Trauma and Learning
description
Transcript of Trauma and Learning
Trauma and Learning
Bruce Perry MD PhD Chris Dunning Ph D
Childhood trauma has profound impact on the emotional behavioral cognitive social and physical functioning of children
2
What does trauma experience do to children
1048729 Each year 5 million children in USexperience an extreme traumatic
event1048729 40 will develop some form of chronic
neuro-psychiatric problem1048729 Most problems classified as anxiety
disorders with post-traumatic stressdisorder being most common
1048729 Trauma event will impair emotionalacademic andor social functioning
3
Primary Trauma and Children
Child Trauma History Most Frequent Exposure Types
CEALo
ss
Impa
ired C
aregiv
er DVCSA
Neglec
tCPA
WarTe
rrorsm
(US)
0
15
30
45
60
593556
471 458408
338
281
184
4
EmotionalAbuse
Loss ImpairedCaregiver
DomesticViolence
SexualAbuse
Neglect PhysicalAbuse
WarTerrorism
Child Trauma History Less Frequent Exposure Types
5
InjuryAccident
IllnessMedical Disaster International
WarterrorismForcedDisplacement
The National Survey of Adolescents foundNearly one-half of American teenagers have experienced at least one of the four types of violent victimization
measured sexual assault physical assault severe physical abuse witnessing community violence
The prevalence is even higher among clinical or social
service samples
Of those victimized well over half have histories of multiple types of victimization
6
Traumatic experiences in childhood are highly prevalent
bull Children are victimized in multiple ways physical abuse and assault sexual assault and exploitation neglect kidnapping and homicide
bull Children are victimized by family members caretakers friends acquaintances and strangers
bull Children experience trauma from being eyewitnesses to crime violence and homicide
7
Children Experience Traumatic Events
Nearly all psychological symptoms of trauma are associated with neurological impairments Problems of regulating emotion and arousal Alterations in consciousness and memory Damage to self-concept and identity Disruption in cognitive capacities Hyperactivity and attention problems Relationship problems Alterations in systems of self
8
Psychobiological Syndrome
9
Why Understand Psychobiology
Physical and Emotional trauma can physically injure the brain
Severity of brain injury depends on child and environmental factors
Hurt children develop various emotional defense mechanisms
Many traumatized children develop disorders such as depression PTSD Somatoformhellip
10
Why Does This Happen Trauma activates stress-response
systems in the brain Severe or chronic stress prevents the
brain from returning to relaxed state Traumatized children are in constant
fight flight or freeze mode Children are ldquotaughtrdquo how to behave by
trauma
They includebull Characteristics of the stressor and
exposure to itbull Individual factors such as gender age and
developmental level and psychiatric history
bull Family characteristicsbull Cultural factors-norms and beliefs
11
Factors Influencing Response To Trauma And Recovery
Fewer than 20 of children with a history of exposure to a traumatic event have had a psychiatric disorder mainly anxiety disorders including posttraumatic stress disorder (PTSD)
Anxiety disorders including PTSD were three times as likely in children who had suffered the violent death of a parent or loved one but only one in five of this group showed this level of distress
Most children exposed to extreme events are remarkably resilient which can explain the success of the human species despite the violence of our history (Costello Erkanli Fairbank amp Angold)
12
Prevalence of Posttraumatic Stress Reactions
Lifetime Current (1 Yr)Psychiatric Disorder of Group of GroupMajor Depression
PTSD 417 292Trauma Only 92 71No Trauma 59 46
Simple PhobiaPTSD 292 292Trauma Only 121 106No Trauma 87 78
Social PhobiaPTSD 333 292Trauma Only 113 106No Trauma 146 123
Alcohol DependencePTSD 458 375Trauma Only 314 279No Trauma 166 157
Drug DependencePTSD 250 208Trauma Only 149 128
13
What Does Happen to Children
Adults have more fully developed internal and external resources to make sense of and to cope with a traumatic event
The central nervous systems (brains) of children are not yet fully developed
They are unable to put their experiences into context or to make sense of them
14
Traumatic events impact children and adults differently
The two most fundamental responses to trauma are the ldquofight or flight responserdquo where the instinct for survival takes control or disassociation which is a protective mechanism that creates a barrier to the actual experience
Repeated exposure to trauma prevents normal brain development in children
15
Traumatic events impact children and adults differently
16
Why Does This Happen Trauma activates stress-response systems in the
brain Severe or chronic stress prevents the brain from
returning to relaxed state
Traumatized children are in constant fight flight or freeze mode biologically
lsquoFight or flightrsquo responses or actions are usually not available to children ndash therefore lsquofreezersquo and other dissociative responses are common
Children are ldquotaughtrdquo how to behave by trauma
The lsquofreezersquo response has been linked with the lsquolearned helplessnessrsquo models in animal studies ndash it appears to involve both sympathetic arousal and parasympathetic counter-effects or stepping on the lsquogas and the brakersquo at the same time
17
Trauma and Children
bull If a childrsquos early environment is abusive or neglectful the brain creates memories of these experiences coloring the childrsquos view of the world
bull Neuronal pathways developed under negative conditions prepare children to cope in a negative environment
18
Impact of Trauma on Brain Development and Protective Factors
Brain development in abusedneglectedand traumatized children is adaptive for abusiveneglectful or dangerous environments
The focus is on survival and the childdoes not know how to deal with nurturing and kindness
Childrsquos brain has adapted to anunpredictable and dangerous world
19
Neuro-Processing
Our minds our brains and our bodies are set up to make sure we make danger a priority
Things that are dangerous change over the course of childhood adolescence and adulthood
20
How we recognize and deal with danger
First we try to figure out what the danger is and how serious it is
Second we have strong emotional and physical reactions These reactions help us to take action yet they can be very distressing to feel and difficult to handle
21
Danger
Third we try to come up with what to do that can help us with the danger We try to prevent it from happening try to protect ourselves or other people against harm or try to do something to keep it from getting worse How we feel about a danger depends on both how serious we think it is and what we think can be done about it
Dangers can become traumatic when they threaten serious injury or death
22
Danger
Can feel totally helpless and passive They can cry for help or desperately wish
for someone to intervene They can feel deeply threatened by
separation from parents or caretakers Young children rely on a protective shield
provided by adults and older siblings to judge the seriousness of danger and to ensure their safety and welfare
23
Young Children
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
Childhood trauma has profound impact on the emotional behavioral cognitive social and physical functioning of children
2
What does trauma experience do to children
1048729 Each year 5 million children in USexperience an extreme traumatic
event1048729 40 will develop some form of chronic
neuro-psychiatric problem1048729 Most problems classified as anxiety
disorders with post-traumatic stressdisorder being most common
1048729 Trauma event will impair emotionalacademic andor social functioning
3
Primary Trauma and Children
Child Trauma History Most Frequent Exposure Types
CEALo
ss
Impa
ired C
aregiv
er DVCSA
Neglec
tCPA
WarTe
rrorsm
(US)
0
15
30
45
60
593556
471 458408
338
281
184
4
EmotionalAbuse
Loss ImpairedCaregiver
DomesticViolence
SexualAbuse
Neglect PhysicalAbuse
WarTerrorism
Child Trauma History Less Frequent Exposure Types
5
InjuryAccident
IllnessMedical Disaster International
WarterrorismForcedDisplacement
The National Survey of Adolescents foundNearly one-half of American teenagers have experienced at least one of the four types of violent victimization
measured sexual assault physical assault severe physical abuse witnessing community violence
The prevalence is even higher among clinical or social
service samples
Of those victimized well over half have histories of multiple types of victimization
6
Traumatic experiences in childhood are highly prevalent
bull Children are victimized in multiple ways physical abuse and assault sexual assault and exploitation neglect kidnapping and homicide
bull Children are victimized by family members caretakers friends acquaintances and strangers
bull Children experience trauma from being eyewitnesses to crime violence and homicide
7
Children Experience Traumatic Events
Nearly all psychological symptoms of trauma are associated with neurological impairments Problems of regulating emotion and arousal Alterations in consciousness and memory Damage to self-concept and identity Disruption in cognitive capacities Hyperactivity and attention problems Relationship problems Alterations in systems of self
8
Psychobiological Syndrome
9
Why Understand Psychobiology
Physical and Emotional trauma can physically injure the brain
Severity of brain injury depends on child and environmental factors
Hurt children develop various emotional defense mechanisms
Many traumatized children develop disorders such as depression PTSD Somatoformhellip
10
Why Does This Happen Trauma activates stress-response
systems in the brain Severe or chronic stress prevents the
brain from returning to relaxed state Traumatized children are in constant
fight flight or freeze mode Children are ldquotaughtrdquo how to behave by
trauma
They includebull Characteristics of the stressor and
exposure to itbull Individual factors such as gender age and
developmental level and psychiatric history
bull Family characteristicsbull Cultural factors-norms and beliefs
11
Factors Influencing Response To Trauma And Recovery
Fewer than 20 of children with a history of exposure to a traumatic event have had a psychiatric disorder mainly anxiety disorders including posttraumatic stress disorder (PTSD)
Anxiety disorders including PTSD were three times as likely in children who had suffered the violent death of a parent or loved one but only one in five of this group showed this level of distress
Most children exposed to extreme events are remarkably resilient which can explain the success of the human species despite the violence of our history (Costello Erkanli Fairbank amp Angold)
12
Prevalence of Posttraumatic Stress Reactions
Lifetime Current (1 Yr)Psychiatric Disorder of Group of GroupMajor Depression
PTSD 417 292Trauma Only 92 71No Trauma 59 46
Simple PhobiaPTSD 292 292Trauma Only 121 106No Trauma 87 78
Social PhobiaPTSD 333 292Trauma Only 113 106No Trauma 146 123
Alcohol DependencePTSD 458 375Trauma Only 314 279No Trauma 166 157
Drug DependencePTSD 250 208Trauma Only 149 128
13
What Does Happen to Children
Adults have more fully developed internal and external resources to make sense of and to cope with a traumatic event
The central nervous systems (brains) of children are not yet fully developed
They are unable to put their experiences into context or to make sense of them
14
Traumatic events impact children and adults differently
The two most fundamental responses to trauma are the ldquofight or flight responserdquo where the instinct for survival takes control or disassociation which is a protective mechanism that creates a barrier to the actual experience
Repeated exposure to trauma prevents normal brain development in children
15
Traumatic events impact children and adults differently
16
Why Does This Happen Trauma activates stress-response systems in the
brain Severe or chronic stress prevents the brain from
returning to relaxed state
Traumatized children are in constant fight flight or freeze mode biologically
lsquoFight or flightrsquo responses or actions are usually not available to children ndash therefore lsquofreezersquo and other dissociative responses are common
Children are ldquotaughtrdquo how to behave by trauma
The lsquofreezersquo response has been linked with the lsquolearned helplessnessrsquo models in animal studies ndash it appears to involve both sympathetic arousal and parasympathetic counter-effects or stepping on the lsquogas and the brakersquo at the same time
17
Trauma and Children
bull If a childrsquos early environment is abusive or neglectful the brain creates memories of these experiences coloring the childrsquos view of the world
