THE FIRST R:RELATIONSHIPS Connection is the Key

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THE FIRST RRELATIONSHIPSConnection is the Key

• JEAN CLINTON B.Mus MD FRCP(C)
• MCMASTER UNIVERSITY CHILDRENS HOSPITAL
• OFFORD CENTRE FOR CHILD STUDIES
• VOICES FOR CHILDREN

REACH AGM June 13 2007
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Guiding Principles

• Development of the whole child.
• The importance of belonging.
• Relationships as central.

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• The Health and creativity of a community is
  renewed each generation through its children.
• The family, community, or society that
  understands and values its children thrives---the
  society that does not is destined to fail

www.childtrauma.org
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UNICEF REPORT CARD 2007

• The true measure of a nations standing is how
  well it attends to its children-their health and
  safety, their material security, their education
  and socialization, and their sense of being
  loved, valued and included in the families and
  societies into which they are born.

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Canada Place vs First Place

• 6 SWEDEN 1
• 13 SWEDEN 1
• 2 BELGIUM 1
• 18 ITALY 1
• 17 SWEDEN 1
• 15 NETHERLANDS 1
• 12/21

• Material Well Being
• Health and Safety
• Educational Well being
• Family and Peer Relationships
• Behaviours and Risks
• Subjective well being
• Overall

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The Brain Matters

• The human brain is the organ responsible for
  everything we do. It allows us to laugh, walk,
  love, talk.
• For each of us, our brain is a reflection of our
  experiences.
• The brain is an environmental organ. It reflects
  our environment.

Adapted from Bruce Perry
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03-078
Experience and Brain Development
Stimuli in early life switch on genetic pathways
that differentiate neuron function sensitive
periods
Stimuli affect the formation of
the connections (synapses)
among the billions of neurons
From studies in humans, monkeys and rats
Founders Network
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04-212
Sound Vision Smell
Touch Proprioception Taste
Neal Halfon
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03-080
The Founders Network
Experience-Based Brain Development in the early
years of life sets neurological and biological
pathways that affect
Health
Learning
Behaviour
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The nerve cell, or neuron resembles a miniature
tree (p. 21)
Diamond Hopson, 1998
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USE IT OR LOSE IT !

• The more a system, or set of brain cells is
  activated, the more that system changes in
  response. The stronger the repetitions the
  stronger the memory.

Bruce Perry MD
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03-012
Synaptic Density
At Birth
6 Years Old
14 Years Old
Rethinking the Brain, Families and Work
Institute, Rima Shore, 1997.
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02-002
Estimated Culmulative Difference in Language
Experiences by 4 Years of Age
Million
50
Professional
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Working-class
30
Estimated cumulative words
addressed to child
20
10
Welfare
0
0
12
24
36
48
Age of child in months
From Hart and Risley
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Exceptional Returns on InvestmentLong-Term
Benefit-Cost Ratios for Four Exemplary ECD
Programs
Up to 16 rate of return on investment in ECD,
compared to the highly touted 6 rate of return
of the U.S. stock market (1871-1998) Sources
Lynch (2004), Rolnick Grunewald (2003)
Sources Karoly et al. (1998), Masse Barnett
(2002), Reynolds et al. (2002), Schweinhart et
al. (2004)
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97-044
The Mismatch Between Opportunity and Investment
Brain's "Malleability"
Spending on Health,
Education and Welfare
Age
0
3
10
70
Medicare
Headstart
Welfare
Social Security
Public Education
Research
Medicaid
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A Work in ProgressUNDER CONSTRUCTION

• The teen brain is like a computer. Adding new
  programs, but not yet developed.
• Development is downloading new software. You
  cant do anything else while downloading!

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The Frontal Lobes

• Executive Functions
• Governing emotions
• Judgment
• Planning
• Organization
• Problem Solving
• Impulse Inhibition
• Abstraction
• Analysis/synthesis
• Self-awareness
• Self-concept
• Identity
• and
• Spirituality

Self- everything
Williamsgroup, 2003 Please credit Protecting
You/Protecting Me (PY/PM)
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Anterior Cingulate Cortex
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ACC The Oops Centre
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UNDER CONSTRUCTION

• Back of brain matures before to the front of the
  brain
• sensory and physical activities favored over
  complex, cognitive-demanding activities
• propensity toward risky, impulsive behaviors
• group setting may promote risk taking
• poor planning and judgment

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AREAS UNDER CONSTRUCTION

• Parietal lobes associated with logic and spatial
  reasoning.
• Temporal areas linked to language.
• Frontal lobes making decision
• Cerebellum has changed the most during the teens.

