observed
                                                                                Proximal
                                           Observed                              Effect
                                                           Kernel
                                           Proximal        Kernel
                                                             #2
                                            Effect


                                                            Kernel                Big
                                                           Kernel
                                                             #3                 Change
                                  Effect
                                                                     Observed
                                                                     Proximal
                                                                      Effect
t


    Thursday, November 18, 2010                                                            74
Rule #1 of big change
                              A big population-level change requires
                              myriads of reliable, measurable small
                              behavioral changes in at least 20% to 25% of
                              the the total population.
                              Blame is not a kernel. A diagnoses is not a kernel.
                              “Shoulds” are not a kernel. Blame, diagnoses, and
                              “shoulds” are personal or group ways of
                              experiential avoidance for dealing with failure of the
                              methods to create desired change.




Thursday, November 18, 2010                                                            75
Rule #2 of big change
                              Always maximize the dignity and self-sufficiency of the
                              persons whose behavior you wish to influence.
                              If you fail this step, you will be meet resistance,
                              counter-control and sabotage of the group of persons
                              to maintain their dignity and self-sufficiency. This is a
                              basic feature of human social interactions from which
                              our species has evolved. Dead, disposed or failed
                              chiefs and leaders liter human history who failed to
                              observe the key universal feature of human societies.




Thursday, November 18, 2010                                                              76
Rule #3 of big change
                              Pay attention to variations in behavior for improvement.

                              Small differences—when done by many people—
                              can make the difference between night and day.
                              These small differences are the the variation in
                              quality control that great car companies like
                              Toyota or Honda to make incremental
                              improvements. Look for innovations as well as
                              problems.




Thursday, November 18, 2010                                                              77
Rule # 4 Big Change with a
                              kernel requires other kernels
                              A kernel that you want to promote to affect a
                              specific behavior will require other kernels to make
                              the specific action happen. This because other
                              behaviors or people will be required before and
                              after or in other settings for cooperation to happen.




Thursday, November 18, 2010                                                           78
Why not use a new word to convey our support
                              every child being healthy in Manitoba




Thursday, November 18, 2010                                                  79
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Thursday, November 18, 2010   89
Thursday, November 18, 2010   90
Thursday, November 18, 2010   91
Thursday, November 18, 2010   92
Spreading healthy children in Manitoba like dandelions




Thursday, November 18, 2010                                                            93
is the gift of our futures




Thursday, November 18, 2010                                94
Contact: Dr. Dennis D. Embry, PAXIS Institute, PO Box 31205, Tucson, AZ USA
                                       dde@paxis.org • www.paxis.org • www.slideshare.net/drdennisembry




Thursday, November 18, 2010                                                                                 95

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Kernels for-life-manitoba-2010

