SCSN Annual Conference – Early YearsThursday 10th October 2013

Heather Stack, Founder & SEND

ConsultantHM Stack

Consulting

Impact on babies & young children of Parental Absence & Return,

Re-location & Disability

Commonality of Concerns

Parental absence & return

Re-location Disability, physical

and/or mental health

Potential for one or both parents to experience –

Loneliness Social isolation Fear & uncertainty Insecurity Loss & adjustment Anger & resentment Additional pressure Of life becoming a little

smaller... All of which impact on

parenting skills & family life

Much research pointing to risk factors & adverse impacts of service life on children

Links established between – Repeated re-location & risk of suicide in young people Parental depression & mental health problems in children Demands of caring for a disabled person & mental health

problems of carers, leading to elevated risk of mental health problems in children...

Not difficult to find evidence base for risk

Of Risk and Resilience

“We should never lose sight of the fact that our genetic inheritance is all about survival, and that’s just as important for new born babies as it is for the adult hunter.”

(Robert Winston – Human Instinct, 2002)

Our starting point, at birth, is one of survival and resilience.

Human Instinct & Resilience

There are 3 crucial elements for adult happiness –

1. Optimism2. High self esteem3. Control over one’s life

For infants, self esteem and control are not an issue What infants need, and can be taught, is optimism. The determining factor is happiness and laughter

Elements for Happiness

1. Happiness2. Confidence3. Success

Securing these characteristics should be a primary goal Between 1 & 2 years of age, personality begins to emerge An optimistic or a pessimistic personality The child who is happy, laughs a lot, is excited by the world, v

the child who is fearful, timid, prone to crying, anxious

What parents want for their children

Babies can imitate expressions not long after birth – key to the bonding process

At 6 months, babies grasp the significance of facial recognition

The process of attachment follows soon after Attachments are vital to a baby’s survival Adults can recognize hundreds of faces & recognize emotions We can tell if a baby is happy, sad, frightened or hungry Research has shown that the reverse is true Relatively young babies can read our emotional expressions

almost as well as adults can If a mother is scared, or anxious, or angry, a baby takes notice Babies tune into the tone of voice as an indicator of mood

The Process of Attachment

Baby to Adult Communication

Infants communicate with other people by a multi-channel system of senses and expressions – linking the baby’s brain activities to those of the

adult, expressed in touches, vocalisation, face expressions and gestures

Parental low mood state over a protracted period can impact on a baby’s brain activity & development

Relationships & experiences are key to brain development Brain activity is stimulated by touch, language, sounds,

gesture, facial expressions & physical contact Speech and language, emotional & social development &

attachment depend on that early parent-child interaction Where that interaction & connection is impoverished, the

foundation for developmental difficulties is formed

Brain Activity & Early Development

1 in 10 first time mothers suffer from post-natal depression Difficulties arise when depressed mothers are unable to be

sensitive to their babies’ emotional needs High levels of stress hormone make mothers short-tempered,

responding more emotionally when a baby cries Presence of a supportive partner a factor in recovery The effects on children are not always extreme Easy, resilient babies come out of it best Difficult, needy babies are more at risk and boys are

particularly vulnerable

Vulnerable Mothers & Babies

Girls of depressed mothers can be more withdrawn & unhappy at 5 years of age

Boys of 5 years could also suffer intellectually & may become hyperactive

No real research on why this gender difference occurs, but boys are generally less mature at birth

Studies in brain development show that neglect affects parts of the brain responsible for mood and judgement

This may explain why children of depressed parents are known to have higher propensity to depression in later life

Vulnerable Babies & Young Children

The emotional challenge of deployment & pre-deployment complex & demanding

For parents, the challenges made more complex by the needs of dependent young children

“A guide for the families of deployed regular Army Personnel” (March 2011)

Guidance provides support and information to help prepare for what to expect at a practical & psychological level

Tips for dealing with stress in children & other concerns The storybook project for young children

Parental Absence & Return

7 Stages of the Emotional Cycle of Deployment

Pre-deployment Deployment &

R & R Recovery Post Deployment

1: Anticipating departure 2: Detachment & withdrawal

3: Emotional disorganization 4: Recovery & establishing stability 5: Anticipation & home-coming

6: Adjustment, renegotiating relationships

7: Re-establishing stability

Risk Factors Resilience

First time mothers Partners on first

deployment Difficult babies Babies under 2 years Boys Socially isolated mothers Unexpected or prolonged

stress Support ‘out there’ Insecure family context

Experienced mothers Partners on second or

subsequent deployments Strong support networks Effective community

support Easy babies Girls Positive relationships Anticipated challenges Support at point of need Secure family context

Inattentive, persistent, non-attuned parenting Relationship tensions & stresses Increase in working hours & stress factors Shifting roles & responsibilities Dominant needs set the tone & mood for family life Emotional absence, preceding actual physical absence Taboo subjects, niggling issues, fractured relationships Irregularity of time at home, absence from family life Changing or reduced connections within the community

Features of Pre-Deployment

Anticipated stress can be a positive force enabling a child to develop coping strategies for later in life