bull Neuronal pathways developed under negative conditions prepare children to cope in a negative environment
18
Impact of Trauma on Brain Development and Protective Factors
Brain development in abusedneglectedand traumatized children is adaptive for abusiveneglectful or dangerous environments
The focus is on survival and the childdoes not know how to deal with nurturing and kindness
Childrsquos brain has adapted to anunpredictable and dangerous world
19
Neuro-Processing
Our minds our brains and our bodies are set up to make sure we make danger a priority
Things that are dangerous change over the course of childhood adolescence and adulthood
20
How we recognize and deal with danger
First we try to figure out what the danger is and how serious it is
Second we have strong emotional and physical reactions These reactions help us to take action yet they can be very distressing to feel and difficult to handle
21
Danger
Third we try to come up with what to do that can help us with the danger We try to prevent it from happening try to protect ourselves or other people against harm or try to do something to keep it from getting worse How we feel about a danger depends on both how serious we think it is and what we think can be done about it
Dangers can become traumatic when they threaten serious injury or death
22
Danger
Can feel totally helpless and passive They can cry for help or desperately wish
for someone to intervene They can feel deeply threatened by
separation from parents or caretakers Young children rely on a protective shield
provided by adults and older siblings to judge the seriousness of danger and to ensure their safety and welfare
23
Young Children
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
1048729 Each year 5 million children in USexperience an extreme traumatic
event1048729 40 will develop some form of chronic
neuro-psychiatric problem1048729 Most problems classified as anxiety
disorders with post-traumatic stressdisorder being most common
1048729 Trauma event will impair emotionalacademic andor social functioning
3
Primary Trauma and Children
Child Trauma History Most Frequent Exposure Types
CEALo
ss
Impa
ired C
aregiv
er DVCSA
Neglec
tCPA
WarTe
rrorsm
(US)
0
15
30
45
60
593556
471 458408
338
281
184
4
EmotionalAbuse
Loss ImpairedCaregiver
DomesticViolence
SexualAbuse
Neglect PhysicalAbuse
WarTerrorism
Child Trauma History Less Frequent Exposure Types
5
InjuryAccident
IllnessMedical Disaster International
WarterrorismForcedDisplacement
The National Survey of Adolescents foundNearly one-half of American teenagers have experienced at least one of the four types of violent victimization
measured sexual assault physical assault severe physical abuse witnessing community violence
The prevalence is even higher among clinical or social
service samples
Of those victimized well over half have histories of multiple types of victimization
6
Traumatic experiences in childhood are highly prevalent
bull Children are victimized in multiple ways physical abuse and assault sexual assault and exploitation neglect kidnapping and homicide
bull Children are victimized by family members caretakers friends acquaintances and strangers
bull Children experience trauma from being eyewitnesses to crime violence and homicide
7
Children Experience Traumatic Events
Nearly all psychological symptoms of trauma are associated with neurological impairments Problems of regulating emotion and arousal Alterations in consciousness and memory Damage to self-concept and identity Disruption in cognitive capacities Hyperactivity and attention problems Relationship problems Alterations in systems of self
8
Psychobiological Syndrome
9
Why Understand Psychobiology
Physical and Emotional trauma can physically injure the brain
Severity of brain injury depends on child and environmental factors
Hurt children develop various emotional defense mechanisms
Many traumatized children develop disorders such as depression PTSD Somatoformhellip
10
Why Does This Happen Trauma activates stress-response
systems in the brain Severe or chronic stress prevents the
brain from returning to relaxed state Traumatized children are in constant
fight flight or freeze mode Children are ldquotaughtrdquo how to behave by
trauma
They includebull Characteristics of the stressor and
exposure to itbull Individual factors such as gender age and
developmental level and psychiatric history
bull Family characteristicsbull Cultural factors-norms and beliefs
11
Factors Influencing Response To Trauma And Recovery
Fewer than 20 of children with a history of exposure to a traumatic event have had a psychiatric disorder mainly anxiety disorders including posttraumatic stress disorder (PTSD)
Anxiety disorders including PTSD were three times as likely in children who had suffered the violent death of a parent or loved one but only one in five of this group showed this level of distress
Most children exposed to extreme events are remarkably resilient which can explain the success of the human species despite the violence of our history (Costello Erkanli Fairbank amp Angold)
12
Prevalence of Posttraumatic Stress Reactions
Lifetime Current (1 Yr)Psychiatric Disorder of Group of GroupMajor Depression
PTSD 417 292Trauma Only 92 71No Trauma 59 46
Simple PhobiaPTSD 292 292Trauma Only 121 106No Trauma 87 78
Social PhobiaPTSD 333 292Trauma Only 113 106No Trauma 146 123
Alcohol DependencePTSD 458 375Trauma Only 314 279No Trauma 166 157
Drug DependencePTSD 250 208Trauma Only 149 128
13
What Does Happen to Children
Adults have more fully developed internal and external resources to make sense of and to cope with a traumatic event
The central nervous systems (brains) of children are not yet fully developed
They are unable to put their experiences into context or to make sense of them
14
Traumatic events impact children and adults differently
The two most fundamental responses to trauma are the ldquofight or flight responserdquo where the instinct for survival takes control or disassociation which is a protective mechanism that creates a barrier to the actual experience
Repeated exposure to trauma prevents normal brain development in children
15
Traumatic events impact children and adults differently
16
Why Does This Happen Trauma activates stress-response systems in the
brain Severe or chronic stress prevents the brain from
returning to relaxed state
Traumatized children are in constant fight flight or freeze mode biologically
lsquoFight or flightrsquo responses or actions are usually not available to children ndash therefore lsquofreezersquo and other dissociative responses are common
Children are ldquotaughtrdquo how to behave by trauma
The lsquofreezersquo response has been linked with the lsquolearned helplessnessrsquo models in animal studies ndash it appears to involve both sympathetic arousal and parasympathetic counter-effects or stepping on the lsquogas and the brakersquo at the same time
17
Trauma and Children
bull If a childrsquos early environment is abusive or neglectful the brain creates memories of these experiences coloring the childrsquos view of the world
bull Neuronal pathways developed under negative conditions prepare children to cope in a negative environment
18
Impact of Trauma on Brain Development and Protective Factors
Brain development in abusedneglectedand traumatized children is adaptive for abusiveneglectful or dangerous environments
The focus is on survival and the childdoes not know how to deal with nurturing and kindness
Childrsquos brain has adapted to anunpredictable and dangerous world
19
Neuro-Processing
Our minds our brains and our bodies are set up to make sure we make danger a priority
Things that are dangerous change over the course of childhood adolescence and adulthood
20
How we recognize and deal with danger
First we try to figure out what the danger is and how serious it is
Second we have strong emotional and physical reactions These reactions help us to take action yet they can be very distressing to feel and difficult to handle
21
Danger
Third we try to come up with what to do that can help us with the danger We try to prevent it from happening try to protect ourselves or other people against harm or try to do something to keep it from getting worse How we feel about a danger depends on both how serious we think it is and what we think can be done about it
Dangers can become traumatic when they threaten serious injury or death
22
Danger
Can feel totally helpless and passive They can cry for help or desperately wish
for someone to intervene They can feel deeply threatened by
separation from parents or caretakers Young children rely on a protective shield
provided by adults and older siblings to judge the seriousness of danger and to ensure their safety and welfare
23
Young Children
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
Child Trauma History Most Frequent Exposure Types
CEALo
ss
Impa
ired C
aregiv
er DVCSA
Neglec
tCPA
WarTe
rrorsm
(US)
0
15
30
45
60
593556
471 458408
338
281
184
4
EmotionalAbuse
Loss ImpairedCaregiver
DomesticViolence
SexualAbuse
Neglect PhysicalAbuse
WarTerrorism
Child Trauma History Less Frequent Exposure Types
5
InjuryAccident
IllnessMedical Disaster International
WarterrorismForcedDisplacement
The National Survey of Adolescents foundNearly one-half of American teenagers have experienced at least one of the four types of violent victimization
measured sexual assault physical assault severe physical abuse witnessing community violence
The prevalence is even higher among clinical or social
service samples
Of those victimized well over half have histories of multiple types of victimization
6
Traumatic experiences in childhood are highly prevalent
bull Children are victimized in multiple ways physical abuse and assault sexual assault and exploitation neglect kidnapping and homicide
bull Children are victimized by family members caretakers friends acquaintances and strangers
bull Children experience trauma from being eyewitnesses to crime violence and homicide
7
Children Experience Traumatic Events
Nearly all psychological symptoms of trauma are associated with neurological impairments Problems of regulating emotion and arousal Alterations in consciousness and memory Damage to self-concept and identity Disruption in cognitive capacities Hyperactivity and attention problems Relationship problems Alterations in systems of self
8
Psychobiological Syndrome
9
Why Understand Psychobiology
Physical and Emotional trauma can physically injure the brain
Severity of brain injury depends on child and environmental factors
Hurt children develop various emotional defense mechanisms
Many traumatized children develop disorders such as depression PTSD Somatoformhellip
10
Why Does This Happen Trauma activates stress-response
systems in the brain Severe or chronic stress prevents the
brain from returning to relaxed state Traumatized children are in constant
fight flight or freeze mode Children are ldquotaughtrdquo how to behave by
trauma
They includebull Characteristics of the stressor and
exposure to itbull Individual factors such as gender age and
developmental level and psychiatric history
bull Family characteristicsbull Cultural factors-norms and beliefs
11
Factors Influencing Response To Trauma And Recovery
Fewer than 20 of children with a history of exposure to a traumatic event have had a psychiatric disorder mainly anxiety disorders including posttraumatic stress disorder (PTSD)
Anxiety disorders including PTSD were three times as likely in children who had suffered the violent death of a parent or loved one but only one in five of this group showed this level of distress
Most children exposed to extreme events are remarkably resilient which can explain the success of the human species despite the violence of our history (Costello Erkanli Fairbank amp Angold)
12
Prevalence of Posttraumatic Stress Reactions
Lifetime Current (1 Yr)Psychiatric Disorder of Group of GroupMajor Depression
PTSD 417 292Trauma Only 92 71No Trauma 59 46
Simple PhobiaPTSD 292 292Trauma Only 121 106No Trauma 87 78
Social PhobiaPTSD 333 292Trauma Only 113 106No Trauma 146 123
Alcohol DependencePTSD 458 375Trauma Only 314 279No Trauma 166 157
Drug DependencePTSD 250 208Trauma Only 149 128
13
What Does Happen to Children
Adults have more fully developed internal and external resources to make sense of and to cope with a traumatic event
The central nervous systems (brains) of children are not yet fully developed
They are unable to put their experiences into context or to make sense of them
14
Traumatic events impact children and adults differently
The two most fundamental responses to trauma are the ldquofight or flight responserdquo where the instinct for survival takes control or disassociation which is a protective mechanism that creates a barrier to the actual experience
Repeated exposure to trauma prevents normal brain development in children
