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The Disconnections and Connections of Adolescent Brain - PowerPoint PPT Presentation

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The Disconnections and Connections of Adolescent Brain Development Margaret Cary, MD, MPH King County Behavioral Health and Recovery Division, DCHS Best Starts for Kids mcary@kingcounty.gov Disclosures No conflicts of interest or

  1. The Disconnections and Connections of Adolescent Brain Development Margaret Cary, MD, MPH King County Behavioral Health and Recovery Division, DCHS Best Starts for Kids mcary@kingcounty.gov

  2. Disclosures No conflicts of interest or financial disclosures Cary: SBH Retreat August 29, 2018 2

  3. The brain in action Cary: SBH Retreat August 29, 2018 3

  4. Adolescent Brain Development & Some Strategies to Support it Cary: SBH Retreat August 29, 2018 4

  5. Adolescent Neurodevelopment ABCDStudy.org Rosenberg, Nat Comm. 2018 Cary: SBH Retreat August 29, 2018 5

  6. Adolescent Brain Development EXPERIENCES: SKILLS: - Life experiences - Unique biology - Neurodevelopment - Social environment Cary: SBH Retreat August 29, 2018 6

  7. Adolescence: Sensitive Period “Biological systems undergoing rapid developmental changes are especially vulnerable to disorganizing influences.” Lenroot & Giedd, 2006 Cary: SBH Retreat August 29, 2018 7

  8. O’Don ‘bac nt’ Adolescence: Pruning 4–21 Tau & Peterson, Neuropsychopharmacology, 2009. Cary: SBH Retreat August 29, 2018 8

  9. Regions of Most Change Prefrontal LIMBIC SYSTEM: Cortical Regions • EXECUTIVE • Smell Hippocampus FUNCTION • MEMORY: • Emotion FACT/EVENT & • Memory EMOTIONALLY SALIENT • Drives • Autonomic (automatic Basal Ganglia • BEHAVIOR function) & INITIATION, Amygdala Neuroendocrine POSTURAL • EMOTIONAL RESPONSE, (stress response) SIGNIFICANCE HABITS (fear and anger) Regulation Nucleus Accumbens • REGULATION OF MOTIVATION & DRIVES (pleasure) Cary: SBH Retreat August 29, 2018 9

  10. Cary: SBH Retreat August 29, 2018 10

  11. Adolescence: Disproportional Maturation Limbic regions: emotional reactions, social connection : motivation (sex, drugs, rock ‘n roll) Casey, Dev Rev. 2008. Cary: SBH Retreat August 29, 2018 11

  12. Adolescence: Burgeoning Ability to Pursue Goals d‘: capacity to discriminate, select, and execute correct response August 29, 2018 Cary: SBH Retreat 12 Insel, Nat Comm. 2017.

  13. Adolescence: Reactive to Peer Influence Gardner & Steinberg, Dev Psychology, 2005. Cary: SBH Retreat August 29, 2018 13

  14. Adolescents: • Are in a sensitive & unique developmental stage • Period of rapid change • Pruning and refinement • Cannot always act on their knowledge of risk and reward • Developmental imbalance between the executive function regions and emotionally & socially responsive regions • Not impulsive, differently-motivated • Particularly motivated by emotionally-driven priorities and social connection Cary: SBH Retreat August 29, 2018 14

  15. Adolescent Brain Development: EXPERIENCES: SKILLS: - Life experiences - Unique biology - Neurodevelopment - Social environment Cary: SBH Retreat August 29, 2018 15

  16. “A cell is a machine for turning experience into biology.” Steve Cole, quoted in Dobbs, The social life of genes. Pacific Standard, 2014. Cary: SBH Retreat August 29, 2018 16

  17. Neurodevelopment: Individualized • Adaptation • Experience independent & Experience dependent processes • Impacts experience Cary: SBH Retreat August 29, 2018 17

  18. Adolescent Functional Tasks • Self-control strengthening • Reflective capacity, empathy • Moral development • Executive function maturation • Identity formation • Individuation The Creation of Crow, Bartow • Independence Cary: SBH Retreat August 29, 2018 18

  19. Impact of Adversity and Trauma “Responsive relationships are developmentally expected and biologically essential.” Harvard Center on the Developing Child: Working Paper 12: The Science of Neglect Cary: SBH Retreat August 29, 2018 19

  20. Impact of Trauma and Adversity Andersen & Teicher. Trends in Neurosci, 2008. Cary: SBH Retreat August 29, 2018 20

  21. Impact of Resilience, Post-Traumatic Growth, Culture, Connection Cary: SBH Retreat August 29, 2018 21

  22. Some Strategies to Support Adolescent Brain Development Cary: SBH Retreat August 29, 2018 22

  23. Create Connection & Reflection What Help me are you understand up to? you? Cary: SBH Retreat August 29, 2018 23

  24. • RELATE • REASON • REGULATE Curiosity, connection, collaboration Problem solving Cary: SBH Retreat August 29, 2018 24

  25. REGULATE • Statements , not questions • Smile. Say, “Hi” or “Nice to see you.” • Talk with individuals , not groups • To allow regulation, not separation • To attend to individual life experiences and skills • Be clear with your goal : stop behavior or behavior change • Regulate own emotions first • Just Breathe video by Bayer Salzman & Salzman Strike when the iron is cold Cary: SBH Retreat August 29, 2018 25

  26. RELATE • Foster curiosity , connection, collaboration • Remember what it was like to be an adolescent • Model authentic connection • Narrate your experience & expectations • Reinforce positives • Effective behaviors and things that are going well Cary: SBH Retreat August 29, 2018 26

  27. REASON • Youth-led problem solving • Listen, not lecture • Work with youth’s motivations • Validate rationale • Peer teaching and learning • If supportive and productive Cary: SBH Retreat August 29, 2018 27

  28. Thank You From the Mad River to the Little Salmon River, or Cary: SBH Retreat August 29, 2018 28 The Responsibility of Raising a Child . Bartow

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