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Research Update: Early Deprivation and Brain Development

A new article has been published which adds more to that we know about deprivation on development of the mind, body and brain.

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Millions of children worldwide live in nonfamilial institutions. We studied impact on adult brain structure of a particularly severe but time-limited form of institutional deprivation in early life experienced by children who were subsequently adopted into nurturing families. Institutional deprivation was associated with lower total brain volume in a dose-dependent way. Regionally specific effects were seen in medial prefrontal, inferior frontal, and inferior temporal areas. Deprivation-related alterations in total brain volume were associated with lower intelligence quotient and more attention deficit/hyperactivity disorder symptoms; alterations in temporal volume seemed compensatory, as they were associated with fewer attention deficit/hyperactivity disorder symptoms. We provide evidence that early childhood deprivation is related to alterations in adult brain structure, despite environmental enrichment in intervening years.

Read more here: https://www.pnas.org/content/early/2020/01/01/1911264116

Download a copy [open access] Early childhood deprivation is associated with alterations in adult brain structure despite subsequent environmental enrichment


More articles here…

Enriched Environments as a Potential Treatment for Developmental Disorders: A Critical Assessment

The beneficial effects of enriched environments have been established through a long history of research. Enrichment of the living conditions of captive animals in the form of larger cages, sensory stimulating objects, and opportunities for social interaction and physical exercise, has been shown to reduce emotional reactivity, ameliorate abnormal behaviors, and enhance cognitive functioning. Recently, environmental enrichment research has been extended to humans, in part due to growing interest in its potential therapeutic benefits for children with neurodevelopmental disorders (NDDs). This paper reviews the history of enriched environment research and the use of enriched environments as a developmental intervention in studies of both NDD animal models and children. We argue that while environmental enrichment may sometimes benefit children with NDDs, several methodological factors need to be more closely considered before the efficacy of this approach can be adequately evaluated, including: (i) operationally defining and standardizing enriched environment treatments across studies; (ii) use of control groups and better control over potentially confounding variables; and (iii) a comprehensive theoretical framework capable of predicting when and how environmental enrichment will alter the trajectory of NDDs.

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Read more here: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00466/full


Early Adverse Experiences and the Developing Brain

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Read more here: https://www.nature.com/articles/npp2015252

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CPD: Understanding and Applying Trauma-Informed Approaches Across Occupational Therapy Settings

AOTA has really helpful and supportive articles right now – promoting the best clinical practice, with an emphasis on participation in occupation.

This article is particularly pertinent to OT’s using ASI theory and practice to create therapeutic environments supporting and scaffolding participation in daily life for those with trauma.

Read the full article here.

 

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Autumn Special: Book now for a chance to win an online module free

#book classroom module now to win online module freeAutumn Special – Book and pay in full for one of our ASI WISE onsite classroom modules in November or December 2018, and you will be entered into a free draw to win a place on an online module worth £200.

You can use this place for yourself or gift it to a colleague or friend. The person attending must be eligible to attend and commence learning by June 2019.

You can make your booking here today or request an invoice

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Trauma and development of the brain.

Watch this amazing TED about trauma…here’s a taster of what Nadine Burke Harris will share with you in her presentation, which explores the underlying neuroscience.

close up photography of grizzly bear

Well, imagine you’re walking in the forest and you see a bear. Immediately, your hypothalamus sends a signal to your pituitary, which sends a signal to your adrenal gland that says, “Release stress hormones! Adrenaline! Cortisol!”

And so your heart starts to pound, Your pupils dilate, your airways open up, and you are ready to either fight that bear or run from the bear. And that is wonderful if you’re in a forest and there’s a bear. (Laughter) But the problem is what happens when the bear comes home every night,and this system is activated over and over and over again, and it goes from being adaptive, or life-saving, to maladaptive, or health-damaging.

Children are especially sensitive to this repeated stress activation, because their brains and bodies are just developing. High doses of adversity not only affect brain structure and function, they affect the developing immune system, developing hormonal systems, and even the way our DNA is read and transcribed.”

