Babies, Brains and Relationships: What we Are Learning About Interpersonal Neurobiology and the Foundations of Learning NJCCA

March 7, 2015 – Rutgers University- Busch Campus

Gerard Costa, Ph.D. Director and Senior Lecturer Center for Autism and Early Childhood Mental Health

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Note

I have provided you with more slides than I will display. Gerard Costa, Ph.D.

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Plan 

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The interpersonal nature of human development Infant mental health Interpersonal neurobiology Attachment and Developmental Capacities Trauma and its consequences The way we must be! Gerard Costa, Ph.D. 2015

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5 Fallacies About Infants and Young Children we MUST Challenge     

They are too young to be affected! They’ll get over it! They won’t notice the difference! They’ll get used to it! They’ll never remember!

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In the beginning…. There was the

RELATIONSHIP!!!! Gerard Costa, Ph.D. 2015

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But first….Think “Parenting”

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Imagine…… 

A 6 week old baby awakening……..

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365 “wonderful” caregivers a year…..

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Starting Points….

Parenting with the “brain” in mind! (Siegel)  Early Experience Matters! (ZTT)  “Lived Moments” (Stern) 

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The field of Infant Mental Health offers us ways to understand and support early capacities and relationships.

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A very brief review about babies, children and us!!! Gerard Costa, Ph.D. 2015

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Infant Mental Health A field of study 

Infant Mental Health is an interdisciplinary field concerned with the optimal physical, social, emotional and cognitive development of the human infant within the context of his family. The infant is principally viewed within a primary relationship - usually but not always his mother - and this pair or dyad is the principal focus of infant mental health. Gerard Costa, Ph.D. 2015 11

Infant Mental Health The emotional capacities

The capacity that infants and children develop to:  Self regulate  Experience the full range of human emotions  Engage in loving, reciprocal relationships  Represent the world in thought and language  Engage in shared emotional thinking and relatedness  Become intimate and care for others interdependently  Engage in productive activities Gerard Costa, Ph.D. 2015 12

Core Principle 

Infants and children arrive in the world ready for, and designed to form, relationships – with Attachment Promoting Behaviors (APBs) This readiness includes a remarkable array of competencies that help us know how they are doing but also how we are doing with them? These capacities can go awry when children undergo “sins” of omission and “sins” of commission. Gerard Costa, Ph.D. 2015 13

So….. 

Babies are remarkably competent at birth and constantly let us know how they are doing and how We are doing with them!   

Can babies see at birth? Can they “hear” at birth and even show ‘preferences”? How do babies “communicate”?

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And…….

Babies require regular, consistent, predictable, attuned, loving, responsive relationships to promote health social, emotional and intellectual development. Gerard Costa, Ph.D. 2015 15

My Personal Story: Communication at work!

Father and 6 month old daughter Gerard Costa, Ph.D. 2015

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Core Principle 

The brain's most rapid growth spurt occurs from the last trimester of pregnancy through the first 2 years of life. Both good and bad experiences create associated chemical and anatomical brain changes. During this period the brain makes connections more readily than losing them. Both the “mind” and

“brain” are being formed. Gerard Costa, Ph.D. 2015 17

The Interpersonal Nature of Development 

Developmentally, our biological systems are organized by the nature of early emotional relationships.

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Experience, THROUGH RELATIONSHIPS, “sculpts” the brain. Gerard Costa, Ph.D. 2015 18

The Importance of a Parent’s/Caregiver’s “Emotional Availability” and “attunement”

The “Jack in the Box” moment Gerard Costa, Ph.D. 2015 19

Colwyn Trevarthen

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Bi-Directional Effects in Mother-Infant Interactions Mother’s mood can induce an emotional state in the infant

Field 1997

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Mirroring 

“…the precursor of the mirror is the mother’s face.” (Winnicott, 1971)

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“If the mother’s face is unresponsive, then a mirror is something to be looked at but not looked into.” (Winnicott, 1971)

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Samaroff (2004)

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A word about … THE BRAIN

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Brain Numbers to Know! 

