Child Development and the Brain: Promoting Resilience and Joy...Child Development and the Brain: Promoting Resilience and Joy Adele Diamond, PhD, FRSC Canada Research Chair Professor

Child Development and the Brain:

Promoting Resilience and Joy

Adele Diamond, PhD, FRSC

Canada Research Chair Professor of

Developmental Cognitive Neuroscience

University of British Columbia (UBC)

[email protected]

What abilities and

skills will children

need to be successful

in the 21st century?

What will it likely take to be successful in the

21st century?

1) Creative Problem-solving

• Coming up with new ideas, hypotheses and

Inventions.

• If one way of solving a problem isn’t

working, how else might we succeed here?

Can we think outside the box to come up

with a way of attacking this no one else has

considered before?

2) Flexibility

• Seeing opportunities and seizing them:

I was planning to do X, but an amazing

opportunity has arisen to do Y, do I have

the flexibility to take advantage of

serendipity?

• My opinion was X, but now that I see this

new information, I’m able to change my

opinion.

• Being able & willing to change course

when it seems you were wrong

When one door closes, another

door opens;

but we often look so long and so

regretfully upon the closed door,

that we do not see the ones which

open for us.

- Alexander Graham Bell

An example of poor

cognitive flexibility:

3) Self-control

Having the self-control to resist temptations and

not act impulsively -- be able to:

• think before you speak or act -- give a con-

sidered response instead of an impulsive one

• not over-indulge or indulge in the wrong things

• resist saying something socially inappropriate

(or hurtful)

• resist ‘tit for tat’ (hurting someone because

that person hurt you)

• resist jumping to an interpretation of what

something meant or why it was done

4) Discipline / Perseverance

Having the discipline to stay on task…

seeing it through to completion despite

unexpected problems, some aspects

being boring or perhaps frustratingly

difficulty, & tempted by lots of things far

more fun

continuing to work at something though the

reward may be a long time in coming

Evidence shows that discipline

accounts for over twice as

much variation in final grades

as does IQ, even in college.

(Duckworth & Seligman, 2005)

Question:

How do creativity,

flexibility, self-control, &

discipline map onto the 3

core EFs?

ALL of them are

“Executive Functions”

or rely on them

The 3 core Executive Functions are:

• Cognitive Flexibility

(including being able to switch perspectives

& see things in a new light)

• Inhibitory Control

(which includes self-control & discipline)

• Working Memory

Higher-order Executive Functions are:

• Problem-solving

• Reasoning

• Planning

Inhibitory control includes being able to

(1) stay focused despite distraction

SELECTIVE or FOCUSED ATTENTION

(2) stay on task (& complete task)

though tempted not to - DISCIPLINE

(3) inhibit acting impulsively & instead

make a more considered response (not

putting your foot in your mouth, not

hitting, not drinking too much, dieting)

SELF-CONTROL

Children with less inhibitory control (i.e.,

children who were less persistent, more

impulsive, and had poorer attention regulation)

as adults 30 years later have…

worse health

earn less

and commit more crimes

than those with better inhibitory control as

young children,

controlling for IQ, gender, social class, & home

lives & family circumstances growing up

across diverse measures of inhibitory control.

That’s based on a study of 1,000 children born

in the same city in the same year followed for 32

years with a 96% retention rate.

by Terrie Moffitt et al. (2011)

Proceedings of the Nat’l Academy of Sci.

Since inhibitory control’s “effects follow a linear

gradient, interventions that achieve even small

improvements in [inhibitory control ] for

individuals could shift the entire distribution of

outcomes in a salutary direction and yield large

improvements in health, wealth, and crime rate

for a nation.”

Inhibitory control predicts

academic performance in

the earliest elementary

grades through university

better than does IQ.

(b) Working Memory:

Holding information in mind

and mentally working with it

Working memory is critical for

making sense of anything that

unfolds over time, for that always

requires holding in mind what

happened earlier & relating that

to what is happening now.

relating one idea to another

relating what you read (or learned /

heard) earlier to what you are

reading (learning / hearing) now

mental math calculations

understanding cause and effect

remembering multi-step instructions

& executing them in the correct order

Reasoning would not be possible

without working memory, for

reasoning requires holding bits of

information in mind and seeing

how they relate. Working memory

enables us to consider the past

and possible future in making

plans and decisions.

being able to easily & quickly switch

perspectives or the focus of attention,

flexibly adjusting to changed demands

or priorities,

being able to think outside the box.

(c) COGNITIVE FLEXIBILITY

For example, try to think of as

many uses for a TABLE as you

can.

What are all the things you might

use a table for?

A table might be used to write on or to

eat food on.

It might be turned on its side and used

to keep a door closed or used as a

shield against bullets or snowballs.

You could get under it to hide or to keep

dry.

You could cut it up for firewood.

How can we stop ourselves from get really upset

when a child misbehaves? What we usually get

upset about is the intent we think is behind an

action.

Could use Cognitive Flexibility to re-frame:

A child might be acting in the most awful manner

because he has been terribly hurt and is afraid of

being hurt again, so he will push you away before

you have a chance to reject him or he will test you to

see if are really someone he can feel safe with.

If we see the misbehavior as coming from hurt,

we can react completely differently.

“Executive Functions”

depend on Prefrontal

Cortex and the other

neural regions with which

it is interconnected.

Unusual properties of the

prefrontal dopamine system

contribute to PFC’s

vulnerability to environmental

and genetic variations that

have little effect elsewhere.

The best mechanism from clearing

away released dopamine is by

dopamine transporter (DAT)

protein.

Dopamine transporter is

abundant in the striatum

but sparse in prefrontal cortex.

The dopamine transporter gene

(DAT1) and the striatum are

implicated most in the impulsive

& hyperactive aspects of ADHD

whereas PFC is implicated most

in the cognitive deficits.

