Frozen The impact of ACES on early brain development. –The impact of ACES on early brain...
Transcript of Frozen The impact of ACES on early brain development. –The impact of ACES on early brain...
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Frozen – The impact of ACES on early brain development.
Thursday 6th April, 2017
Kinmel Manor Hotel, Abergele
Chris Dunne – Children’s Service Manager, Powys
12 April, 2017
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Recognising the symptoms of trauma in early years’ development and behaviours.
Ensure support is focused to challenge the root causes.
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‘Experience may alter the behaviour of an adult but it provides the organising framework of the infant and child’(Bruce Perry)
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• 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
Wales ACES exposure
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Trauma memory is saved in a state specific way, ‘frozen’ at the age and stage when trauma occurred
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ACES – Critical Years
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ACES – Early Brain Development
`Sensitive periods’ in early brain development
Vision
0 1 2 3 7654
High
Low
Years
Habitual ways of responding
Language
Emotional control
Symbol
Peer social skills`Numbers’
Hearing
Graph developed by Council for Early Child Development (ref: Nash, 1997; Early Years Study, 1999; Shonkoff, 2000.)
“Pre-school” years School years
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What implications do ACEs have for
brain development?
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• 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.
Facts – Brain Development
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• 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.
Facts – Brain Development
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• 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.
Neuroplasticity
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Brain
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• 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.
Dissociation and hyperarousal
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Trauma Response
Chemicals flood in
Chronic Stress from ACEs over-develop
‘life-preserving’ part of the brain.
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• 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.
Reality
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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
Summary of Impact
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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)
Recognising Trauma in Early Years
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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.
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• 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.
Recognising Trauma in Early Years
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• 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
Play – What might you observe?
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• Distress
• Looking withdrawn
• Fear
• Aggression
• Guilt or Shame
Emotion – What might you observe?
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• Problems with concentration
• Hypervigilance
• Repetitive questioning
“Attention seeking behaviours”
“Attention needing behaviours”
Behaviour – What might you observe?
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• 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.
0-5 Years
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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
Intervention
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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.
Trauma – Fright without Solution
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Frozen – The impact of ACES on early brain development.
Thursday 6th April, 2017
Kinmel Manor Hotel, Abergele
Chris Dunne – Children’s Service Manager, Powys
12 April, 2017