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Kellie Turner Prevent Child Abuse Delaware 302-425-7490.

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Presentation on theme: "Kellie Turner Prevent Child Abuse Delaware 302-425-7490."— Presentation transcript:

1 Kellie Turner Prevent Child Abuse Delaware

2 A traumatic event is one in which a person experiences (witnesses or is confronted with):  Actual or threatened death  Serious injury  Threat to the physical integrity of self or another  Responses to a traumatic event may include  Intense fear  Helplessness  Horror  Attachment

3  Perception of trauma varies vastly among individuals.  Trauma is something that overwhelms our coping capacity  Affects the whole self

4  A report of child abuse is made every ten seconds in the United States. (Childhelp, 2013)  Children who experience child abuse and neglect are 59% more likely to be arrested as a juvenile, 28% more likely to be arrested as an adult, and 30% more likely to commit violent crime. (Child Welfare Information Gateway, 2006)  More than 1 in 3 women (35.6%) and more than 1 in 4 men (28.5%) in the United States have experienced rape, physical violence, and/or stalking by an intimate partner. (CDC,2013)

5  Nearly 80% of female offenders with a mental illness report having been physically and/or sexually abused. (Marcenich, 2009)  Seventy-five percent (75%) of women and men in treatment for substance abuse report trauma histories. (SAMSHA/CSAT, 2000)

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8  Dr. Robert Anda and Dr. Vincent Felitti surveyed 17,421 adults who were having medical difficulties about their childhood experiences.  Created 9 categories of adverse childhood experiences which generated a person’s ACE score (number of categories a person experienced) 1. Recurrent physical abuse 2. Recurrent emotional abuse 3. Sexual abuse 4. Neglect

9 5. Growing up in a household where there was domestic violence 6. Growing up in a household with an alcoholic or drug abuser 7.Growing up in a household where someone was chronically depressed, mentally ill or suicidal 8.Growing up in a household where at least one biological parent was lost to the patient during childhood – regardless of cause 9.Growing up in a household where someone was in prison

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11  Shows a relationship between a person’s adverse childhood experience and their physical and mental health as adults as well as are associated with major causes of adult mortality

12  The higher the ACE score the greater the likelihood that person would suffer significant health problems in adulthood

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15  Adolescent Health  Teen pregnancy  Smoking  Alcohol abuse  Illicit drug use  Sexual abuse  Mental Health  Risk of revictimization  Stability of relationships  Performance in the workforce

16  Heart Disease  Chronic Lung Disease  Liver Disease  Suicide  Injuries  HIV and STDs

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18  The ACE Study The ACE Study

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20  At birth about 100 billion neurons have been produced  Genes (genetic code) and the environment both influence how a baby’s brain develops  Genes are responsible for the basic wiring of the brain  Environment and experience are responsible for the fine-tuning of those connections

21  Within a week of conception  During the prenatal period brain cells are sending and receiving sensory messages of touch, hearing, and movement.

22  Built from the bottom up  Brainstem  Midbrain  Cerebellum  Limbic  Cortex

23  Midbrain is the top of the brainstem  Governs the bodily functions necessary for life  Warns us of important incoming information  Midbrain controls: ▪ motor activity, ▪ appetite ▪ Heart rate ▪ sleep

24  Behind brainstem  Coordinates movement and balance

25  Responsible for:  Emotions  Attachment  Memory  Consists of  Hypothalamus  Amygdala  Hippocampus

26  Regulates:  Appetite  Sexual urges  Sleeping  Hormones  Immune system

27  Upper brain  Makes up two-thirds of our brain  Crumpled up space – if unfolded it would be about half a square yard  Divided into two hemispheres

28  Top layer/outside of the cerebrum  Our “thinking cap”  Regulates decision-making and controls thinking, reasoning and language  Understands time – sense of past, present, future  Allows us to reflect, plan make decisions and move  Responsible for abstract thinking  Contains 80% of the neurons  Divided into 4 lobes

29  Located in the forehead area  Last area to develop  Biggest section  Planning for the future  Decision making  Problem solving  Empathy  Feelings  Stimulated by nurturing touch

30  Located at the top of the brain  Represent the body in the brain  Receive incoming sensory information  Allow us to judge things like weight, shape and texture  Mathematical and visual reasoning

31  Located above the ear  Language  Auditory processing  Language comprehension  Speaking

32  Located in the back of the brain  Devoted to vision

33  Upper parts of the brain control or monitor lower parts of the brain  Important because if this did not occur there would be no time between impulsivity and reaction  Baby example