  • 1. Kernels for Life: from what we know about prevention science and human development to what we do for children and youth for our futures… Twitter hashtag: #HCMMB Slides and publications http://www.slideshare.net/drdennisembry Copyright © 2010, PAXIS Institute, All rights reserved. May be reproduced in whole without charge, provided copyright notice included. Thursday, November 18, 2010 1
  • 3. We must move in the right direction, with all due speed for the next decade—not just for the children of Manitoba, but also as the Inukshuk for the Western Hemisphere. Thursday, November 18, 2010 3
  • 7. FREE DOWNLOAD Embry, D. D., & Biglan, A. (2008). Evidence-Based Kernels: Fundamental Units of Behavioral Influence. Clinical Child & Family Psychology Review, 39. Download at: www.pubmed.gov Described in the 2009 IOM Report, p. 210 Thursday, November 18, 2010 7
  • 8. Relational Antecedent Reinforcement Physiological Frame Kernel Kernel Kernel Kernel Changes Creates verbal Happens BEFORE Happens AFTER the biochemistry of relations for the the behavior behavior behavior behavior Embry, D. D., & Biglan, A. (2008). Evidence-Based Four Types of Kernels Kernels: Fundamental Units of Behavioral Influence. Clinical Child & Family Psychology Review, 39. Thursday, November 18, 2010 8
  • 9. What is a kernel? Is the smallest unit of scientifically proven behavioral influence. • Is indivisible; that is, removing any part makes it inactive. Produces quick easily measured change that can grow much bigger change over time. Can be be used alone OR combined with other kernels to create new programs, strategies or policies. • Are the active ingredients of evidence-based programs • Can be spread by word-of-mouth, by modeling, by non professionals. • Can address historic disparities without stigma, in part because they are also found in cultural wisdom. Thursday, November 18, 2010 9
  • 11. Community Prenatal Ages 0-2 Ages 3-5 Text Text Text Text Primary Intermediate Early Teens Later Teens Thursday, November 18, 2010 11
  • 12. Your take away task for communities and families… List five ideas you can take back to your community or even your own family Explain the benefits of how these five things Ask others to try one or more of these thing Ask them use their social and electronic networks to spread these ideas For the benefit of all children and families in Manitoba Thursday, November 18, 2010 12
  • 13. Epigensis revisited Fraser Mustard’s talk Thursday, November 18, 2010 13
  • 14. Obesity Conduct Disorders Homicide & Suicide Early Sex Early Pregnancy Addictions Aggression Disease School failure Epigensis results in a risky path or a healthy path Thursday, November 18, 2010 14
  • 16. Redness, rubor, a response of body tissues to injury or irritation; characterized by pain and swelling and redness and heat. Excitation, excitement, fervor, fervour the state of being emotionally aroused and worked up Inflaming arousal to violent emotion Firing, ignition, kindling, lighting the act of setting on fire or catching fire Hypothesis: Evolutionary “inflammatory” processes Thursday, November 18, 2010 16
  • 17. Threat from parasites, Threat from humans bacteria, and viruses who might kill or steal Thursday, November 18, 2010 17
  • 19. Human Infectious/Biological Threats Human Predatory Threats Evolutionary Adaptive Responses Evolutionary Adaptive Responses (Simplified) (Simplified) Neuro-Hormones Mood Modulators Reward Delay Intra-Group Threat Attributional Generalized Localized Modulators Affiliation Bias (Inflammatory) Inflammatory Inflammatory (Anti-Inflammatory) Out-Group Response Response Stress Modulators Aggress. (Inflammatory) Intra-Group Cooperation Tit-for-Tat Beh. Bias Anti-Inflammatory Regulators Puberty/Sex (Anti-Inflammatory) Modulators (Inflammatory) Thursday, November 18, 2010 19
  • 20. Substance Work Obesity, Early Mental Illness Violence Cancer School Abuse Problems etc Sex Failure Mood Reward Executive Behavioral Attention Stability Delay Function Competencies Immune- STD’s Motor Healing Special Skills Multi-Inflammatory Threat Reaction Functions Ed Major Ecologic Causes of the Dual Inflammatory Threats to Children & Youth Physiological Antecedents Reinforcement Verbal Relations Thursday, November 18, 2010 20
