Neighborhood House, 4/1/08€¦ · and continues development until early 20s Slide 40 Things to Keep in Mind Slide 41 Early Relationships Are Important !!! “Each achievement –

Neighborhood House, 4/1/08

Sheri L. Hill, PhD, Copyright 2008

Babies, Brains and Relationships

Sheri L. Hill, PhD

[email protected]: 206.940.0892

www.earlychildhoodpolicy.comSlide 2

Today’s Topics

Brain BasicsRelationships and the BrainHow Relationships EmergeWhat Very Young Children RememberThings to Keep in MindThings to DoResources

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Brain Basics

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What the Brain Needs to Do

Creation of NeuronsFinding a Home Laying the CableCreating ConnectionsRefining the SystemImproving Efficiency

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Primarily in Pregnancy

Creation of NeuronsAll is not lost for adults though!

Finding a HomeFASD

Laying the Cables Starts

Building Connections Starts

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0-3 Brain Changing Prime Time

Newborn – 400 grams3 Year Old – 1100 gramsAdult – 1500 grams

Image: www.brainconnection.com© 1999 Scientific Learning Corporation

Neighborhood House, 4/1/08

Sheri L. Hill, PhD, Copyright 2008

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Prime Time and Beyond

Setting Up the SystemLaying the CableCreating Connections

Improving EfficiencyInsulating the WiresRefining the Focus

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Pruning

Newborn Early Childhood

Later Childhood

Refining the System and Improving Efficiency

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Getting a Hand-le on the BrainBrain Stem

Base of thumbMid-brain / Thalamus

ThumbLimbic System

PalmCortex / Neocortex

Fingers

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Experience Changes the Brain

“…our experiences are what create the unique connections and mold the basic structure of each individual’s brain.”

Siegel, D., Hartzell, M. (2003)

“Neurons that fire together, wire together.”

Daniel Siegel

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Experience Changes the BrainToday will change your brain

Anything can become ‘normal’ to a young child.

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Relationships and the Brain

Neighborhood House, 4/1/08

Sheri L. Hill, PhD, Copyright 2008

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Babies Come Relationship Ready

Babies are born (hard-wired) to fit into social relationships

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The Brain in Relationship

Monkey See –Monkey Do

Video Learning a No Go for Babies

Sharing Brain Wave Patterns

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How Relationships Emerge

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Patterns → Relationships

Babies are precocious at pattern recognition.

A baby’s daily routine promotes this ability to recognize patterns.

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Patterns → Attachment

These early experiences and routines are the building blocks of the baby’s emotional bond with the caregiver

This ‘emotional bond’

is also called attachment.

Neighborhood House, 4/1/08

Sheri L. Hill, PhD, Copyright 2008

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Attachment

Repeated relationship experiences w/ caregivers:

allow infant to understand the way things work,to develop a sense of their own importance,to understand about how others are, and to understand their relationships w/ others.

John Bowlby, 1980

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It Takes Time

Attachment is built over time.

Focused, preferred, or specific attachments emerge at 7-9 months

The hallmark of these important relationship(s) is the observable fact that these special adult(s) are not readily interchangeable with others.

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Attachment

Involves a feeling of security & protection

Distinctly different interaction patterns and patterns of attachment are possible with different key caregivers

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Experience Matters

Very young children with positive relationship experiences ….

“will transfer those positive expectations to the foster mother, making it easier for the new caregiver to understand the baby’s need.”

Dozier, M. et.al (2001). Child Development, 72(5).

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Neighborhood House, 4/1/08

Sheri L. Hill, PhD, Copyright 2008

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Experience Matters

Very young children with negative relationship experiences ….

“have low expectations for nurturing care and behave in ways that do not elicit nurturance.”

Dozier, M. et.al (2001). Child Development, 72(5).

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Experience Matters

Positive or negative experiences can work both ways.

Apply to parents as well as non-parental caregivers.

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Attachment

Operative throughout life

Even as adults, our early experiences with attachment impact how we approach intimacy and close relationships

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What “love maps” do you see at work?

John Gottman

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What Babies Remember

Neighborhood House, 4/1/08

Sheri L. Hill, PhD, Copyright 2008

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Expectations and MemoryWhen patterns get constantly repeated, a baby begins to form prototypes or schemas - a mathematical average of these events.

Daniel Stern, M.D., Wash.D.C., 2000

Babies form expectations of the way the world ‘is’ around them.

