Saturday, November 22, 2008

Celebrated psychiatrist to explain early childhood trauma theory

IF A child has behavioural problems such as impulsivity, aggression or attention-seeking, the roots are often in some kind of childhood trauma.

But can bad experiences in the early years affect the physiology of the brain, "rewiring" it, and influencing a child's future health and happiness?

That's the view of Dr Bruce Perry, a leading child psychiatrist who is taking part in a series of one-day conferences next week.

Dr Perry is the senior fellow at The Child Trauma Academy (CTA) in Texas. The co-author of the book The Boy Who Was Raised As a Dog: What Traumatised Children Can Teach Us About Loss, Love and Healing, he is regularly called to advise after major crises in the United States.

He counselled children involved in the Waco siege in Texas, the Columbine school massacre, the 9/11 attacks and the Oklahoma City bombings. He was vocal after Hurricane Katrina struck New Orleans about the need to address child trauma or face a greater social cost later on.

Perry's talks at four one-day conferences in Paisley next week will be the only open events he takes part in while he is in the UK, and have attracted participants from as far afield as Wales and Shetland.

Attendees will come to hear less about his high-profile work than his ongoing efforts to map out the true cost of trauma in early life and the sometimes unexpected ways he advises reversing that damage.

That includes non-traditional mental health interventions such as yoga, therapeutic massage and movement. This approach assesses the stage children are on in terms of motor, cognitive and emotional development, for example, then "matches patterned repetitive activities to the systems/areas of the brain impacted by the developmental trauma," Perry explains.

The approaches are based on an understanding of the impact of trauma on different parts of the brain which has grown out of research work at the CTA, initially carried out with older children, he explains. But gradually the research "crept backwards".

"When we tried to figure out how they ended up the way they are, we kept finding these relationships between the nature and intensity of their developmental trauma and their functioning." As children with problems in the US increasingly began to be picked up as soon as they entered formal systems such as school, the realisation grew that many were suffering from forms of mental illness.

"Infant mental health is a very new field. Most young children are not in a position to tell people they have mental health issues, but when they can tell you, they are articulate about the specifics of their problems."

In terms of demonstrating the reality of what he and colleagues are suggesting, new imaging techniques are helpful, Perry says. "Colleagues are looking at various aspects of brain functioning and in extreme cases you can see differences in things like size of the brain, its physical structure, and how things are organised."

In America, when pupils are disruptive, the typical response has been to diagnose syndromes such as ADHD, and blame impulsivity or attention seeking, Perry adds. "I think the label of ADHD is overused in the US and the use of medications is sloppy. Some children who might benefit from medications are not getting mental health access and many children with access are inappropriately medicated, when other interventions would be safer and more effective," he explains.

While his high-profile consultancy roles get media attention most of Perry's work is to do with children raised in ordinary homes. He says: "Trauma can occur where there is a parent struggling with substance abuse or domestic violence, and so don't parent the kids appropriately.

"We can be involved where there hasbeenphysicalabuse,child sexual abuse or neglect."

At the Scottish conferences, Perry will explore concerns about the "relational poverty" which he argues has become the norm for many western children. Whereas children used to be raised in multi-family inter-generational groups that is less common now, he says. Instead, children spend longer in child-rearing settings where a lone adult is shared between a large group.

When family fragmentation and geographical spread are taken into account, Perry says, "our children are having far fewer opportunities for social-emotional and relational learning opportunities. This means that the systems in the brain which mediate empathy, nurturing and the capacity to form and maintain healthy relationships are often not getting the stimulation required."

He warns that everyone concerned with young people needs to re-evaluate the way they are living. "Do we have enough family meals, do we regulate access to television? Do we spend the quantity and quality of time with our children that we should? Do we allow public systems to continue to dilute the ratio of teacher to student?"

"We have a lot of broader cultural elements we should examine in light of the things we are learning about development."

Dr Bruce Perry is key speaker at four one-day conferences running from November 3 to 6 in Paisley. The event is hosted by Kibble, Scotland's Specialist Centre for Young People at Risk. For details, visit

Source: The Herald

Also see: Cuddles give tiny brains a head start
Instinct rules trauma victims
Leaders are mindful of kid's needs

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