Brain Development and the Impact of Trauma

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Beverly Campbell
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2 Brain Development and the Impact of Trauma Sarah Lusardi, MSW and Alison Morrisey, LCSW July 17,

3 Objectives: Understand the critical importance of early brain development and architecture. Understand the basic mechanisms that determine early brain development and the ideal time frames ( windows ) for specific types of learning. Understand how abuse, neglect, trauma and toxic stress as well as prenatal exposure to drugs and alcohol affect brain development and impact the overall health of infants and toddlers. Select the most useful brain development concepts to share with early childhood staff and parents/caregivers and be able to express them in simple language. 3

4 Conception to three is the most critical time in human development. Anything is possible during this time. Phyllis Porter, MA 4

5 Basics on the brain. The brain is the only organ not fully developed at birth. Central nervous system: is made up of brain, neurons, and the spinal cord and is responsible for sending, receiving and interpreting information from all parts of the body. Neurons: are cells in the brain that process and transmit information through chemical and electrical signals. Synapses: allow neurons to pass information along the axon to other neurons. 5

6 Basics on the brain In other words The central nervous system is emergency dispatch, neurons are first responders, synapses are the local roads to the highway (axons) to get to the other first responders 6

7 Fire in the Brain! Neurons that fire together wire together Donald Hebb, Neuropsychologist For each experience we encounter, whether a feeling, a thought, a sensation and especially those that we are not aware of neurons are firing off messages to one another. Repeated experiences make it easier for the neurons to fire (respond to the experience), strengthening the connection and also making it more difficult to unwire or rewire them to respond differently. 7

8 Look at those synapses grow! Lisa Freund, PhD Nuturing the Developing Brain in Early Childhood 8

9 And then the pruning begins Lisa Freund, PhD Nuturing the Developing Brain in Early Childhood 9

10 Pruning The brain ascribes to the philosophy of use it or lose it. New synapses are formed as others, that are rarely or not used, are pruned away. The brain constantly is wiring and rewiring. 10

11 Pruning After 1st birthday, pruning occurs more quickly. The greatest increase in pruning is between 1year and 3 to 4 years. By age 10, a child has 500 trillion synapses, the same as an average adult. Early experiences, both positive and negative, have a dramatic effect on formation of synapses. 11

12 Pruning Neuroscience is telling us that this may be one of the most important periods [one to three years old] for developing self-regulation, problemsolving, social-emotional, and language/communication behaviors. Lisa Freund, PhD 12

13 The Why of Wiring The wiring sets a foundation for development in all other aspects of life. The quality of experiences and relationships in the first three years has a deep and lasting impact on how the brain becomes wired. Developmental progression depends on appropriate sensory input and stable, responsive relationships to build healthy brain architecture. Early experiences, both positive and negative, have a dramatic effect on formation of synapses. Serve and Return : Infants and toddlers naturally reach out for interaction through babbling, facial expressions, gestures etc. Adults respond with the same kind of vocalizing and gesturing. This serve and return continues back and forth. When unreliable, inappropriate or absent, the developing architecture of the brain may be disrupted having devastating effects for the future. 13

14 What Science is Telling Us about Early Brain Development Early relationships have permanent effects on brain development, health, and later mental health. Social-emotional health and physical health are inseparable in the very early years. Responsive caregivers can mediate the effects of some chronic health issues, such as those related to prematurity, prenatal drug exposure, poverty etc. Social and emotional development is strongly linked to success in school (and beyond). Intervention can be effective. Children and adults can recover. D. Richardson 14

15 Windows of Learning Periods in development when particular experiences are especially important or when some skills are more easily developed Some windows should not be missed if so, opportunity to learn can be greatly diminished but windows don t close all of the way. 15

16 Windows of Learning When can they do what? Birth to 4 years visual development Birth to 4 years math and logic skills Birth to 10 years language skills By age 2 emotional control By age 2 social attachment 3 to 10 years music By age 5 motor development D. Richardson 16

17 Impact of Prenatal Drug Exposure Brain development begins 3 weeks after conception. Tobacco Exposure Marijuana Exposure Central Nervous System (CNS) stress No major fetal growth issues Lower birth weight Greater muscle tension Mild withdrawal symptoms Poor autonomic control More difficulty self-soothing Executive functioning impairment More negative affect (higher rate of depression and anxiety) Lower IQ throughout childhood Attention deficits Greater risk for depression ADHD and impulsivity Reading and spelling difficulties **Effects may be subtle, transient or non-existent 17

18 Impact of Prenatal Drug Exposure Opiate Exposure Cocaine Exposure Methamphetamine Exposure More severe post-natal withdrawals More difficulty swallowing Possible delay in general cognitive functioning Anxiety Disruptive or inattentive behaviors Increase rate of seizures Hypotonia low muscle tone Low birth weight and smaller head circumference. Neurobehavioral deficits: orientation, regulation, autonomic stability, attention, sensory, jitteriness. Poor cueing during feeding Delay in information processing General cognitive delay Attention problems in childhood Self-regulation issues Lower arousal No mental or motor delays seen in infants and toddlers Increased lethargy Low birth weight and smaller head circumference **Few studies have been done on methamphetamine exposure or long term effects. **Effects may be subtle, transient or non-existent 18

19 Impact of Prenatal Drug Exposure Fetal Alcohol Spectrum Disorder (FASD) or Fetal Alcohol Syndrome (FAS) Leading cause of mental retardation Facial and cranial abnormalities* Alcohol Exposure ADHD Inability to foresee consequences Hyperactivity and poor attention Low birth weight and small throughout childhood Weakness in core/midline Decrease in social emotional functioning Inability to learn from previous experiences Lack of organization Poor adaptability Poor judgment Vision impairment Speech problems *Facial and cranial abnormalities include: Microcephaly (small head), small or nonexistent philtrum (vertical grove above the top lip), thin upper lip, shortening of eye slits, wide set eyes, flattening across nasal bridge, flat mid-face. ONLY TRULY PERMANENT DAMAGE OF DRUGS others can be moderated by environment or brain remapping to adjust. 19