Levels of hyperactive-

impulsive symptoms are

correlated with the number

of DAT1 high-risk alleles

but levels of inattentive

symptoms are not

(Waldman et al., 1998)

Most children (about 90%) with ADHD

(combined or hyperactive types) - -

respond positively to methylphenidate

(Ritalin)

and over 67% of them respond positively

to methylphenidate in moderate to high

doses.

Barkley et al., 1991; Barkley, 2001; Milich

et al., 2001; Weiss et al., 2003

The dopamine transporter

moves dopamine from the

synapse back into the sending

neuron.

Methylphenidate blocks the

dopamine transporter (i.e.,

blocks re-uptake), causing an

increase in dopamine

concentration at the synapse.

Synapse

Dopamine

Dopamine receptor

Mechanism of Action of Methylphenidate in High Doses

A significant percentage of

children with ADHD-IA are not

helped by methylphenidate and

those who are helped often do

best at low doses.

(Barkley et al., 1991; Barkley, 2001;

Milich et al., 2001; Weiss et al., 2003)

The doses of MPH that are optimal

for controlling behavioral problems

are too high for aiding the

cognitive problems

indeed they can have the effect of

the patient being less able to

concentrate & attend (more in a

daze)

Recent research show that low

doses of MHP (dosages likely

to be effective in treating

ADHD-IA) preferentially

increase dopamine release in

the prefrontal cortex.

(Berridge et al., 2006)

I predict that many children with

ADHD are being prescribed a level of

MPH that is too high for optimal

performance in school

and that the high level of MPH is

actually impairing their ability to get

as much out of class (listening or

reading) as they could without

medication.

How do you usually determine whether

a particular dose of MHP is optimal

for a child?

Usually you ask his/her parents.

Usually parents base their answer on

whether the child’s behavior is

better.

No one uses cognitive measures to see

if the children’s attention, working

memory, or any other EFs are better.

My hypothesis is only that --

just a hypothesis

But I would encourage you to get

cognitive testing done to determine the

optimal medication type & dosage --

for a younger children it could be the

NEPSY; for a child 10 or older it could

be the Delis-Kaplan Battery, for ex.

Unusual properties of the

prefrontal dopamine system

contribute to PFC’s

vulnerability to environmental

and genetic variations that

have little effect elsewhere.

Prefrontal Cortex & Executive

Functions are the first to suffer,

& suffer disproportionately, if

we are

• sad or stressed

• lonely or

• not physically fit

To show the EFs they are capable of, to

achieve the academic outcomes they

are capable of, children need to

• feel joyful and relaxed (not stressed)

• feel they are in a supportive

community they can count on, and

• their bodies need to be fit and healthy.

Amy Arnsten, 1998 The biology of being frazzled

Science

This is particularly true for PFC & EFs.

Our brains work better

when we are not in a

stressed emotional state.

Even mild stress increases DA release

in PFC but not elsewhere in the brain

Stress and Prefrontal Cortex

(Roth et al., 1988)

Stress impairs EFs and can cause

anyone to look as if he or she has

an EF impairment (like ADHD)

when that is not at all the case.

(You may have noticed that when

stressed you cannot think as

clearly or exercise as good self-

control.)

In college students, one month of stress in

preparation for a major exam disrupts

prefrontal cortex functional connectivity.

Stress decreases coupling between left DL-PFC and right DL-

PFC, and between DL-PFC and premotor cortex, the ACC, the

insula, posterior parietal cortex (PPC), and the cerebellum.

Stress impairs their attention shifting (shifting

between attending to color or motion).

Liston et al. (2009) PNAS

Desseilles et al., 2009 von Hecker & Meiser, 2005

When we are sad we’re worse at

filtering out irrelevant information

(i.e., worse at selective attention).

When we are happy we are better at

selective attention.

Gable & Harmon-Jones, 2008

THE most heavily researched predictor of

creativity in social psychology is mood.

The most robust finding is that a happy mood

leads to greater creativity (Ashby et al. 1999).

It enables people to work more flexibly (Murray

et al. 1990) & to see potential relatedness

among unusual & atypical members of

categories (Isen et al. 1985, 1987).

People show more creativity

when they are happy

Hirt et al. 2008: 214

If you’re stressed,

you cannot be the parent

[or clinician] you want to be.

If you’re stressed,

your children [your clients] will

pick on it.

It will cause them to feel

stressed.

And if they’re stressed… their

EFs will suffer & therefore their

school performance will suffer.

You’re not perfect.

You’re going to make

mistakes.

That’s OK.

You don’t need to be perfect.

Besides, no one ever is.

I can guarantee that worrying

about whether you’re a good-

enough parent [or clinician] will

NOT improve your parenting

[therapeutic effectiveness] – it

will only make it worse.

RELAX

Imperfect ≠ Worthless

Your humanity is more

important than your

knowledge or skill or doing

the textbook-perfect thing.

Jerome Frank conducted a study

comparing several different forms of

psychotherapy to one another.

He concluded:

“A totally untrained therapist who

exercises a great capacity to love

will achieve psychotherapeutic

results equal to the best.”

Results of a poll by the British Medical

Journal:

The majority of respondents said:

“A good doctor, is first and

foremost, a good human being.”

Your caring -- your openness to

truly listen; being there for your

child [your client] when he or she

needs you -- is more important

than your knowledge or skill.

The spirit rather than the technique.

Who do you prefer to hear -- the musician who

plays from the heart or the musician with

absolutely perfect technique but no heart?

You can do the textbook-perfect thing, but if it

doesn’t come from the right place, it will not have

the desired result. You can mess up, but if it

comes from the right place, it will be all right.

Relax: Your ability to truly care, and to be

genuinely present for them, is what is most

important.

The most powerful way to

communicate to our children that we

care about them is to listen to them.

Truly listen.

Give them our time and our attention.