15
Traumatic events impact children and adults differently
16
Why Does This Happen Trauma activates stress-response systems in the
brain Severe or chronic stress prevents the brain from
returning to relaxed state
Traumatized children are in constant fight flight or freeze mode biologically
lsquoFight or flightrsquo responses or actions are usually not available to children ndash therefore lsquofreezersquo and other dissociative responses are common
Children are ldquotaughtrdquo how to behave by trauma
The lsquofreezersquo response has been linked with the lsquolearned helplessnessrsquo models in animal studies ndash it appears to involve both sympathetic arousal and parasympathetic counter-effects or stepping on the lsquogas and the brakersquo at the same time
17
Trauma and Children
bull If a childrsquos early environment is abusive or neglectful the brain creates memories of these experiences coloring the childrsquos view of the world
bull Neuronal pathways developed under negative conditions prepare children to cope in a negative environment
18
Impact of Trauma on Brain Development and Protective Factors
Brain development in abusedneglectedand traumatized children is adaptive for abusiveneglectful or dangerous environments
The focus is on survival and the childdoes not know how to deal with nurturing and kindness
Childrsquos brain has adapted to anunpredictable and dangerous world
19
Neuro-Processing
Our minds our brains and our bodies are set up to make sure we make danger a priority
Things that are dangerous change over the course of childhood adolescence and adulthood
20
How we recognize and deal with danger
First we try to figure out what the danger is and how serious it is
Second we have strong emotional and physical reactions These reactions help us to take action yet they can be very distressing to feel and difficult to handle
21
Danger
Third we try to come up with what to do that can help us with the danger We try to prevent it from happening try to protect ourselves or other people against harm or try to do something to keep it from getting worse How we feel about a danger depends on both how serious we think it is and what we think can be done about it
Dangers can become traumatic when they threaten serious injury or death
22
Danger
Can feel totally helpless and passive They can cry for help or desperately wish
for someone to intervene They can feel deeply threatened by
separation from parents or caretakers Young children rely on a protective shield
provided by adults and older siblings to judge the seriousness of danger and to ensure their safety and welfare
23
Young Children
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
Child Trauma History Less Frequent Exposure Types
5
InjuryAccident
IllnessMedical Disaster International
WarterrorismForcedDisplacement
The National Survey of Adolescents foundNearly one-half of American teenagers have experienced at least one of the four types of violent victimization
measured sexual assault physical assault severe physical abuse witnessing community violence
The prevalence is even higher among clinical or social
service samples
Of those victimized well over half have histories of multiple types of victimization
6
Traumatic experiences in childhood are highly prevalent
bull Children are victimized in multiple ways physical abuse and assault sexual assault and exploitation neglect kidnapping and homicide
bull Children are victimized by family members caretakers friends acquaintances and strangers
bull Children experience trauma from being eyewitnesses to crime violence and homicide
7
Children Experience Traumatic Events
Nearly all psychological symptoms of trauma are associated with neurological impairments Problems of regulating emotion and arousal Alterations in consciousness and memory Damage to self-concept and identity Disruption in cognitive capacities Hyperactivity and attention problems Relationship problems Alterations in systems of self
8
Psychobiological Syndrome
9
Why Understand Psychobiology
Physical and Emotional trauma can physically injure the brain
Severity of brain injury depends on child and environmental factors
Hurt children develop various emotional defense mechanisms
Many traumatized children develop disorders such as depression PTSD Somatoformhellip
10
Why Does This Happen Trauma activates stress-response
systems in the brain Severe or chronic stress prevents the
brain from returning to relaxed state Traumatized children are in constant
fight flight or freeze mode Children are ldquotaughtrdquo how to behave by
trauma
They includebull Characteristics of the stressor and
exposure to itbull Individual factors such as gender age and
developmental level and psychiatric history
bull Family characteristicsbull Cultural factors-norms and beliefs
11
Factors Influencing Response To Trauma And Recovery
Fewer than 20 of children with a history of exposure to a traumatic event have had a psychiatric disorder mainly anxiety disorders including posttraumatic stress disorder (PTSD)
Anxiety disorders including PTSD were three times as likely in children who had suffered the violent death of a parent or loved one but only one in five of this group showed this level of distress
Most children exposed to extreme events are remarkably resilient which can explain the success of the human species despite the violence of our history (Costello Erkanli Fairbank amp Angold)
12
Prevalence of Posttraumatic Stress Reactions
Lifetime Current (1 Yr)Psychiatric Disorder of Group of GroupMajor Depression
PTSD 417 292Trauma Only 92 71No Trauma 59 46
Simple PhobiaPTSD 292 292Trauma Only 121 106No Trauma 87 78
Social PhobiaPTSD 333 292Trauma Only 113 106No Trauma 146 123
Alcohol DependencePTSD 458 375Trauma Only 314 279No Trauma 166 157
Drug DependencePTSD 250 208Trauma Only 149 128
13
What Does Happen to Children
Adults have more fully developed internal and external resources to make sense of and to cope with a traumatic event
The central nervous systems (brains) of children are not yet fully developed
They are unable to put their experiences into context or to make sense of them
14
Traumatic events impact children and adults differently
The two most fundamental responses to trauma are the ldquofight or flight responserdquo where the instinct for survival takes control or disassociation which is a protective mechanism that creates a barrier to the actual experience
Repeated exposure to trauma prevents normal brain development in children
15
Traumatic events impact children and adults differently
16
Why Does This Happen Trauma activates stress-response systems in the
brain Severe or chronic stress prevents the brain from
returning to relaxed state
Traumatized children are in constant fight flight or freeze mode biologically
lsquoFight or flightrsquo responses or actions are usually not available to children ndash therefore lsquofreezersquo and other dissociative responses are common
Children are ldquotaughtrdquo how to behave by trauma
The lsquofreezersquo response has been linked with the lsquolearned helplessnessrsquo models in animal studies ndash it appears to involve both sympathetic arousal and parasympathetic counter-effects or stepping on the lsquogas and the brakersquo at the same time
17
Trauma and Children
bull If a childrsquos early environment is abusive or neglectful the brain creates memories of these experiences coloring the childrsquos view of the world
bull Neuronal pathways developed under negative conditions prepare children to cope in a negative environment
18
Impact of Trauma on Brain Development and Protective Factors
Brain development in abusedneglectedand traumatized children is adaptive for abusiveneglectful or dangerous environments
The focus is on survival and the childdoes not know how to deal with nurturing and kindness
Childrsquos brain has adapted to anunpredictable and dangerous world
19
Neuro-Processing
Our minds our brains and our bodies are set up to make sure we make danger a priority
Things that are dangerous change over the course of childhood adolescence and adulthood
20
How we recognize and deal with danger
First we try to figure out what the danger is and how serious it is
Second we have strong emotional and physical reactions These reactions help us to take action yet they can be very distressing to feel and difficult to handle
21
Danger
Third we try to come up with what to do that can help us with the danger We try to prevent it from happening try to protect ourselves or other people against harm or try to do something to keep it from getting worse How we feel about a danger depends on both how serious we think it is and what we think can be done about it
Dangers can become traumatic when they threaten serious injury or death
22
Danger
Can feel totally helpless and passive They can cry for help or desperately wish
for someone to intervene They can feel deeply threatened by
separation from parents or caretakers Young children rely on a protective shield
provided by adults and older siblings to judge the seriousness of danger and to ensure their safety and welfare
23
Young Children
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
The National Survey of Adolescents foundNearly one-half of American teenagers have experienced at least one of the four types of violent victimization
measured sexual assault physical assault severe physical abuse witnessing community violence
The prevalence is even higher among clinical or social
service samples
Of those victimized well over half have histories of multiple types of victimization
6
Traumatic experiences in childhood are highly prevalent
bull Children are victimized in multiple ways physical abuse and assault sexual assault and exploitation neglect kidnapping and homicide
bull Children are victimized by family members caretakers friends acquaintances and strangers
bull Children experience trauma from being eyewitnesses to crime violence and homicide
7
Children Experience Traumatic Events
Nearly all psychological symptoms of trauma are associated with neurological impairments Problems of regulating emotion and arousal Alterations in consciousness and memory Damage to self-concept and identity Disruption in cognitive capacities Hyperactivity and attention problems Relationship problems Alterations in systems of self
8
Psychobiological Syndrome
9
Why Understand Psychobiology
Physical and Emotional trauma can physically injure the brain
Severity of brain injury depends on child and environmental factors
Hurt children develop various emotional defense mechanisms
Many traumatized children develop disorders such as depression PTSD Somatoformhellip
10
Why Does This Happen Trauma activates stress-response
systems in the brain Severe or chronic stress prevents the
brain from returning to relaxed state Traumatized children are in constant
fight flight or freeze mode Children are ldquotaughtrdquo how to behave by
trauma
They includebull Characteristics of the stressor and
exposure to itbull Individual factors such as gender age and
developmental level and psychiatric history
bull Family characteristicsbull Cultural factors-norms and beliefs
11
Factors Influencing Response To Trauma And Recovery
Fewer than 20 of children with a history of exposure to a traumatic event have had a psychiatric disorder mainly anxiety disorders including posttraumatic stress disorder (PTSD)
Anxiety disorders including PTSD were three times as likely in children who had suffered the violent death of a parent or loved one but only one in five of this group showed this level of distress
Most children exposed to extreme events are remarkably resilient which can explain the success of the human species despite the violence of our history (Costello Erkanli Fairbank amp Angold)
12
Prevalence of Posttraumatic Stress Reactions
Lifetime Current (1 Yr)Psychiatric Disorder of Group of GroupMajor Depression
PTSD 417 292Trauma Only 92 71No Trauma 59 46
Simple PhobiaPTSD 292 292Trauma Only 121 106No Trauma 87 78
Social PhobiaPTSD 333 292Trauma Only 113 106No Trauma 146 123
Alcohol DependencePTSD 458 375Trauma Only 314 279No Trauma 166 157
Drug DependencePTSD 250 208Trauma Only 149 128
13
What Does Happen to Children
Adults have more fully developed internal and external resources to make sense of and to cope with a traumatic event
The central nervous systems (brains) of children are not yet fully developed
They are unable to put their experiences into context or to make sense of them
14
Traumatic events impact children and adults differently
The two most fundamental responses to trauma are the ldquofight or flight responserdquo where the instinct for survival takes control or disassociation which is a protective mechanism that creates a barrier to the actual experience
Repeated exposure to trauma prevents normal brain development in children
15
Traumatic events impact children and adults differently
