What can we do to improve the outcomes for all adolescents? Changes to the brain and adolescence-- Structural and functional changes in the brain

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1 The Adolescent Brain-- Implications for the SLP Melissa McGrath, M.A., CCC-SLP Ball State University Indiana Speech Language and Hearing Association- Spring Convention April 15, 2016 State of adolescents in the U.S. Academic achievement Mental health Teen pregnancy Delinquency/ aggression Suicide The adolescent Why do we care again? Without healthy, productive adults, no culture could continue to be successful Arnold Sameroff 0-3 OR 10-25? Nature versus Nurture? Epigenesis and bidirectional influences What can we do to improve the outcomes for all adolescents? Insights into adolescence- Mom, you just don t understand Influence of peers Being an adolescent in the age of social media Social cognitive development and adolescent thinking Moral development and expectations The need for autonomy and independence Changes to the brain and adolescence-- Structural and functional changes in the brain Most significant changes -- Prefrontal cortex, Limbic system T1W, T2W, DTIs and MT Used to measure gray and white matter volumes; Cortical thickness; Cortical folding Changes to the PFC improve efficiency of information processing via 2 important methods Synaptic pruning, Myelination Structural changes to the brain during adolescence

2 Synaptic Pruning Decrease in gray matter Brain becomes more efficient Myelination Increase in white matter Reflects improved connectivity within and between brain regions More changes in brain structure Full maturation of PFC not complete until mid-20 s Specialized development - Dorsolateral PFC Ventromedial PFC Orbitofrontal cortex Functional changes to the brain during adolescence FMRI and BOLD technology, EEG 2 major changes in PFC- Activation of PFC more focused Increased in coordination of PFC with other parts of the brain Functional changes result in greater efficiency and information processing Implication of change Integrating cognition and emotion Facial expression discrimination Mixed signals in reward processing BUT. The limbic system enters Input and output Cortical and subcortical Hypothalamus, Amygdala, Hippocampus, Limbic cortex Limbic system changes in adolescence Reactions to neurotransmitters

3 Dopamine role in experience of reward Serotonin- role in experiences of various moods Changes in the limbic system contribute to Increase emotional reactivity More reactive to stress More likely to engage in reward seeking/ sensation seeking behaviors More vulnerable to substance abuse, depression, other mental health problems The timing of brain maturation Limbic system- matures at puberty Novelty, reward, stimulation PFC does not mature until mid 20 s Time gap is biological explanation for risk taking Decision making process same as adults May be more in tune to rewards vs. risks Social context peers present, adults absent The hot versus the cold environments Sex differences Males > Females Differences in brain size Total WM volume Size of amygdala and hippocampus Females > Males Size of orbitofrontal and anterior cingulate cortex Size of corpus callosum Hormone differences and puberty? Nature vs. Nurture? Puberty! Puberty is a neuroendocrine event

4 Relies on reactivation of the HPG axis- feedback loop The timing of puberty Secular trends males and females Males- earlier maturing Less research Positive or neutral outcomes Females- earlier maturing Lower GPAs at beginning of high school More likely to have a failed course Less likely to graduate Neuroendocrinology and brain development- influences on cognitive development emerging research Developmental changes in cognition Exaggerated activation of limbic subcortical regions (reward-related learning) Delayed functional connectivity between limbic and prefrontal regions Result is insufficient control of this activity during adolescence (Casey, Getz, & Glavin, 2010) The PFC and executive functions The PFC as a changing system Important considerations in the executive functions! Planning Organization-- Time management-- Working memory Metacognition--Cognitive development Processing speed- link to myelination Inhibition-- Processing efficiency cognitive flexibility-- Processing capacity- working memory-- Argument Decision making-- Ability to consider multiple variables scientific thinking Treatment of executive functions Facilitating development At risk versus group-based Direct intervention Caregiver and teacher education How early is too early to start EF training?

5 Stereotype threat Neuroplasticity and Mindset-- Carol Dweck- Fixed versus growth mindset Mindset = Student s perception of their abilities Fixed mindset = Intelligence is static Growth mindset = Intelligence can be developed Perils and Promise of Praise - implications on how we reinforce our adolescents-- Students praised for intelligence made significantly more references to innate, fixed capacity, whereas the students praised for effort made more references to skills, knowledge, and areas they could change through effort and learning. Thus, we found that praise for intelligence tended to put students in a fixed mind-set (intelligence is fixed, and you have it), whereas praise for effort tended to put them in a growth mind-set (you're developing these skills because you're working hard). Carol Dweck PhD Carryover to the ADHD population: Increasing epidemic, Indiana 4 th highest incidence in nation ADHD co-morbidities: Language delays/ disorders, SPD, LD, Executive dysfunction Brain structure/functional differences in ADHD exaggerated in the adolescent Studies linking neural circuit similarities in Autism spectrum and ADHD Outcome risks include: Academic failure, substance abuse, risk taking behaviors, decreased peer acceptance and support Must give ALL of our students the TOOLS to succeed To encourage our adolescents (and younger) to have a growth mindset Effort is not the goal Encourage students to try new strategies Seek input from others when needed Teach them tools to succeed- must have their tool box, not just effort for improvement and learning Understand the end game- LEARNING Acknowledge the process versus the effort Effort should be praised, but only as a means to an end of learning- not as the end goal Teach students to embrace the growth versus the fixed view of their abilities Acknowledge mistakes as a part of the process versus problematic or failures Teach parents to follow through with same goals at home Legitimize the presence of the fixed mindset

6 We are all a mixture of fixed and growth mindsets- and will likely always be Must stay in touch with personal fixed mindsets to be aware when we are using them in response to our students Encourage students learning process using the growth mindset, not the fixed mindset response Discussion/ group examples/ It's time to deliver interventions that will truly boost students' motivation, resilience, and learning. - Carol Dweck QUESTIONS? COMMENTS? SUGGESTIONS? Want references? Melissa McGrath, M.A., CCC-SLP Assistant Professor Department of Speech Language Pathology & Audiology Ball State University (765)