Child Abuse and Neglect Prevention Powerpoint Class 2 The NEATS: Neurobiology, Executive Function,...

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  • 8/7/2019 Child Abuse and Neglect Prevention Powerpoint Class 2 The NEATS: Neurobiology, Executive Function, Attachment, Trauma, & Self-Regulation

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    The NEATS:

    Neurobiology, Executive function,

    Attachment,Trauma,

    &Self-regulation

    Jane F. Gilgun, Ph.D., LICSWSchool of Social Work

    University of Minnesota, Twin Cities

    1404 Gortner Avenue

    St. Paul, MN 55108 USA

    [email protected]

    http://www.cehd.umn.edu/ssw/people/profiles/GilgunJ.asp

    Topics

    Perspectives on the NEATS

    Neurobiology

    Executive Function

    Attachment

    Trauma

    Self-Regulation

    Perspectives on theNEATS

    Relational

    Ecosystems

    Developmental

    Competency-Based

    Influences on Child &

    Family

    Functioning

    Historical Forces,Culture, Values

    Community Resources

    Religious/Spiritual Institutions

    ParentsWork

    School

    Extended Family/Soci al Networks

    Peer group

    Family

    Child

    Social

    history

    Children MirrorParents:

    Parents IssuesNeurobiological

    Executive Function

    Attachment

    Trauma

    Self-Regulation Within a social context

    Developmental & relational

    Child & Family Ecomap

    Mental

    Health

    Public

    financial

    support

    Religious

    orSpiritual

    Institutions

    Parents

    Work

    Neighborhood

    Extended

    Family/Soci

    al Networks

    Recreation

    School

    FocalChild

    Parent(s)/Carer(s)

    Key

    ++++ strong connection.. weak connection

    ///////// conflicted connection

    no connection

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    Behaviors Associated

    with Neurological

    ConditionsImpulsivity

    Distractibility

    Self-organization

    Behavioral activity levels

    Awareness of effects of behaviors on others

    Intelligence

    Neurobiology

    Anatomy of Brain

    Frontal lobe and executive skills

    Emotion circuits

    Applications

    From LeDoux (1996)

    Frontal Lobe

    & Executive Functions

    Planning and executing of movements

    Two main subdivisions

    Motor cortex

    Prefrontal cortex

    Executive functions

    Working memory

    Has connections to emotion and long-term memorystructures and circuits

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    Emotion Circuit

    Sensory input

    Thalamus

    Amygdala

    Hippocampus

    Prefrontal cortex

    Other structures as well

    Amygdala

    Almond-shaped

    Site of emotional learning

    Matures very early in life

    Receives signals from the thalamus, whoseinformation is relatively undifferentiated

    Also receives signals from the neocortex, whoseinformation is highly differentiated

    Turns on all sorts of systems, including theautonomic

    Stress does not harm amygdala

    Amygdala

    The amygdala part of a system that promptsreleases of adrenaline and other hormones into theblood stream.

    This may disrupt rational thought.

    Hippocampus

    A horseshoe shaped region of the subcortical brain

    Has roles in emotion and memory

    Has a very high density of receptor cells for cortisolwhich is a hormone secreted in response to stress

    Cortisol can change the shape of the nerve cells in the hippocampusand even kill them

    Hippocampus

    Creates memories that are representations of pooledinformation, including relationships between bits ofinformation

    Inf

    r

    ati

    n is

    i

    ly

    iff

    r

    ntiat

    Child Conditions Related

    to Brain Functioning

    ADHD

    Childhood Depression

    Obsessive-Compulsive Disorders

    Tourette Spectrum Disorders

    Bipolar Disorders

    Autism Spectrum Disorders

    Fetal Alcohol Spectrum Disorders

    Sensory IntegrationIssues

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    Impli ti n forractic

    Neurological evaluations

    Complete medical and social histories

    Structure

    tasks broken down into simple steps

    calm environments

    care providers who under-react and who have strongsupport systems for themselves

    Summary

    Neuroscience important to work with children andfamilies

    Plasticity of human brain

    Interaction of genes and environment

    Medication can sometimes slow down or speed upbrain functions

    Case Example, John, 7

    Mothers Descriptions

    Walked at 10 months, running ever since

    Constant motion, crashes into things

    Never listens

    Ask him to put his clothes in hamper He plays on floor, clothes not in hamper

    Oblivious

    Taught his 2 y.o. brother how to use matches

    Case Example, John, 7

    Teachers Views

    Blurts out in class

    Fidgets, gets out of his chair

    Forgets to bring home books he needs to do hishomework

    Difficulty waiting his turn & following rules

    Other kids think he is weird Do not want to play with him

    Case Example, Martha, 1010th birthday

    Fascinated by waitresss hair

    Quiet and cooperative in school Daydreamed

    Forgets where she puts things

    Cant made simple decisions

    Cant organize self

    Sobbed: Whats wrong with me?