The quality of our listening, rather

than the wisdom of our words, is often

what has the most impact.

It is extremely important that

parents take time to SLOW DOWN

and give their child their undivided

attention. The importance of that

cannot be over-emphasized.

“Children who are truly loved…know

themselves to be valued. This knowledge is

worth more than any gold.

“The principal form that love takes is giving of

your time, and truly listening. When

something is of value to us we spend time with

it. When we love our children, we give them

our time.... True listening, total concentration

on the other, is always a manifestation of love.

-- Scott Peck, The Road Less Traveled

“Your willingness to listen is the best possible

concrete evidence of your esteem that you

can give your child. There is no better and

ultimately no other way to teach your children

that they are valuable people than by valuing

them.

When children know that they are valued…

they feel valuable….This feeling of being

valuable is the cornerstone of discipline

because when one considers oneself valuable

one will take care of oneself in all ways that

are necessary. Self-discipline is self-caring.”

-- Scott Peck, The Road Less Traveled

“Perhaps the most important thing

we ever give each other is our

attention. And especially if it's given

from the heart…”

“Listening is the oldest and perhaps

the most powerful tool of healing.”

-- Dr. Rachel Naomi Remen

Sometimes we’re so busy doing

for our children, we forget how

important it is to take time to

simply be with them.

(p.11)

Mindful Listening means staying fully in the

present moment, giving your child [your client]

your full, undivided attention.

That’s not so easy.

To do that you need to set aside your own worries

and preoccupations, thinking about what you

need to do next, even trying to anticipate where

your child’s train of thought is going or whether

you are sufficiently in tune with your child.

Listening with your heart as well as your head --

listening not just to the words but to what’s

unspoken.

“The greatest gift

I can conceive of

having

from anyone

is

to be seen by them,

heard by them,

to be understood.”

-- Virginia Satir

But it is so worth it:

It's so powerful is to be heard

/ understood –

and to be liked anyway

When we interrupt to try to show

we understand, we move the focus of

attention to ourselves.

Because we care, we are tempted

to want to do ‘more’ than ‘just’ listen.

But what a child needs most is for us to

listen. Truly listen.

Don’t rush to try to problem-solve or

suggest solutions. Be patient; give your

child time. Let solutions emerge from

the child.

Fire

What makes a fire burn

is space between the logs,

a breathing space.

Too much of a good thing,

too many logs

packed in too tight

can douse the flames

almost as surely

as a pail of water would.

So building fires

requires attention

to the spaces in between,

as much as to the wood.

When we are able to build

open spaces

in the same way

we have learned

to pile on the logs,

then we can come to see how

it is fuel, and absence of the fuel

together, that make fire possible.

We only need to lay a log

lightly from time to time.

A fire

grows

simply because the space is there,

with openings

in which the flame

that knows just how it wants to burn

can find its way. - Judy Brown

When a child doesn’t feel

understood, little things can

become BIG issues.

In Gottman’s studies, if the wife felt she

was being heard the marriage was

essentially divorce-proof.

Gottman JM & Levenson RW. (1999). Rebound

from marital conflict and divorce prediction.

Family Process. 38(3):287-92.

“Differences must be grasped, even if no

problems are solved. One of the reasons

empathy works so well is because it does

not require a solution. It requires only

understanding.”

John Medina, Brain Rules for Baby

We bring with us issues from our own past that

impair our ability to listen. Experiences that are

not fully processed may create unresolved and

leftover issues that influence how we react to

our children. These issues can easily get

triggered in the parent-child relationship.

At these times, we’re not acting like the parent

we want to be and are often left wondering why

parenting sometimes seems to “bring out the

worst in us.

Siegel & Hartzell (2004)

When we have an unresolved

issue...we’re not really listening to our

children because our own internal

experiences are being so noisy that’s all

we can hear.

We are no longer making thoughtful

choices about how we want to parent or

teach, but are reacting on the basis of

experiences in our past.

Siegel & Hartzell (2004)

The major insight of Mary Main et al. (1985): the direct

intergenerational transmission of relationship patterns,

while relatively common, is NOT inevitable.

Some parents who experienced abusive or rejecting

relationships growing up have children who are securely

attached to them.

What distinguished that group of parents, from other

parents with similarly unfortunate childhoods whose

own children were insecurely attached, was their ability

to discuss adverse childhood experiences with

emotional openness, coherence, and reflective insight.

They seemed to have come to terms with what had

happened to them, and had gained an understanding

why their parents had behaved as they did.

Inge Bretherton

Outcome of secure vs. insecure

attachment:

It’s better to be securely

attached.

But outcome is AS GOOD for

those insecurely attached IF they

have organized their attachment

experience into a coherent story.

Zeigarnik Effect: the mind

keeps working on things that

aren’t complete.

Coming to an understanding

allows closure.

Zeigarnik, 1967

One way to get closure is to write. Writing forces a

degree of structure and organization of one’s

thoughts. When writing, the thinking process has to

slow down.

The act of repeatedly telling about your experience

results in both an organization of the event and a

summarizing of it. Over days, the description of the

event is gradually shortened and summarized.

Constructing stories -- day by day, as you write, the

episode takes on shape as a coherent story.

Any type of event is less overwhelming and

easier to think about once it is summarized.

Once organized, events are often smaller and

easier to deal with.

If you can get people to talk or

write about their problems, their

psychological and physical health

improves.

--- James Pennebaker,

Opening Up: The Healing Power

of Expressing Emotions

Putting Feelings Into Words

Produces Therapeutic Effects

on the Brain

When you put feelings into words, you

increase activation in prefrontal cortex and

that produces a reduced response in the

amygdala.

PFC Stress

Matt Lieberman et al., 2007

Amygdala activation went up in ALL conditions when an

angry or fearful face was shown, but ONLY in the one

condition (a) where subjects had to assign a verbal label

to the emotion, did amygdala activation GO DOWN.

