What if there was a way to tell if a child is likely to grow up into an adult with addictions, chronic illnesses or worse, criminal tendencies?
More importantly, what if there was a way of changing the development trajectories for these children, so that they can go on to lead healthy, successful lives as adults?
These are among the important questions that an international team of researchers is seeking to answer in the Dunedin Multidisciplinary Health and Development Study, which started tracking 1,037 children since their birth in 1972 in Dunedin, a university town of 127,000 that occupies the bulging southern tip of New Zealand's South Island.
Professor Richie Poulton, who heads the study, known more commonly as the Dunedin Study, says the cohort completed their first medical assessment at age three. Since then, follow-up assessments have taken place every two years until age 15, and then at wider intervals through adulthood (18, 21, 26, 32 and 38 years). The 13th round of data collection is ongoing now at age 45.
The 55-year-old professor, who is currently in Singapore to deliver the CJ Koh Professorial lecture at the National Institute of Education, says what is remarkable is that almost all the participants, including those living overseas, have stayed with the study.
They return to Dunedin every few years to go through one to two days of intensive interviews and tests, covering every aspect of their lives and well-being - from mental health to cardiac fitness and respiratory tests.
GIVE HELP EARLY
The early years are absolutely critical for how a person's life turns out, and if you really want to make a difference to people's lives, intervening early is key. That's where governments should put their money. That is where their focus should be.
PROFESSOR RICHIE POULTON
Over the past four decades, the study has netted many important findings. Its 1,200 research articles, reports, books and book chapters have influenced thinking and policymaking both in New Zealand and around the world, says Prof Poulton, noting that over the years, the study housed in the University of Otago has received millions of dollars in funding from organisations in the United States and Britain.
In December last year, the researchers published the latest findings of the study, which attempted to provide an answer to the question on whether adult outcomes can be predicted from childhood.
The researchers, who had studied the "brain health" of the participants at age three, compared the results to their well-being as adults at age 38.
What they found was startling - the brain tests at age three could predict a child's future chance of success in life.
The children had been assessed on their ability to express and understand language, motor skills and an important trait or ability called self-control, which is the ability to regulate one's emotions to respond to experiences appropriately.
About Richie Poulton
Professor Richie Poulton, 55, worked as a clinical psychologist in New Zealand and Australia before getting a PhD from the University of New South Wales in Sydney.
He returned to New Zealand in 1995 and became deputy director of the Dunedin Multidisciplinary Health and Development Research Unit, which conducts the Dunedin longitudinal study, one of the most detailed studies of human health and development ever undertaken. In 2000, he became director of the unit.
In 2007, he led the establishment of the National Centre for Lifecourse Research, of which he is a co-director. He has published more than 150 scientific papers, with many appearing in leading international journals.
His research interests include mental health, gene-environment interplay in the prediction of complex disorders, and psychosocial determinants of physical health.
He is married to clinical psychologist Sandhya Ramrakha and they have a 16-year-old daughter, Priyanka.
Prof Poulton will deliver his public lecture on Wednesday at Nanyang Technological University at one-north. He will speak on the lessons for Singapore from the Dunedin study and the implications for teacher education.
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At age 38, with study members' permission, the research team analysed government administrative databases and electronic medical records. The team found that nearly 80 per cent of adult economic burden on a state or country can be attributed to just 22 per cent of the study participants.
That small slice accounted for 81 per cent of the group's criminal convictions, 66 per cent of welfare benefits, 78 per cent of prescription fillings and 40 per cent of those considered obese.
Says Prof Poulton of the findings: "We sought to answer a key question that behavioural and social scientists are faced with and that can inform government policies on children: How strongly do childhood risks impact adult outcomes? The findings showed quite clearly that the importance of childhood risks for poor adult outcomes has generally been underestimated."
He adds: "Those working in social services have long observed that some individuals use more than their share of services, but this is the first evidence that the same group of individuals feature in multiple service sectors and that they can be identified as young children, with very good accuracy."
He is only too aware of the potential misuse of the findings, and how it can lead to stigmatising and stereotyping.
"There is no merit in blaming a person for economic burden following from childhood disadvantage," he argues.
"The focus should be on tackling the effects of childhood disadvantage. This will benefit society as a whole."
But what can be done to ameliorate childhood risks to improve adult outcomes? Here, too, the study has thrown up some answers, says Prof Poulton.
One stream of research from the study explored the role of self-control in childhood.
The study found that children who scored low on such measures - for instance, becoming easily frustrated, lacking persistence in reaching goals or performing tasks, or having difficulty waiting their turn in line - were roughly three times more likely to wind up as poor, addicted, single parents or to have multiple health problems as adults, compared with children who behaved less impulsively as early as age three.
The study also found a "gradient" of success with children who had more self-control enjoying more health and wealth in adulthood than others who had even a bit less self-control.
Prof Poulton explains the significance of the finding: "Our research singles out children's self-control as a clear target for prevention policy, apart from all other influential features of children's backgrounds, such as their family life, socio-economic status or the child's intelligence."
He brings up another significant finding of the study which suggests that interventions early on in life - and not necessarily by parents - can make a difference.
"About 7 per cent of the children dramatically increased their own self-control over the course of the research, suggesting that such change is possible," he says.
"We don't know why or how their self-control improved. Perhaps some of them could have attended a school that stressed achievement and provided structure. Some could have had teachers who took an interest in them and supported them better.
"But what it shows is that self-control is not fixed. It is malleable."
Prof Poulton says the challenge now is to develop interventions specifically focused on improving self-control skills.
"There has been some promising work done in this area. Not just in New Zealand, but around the world. There is a need to come up with something that could be applied on a wide scale with a good cost-benefit ratio," he says.
Turning his attention to Singapore, he says he is heartened by the Ministry of Education's intensification of its efforts in providing quality early childhood education to more children. He also applauds the launch of KidStart, a pilot programme for low-income and vulnerable young children, to enable them to have a good start in life.
Prof Poulton says Singapore is on the right track in redoubling its efforts in early-years education and care.
It is not just the Dunedin Study. There are other renowned studies, including the Perry Preschool Project and The Carolina Abecedarian Project, that present a strong case for governments to invest in quality children's programmes.
Says Prof Poulton: "The early years are absolutely critical for how a person's life turns out, and if you really want to make a difference to people's lives, intervening early is key. That's where governments should put their money. That is where their focus should be."