Understanding the Adolescent Brain and Behavior in the Context of Foster Care. Victor Rico, Ph.D. Staff Psychologist UCLA TIES for Families 1000 Veteran Avenue, Box 957142 Los Angeles, CA  90095-7142 o - (310) 825-6110 f - (310) 794-4996

UCLA TIES for Families Model Intensive supports for high-risk children at time of transition to adoptive home Pre-match education for parents Pre-placement interdisciplinary consultation Mental health services Support groups Child therapy, parent counseling, family therapy Testing Psychiatric, pediatric & educational consultation and advocacy, occupational therapy, speech/language assessment, behavioral services, and mentoring. So many services … why? Brain Development differs for foster youth. Stark differences in sxs/bxs compared to General population (Compare clinics).

Brain Development: Lobes of the brain The four lobes of the brain process different types of information and control different functions. Parietal Lobe: Responsible for touch, smell and taste. Temporal Lobe: Processes hearing and some language. Occipital Lobe: Brains vision center. Frontal Lobe: Controls thinking, planning, and reasoning processes.

Experience Grows the Brain Brain development happens from the bottom up: From primitive (basic survival) To more complex (rational thought, planning, abstract thinking)

Experience Grows the Brain (Continued) The brain develops by forming connections (neural pathways). Interactions with caregivers are critical to brain development. The more an experience is repeated, the stronger the connections become.

Trauma Derails Development Exposure to trauma causes the brain to develop in a way that will help the child survive in a dangerous world: On constant alert for danger Quick to react to threats (fight, flight, freeze) The stress hormones produced during trauma also interfere with the development of higher brain functions. Source: Teicher., M. H. (2002). Scars that won't heal: The neurobiology of child abuse. Scientific American, 286 (3),68-75.

Your Internal Alarm System If the threat is removed, everything returns to normal The brain releases chemicals that help the body to respond to the threat (fight, flight, freeze)

Your Internal Alarm System (Continued) If the threat continues or is repeated, the system stays on "red alert“ Severe or chronic trauma=Stuck in “On”-hormones keep flowing, can’t think, plan efficiently. When were you last frightened? Lost? Could you think clearly? The brain releases chemicals that help the body to respond to the threat (fight, flight, freeze)

Young Children (0–5) Key Developmental Tasks Trauma’s Impact Development of visual and auditory perception Recognition of and response to emotional cues Attachment to primary caregiver Sensitivity to noise Avoidance of contact Heightened startle response Confusion about what’s dangerous and who to go to for protection Fear of being separated from familiar people/places

School-Aged Children (6–12) Key Developmental Tasks Trauma’s Impact Manage fears, anxieties, and aggression Sustain attention for learning and problem solving Control impulses and manage physical responses to danger Emotional swings Learning problems Specific anxieties and fears Attention seeking Reversion to younger behaviors

Adolescents (13–21) Key Developmental Tasks Trauma’s Impact Think abstractly Anticipate and consider the consequences of behavior Accurately judge danger and safety Modify and control behavior to meet long-term goals Difficulty imagining or planning for the future Over- or underestimating danger Inappropriate aggression Reckless and/or self-destructive behaviors Isolation (think they are strange or going crazy; anxiety and depression)

The Invisible Suitcase Trauma shapes children’s beliefs and expectations: About themselves. About the adults who care for them. About the world in general. Kids carry these from placement to placement, school to school, and childhood to adulthood.

The Invisible Suitcase

Getting Development Back on Track Good news: Traumatized children and adolescents can learn new ways of thinking, relating, and responding. (Cortex develops into adulthood). New, positive experiences=new neural pathways and bypasses. Rational thought and self-awareness can help children override primitive brain responses. Unlearning—and rebuilding—takes time. Positive Connections: Peers/Friends; Teachers/Staff -School Environment; Caregivers –Home Environment; Community members (e.g., CASA)

Case Conceptualization Considerations Trauma Loss and grief Attachment adoption is created through loss to gain a family, one must first lose (a family, a child, dream of a child);

Critical Developmental Tasks for Adolescents Identity and awareness of self – who am I? Two connections/families to figure out similarities and differences. Fantasies of birth parents. Questions arise about birth parents and selves. Seek greater independence and autonomy Previous loss issues may re-emerge Separation from not only one set of parents, but multiple sets – the birth family, foster family, and adoptive family. Fear of abandonment and rejection.

Critical Developmental Tasks (continued) Seek belongingness Feelings of difference and issues of permanence need to be addressed. Seek peer group for support and acceptance. Cognitive changes Questions about the reason they were placed in foster care: explore issues of rejection, abandonment, etc. Biological changes in puberty Birth histories may re-emerge

Why can working with foster/adopt teens be Difficult? Teens may stop talking to create distance from caregivers and other adults. Foster/Adopt teens may not be able to articulate what they are feelings, even to themselves. Thoughts about birth parents may make teens feel disloyal to their current caregivers/family.

How to Effectively work with foster/adopt Teens Parent/Caregivers/Workers needs to send a clear message that they are open and willing to talk about the teen’s history, foster care, and/or adoption. Direct vs. indirect approaches Respect teens’ feelings and value their opinion. Examine what the teen is trying to say in his/her behavior. Share information – it is their story. Help teens make connections to his/her heritage and past.

Continued … Offer a secure base of love and protection. Be emotionally and physically available. Recognize and respond to the their needs. Provide guidance and example. Provide opportunities to safely explore the world. Source: Better Brains for Babies. (2007). Attachments and the role of the caregiver. Available at http://www.fcs.uga.edu/ext/bbb/attachCareGiver.php

Questions?