Inverse Relation between Activation in PFC and

the Amygdala in the Lieberman et al. study

(When activation in PFC goes up, activation in the

amygdala goes down.)

Translating an emotional

experience into language,

talking or writing about, alters

the way it is represented and

understood in our mind and our

brain (gets prefrontal cortex

more involved).

To reduce stress in

children’s lives…

Pets can reduce stress

The presence of a dog in the classroom

reduces stress and helps children

perform better.

Gee, N. R., Church, M. T., & Altobelli, C. L. (2010). Preschoolers make

fewer errors on an object categorization task in the presence of a dog.

Anthrozoös, 23, 223-230.

Gee, N. R., Crist, E. N., & Carr, D. N. (2010). Preschool children require

fewer instructional prompts to perform a memory task in the presence of

a dog. Anthrozoös, 23, 173-184.

Gee, N. R., Harris, S. L., & Johnson, K. L. (2007). The role of therapy dogs

in speed and accuracy to complete motor skills tasks for preschool

children. Anthrozoös, 20, 375-386.

Beetz, A., Julius, H., Turner, D., & Kotrschal, K. (2012). Effects of social support by

a dog on stress modulation in male children with insecure attachment. Frontiers in Psychology, 3.

Beetz, A., Kotrschal, K., Turner, D. C., Hediger, K., Uvnäs-Moberg, K., & Julius, H.

(2011). The effect of a real dog, toy dog and friendly person on insecurely attached

children during a stressful task: An exploratory study. Anthrozoös, 24, 349-368.

Pets teach us about

gentleness, patience, &

never holding a grudge

Animals love us unconditionally,

ask little in return, & don’t even

require eye contact.

Exercise Reduces Stress

Exercise in almost any form can

act as a stress reliever.

Being active can boost your feel-

good endorphins and distract

you from daily worries.

Virtually any form of exercise, from

aerobics to a nature hike to yoga, can act

as a stress reliever.

Regular exercise can lower symptoms

associated with mild depression or

anxiety.

Exercise can also improve your sleep,

which is often disrupted by stress,

depression and anxiety.

All this can ease your stress levels and

give you a sense of command over your

body and your life. Mayo Clinic

Williamson et al. (2001) Mood change through physical exercise in

nine- to ten-year-old children. Perceptual Motor Skills. 93(1):311-6.

64 9 & 10-year-old children responded to a self-report mood

measure after two different types of aerobic exercise of 15 min.

Significant increases in positive mood and significant decreases in

negative mood were found after each exercise treatment

Annals of Behavioral Medicine (1999): College students who

exercised regularly coped with stress better and had 37% fewer

physical symptoms than those who did not exercise regularly.

Sedentary students had 21% more anxiety than the students who

exercised regularly.

Lane & Lovejoy (2001) The effects of exercise on mood changes:

the moderating effect of depressed mood. Journal of Sports

Medicine and Physical Fitness, 41:539-545

Exercise improved the mood of depressed individuals. 80

volunteers took a mood test prior to an aerobics class; 52 were

determined to be in a depressed mood. The questionnaire was

given again after the class. Participating in the class improved the

mood of depressed individuals and reduced feelings of anger.

Predictability

Consistency

Clear expectations

Clarity about what is & is not permitted

Stable routine

Things in their place

Know what to expect

It is inevitable that misunderstandings, arguments,

& other breakdowns in communication will occur.

Being aware that this has happened is essential

before you can repair your relationship with your

child [client].

We have to take responsibility for our actions. An

important aspect of repair is to acknowledge our

own role in the disrupted connection: “I’m sorry I

was cross with you when you came in late without

even listening to what you had to say about why you

were late.”

Several Montessori activities are

essentially walking meditation,

though Montessori never called

them that.

Walking meditation is more age-

appropriate for little kids than

sitting meditation.

An activity from

Montessori schools, that

is essentially a type of

walking meditation.

Everyone (even the

grown-ups) gets a bell

and walks in a line or

circle. The goal is

for no one’s bell to

make a sound.

You've never failed until you've tried for the

last time, and you've never lost until you quit.

-- Samuel Proctor Massie

Few people have attained the respect, admiration, and degree of

excellence achieved by Samuel Massie, born in the segregated South.

Born in Little Rock, Arkansas in 1919, Samuel

Massie was the grandson of slaves. In 1966 he

became the first African-American professor at

the US Naval Academy. He was named 1 of the

6 best college chemistry professors in the US &

one of the 75 premier chemists of the 20th

century, along with Marie Curie, James Watson,

and Francis Crick. In 1995 Dr. Massie’s portrait

was hung in the National Academy of Science

gallery and in 2002 the US Dept. of Energy

chose to name its Chairs of Excellence in the

environmental sciences in his honour.

It should help to ease one’s stress & self-recriminations to remember:

It’s never over

‘til it’s over

One of the most important findings

to emerge from neurobiology is

that biology is not “destiny.”

Neuroscience research has shown

that experience plays a far larger

role in shaping the mind, brain, and

even gene expression than ever

imagined.

Very little is fixed or unchangeable.

90% of our genes are switched off.

To a large extent, our experiences, and

our reactions to them, determine which

genes get turned on (& off), when this

happens, & which genes stay on

(epigenetics).

Experience also sculpts the brain,

and the brain changes throughout life

(neuroplasticity).

We need to let children know

that it is okay to make a

mistake; everyone makes

mistakes.

The only alternative is to

stay with what you already

know, to stop growing.

Anyone who has never

made a mistake has never

tried anything new.

- Albert Einstein

Children need to feel safe

…to push the limits of what they know,

…to venture into the unknown,

…to take the risk of making a mistake or of

being wrong.

Children cannot relax if they’re

worried you might embarass them.

