Why Attachment Matters in Children's Development - Helen Minnis

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    Why Attachment Matters in Children's Development - Helen Minnis - Presentation Transcript

    1. Why does attachment matter for children’s development? The importance of soothing
    2. Why does attachment matter for children’s development? Bowlby, 1973 Anxiety attachment behaviours comfort from caregiver reduction in anxiety
      • Attachment behaviours present from birth
      • Selective attachment present from around 6 or 7 months
      • Attachment patterns are a measure of the relationship , not of the child
      Attachment and Attachment Disorders
    3. Why does attachment matter for children’s development? General population: ~70% secure ~30% insecure Ainsworth, 1979
      • Attachment can be measured at 12-18 months using the strange situation procedure
    4. Why does attachment matter for children’s development?
      • Secure attachment
      • Infant goes to parent when stressed
      • Easily comforted
      • Back to the job of exploring/learning
    5. Why does attachment matter for children’s development?
      • Insecure-avoidant attachment
      • Infant doesn’t use parent for soothing
    6. Why does attachment matter for children’s development?
      • Insecure-resistant/ambivalent attachment
      • Infant goes to parent when stressed
      • But not easily comforted
      Some insecure attachment patterns make perfect sense!
    7. Why does attachment matter for children’s development?
      • Insecure-disorganised/disorientated attachment
      • Acts as if not sure what to do when stressed
      Higher risk of aggressive behaviour later
    8. What happens if children are not soothed as babies? Why does attachment matter for children’s development?
    9. Normal diurnal rhythm of cortisol Stress Why does attachment matter for children’s development?
    10. Romanian orphans Response to stress ca n be unpredictable Stress Why does attachment matter for children’s development?
    11. Maltreated children pre-school Dozier Stress Why does attachment matter for children’s development?
    12. Why does attachment matter for children’s development? Edlington boys Exposed to neglect and violence, alcohol and cannabis
    13. Why does attachment matter for children’s development? The parts most affected are those which have the most rapid development after birth What can happen to the brain with maltreatment in early life?
    14. Hippocampus Why does attachment matter for children’s development? Role in dissociative states, anxiety disorders Apparent hippocampal shrinkage with PTSD but twin study suggests small hippocampus might predispose to PTSD
    15. Hippocampus retains its ability to generate neurons throughout life e.g. taxi drivers “knowledge” Eriksson et al 1998 Nature Medicine Maguire et al 1997 Journal of Neuroscience “ Its not grey matter that I’ve got in mine… its faecal matter because of all the s**t that comes through that partition!” Glasgow Taxi Driver But there is always hope… Why does attachment matter for children’s development?
    16. Amygdala Why does attachment matter for children’s development? Role in fear conditioning, control of aggressive and sexual behaviours
    17. Corpus callosum and interhemispheric integration
      • Left hemisphere - language and logical thought
      • Right hemisphere - perception and expression of emotion, particularly negative
      • Reduced corpus callosum size in childhood maltreatment, especially in boys
      Why does attachment matter for children’s development?
    18. Why does attachment matter for children’s development?
    19. Neurobiology of Maltreatment Cerebellum
      • Role in attention, language, cognition, affect and movement
      • Very high density of stress hormone receptors – may be very susceptible to stress postnatally
    20. Neurobiology of Maltreatment Cerebral cortex
      • Lots of stress hormone receptors – may be very susceptible to stress in postnatal period
      • Fronto-temporal area is particularly important – involved in “executive functioning” i.e. planning, complex social interaction
    21. Neurobiology of Maltreatment
      • Cerebral cortex
      • maltreatment may cause a precociously mature cerebral cortex with “stunted final capacity”
      • Teicher, 2003
    22. Neurobiology of Maltreatment HPA axis and stress Adapts, in a situation of neglect/violence, to deal with stressful early environment: fight, flight, freeze Stress thermostat -Adaptive in situations of high stress -Maladaptive or leading to psychiatric disorders in situations of low stress
    23. Neurobiology of Maltreatment Gunnar 2002 Psychoneuroendocrinology Doctors for a jag
    24. Neurobiology of Maltreatment
      • HPA axis and stress
      • At 3 months, children cry and see cortisol peak on immunisation
      • By 12-18 months, securely attached infants cry but no longer see cortisol peak
      • In insecurely attached or temperamentally inhibited children, still see a cortisol peak in presence of caregiver
      Gunnar 2002 Psychoneuroendocrinology
      • Infants:
      • Attachment and Biobehavioural Catch-up (ABC) –
      • Trains carers of maltreated children to be extra-nurturing
      • Randomised Controlled Trial evidence that can return cortisol patterns to normal
      Treatment? Attachment Disorders
      • Older children:
      • Dyadic Developmental Psychotherapy
      • Good US pilot study suggests very effective in reducing behaviour problems
      • Needs Randomised Controlled Trial – plans for this in Glasgow
      Treatment? Attachment Disorders
    25. Neurobiology of Maltreatment Who is right? Ed Balls asks 'Can we sort out the problems in the family?' Martin Nary (Barnardos) says more children should be adopted at birth Prevention?
      • New Orleans Model:
      • Every maltreated child under 5 and their family has an intensive attachment-based assessment
      • Intensive intervention for birth family (while child in foster care) to maximise chance of rehabilitation
      • Time limit of 15 months , then decision:
      • Adoption or Rehabilitation?
      Prevention? Attachment Disorders
      • New Orleans Results:
      • Increased freeing for adoption
      • BUT
      • Where rehabilitated, reduction in maltreatment of both that child and subsequent siblings
      • i.e. good decisions
      • Plan for Glasgow pilot and trial
      Attachment Disorders Prevention?
    26. Why does attachment matter for children’s development?
      • Final points:
      • Lets support parents to get attachment right in the first place
      • Lets prevent damage to development by making decisions about children early
      • Lets find and test ways of helping when there have been problems
      • These are some of the core aims of Scottish Attachment in Action

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    Dr. Helen Minnis , Senior Lecturer in Child and Ado more

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