16
Why Does This Happen Trauma activates stress-response systems in the
brain Severe or chronic stress prevents the brain from
returning to relaxed state
Traumatized children are in constant fight flight or freeze mode biologically
lsquoFight or flightrsquo responses or actions are usually not available to children ndash therefore lsquofreezersquo and other dissociative responses are common
Children are ldquotaughtrdquo how to behave by trauma
The lsquofreezersquo response has been linked with the lsquolearned helplessnessrsquo models in animal studies ndash it appears to involve both sympathetic arousal and parasympathetic counter-effects or stepping on the lsquogas and the brakersquo at the same time
17
Trauma and Children
bull If a childrsquos early environment is abusive or neglectful the brain creates memories of these experiences coloring the childrsquos view of the world
bull Neuronal pathways developed under negative conditions prepare children to cope in a negative environment
18
Impact of Trauma on Brain Development and Protective Factors
Brain development in abusedneglectedand traumatized children is adaptive for abusiveneglectful or dangerous environments
The focus is on survival and the childdoes not know how to deal with nurturing and kindness
Childrsquos brain has adapted to anunpredictable and dangerous world
19
Neuro-Processing
Our minds our brains and our bodies are set up to make sure we make danger a priority
Things that are dangerous change over the course of childhood adolescence and adulthood
20
How we recognize and deal with danger
First we try to figure out what the danger is and how serious it is
Second we have strong emotional and physical reactions These reactions help us to take action yet they can be very distressing to feel and difficult to handle
21
Danger
Third we try to come up with what to do that can help us with the danger We try to prevent it from happening try to protect ourselves or other people against harm or try to do something to keep it from getting worse How we feel about a danger depends on both how serious we think it is and what we think can be done about it
Dangers can become traumatic when they threaten serious injury or death
22
Danger
Can feel totally helpless and passive They can cry for help or desperately wish
for someone to intervene They can feel deeply threatened by
separation from parents or caretakers Young children rely on a protective shield
provided by adults and older siblings to judge the seriousness of danger and to ensure their safety and welfare
23
Young Children
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
bull Children are victimized in multiple ways physical abuse and assault sexual assault and exploitation neglect kidnapping and homicide
bull Children are victimized by family members caretakers friends acquaintances and strangers
bull Children experience trauma from being eyewitnesses to crime violence and homicide
7
Children Experience Traumatic Events
Nearly all psychological symptoms of trauma are associated with neurological impairments Problems of regulating emotion and arousal Alterations in consciousness and memory Damage to self-concept and identity Disruption in cognitive capacities Hyperactivity and attention problems Relationship problems Alterations in systems of self
8
Psychobiological Syndrome
9
Why Understand Psychobiology
Physical and Emotional trauma can physically injure the brain
Severity of brain injury depends on child and environmental factors
Hurt children develop various emotional defense mechanisms
Many traumatized children develop disorders such as depression PTSD Somatoformhellip
10
Why Does This Happen Trauma activates stress-response
systems in the brain Severe or chronic stress prevents the
brain from returning to relaxed state Traumatized children are in constant
fight flight or freeze mode Children are ldquotaughtrdquo how to behave by
trauma
They includebull Characteristics of the stressor and
exposure to itbull Individual factors such as gender age and
developmental level and psychiatric history
bull Family characteristicsbull Cultural factors-norms and beliefs
11
Factors Influencing Response To Trauma And Recovery
Fewer than 20 of children with a history of exposure to a traumatic event have had a psychiatric disorder mainly anxiety disorders including posttraumatic stress disorder (PTSD)
Anxiety disorders including PTSD were three times as likely in children who had suffered the violent death of a parent or loved one but only one in five of this group showed this level of distress
Most children exposed to extreme events are remarkably resilient which can explain the success of the human species despite the violence of our history (Costello Erkanli Fairbank amp Angold)
12
Prevalence of Posttraumatic Stress Reactions
Lifetime Current (1 Yr)Psychiatric Disorder of Group of GroupMajor Depression
PTSD 417 292Trauma Only 92 71No Trauma 59 46
Simple PhobiaPTSD 292 292Trauma Only 121 106No Trauma 87 78
Social PhobiaPTSD 333 292Trauma Only 113 106No Trauma 146 123
Alcohol DependencePTSD 458 375Trauma Only 314 279No Trauma 166 157
Drug DependencePTSD 250 208Trauma Only 149 128
13
What Does Happen to Children
Adults have more fully developed internal and external resources to make sense of and to cope with a traumatic event
The central nervous systems (brains) of children are not yet fully developed
They are unable to put their experiences into context or to make sense of them
14
Traumatic events impact children and adults differently
The two most fundamental responses to trauma are the ldquofight or flight responserdquo where the instinct for survival takes control or disassociation which is a protective mechanism that creates a barrier to the actual experience
Repeated exposure to trauma prevents normal brain development in children
15
Traumatic events impact children and adults differently
16
Why Does This Happen Trauma activates stress-response systems in the
brain Severe or chronic stress prevents the brain from
returning to relaxed state
Traumatized children are in constant fight flight or freeze mode biologically
lsquoFight or flightrsquo responses or actions are usually not available to children ndash therefore lsquofreezersquo and other dissociative responses are common
Children are ldquotaughtrdquo how to behave by trauma
The lsquofreezersquo response has been linked with the lsquolearned helplessnessrsquo models in animal studies ndash it appears to involve both sympathetic arousal and parasympathetic counter-effects or stepping on the lsquogas and the brakersquo at the same time
17
Trauma and Children
bull If a childrsquos early environment is abusive or neglectful the brain creates memories of these experiences coloring the childrsquos view of the world
bull Neuronal pathways developed under negative conditions prepare children to cope in a negative environment
18
Impact of Trauma on Brain Development and Protective Factors
Brain development in abusedneglectedand traumatized children is adaptive for abusiveneglectful or dangerous environments
The focus is on survival and the childdoes not know how to deal with nurturing and kindness
Childrsquos brain has adapted to anunpredictable and dangerous world
19
Neuro-Processing
Our minds our brains and our bodies are set up to make sure we make danger a priority
Things that are dangerous change over the course of childhood adolescence and adulthood
20
How we recognize and deal with danger
First we try to figure out what the danger is and how serious it is
Second we have strong emotional and physical reactions These reactions help us to take action yet they can be very distressing to feel and difficult to handle
21
Danger
Third we try to come up with what to do that can help us with the danger We try to prevent it from happening try to protect ourselves or other people against harm or try to do something to keep it from getting worse How we feel about a danger depends on both how serious we think it is and what we think can be done about it
Dangers can become traumatic when they threaten serious injury or death
22
Danger
Can feel totally helpless and passive They can cry for help or desperately wish
for someone to intervene They can feel deeply threatened by
separation from parents or caretakers Young children rely on a protective shield
provided by adults and older siblings to judge the seriousness of danger and to ensure their safety and welfare
23
Young Children
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
Nearly all psychological symptoms of trauma are associated with neurological impairments Problems of regulating emotion and arousal Alterations in consciousness and memory Damage to self-concept and identity Disruption in cognitive capacities Hyperactivity and attention problems Relationship problems Alterations in systems of self
8
Psychobiological Syndrome
9
Why Understand Psychobiology
Physical and Emotional trauma can physically injure the brain
Severity of brain injury depends on child and environmental factors
Hurt children develop various emotional defense mechanisms
Many traumatized children develop disorders such as depression PTSD Somatoformhellip
10
Why Does This Happen Trauma activates stress-response
systems in the brain Severe or chronic stress prevents the
brain from returning to relaxed state Traumatized children are in constant
fight flight or freeze mode Children are ldquotaughtrdquo how to behave by
trauma
They includebull Characteristics of the stressor and
exposure to itbull Individual factors such as gender age and
developmental level and psychiatric history
bull Family characteristicsbull Cultural factors-norms and beliefs
11
Factors Influencing Response To Trauma And Recovery
Fewer than 20 of children with a history of exposure to a traumatic event have had a psychiatric disorder mainly anxiety disorders including posttraumatic stress disorder (PTSD)
Anxiety disorders including PTSD were three times as likely in children who had suffered the violent death of a parent or loved one but only one in five of this group showed this level of distress
Most children exposed to extreme events are remarkably resilient which can explain the success of the human species despite the violence of our history (Costello Erkanli Fairbank amp Angold)
12
Prevalence of Posttraumatic Stress Reactions
Lifetime Current (1 Yr)Psychiatric Disorder of Group of GroupMajor Depression
PTSD 417 292Trauma Only 92 71No Trauma 59 46
Simple PhobiaPTSD 292 292Trauma Only 121 106No Trauma 87 78
Social PhobiaPTSD 333 292Trauma Only 113 106No Trauma 146 123
Alcohol DependencePTSD 458 375Trauma Only 314 279No Trauma 166 157
Drug DependencePTSD 250 208Trauma Only 149 128
13
What Does Happen to Children
Adults have more fully developed internal and external resources to make sense of and to cope with a traumatic event
The central nervous systems (brains) of children are not yet fully developed
They are unable to put their experiences into context or to make sense of them
14
Traumatic events impact children and adults differently
The two most fundamental responses to trauma are the ldquofight or flight responserdquo where the instinct for survival takes control or disassociation which is a protective mechanism that creates a barrier to the actual experience
Repeated exposure to trauma prevents normal brain development in children
15
Traumatic events impact children and adults differently
16
Why Does This Happen Trauma activates stress-response systems in the
brain Severe or chronic stress prevents the brain from
returning to relaxed state
Traumatized children are in constant fight flight or freeze mode biologically
lsquoFight or flightrsquo responses or actions are usually not available to children ndash therefore lsquofreezersquo and other dissociative responses are common
Children are ldquotaughtrdquo how to behave by trauma
The lsquofreezersquo response has been linked with the lsquolearned helplessnessrsquo models in animal studies ndash it appears to involve both sympathetic arousal and parasympathetic counter-effects or stepping on the lsquogas and the brakersquo at the same time
17
Trauma and Children
bull If a childrsquos early environment is abusive or neglectful the brain creates memories of these experiences coloring the childrsquos view of the world
bull Neuronal pathways developed under negative conditions prepare children to cope in a negative environment
18
Impact of Trauma on Brain Development and Protective Factors
Brain development in abusedneglectedand traumatized children is adaptive for abusiveneglectful or dangerous environments
The focus is on survival and the childdoes not know how to deal with nurturing and kindness
Childrsquos brain has adapted to anunpredictable and dangerous world
19
Neuro-Processing
Our minds our brains and our bodies are set up to make sure we make danger a priority