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Expectations and Memory

“Representations of how things happen”Daniel Stern, M.D., Wash.D.C., 2000

This summary of experiences becomes part of memory

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First Memories - Implicit Memory

“Implicit memory is a form of nonverbal memory that is present at birth and continues throughout the life span.”

Siegel, D., Hartzell, M. (2003)

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Implicit Memory

Amygdala

What do they carry in the palm of their hands?

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Implicit Memory

Comfort Food

Post-Traumatic Stress DisorderTrauma Lives in the Body (Lieberman, 2005)

Neighborhood House, 4/1/08

Sheri L. Hill, PhD, Copyright 2008

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Implicit Memory and Caregiving

Why cut that ham?

Powerful Remembering ContextWinnicott

Babies Bring Up Your Stuff!!! ……

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Video Courtesy of Circle of Security in Spokane

www.circleofsecurity.org

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Explicit Memory

Autobiographical Memory

Narrative Memory

Hippocampus BasedNot developed until about 3 and continues development until early 20s

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Things to Keep in Mind

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Early Relationships Are Important !!!

“Each achievement – language and learning, social development, the emergence of self-regulation – occurs in the context of close relationships with others.”

From Neurons to Neighborhoods, National Academyof Science, 2000

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Neighborhood House, 4/1/08

Sheri L. Hill, PhD, Copyright 2008

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Very Young ChildrenDo Have Mental Health

Infant mental health is the capacity of the child from birth to three to experience, regulate and express emotions; form close and secure interpersonal relationships; and explore the environment and learn.

Infant mental health is synonymous with healthy social and emotional development.

www.zerotothree.ogSlide 44 Slide 44

Young Children in Child Care

Colorado 0-5 year olds23% of children were identified as having severe emotional behavioral problems

Illinois 0-3 year olds16%-24% had significant social-emotional problems

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Young Children OUT of Child Care

Washington 3-5 year olds1 in 10 pre-K teachers expelled a childTwice the rate of school-age children.

Illinois 0-3 year olds42% of programs had asked families to withdraw their infant or toddler Program was unable to handle the child’s social and emotional problems

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Early on the Path

Children who maintain high levels of problem behavior from preschool to grade school are 52 times as likely to be diagnosed with a conduct disorder in adolescence than children whose problem behaviors are resolved before school entry.

Pierce, W. W., Ewing, L. J., & Campbell, S. B. (1999)

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Babies Can Suffer

ZERO TO THREE: National Center for Infants, Toddlers, and Families. (2005) Diagnostic Classification of Mental Health and Development Disorders of Infancy and Early Childhood, Revised (DC:0-3R)

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Neighborhood House, 4/1/08

Sheri L. Hill, PhD, Copyright 2008

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Disruptions to Relationships Matter

Young children grieve when their attachment relationships are disrupted – regardless of whether we as adults would consider it a positive, less than adequate or even abusive relationship.

Neurons to NeighborhoodsSlide 50

What Has Changed?

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Babies Need a Special Someone

“Who fills this role is far less important than the quality of the relationship she or he establishes with the child.”

From Neurons to Neighborhoods, National Academy of Science, 2000 Slide 52 Slide 52

“Babies don’t see legal or blood relationships -- they only see interpersonal relationships.”

Hill, S. & Solchany J. (November, 2005) Mental Health Assessments for Infants and Toddlers. ABA Child Law Practice.

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What We Can Do

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Ask Questions

Questions Every Judge and Lawyer Should ask About Infants and Toddlers in the Child Welfare System

www.ncjfcj.org/store/product_info.php?cPath=21_22_28&products_id=90

Ensuring the Healthy Development of Infants in Foster Care: A Guide for Judges, Advocates and Child Welfare Professionals

www.zerotothree.org/site/PageServer?pagename=key_childabuse

Neighborhood House, 4/1/08

Sheri L. Hill, PhD, Copyright 2008

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How is the child developing?

Child Profile – Developmental Charts and Letterswww.childprofile.org

WithinReachwww.withinreachwa.org or 1.800.322.2588Connections to free developmental screenings

www.dshs.wa.gov/pdf/Publications/22-645.pdf

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Watch for Red FlagsRed Flags from Hill, S. & Solchany J. (November, 2005) Mental Health Assessments for Infants and Toddlers. ABA Child Law Practice.www.zerotothree.org/site/DocServer/Hill_Solchany_Infant_Men

tal_Health_Assessments_for_court.pdf?docID=1851(www.zerotothree.org/site/DocServer/Hill_Solchany_Infant_Mental_Health_Assessments_for_court.pdf?docID=1851 )

Kids Get Care – A program in King County www.metrokc.gov/health/kgc/See their “Red Flags” Tool

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Address Caregiver Mental Health

Help Parents and Caregivers De-Stress

Caregiver state of mind matters.Think outside the box when you think about caregivers.

