NONVERBAL CUES IN AFFECT REGULATION BABIES FEEL BEFORE THEY THINK! What We Will Learn to Inform Our Care in Trauma

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1 NONVERBAL CUES IN AFFECT REGULATION BY MARILEE BURGESON, MA. CCC-DIR SLP 1 What We Will Learn to Inform Our Care in Trauma 2 Recognize Non verbal Affect cues Regulation and Brain Development DIR Floortime model Case Study Reflection 2 3 THE POWER OF AFFECT 3 4 BABIES FEEL BEFORE THEY THINK 4

WHAT ARE NON VERBAL AFFECT CUES? 5 REFLECTION OF THE FELT EXPERIENCE Affect is the experience of feeling or emotion. Affect is a key part of the process of an organism's interaction with stimuli. The word also refers sometimes to affect display, which is "a facial, vocal, or gestural behavior that serves as an indicator of affect" (APA 2006). en.wikipedia.org 5 6 6 Affect is mediated through co regulation 7 Regulation: infants ability to modulate the intensity of sensation and remain interested in full range of sensations. Self Regulation: function that arises from co-regulating interactions between parents and infants. Intense Mutual Gaze: a mutual regulatory system of arousal that allows for parent and child to move together from a state of neutral affect and low arousal to heightened positive emotion yet modulated arousal Affect Cueing: ability to express intention through subtle vocal and motor acts, and to read the vocal motor cues by others to express their intent or state. Osten, Beth, A Comprehensive Overview of the DIR approach, Profectum, Assessment as Intervention, 2012. 7 REGULATION 8 mutual regulation self regulation emotional regulation 8

THE AFFECT DIATHESIS GREENSPAN 9 AFFECT MOTOR MOTOR PLANNING SEQUENCING EMERGING SYMBOL FORMATION 9 STABLE LEARNING PROCESSES THAT HAVE PASSED THROUGH TIME attend relate signal with emotions 10 The survival of humans depends on the social capacity for intimacy, empathy, reflective thinking and a shared sense of humanity and reality. Stanley Greenspan, The First Idea. 10 Trauma-Informed Care 11 strengths-based responsive safe rebuilds 11 Parallel Process We Want to Create with Families strengths based safe 12 responsive create meaning 12

AFFECT TRANSFORMS THROUGH SHARED EXPERIENCES 13 13 NON VERBAL AFFECT CUES 14 EMOTIONS HAVE HISTORICALLY BEEN VIEWED AS: OUTLETS FOR EXTREME PASSION SUBJECTIVE STATES OF FEELING INTERPERSONAL SOCIAL CUES STANLEY GREENSPAN THE AFFECT DIATHESIS HYPOSTHESIS, JOURNAL OF DEVELOPMENTAL AND LEARNING DISORDERS 14 AFFECT EVOLVES 15 SIMPLE AFFECT STATES RANGE OF AFFECTS: SURPRISE, FEAR, CAUTION, JOY, HAPPINESS, ENTHUSIASM, CURIOSITY SHARED EXPERIENCES Stanley Greenspan 15 16 AFFECT SPEAKS LOUDER THAN WORDS 16

I SEE AND FEEL THROUGH 17 SYNCHRONY RESPONSIVENESS APPRAISAL REGULATION COMMUNICATION 17 18 18 TRANSFORMATIONS. 19 Though their progressive transformations, emotions, which can be experienced in an almost infinite number of subtle variations, can organize and give meaning to experience. They can therefore serve as the as the architect, orchestra leader for the mind s many functions at each stage in the pathway function. At each stage in the pathway to intelligence, emotions orchestrate cognitive language,motor,sensory and social experience. (Greenspan & Shankar,2004,p51) 19 20 Tiny progressive transformations build emotional stability 20

REGULATION OF EMOTION SELF OTHER appraisal (reflecting on our emotion and understanding the affect cues of others) 21 physiological ( arousal) (feeling emotion in the body intensity sets meaning) emotional expression(involuntary/intentional) socialization( how others react) Barry Prizant, SCERTS MODEL, 2006 21 WE MAKE MEANING THROUGH WHAT IS NOT SAID 22 22 Affect cues Patterns to Observe: 23 synchronous movement rhythm with mother s affect: voice inflections, facial expressions, body movements interactive rhythm of gestural, vocal or verbal communication 23 24 Babies experience emotions in the physiologic sensory system and become the vehicles of interpersonal development. Stanley Greenspan (2004) 24

AFFECT INVESTS 25 shared meaning to sounds words and behaviors processing of motor planning and visual spatial capacity 25 26 26 27 WIRED TO LOVE ATTACHMENT AND ATTUNEMENT 27 28 WHY DO WE HAVE AFFECT CUES? 28

MIRROR NEURONS 29 The survival value of being able to read minds in a social setting to determine another s status as friend or foe is profound. Hence we are with a legacy of empathy and the capacity for mind sight rooted in our evolution. Dan Siegal 29 SURVIVAL 30 RIGHT BRAIN ATTACHMENT SYSTEM MOTHER REGULATES SOCIAL EMOTIONAL ENVIRONMENT EMOTIONAL ATTACHMENT TO MOTHER REGULATION OF WITHDRAWAL INTEGRATION OF AFFECT DANIEL SHORE 30 31 BRAIN POWER SERVE AND RETURN 31 32 WOW 32

