The Disconnections and Connections of Adolescent Brain - - PowerPoint PPT Presentation

The Disconnections and Connections

• f 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 financial disclosures

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The brain in action

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Adolescent Brain Development & Some Strategies to Support it

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Adolescent Neurodevelopment

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ABCDStudy.org

Rosenberg, Nat Comm. 2018

Adolescent Brain Development

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EXPERIENCES:

• Life experiences
• Social environment

SKILLS:

• Unique biology
• Neurodevelopment

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Adolescence: Sensitive Period

“Biological systems undergoing rapid developmental changes are especially vulnerable to disorganizing influences.”

Lenroot & Giedd, 2006

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Adolescence: Pruning

O’Don ‘bac nt’

4–21

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Tau & Peterson, Neuropsychopharmacology, 2009.

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Amygdala

• EMOTIONAL

SIGNIFICANCE (fear and anger) Hippocampus

• MEMORY:

FACT/EVENT & EMOTIONALLY SALIENT Prefrontal Cortical Regions

• EXECUTIVE

FUNCTION Nucleus Accumbens

• REGULATION

OF MOTIVATION & DRIVES (pleasure)

LIMBIC SYSTEM:

• Smell
• Emotion
• Memory
• Drives
• Autonomic

(automatic function) & Neuroendocrine (stress response) Regulation

Regions of Most Change

Basal Ganglia

• BEHAVIOR

INITIATION, POSTURAL RESPONSE, HABITS

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Adolescence: Disproportional Maturation

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Casey, Dev Rev. 2008.

Limbic regions: emotional reactions, social connection

: motivation (sex, drugs, rock ‘n roll)

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Adolescence: Burgeoning Ability to Pursue Goals

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d‘: capacity to discriminate, select, and execute correct response

Insel, Nat Comm. 2017. August 29, 2018

Gardner & Steinberg, Dev Psychology, 2005.

Adolescence: Reactive to Peer Influence

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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

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Adolescent Brain Development:

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EXPERIENCES:

• Life experiences
• Social environment

SKILLS:

• Unique biology
• Neurodevelopment

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“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 16 August 29, 2018

Neurodevelopment: Individualized

• Adaptation
• Experience

independent & Experience dependent processes

• Impacts

experience

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Adolescent Functional Tasks

• Self-control

strengthening

• Reflective capacity,

empathy

• Moral development
• Executive function

maturation

• Identity formation
• Individuation
• Independence

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The Creation of Crow, Bartow

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Impact of Adversity and Trauma

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“Responsive relationships are developmentally expected and biologically essential.”

Harvard Center on the Developing Child: Working Paper 12: The Science of Neglect

Impact of Trauma and Adversity

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Andersen & Teicher. Trends in Neurosci, 2008.

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Impact of Resilience, Post-Traumatic Growth, Culture, Connection

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Some Strategies to Support Adolescent Brain Development

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Create Connection & Reflection

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Help me understand you? What are you up to?

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• REGULATE

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• RELATE
• REASON

Curiosity, connection, collaboration Problem solving

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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

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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

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REASON

• Youth-led problem solving
• Listen, not lecture
• Work with youth’s motivations
• Validate rationale
• Peer teaching and learning
• If supportive and productive

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From the Mad River to the Little Salmon River, or The Responsibility of Raising a Child. Bartow

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Thank You