  • 21. K R Path Path Evolutionary Path of a Child’s Life Probability of short-life and doubtful Probability of long-life and reproductive success reproductive success Thursday, November 18, 2010 21
  • 22. Obesity Conduct Disorders Homicide & Suicide Early Sex Early Pregnancy Addictions Aggression Disease School Disabilities failure R PATH = Risky behaviors or health Thursday, November 18, 2010 22
  • 23. Physically and Successful in emotionally life-long healthy learning Safe and Socially engaged secure Healthy Child and responsible Manitoba Thursday, November 18, 2010 23
  • 24. Community Prenatal Ages 0-2 Ages 3-5 Text Text Text Text Primary Intermediate Early Teens Later Teens Thursday, November 18, 2010 24
  • 25. Coaster and Poster case study for women Thursday, November 18, 2010 25
  • 26. Do these effect epigensis? Thursday, November 18, 2010 26
  • 27. Antecedent Kernel Happens BEFORE the behavior Thursday, November 18, 2010 27
  • 28. Antecedent Kernel Happens BEFORE the behavior Thursday, November 18, 2010 28
  • 29. Addictions intervention or treatment kernels Thursday, November 18, 2010 29
  • 30. Antecedent Kernel “Wait for the Timer” for addictions and other issues Thursday, November 18, 2010 30
  • 31. Reinforcement Kernel “Prize Bowl” for change, recovery & addictions Thursday, November 18, 2010 31
  • 32. Reward & Reminder case study on tobacco Thursday, November 18, 2010 32
  • 35. Reward & Reminder: Logic model Thursday, November 18, 2010 35
  • 36. Baseline After Reward and Reminder 60% Wyoming Percentage of Illegal or Non-Compliant Tobacco Sales to Minors 50% 40% Reward & 30% Reminder Impact 20% 10% on Access 0% 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 60% Wisconsin 50% 40% 30% 20% 10% 0% 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 Data Source: Synar Report, SAMSA Thursday, November 18, 2010 36
  • 37. Reward & Reminder: Impact on prevalence Source: Youth Risk Behavior Survey (YRBS), Centers for Disease Control Thursday, November 18, 2010 37
  • 38. The Lancet case study on fish consumption Thursday, November 18, 2010 38
  • 40. Apparent consumption o inoleic acid (% of dietary energy) among Australia, Canada, UK and USA for the years 1961–2000 #" +651.-:8- A-0-;- BC BD+2 +,,-./012340567,1840 492:804:/83 -38; $ & ' <=2/0/.>?@ ( % * ) ! # " #$(" #$(% #$'" #$'% #$&" #$&% #$$" #$$% !""" “Risky” Beh. Evolution Neonates Breast Milk & Mismatch In the Rife Valley, the Successful human American infants have human brain evolution neonates born with been getting steadily Theory the result of eating 60-day supply of less omega-3 (n3) and Almost all adolescent fish high in omega-3 omega-3 in more pro-inflammatory risky behaviors have omega-6 (n6) in breast now been documented not savannah animals subcutaneous fat from milk to be related to low n3 mother’s diet and high n6 in US diet See Broadhurst, Cunnane, & Crawford (1998). Rift Valley lake fish See HIbbeln et al. (2007).Maternal seafood consumption in pregnancy and See Ailhaud et al. (2006).Temporal change in last 50 years changes in dietary fats: Role of n6 and shellfish provided brain-specific neurodevelopmental outcomes in Hibbeln et al. (2006). Healthy intakes of polyunsaturated fatty acids in excessive nutrition for childhood (ALSPAC study): an adipose tissue n-3 and n-6 fatty acids: estimations early Homo observational cohort study considering worldwide diversity. development and relationship to obesity Thursday, November 18, 2010 40
  • 41. Low maternal omega-3 consumption from seafood and 34 Physiological 32 Kernel 30 Percentage of children with low verbal IQ, WISC-III , 8y 28 Hibbeln et al, Lancet 2007: 369: 578-585 UK 26 r = 0.97 24 r2 = 0.95 F=27.2 22 p<0.02. 20 Changes 18 biochemistry of 16 behavior 14 0 0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40 0.45 0.50 0.55 0.60 - Estimated omega 3 fatty acids from seafood (en %) Mother at 32 wk gestation Thursday, November 18, 2010 41
  • 42. Physiological Mother Mother concordant Kernel concordant exceeds Changes biochemistry of behavior Mother concordant Mother concordant exceeds exceeds Thursday, November 18, 2010 42
  • 43. Omega-3 for all pregnant mothers, nursing mothers and weaned infants and toddlers Thursday, November 18, 2010 43
  • 44. The cost? About $40 per year Thursday, November 18, 2010 44
