The NEATS: N eurobiology, E xecutive function, A ttachment, T rauma, & S elf-regulation Jane F....

The NEATS:The NEATS:

NNeurobiology, eurobiology, EExecutive xecutive

function, function, AAttachment, ttachment, TTrauma, rauma,

& & SSelf-regulationelf-regulation

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

University of Minnesota, Twin CitiesUniversity of Minnesota, Twin Cities1404 Gortner Avenue1404 Gortner Avenue

St. Paul, MN 55108 USASt. Paul, MN 55108 [email protected]@umn.edu

ssw.che.umn.edu/Faculty_Profiles/Gilgun_Jane.htmlssw.che.umn.edu/Faculty_Profiles/Gilgun_Jane.html

TopicsTopics

Perspectives on the NEATSPerspectives on the NEATS

NNeurobiologyeurobiology

EExecutive Functionxecutive Function

AAttachmentttachment

TTraumarauma

SSelf-Regulationelf-Regulation

PerspectivesPerspectives on the on the NEATSNEATS

EcosystemsEcosystems

DevelopmentalDevelopmental

Competency-BasedCompetency-Based

Influences on Child & Influences on Child & FamilyFamily

FunctioningFunctioning

Historical Forces,Culture, Values

Community Resources

Religious/Spiritual Institutions

Parents’ Work

School

Extended Family/Social Networks

Peer group

Family

Child

Socialhistory

Children Can’t Do Children Can’t Do What Parents Can’t DoWhat Parents Can’t Do

Children mirror parentsChildren mirror parentsParents’ IssuesParents’ Issues– NNeurobiological eurobiological

– EExecutive Functionxecutive Function

– AAttachmentttachment

– TTraumarauma

– SSelf-Regulationelf-Regulation

Child & Family EcomapChild & Family Ecomap

Mental Health

Public financial support

Religiousor SpiritualInstitutions

Parents’Work

Neighborhood

ExtendedFamily/Social

Networks

Recreation

School

Focal Child

Parent(s)/Carer(s)

Key++++ strong connection….. … weak connection///////// conflicted connection no connection

Behaviors Associated Behaviors Associated with Neurological Conditionswith Neurological ConditionsImpulsivityImpulsivity

DistractibilityDistractibility

Self-organizationSelf-organization

Behavioral activity levels Behavioral activity levels

Awareness of effects of behaviors on Awareness of effects of behaviors on othersothers

IntelligenceIntelligence

NeurobiologyNeurobiology

Anatomy of BrainAnatomy of Brain

Frontal lobe and executive skillsFrontal lobe and executive skills

Emotion circuitsEmotion circuits

ApplicationsApplications

Neurons: Basic Signaling Neurons: Basic Signaling UnitsUnits

Frontal Lobe Frontal Lobe & Executive Functions& Executive Functions

Planning and executing of movementsPlanning and executing of movements



Two main subdivisionsTwo main subdivisions– Motor cortexMotor cortex– Prefrontal cortexPrefrontal cortex



Two main subdivisionsTwo main subdivisions– Motor cortexMotor cortex– Prefrontal cortexPrefrontal cortex

Executive functionsExecutive functions

Working memoryWorking memory

Has connections to emotion and long-term Has connections to emotion and long-term memory structures and circuits memory structures and circuits

Emotion CircuitEmotion Circuit

Sensory inputSensory input

ThalamusThalamus

AmygdalaAmygdala

HippocampusHippocampus

Prefrontal cortex Prefrontal cortex

Other structures as wellOther structures as well

AmygdalaAmygdala

Almond-shapedAlmond-shapedSite of emotional learningSite of emotional learning

AmygdalaAmygdala

Almond-shapedAlmond-shapedSite of emotional learningSite of emotional learningMatures very early in lifeMatures very early in lifeReceives signals from the thalamus, whose Receives signals from the thalamus, whose information is relatively information is relatively undifferentiatedundifferentiatedAlso receives signals from the neocortex, whose Also receives signals from the neocortex, whose information is highly differentiated information is highly differentiated

AmygdalaAmygdala

Almond-shapedAlmond-shapedSite of emotional learningSite of emotional learningMatures very early in lifeMatures very early in lifeReceives signals from the thalamus, whose Receives signals from the thalamus, whose information is relatively information is relatively undifferentiatedundifferentiatedAlso receives signals from the neocortex, whose Also receives signals from the neocortex, whose information is highly differentiated information is highly differentiated Turns on all sorts of systems, including the Turns on all sorts of systems, including the autonomicautonomicStress does not harm amygdalaStress does not harm amygdala

AmygdalaAmygdala

The amygdala part of a system that The amygdala part of a system that prompts releases of adrenaline and other prompts releases of adrenaline and other hormones into the blood stream.hormones into the blood stream.

– This may This may disrupt rational thought.disrupt rational thought.