34  The ability to regulate reactivity is related to how well your cortex works  Mature cortex controls aggressive and impulsive behaviors better  Things that impair cortex functioning increases reactivity ▪ Alcohol/drugs ▪ Stress ▪ trauma

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36  Develops later  Responsive to stability  Promotes inhibition  Math  Logic  Language Cause and effect  Content  Social emotions – like guilt and remorse

37  Develops earlier  Responsive to action  Promotes activation  Nonverbal communication  Context  Primary emotions – like mad, scared and happy  Receives and analyzes information from the outside world  Spatial abilities  Face recognition  Visual imagery  Music

38  Genetics predispose us to develop in certain ways but our interactions with our environment have a significant impact on how our predispositions will be expressed – these interactions organize our brain’s development and shape the person we become.  Responsiveness of parents  Daily experiences  Physical activity  Love  Food and nutrition

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40  Young children learn from the responses they receive from care giving adults  When parents and caregivers respond in a positive, attentive way, babies begin to learn to care about others..

41  Overall brain development is profoundly influenced by attachment experiences  Healthy balance between security and exploration – caregiver as secure base  Sharing emotions  Attachment is relationship specific  “Is a blueprint of adult functioning” – Dr. Vicky Kelly

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43  Self esteem,  Independency and autonomy  Resilience  Self-control –ability to manage impulses and feelings  Ability to develop long-term friendships  Positive relationships with parents, caregivers and other authority figures  Uses pro-social coping skills  Trust, intimacy and affection  Positive and hopeful belief systems about self, family and society  Empathy, compassion and conscience  Academic success  Better language skills  Superior motor skills and cognitive ability

44  Attachment is primarily established in the first three years of life as the caregiver fulfills a child' s basic needs and provides touch, eye contact, smiles and positive affective engagement.  “Through an active and constant cycle of bonding, repeated thousands, if not millions of times in the first few years of life, a child develops a positive internal working model (I am loveable, worthwhile, my needs are met, I am safe), establishes a sense of trust and security and learns how to organize their reality.”

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46  Need goes unsatisfied or punished  Child learns world is uncaring, unsafe, dangerous and frightening  Belief repeated – believed over time  Focus becomes on taking care of self  As child gets older looks for examples to reinforces our beliefs

47  Dependent  Learned helplessness  Underdeveloped ego  Cognitive stunting  Poor impulse control  Poor coping strategies  Low self-esteem  Unable to develop and maintain friendships  Are alienated from and oppositional with parents, caregivers and other authority

48  Are aggressive and violent  Are incapable of trust, intimacy and affection  Are negative, hopeless and have a pessimistic view of self, family and society  Poor academic performance  Lack empathy, compassion and remorse  Perpetuate the cycle of maltreatment

49 “As the brain is organizing, it is waiting for the world to tell it how to structure itself.” – Dr. Bruce Perry

50  Trauma, Brain and Relationship Trauma, Brain and Relationship

51  Brain stem and limbic system  Need therapy that works to change the brain stem activity

52  By the time a child enters kindergarten, much of their “wiring” is set.  By age 4 the child’s brain is 90% adult size. (Dr. Bruce Perry)  “Whether children are on a path leading to academic success and positive social behavior or to violence and school failure is determined largely by the manner in which this wiring has occurred”- (Joan Lessen-Firestone)

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54  Children who have experienced chronic abuse and neglect during their first few years may live in a persistent state of hyper-arousal or dissociation, anticipating threats around every corner and their ability to benefit from social, emotional and cognitive experiences may be impaired - Perry

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56  Amygdala is fully developed at birth  It processes highly charged emotions  Babies can feel a range of emotions, even though they cannot understand what is going on  Hippocampus – organizes memories  Not fully developed until 2 to 4 years of age  So can not organize or put words to these early memories

57 They do exist

58  Explicit Memories  Full maturity at 3 years of age  Conscious memory  Enables us to tell stories  Understand what happens  Implicit Memories  Available at birth  Unconscious  Encoded in emotional, sensory, and visceral recall  We don’t remember with our minds, we remember with our bodies, our hearts and guts

59  If the early environment is abusive or neglectful, our brains create memories of these experiences that may adversely color our view of the world throughout our lives

60  Brief periods of moderate, predictable stress are not problematic – they prepare the child to cope with the world  Prolonged, severe, or unpredictable stress during a child’s early years is problematic

61  Learning how to cope with adversity is an important part of healthy development  When we perceive a threat our body responds – increased heart rate, blood pressure and secretion of stress hormones  When protected by caring adults, children learn how to cope and response system returns to baseline