  • 45. Why not help our serious at- risk children with omega-3? 30% Percentage with Psychosis at 12 months 27.5% 24% 18% 12% 6% 4.9% 0% Omega-3 Placeo Psychosis Amminger, G. P., M. R. Schafer, et al. (2010). "Long-Chain {omega}-3 Fatty Acids for Indicated Prevention of Psychotic Disorders: A Randomized, Placebo-Controlled Trial." Arch Gen Psychiatry 67(2): 146-154. Thursday, November 18, 2010 45
  • 46. Before Omega 3 Omega-3 can improve school grades and success Omega 3 Placebo 7 These were gains in 6 After Omega 3 academics after 3 5 months of 4 exposure to fish oil. 3 2 1 0 -1 -2 Reading Spelling See www.durhamtrial.org/ Thursday, November 18, 2010 46
  • 47. The British and Netherlands Prison Studies Thursday, November 18, 2010 47
  • 49. Reduce Omega 3 and Micronutrient Brain Deficiency Thursday, November 18, 2010 49
  • 50. !"#$%"#&'"()*+&,-)("*.&/0"*%"1&23)*4&56-1)*"61& 7-.8&6"%)33"*#"#&#9-(+&93)$*.1&):&;-.93-*1<&3-*"69(1&9*#&"11"*=9(&:9>+&9%-#1 Ratio of Disciplinary Incidents Supplementation/Baseline 1.00 2%=;"&CDGKOQ 5(9%"J)&CFOKFQ 0.75 &B&R&OKOOS &B&T&*1 0.50 Active 0.25 Placebo 0 Before supplementation During supplementation ?@&39A-3$3&1"%$6-.+&B6-1)*&C&DDE&)0"*%"1&93)*4&FGH&B6-1)*"61&);"6&I&3)*.81&.6"9.3"*.&-*&9& %)3B96"#&.)&I&3)*.81&J91"(-*"K& L"1%8&".&9(K&&M6&N&51+%8-9.6+&HOOH<&FEFPHHCHE Thursday, November 18, 2010 50
  • 51. Why not reproduce the rapid results in Manitoba to get a 37% reduction in jail violence? It cost the Brits 19¢ per day or $69.35 per year. Thursday, November 18, 2010 51
  • 52. Safe Playing Case Study Thursday, November 18, 2010 52
  • 53. A environmental policy case study in reducing early rebelliousness, risk taking and sensation seeking This risk factor can be easily measured in early-childhood, and it predicts lifetime injuries, delinquency, alcohol/drug abuse abuse, and school difficulties. Thursday, November 18, 2010 53
  • 54. Contextual example of such risk Thursday, November 18, 2010 54
  • 55. Oh,prior prevention efforts in Sweden had resulted in more fatalities… Thursday, November 18, 2010 55
  • 56. A book about “me” being a Safe Player Thursday, November 18, 2010 56
  • 57. Adults defining boundaries of safe play Thursday, November 18, 2010 57
  • 58. Adults setting timer to watch safe play in child Thursday, November 18, 2010 58
  • 59. Parent praising safe play with stickers Thursday, November 18, 2010 59
  • 60. Study 1 showed preschool intervention alone had short- term benefits Study 2 showed preschool plus parenting intervention had long-term benefits Study 3 showed strategy could be implemented in 35 Head Starts nationally Study 4 showed parents could change child’s behavior from special story workbook Study 5 showed behavior change for over 100 preschoolers, with no adverse effect. Study 6 showed effort could be successful in a 3-city multiple baseline in New Zealand Study 7 is national campaign, adopted by 50% of New Zealand families Study 8 replicates city results in US Thursday, November 18, 2010 60
  • 61. Kernels and 4-P’s used in multi-city/national Safe Playing campaign Proclamations in cities and nationally Endorsements/Sponsorships by prestige organizations AND businesses Media models of adoption by high-status people Media models showing rapid results/benefits Public posting of rates of adoption/use Competitions between cities on adoptions Placement in supermarket or other easy venues Price free after filling out Safe Playing Promise (with address, etc.) Promotion for every family who wants their child to be safe Product promises child will be safer in two weeks when steps followed Thursday, November 18, 2010 61
  • 62. Why not distribute specially constructed books for parents with young children… Reduce dangerous, impulsive, disturbing behavior quickly? Increase social- competence quickly? Improve school readiness quickly? Embry, D. D. and L. Peters (1985). A three-city evaluation of the diffusion of a pedestrian-safety injury control intervention. R. S. Division, New Zealand Ministry of Transport, Wellington, NZ. Thursday, November 18, 2010 62
  • 63. Good Behavior Game Case Study Thursday, November 18, 2010 63
  • 64. Why not turn about the lives of high risk primary grade children using a teacher invented procedure? Muriel Saunders, the teacher Thursday, November 18, 2010 64