Things that are dangerous change over the course of childhood adolescence and adulthood
20
How we recognize and deal with danger
First we try to figure out what the danger is and how serious it is
Second we have strong emotional and physical reactions These reactions help us to take action yet they can be very distressing to feel and difficult to handle
21
Danger
Third we try to come up with what to do that can help us with the danger We try to prevent it from happening try to protect ourselves or other people against harm or try to do something to keep it from getting worse How we feel about a danger depends on both how serious we think it is and what we think can be done about it
Dangers can become traumatic when they threaten serious injury or death
22
Danger
Can feel totally helpless and passive They can cry for help or desperately wish
for someone to intervene They can feel deeply threatened by
separation from parents or caretakers Young children rely on a protective shield
provided by adults and older siblings to judge the seriousness of danger and to ensure their safety and welfare
23
Young Children
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
9
Why Understand Psychobiology
Physical and Emotional trauma can physically injure the brain
Severity of brain injury depends on child and environmental factors
Hurt children develop various emotional defense mechanisms
Many traumatized children develop disorders such as depression PTSD Somatoformhellip
10
Why Does This Happen Trauma activates stress-response
systems in the brain Severe or chronic stress prevents the
brain from returning to relaxed state Traumatized children are in constant
fight flight or freeze mode Children are ldquotaughtrdquo how to behave by
trauma
They includebull Characteristics of the stressor and
exposure to itbull Individual factors such as gender age and
developmental level and psychiatric history
bull Family characteristicsbull Cultural factors-norms and beliefs
11
Factors Influencing Response To Trauma And Recovery
Fewer than 20 of children with a history of exposure to a traumatic event have had a psychiatric disorder mainly anxiety disorders including posttraumatic stress disorder (PTSD)
Anxiety disorders including PTSD were three times as likely in children who had suffered the violent death of a parent or loved one but only one in five of this group showed this level of distress
Most children exposed to extreme events are remarkably resilient which can explain the success of the human species despite the violence of our history (Costello Erkanli Fairbank amp Angold)
12
Prevalence of Posttraumatic Stress Reactions
Lifetime Current (1 Yr)Psychiatric Disorder of Group of GroupMajor Depression
PTSD 417 292Trauma Only 92 71No Trauma 59 46
Simple PhobiaPTSD 292 292Trauma Only 121 106No Trauma 87 78
Social PhobiaPTSD 333 292Trauma Only 113 106No Trauma 146 123
Alcohol DependencePTSD 458 375Trauma Only 314 279No Trauma 166 157
Drug DependencePTSD 250 208Trauma Only 149 128
13
What Does Happen to Children
Adults have more fully developed internal and external resources to make sense of and to cope with a traumatic event
The central nervous systems (brains) of children are not yet fully developed
They are unable to put their experiences into context or to make sense of them
14
Traumatic events impact children and adults differently
The two most fundamental responses to trauma are the ldquofight or flight responserdquo where the instinct for survival takes control or disassociation which is a protective mechanism that creates a barrier to the actual experience
Repeated exposure to trauma prevents normal brain development in children
15
Traumatic events impact children and adults differently
16
Why Does This Happen Trauma activates stress-response systems in the
brain Severe or chronic stress prevents the brain from
returning to relaxed state
Traumatized children are in constant fight flight or freeze mode biologically
lsquoFight or flightrsquo responses or actions are usually not available to children ndash therefore lsquofreezersquo and other dissociative responses are common
Children are ldquotaughtrdquo how to behave by trauma
The lsquofreezersquo response has been linked with the lsquolearned helplessnessrsquo models in animal studies ndash it appears to involve both sympathetic arousal and parasympathetic counter-effects or stepping on the lsquogas and the brakersquo at the same time
17
Trauma and Children
bull If a childrsquos early environment is abusive or neglectful the brain creates memories of these experiences coloring the childrsquos view of the world
bull Neuronal pathways developed under negative conditions prepare children to cope in a negative environment
18
Impact of Trauma on Brain Development and Protective Factors
Brain development in abusedneglectedand traumatized children is adaptive for abusiveneglectful or dangerous environments
The focus is on survival and the childdoes not know how to deal with nurturing and kindness
Childrsquos brain has adapted to anunpredictable and dangerous world
19
Neuro-Processing
Our minds our brains and our bodies are set up to make sure we make danger a priority
Things that are dangerous change over the course of childhood adolescence and adulthood
20
How we recognize and deal with danger
First we try to figure out what the danger is and how serious it is
Second we have strong emotional and physical reactions These reactions help us to take action yet they can be very distressing to feel and difficult to handle
21
Danger
Third we try to come up with what to do that can help us with the danger We try to prevent it from happening try to protect ourselves or other people against harm or try to do something to keep it from getting worse How we feel about a danger depends on both how serious we think it is and what we think can be done about it
Dangers can become traumatic when they threaten serious injury or death
22
Danger
Can feel totally helpless and passive They can cry for help or desperately wish
for someone to intervene They can feel deeply threatened by
separation from parents or caretakers Young children rely on a protective shield
provided by adults and older siblings to judge the seriousness of danger and to ensure their safety and welfare
23
Young Children
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
10
Why Does This Happen Trauma activates stress-response
systems in the brain Severe or chronic stress prevents the
brain from returning to relaxed state Traumatized children are in constant
fight flight or freeze mode Children are ldquotaughtrdquo how to behave by
trauma
They includebull Characteristics of the stressor and
exposure to itbull Individual factors such as gender age and
developmental level and psychiatric history
bull Family characteristicsbull Cultural factors-norms and beliefs
11
Factors Influencing Response To Trauma And Recovery
Fewer than 20 of children with a history of exposure to a traumatic event have had a psychiatric disorder mainly anxiety disorders including posttraumatic stress disorder (PTSD)
Anxiety disorders including PTSD were three times as likely in children who had suffered the violent death of a parent or loved one but only one in five of this group showed this level of distress
Most children exposed to extreme events are remarkably resilient which can explain the success of the human species despite the violence of our history (Costello Erkanli Fairbank amp Angold)
12
Prevalence of Posttraumatic Stress Reactions
Lifetime Current (1 Yr)Psychiatric Disorder of Group of GroupMajor Depression
PTSD 417 292Trauma Only 92 71No Trauma 59 46
Simple PhobiaPTSD 292 292Trauma Only 121 106No Trauma 87 78
Social PhobiaPTSD 333 292Trauma Only 113 106No Trauma 146 123
Alcohol DependencePTSD 458 375Trauma Only 314 279No Trauma 166 157
Drug DependencePTSD 250 208Trauma Only 149 128
13
What Does Happen to Children
Adults have more fully developed internal and external resources to make sense of and to cope with a traumatic event
The central nervous systems (brains) of children are not yet fully developed
They are unable to put their experiences into context or to make sense of them
14
Traumatic events impact children and adults differently
The two most fundamental responses to trauma are the ldquofight or flight responserdquo where the instinct for survival takes control or disassociation which is a protective mechanism that creates a barrier to the actual experience
Repeated exposure to trauma prevents normal brain development in children
15
Traumatic events impact children and adults differently
16
Why Does This Happen Trauma activates stress-response systems in the
brain Severe or chronic stress prevents the brain from
returning to relaxed state
Traumatized children are in constant fight flight or freeze mode biologically
lsquoFight or flightrsquo responses or actions are usually not available to children ndash therefore lsquofreezersquo and other dissociative responses are common
Children are ldquotaughtrdquo how to behave by trauma
The lsquofreezersquo response has been linked with the lsquolearned helplessnessrsquo models in animal studies ndash it appears to involve both sympathetic arousal and parasympathetic counter-effects or stepping on the lsquogas and the brakersquo at the same time
17
Trauma and Children
bull If a childrsquos early environment is abusive or neglectful the brain creates memories of these experiences coloring the childrsquos view of the world
bull Neuronal pathways developed under negative conditions prepare children to cope in a negative environment
18
Impact of Trauma on Brain Development and Protective Factors
Brain development in abusedneglectedand traumatized children is adaptive for abusiveneglectful or dangerous environments
The focus is on survival and the childdoes not know how to deal with nurturing and kindness
Childrsquos brain has adapted to anunpredictable and dangerous world
19
Neuro-Processing
Our minds our brains and our bodies are set up to make sure we make danger a priority
Things that are dangerous change over the course of childhood adolescence and adulthood
20
How we recognize and deal with danger
First we try to figure out what the danger is and how serious it is
Second we have strong emotional and physical reactions These reactions help us to take action yet they can be very distressing to feel and difficult to handle
21
Danger
Third we try to come up with what to do that can help us with the danger We try to prevent it from happening try to protect ourselves or other people against harm or try to do something to keep it from getting worse How we feel about a danger depends on both how serious we think it is and what we think can be done about it
Dangers can become traumatic when they threaten serious injury or death
22
Danger
Can feel totally helpless and passive They can cry for help or desperately wish
for someone to intervene They can feel deeply threatened by
separation from parents or caretakers Young children rely on a protective shield
provided by adults and older siblings to judge the seriousness of danger and to ensure their safety and welfare
23
Young Children
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
They includebull Characteristics of the stressor and
exposure to itbull Individual factors such as gender age and
developmental level and psychiatric history
bull Family characteristicsbull Cultural factors-norms and beliefs
11
Factors Influencing Response To Trauma And Recovery
Fewer than 20 of children with a history of exposure to a traumatic event have had a psychiatric disorder mainly anxiety disorders including posttraumatic stress disorder (PTSD)
Anxiety disorders including PTSD were three times as likely in children who had suffered the violent death of a parent or loved one but only one in five of this group showed this level of distress
Most children exposed to extreme events are remarkably resilient which can explain the success of the human species despite the violence of our history (Costello Erkanli Fairbank amp Angold)
12
Prevalence of Posttraumatic Stress Reactions
Lifetime Current (1 Yr)Psychiatric Disorder of Group of GroupMajor Depression
PTSD 417 292Trauma Only 92 71No Trauma 59 46
Simple PhobiaPTSD 292 292Trauma Only 121 106No Trauma 87 78
Social PhobiaPTSD 333 292Trauma Only 113 106No Trauma 146 123
Alcohol DependencePTSD 458 375Trauma Only 314 279No Trauma 166 157
Drug DependencePTSD 250 208Trauma Only 149 128
13
What Does Happen to Children
Adults have more fully developed internal and external resources to make sense of and to cope with a traumatic event
The central nervous systems (brains) of children are not yet fully developed
They are unable to put their experiences into context or to make sense of them
14
Traumatic events impact children and adults differently