<div style=”max-width:854px”><div style=”position:relative;height:0;padding-bottom:56.25%”><iframe src=”https://embed.ted.com/talks/lang/en/nadine_burke_harris_how_childhood_trauma_affects_health_across_a_lifetime&#8221; width=”854″ height=”480″ style=”position:absolute;left:0;top:0;width:100%;height:100%” frameborder=”0″ scrolling=”no” allowfullscreen></iframe></div></div>

 

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Early trauma is stored in the body via the senses, this is why therapy through the senses is effective

“Early trauma is stored in the body via the senses, this is why therapy through the senses is effective.”
Smith, K BPD and SI 2004
boy wearing gray hoodieOccupational Therapists are ideally placed to work through play and via the senses to promote the development of healthy neurological pathways and structures; impacting the development of sensory motor skills and abilities that underpin our ability to move, learn, play, develop, communicate, think and process emotions.

 Sensory integration is integral to the process of healthy development ‘when the functions of the brain are whole and balanced, body movements are highly adaptive, learning is easy and good behaviour is a natural outcome’

Ayres, 1979

girl jeans kid lonelinessThey can do this with clients who are very young, or those who are adults with childhood trauma, who often find talking therapies very hard to engage with as the trauma memories are stored before language has developed, so are instead stored in the body and via the senses.
These young people do need trauma-informed schools, but this is not enough! The problem with whole school approaches to trauma is that for these children whole school strategies are not individualised and personalised and as such, are not specifically targeted. Specialist assessment and intervention is needed for these young people to reduce the impact of trauma on their young plastic brains, still in development.

Postgraduate education in Ayres’ Sensory Integration theory and practice alongside undergraduate education in infant and child development means that occupational therapists are ideally placed to address the sensory-motor needs of looked after children who have often been subjected to trauma in utero and early childhood.

Ayres’ Sensory Integration is a theory that suggests that brain “maturation is the process of the unfolding of genetic coding in conjunction with the interaction of the individual with the physical and social environment. As a result of experience, there are changes in the nervous system.”
Spitzer and Roley 1996
Sensory qualities of the environment can positively or negatively interact with function and development.
Schneider et al, 200
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created, a sensory ladder key ring with football players, to support a young man with trauma to develop improved self-awareness and how to communicate what he needs and when to others

Occupational Therapists working in this area are able to use a discreet but comprehensive range of skills and resources within their scope of practice to offer direct one to one sensory integration – based intervention. These may be with the individual child, while also supporting foster and adoptive families, and typically includes parent participation in therapy.  Occupational therapists will also offer parent and family education and work alongside schools and other organisations via a consultation model, offering education, in-service training, supervision for staff.

“Adopted children who have suffered traumatic early experiences are “barely surviving” in the current high-pressure school environment and need greater support if they are to have an equal chance of success, a charity has said.

They are falling behind in their studies because they are struggling to cope emotionally with the demands of the current education system which “prizes exam results at the expense of wellbeing”, according to a report from Adoption UK.”

from The Guardian 27 June 2018

https://www.theguardian.com/society/2018/jun/27/adopted-children-barely-surviving-in-high-pressure-schools

The development of Occupational Therapy care pathways for children, adolescents and adults with trauma is increasing, as the role of Occupational Therapists in this area is increasingly being recognised.
‘Sensory Integration sorts, orders and eventually puts all the sensory inputs together into whole brain function.’
Ayres 1979
What emerges from this process is increasingly complex behaviour, the adaptive response and occupational engagement.
Allen, Delport and Smith 2011
You can read more about work in this area by following these links:
1. MayBenson, T. A. (2016). A Sensory Integrative Intervention Perspective to
TraumaInformed Care. OTA The Koomar Center White Paper. Newton,
MA: OTA The Koomar Center(PDF) A Sensory Integration-Based Perspective to Trauma-Informed Care for Children. Available from: https://www.researchgate.net/publication/303383214_A_Sensory_Integration-Based_Perspective_to_Trauma-Informed_Care_for_Children [accessed Jul 01 2018]
3. Werner, K. (2016) “Occupational Therapy’s Role in Addressing the Sensory Processing Needs of Young Children with Trauma History” Entry-Level OTD Capstones. 8. http://commons.pacificu.edu/otde/8[accessed Jul 01 2018]