Saturday 10 April 2010
Bruce Perry (USA)
Senior Fellow, The Child Trauma Academy, Texas
"The Neurodevelopmental Impact of Childhood Maltreatment: Implications for Programs, Practice, and Policy"
Experience shapes the organization of the developing child’s brain, which, in turn, influences the functional capacity of brain-mediated emotional, social, cognitive and physiological activities. Developmental trauma has profound impact on these normal developmental processes resulting in a host of neuropsychiatric (and other) sequelae. Insights into this process can be gained by understanding the sequential and use-dependent process of brain organization. Deprivation or abnormal patterns of sensory stimuli during critical periods of development results in altered brain organization and functioning. During an acute traumatic experience, abnormal or extreme patterns of activation of heterogeneous stress response patterns during these critical periods can lead to alterations in the neural networks mediating these adaptive responses. The unique pattern of activation of the two inter-related stress response patterns – hyperarousal (“fight or flight”) and dissociation during the acute event will predict the nature of the long-term neuropsychiatric sequelae. In many cases the adaptive balance of hyperarousal and dissociation can “neutralize” the toxic effects of an acute traumatic experience. Further, due to the sequential nature of neurodevelopment, similar “traumatic” experiences occurring at different times during development will impact the brain differently. The complex array of trauma-related sequelae in emotional, behavioral, social and physiological functioning can be understood in context of this “use-dependent” and “neuroarcheological” perspective. This presentation will review clinical work and research in the areas of abuse and neglect which support a neuroarcheological view of trauma. An introduction to a neurodevelopmentally-informed approach to clinical work, the Neurosequential Model of Therapeutics (NMT), will be provided, suggesting new directions for clinical practice, program development and social policy initiatives.
