Randomized Chilhdoods

Parents, especially first-time parents, have all kinds of worries and questions. Is it best to breastfeed? Does Baby Einstein really make a difference? The list of anxieties goes on and on as various "experts" bombard parents with mixed messages about vaccines, sleeping positions, parental work, etc.

Last week's New Yorker featured an article by Jerome Groopman, former surgeon general, on food allergies- another anxiety-ridden topic.  The Peanut Puzzle discusses the decision of the American Academy of Pediatrics to advise mothers to limit their young children's exposure to nuts, eggs, and even dairy, to help prevent their kids from developing an allergy.  That 2000 recommendation has now been overturned.  One expert is quoted as saying, "I try to emphasize with my patients not to feel guilty that they did or did not do something that would have resulted in their child having a food allergy.  Even the experts are not certain what to advise."

Why is it that medical experts are not able to offer better advice on important childhood health matters? Shouldn't we be able to establish guidelines, to the best of our current scientific knowledge, on these important questions around childhood development?

As I have studied children and education over the past several years, and child health more recently, I have been dismayed by our lack of knowledge on questions like food allergies, or how children learn best in a classroom.  A big part of the problem is that it takes many, many years to sort out whether a particular situation or action helps or hurts a child in the long-term.  That type of research is costly both in terms of money and in terms of time (especially in a system of higher education that rewards researchers for publishing as many journal articles as quickly as possible-- but that's a discussion for another time!).  It also is quite difficult-- what defines someone as successful and healthy in their twenties? Income? Educational attainment? Marital status?

A group of economists (shameless plug, this group includes my husband, John Friedman), have recently been able to investigate the long-term effects of being in a small kindergarten classroom on all kinds of measures at age 27.  The quick answer is that your kindergarten classroom size, and your teacher and peers, do indeed matter later in life (for the long, academic version of the paper, which is forthcoming, click here; for a condensed NYT version, click here).

But the type of data they have don't come along every day. It is rare to be able to track individuals on so many measures over time. More importantly, especially when it comes to children, it is rare to have such a large number of kids participating in a randomized experiment.  I think this is especially true when it comes to health and education issues. What parent is going to voluntarily enroll their child in an experiment that could place that child at risk in some way? Most parents, with few exceptions (perhaps many economists though!), are going to be willing to take the chance to jeopardize their child's health, even in a small way, or their education.

While much of life, and childhood, is random, we still turn to medical experts and education scholars to guide or decisions, even if their recommendations are based on limited data. Would you be willing to take a chance to advance (social) science?  Even if it turns out 25 years later that your child was randomized into the less effective group, potentially hurting their life chances?