I now realize that I have long subscribed to the notion of “a good-enough childhood,” both in my personal life and my work as a developmental-behavioral pediatrician. My underlying belief is that most children who experience a nurturing, warm, motivating family and home environment will develop the capacity and resilience to thrive under a broad array of circumstances. Furthermore, I have never subscribed to the notion that “more is better” or that the relentless pursuit of enriching experiences will inevitably translate into greater success and fulfillment. In fact, I have often professed a viewpoint that is quite contrary to such notions.

My personal life offers multiple examples of my reluctance to embrace the concept that intensive interventions are necessary to ensure the best possible long-term outcomes for most children. I recall how, as house-hunting parents of school-age children, we strived to balance a community’s diversity, affordability, and general quality of life with the quality of its school system. We encouraged our children to be mindful of “goodness of fit” in their considerations of activities and life choices. 

In my professional work, I often find myself advising families to similarly subscribe to a “good-enough” philosophy. In counseling students and families on the issue of school selection, I encouraged families to consider a student’s unique profile of strengths and weaknesses and select the setting that is best prepared to accommodate that student’s unique needs. I never advise selection of a school solely on the basis of its prestige or ranking, and recognize that the proper program in a suitable educational milieu often affords advantages over a more exclusive setting. 

Despite confidence in my deep-seated beliefs, I am occasionally challenged and even impressed by professional colleagues and parents who extol the virtues of passionately investing extraordinary time, attention, and expense to support young children’s optimal healthy development through pursuit of the very best in educational supports and placements to achieve exceptional outcomes. Despite my convictions, I am periodically prone to wonder whether they are correct, and whether I am misguided in not embracing intensely programmed and expensive lessons and experiences as practiced by so-called helicopter and tiger parents.

My colleague, Lisa Honigfeld, recently called my attention to a compelling and convincing article from an unusual source for child health providers that challenges contemporary societal views on child rearing and bolsters my confidence in my beliefs and actions. Grover (Russ) Whitehurst, a senior fellow in Economic Studies at Brookings Institution Center on Children and Families, proposes a different way of thinking about the role of early experience based on an intriguing evolutionary perspective that views humans as evolving in conditions that support normal brain and behavior development in a wide range of environments and circumstances. In his “good-enough model,” he proposes a basic level of experience and stimulation, the “good-enough point,” above which the majority of children will normally develop without the need for extra intervention. 

Whitehurst defends his thesis by demonstrating how his model incorporates research findings not explained by or consistent with the standard model of early human experience. This brief commentary cannot do justice to his carefully woven argument and I urge interested readers to access the original article, as his review of observed inconsistencies with the standard model are deserving of our attention. Whitehurst highlights five research findings that are incompatible with or, at the least, not explained by the current, predominant model: preschool programs that do not improve and may even harm children’s subsequent development; normal developmental outcomes among children who have experienced stressful and impoverished early circumstances and environments; weak correlations between measures of cognitive development in infants and toddlers and IQ scores during later childhood; universal preschool programs’ disproportionately larger positive impact on the most disadvantaged of children; and the strong genetic influence on children’s personality and intelligence.

Whitehurst further explains how his “good-enough model” of early experience incorporates each of the above anomalies while supporting a significant role for public programs and parental activities intended to enhance outcomes for children from disadvantaged families. From an evolutionary perspective, he speaks of intriguing epigenetic mechanisms of development that require only adequate (i.e., good-enough) support. He also employs the model to challenge many prevalent, contemporary parenting assumptions, such as “the earlier the better,” and “more is better.” He supports his thesis by calling out a number of additional, compelling points, such as the fact that human species, in contrast to other primates, has an extended period of early development because fully formed brains are too large to pass through the birth canal and that Darwinian selection for the human species favors large allowances for differences in experience and nurturing. He also emphasizes how his model reinforces the important distinction between the “average expectable environment” and the “damaging environment” that interferes with a genetically-programmed developmental progression, as well as the critical importance of interventions to help children experiencing damaging environments avoid lasting, deleterious effects.

Perhaps the most intriguing of Whitehurst’s comments relate to implications for policy and practice. He speaks of the need to “…reduce as much as possible environmental circumstances that are toxic for young children.” He advocates for investments in families and communities that “…open doors to children throughout their dependent years” and a focus on family income, stability, and the circumstances in which abused and neglected children are raised.

Whitehurst concludes his article by acknowledging that “there is simply a lot we don’t know and much we need to learn going forward.” He is, of course, correct and we should neither abandon the standard model nor exclusively embrace the good-enough model of early experience. Despite limitations in our understanding, I am reassured by the extent to which Whitehurst’s treatise validates much of our current thoughts and actions. While the notion of a “good-enough childhood” may seem to lower the bar on parental and family expectations and efforts, we should be ever so mindful of the need to focus on children and families for whom good-enough is an unreachable challenge. Our focus on universal interventions of particular benefit to disadvantaged children and families, our efforts to strengthen all families by enhancing such protective factors as resiliency and social connections, and our recognition of the need to engage all sectors important to children and families in our efforts at comprehensive system building are aligned with the key precepts of both models. Perhaps our ultimate task is to ensure that all children have access to a good-enough environment that affords everyone the opportunity to experience their genetically-programmed developmental progression. I propose that despite the uncertainties, this notion is worthy of our very careful consideration. 

Reference:
G Whitehurst. A good-enough early childhood.  Evidence Speaks Reports, Vol 2, #63.  Economic Studies at Brookings, December 20, 2018. (Retrieved from https://www.brookings.edu/research/a-good-enough-early-childhood/ , December 29, 2018.)

Paul H. Dworkin, MD is the executive vice president for community child health at Connecticut Children’s, the director of Connecticut Children’s Office for Community Child Health and the founding director of the Help Me Grow National Center. Dr. Dworkin is also a professor of pediatrics at the UConn School of Medicine.