What is your shark music?

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Keep an Eye out for Depression

Speak Up When You’re Downwww.speakup.wa.gov1-888-404-7763

Siblings

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Keys to Perinatal DepressionA free, web-based training program for nurses, social workers, mental health providers and other health professionals. Developed by Dr. Barnard and others working with First Steps at Stepping Up Washington.

http://steppingup.washington.edu/keys/default.htm

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Keys Modules

Module I: Understanding and Assisting Women with Perinatal and Postpartum Mood Disorders

Module II, Relationship Focused Practice

Module III, Screening for Perinatal DepressionTwo no-cost, self-administered detection and measurement tools are introduced and their application is demonstrated.

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Neighborhood House, 4/1/08

Sheri L. Hill, PhD, Copyright 2008

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Help Caregivers Communicate Understanding and learning the dance takes time.

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Help Babies Communicate

Promote one-on-one interactions with very young children.

Singing, Talking, and Reading with Babies

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Do Caregivers Know?

You can’t spoil a baby!!Your state of mind matters.Infants and toddlers need you to be bigger, stronger, wiser and kind.

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Caregivers May Need

Support and help to develop these capacities.

The challenge with parenting classes.

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Caregivers May Need

Their own corrective experience in being parented to achieve this goal.

Their own special someone orMental health intervention

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Most Importantly Caregivers Need to Know

Early Relationships Are Important!

Neighborhood House, 4/1/08

Sheri L. Hill, PhD, Copyright 2008

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RESOURCES

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ZERO TO THREE Journal

Infant Mental Health and Early Head Start: Lessons for early childhood programs. (2001) August/September. Volume 22, No. 1.Is Mom’s Mind on Her Baby? Infant Mental Health in Early Head Start

JoAnne Solchany & Kathryn Barnard

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Book Recommendations: For All Caregivers

Siegel, D. & Hartzell, M. (2004) Parenting from the Inside Out: How a Deeper Self-Understanding Can Help You Raise Children Who Thrive. New York, NY: Penguin Paperback.Talaris Research Institute has prepared an excellent booklet for caregivers based on Dr. John Gottman’s work on emotion-coaching. What am I feeling? The Five Steps of Emotion Coaching. This has accompanying pamphlets and a video/DVD.

www.talaris.orgGreenspan, S (2000). Building Healthy Minds: The Six Experiences that Create Intelligence and Emotional Growth in Babies and Young Children. Cambridge, MA: PerseusPublishing.

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Booklets and Newsletters

What’s Best for My Baby and Me?A 3-Step Guide for Parentswww.zerotothree.org go to the eStore

Off to a Good Start: Mental Health Promotion for Young Children

Northwest Bulletin (see previous issue on Post Partum Depression also)http://depts.washington.edu/nwbfch/

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From Neurons to Neighborhoods: The Science of Early Childhood Development

“If you only ever buy one book on early childhood development – buy this one” – Sheri L. Hill, PhD

Committee on Integrating the Science of Early Childhood Development

Board on Children, Youth, and FamiliesInstitute of MedicineNational Research Council

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More Good Books

Brazelton, T. B. (1992). Touchpoints Birth to Three: The Essential Reference for the Early Years.United States: Perseus Books.

DeLoache, J. & Gottlieb, A. (2000). A World of Babies: Imagined Childcare Guides for Seven Societies. Cambridge, MA: Cambridge University Press.

Gopnik, A., Meltzoff, A., & Kuhl, P. (1999). The Scientist in the Crib: What Early Learning Tells Us About the Mind. New York, NY: Harper Collins Press.

Neighborhood House, 4/1/08

Sheri L. Hill, PhD, Copyright 2008

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More Good Books/Videos

Lieberman, A (1993). The Emotional Life of the Toddler. New York, NY: The Free Press.

Williamson, G., & Anzalone M. F. (2001) Sensory Integration and Self-Regulation in Infants and Toddlers: Helping Very Young Children Interact with their Environment. Washington, DC: ZERO TO THREE Publishing.

The Secret Life of the Brain. The full 5-part PBS/NOVA series covers brain development throughout the lifespan and is available at www.shoppbs.org. Most public libraries also have this series.