“No matter if he does it wrong – do

not correct him or he will retire into

his shell.” -- Maria Montessori

When a toddler falls while trying to

learn to walk, we don’t say he gets

a ‘D’; we say, “Don’t worry; I know

you’re going to be able to do this.”

Communicate loud and

clear the faith and

expectation that your

child [client] will succeed.

Powerful Role of

Expectations (by others AND yourself)

and Attitude

Pygmalion in the Classroom -- powerful

role of expectations Robert Rosenthal

Stereotype threat - female performance on

math exams Claude Steele

“Treat people as if they

were what they ought to be

and you help them become

what they are capable of

being.”

– Johann W. van Goethe

Children need to believe in themselves.

They need to have confidence that they

will succeed.

Two routes to that:

• They need to feel you believe in them -

that you fully expect them to succeed.

&

• They need do-able challenges. We need

to give children the opportunity to do

things that enable them to see for

themselves that they are capable.

Children need opportunities to do

things that enable them to see for

themselves that they are capable:

do-able challenges.

(research studies by Duckworth, 2010; Lewis

& Goldberg, 1969; White, 1960)

Pride and self-confidence (and joy)

come from seeing yourself succeed at

something that you know is not easy.

Another way to show children

we believe in them and have

faith in them is to give them an

important responsibility.

the ‘Coca Cola’ study

Because PFC does not have much

dopamine transporter, PFC is more

dependent on secondary mechan-

isms (such as the COMT [catechol-

O-methyltransferase] enzyme) for

clearing dopamine from extra-

cellular space than are other brain

regions, such as the striatum.

COMT Gene

catechol-O-methyltransferase

gene

codes for the COMT enzyme,

which methylates released

dopamine.

It’s located on chromosome 22.

A single base pair substitution

CGTG to CATG

translates into a substitution of

Methionine for Valine at codon 158

Catechol-O-methyltransferase (COMT) Val158 Met

High dopamine

Zalsman et al.

Low activity

enzyme

High activity

enzyme Low dopamine

SYNAPSE

The Methionine variant of

the COMT gene is

associated with better PFC

function and better

executive functions.

This is specific to EFs:

There is no relation

between COMT genotype

and IQ or other non-PFC

functions.

too little too much

Optimal level of DA in PFC

PF

C F

un

cti

on

ing

Dopamine:

The Optimum Level of Dopamine

in PFC is an Intermediate Level

too little too much Met-158

Val-158

Optimal level of DA in PFC

Differences in COMT Genotypic

lead to Differences in PFC DA Levels

Dopamine:

What’s the downside

of Met variant of

COMT?

Even mild stress increases DA release in

PFC but not elsewhere in the brain

Stress and Prefrontal Cortex

(Roth et al., 1988)

Genotypic Difference in PFC DA Levels

leads to Genotypic Differences in Stress

Reactivity

too little too much Met-158

Val-158

Effect

of Mild

Stress

Val/ Val COMT

Met / Met COMT

Buckert et al. (2012): Under stress, young adults homozy-

gous for COMT-Met158 showed worse EF performance

than young adults homozygous for COMT-Val158

Persons homozygous for

COMT-Met158 tend to

be more sensitive to stress Buckert et al. 2012; Armbuster et al. 2012

have higher anxiety Olsson et al. 2005

and have heightened pain stress

responses Zubieta et al., 2003

Diatchenko et al., 2005

It has long been known that some of

the brightest people also have the

most fragile personalities and are

highly reactive to stress.

Here’s a possible mechanism for

why the two might go together.

Persons homozygous for the MET

variant of the COMT gene (which

results in more DA in PFC), tend to

have better executive function, but

also tend to be more sensitive to

stress, have higher anxiety, and

higher pain stress responses.

Zubieta et al., Science (2003)

It has long been known that some of

the brightest people also have the

most fragile personalities and are

highly reactive to stress.

Here is a possible mechanism for

why the two might go together.

re: dandelion & orchid children

‘Dandelions’ are children who do okay

wherever they are planted. They are

often seen as models of resilience.

Perhaps children homozygous for

COMT Val-158 are the dandelions;

they will do okay even in a stressful

environment, but might lack the

exquisite fine-tuning of prefrontal

cortex needed to achieve the

brilliance of which a COMT Met-158

child might be capable.

Research shows that some of the

children who look the worst when they

are in an unsupportive, stressful

environment are exactly those who

blossom the most when in a good

environment.

Perhaps some children homozygous

for COMT Met-158 are among the

orchids -- they might look like a

disaster when in a stressful

environment, yet might blossom

brilliantly in the right environment.

The COMT Met-158 genotype, which

confers risk on individuals when they

are in adverse, stressful

circumstances, holds out promise of

extraordinary potential if only the

right fit of circumstances can be

found for the individual.

A child who is not doing well in

one environment, or with a particular

instructional style, might shine in

another environment or with a

different teaching approach.

We’re not just intellects,

we have emotions

we have social needs

& we have bodies

Our brains work better when we are

not feeling lonely or socially

isolated.

Loneliness: Human Nature and

the Need for Social Connection 2008

a book by John Cacioppo & William Patrick

This is particularly true for PFC & EFs.

Roy Baumeister et al. (2002, Journal of Personality and Social Psychology)

- One group of subjects were told beforehand they’d

have close relationships throughout their lives;

- another group was told the opposite;

- a third group was told unrelated bad news.

On simple memorization questions, the groups were

comparable.

On sections involving logical reasoning (EF),

subjects told they’d be lonely performed much worse.

Campbell et al. (2006) found that during math tests

there was Prefrontal Cortex worked less efficiently

among participants who felt isolated.

We are not just intellects,

we have emotions

we have social needs

& we have bodies

You need your sleep.

Lack of sleep will produce

deficits in EF skills, and cause

someone to look as if he or she

has an EF

impairment,

like ADHD.

Our brains work better when our

bodies are physically fit.