62  Caused by more serious events – fire, hurricane, death of a loved one, serious injury  Child is buffered by caring, supportive adults who helps that child deal with the challenging situation  Brain is protected from potentially damaging hormones

63  Caused by prolonged and serious events – extreme poverty, repeated abuse, violence,  Child is NOT supported by caring, supportive adults who helps that child deal with the challenging situation  Brain is NOT protected from the increased levels of cortisol and brain development is disrupted

64 Toxic Stress

65  Sensitizes neural pathways and over- develops certain regions of the brain involved in anxiety and fear responses of the brain (Shore, 1997)  Focus becomes on survival and responding to threats in their environment (physical, sexual, neglect) – “Me against the world”

66  When a child is stressed or frightened the limbic system secretes cortizal into the blood.  The cortizal washes over the neural cortex and prevents neural connections from being formed and strengthened.  This causes a child to revert back to basic survival and child uses fight or flight to respond.  Studies have shown that many maltreated infants and children have abnormal secretions of cortisol, indicating that their bodies’ responses have been impaired

67  Repeated exposure to a great deal of cortisol programs the child’s brain to expect, like and seek out situations that will lead to the release of cortisol.  Children who are accustomed to high levels of cortisol begin to live in the brain stem rather then in the thinking cortex. They view each interaction as one that may threaten their survival.  Toxic stress brings the past to the present  Joan Lessen-Firestone

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69  When a child is exposed to chronic, traumatic stress, his brain sensitizes the pathways for the fear response and creates memories such that his fear response becomes almost automatic  Because of constant stress the part of the brain responsible for the hyper-arousal response is always working  Child experiences hyperactivity, anxiety, impulsivity and sleep problems  When child experiences something that reminds him of previous trauma he responds anxiously and/or aggressively

70 Traumatic Event Prolonged Alarm Reaction Altered Neural Systems

71  Brain develops in a way that is very adaptive to the child’s negative environment but is maladaptive in other environments  The child may have difficulty functioning when presented with a world of kindness, nurturing and stimulation – it is an unfamiliar world to the child and his brain has not developed the pathways and the memories to adapt to his new world  Children who spend a great deal of time in a chronic state of fear often exhibit behavioral impulsivity and cognitive distortions

72  Areas of the brain may be underdeveloped due to abuse and/or neglect  No part of the brain can change without being activated  “To learn and incorporate new information, the child’s brain must be in a state of “attentive calm” which traumatized children rarely achieve.”  Understanding the Effects of Maltreatment on Early Brain Development

73  Right side address primary emotions, fear, stress, etc.  Right side “turns on” in distress  In order for the left side to “turn on” - function and grow the brain must be in a state of calm  Children under severe stress may have deficits on the left side – language, logic, social emotions etc.  Left side can work up to 7x slower

74  Child needs to be in a calm state  Traumatized children are in an alarm state – sense of time is altered  A threatened child is not thinking of the future  Immediate reward is most reinforcing  Delayed gratification is impossible  Consequences become more inconceivable to the threatened child  Reflection on the behavior is impossible

75  Viewed by infants as intense anxiety  Capacities like language, kindness, empathy, positive interactions may not fully develop because the required neuronal pathways were not activated enough to form memories needed for future learning  Studies show a decrease in brain growth

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77  Don’t know how to give and take  Can’t trust – believes “ I don’t matter”  Impaired interest – attention  Difficulty managing emotions  Difficulty focusing  Don’t receive joy and reward the same way

78  Ability to feel remorse and empathy are built on experience  Altered cortisol reactivity in maltreated children may also relate to impairments in social competence

79  A young child growing up in a home with pervasive threat will create a set of associations between a host of neutral cues and threats  These associations become automatic – and will elicit fear response for the rest of the child’s life  The cues can be scents, facial expressions, music of interpersonal styles of interaction  In order to change these inaccurate and false associations, the child must have opportunities for new experiences that will allow the brain to decrease the overgeneralization of these trauma-related associations

80  Aims to avoid re-victimization.  Appreciates many problem behaviors began as understandable attempts to cope.  Strives to maximize choices for the survivor and control over the healing process.  Seeks to be culturally competent  Understands each survivor in the context of life experiences and cultural background. (Alvarez and Sloan, 2010)

81  There are behaviors, characteristics and qualities inherent in some personalities that that will assist in recovery after exposure to a traumatic event, these are called, protective factors.

82  Researchers who examined the life histories of children who succeeded despite many challenges in their lives have consistently found that these children had had at least one stable, supportive relationship with an adult beginning early in life


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