The two most fundamental responses to trauma are the ldquofight or flight responserdquo where the instinct for survival takes control or disassociation which is a protective mechanism that creates a barrier to the actual experience
Repeated exposure to trauma prevents normal brain development in children
15
Traumatic events impact children and adults differently
16
Why Does This Happen Trauma activates stress-response systems in the
brain Severe or chronic stress prevents the brain from
returning to relaxed state
Traumatized children are in constant fight flight or freeze mode biologically
lsquoFight or flightrsquo responses or actions are usually not available to children ndash therefore lsquofreezersquo and other dissociative responses are common
Children are ldquotaughtrdquo how to behave by trauma
The lsquofreezersquo response has been linked with the lsquolearned helplessnessrsquo models in animal studies ndash it appears to involve both sympathetic arousal and parasympathetic counter-effects or stepping on the lsquogas and the brakersquo at the same time
17
Trauma and Children
bull If a childrsquos early environment is abusive or neglectful the brain creates memories of these experiences coloring the childrsquos view of the world
bull Neuronal pathways developed under negative conditions prepare children to cope in a negative environment
18
Impact of Trauma on Brain Development and Protective Factors
Brain development in abusedneglectedand traumatized children is adaptive for abusiveneglectful or dangerous environments
The focus is on survival and the childdoes not know how to deal with nurturing and kindness
Childrsquos brain has adapted to anunpredictable and dangerous world
19
Neuro-Processing
Our minds our brains and our bodies are set up to make sure we make danger a priority
Things that are dangerous change over the course of childhood adolescence and adulthood
20
How we recognize and deal with danger
First we try to figure out what the danger is and how serious it is
Second we have strong emotional and physical reactions These reactions help us to take action yet they can be very distressing to feel and difficult to handle
21
Danger
Third we try to come up with what to do that can help us with the danger We try to prevent it from happening try to protect ourselves or other people against harm or try to do something to keep it from getting worse How we feel about a danger depends on both how serious we think it is and what we think can be done about it
Dangers can become traumatic when they threaten serious injury or death
22
Danger
Can feel totally helpless and passive They can cry for help or desperately wish
for someone to intervene They can feel deeply threatened by
separation from parents or caretakers Young children rely on a protective shield
provided by adults and older siblings to judge the seriousness of danger and to ensure their safety and welfare
23
Young Children
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
Fewer than 20 of children with a history of exposure to a traumatic event have had a psychiatric disorder mainly anxiety disorders including posttraumatic stress disorder (PTSD)
Anxiety disorders including PTSD were three times as likely in children who had suffered the violent death of a parent or loved one but only one in five of this group showed this level of distress
Most children exposed to extreme events are remarkably resilient which can explain the success of the human species despite the violence of our history (Costello Erkanli Fairbank amp Angold)
12
Prevalence of Posttraumatic Stress Reactions
Lifetime Current (1 Yr)Psychiatric Disorder of Group of GroupMajor Depression
PTSD 417 292Trauma Only 92 71No Trauma 59 46
Simple PhobiaPTSD 292 292Trauma Only 121 106No Trauma 87 78
Social PhobiaPTSD 333 292Trauma Only 113 106No Trauma 146 123
Alcohol DependencePTSD 458 375Trauma Only 314 279No Trauma 166 157
Drug DependencePTSD 250 208Trauma Only 149 128
13
What Does Happen to Children
Adults have more fully developed internal and external resources to make sense of and to cope with a traumatic event
The central nervous systems (brains) of children are not yet fully developed
They are unable to put their experiences into context or to make sense of them
14
Traumatic events impact children and adults differently
The two most fundamental responses to trauma are the ldquofight or flight responserdquo where the instinct for survival takes control or disassociation which is a protective mechanism that creates a barrier to the actual experience
Repeated exposure to trauma prevents normal brain development in children
15
Traumatic events impact children and adults differently
16
Why Does This Happen Trauma activates stress-response systems in the
brain Severe or chronic stress prevents the brain from
returning to relaxed state
Traumatized children are in constant fight flight or freeze mode biologically
lsquoFight or flightrsquo responses or actions are usually not available to children ndash therefore lsquofreezersquo and other dissociative responses are common
Children are ldquotaughtrdquo how to behave by trauma
The lsquofreezersquo response has been linked with the lsquolearned helplessnessrsquo models in animal studies ndash it appears to involve both sympathetic arousal and parasympathetic counter-effects or stepping on the lsquogas and the brakersquo at the same time
17
Trauma and Children
bull If a childrsquos early environment is abusive or neglectful the brain creates memories of these experiences coloring the childrsquos view of the world
bull Neuronal pathways developed under negative conditions prepare children to cope in a negative environment
18
Impact of Trauma on Brain Development and Protective Factors
Brain development in abusedneglectedand traumatized children is adaptive for abusiveneglectful or dangerous environments
The focus is on survival and the childdoes not know how to deal with nurturing and kindness
Childrsquos brain has adapted to anunpredictable and dangerous world
19
Neuro-Processing
Our minds our brains and our bodies are set up to make sure we make danger a priority
Things that are dangerous change over the course of childhood adolescence and adulthood
20
How we recognize and deal with danger
First we try to figure out what the danger is and how serious it is
Second we have strong emotional and physical reactions These reactions help us to take action yet they can be very distressing to feel and difficult to handle
21
Danger
Third we try to come up with what to do that can help us with the danger We try to prevent it from happening try to protect ourselves or other people against harm or try to do something to keep it from getting worse How we feel about a danger depends on both how serious we think it is and what we think can be done about it
Dangers can become traumatic when they threaten serious injury or death
22
Danger
Can feel totally helpless and passive They can cry for help or desperately wish
for someone to intervene They can feel deeply threatened by
separation from parents or caretakers Young children rely on a protective shield
provided by adults and older siblings to judge the seriousness of danger and to ensure their safety and welfare
23
Young Children
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
Lifetime Current (1 Yr)Psychiatric Disorder of Group of GroupMajor Depression
PTSD 417 292Trauma Only 92 71No Trauma 59 46
Simple PhobiaPTSD 292 292Trauma Only 121 106No Trauma 87 78
Social PhobiaPTSD 333 292Trauma Only 113 106No Trauma 146 123
Alcohol DependencePTSD 458 375Trauma Only 314 279No Trauma 166 157
Drug DependencePTSD 250 208Trauma Only 149 128
13
What Does Happen to Children
Adults have more fully developed internal and external resources to make sense of and to cope with a traumatic event
The central nervous systems (brains) of children are not yet fully developed
They are unable to put their experiences into context or to make sense of them
14
Traumatic events impact children and adults differently
The two most fundamental responses to trauma are the ldquofight or flight responserdquo where the instinct for survival takes control or disassociation which is a protective mechanism that creates a barrier to the actual experience
Repeated exposure to trauma prevents normal brain development in children
15
Traumatic events impact children and adults differently
16
Why Does This Happen Trauma activates stress-response systems in the
brain Severe or chronic stress prevents the brain from
returning to relaxed state
Traumatized children are in constant fight flight or freeze mode biologically
lsquoFight or flightrsquo responses or actions are usually not available to children ndash therefore lsquofreezersquo and other dissociative responses are common
Children are ldquotaughtrdquo how to behave by trauma
The lsquofreezersquo response has been linked with the lsquolearned helplessnessrsquo models in animal studies ndash it appears to involve both sympathetic arousal and parasympathetic counter-effects or stepping on the lsquogas and the brakersquo at the same time
17
Trauma and Children
bull If a childrsquos early environment is abusive or neglectful the brain creates memories of these experiences coloring the childrsquos view of the world
bull Neuronal pathways developed under negative conditions prepare children to cope in a negative environment
18
Impact of Trauma on Brain Development and Protective Factors
Brain development in abusedneglectedand traumatized children is adaptive for abusiveneglectful or dangerous environments
The focus is on survival and the childdoes not know how to deal with nurturing and kindness
Childrsquos brain has adapted to anunpredictable and dangerous world
19
Neuro-Processing
Our minds our brains and our bodies are set up to make sure we make danger a priority
Things that are dangerous change over the course of childhood adolescence and adulthood
20
How we recognize and deal with danger
First we try to figure out what the danger is and how serious it is
Second we have strong emotional and physical reactions These reactions help us to take action yet they can be very distressing to feel and difficult to handle
21
Danger
Third we try to come up with what to do that can help us with the danger We try to prevent it from happening try to protect ourselves or other people against harm or try to do something to keep it from getting worse How we feel about a danger depends on both how serious we think it is and what we think can be done about it
Dangers can become traumatic when they threaten serious injury or death
22
Danger
Can feel totally helpless and passive They can cry for help or desperately wish
for someone to intervene They can feel deeply threatened by
separation from parents or caretakers Young children rely on a protective shield
provided by adults and older siblings to judge the seriousness of danger and to ensure their safety and welfare
23
Young Children
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
Adults have more fully developed internal and external resources to make sense of and to cope with a traumatic event
The central nervous systems (brains) of children are not yet fully developed
They are unable to put their experiences into context or to make sense of them
14
Traumatic events impact children and adults differently
The two most fundamental responses to trauma are the ldquofight or flight responserdquo where the instinct for survival takes control or disassociation which is a protective mechanism that creates a barrier to the actual experience
Repeated exposure to trauma prevents normal brain development in children
15
Traumatic events impact children and adults differently
16
Why Does This Happen Trauma activates stress-response systems in the
brain Severe or chronic stress prevents the brain from
returning to relaxed state
Traumatized children are in constant fight flight or freeze mode biologically
lsquoFight or flightrsquo responses or actions are usually not available to children ndash therefore lsquofreezersquo and other dissociative responses are common
Children are ldquotaughtrdquo how to behave by trauma
The lsquofreezersquo response has been linked with the lsquolearned helplessnessrsquo models in animal studies ndash it appears to involve both sympathetic arousal and parasympathetic counter-effects or stepping on the lsquogas and the brakersquo at the same time
17
Trauma and Children
bull If a childrsquos early environment is abusive or neglectful the brain creates memories of these experiences coloring the childrsquos view of the world
bull Neuronal pathways developed under negative conditions prepare children to cope in a negative environment
18
Impact of Trauma on Brain Development and Protective Factors
Brain development in abusedneglectedand traumatized children is adaptive for abusiveneglectful or dangerous environments
The focus is on survival and the childdoes not know how to deal with nurturing and kindness
