Roger Mills-Koonce, Ph.D., remembers it vividly: the moment years ago when the hospital handed over a tiny infant and sent his new family on their way.
“I remember our first kid being born and taking them out of the hospital and putting them in the car and thinking — my wife and I are both developmental science Ph.D.s. We’d spent 10 years studying this, and even we felt like we had no idea what we were doing.”
Caring for a baby is a lot of pressure, Mills-Koonce acknowledges, because research shows that even from as early as conception, humans — children — are absorbing the atmosphere of the caregiving mood around them.
And that mood makes a difference.
Roger Mills-Koonce’s areas of expertise integrate experiences and psychobiological functioning across development. His primary research interest focuses on biopsychosocial models of parenting, parent-child attachment relationships, and the emergence of self-regulation in early childhood.
These fraught first moments of family life capture a 20-year-long research passion for Mills-Koonce — the impact that positive or negative caregiver influences from birth through early childhood can have on brain development, attachment, behavioral patterns, or even complex emotions like empathy or guilt.
Every child has tremendous potential, says Mills-Koonce, a professor of Human Development and Family Science at the UNC School of Education. And his research shows that those early life experiences with a parent or caregiver — even before we think children are cognizant of it — can actually modulate that potential, optimizing it or impeding it, as brains grow.
“My work has focused specifically on the nuances of what parents or caregivers do in those first three to four years of life that either promote or constrain that potential, particularly from an attachment perspective,” Mills-Koonce said. “It’s in those first relationships that children develop, and it’s more than just a physical context for development. It’s a set of increasingly complex emotional experiences that provide a lens for the child to understand and interact with the world around them for years to come.”
A perfect storm
Mills-Koonce studies how early childhood experiences in the family or caregiver setting from ages birth to 4 impact psychobiological functioning — the relationships between biological processes and psychological phenomena like behavior, for example — as children develop, showing how the moods and emotions of those first trusted adults shape the brain as it grows.
“It’s the little things that add up over time. They require physical, emotional, and cognitive engagement and attunement, and it’s a lot to commit to, and it’s challenging,” he says. “This is why I’m so passionate about the parent-child relationship, because that relationship is everything.”
Mills-Koonce is a longtime collaborator on the National Institute of Child Health and Human Development-funded Family Life Project, a longitudinal study of families living in low-wealth, nonurban areas. The study has found that children whose caregivers interacted with them in positive ways, such as being sensitive to their needs and expressing positive feelings about them, had better language development, behavior, and executive functioning than those with negative or problematic interactions with caregivers. His research has also shown that when mothers have high levels of cortisol, a hormone associated with stress reactivity, they interact more negatively with their children, showing the link between stress and the kinds of negative experiences that can impact a child’s trajectory.
As part of the federally funded Brain and Early Experience study, a five-year, multidisciplinary, longitudinal study looking at the influence of poverty and early life experiences on neurocognitive and behavioral development, Mills-Koonce is looking at how the developing brain and the gut microbiome connect lived experiences to child outcomes. The gut microbiome can tell us a lot about our health, most obviously about digestion. But it also can tell us about our stress, mood, and anxiety.
Infants and toddlers can’t think about their experiences yet, but it’s clear they’re impacted, and that’s part of why Mills-Koonce is so fascinated by the topic. The salience of those early relationships and experiences affects them directly in terms of their physical growth and safety, but as their brains develop, it impacts behavioral patterns, shaping their emotional experience in the world and how they’ll see themselves and others.
One example: A child might be anxious, he explains, because they have a genotype that promotes anxiety. But, with positive early relationships, they can be equipped to push the boundaries of what they’re comfortable with and try new things, which can mitigate the experience of that anxiety.
“Other kids that are anxious and have more controlling and limiting experiences might end up withdrawing even more. There is a lot of variation that kids bring into the world with them genetically, and the ways these relationships carry forward and evolve over time affect them in ways that we might not see for years to come.”
One of those ways Mills-Koonce has spent the last decade researching: how young children with callous and unemotional (CU) traits, which can be indicative of psychopathy, begin to exhibit those behaviors and what can be done very young to modify that course. Children with CU traits may lack empathy or the ability to experience guilt or remorse. They may exhibit persistent antisocial behavior throughout their lives, leading to conduct problems in school or in society. The roots of those complex emotions are developing in the context of relationships from the start, he says.
Though most research investigates CU behaviors in older children and adolescents, recent findings indicate that children as young as 3 who exhibit elevated levels of oppositional defiance and CU behaviors, and who have insecure attachments with caregivers, are at increased risk for exhibiting elevated levels of aggression across middle childhood.
“Empathy doesn’t just emerge magically,” he said. “It emerges as a product of interacting with people that you care about. That’s why you care about why they feel the way they feel, and how that starts to affect you, and those mirror neurons in your brain allow you to experience the feelings of others the way you experience them yourselves.
“We’ve evolved over time to do that. It’s a normative part of our development as humans, so we have a fascinating question – what makes this happen for some children but not for others?”
Mills-Koonce believes these children could be in a perfect storm of where nature meets nurture — where their genetic predispositions to these disorders are affected in big or small ways by negative or positive early emotional socialization experiences with their caregivers.
“Let’s say you have a child who doesn’t respond to behavior modification,” he says. “You couple that with a parent who is very stressed and who has tried all the right things, but nothing is working. That parent is going to wear down. Their temper gets short, and they become more controlling or more punitive. They start saying things that they know are hurtful, because they’re at the end of their rope.”
In many circumstances, it can undermine closeness, confidence, and trust, and maybe even the child’s sense of safety and security in the relationship. When problematic things happen in the lives of these kids, and they’re carrying a good degree of genetic risk as well, it can be a foundation for having less concern about others, less guilt about what happens to others, and more difficulty considering their feelings.
Caring in community
Mills-Koonce says there’s a reason why this kind of research belongs in the School of Education — caregivers really can’t, and shouldn’t have to, do this alone.
Many families are under incredible pressure and experience varying degrees of life stress, and no matter how much they prepare themselves, there’s only so much they can do. In so many ways, they already feel like they aren’t doing enough, and they’ve carried their own life experiences into parenting.
But, he says, broader community support can lessen the load and enhance child development outcomes.
That’s where schools can come in. Educational settings, which are full of adults who care about children, are about more than just education; they also focus on a child’s total well-being. Those adults are the “heart and soul of the community,” he says, a hub for family and community engagement.
“Any significant and caring adult can play an important role in a child’s life, and that’s why we say it takes a village to raise a child. This is nothing new. When we all invest in the welfare and well-being of our children, of course they benefit, but so does the entire community. ”
Mills-Koonce says he’s inspired by the work of Maya Bracy, a Ph.D. student in the School’s Applied Developmental Science and Special Education concentration, who brings a community focus that takes the ideas of these essential kinds of interactions to the next level. A school is a place where families naturally converge, and there’s an opportunity there to connect those who are dealing with the same things, or for parents of older children to help scaffold parents of younger children, and to invest in more wraparound services and opportunities to connect.
Within communities, young children watch the adults in their lives interact with other adults, extend courtesies or navigate frustrations. These kinds of models can provide an opportunity for young children to see how others navigate the cultural norms of interacting with others, even if they lack the ideal relationships in the home.
Embedded, community-based support and social networks of real people and real relationships can go far, says Mills-Koonce.
“The soul of the community is the school. It fits in so well into an evolutionary model collectivist childrearing. We don’t just have kids and go off to live by ourselves. We can survive that way, but we thrive in groups that invest in each other and especially in the next generation.”