    Executive FunctionDefinition

    a set of inter-related processes responsible

    for purposeful, goal-directed behaviors.

    Neural pathways are in the neocortex with

    connections to many other areas of the

    brain

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    Case Examples

    Jimmy, 8, climbs on the roof

    Frankie, 2, can follow two-step directions

    Janie, 5, screams, You liar at kindergarten

    John, 7, teaches his 2 y.o. brother how to usematches

    Sally, 8, is very good at playing Simon Says

    Implications for Practice

    structured environments

    clear expectations & simple directions

    patient, under-reacting adults

    arrangement of play and leisure time with otherchildren

    one-on-one time with adults

    important for adults to set examples

    Parental support

    Attachment

    Strategies for maintaining proximity

    Strategies vary according to

    Developmental levels

    Quality of attachments

    Two main types

    SecureInsecure

    In infancy, shapes inner working models

    Purposes of Attachment

    Survival in infancy

    Quality of life as we get older

    Optimal Development

    A base from which to experience and internalize

    Safety and security

    Regulation of emotions, body functions, body rhythmsTo explore environment

    To which to return when stressed, frightened

    Synchrony andAsynchrony

    Synchrony

    Contingent reciprocity

    Mutual regulation

    Asynchrony

    Breaks in reciprocity

    Significance of repair

    Case Examples, Ronnie, 2Father leaves the room

    Ronnie cries

    Father returns to the room

    Ronnie laughs, runs to father

    Father and son hug

    Ronnie has trouble getting a puzzle piece

    into place

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    Case Examples, Amelia, 18 mos

    Mother leaves the room

    Amelia doesnt seem to notice

    Mother returns to the room

    Amelia glances up and resumes playing

    Mother sits on a chair

    Cas a l s, Jack, 26s

    Father leaves the room

    Ronnie screams and throws self on floor

    Father returns to the room

    Ronnie laughs, runs to father

    Slugs father in the face

    Father slaps Jack on the face

    Trauma

    Definition

    events that are

    life-threatening or

    psychologically devastating to thepoint where

    persons capacities to cope areoverwhelmed

    and that result in changes in braincircuitry and structures

    Case Examples

    Joey, 3, screams whenever he sees a woman withred hair

    Sally, 4, runs away whenever her mother approachesher

    Mark, 9, crawls on his hands and knees and barks

    like a dog

    Marietta, 7, wets the bed nightly for the first time infour years

    Implications for Practice Do not isolate children/adolescents/adults who are

    re-experiencing trauma

    Show up

    Provide a safe environment

    Work directly with the effects of the traumatic event

    Involve children with enjoyable, safe, structuredenvironments

    Self-RegulationDefinition

    capacities to manage and make sense of ones own

    thoughts,

    emotions, and

    behaviors in times of stress

    and in the course of everyday life.

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    Emotion lation& ra ma

    Emotion

    lation:Capaciti s tomod lat

    motional r

    spons

    s in a rangeof sit

    ations

    ra

    ma: lifeevents that overwhelmeverydaycopingcapacities

    Emotion egulation& rauma

    Emotion egulation:Capacities tomodulateemotional responses in a rangeof situations

    rauma: lifeevents that overwhelmeverydaycopingcapacities

    egulation& ysregulation

    Related to

    Styles of attachment

    Internalized working models

    Self-regulation

    neurobiology

    Coping with Dysregulation

    Re-regulation: To regain a sense of self-efficacy, control, and mastery over self and theenvironment

    Three strategies:

    Pro-social

    Anti-social

    Self-injurious

    inappropriate

    Noxious Events, Dysregulation,

    Outcome

    Hot Button

    Dysregulation

    Human Agency/Automatic Activation of Schemas

    Outcome

    Pro-soc ial Ant i-Soc ialSelf-

    destructiveiInappropriate

    Noxious Event

    Search for Coping Strategies

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    Implications for Practice

    overall goal is to help ch ildren re-regulate Show up

    direct work with parents

    re-arranging environments

    Summary

    Ecosystems

    Family History

    Neurological Exams

    Work with Families

    Components of NEATS Interconnected