A horseshoe shaped region of the subcortical A horseshoe shaped region of the subcortical brain brain

Has roles in emotion and memoryHas roles in emotion and memory


A horseshoe shaped region of the subcortical A horseshoe shaped region of the subcortical brain brain

Has roles in emotion and memoryHas roles in emotion and memory

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

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


Creates memories that are Creates memories that are representations of pooled information, representations of pooled information, including relationships between bits of including relationships between bits of informationinformation– Information is highly differentiatedInformation is highly differentiated


Creates memories that are Creates memories that are representations of pooled information, representations of pooled information, including relationships between bits of including relationships between bits of informationinformation– Information is highly differentiatedInformation is highly differentiated

Represents contexts of experiences Represents contexts of experiences

Stressful life events can damage the Stressful life events can damage the hippocampushippocampus

Child Conditions RelatedChild Conditions Relatedto Brain Functioningto Brain Functioning

ADHDADHDChildhood DepressionChildhood DepressionObsessive-Compulsive DisordersObsessive-Compulsive DisordersTourette Spectrum DisordersTourette Spectrum DisordersBipolar DisordersBipolar DisordersAutism Spectrum DisordersAutism Spectrum DisordersFetal Alcohol Spectrum DisordersFetal Alcohol Spectrum DisordersSensory Integration IssuesSensory Integration Issues

Implications for PracticeImplications for Practice

– Neurological evaluations Neurological evaluations

– Complete medical and social historiesComplete medical and social histories

– StructureStructure tasks broken down into simple stepstasks broken down into simple steps

calm environmentscalm environments

care providers who under-react and who have care providers who under-react and who have strong support systems for themselvesstrong support systems for themselves

SummarySummary

Neuroscience important to work with Neuroscience important to work with children and familieschildren and families

Plasticity of human brainPlasticity of human brain

Interaction of genes and environment Interaction of genes and environment

Medication can sometimes slow down or Medication can sometimes slow down or speed up brain functionsspeed up brain functions

Case Example, John, 7Case Example, John, 7

Mother’s DescriptionsMother’s Descriptions

Walked at 10 months, running ever sinceWalked at 10 months, running ever since

Constant motion, crashes into thingsConstant motion, crashes into things

Never listensNever listens– Ask him to put his clothes in hamperAsk him to put his clothes in hamper– He plays on floor, clothes not in hamperHe plays on floor, clothes not in hamper

ObliviousOblivious

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

Case Example, John, 7Case Example, John, 7

Teacher’s ViewsTeacher’s Views

Blurts out in classBlurts out in class

Fidgets, gets out of his chairFidgets, gets out of his chair

Forgets to bring home books he needs to Forgets to bring home books he needs to do his homeworkdo his homework

Difficulty waiting his turn & following rulesDifficulty waiting his turn & following rules

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

Case Example, Martha, 10Case Example, Martha, 10

1010thth birthday birthday– Fascinated by waitress’s hairFascinated by waitress’s hair

Quiet and cooperative in schoolQuiet and cooperative in school– DaydreamedDaydreamed

Forgets where she puts thingsForgets where she puts things

Can’t made simple decisionsCan’t made simple decisions

Can’t organize selfCan’t organize self

Sobbed: What’s wrong with me? Sobbed: What’s wrong with me?

Executive FunctionExecutive Function

DefinitionDefinition

a set of inter-related processes responsible a set of inter-related processes responsible

for purposeful, goal-directed behaviors. for purposeful, goal-directed behaviors.

Neural pathways are in the neocortex with Neural pathways are in the neocortex with

connections to many other areas of the connections to many other areas of the

brainbrain

Case ExamplesCase Examples

Jimmy, 8, climbs on the roofJimmy, 8, climbs on the roof

Frankie, 2, can follow two-step directionsFrankie, 2, can follow two-step directions

Janie, 5, screams, “You liar” at Janie, 5, screams, “You liar” at kindergarten kindergarten

John, 7, teaches his 2 y.o. brother how to John, 7, teaches his 2 y.o. brother how to use matchesuse matches

Sally, 8, is very good at playing Simon Sally, 8, is very good at playing Simon SaysSays


structured environments structured environments clear expectations & simple directionsclear expectations & simple directionspatient, under-reacting adults patient, under-reacting adults arrangement of play and leisure time with arrangement of play and leisure time with other children other children one-on-one time with adults one-on-one time with adults important for adults to set examples important for adults to set examples Parental supportParental support

AttachmentAttachment

Strategies for maintaining proximityStrategies for maintaining proximity– Strategies vary according toStrategies vary according to

Developmental levelsDevelopmental levels

Quality of attachmentsQuality of attachments

Two main typesTwo main types

In infancy, shapes inner working modelsIn infancy, shapes inner working models

Purposes of AttachmentPurposes of Attachment

Survival in infancySurvival in infancyQuality of life as we get olderQuality of life as we get olderOptimal DevelopmentOptimal Development– A base from which to experience and A base from which to experience and

internalizeinternalizeSafety and securitySafety and securityRegulation of emotions, body functions, body Regulation of emotions, body functions, body rhythmsrhythmsTo explore environmentTo explore environmentTo which to return when stressed, frightenedTo which to return when stressed, frightened