Nature Reviews Neuroscience (January 2008)

“Be Smart, Exercise Your Heart:

Exercise Effects on Brain and Cognition”

Charles Hillman, Kirk Erickson & Art Kramer

“There is little doubt that leading a sedentary life

is bad for our cognitive health.”

This is particularly true for PFC & EFs.

Nature Reviews Neuroscience (January 2008)

“Be Smart, Exercise Your Heart:

Exercise Effects on Brain and Cognition”

Charles Hillman, Kirk Erickson & Art Kramer

Evidence shows that physical activity (especially aerobic

exercise) robustly improves cognition and brain function.

In particular, the frontal lobe and the executive functions

that depend on it show the largest benefit from improved

fitness.

The positive effects of aerobic physical activity on

cognition and brain function are evident at the molecular,

cellular, systems, and behavioral level.

and there have been many more review papers

since 2008 including:

Streiner, D. L. (2009). The effects of exercise programs

on cognition in older adults: A review. Clinical Journal of

Sport Medicine, 19(5), 438.

Tseng, C. N., Gau, B. S., & Lou, M. F. (2011). The

effectiveness of exercise on improving cognitive function

in older people: A systematic review. The Journal of

Nursing Research, 19(2), 119-130.

Voss, M. W., Nagamatsu, L. S., Liu-Ambrose, T. , &

Kramer, A. F. (2011). Exercise, brain, and cognition across

the lifespan. Journal of Applied Physiology, 111(5), 1505-

1513.

The brain doesn’t recognize the

same sharp division between

cognitive and motor function that

we impose in our thinking.

The SAME or substantially

overlapping brain systems subserve

BOTH cognitive and motor function.

For example, the pre-Supplementary

Motor Area (SMA) is important for

sequential tasks,

whether they are sequential motor

tasks or

sequential numerical, verbal, or

spatial cognitive tasks.

Hanakawa et al., 2002

Motor development and

cognitive development appear

to be fundamentally intertwined.

Diamond, A. (2000)

Close interrelation of

motor development and cognitive development

and of the cerebellum and prefrontal cortex.

Child Development, 71, 44-56

When cognitive development

is perturbed,

as in a neurodevelopmental

disorder,

motor development is often

adversely affected as well.

For example……

At least half of all children with ADHD have

poor motor coordination & fit the diagnosis

for developmental coordination disorder.

At least half of all children with develop-

mental coordination disorder have ADHD.

Similarly for dyslexia, autism, and other

disorders.

Diamond, A. & Lee, K.

(2011)

Interventions shown to Aid

Executive Function Development

in Children 4-12 Years Old

Science, vol. 333

accompanying online tables

Science asked me to write a review of all interven-

tions shown to improve EFs in young children

Diverse activities including

computer training, aerobics,

martial arts, yoga, mindfulness,

& school curricula have all been

shown to improve children’s

executive functions..

Exercise alone appears not to

be as effective in improving EFs

in children as exercise-plus-

character-development (tradi-

tional martial arts) or exercise-

plus-mindfulness (yoga).

Lakes & Hoyt (2004) randomly

assigned children in grades K

thru 5 (roughly 5-11 years-old)

by homeroom class to Tae-

Kwon-Do martial arts (N = 105)

or standard physical education

(N = 102).

Children who had been assigned to Tae-

Kwon-Do training showed greater gains

than children in standard phys. ed. on all

dimensions of EFs studied (e.g., cognitive

[distractible —focused] and affective

[quitting —persevering] - subtests of the

Response to Challenge Scale). This

generalized to multiple contexts and was

found on multiple measures. They also

improved more on mental math (which

requires working memory).

Traditional martial arts

emphasize self-control,

discipline (inhibitory control),

and character development.

In a study with adolescent juvenile

delinquents (Trulson, 1986), one

group was assigned to traditional

Tae-Kwon-Do (emphasizing qualities

such as respect, humility,

responsibility, perseverance, honor

as well as physical conditioning).

Another group was assigned to

modern martial arts (martial arts as a

competitive sport).

Those in traditional Tae-Kwon-Do

showed less aggression and anxiety

and improved in social ability and

self-esteem.

Those in modern martial arts

showed more juvenile delinquency

and aggressiveness, and decreased

self-esteem and social ability.

Whether EF gains are

seen depends on the

way an activity is done.

A few principles hold

across all programs.

Such as:

EFs need to be

continually challenged

to see improvements -

not just used, but

challenged.

Groups assigned to the same

program, but without difficulty

increasing, do not show EF gains.

Setting aside a time to work on EFs

is less effective than working on

EFs as part & parcel of everything

you do.

The Importance of

Repeated Practice

Whether EF gains are seen

depends on the amount of time

spent practicing, working on

these skills, pushing oneself to

improve.

To learn something new, we need

prefrontal cortex.

But after something is no longer

new, persons who perform best

recruit prefrontal cortex least.

Prefrontal cortex

(what I specialize in)

is over-rated.

Prefrontal

Cortex

TT

NS MT

DO

DC KO

RB

The DLPFC

Slice for

8 Individuals

CB

When something is new, those who

recruit PFC most, usually perform

best.

(Duncan & Owen 2000, Poldrack et al. 2005)

But when you are really good at it,

you are NOT using PFC.

(Chein & Schneider 2005, Garavan et al. 2000,

Landau et al. 2007, Milham et al. 2003, Miller et

al. 2003)

Older brain regions have had far longer to

perfect their functioning; they can subserve

task performance ever so much more

efficiently than can prefrontal cortex (PFC).

A child may know intellectually (at the level of

PFC) that he shouldn’t hit another, but in the

heat of the moment if that knowledge has not

become automatic (passed on from PFC to

subcortical regions) the child hit another

(though if asked, he knows he shouldn’t do

that).

knowing what one should do

vs.