Childrsquos brain has adapted to anunpredictable and dangerous world
19
Neuro-Processing
Our minds our brains and our bodies are set up to make sure we make danger a priority
Things that are dangerous change over the course of childhood adolescence and adulthood
20
How we recognize and deal with danger
First we try to figure out what the danger is and how serious it is
Second we have strong emotional and physical reactions These reactions help us to take action yet they can be very distressing to feel and difficult to handle
21
Danger
Third we try to come up with what to do that can help us with the danger We try to prevent it from happening try to protect ourselves or other people against harm or try to do something to keep it from getting worse How we feel about a danger depends on both how serious we think it is and what we think can be done about it
Dangers can become traumatic when they threaten serious injury or death
22
Danger
Can feel totally helpless and passive They can cry for help or desperately wish
for someone to intervene They can feel deeply threatened by
separation from parents or caretakers Young children rely on a protective shield
provided by adults and older siblings to judge the seriousness of danger and to ensure their safety and welfare
23
Young Children
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
The two most fundamental responses to trauma are the ldquofight or flight responserdquo where the instinct for survival takes control or disassociation which is a protective mechanism that creates a barrier to the actual experience
Repeated exposure to trauma prevents normal brain development in children
15
Traumatic events impact children and adults differently
16
Why Does This Happen Trauma activates stress-response systems in the
brain Severe or chronic stress prevents the brain from
returning to relaxed state
Traumatized children are in constant fight flight or freeze mode biologically
lsquoFight or flightrsquo responses or actions are usually not available to children ndash therefore lsquofreezersquo and other dissociative responses are common
Children are ldquotaughtrdquo how to behave by trauma
The lsquofreezersquo response has been linked with the lsquolearned helplessnessrsquo models in animal studies ndash it appears to involve both sympathetic arousal and parasympathetic counter-effects or stepping on the lsquogas and the brakersquo at the same time
17
Trauma and Children
bull If a childrsquos early environment is abusive or neglectful the brain creates memories of these experiences coloring the childrsquos view of the world
bull Neuronal pathways developed under negative conditions prepare children to cope in a negative environment
18
Impact of Trauma on Brain Development and Protective Factors
Brain development in abusedneglectedand traumatized children is adaptive for abusiveneglectful or dangerous environments
The focus is on survival and the childdoes not know how to deal with nurturing and kindness
Childrsquos brain has adapted to anunpredictable and dangerous world
19
Neuro-Processing
Our minds our brains and our bodies are set up to make sure we make danger a priority
Things that are dangerous change over the course of childhood adolescence and adulthood
20
How we recognize and deal with danger
First we try to figure out what the danger is and how serious it is
Second we have strong emotional and physical reactions These reactions help us to take action yet they can be very distressing to feel and difficult to handle
21
Danger
Third we try to come up with what to do that can help us with the danger We try to prevent it from happening try to protect ourselves or other people against harm or try to do something to keep it from getting worse How we feel about a danger depends on both how serious we think it is and what we think can be done about it
Dangers can become traumatic when they threaten serious injury or death
22
Danger
Can feel totally helpless and passive They can cry for help or desperately wish
for someone to intervene They can feel deeply threatened by
separation from parents or caretakers Young children rely on a protective shield
provided by adults and older siblings to judge the seriousness of danger and to ensure their safety and welfare
23
Young Children
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
16
Why Does This Happen Trauma activates stress-response systems in the
brain Severe or chronic stress prevents the brain from
returning to relaxed state
Traumatized children are in constant fight flight or freeze mode biologically
lsquoFight or flightrsquo responses or actions are usually not available to children ndash therefore lsquofreezersquo and other dissociative responses are common
Children are ldquotaughtrdquo how to behave by trauma
The lsquofreezersquo response has been linked with the lsquolearned helplessnessrsquo models in animal studies ndash it appears to involve both sympathetic arousal and parasympathetic counter-effects or stepping on the lsquogas and the brakersquo at the same time
17
Trauma and Children
bull If a childrsquos early environment is abusive or neglectful the brain creates memories of these experiences coloring the childrsquos view of the world
bull Neuronal pathways developed under negative conditions prepare children to cope in a negative environment
18
Impact of Trauma on Brain Development and Protective Factors
Brain development in abusedneglectedand traumatized children is adaptive for abusiveneglectful or dangerous environments
The focus is on survival and the childdoes not know how to deal with nurturing and kindness
Childrsquos brain has adapted to anunpredictable and dangerous world
19
Neuro-Processing
Our minds our brains and our bodies are set up to make sure we make danger a priority
Things that are dangerous change over the course of childhood adolescence and adulthood
20
How we recognize and deal with danger
First we try to figure out what the danger is and how serious it is
Second we have strong emotional and physical reactions These reactions help us to take action yet they can be very distressing to feel and difficult to handle
21
Danger
Third we try to come up with what to do that can help us with the danger We try to prevent it from happening try to protect ourselves or other people against harm or try to do something to keep it from getting worse How we feel about a danger depends on both how serious we think it is and what we think can be done about it
Dangers can become traumatic when they threaten serious injury or death
22
Danger
Can feel totally helpless and passive They can cry for help or desperately wish
for someone to intervene They can feel deeply threatened by
separation from parents or caretakers Young children rely on a protective shield
provided by adults and older siblings to judge the seriousness of danger and to ensure their safety and welfare
23
Young Children
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
Children are ldquotaughtrdquo how to behave by trauma
The lsquofreezersquo response has been linked with the lsquolearned helplessnessrsquo models in animal studies ndash it appears to involve both sympathetic arousal and parasympathetic counter-effects or stepping on the lsquogas and the brakersquo at the same time
17
Trauma and Children
bull If a childrsquos early environment is abusive or neglectful the brain creates memories of these experiences coloring the childrsquos view of the world
bull Neuronal pathways developed under negative conditions prepare children to cope in a negative environment
18
Impact of Trauma on Brain Development and Protective Factors
Brain development in abusedneglectedand traumatized children is adaptive for abusiveneglectful or dangerous environments
The focus is on survival and the childdoes not know how to deal with nurturing and kindness
Childrsquos brain has adapted to anunpredictable and dangerous world
19
Neuro-Processing
Our minds our brains and our bodies are set up to make sure we make danger a priority
Things that are dangerous change over the course of childhood adolescence and adulthood
20
How we recognize and deal with danger
First we try to figure out what the danger is and how serious it is
Second we have strong emotional and physical reactions These reactions help us to take action yet they can be very distressing to feel and difficult to handle
21
Danger
Third we try to come up with what to do that can help us with the danger We try to prevent it from happening try to protect ourselves or other people against harm or try to do something to keep it from getting worse How we feel about a danger depends on both how serious we think it is and what we think can be done about it
Dangers can become traumatic when they threaten serious injury or death
22
Danger
Can feel totally helpless and passive They can cry for help or desperately wish
for someone to intervene They can feel deeply threatened by
separation from parents or caretakers Young children rely on a protective shield
provided by adults and older siblings to judge the seriousness of danger and to ensure their safety and welfare
23
Young Children
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
bull If a childrsquos early environment is abusive or neglectful the brain creates memories of these experiences coloring the childrsquos view of the world
bull Neuronal pathways developed under negative conditions prepare children to cope in a negative environment
18
Impact of Trauma on Brain Development and Protective Factors
Brain development in abusedneglectedand traumatized children is adaptive for abusiveneglectful or dangerous environments
The focus is on survival and the childdoes not know how to deal with nurturing and kindness
Childrsquos brain has adapted to anunpredictable and dangerous world
19
Neuro-Processing
Our minds our brains and our bodies are set up to make sure we make danger a priority
Things that are dangerous change over the course of childhood adolescence and adulthood
20
How we recognize and deal with danger
First we try to figure out what the danger is and how serious it is
Second we have strong emotional and physical reactions These reactions help us to take action yet they can be very distressing to feel and difficult to handle
21
Danger
Third we try to come up with what to do that can help us with the danger We try to prevent it from happening try to protect ourselves or other people against harm or try to do something to keep it from getting worse How we feel about a danger depends on both how serious we think it is and what we think can be done about it
Dangers can become traumatic when they threaten serious injury or death
22
Danger
Can feel totally helpless and passive They can cry for help or desperately wish
for someone to intervene They can feel deeply threatened by
separation from parents or caretakers Young children rely on a protective shield
provided by adults and older siblings to judge the seriousness of danger and to ensure their safety and welfare
23
Young Children
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
Brain development in abusedneglectedand traumatized children is adaptive for abusiveneglectful or dangerous environments
The focus is on survival and the childdoes not know how to deal with nurturing and kindness
Childrsquos brain has adapted to anunpredictable and dangerous world
19
Neuro-Processing
Our minds our brains and our bodies are set up to make sure we make danger a priority
Things that are dangerous change over the course of childhood adolescence and adulthood
20
How we recognize and deal with danger
First we try to figure out what the danger is and how serious it is
Second we have strong emotional and physical reactions These reactions help us to take action yet they can be very distressing to feel and difficult to handle
21
Danger
Third we try to come up with what to do that can help us with the danger We try to prevent it from happening try to protect ourselves or other people against harm or try to do something to keep it from getting worse How we feel about a danger depends on both how serious we think it is and what we think can be done about it
Dangers can become traumatic when they threaten serious injury or death
22
Danger
Can feel totally helpless and passive They can cry for help or desperately wish
for someone to intervene They can feel deeply threatened by
separation from parents or caretakers Young children rely on a protective shield
provided by adults and older siblings to judge the seriousness of danger and to ensure their safety and welfare
23
Young Children
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
Our minds our brains and our bodies are set up to make sure we make danger a priority
Things that are dangerous change over the course of childhood adolescence and adulthood
20
How we recognize and deal with danger
First we try to figure out what the danger is and how serious it is
