1. Trauma, Attachment and Early Brain Development: Reflections and Discussion October 2010 Sponsored by: Family Service Saskatoon Speaker: Deborah Parker-Loewen

2. Outline Brief introductions Background to the presentation today Summary of research and practice information How do we translate this into practice? Are there policy implications? Do we, as a human services community, want to explore this further? Closure

3. Early Brain Development Many sources of information on this topic Participating in Early Brain and Biological Development project in Alberta funded by the Norlien Foundation/Government of Alberta Based on materials from Center on the Developing Child, Harvard University (www.developingchild.net)www.developingchild.net All information available free from the website

4. Some key points about early brain development: Critical aspects of brain architecture begin to be shaped by experience before and soon after birth Many fundamental aspects of that brain architecture are established before a child starts school Scientific evidence that for children to reach their full potential, communities need to support the capacity of all families to provide appropriate experiences in the earliest years

5. The architecture of the brain depends on the mutual influences of genetics, environment and experience. Genetics provides the initial construction plan for the brain’s architecture Environment: the effects of threatening environmental conditions can cause neural circuits to change in was that prevent them from functioning well (ie: lack of essential nutrients; excessive maternal exposure to alcohol during pregnancy) Experience: the interaction of the child with his or her environment; experience adjusts the genetic plan for the brain and shapes the architecture of its neural circuits according to the distinctive environment of the individual

6. Early environments and experiences have an exceptionally strong influence on brain architecture Persistent adversity leads to weak brain architecture with impaired capabilities Sensitive periods exist The brain adapts to the experience it has. Certain types of adaptations result in healthy systems, such as effective learning and memory; other adaptations lead to the development of less healthy systems For our purposes today, I want to focus on the effects of toxic stress/trauma on relationships, however there are other aspects of this to explore as well (for example: nutrition, environmental toxins)

7. Excessive stress disrupts the architecture of the developing brain: Stressful events can be harmful, tolerable, or beneficial, depending on how much of a bodily stress response the stressful events provoke and how long the response lasts. These in turn depend on whether the stressful experience is controllable, how often and for how long the body’s stress system has been activated in the past and whether the affected child has safe and dependable relationships to turn to for support

8. The extent to which stressful events have lasting adverse effects is determined more by the individual’s response to stress, based in part on past experiences and the availability of a supportive adult, than by the stressor itself A child’s ability to cope with stress in the early years affects physical and mental health throughout life

9. Types of stress Toxic stress refers to strong, frequent or prolonged activation of the body’s stress management system. This could also be trauma. Stressful events that are chronic, uncontrollable, and/or experienced without the child having access to support from caring adults. Toxic stress changes the brain architecture—lower threshold to events that others might not find stressful (as an example)

10. Tolerable stress refers to stress that could affect brain architecture, but generally briefer and allows time for the brain to recover and reverse the potentially harmful effects. Made tolerable by the presence of supportive adults who create safe environment and help children recover. Examples could be death of a loved person, a frightening accident. Positive stress refers to moderate, short-lived stress responses (brief increase in heart rate for example). Learning to adjust to this kind of stress is a normal part of life and an essential feature of healthy development (For example: new people or situations, getting a needle, dealing with a frustration)

11. Chronic stress prevents the brain from returning to a relaxed state Children will normalize this activated state They start to become intolerant of peace and quiet and may create chaos to keep the activated state in place Children may not have peacefulness in their bodies/fidgety. They can’t “just relax” any more than you can “get taller”

12. Trauma settles in the brain The cortex—executive functions/how we think about people, life, the future The limbic system—our affect, feelings, emotions The mid-brain—beginning of arousal, this is where trauma is perceived Brain stem– autonomic responses People who have experienced trauma may stay focussed in the lower part of their brain/may be in a fairly constant state of fear This takes a long time to change Children respond to what they sense/the experience is stored in the brain as images, sensations,

13. The brain creates memories of the traumatic experiences and can shape how the child views the world The child learns to cope and the brain adapts to an unpredictable and dangerous world Child might have difficulty dealing with some types of kindness Children who experience trauma may spend so much time in the fear/survival part of their brain that they limit other learning

14. What science tells us The neural circuits for dealing with stress are particularly malleable (or plastic) during the fetal and early childhood periods Frequent or sustained activation of brain systems that respond to stress can lead to heightened vulnerability to a range of behavioural and physiological disorders over a lifetime (depression, anxiety disorders, alcoholism, drug abuse as examples)

15. Sustained or frequent activation of the hormonal systems that respond to stress can have serious developmental consequences. For example when children experience toxic stress (trauma) their cortisol levels remain elevated for prolonged periods of time. Both animal and human studies show that long- term this can alter regions of the brain, such as those essential for learning and memory

16. The relationships children have with their caregivers play critical roles in regulating stress hormone production during the early years of life. This means that with a more secure relationship (secure attachment), children have more controlled stress hormones when they are upset or frightened. With less stress, children are able to explore the world, meet challenges, and be frightened sometimes without sustaining the adverse neurological impacts of chronically elevated levels of hormones. Young children who are neglected or maltreated have abnormal patterns of cortisol production that can last even after the child is in a safe and loving environment.

17. A few more examples There is a lot of research in this area. Week at the Banff Symposium was overwhelming! Restrictions on copying the materials, however I just wanted to talk about some of the information that excited me. Mayes: How stress impacts parental care and intergenerational transmission of parenting capacities Burak: Challenging notions of risk and wellness from a study of First Nations Peoples (in BC)

18. What about attachment? Secure, early attachment is a protective factor Won’t review attachment theory/research here today Center on Developing Child (one source) emphasizes the importance of ‘serve and return’. Serve and return is seen as the active ingredient in shaping the architecture of the developing brain. What researchers refer to as mutuality and reciprocity can also be described as serve and return.

19. Serve and Return Young children naturally reach out for interaction through babbling, facial expressions, vocalizing, gestures; adults respond with responsive vocalizing and gesturing back---a continuous back and forth. Attachment Resource Kit Other

20. Conversation In small groups (3 or 4) discuss this material and how it does or doesn’t fit with what you are doing in your human services work In our larger group, share one or two themes from your discussion How can we translate this information into our work? Do we, as a community of human service providers in Saskatoon, want to engage in ongoing learning in this area of study? What might that look like?

21. Resources (incomplete) Much of this talk has been adapted from the Harvard working papers. The website: www.developingchild.net www.developingchild.net www.childtrauma.org This website, based on work by Dr. Bruce Perry has a wealth of information, including various training programs you can do on line and for free. www.childtrauma.org www.nctsn.org This website, for the National Child Traumatic Stress Network also has great information, training videos and other toolkits and tutorials. www.nctsn.org