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Influences on Brain Development

• Dr Jay Giedd If that teenage brain is still
  changing so much, we have to think about what
  kinds of experiences we want that brain to have.
• Brain absorbs a huge amount
• Experience models the brain.
• Teens have trouble making decisions
• Worst time to expose brain to anything harmful

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SCENARIOS

• What we THINK.
• Affects what we FEEL
• Affects how we ACT.

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02-066
The Fear Response
Visual Thalamus
Visual Cortex
Amygdala
Scientific American
The Hidden Mind, 2002, Volume 12, Number 1
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03-002
Emotional Stimulus
Amygdala
Hippocampus
-

-

Hypothalamus PVN
Cortisol
Cortisol
CRF
PIT
ACTH
Adrenal Cortex
LeDoux, Synaptic Self
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Childrens Stress Pathway

• Childrens number one fear is PUBLIC
  HUMILIATION. They will do anything to belong.
• If a child is not sure if they are going to be
  embarrassed or humiliated they cant learn
  
• Mary
  Gordon

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00-058
Cortisol can be bad for the brain
Hippocampus
high sterol levels cause loss of dendrites
and cell death
Frontal brain
attention deficits
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EPIGENETICS

• Any Functional Change in the Genome that does not
  involve an alteration of sequence.
• Familial transmission of traits vulnerabilities)
  from parent(s) to offspring can occur through a
  nongenomic mechanism of inheritance

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05-056
Individual differences in stress reactivity of
the adult are determined by maternal behaviour
during infancy
HIGH LG
LOW LG
Development of Stress Reactivity
Increased Stress Reactivity Increased Risk for
Heart Disease, Type II Diabetes, Alcoholism,
Affective Disorders, Brain Aging, etc.
Modest Stress Reactivity Reduced Risk for
Disease
M. Szyf
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05-057
Is maternal care the mediator of these effects on
hippocampal (GR(17) promoter methylation?
ADOPTION/CROSS FOSTERING STUDIES
Adoptive Mother
Biological Mother
LOW
LOW
HIGH
HIGH
M. Szyf
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04-006
Swedish Longitudinal Study ECD and Adult Health
Number of Adverse ECD Circumstances
3
1
2
4
0
Adult Health
Odds - Ratios
2.08
General Physical
1
1.39
1.54
2.66
1
1.56
1.53
2.91
7.76
Circulatory
Mental
1
1.78
2.05
10.27
3.76
Economic, family size, broken family and family
dissention
Lundberg, Soc. Sci. Med, Vol. 36, No. 8, 1993
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The Prevalence of Children with Difficulties by
Family Income
The Founders Network
QUARTILE
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Prevalence of Children With Difficulties by
Parenting Style
Wilms (1999)
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03-074
Rates of Return to Human Development Investment
Across all Ages
8
6
Pre-school Programs
Return Per Invested
School
4
R
Job Training
2
Pre- School
School
Post School
0
6
18
Age
Carneiro, Heckman, Human Capital Policy, 2003
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Our Biological Unit of SurvivalThe Clan

• We are WIRED to connect.
• We are unavoidably inter-dependant on each other
  to survive
• YET
• .

www.childtrauma.org
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The Relational Landscape is changing.Children
have fewer emotional ,social and cognitive
interactions with fewer people
www.childtrauma.org
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POVERTY OF RELATIONSHIPS

• The compartmentalizing of our culture has
  resulted in material wealth yet poverty of social
  and emotional opportunity.

Modernitys Paradox
Hertzman and Keating
www.childtrauma.org
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Importance of Relationships

• "Human beings of all ages are happiest and able
  to deploy their talents to best advantage" when
  they experience trusted others as "standing
  behind them."
• 
  Bowlby, 1973