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More Good Books/Videos

Foley, G. M. & Hochman, J.D. Editors (2006). Mental Health in Early Intervention: Achieving Unity in Principles and Practice. Baltimore, MD: Brookes Publishing.

Weatherston, D., & Tableman B. (2002) Infant Mental Health Services Supporting Competencies/ Reducing Risks: A Manual for Community Programs. Michigan Association for Infant Mental Health. www.mi-aimh.msu.edu/intro/index.html

It Feels Good to Help Your Baby Learn.14 minute video for young/teen parents produced by Illinois Voices for Children – 1.800.323.GROW

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Websites with Resources

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Washington Resources

Department of Early Learning: www.del.wa.gov

Parent Trust for Washington Children: www.parenttrust.org They also have a Family Help Line 1-800-932-HOPE (4673).

Conscious Fathering (Help for Families –Program Overview)

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More Washington Resources

Foundation for Early Learning Ten Simple Ways to Encourage Learning. (2005 booklet) Downloadable for free in both English and Spanish.

www.earlylearning.org/resources/publications/ten-simple-ways-booklets

www.parenthelp123.org (WithinReach)This website includes a benefit calculator for services such as food stamps and health insurance.

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National Websites

Healthy Kids, Healthy Care: Parents as Partners in Promoting Healthy and Safe Child Care

www.healthykids.usOunce of Prevention Fund, Publications:

www.ounceofprevention.orgDocs for Tots

www.docsfortots.org

Neighborhood House, 4/1/08

Sheri L. Hill, PhD, Copyright 2008

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National Websites

National Scientific Council on the Developing Child

Collaboration - neuroscience, early childhood development, pediatrics, and economics.www.developingchild.net

Birth to Five Policy Alliancewww.birthtofivepolicy.org

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More National Sites

National Technical Assistance Center for Children’s Mental Health

http://gucchd.georgetown.edu/programs/ta_center/index.html

Georgetown University Center for Child and Human DevelopmentLots of great stuff, including free training conference calls

http://gucchd.georgetown.edu/programs/ta_center/tacalls2008.htmlSlide 80

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Mental Health Consultation

SAMHSA Mental Health in Early Childhood with Training Guide for Early Childhood Community:

Volume 1: http://mentalhealth.samhsa.gov/publications/allpubs/svp05-0151/Volume 2: http://mentalhealth.samhsa.gov/publications/allpubs/svp05-0151B/

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ZERO TO THREE – National Center for Infants, Toddlers and Families

www.zerotothree.org

Great stuff for professionals

Great policy materials to help you advocate

Great stuff for parents

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Web Resources on Trauma

Healing Resources.info: Preventing and Healing Stress Related Problems

www.traumaresources.orgThey have a great video you can download in sections or purchase on DVD – Trauma, Brain & Relationship: Helping Children Heal

National Child Traumatic Stress Networkwww.nctsnet.org

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Web Resources on Trauma

National Center for Trauma Informed Carehttp://mentalhealth.samhsa.gov/nctic/

The ChildTrauma Academywww.childtrauma.org

National Center for Children Exposed to Violence

www.nccev.org

Neighborhood House, 4/1/08

Sheri L. Hill, PhD, Copyright 2008

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National Projects

ZERO TO THREE Court Teams for Maltreated Infants & Toddlers

www.zerotothree.org/site/PageServer?pagename=ter_pub_courtteams

American Bar Association – Improving Understanding of Maternal and Child Health

www.abanet.org/child/baby-health.shtml

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Summary Briefs

Clinical Interventions to Enhance Infant Mental Health: A Selective Review – July 2005, Zeanah, Stafford and Zeanah

www.healthychild.ucla.edu/publications/IMH%20Evidence%20Review%20FINAL.pdf

Improving Maternal and Infant Mental Health: Focus on Maternal Depression

www.healthychild.ucla.edu/publications/Maternal%20Depression%20Report%20FINAL.pdf

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Topical Briefs

Reducing Maternal Depressionwww.nccp.org/publications/pub_791.html

The affects of childhood stress across the lifespan.

www.cdc.gov/ncipc/pub-res/effects_of_childhood_stress.htm

Reducing Pre-K Expulsionwww.fcd-us.org/resources/resources_show.htm?doc_id=636702

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IMH Court Work Brief

“It’s about the kids. People talk about parents getting their children back. But really, this is about the children getting their parents back.”Judge Douglas F. Johnson of Omaha

Healing the Youngest Children: Model Court-Community Partnerships

www.zerotothree.org/site/DocServer/Healing_the_Youngest_Children.pdf?docID=3761