5 questions with the Perigee Fund’s Dr. David Willis

David Willis, M.D. is the Executive Director of the Perigee Fund, a new philanthropic endeavor based in Seattle, promoting early relational health, improving young children’s social emotional development and advancing infant early childhood mental health in Washington State, the northwest and nationally. Prior to joining Perigee, David served as the Director of the Division of Home Visiting and Early Childhood Services within the Health Resources and Services Administration, within the Obama Administration. Boarded in Pediatrics and Behavioral and Developmental Pediatrics, Dr. Willis was a clinician for 30 years in Portland, Oregon and long-standing early childhood leader in Oregon and nationally. Dr. Willis was a Harris Mid-Career Fellow with ZERO TO THREE, past President of the Oregon Pediatric Society, an executive member of the American Academy of Pediatrics Section on Early Education and Child Care, the first Chair the AAP’s Board’s Early Brain & Child Development Strategic Initiative and a previous member of Dr. Jack Shonkoff’s Frontiers for Innovation at Harvard’s Center for the Developing Child.

A great friend of mine and of Capita’s, Dave shared his thoughts on his new role, the importance of early relational health, and why he remains optimistic about our country’s — and our children’s — future with me last week.

JW: You recently joined the Perigee Fund which is a brand new philanthropic endeavor focused on promoting social emotional development and advancing the field of early childhood mental health. What are you most hopeful about for this new chapter?

DW: I am honored to lead the development of our new Perigee Fund that uniquely and specifically focuses on finding ways to improve the early social emotional development of all infants and young children, by advancing the awareness of the critical importance of a focus on early relational health. We know that nearly a third of young children come to school not prepared for learning, most of which is related to delays in their social emotional skill development– that is, their desire to engage in learning, their ability to pay attention, their capacity to regulate their behavior and emotions and their ability to socialize and interact with others. These critical life skills are brain based and built by the complex and essential interactive experiences with their caregivers within positive, supportive, safe and nurturing relationships. Unfortunately, too many young families struggle to provide the necessary early experiences for various reasons related to personal stress, poverty, histories of trauma or lack of information which results in their young children struggling with loss of their future potential and a lifetime of struggle and suffering. Yet our knowledge of how to promote heathy development, prevent delays and intervene when problems is strong from the developmental neuroscience and early child developmental sciences. And all parents want the best for their children, often worry about the future for their children and welcome parenting information and support. Thus, the time is now for advancing the wellbeing of the next generation of young children with targeted and state of the art efforts. Hence, this is space where the Perigee Fund seeks to have influence. We are eager to bring new approaches to support parents in their earliest relationships with their infants and young children, like expanded home visiting, new parenting education approaches in pediatric offices and efforts to support the confidence and competence of young mothers and parents. Our work will require partnerships across the early childhood sector with all who touch new families lives: birthing centers, obstetricians, pediatricians, home visitors, child care providers and early educators. Yet all of this work will require inspiring the communities that families live in and the policy makers who help assure that system changes and advances remain sustainable and accessible. Finally, all of these efforts will require training anew the current workforce in their focus on relational health, while broadening a new workforce training pipeline and their career ladders for specialists at every level in infant early childhood mental health for promoting and preventing relational health challenges and healing who with disorders and suffering. We will be building partnerships, strategies and initiatives to improving the wellbeing of the next generation of our children — our bold and ambitious aim.

JW: You are a champion of the concept of “early relational health.” Healthy relationships within families and our broader society seem especially difficult to achieve today. Why is relational health so important for our country’s future?

DW: Early relational health is established by the positive, supportive, nurturing and dyadic parent-infant interactions of everyday life within the first 1000 days of life. New discoveries have elevated relational health’s importance beyond physical health and child development alone, such that we now understand that early relational health is the very foundation for the development of life long health, learning and future well-being. The science is compelling that early relational experiences create the remarkable processes that develop the human brain and body to its full potential. Hence the early relational health is responsible for the human capacities for education success, goal-directedness, strong work ethics, compassion for others, community engagement, moral and ethical values, self-reflection, and personal responsibilities. Unfortunately, our culture faces a number of societal and population issues from chronic diseases, mental illness, addictions, failed education, poor work ethics and achievement, isolation and decreased civic engagement. Neuroscientists, sociologists, psychologists, physicians, public health officials and early childhood leaders now recognize the importance of generating bold new policies and community actions to safeguard the critical early relationships for the next generation of infants, recapturing the natural social supports within communities and social networks and intentional efforts to monitor, assure and support early relational health for the future wellbeing of the nation, our upcoming workforce and our future economic vitality.