The ability of parents to buffer stresses crucial to impact – Support groups Secure relationships (‘Strong Families. Strong Forces’) Friendships Information & knowledge On-going communications with the absent parent Targeted support Community groups and positive integration projects

Fostering Resilience through Deployment

Complex psychological issues impact upon a parent’s ability to recognize the need for help & support

Difficulties experienced by mothers in prioritising own needs Concepts of –

FailureInadequacyPride & loyalty

A barrier to intervention Integration issues and tensions (military & civilian) can hinder

access to support Stigma attached to visiting professionals (welfare)

Those Left Behind - Hidden Voices

Community Covenants complement at local level the work of the Armed Forces Covenant, June 2011 launch

A voluntary pledge of mutual support between a civilian community & its local armed forces community

Ideal v current reality Much work to integrate communities with fixed identities The brown porch, white porch syndrome – all those with

white porches are civilian owned, all those... Children grow up learning trust, co-operation, a sense of

belonging, or grow up with tension, suspicion & mistrust

Reintegration – Brown Porch, White Porch Syndrome

The children of parents on active military duty are vulnerable to long term emotional strain

US Study by Child Trends, Home Front Alert, 25 July 2013 Author David Murphey, ‘Home Front Alert: The Risks Facing Young Children in

Military Families’ This group of children are facing emotional obstacles that

could develop into more serious long term issues. As many as half a million American children face the elevated

risk for emotional problems, particularly anxiety issues.

Home Front Alert

“We’re concerned that children exposed to stressful events, particularly traumatic stressful events, will have difficulty learning to cope with emotions, to do well socially and emotionally, and even have problems with their physical health.”

“As these children grow up, there will be at least a subset of them that will face very substantial problems.”

David Murphey, Home Front Alert, July 2013

Home Front Alert

“It could be the accumulation of those stresses as well as a single overwhelming stress that can lead to really lasting changes in the developing brain, that can have negative implications for development further along the line.”

A single overwhelming stress or multiple stresses that accumulate...

Home Front Alert

Infantile amnesia – the absence of long-term memory events from childhood

Young children can remember events in the short term, but these memories do not persist

New research suggests early childhood events are forgotten because of the high level of neuron production during the first years of life

The formation of new brain cells increases the capacity for learning but also clears the mind of old memories

Research by The Hospital for Sick Children in Toronto & University of Toronto – Dr Paul Frankland & Dr Sheena Josselyn

Memory & the Highly Dynamic Hippocampus

Neural pathways 0 – 2 years

Links shown in research between reduced neuron growth and increased memory recall

The opposite also true – a decreased ability to remember when neuro-genesis is increased (as during infancy)

“Before the ages of four or five, we have a highly dynamic hippocampus which can’t stably store information.

As new neurons are generated, memory may be compromised by that process.”

Dr Frankland, HfSC, Toronto, September 2013

Memory Development

Babies’ brains grow & develop as they interact with their environment & form relationships

Babies whose needs are not met, or are met with neglect, learn different lessons

Neural pathways that develop under negative conditions prepare children to cope in that negative environment

The ability of babies to respond to nurturing and kindness may be impaired

Brief periods of moderate, predictable stress are not problematic – they can prepare a child to cope with the world.

Effects of Neglect on Brain Development

Children learn to deal with moderate stress in the context of positive relationships with reliable care givers

Great amounts of stress may also be tolerable if a child has a reliable adult who can help buffer the child

But prolonged, severe or unpredictable stress, including neglect or abuse, during a child’s early years, is problematic

The brain’s development can be altered by this toxic stress resulting in impacts on a child’s physical, cognitive, emotional and social growth

Responses to Neglect or Maltreatment

Brain development of 3 Year Old Children

Effects of ‘global’ neglect on brain development – severe sensory-deprivation neglect (from research into brain development of children from

Romanian Orphanages in early 1990s)

Brain imaging technologies and studies of human development in optimal and deprived conditions, show impact of neglect or prolonged stress on brain development

Major effects include – Persistent fear response – chronic stress or repeated trauma

can result in biological reactions, including a persistent fear state

Neural pathways involved in the fear response can create permanent memories that shape the child’s perception of, and response to, the environment

Emotional & Behavioural Impact

Hyper-arousal – when children are exposed to chronic, persistent stress, their brains sensitive pathways for the fear response and create memories that automatically trigger the response without conscious thought – this is hyper-arousal

Dissociation – a coping mechanism whereby children mentally & emotionally remove themselves from a traumatic experience – (zoning out)

In adults a capacity to zone out may be a safeguard against stressful circumstances

In children, the process is less likely to be engaged at a conscious level

Emotional & Behavioural Impact (2)

Disrupted attachment process – the foundation of much of childhood development is attachment – the emotional relationships formed with other people.

An infant’s early attachments form the basis for future emotional relationships. It also provides the basis for other learning.