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By 5 months pregnancy, the fetus has 100 billion neurons – the amount of the adult cortex. 20% of the neurons are interconnected related to genetics and intrauterine life. 80% of the connections are formed through the nature of experiences and interpersonal relationships. Each neuron can form up to 10,000 connections! Connections (synapses) can occur at the rate of 700/second for each neuron in the first years of life. One million/sec! In the first years of life, connections are formed more easily than they are broken! Gerard Costa, Ph.D. 2015

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While the ways in which the brain forms from conception are organized by genes, the brain is fundamentally……

A social organism that is developed through interactions and relationships!

http://danceofinnocence.deviantart.com/art/ThisGerard Costa, Ph.D. 2015 Hurricane-318445475

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Physiological Responses to Trauma Fight - Flight - Freeze Gerard Costa, Ph.D. 2015

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Limbic System “Emotion”

Image: www.brainconnection.com 29 29 © 1999 Scientific Learning Corporation

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About the Limbic System 

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“Serves as a source of social processing, stimulus appraisal and brain/body (“emotional”) arousal.” -Daniel J Siegel (1999) THIS MEANS – that the structures in the core of the brain that make up the “limbic system” “process” the meaning of social situations, and connects present perceptions of a situation with the memories of past situations. Gerard Costa, Ph.D. 2015

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GerardCosta, Costa, Ph.D. Gerard Ph.D.2015 2011

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Amygdala 

This structure is part of the Limbic System- and in the development of brains in babies, this structure (based on real experiences with caregivers and the world) begins to get “wired” to “process” (interpret the meaning of) new experiences. Because the amydala is connected to other brain regions, what happens in the amydala affects the entire brain! 32 32 Gerard Costa, Ph.D. 2015

Dan Siegel – “Hand Model of the Brain” (Mindsight, 2010)

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Daniel Siegel The “Hand Model of the Brain”

“….Lift up your fingers and you’ll have an image of how we ‘flip our lids’ and head down the ‘low road’ in our interaction with others.” Mindsight (2010), p. 22 Gerard Costa, Ph.D. 2015

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Unlike Las Vegas….

What happens in the amygdala does NOT stay in the amygdala! Gerard Costa, Ph.D. 2015

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Hypothalamic-Pituitary Adrenal (HPA) Axis Fear Trauma Danger

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Video Clip 

A moment of connectedness, rupture and repair in the life of a mother and baby.

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Based on the work of Dr. Ed Tronick and the “still-faced” paradigm

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What we know about babies, brains and relationships! Gerard Costa, Ph.D. 2015 39

What we now know about the brain in infants? 

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The right side of the brain (affect, rhythm, tonality) comes “on line” before the left brain! The sub-cortex – particularly the amygdala – is “wired” and interconnected, early in development through the nature of the earliest relationships. Gerard Costa, Ph.D. 2015

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What we now know about the brain in infants? 

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Children in securely attached relationships have brains that are more efficiently organized! The baby’s brain is more sensitive to affective, gestural and intonational cues (“musicality”) than the words themselves! Gerard Costa, Ph.D. 2015

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Meharabian (1981)

Affect and gesture are communicative drivers 55%- facial expressions  38% - vocal tone  7% - words Gerard Costa, Ph.D. 2015

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So…………… Your facial expressions, tone of voice, movement and gestures are more powerful than your words! When you speak with an infant and young child, move to their eye level (monitoring how they “take you in”), keep a respectful distance to be sure he/she “is in control”, convey in all of your “body language”, calmness, interest and willingness to “follow the child’s lead”. Gerard Costa, Ph.D. 2015

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Core Messages  

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The infant brain is organized through the nature of relationships. The brain grows from the “inside-out”, meaning that earlier and sub-cortical areas that are most responsible for regulation, attention and “fight or flight” responses are “wired” earlier than the higher brain centers. This occurs before language and symbol formation. Exposure to neglect, abuse, violence and dysregulation adversely changes the brain Gerard Costa, Ph.D. 2015 44

Attachment and Developmental Capacities

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Wondering  How

do you feel when you are secure?  How do you behave when you are secure? Gerard Costa, Ph.D.

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School Readiness 

Emphasis on emotional competence  

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Capacity for attention Social skills Emotional regulation Peer relationships

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What are the Precursors of School Readiness? LOTS OF DATA!!!  

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Attachment Healthy representation of others – e.g. adults as trustworthy and caring. Representation of self as good and competent Peer relationships/Social competence. Exploratory Competence Executive Functioning – working memory, impulse control, delay of gratification, attention shifting. Gerard Costa, Ph.D.