2nd nature (automatic)

(i.e., NOT dependent on PFC)

The only way something

becomes automatic

(becomes passed off from

PFC) is through action,

repeated action.

Nothing else will do.

“We are what we repeatedly do.

Excellence, then, is not an act, but a habit.

We don’t act rightly because we have virtue

or excellence, but we rather have these

because we have acted rightly; these

virtues are formed in a person by doing the

actions;

we are what we repeatedly do.”

Aristotle, Ethica Nicomachea, 4th century BC

How can someone practice

a skill he or she is not yet

capable of performing?

The answer: Scaffolds

Scaffolds enable people to

practice skills they would not

otherwise be able to practice.

Buddy Reading

a scaffold

Almost any activity can be the

way in, can be the means for

disciplining the mind and

enhancing resilience.

MANY activities not yet

studied might well improve EFs.

It all depends on the spirit in which an

activity is presented, the way one does

the activity, and the amount of time

spent doing it, pushing oneself to do

better. The most important element is

probably that the child really want to do

it, so s/he will spend a lot of time at it.

It’s the discipline, the practice, that

produces the benefits.

Might as well have children

do something they can put

their heart and soul into.

El Sistema Orchestra

National Dance Institute

Provided free. It takes all children (even those

in wheelchairs). Has reached over half a million

children in some of the poorest areas.

Circus Arts

could be caring for an animal….

SERVICE ACTIVITIES

activities where the children are working to help

their community or people elsewhere

a goal larger than oneself --

helping children in Haiti, helping a

local family whose home burned

down, lobbying to get a new

playground for the neighborhood

These are acts of caring and generosity,

They require forethought , planning, and

perseverance even in the face of setbacks,

creativity and flexibility when unexpected

obstacles or opportunities arise, and

putting into use what they’ve learned in school.

Each is a member of a group working toward

an important shared goal.

Free the Children

Children Changing the World

More than 1.7 million youth involved

in innovative education and develop-

ment programs in 45 countries.

Educates, engages, and empowers

young people to be confident young

change-makers and lifelong active

citizens.

97% of their students now believe they

can make a difference in the world. 89%

confirm that their students are

more confident in their goal-setting

and completion.

85% find a greater atmosphere of caring

and compassion in the school. 90%

of their students have

demonstrated increased leadership

among their peers.

Educators whose students are engaged in Free the Children report:

In 2011, Mission Measurement conducted a survey of Free the

Children alumni to assess lasting impacts. The survey found that:

90% now believe they are responsible for

addressing social justice issues. 68%

gained a clear sense of their

aspirations and life’s intentions.

80% volunteered >150 hours the previous

year. 79%

of those of voting age voted in the

most recent national election—

double the rate of their peers.

For 10's of 1,000's of years, across all

cultures, storytelling, dance, art, & play

have been part of the human condition.

People in all cultures made music,

sang, danced, and played games.

There are good reasons why those

activities have lasted so long and been

found so ubiquitously.

Music-making, singing, dance, and

play address our physical,

cognitive, emotional, and social

needs.

They

challenge our executive functions,

make us happy & proud,

address our social needs, &

help our bodies develop

Because they challenge EFs directly,

and indirectly support EFs by

increasing joy,

a sense of belonging, &

physical exercise,

I predict they should improve EFs.

(and we’re hoping to get funding to test my prediction for

El Sistema Orchestra & for social, communal dance)

The Best of these Programs

Engage Child’s Hearts & Minds

JOY, PASSION – engage & motivate EMOTIONS

These are fun, rewarding activities!

HARD WORK, PERSISTENCE, DISCIPLINE

practice, practice, practice

HIGH STANDARDS – challenge the children

COGNITIVELY DEMANDING – challenge

concentration, sustained attention,

working memory (remember complicated

sequences), self-control COGNITIVE

SELF-CONFIDENCE, PRIDE

PROGRESS AT THEIR OWN RATE

SOCIAL SUPPORT / BELONGING – part of a

team or an ensemble of dancers or musicians.

Children help one another, listen to one other, &

respect one another. “We’re in this together.”

Each is an important part of the whole. SOCIAL

CLOSE MENTORING RELATIONSHIPS

“I care about you”

Only competition is with your own past perform-

ance - NO LOSERS - only winners - Children are

not left to flounder (scaffolds) or feel embarassed

PHYSICAL ACTIVITY - develop cardio fitness,

balance, coordination, strength, & flexibility)

PHYSICAL

Research shows that what brings people

the most happiness is not money or creature

comforts,

but rather feeling that what you are doing has

meaning, that it benefits others, that you are

united with others in trying to achieve an

important shared goal.

Happiness runs in a circular motion.

Often, what makes us happiest is making

others happy. Being kind to others is not only

good for others; it is good for YOU -- it is the

best route to genuine happiness.

Carol Ryff

to recap:

‘Executive Functions’ are

needed whenever going ‘on

automatic’ or relying on

instinct or intuition would be

ill-advised, insufficient, or not

possible.

“Brain-based” does NOT mean

immutable or unchangeable.

Experience and activity change the

brain.

EFs depend on the brain --

but they can be improved

by the proper activities

“We are what we repeatedly do.”

Aristotle

• The importance of repeated practice.

The only way something becomes automatic

(becomes passed off from PFC) is through

practice, repeated practice.

Nothing else will do.

Scaffolds can help someone practice a skill

that he or she could not perform unaided.

We are not just intellects,

we also have emotions

social needs

& bodies.

The different parts of the

human being are fundamentally

interrelated.

Each part (cognitive, spiritual,

social, emotional, & physical)

probably develops best when

no part is neglected.

Diamond, 2000

Our brains work better when

• we’re not stressed or sad

• we’re not feeling lonely or isolated

• we’re physically fit

Nowhere is the importance of

social, emotional, and physical

health for cognitive health more

evident than with PFC & EFs.