SELF REGULATION IS ESSENTIAL TO ADAPT TO: 33 CHALLENGING SOCIAL SITUATIONS BIDS FOR INTERACTIONS DISORGANIZING ENVIRONMENTAL STIMULATION VIOLATION OF EXPECTATIONS Barry Prizant, SCERTS, 2006 33 34 EXPERIENCE SHAPES THE BRAIN 34 35 BRUCE PERRY: NEURODEVELOPMENTAL SEQUENCE OF PLAY 35 PEEK A BOO IS A DEVELOPMENTAL PROCESS 36 separation/individuation constancy maintaining attachment across space shared experiences and meaning concept of mom is growing 36

37 THE IMPORTANCE OF PEEKABOO 37 Bring awareness to the nonverbal signals 38 Babies come into the world equipped with a wide range of sensory, informa:on- processing and motor- control capaci:es. Caregivers have to learn which rhythms, touches and sounds calm an infant effec:vely and conversely, they must discover the sorts of animated voices, facial expressions, body movements, and gestures that will s:mulate an infant s desire to interact socially or to explore her world. Stanley Greenspan, The First Idea, 2004 38 FOSTERING SECURE ATTACHMENT 39 DAN SIEGAL, WHOLE BRAIN CHILD SEEN SAFE SOOTHED SECURE 39 40 40

41 A BABY SMILE ENCOURAGES MATERNAL CARE 41 WHEN BASIC NEEDS ARE NOT CONSISTENTLY MET, WE SEE 42 lack of confidence and autonomy lack of agency poor regulation of emotion anticipation of failure 42 43 Intervention 43 44 DIR FLOORTIME MODEL BRIDGES ACES 44

45 The Dyad 45 DIR Floortime Model 46 Emotional Thinking Emotional Ideas Shared Problem Solving Functional Developmental Levels Intentional Two Way Communication Engagement or Falling in Love Regulation and Shared Attention 46 47 Relationship 47 The$Mutual$Regulatory$ Influence$on$$ the$four$a s$ Action Arousal 48 Sensory( Integra-on(and( Modula-on( Affect Attention Williamson)&)Anzalone,)2001) Individual Processing Differences 48

49 REGULATION AND SHARED ATTENTION DIR Level One 49 IF THE CAREGIVER IS CALM, THE CHILD IS CALM 50 50 51 REGULATION CALM ENOUGH TO TAKE IN THE WORLD. Calm enough to take in the world 51 REGULATION OF THE BODY 52 adaptive capacity self regulation.co regulation homeostasis: calm body provides the foundation to take in others biological synchrony 52

53 Optimal State of Arousal 53 54 ENGAGEMENT OR FALLING IN LOVE DIR LEVEL TWO 54 55 TWO WAY INTENTIONAL COMMUNICATION DIR LEVEL THREE 55 56 SHARED SOCIAL PROBLEM SOLVING DIR LEVEL 4 56

AFFECTIVE SYNCHRONY 57 affective synchrony interaction repair modulates negative arousal fundamental building blocks of attachment and associated emotions. 57 58 Famous Pairs 58 Strategies to Support a Synchronous Dyad 59 Modify demand Enhance coping Providing Contingent Feedback Gordon Williamson 59 SPECIFICALLY FITTED INTERACTION 60 Resilience in stressful or new experiences is the ultimate indicator of attachment security. Allan Shore 60

61 Break and Repair: Ed Tronick 61 62 HOW COMFORTABLE ARE YOU WITH THE DISCOMFORT? 62 Look Listen Feel with Care 63 63 64 What one thing will you try to encourage your understanding of nonverbal cues in affect regulation? 64

References Greenspan, Stanley, MD., and Shanker, Stuart, D.Phil. The First Idea: how Symbols, Language, and Intelligence evolved from Our Primate Ancestors to Modern Humans.DeCapo Press, 2004 Greenspan, Stanley, The Affect Diathesis Hypothesis: The Role of Emotions in the Core Deficit in Autism and in the Development of Intelligence and Social Skills, Journal of Developmental and Learning Disorders, Nelson, Katherine, Young Minds in Social Worlds, Experience, Meaning and Memory,Harvard University Press, 2007. Osten, Beth, Assessment as Intervention, Profectum Introductory Course: OVerview of the DIR Model, 2012. Prizant, Barry M., Wetherby Amy, Rubin Emily, Laurent, Amy C., Rydell, Patrick J., The Scerts Model, A Comprehensive educational approach for Children with Autism Spectrum Disorders, Volume 1 Assessment, Brooke s Publishing, 2006 Siegal, Daniel and Hartzell Mary, Parenting from the Inside Out, Penguin Publishing, 2003. Wetherby, Amy, Communication and Language Intervention for Preschool Children, Florida State University, EDUCOM, 1992 Williamson, G.Gordon, Enhancing Adaptation and Resilience in Infants and Toddlers, IDA, California 65 65 66 Lily: a case study 66 67 Assessment 67 68 Power of Movement and Positioning 68

69 Mom Takes the Lead 69 70 70 71 Small Transformations 71 72 FALLING IN LOVE 72

73 REGULATION 73 74 WHERE S MOMMY? 74 75 BREAK AND REPAIR 75 76 Signaling Getting Stronger 76

77 I See you 77 78 DEVELOPING A RHYTHM 78 79 FROM OBJECTS TO MOMMY 79 80 TAKING INITIATIVE 80