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Emotional Regulation Skills Positive Cognitive Models

Secure Attachment

Child Functioning

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1. Relationship Functioning 2. Psychopathology 3. School Readiness

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James Garbarino, Ph.D. Lost Boys: Why Our Sons Turn Violent and How we Can Save Them(1999)

“We begin our journey to understand lost boys by studying the quality of their early relationships, the psychological condition of their inner life, the development of their spirit. At the heart of the matter is whether a young child is connected rather than abandoned, accepted rather than rejected, and nurtured rather than neglected and abused.” p.34 Gerard Costa, Ph.D.

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What is Attachment? 

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A biologically rooted motivational system in the baby related to seeking comfort, support, nurturance, and protection. Motivates baby to seek proximity when frightened, distressed, lonely, etc. Operates in balance with motivation to explore.

Attachment and Brain Development A secure attachment relationship provides the setting for wiring the brain in an organized, efficient way, and sets the stage for selfregulation, moral development and learning. Children who undergo repeated disruptions in attachments, or who are chronically neglected or abused, or traumatized, are at-risk for a host of developmental, health and mental health disorders. Schore (2002), Siegel (2006), Perry (2006)

Attachment: Developmental/LifeSpan 

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Child develops expectations about the dependability of attachment figures to provide comfort, support, and nurturance in times of need. Eventually these expectations become Internal Working Models. Infant’s quality of attachment to primary caregiver is one of strongest predictors of psychological and social outcomes in middle childhood and adolescence

Attachment is NOT a sudden and magical bond, but rather a slow, social unfolding that requires the full participation of both parties.

Thanks to:

Circle of Security   

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Kent Hoffman Glen Cooper Burt Powell Robert Marvin 

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Spokane, Washington

http://circleofsecurity.net/about-us/originatorsand-trainers/

Jude Cassidy, Ph.D. – Research- University of Maryland Gerard Costa, Ph.D.

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Critical importance of Self-Regulation  First

required neural and mental (psychobiological) systems.  Foundational for all higher level systems. Gerard Costa, Ph.D.

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Trauma and brain development Gerard Costa, Ph.D. 2015 58

Question?

When you hear a humming noise, what is making the sound? Gerard Costa, Ph.D.

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An Exhaust Fan?

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An Sound Machine?

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A Plane Crashing into a Building ?

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What are the experiences that determine the range of ideas that are generated, and the areas of the brain that are activated? Gerard Costa, Ph.D.

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Question? When you see aggression, or deception, or sexualized behavior or oppositionality, or school failure, in a child, what are the forces that created them? Gerard Costa, Ph.D.

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Is it Intentional, willful behavior?

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Is it anxiety, fear or reactive behavior?

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Is it sadness or depression?

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Is it a traumatic response?

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What are the experiences that determine the range of behaviors and “problems” that are generated, and the areas of the brain that are activated? Gerard Costa, Ph.D.

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AND What are the experiences

IN YOU that determine the range of ideas that are generated, and the areas of the brain that are activated? Gerard Costa, Ph.D.

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What do we see and what does it mean? How do we treat and help, if needed? What do we recommend?

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Wondering 

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Can the cause, meaning and intention behind the viewed behavior be for reasons other than we initially think? Can an infant, child or parent “activate” feelings and reactions within us? If so, where does these “come from”?   

Our own lives, our experiences, our “brains”? Our work with others? The stress we experience? Gerard Costa, Ph.D.

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Wondering 

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3/22/13

In the moment, can we attempt to RESPOND rather than REACT? Can we imagine the child’s behavior as stemming from “front end” factors (neurological, psychological, social)? How can we “See through the Eyes of the Child”? Gerard Costa, Ph.D. 2013

Trauma adversely effects the infant and child brain (e.g. Bruce Perry) Gerard Costa, Ph.D. 2015 74

The Neurodevelopmental Context of Exposure to Violence

Bruce D. Perry, MD, Ph.D. 

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Trauma adversely effects the infant and child brain by causing abnormal organization and function of important neural systems in the brain. Timing of trauma effects emerging brain systems and an understanding of these systems will influence the assessment process and selection of therapeutic interventions. Proper therapeutics are effective! Gerard Costa, Ph.D. 75 752015

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Bruce Perry: The ChildTrauma Academy, 5161 San Felipe, Suite 320, Houston, Texas 77056 Gerard Costa, Ph.D. 76 762015

Bruce Perry, MD, Ph.D. 

