The Impact of Trauma and Neglect on Young Children
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1 The Impact of Trauma and Neglect on Young Children Bruce Perry, M.D.,Ph.D. Senior Fellow, The ChildTrauma Academy, Houston,TX Adjunct Professor, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University in Chicago Senior Fellow, Berry Street Childhood Institute, Australia
2 Core Concepts in Developmental Trauma RHYTHM AND RELATIONSHIP
3 The human brain is not designed for the modern world. For thousands of generations we lived in small, multigenerational.
4 Efferent Distribution of Primary Regulatory Networks Cortex Abstract & Reflective Cognition Concrete Cognition Affiliation Limbic Attachment/Reward Sexual Behavior Emotional Reactivity Motor Regulation Diencephalon Cerebellum Brainstem DA NE SER Arousal Appetite/Satiety Sleep Blood Pressure Heart Rate Body Temperature All rights reserved Bruce D. Perry ANS - body
5 Developmental Trauma: The Great Imposter Is this trauma-informed?
6
7 Sensitization and Tolerance
8 Sensitization
9 Tolerance
10 Differential State Reactivity Terror Fear Vulnerable Alarm Normal Alert Resilient Calm Baseline Stress Extreme Stress
11 The Learning Window: State Dependence Terror Fear Alarm Alert Calm Challenge Distress Extreme stress
12 Sense of Time Primary secondary Brain Areas Cognition Abstract Concrete Emotional Reactive Reflexive Mental State Extended Future NEOCORTEX Subcortex Days Hours SUBCORTEX Limbic Hours Minutes LIMBIC Midbrain Minutes Seconds MIDBRAIN Brainstem CALM ALERT ALARM FEAR Loss of Sense of Time BRAINSTEM Autonomic TERROR
13 Adaptive Response Hyperarousal Continuum Dissociative Continuum Rest (Adult Male) Rest (Male Child) Rest (Female Child) Vigilance Freeze Flight Fight Vigilance Resistance Defiance Aggression Avoidance Compliance Dissociation Fainting Mental State CALM ALERT ALARM FEAR TERROR
14 Dimensions of Neuroplasticity Development (Time) Anatomy/Structure Specificity (Specific neural network) Pattern (frequency, intensity, timing) All related to the dynamic activity of complex systems.
15
16 Self-regulation (SR) Somatosensory regulation/self-soothing (SS) Bottom Up: Primary Starts in womb; suck/swallow Tied to intrauterine and perinatal associations Breathing, walking, running, rocking, swimming, rhythm Doodle, hum, swing, jump, dance Cortical Modulation (CM) Top Down: Secondary Tied to cortical development & state-dependence Slower process - Dissociation (Diss) In Out: Pervasive Adaptive continuum Mind-wandering to threat-induced full dissociation Used rhythmically ( in-out )
17 Relational Regulation
18 Self-regulation (SR) Self- soothing using SS Cortical modulation Dissociation Somatosensory regulation (SS) Self vs Other Relational regulation (Rel) Positive co-regulation Co-dysregulation Tied to primary relational templates Pharmacological regulation (Rx) Optimal regulatory interactions use multiple pathways SS and Rel Cort and SS Diss and SS
19 Developmental Trauma: Poly-pharmacy Is this trauma-informed?
20 Co-dysregulation Reactive child and overwhelmed teacher Terror Child Fear Alarm Adult Alert Calm Present, overwhelmed, frustrated, angry = escalation = increased incidents/ restraint Time
21 Co-regulation Reactive child and well-regulated teacher Terror Fear Present, parallel, patient, persistent facilitate multisensory, multi-domain, repetitive activity Child Rhythm & Relationship= Regulation Alarm Alert Adult Calm Time
22 Sequence of Engagement Reason Relate Regulate
23 Core elements of positive developmental, educational and therapeutic experiences Relational (safe) Relevant (developmentally-matched) Repetitive (patterned) Rewarding (pleasurable) Rhythmic (resonant with neural patterns) Respectful (child, family, culture)
24 Healthy Early Caregiving Weaving Together the Neurobiology of Relationship, Reward and Regulation
25
26
27 Developmental Trauma: Relational Poverty Is this trauma-informed?
28 What is Trauma-informed? Trauma-informed appreciates the individual & the need for individualized treatment
29 Post AE Life AE 3 AE 2 AE 1 Stressors Attachment Intrauterine Epigenetic Genetic Birth Child A Child B Child C Dysregulated Typically Regulated Hardy, Resilient
30 (Main Website) (Online mini-courses) Also Facebook: ChildTrauma Academy YouTube Channel: The ChildTrauma Academy Channel
31 Upcoming CTAC Events February 12, 2014 from 12-1PM Working with Older Adults in Mental Health Services Presented by: Mari Umpierre, Ph.D., LCSW
32 Contact Us. Contact Kara Dean-Assael or Lydia Franco, the CTAC Clinical Lunch & Learn Webinar Series Coordinators at Additional information and resources available at: Materials owned
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