child abuse & neglect prevention, handout class 3 and following classes

8/7/2019 Child Abuse & Neglect Prevention, Handout Class 3 and Following Classes

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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 Cities1404 Gortner Avenue

St. Paul, MN 55108 [email protected]

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

Frontal Lobe

& Executive Functions

Planning and executing of movements

Two main subdivisions

Motor cortex

Prefrontal cortex

Executive functions

Working memoryHas connections to emotion and long-term memorystructures and circuits

Emotion Circuit

Sensory input

Thalamus

Amygdala

Hippocampus

Prefrontal cortex

Other structures as well

AmygdalaAlmond-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

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

This may disrupt rational thought.


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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

Hi cam s

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

Information is highly differentiated

Represents contexts of experiences

Stressful life events can damage the hippocampus

Child Conditions Related

to Brain Functioning

ADHD

Childhood Depression

Obsessive-Compulsive Disorders

Tourette Spectrum Disorders

Bipolar DisordersAutism Spectrum Disorders

Fetal Alcohol Spectrum Disorders

Sensory IntegrationIssues

Implications forPractice

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

SummaryNeuroscience 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, 7Mothers 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


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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, 10

10th 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 Function

Definition

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

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 use

matches

Sally, 8, is very good at playing Simon Says

Implications for Practicestructured 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

AttachmentStrategies for maintaining proximity

Strategies vary according to

Developmental levels

Quality of attachments

Two main types

In infancy, shapes inner working models


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Purposes ofAttachment

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 rhythms

To explore environment

To which to return when stressed, frightened

Sync r ny andAsync r ny

Synchrony

Contingent reciprocity

Mutual regulation

Asynchrony

Breaks in reciprocity

Significance of repair

Case Examples, Ronnie, 2

Father 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

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

Case Examples, Jack, 26mos

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

TraumaDefinition

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


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Case Examples

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

Case Examples


Sally, 4, runs away whenever her mother approachesher

Case Examples



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

like a dog

Case Examples



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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Em ti n lati n& Tra ma

Em ti n

lati n: Capaciti s t m d lat

m

ti

nal r

sp

ns

s in a range

f sit

ati

ns

Tra

ma: lifeevents that

verwhelm everydayc

ping capacities

Em ti n egulati n& Trauma

Em ti n egulati n: Capacities t m dulateem

ti

nal resp

nses in a range

f situati

ns

Trauma: lifeevents that

verwhelm everydayc

ping capacities

egulati n& ysregulati n

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

Noxious Events, Dysregulation,

Agency, OutcomeNoxious Event

Search for Coping Strategies

Human Agency

Outcome

Pro-social Anti-SocialSelf-

destructive

Dysregulation


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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

child abuse & neglect prevention, handout class 3 and following classes

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