Frozen The impact of ACES on early brain development.

Transcription

1 Frozen The impact of ACES on early brain development. Thursday 6 th April, 2017 Kinmel Manor Hotel, Abergele Chris Dunne Children s Service Manager, Powys 12 April, 2017

2 Recognising the symptoms of trauma in early years development and behaviours. Ensure support is focused to challenge the root causes.

3 Experience may alter the behaviour of an adult but it provides the organising framework of the infant and child (Bruce Perry)

4 Wales ACES exposure Wales Structure Skills for Living Families First gofod 3 Skype Scrums Clothes Banks Mobile Network Tethering Loop & Policies Annual Leave End of Year Stats & REACH

5 Trauma memory is saved in a state specific way, frozen at the age and stage when trauma occurred

6 ACES Critical Years

7 ACES Early Brain Development `Sensitive periods in early brain development High Pre-school years School years `Numbers Peer social skills Symbol Language Habitual ways of responding Emotional control Vision Hearing Low Years Graph developed by Council for Early Child Development (ref: Nash, 1997; Early Years Study, 1999; Shonkoff, 2000.)

8 What implications do ACEs have for brain development?

9 Facts Brain Development Sensitive periods of brain development mean that the brain has certain tasks to carry out in the early years. Developing brain: neurons changing in response to external signals from the environment. Sensitisation of templates: states becoming traits. Use it or lose it. Conversely, the more frequently patterns are activated, the stronger the template. Some children are frequently in a state of threat and are somewhere along the arousal continuum (calm, to vigilance, to alarm, to fear, to terror). As are some adults.

10 Facts Brain Development 85% of foundational neurobiological systems are organised in the first 5 years. The brain is a historical organ : stores experiences and these have an effect on the way the brain is organised. Within the 2 way attuned reciprocal relationship, the baby finds the sense of self. Attachment is the system which is moulding itself for survival.

11 Neuroplasticity The brain develops ways of managing threat. With repeated experiences - super highways develop. Neurones fire together, wire together The brain is wired to react quickly. States become traits. After the threat is removed, the brain might react as if the threat is still present.

12 Brain

13 Dissociation and hyperarousal Full blown response pattern (hyper arousal/dissociation) at minor stresses. The amygdala is set off quicker, which means less processing of later trauma. The earlier this becomes a habitual way of dealing with stress, the harder it is to change things. Treatment is about the threat response not being activated or minimised, to create enough time to bring the other element of high order thinking into the equation so the person can begin to process the event.

14 Trauma Response Chemicals flood in Chronic Stress from ACEs over-develop life-preserving part of the brain.

15 Reality Children who have experienced a lot of trauma can find it harder to process positive experiences. They are using the right side of the brain more. The left side (language, sense of time) is turned off. Pure Survival.

16 Summary of Impact Effect on child development Effect on brain development Effect on self regulation Effect on ways of managing trauma in the future Effect on positive experiences

17 Recognising Trauma in Early Years Definition of PTSD :- History of exposure to traumatic event Re-experiencing event: e.g. Intrusions, dreams Avoidance of stimuli associated with trauma Negative alterations in cognitions and mood Alterations in arousal and reactivity Prevalence of PTSD in a non referred sample of children and adolescents: 16% with rate highest amongst those that have experienced interpersonal trauma. (Perrin, 2014)

18 Recognising Trauma in Early Years Developmental Trauma Disorder current diagnostic proposal:- Witnessing or experiencing multiple adverse interpersonal events involving caretaker(s) for at least one year; Affective and physiological dysregulation; Attentional and behavioural dysregulation; Self and relational dysregulation; Chronically altered perception and expectations; At least two posttraumatic symptoms. Functional impairment- at least two of the following areas: academic, family, peers, legal, health.

19 Recognising Trauma in Early Years More behavioural examples either outward or inward More developmentally sensitive potential delay motor skills, speech and sensory. More emotionally sensitive. Unprocessed memories from trauma are activated by everyday triggers.

20 Play What might you observe? a replay or play displaying themes of the traumatic event repetitive compulsive play themes of mastery of people & objects restricted range of toys in play

21 Emotion What might you observe? Distress Looking withdrawn Fear Aggression Guilt or Shame

22 Behaviour What might you observe? Problems with concentration Hypervigilance Repetitive questioning Attention seeking behaviours Attention needing behaviours

23 0-5 Years show more generalized fears such as stranger or separation anxiety avoid situations that may or may not be related to the trauma have sleep disturbances be preoccupied with words or symbols that may or may not be related to the trauma These children may also display posttraumatic play in which they repeat themes of the trauma. In addition, children may lose an acquired developmental skill (such as toilet training) as a result of experiencing a traumatic event.

24 Intervention Trauma intervention should target factors causing on-going stress and on supporting natural recovery rather than focus on symptoms. Root causes service design & delivery. What factors inhibit recovery? Continued exposure to ACEs

25 Trauma Fright without Solution If the child uses the caregiver as a mirror to understand the self, the disorganised child is looking into a mirror broken into a thousand pieces.

26 Frozen The impact of ACES on early brain development. Thursday 6 th April, 2017 Kinmel Manor Hotel, Abergele Chris Dunne Children s Service Manager, Powys 12 April, 2017