  • 65. Her invention immediately increases time to learn Thursday, November 18, 2010 65
  • 66. Why not turn about the lives of high risk primary grade children using a teacher invented procedure? Thursday, November 18, 2010 66
  • 68. Community reinforcement case study Thursday, November 18, 2010 68
  • 69. PeaceBuilders School-Community Reinforcement Study Positive Peer-to-Peer Social Home Notes Notes Competence Violence Thursday, November 18, 2010 69
  • 70. Injury Prevention Study Using Positive Reinforcement 60% 50% Change in 40% Nurses’ Office Visits from Year to 30% Year 20% 10% 0% -10% -20% All Visits Injury Viists Non-Injuries Fighting Injuries Non-Fighting Injuries Control/Wait List Intervention Krug, E. G., N. D. Brener, et al. (1997). "The impact of an elementary school-based violence prevention program on visits to the school nurse." American Journal of Preventive Medicine 13(6): 459-463. Thursday, November 18, 2010 70
  • 71. Prevention Store Prevention Science Meets Retail Consumers Dennis D. Embry, Ph.D., Society for Prevention Research, Denver, June, 2010 Thursday, November 18, 2010 71
  • 72. If kernels are so good… Thursday, November 18, 2010 72
  • 73. How have kernels evolved? The first (almost certainly antecedents) were selected by consequence for immediate reinforcement of food, protection, etc. Early tools come to mind as examples. The second (physiological) probably also arouse by selection by consequences by providing relief from physical or emotional distress. The third (relational frames) arouse with invention of oral and written language, selected by consequences to protect against danger from other humans or natural harm. The forth (contingent reinforcement) arouse with invention of oral and written language, selected by consequences for social advantage within groups and survival advantage of kin. Thursday, November 18, 2010 73
  • 74. Using kernels to build population-level change… Problem Kernel #1 Observed Proximal Observed Effect Kernel Proximal Kernel #2 Effect Kernel Big Kernel #3 Change Effect Observed Proximal Effect t Thursday, November 18, 2010 74
  • 75. Rule #1 of big change A big population-level change requires myriads of reliable, measurable small behavioral changes in at least 20% to 25% of the the total population. Blame is not a kernel. A diagnoses is not a kernel. “Shoulds” are not a kernel. Blame, diagnoses, and “shoulds” are personal or group ways of experiential avoidance for dealing with failure of the methods to create desired change. Thursday, November 18, 2010 75
  • 76. Rule #2 of big change Always maximize the dignity and self-sufficiency of the persons whose behavior you wish to influence. If you fail this step, you will be meet resistance, counter-control and sabotage of the group of persons to maintain their dignity and self-sufficiency. This is a basic feature of human social interactions from which our species has evolved. Dead, disposed or failed chiefs and leaders liter human history who failed to observe the key universal feature of human societies. Thursday, November 18, 2010 76
  • 77. Rule #3 of big change Pay attention to variations in behavior for improvement. Small differences—when done by many people— can make the difference between night and day. These small differences are the the variation in quality control that great car companies like Toyota or Honda to make incremental improvements. Look for innovations as well as problems. Thursday, November 18, 2010 77
  • 78. Rule # 4 Big Change with a kernel requires other kernels A kernel that you want to promote to affect a specific behavior will require other kernels to make the specific action happen. This because other behaviors or people will be required before and after or in other settings for cooperation to happen. Thursday, November 18, 2010 78
  • 79. Why not use a new word to convey our support every child being healthy in Manitoba Thursday, November 18, 2010 79
  • 93. Spreading healthy children in Manitoba like dandelions Thursday, November 18, 2010 93
  • 94. is the gift of our futures Thursday, November 18, 2010 94
  • 95. Contact: Dr. Dennis D. Embry, PAXIS Institute, PO Box 31205, Tucson, AZ USA dde@paxis.org • www.paxis.org • www.slideshare.net/drdennisembry Thursday, November 18, 2010 95