These images on the next slide illustrate the negative impact of neglect on the developing brain. In the CT scan on the left is an image from a healthy three year old with an average head size. The image on the right is from a three year old child suffering from severe sensory-deprivation neglect. This child’s brain is significantly smaller than average and has abnormal development of cortex. Gerard Costa, Ph.D. 77 772015

The Impact of Extreme Neglect on the Developing Brain Source: Bruce Perry http://www.childtrauma.org/CTAMAT ERIALS/neuros~1.asp

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From Mindsight (2010) The New Science of Personal Transformation

by Daniel J. Siegel

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German Proverb

“Don’t let fear make the wolf bigger than it is.” Gerard Costa, Ph.D. 2015

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How Children Succeed (2012) Paul Tough

The “firehouse” effect! The result of a chronic activation of the HPA system, and the prefrontal cortex is most affected! 

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What suffers? Executive Functioning! What happens? The “air-traffic” control system of our brain is derailed.(Shonkoff) Gerard Costa, Ph.D. 2015

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Two states of brain/mind 

Open receptive state (lid intact)

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Closed, reactive state (lid flipped)

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Which “side” will win and grow?

The one you feed the most. Gerard Costa, Ph.D. 2015

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Health Risks and Psychopathology

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Children with more early adverse esxperience are more likely to have a host of difficulties. Kids with more attachment difficulties have greater anxiety, anger, sadness, depression – all problems in emotional regulation

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ACE Studies

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10 ACE Factors    

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Emotional abuse Physical abuse Sexual abuse Emotional neglect Physical neglect

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Mother treated violently Household substance abuse Household mental illness Parental separation/divorce Incarcerated household member 85

The ACE (Adverse Childhood Experiences) Study Results published in over 50 scientific articles 

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Demonstrates link between violence-related stressors, including child abuse, neglect and repeated exposure to intimate partner violence and risky behaviors and health problems in adulthood. As the number of ACE a person experiences, the risk increases for a host of emotional, behavioral, health and violent outcomes. As ACE increases, so does history of increased suicide attempts. Gerard Costa, Ph.D.

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Imagining the world through the eyes of the child.

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Allan Schore

The mother’s limbic system communicates directly to the infant’s limbic system! Gerard Costa, Ph.D. 2015

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Impact on child….. 

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Child internalizes a core of negative affect, distrusts the caregiver and his/her own actions as effective. Child less interactive with people and objects Gender effects: boys receive more negative affect and appear to need more regulatory input Gerard Costa, Ph.D. 2015

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Hypothalamic-Pituitary Adrenal (HPA) Axis Fear Trauma Danger

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The way we must feed…..

Handout: Take Home Messages Gerard Costa, Ph.D. 2015

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The way we must feed…..

Be the change you wish to see in the world. -Gandhi

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The way we must feed…..  Never

speak to your babies in

rage.  When you make a mistake with your infant and child, apologize to the children. ! Gerard Costa, Ph.D. 2015

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The way we must feed….. 

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Always be conscious of you affect, your gestures, your movements, intonation and pacing as these are the things that are most powerful in what your child feels and learns from you. Your infant and children are ALWAYS “watching” you. Behave in ways that create “models” of what it is like to “be” with someone. They WILL be the world you create! Gerard Costa, Ph.D. 2015

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The way we must feed….. 

The ability for self-regulation, and to experience and express ALL emotions, is developed through loving, attuned and co-regulating relationships! These are the thousands of moments we spend in all areas of life with our children! Gerard Costa, Ph.D. 2015

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The way we must feed….. 

It is NOT just parents who form these abilities and the “inner life” of the childbut ALL those who form relationships with the infant, child and family – Infant and child care staff, EHS and Head Start, EI providers, teachers, home visitors, friends, family, neighbors.

ALL MEMBERS OF THE VILLAGE matter! Gerard Costa, Ph.D. 2015

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Will this baby become…..

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This?

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Or This?

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This?

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Or This?

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And remember:

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Attributed to Samuel J. Meisels, Ed.D., President, Erikson Institute. What we must answer in a compelling way?

So

What !

Who

Cares?

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Dr. Jeree Pawl

“How you are is as important as what you do!” Gerard Costa, Ph.D. 2015

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“If we are to reach real peace in this world, we shall have to begin with the children.” - Mahatma Gandhi Gerard Costa, Ph.D. 2015 134

Center for Autism and Early Childhood Mental Health Montclair State University College of Education and Human Services 14 Normal Avenue Montclair State University Montclair, New Jersey 07043 973-655-6675 Fax: 973-655-5376 Email: [email protected] Website: www.montclair.edu

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