If the attachment process is disrupted, the child’s brain will be wired to meeting day to day needs for survival, rather than building the foundation for future growth

Slides 14 – 19 with thanks to the Child Welfare Information Gateway

Emotional & Behavioural Impact (3)

Away from severe effects of prolonged stress, negative impact may occur at a lower level of severityChanges in infant behaviourIncreased non complianceDisturbance in sleep patternsChanges in eating habitsIncrease in anxiety levelsHeightened sensitivityNightmares and sleep terrorsIncreased angerFrequent mood changes

Short & Long Term Impact of Stress

Reports on Impact of Deployment – 4 negative themes1. Behaviour2. Loss 3. Emotion & 4. Military life impact

“Many of the parents reported changes in their child’s behaviour across the deployment process. These were changes that they attributed solely to their child’s experience of deployment....”

Katy Farrell-Wright, May 2011, Cardiff University

Study on Impact of Deployment on Spouses & Children

Emergence of 4 positive theme, some of which were in direct opposition to the negative themes –

Behaviour Character Enhanced relationships Military life impact

“There were a number of areas in which participants described the development of positive personality attributes in their child...”

“It brought us all so much closer, having to go through something like that; we were a much stronger family unit afterwards.”

Impact of Deployment (2)

Popular romantic film images of returning service men & women reunited with beaming families

Illusion & reality somewhat different ‘There’s a stranger in the house’ The re-emergence of the father ‘You wait till your Dad gets home!’ Behaviour management – the threat of the absent parent Emotional expectations may not meet real life experiences Yet the illusion persists...

The Romanticism of Return

Aware that Joy has researched extensively the impact of mobility and deployment on service children

Mobility Project -2009, Halton School Cycles of disengagement and re-engagement before and after

school moves Periods of settled and unsettled behaviours in babies and

young children Emotional and physical responses to environmental factors The resilience of children and their parents a factor in

reducing negative impact of mobility

Service Mobility & Impact on Young Children

“Moving between different postings and the potential for deployment are facts of military life. These not only impact on the Service person, but also on the family. Moving on a regular basis, ‘mobility’, may have a deleterious impact on the family and was one of the most significant concerns raised by military families..”

Unsung Heroes, 2012.

“For mobile families, every time they move they enter a lottery; whether they get a choice of school or whether they get children into a good or failing school.. “

Written Evidence from Army Families Federation, 8th Feb 2013

Impact of Re-location

Anecdotal evidence (community centre mothers) to indicate the mostly negative impact of mobility on children

New school entry generating a host of negative experiences & childhood memories

Comment that as service children, they ‘hated every minute of being stood before the whole school’ & introduced to peers

Parents see their own children going through the same processes, with same fears they experienced

What are the practices schools employ to integrate new children? How is intention matched by outcome? How are child sensitivities & needs protected?

Integration Practices & Impact

Potential for a family to share the same experiences Anticipation of stresses, in a familiar context, can offset

anxieties The ability to re-create home environment & routines The mood & attitude of parents a significant determining

factor in how positively young children respond to change Infants, with an emerging optimistic personality, more likely

to gain from the experience Young children, with an emerging sense of self & identity &

pessimistic personality, less likely to fare well from experience

Protective Factors – Building Resilience

Defence Recovery Capability Help for Heroes runs four Recovery Centres – Colchester,

Catterick, Tidworth & Plymouth Designed to inspire, enable and support wounded, sick or

injured service personnel and their families The centres provide a launch-pad-to-life support service See the needs of the individual being grouped into five key

areas – medical, mind, body, spirit and family – all needing to be in balance to ensure a fulfilled and happy life

(Co-Founders’ Letter, Annual Report, H4H, 2012)

Impact of Disability

Disability - Five Key Areas of Support - HfH

Injured Servicemen &

women

Medical

Mind

BodySpirit

Family

“We all need to remember that those wounded in the last 10 years will still need help in 20, 30, 40 years time and beyond...”

Bryn Parry, Chief Executive’s Report, 2012

A need to remember that the partners and children, of those wounded in the last 10 years, will still need help...

Impact of Disability

The impact of physical and/or mental disability profound & long term if not life-long

Sense of loss, adjustment and grief common Changing roles in relationships & families can be problematic The shift from independence to dependence, and shift back

again to independence, fraught with difficulty A toll taken on service families, on partners & children that

can break up families & impact significantly on relationships The needs of babies & young children may be secondary to

more demanding & diverse needs of injured service men

From Independence to Dependence

“The support injured service personnel receive from their families has been shown to be integral to recovery.

As well as addressing the psychological needs of service personnel recovering from physical injuries, the practical and emotional impact on the families who care for them must also be taken into consideration.”

Unsung Heroes: Developing a better understanding of the emotional support needs of service families, March 2012

Impact of Disability on Families

Publishing & publishing houses – Who represents the needs of service children & families? ‘Not our thing’, ‘a niche market’ ‘not commercial enough’ Political lobbying - SEND groups very successful with influence at senior level Funding disparities between needs of service children &

communities & funding on SEND What gains could be made with £30k per pupil per year? What gains could be made with £250k per pupil per year? Individual pupil ‘high-level’ support v whole community

support

Final Thoughts...

Heather Stack E-mail: heather@hmstack.com Tel: 01926 495695 Mobile: 07955 607434

LinkedIn – Heather Stack, Founder & SEN Consultant, HM Stack Consulting

Twitter @HMStack hmstack.wordpress.com

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