JW: You have been a pediatric clinician for over 30 years. What are the most noticeable changes in childhood that you’ve seen in that time?

David Willis, M.D.

DW: There are many remarkable changes in the demographics of our nation’s children, the structure of families, the lives of families, the social and relational experiences of babies and the pressures on young families, all of which bring challenges to the early relational health promoting experiences. For the first time in this nation’s history, more babies were born of color last year, than those being white Caucasian. In addition, more than one quarter of all babies live in poverty, more so for those of color and nationally, nearly 40% live of new babies live with a single mother. Unfortunately, too, nearly 18–40% of young mothers are depressed or stressed and the challenges of working and juggling childcare and parenting desires adds to the stress. Babies, too, now seem to have very different relational experiences in their early lives. From a time when infants were cared for by woman in the home, or in larger families of many children or multi-generations, we now see that most infants attend single age group infant childcare environments for many hours and graduate to join groups of toddlers in classrooms often with under-trained, stressed child care providers. Instead of hours of social interactions with parents, siblings and multiage groups of children, they may spend hours in solitary visual engagement with TV, electronic devices and smart phones instead exploring, creating and playing with others. Even the toy environments have changed from environments of a few decades ago with few toys and books, to environments cluttered with many sensory and interactive toys that provide distractions, toy engagement, repetitive stimulation, arousal and hours of self-absorption rather than complex and spontaneous social interaction and playful learning. Yet the experiences of young children have also seen improvements. Fathers have taken a far stronger role in caregiving to the benefit of the children, the woman and themselves. Also, much more attention has been given by parents, the community and the education system on the importance of investing in early learning. Additionally, although the health, immunization status and nutrition of most American children has improved dramatically, the new morbidities in child health of educational challenges, social-behavioral problems and mental health disorders have appeared in epidemic proportions, overwhelming school special education and the child mental health system, and bringing much suffering to children, youth and their families.

JW: What are you interested in that most people aren’t but should be?

DW: In my career I’ve always been delighted to witness the joy of families at the birth of their new babies. The hope and possibility are pervasive and notably infectious and there are lots of celebrations that mark this moment. Then something happens. Young families seem to become more isolated, in some sense more private, more isolated with some sense they should raise their child themselves, more individually, more “on my own.” The supports seem to disappear, the doubts and anxiety in young parents grow, and communities offer to help but resources are often thin, telling people what they should do and not actually focused on providing the relational and social supports that would ensure the wellbeing of the next generation. In essence, the social community supports that began at the time of birth vanish, leaving behind relative neglect to relational development need. As such, as a nation, we do not have an infant and young family policy — universal health care for young parents AND their children, paid parental leave policies, high quality childcare and early learning environments, early childhood multiage group experiences, strong parent education, relational health promotion, and dyadic parent-child mental health interventions when needed. As a nation, we all need to be seeking this policies and activities for all of our families and children, for ourselves and for those around us.

JW: Looking ahead, what signals or trends do you perceive that make you most hopeful about the future our children will inhabit?

DW: I so believe in the resiliency of the human spirit, the capacities of like-minded people to lead innovation and change and in the fundamental good of all people in seeking that the next generation learns from the mistakes of the past and strives to relieve the sufferings of others, especially those of their families. Hence, I’m finding our nation buzzing with early childhood interest, like I’ve never seen before — in the news, within social media, as a part of the political dialogue, in health and social service systems, and in the intimate conversations at the family dinner tables. I am seeing that in every sector of our nation activated people working together for improving the lives of young families and children. From small teams of local neighborhood activists, church communities and civic leaders joining with early childhood providers to surround and support young families, to some of our nation’s governors declaring early learning agendas for their terms of offices, to the transformation efforts of some of the massive health systems to change delivery systems and financing for improved prevention, measured child outcomes and family satisfaction. At a policy level, I’m seeing paid family leave emerging from new policies in states, within large businesses and even in the national dialogue. I’m witnessing new parenting education efforts joining within pediatric offices offering a new focus on video feedback and reflection with parents to celebrate and strengthen the beauty of their early relational health development. All of these efforts inspire me, delight me and bring me eternal hope for future generations of our children and grandchildren.