20 Impact of Prenatal Drug Exposure Physical features of FAS But not always. Fetal Alcohol Spectrum Disorder (FASD) or Fetal Alcohol Syndrome (FAS) 20

21 Impact of Prenatal Drug Exposure Which children have FAS? Fetal Alcohol Spectrum Disorder (FASD) or Fetal Alcohol Syndrome (FAS) 21

22 Impact of Prenatal Drug Exposure Fetal Alcohol Spectrum Disorder (FASD) or Fetal Alcohol Syndrome (FAS) 22

23 Where in the Brain? ---Left side --- positive emotions, language, approaching new situations or ideas, logic, critical thinking. ---Right side --- negative emotions, intense emotions, creativity, reading emotions, expressing emotions, intuition. Right hemisphere has growth spurt in first 1½ years, and is dominant for first 3 years. Early attachment experiences may impact development of the right brain. Healthy right brain activity supports mental health throughout lifespan. 23

24 Let s grow this brain How are these brains different? 24

25 Let s Grow this Brain. Sights and smells build connections in the brain, when done with continuity in loving, consistent, predictable manner. Or not. Connections die if not maintained. If the child has few experiences, engagement or stimulation, connections are pruned back and brain remains small. Typical Extreme neglect Bruce Perry, Childhood Experience and the Expression of Genetic Potential: What Childhood Neglect Tells Us About Nature and Nurture. 25

26 Let s grow this brain How are these brains different? 26

27 Brains in Traumatized Children Brain activity of a typical 5- year-old child Brain activity of a 5-year-old Romanian orphan who was institutionalized shortly after birth. 27

28 Where in the Brain? Intellect, logic, reasoning Motor area Sensory area Taste Speech Language Hearing Vision Balance Emotional Regulation 28

29 Brains of Traumatized Children Multiple studies of abused and neglect children, who were rarely touched or spoken to had brains 20-30% smaller than most children their age. In some cases, children from deprived environments had brains that resembled Alzheimer's patients brains. Animals raised in a zoo have 20-30% smaller brain than those in the wild. 29

30 Behaviors from a Traumatized Brain After childhood trauma, repeated abuse, witnessing domestic violence, etc., children continue to show physical symptoms of fear even in the absence of threatening stimuli. Physiological changes: --High resting heart rates --High levels of stress hormones in blood --Right brain activity increases --Increased blood pressure --Wiring changes within the brain -- Changes in brain activity --Left brain activity slows --Increase muscle tone 30

31 Behaviors from a Traumatized Brain Behavioral changes: -- Decreased attention -- Decreased impulse control -- Decreased motor control -- Disrupted sleep and toileting -- Anxiety -- Changes in eating behaviors --Tuning out all non-critical information -- Withdrawal -- Loss of acquired speech -- Fussiness, uncharacteristic crying or neediness -- Increased startle response to loud sounds -- Hypervigilance 31

Cortisol A little bit can be a good thing Cortisol a hormone that is released in the brain in response to stress Every morning, we all get a burst of cortisol first thing in the morning and

32 Cortisol A little bit can be a good thing Cortisol a hormone that is released in the brain in response to stress Every morning, we all get a burst of cortisol first thing in the morning and then only low levels for the rest of the day, assuming all goes smoothly. Newborns get a release every 12 hours and then at about 3 months, they start getting it every morning like adults. 32

33 Cortisol Too much can be a bad thing! Cortisol is designed to help the body prepare for stressful situation and dangerous situations. It gives a quick burst of energy and heightens memory and sensitivity to pain. Different types of stress: toxic, tolerable and positive. BUT High or continuously high levels of cortisol can: Increase fear behaviors Cause hypervigilance Suppress the body s immune system Slow brain development in children Alter brain architecture Affect short-term and long-term memory Cause neuron death Cause digestive issues Elevate heart rates 33

34 How to Ensure Good Brain Growth Ensure health, safety and good nutrition. Help children feel safe and secure. Serve and Return with them consistently. Talk, read, sing to and have conversations with child. Be a consistent, responsive and loving caregiver. Minimize stress to keep Cortisol levels low. Encourage safe exploration and play. Establish routines. Really listen to children and respond to their cues, verbal and non-verbal. Be responsive to crying. Remove physical threats. Seek professional help when needed. 34

35 Discussion. Which brain development concepts would you find most helpful to share with early childhood staff and parents/caregivers? How would you express these concepts in simple terms? Questions. Parking lot questions?. 35

36 What s Coming Up? Session 3 Attachment and the Impact of Trauma Session 4 IECMH Best Practices Effective Collaboration and Supporting Resiliency Session 5 Case Conferencing and Collaboration Joint Session with Child Welfare staff 36

37 Brain Development and the Impact of Trauma Contact us! Sarah Lusardi, MSW x 107 Alison Morrisey, LCSW amorrisey@collaborative.org;

T H E S C I E N C E O F E A R LY B R A I N D E V E L O P M E N T. Kristen V.W. Connolly, MD Pediatrician

T H E S C I E N C E O F E A R LY B R A I N D E V E L O P M E N T Kristen V.W. Connolly, MD Pediatrician DOMAINS OF DEVELOPMENT 1. Physical 2. Motor 3. Cognitive 4. Communicative 5. Social-Emotional Body