Synchrony and AsynchronySynchrony and Asynchrony

SynchronySynchrony– Contingent reciprocityContingent reciprocity– Mutual regulationMutual regulation

AsynchronyAsynchrony– Breaks in reciprocityBreaks in reciprocity– Significance of repairSignificance of repair

Case Examples, Ronnie, 2Case Examples, Ronnie, 2

Father leaves the roomFather leaves the room– Ronnie criesRonnie cries

Father returns to the roomFather returns to the room– Ronnie laughs, runs to fatherRonnie laughs, runs to father

Father and son hug Father and son hug

Ronnie has trouble getting a puzzle pieceRonnie has trouble getting a puzzle pieceinto placeinto place

Case Examples, Amelia, 18 mosCase Examples, Amelia, 18 mos

Mother leaves the roomMother leaves the room– Amelia doesn’t seem to noticeAmelia doesn’t seem to notice

Mother returns to the roomMother returns to the room– Amelia glances up and resumes playingAmelia glances up and resumes playing

Mother sits on a chair Mother sits on a chair

Case Examples, Jack, 26 mosCase Examples, Jack, 26 mos

Father leaves the roomFather leaves the room– Ronnie screams and throws self on floorRonnie screams and throws self on floor

Father returns to the roomFather returns to the room– Ronnie laughs, runs to fatherRonnie laughs, runs to father– Slugs father in the faceSlugs father in the face

Father slaps Jack on the faceFather slaps Jack on the face

TraumaTrauma

DefinitionDefinitionevents that are events that are – life-threatening or life-threatening or – psychologically devastating to the point psychologically devastating to the point

where where persons’ capacities to cope are persons’ capacities to cope are overwhelmed overwhelmed and that result in changes in brain and that result in changes in brain circuitry and structures circuitry and structures


Joey, 3, screams whenever he sees a Joey, 3, screams whenever he sees a woman with red hairwoman with red hair



Sally, 4, runs away whenever her mother Sally, 4, runs away whenever her mother approaches herapproaches her




Mark, 9, crawls on his hands and knees Mark, 9, crawls on his hands and knees and barks like a dogand barks like a dog




Mark, 9, crawls on his hands and knees Mark, 9, crawls on his hands and knees and barks like a dogand barks like a dog

Marietta, 7, wets the bed nightly for the Marietta, 7, wets the bed nightly for the first time in four years first time in four years


Do not isolate children/adolescents/adults Do not isolate children/adolescents/adults who are re-experiencing traumawho are re-experiencing trauma

Show upShow up

Provide a safe environmentProvide a safe environment

Work directly with the effects of the Work directly with the effects of the traumatic event traumatic event

Involve children with enjoyable, safe, Involve children with enjoyable, safe, structured environments structured environments

Self-RegulationSelf-Regulation

DefinitionDefinition

capacities to manage and make sense of capacities to manage and make sense of one’s own one’s own – thoughts, thoughts, – emotions, and emotions, and – behaviors in times of stressbehaviors in times of stress

and in the course of everyday life. and in the course of everyday life.

Emotion Regulation Emotion Regulation & Trauma& Trauma

Emotion Regulation:Emotion Regulation: Capacities to Capacities to modulate emotional responses in a modulate emotional responses in a range of situationsrange of situations

Trauma:Trauma: life events that overwhelm life events that overwhelm everyday coping capacities everyday coping capacities

Regulation & DysregulationRegulation & Dysregulation

Related to Related to

– Styles of attachment Styles of attachment

– Internalized working models Internalized working models

– Self-regulationSelf-regulation

– neurobiologyneurobiology

The Effects of Protective Factors

on Human Functioning After Trauma Jane Gilgun, Ph.D., LICSW

emotion

cognition

memory

sympathetic nervous system

Time

CopingCoping with Dysregulationwith Dysregulation

Re-regulationRe-regulation: To regain a sense of : To regain a sense of self-efficacy, control, and mastery over self self-efficacy, control, and mastery over self and the environmentand the environment

Three strategies:Three strategies:– Pro-socialPro-social– Anti-socialAnti-social– Self-injuriousSelf-injurious

Noxious Events, Noxious Events, Dysregulation, Agency, Dysregulation, Agency,

OutcomeOutcome

Noxious Event

Search for Coping Strategies

Human Agency

Outcome

Pro-social Anti-SocialSelf-

destructive

Dysregulation


overall goal is to help children re-regulateoverall goal is to help children re-regulate– Show upShow up

direct work with parentsdirect work with parents

re-arranging environmentsre-arranging environments

SummarySummary

EcosystemsEcosystems

Family HistoryFamily History

Neurological ExamsNeurological Exams

Work with FamiliesWork with Families

Components of NEATS InterconnectedComponents of NEATS Interconnected

Show UpShow Up

The NEATS: N eurobiology, E xecutive function, A ttachment, T rauma, & S elf-regulation Jane F....

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