PFC & EFs are the first to suffer,

and suffer disproportionately, if

anything is wrong in our lives

(canary in the coal mine).

If we ignore that a child is

stressed, lonely, or not healthy

because of poor nutrition, lack

of sleep or lack of exercise

those unmet needs will work

against achievement of our goals

for this children’s development.

LISTEN

• Children need to feel understood and heard.

• They need to feel loved - that you care about

them.

• Slow down & take time to listen with your

undivided, complete attention. Don‘t rush to

try to problem-solve or suggest solutions.

Listen. Let the solutions emerge from the

child. When we try to fix others, we focus on

what’s wrong with them, instead of trusting

their strengths and potential.

RELAX

• You don’t have to be perfect, & worrying

about it won’t help.

• You are going to make mistakes & that’s

okay.

• It’s okay to be wrong. Imperfect ≠

worthless.

• If you’re stressed you can’t be the parent

you want to be.

• If you’re stressed, your children will be

stressed.

CHILDREN NEED TO

BELIEVE IN THEMSELVES.

THEY NEED TO KNOW YOU

BELIEVE IN THEM.

What nourishes the human

spirit may also be best for

Executive Functions.

Perhaps we can learn something

from the traditional practices of

people across many cultures &

1,000’s of years.

thank you for your attention

Mary

Gordon

Dan

Siegel

Susan

Goldin-Meadow

4th conference in the series:

Westin Bayshore Hotel, Vancouver, BC

w w w . b r a i n d e v e l o p m e n t a n d l e a r n i n g . c o m

Michael

Stryker

“For years I have seen people try to bring educa-tors together with health specialists, or either with researchers.

I have never seen any effort work as well as what you put together in Vancouver.”

-- Michael Meaney

Themes & Speakers for our July 2013 conference include:

CHILDHOOD TRAUMA: understanding its deep and diverse effects

but especially how we can help children recover, prosper, and shine

Speakers include:

Bessel van der Kolk, MD, his book Psychological Trauma was the first

integrative text on the subject, setting out far ranging impact of trauma

on the entire person and the range of therapeutic issues that need to

be addressed for recovery.

How Traumatic Memories Can be Stored in the Body & Released

Bruce Perry, MD, PhD, Senior Fellow (Child Trauma Academy), whose

work shows how childhood experiences, including neglect & traumatic

stress, change the biology of the brain, &, thereby, the health of the child.

The Impact of Trauma and Neglect on the Developing Child

Gabor Maté, MD, an expert on mind-body interrelations, and author of

When the Body Says No: The Cost of Hidden Stress

The Biology of Loss and Early Life Stress

PARENTING AND ATTACHMENT: how to help parents develop and

foster that important bond

Speakers include:

Dan Siegel, MD, Clinical Professor (UCLA), the author of The Mindful

Brain, Parenting from the Inside Out, Mindsight, The Developing Mind,

The Whole-Brain Child, and more.

Interpersonal Neurobiology of the Developing Mind: How Relationships and the Brain Interact to Shape Who We Are

Gordon Neufeld, PhD, is an expert on the wisdom & science behind

successful parenting. He has constructed a coherent model of

attachment and is able to convey it in a way that is understandable to all.

Relationship Matters: Harnessing the Power of Attachment

Mary Gordon, Founder of Roots of Empathy and an Ashokan Fellow, studies empathy in infants less than one year old.

Building on the Love between Parents and Newborns to Help Families Succeed

THE SOCIAL BRAIN: We are built for sociability; our mental and

physical health declines without it.

Speakers include:

John Cacioppo, PhD, Tiffany and Margaret Blake Distinguished Service

Professor of Cognitive and Social Neuroscience (U. of Chicago), author of

Loneliness: Human Nature and the Need for Social Connection.

Social Relationships Matter and Why We Need One Another

Matt Lieberman, PhD, Professor of Psychology (UCLA), uses

neuroimaging to unlike secrets of the human mind & personality.

The Social Brain and its Implications

Michael Elkin, MA, LMFT, practices and trains others across North

America and abroad in Internal Family Systems therapy.

Knowing and Healing Your Internal Family

The Importance of Self-Respect, of Deriving Pride and Self-

Confidence from seeing yourself accomplish something difficult

versus the Detrimental Effects of Paternalism.

(Remember the old attitude toward women, “Don’t worry your little

head, we’ll take care of you.”) Well, that paternalistic attitude can still

be found too often toward indigenous peoples and toward people with

disabilities such as blindness. That needs to change. Three impressive

and accomplished Native American speakers and 3 impressive and

accomplished blind individuals will speak at the conference and will

demonstrate by their very being the fallacy of that point of view.

Speakers include:

Joseph Gone, PhD, Professor of Psychology (U. of Michigan), of the

Gros Ventre tribal nation of Montana, explores the intersection of

evidence-based practices and cultural competence in mental

health services for Native peoples of North America.

Re-thinking Cultural Competence in Mental Health Treatment

The conference series began in 2006 & has doubled in size

each time because people find it so valuable.

99% of those who attended the last

meeting rated it *OUTSTANDING*!!

“One of the best conferences I have ever attended –

it was inspiring. I came away with new ideas to work on

and things to put directly into my pediatric practice.”

“Finally a conference that successfully bridges the gap

between Research & Practice.”

“I want to thank you for organizing a conference that I

consider to be the best of any conference I have attended

in my 22 years of working at GF Strong Rehabilitation

Centre. I have never spent 4 days straight sitting inside

dark rooms, wide awake, engaged and amazed.”

“Research and implications presented wonderfully well

with clarity and enthusiasm.”

Conference website: www.braindevelopmentandlearning.com

My thanks to the NIH (NIMH, NICHD, & NIDA), which has continuously funded our work since 1986, & to the Spencer Fdn, CFI, & IES for recently adding to our funding - and especially to all the members of my lab.