toxic stress and early brain development lindsey moss, msw, lcsw valerie glascock, lpa
TRANSCRIPT
Toxic Stress and Early Brain Development
Lindsey Moss, MSW, LCSW
Valerie Glascock, LPA
Growth of Brain
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Conception 5 10 15 20
Conception to BirthBirth to Age 20Birth
Source: A.N. Schore, Affect Regulation and the Origin of the Self, 1994.
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Who
le B
rain
Wei
ght
in G
ram
s
CEREBRALCORTEXCEREBRALCORTEX
LIMBIC SYSTEMLIMBIC SYSTEMBRAINSTEMBRAINSTEM
Experiences Build the Brain
developingchild.harvard.edu
Role of Experience
Repeated use strengthens brain connections
If connections are not used, they are more likely to be “pruned” away
The brain “grows itself” for the environment it experiences
Emotion and relationships appear to play particularly important roles in shaping the brain’s development
What is Stress?
Stress results when there is a threat to our well-being
AND We attempt to
defend ourselves from that threat
Stress
Stress Response
Brain and body coordinate to release a series of biochemicals that prepare us to: – Fight– Flee– Freeze
Response developed for physical threat – Usually intense, but short-lived– Allows us to return to a baseline comfort level
Body’s Response to Stress
Increase in heart rate Increase in blood pressure Increase in breathing rate Increase in muscle tone Release of stored sugar into the blood Hypervigilance (alert to threat) Tuning out of all non critical information
Normal and Chronic Stress
Chronic Stress
Normal Stress
Positive StressPositive Stress
Moderate, short-lived stress responsesModerate, short-lived stress responses Examples include meeting new people, dealing Examples include meeting new people, dealing
with frustration, getting an immunization, or with frustration, getting an immunization, or adult limit-settingadult limit-setting
An important and necessary aspect of healthy An important and necessary aspect of healthy development that occurs in the context of development that occurs in the context of stable and supportive relationships.stable and supportive relationships.
www.developingchild.harvard.edu
Tolerable StressTolerable Stress
Stress responses that could be disruptive, but Stress responses that could be disruptive, but are buffered by supportive relationshipsare buffered by supportive relationships
Examples include death or serious illness of a Examples include death or serious illness of a loved one, a frightening injury, parent divorce, loved one, a frightening injury, parent divorce, a natural disaster, terrorism, or homelessnessa natural disaster, terrorism, or homelessness
Generally occurs within a time-limited period, Generally occurs within a time-limited period, which gives the brain an opportunity to recover which gives the brain an opportunity to recover from potentially damaging effects. from potentially damaging effects.
www.developingchild.harvard.edu
Toxic StressToxic Stress
Prolonged stress in the absence of the Prolonged stress in the absence of the buffering protection of adult support buffering protection of adult support
Examples include extreme poverty, abuse, Examples include extreme poverty, abuse, chronic neglect, severe maternal depression, chronic neglect, severe maternal depression, substance abuse, or family violencesubstance abuse, or family violence
Disrupts brain architecture and leads to highly Disrupts brain architecture and leads to highly reactive stress response systems, increasing reactive stress response systems, increasing the risk of physical and mental illness.the risk of physical and mental illness.
www.developingchild.harvard.edu; Pediatrics, 2012
Toxic Stress Derails Development
developingchild.harvard.edu
Long Term Health Impact of Adverse Childhood Events
ACE Study – CDC Asked about 10 stressful childhood
experiences Looked at long-term health outcomes ACE predicted 10 major causes of adult illness
and death
Felitti, Anda, Nordenberg, Williamson, Spitz, Edwards, Koss, & Marks (1998)
Compared to persons with an ACE score of 0, those with an ACE score of 4 or more were:
2 times as likely to be smokers 4 times more likely to be depressed 7 times more likely to be alcoholic 10 times more likely to have injected street
drugs 12 times more likely to have attempted suicide
ACE predicted higher rates of:
Chronic obstructive pulmonary disease (COPD) Fetal death Heart attack and stroke Obesity Liver disease Risk for intimate partner violence Sexually transmitted diseases (STDs) Unintended pregnancies
Model of Causality
Body’s Response to Stress
Increase in heart rate Increase in blood pressure Increase in breathing rate Increase in muscle tone Release of stored sugar into the blood Hypervigilance (alert to threat)
Risk of Child MaltreatmentRisk of Child Maltreatment
In a study of 188 children under age 3 with In a study of 188 children under age 3 with newly opened child protection cases, 66% had newly opened child protection cases, 66% had developmental delays which met the eligibility developmental delays which met the eligibility criteria for early interventioncriteria for early intervention
In a In a sample of 125 foster children under age 6, over 80% had developmental or emotional problems (and 50% had both)
Massachusetts Early Childhood Linkage Initiative, 2005
Klee, Kronstadt, & Zlotnick, 1997
Impact of Poverty on Parenting
Poor preschool children more likely to have abnormal cortisol (stress hormone) patterns
These patterns were linked to impaired problem-solving, attention, and emotional regulation (and later school achievement)
These links are correlated with a harsh and demanding parenting style
Blair, 2012
And the circle continues…
Family stressors such as low maternal education, low income, and unsafe neighborhoods are strong predictors of adverse outcomes (especially when they occur in combination)
Family stress is linked to negative child outcomes primarily through a harsh and controlling parenting style
Vernon-Feagans, Family Life Project, 2013
Even in Their Sleep, Even in Their Sleep, Babies are Learning….Babies are Learning….
Even during sleep, infants show reactions to Even during sleep, infants show reactions to angry voices (based on fMRI scans)angry voices (based on fMRI scans)
Infants from high conflict homes showed the Infants from high conflict homes showed the greatest reactivity in brain areas linked to greatest reactivity in brain areas linked to stress and emotion regulationstress and emotion regulation
Graham, Fisher, & Pfeifer, 2013
Effects of Toxic Stress in Early Childhood
“Limbic irritability” – reactive stress response A low threshold for daily stressors Impaired brain structures responsible for
memory formation, attention, and self-control Risk for school failure, behavior problems Compromise of immune system, perhaps
permanently
Teicher, 2000; Pollak, 2009; Essex, 2003
So What Can We Do?