Second we have strong emotional and physical reactions These reactions help us to take action yet they can be very distressing to feel and difficult to handle
21
Danger
Third we try to come up with what to do that can help us with the danger We try to prevent it from happening try to protect ourselves or other people against harm or try to do something to keep it from getting worse How we feel about a danger depends on both how serious we think it is and what we think can be done about it
Dangers can become traumatic when they threaten serious injury or death
22
Danger
Can feel totally helpless and passive They can cry for help or desperately wish
for someone to intervene They can feel deeply threatened by
separation from parents or caretakers Young children rely on a protective shield
provided by adults and older siblings to judge the seriousness of danger and to ensure their safety and welfare
23
Young Children
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
First we try to figure out what the danger is and how serious it is
Second we have strong emotional and physical reactions These reactions help us to take action yet they can be very distressing to feel and difficult to handle
21
Danger
Third we try to come up with what to do that can help us with the danger We try to prevent it from happening try to protect ourselves or other people against harm or try to do something to keep it from getting worse How we feel about a danger depends on both how serious we think it is and what we think can be done about it
Dangers can become traumatic when they threaten serious injury or death
22
Danger
Can feel totally helpless and passive They can cry for help or desperately wish
for someone to intervene They can feel deeply threatened by
separation from parents or caretakers Young children rely on a protective shield
provided by adults and older siblings to judge the seriousness of danger and to ensure their safety and welfare
23
Young Children
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
Third we try to come up with what to do that can help us with the danger We try to prevent it from happening try to protect ourselves or other people against harm or try to do something to keep it from getting worse How we feel about a danger depends on both how serious we think it is and what we think can be done about it
Dangers can become traumatic when they threaten serious injury or death
22
Danger
Can feel totally helpless and passive They can cry for help or desperately wish
for someone to intervene They can feel deeply threatened by
separation from parents or caretakers Young children rely on a protective shield
provided by adults and older siblings to judge the seriousness of danger and to ensure their safety and welfare
23
Young Children
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
Can feel totally helpless and passive They can cry for help or desperately wish
for someone to intervene They can feel deeply threatened by
separation from parents or caretakers Young children rely on a protective shield
provided by adults and older siblings to judge the seriousness of danger and to ensure their safety and welfare
23
Young Children
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
School-age children start to face additional dangers with more ability to judge the seriousness of a threat and to think about protective actions
They usually do not see themselves as able to counter a serious danger directly but they imagine actions they wish they could take like those of their comic strip heroes and feel like failures if they donrsquot
24
School-age Children
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
With the help of their friends adolescents begin a shift toward more actively judging and addressing dangers on their own
This is a developing skill and lots of
things can go wrong
Adolescents are learning to handle intense physical and emotional reactions in order to take action in the face of danger
25
Adolescents
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
Controlling impulses Initiating appropriate behavior Inhibiting inappropriate behavior Organizing things Setting priorities Making decisions Insight Working memory
26
Brain Functions to be Developed
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
27
THE RAW MATERIALS
A child is born with 100 billion neurons(brain cells)
Neurons form synapses(the brainrsquos wiring system)
Synapses support basic functions for survival
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
1 Neurogenesis- ldquoneuronsrdquo are born starting in the womb
2 Migration-Brain cells or ldquoneuronsrdquo have the ability to travel within the brain and link itself to other neurons through neural pathways
3 Differentiation-neurons develop into specialized cells to perform or serve a particular function
4 Apoptosis-literally deterioration and death of neuron through atrophy if no ldquohomerdquo is found a process called pruning
28
Core Processes of Neurodevelopment
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
5 Arborization-branching out of neurons using dendrites
6 Synaptogenesis-the vehicle at the end of the dendrite that closes the barrier or gap between two neurons The actual transfer is done by neurotransmitters
7 Synaptic Sculpting-synapses can get stronger or weaker As they weaken they disappear
8 Myelination-As neurons are fired they strengthen the myelin by using proteins hence the brain is stronger
29
Core Processes of Neurodevelopment 2
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
By age four the rate of glucose metabolism to develop synapses is twice that of an adult and continued to age 10
Myelination or development of brain pathways also need to occur
Brain structures do not mature all at the same time
The prefrontal cortex matures last Brain remodeling can be derailed if
trauma occurs during critical periods
30
Brain growth
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
31
Hierarchy of Brain Function
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
32
In the brain of someone who has experienced a variety of emotional behavioral and cognitive stimuli a ldquotop heavyrdquo ratio develops In this ratio the brain matures to moderate the more primitive instincts of the midbrainbrain stem
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
33
When key experiences (Which develop the corticallimbic part of the brain)are absent or minimal the ldquohigherrdquo to ldquolowerrdquo brain ratio is impaired In this case the ability of the brain to moderate impulsive reactive responses and to work through frustration is diminished significantly
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
34
Children raised in environments characterized by domestic violence physical abuse or other persistent trauma will develop an excessively active midbrainbrainstem This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
35
When the developing brain is both deprived of sensory stimuli and experiences traumatic stress the brainstem midbrain to corticallimbic ratio is profoundly altered
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
Trauma impedes brain maturation and interferes in the normal hierarchical development and integration of brain systems
The physical organization of the brain directly reflects the childrsquos interpersonal experiences
In response to trauma a child can develop an overactive stress response and an underdeveloped cortex
36
As a general rule
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
It is highly adaptive for the traumatized child to be hyperaroused hypervigilant and ready to attack and defend
As part of the survival mechanism extreme stress interferes with the functioning of the cortex especially prefrontal cortex the thinking part of the brain that is crucial for inhibiting the stress response
37
Result
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
One traumatic event in life like an earthquake especially in the life of a child can change the structure and the chemistry of the brain
The neurobiological consequences of repeated dissociative or hyperarousal responses on developing brain organization-- the more plastic developing brain may be more vulnerable to disruptions related to these responses
38
Life- and Brain-altering experience
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
39
Conduct Disorders
bull Behavior is the language of trauma bull Most children lack the language skills needed to describe how they are suffering so they use behavior to express themselves
bull Most behaviors used by children to express themselves are
considered ldquonegativerdquo behaviors
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
During a trauma intense fear easily overwhelms young childrens beginning efforts to manage emotions The normal sources of solace protection and help may
be unavailable from an abusive or traumatized parent
40
Emotional Maturity
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
For school-aged children the intensity and speeding up of emotions during traumas blur the ability to identify differences in emotional intensity and take them to the extreme They may have difficulty modulating emotions
They may ldquoclamp downrdquo on emotions and become numb
Shame and guilt can lead them to be secretive about their feelings
Feelings of revenge can interfere with their efforts to manage aggressive feelings in a more constructive rule abiding way
41
Emotional Maturity
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
The capacity to moderate frustration impulsivity aggression and violent behavior is age-related
With sufficient motor sensory emotional cognitive and social experiences during infancy and childhood the mature brain develops (in a use-dependent fashion) a mature humane capacity to tolerate frustration contain impulsivity channel aggressive urges
42
Cortical Modulation Is Age-Related
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
bull Social stigmatizationbull Lose ability to trustbull Retard social and interpersonal growthbull Dilemma between evil and heroic action
43
Impact on Adolescent Development
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs verbal cues
May be very intelligent but canrsquot learn easilyrarrmust do verbal learning when calm
Learning needs to be more experience-based rarr when traumatized children are stressed they are reactivereflexive vs accessing cognitive solutions
44
Implications for Learning
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
During early development these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues
Once out of such an environment it is still difficult for the childs brain to interpret (relearn) these innocent looks and touches as benign
45
Implications for Behavior
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
Difficulties with cognitive organization contribute to a more primitive less mature style of problem solving -- with violence often being employed as a toolldquo
A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn
The brain of this child has different areas activated -- different parts of the brain controlling his functioning
The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated which in turn requires a state of attentive calm
This is a state that the traumatized child rarely achieves
46
These children are often labeled as learning disabled
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-
Bruce Perry MD PhD 1997
UWM School of Continuing Education 47
- Trauma and Learning
- What does trauma experience do to children
- Primary Trauma and Children
- Child Trauma History Most Frequent Exposure Types
- Child Trauma History Less Frequent Exposure Types
- Traumatic experiences in childhood are highly prevalent
- Children Experience Traumatic Events
- Psychobiological Syndrome
- Why Understand Psychobiology
- Why Does This Happen
- Factors Influencing Response To Trauma And Recovery
- Prevalence of Posttraumatic Stress Reactions
- What Does Happen to Children
- Traumatic events impact children and adults differently
- Traumatic events impact children and adults differently (2)
- Why Does This Happen (2)
- Trauma and Children
- Impact of Trauma on Brain Development and Protective Factors
- Neuro-Processing
- How we recognize and deal with danger
- Danger
- Danger (2)
- Young Children
- School-age Children
- Adolescents
- Brain Functions to be Developed
- Slide 27
- Core Processes of Neurodevelopment
- Core Processes of Neurodevelopment 2
- Brain growth
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- As a general rule
- Result
- Life- and Brain-altering experience
- Conduct Disorders
- Emotional Maturity
- Emotional Maturity (2)
- Cortical Modulation Is Age-Related
- Impact on Adolescent Development
- Implications for Learning
- Implications for Behavior
- These children are often labeled as learning disabled
- Slide 47
-