Early Neglect and Child Development

Early Neglect and Child Development: Randomized trail compares children in institutions with those in foster care Summarized by Arthur Becker-Weidman, PhD Severe neglect and institutional care cause significant difficulties in attachment, biology, cognitive functioning including executive and neuropsychological functions, and behavioral and emotional regulation. Studies of children in Romanian orphanages and other settings have demonstrated the pervasive and negative impact of such neglect on various domains of child development. Those of us who work with such children know the complexities of helping families with these children. Their difficulties may include disturbed patterns of attachment, sensory-integration dysfunction, various neuropsychological impairments, mental health issues, and problems with emotional and behavioral regulation. These children are extremely challenging to work with and their families need comprehensive and supportive treatments. The Bucharest study, led by Charles Nelson, III, Nathan Fox, and Charles Zeanah, Jr., is a randomized trial comparing the emotional and physical well being of institutionalized children with those place in foster homes. The study involved 136 children in orphanages in Romania. The average age was 22 month, ranging from 6 to 31 months of age. All children selected were free of neurological, genetic, and other birth defects based on a study-team pediatrician's examination. The children selected then has a series of baseline physical and psychological assessment. Half the children were randomly assigned to foster care while the other half remained in the institution. The children placed in foster care were placed in homes that had been recruited, trained, financed, and maintained by the study team. This would be considered high quality foster care. The study team also recruited a third group of typically developing children who lived with their birth families and who had never been institutionalized. The study went on for ten years. One important finding that has significance not only for institutionalized children, but for all children who experience maltreatment is that there sensitive periods during which environmental influences are particularly powerful. The study found that the average IQ of the institutionalized children, measured at thirty, forty, and fifty-two months was in the low to middle 70's while it was ten points higher for the children in foster care. In other words, after only between eight and thirty months longer in an insitutional setting, there was about a 12.5% drop in IQ. The average IQ for the group of children never institutionalized was 100; or about 20% than the children in foster care. Or, to put it differently, about two years in an institution is associated with a 30% lower IQ. The sensitive period seems to be the first two years. The study found that a child placed in a home before two years of age had a significantly larger gain in IQ than a child placed in foster care after two years of age. The study measured attachment and found that the institutionalized children displayed incompletely formed and aberrant relationships with care-givers. However children place in foster care, at 42 months of age (after an average of 20 months in foster care) displayed major improvements in making emotional attachments. About half the children in foster care demonstrated secure attachments while only eighteen percent of the child in institutions demonstrated secure attachments. Sixty-five percent of the children never placed in institutions displaced secure attachments. This seems to demonstrate the capacity of healing relationships to help remedy these significant early deficits. However, as with IQ, children placed in foster care before two years of age were more likely to form secure attachments when compared with children placed after two years of age. Foster care had a major influence on levels of anxiety and depression; reducing their incidence by half. The more secure the attachment between the child and foster parent, the greater probability that the child's symptoms would be reduced. The study examined brain activity using an EEG. They found that infants in institutions has significant reductions in alpha and heightened theta waves, which they stated reflect delayed brain maturation. When measured eight years later they found that children placed in foster care before two years of age showed no difference in EEG when compared with children never in an institution. Children who remained in the institution and those placed in foster care after two years of age showed EEG patterns reflecting delayed brain maturation. Institutionalized children had smaller brain volumes. Finally they examined telomeres, regions at the ends of chromosomes that provide protection from the stresses of cell division and which are shorter in people who have experienced extreme psychological distress than in those who have not experienced such stresses. Children who spent any time in an institution had shorter telomeres than those who had not. REFERENCES Almas, A., et. al., (2012). Effects of Early Intervention and the Moderating Effects of Brain Activity on Institutionalized Children's Social Skills at Age 8. Proceeding of the National Academy of Sciences, 109 (2), 17,228-17,231. Nelson, C., (2007). Cognitive Recovery in Socially Deprived Young Children: The Bucharest Early Intervention Project. Science 318, 1937-1940. Scientific American (2013). How Adversity Affects Young Children www.ScientificAmerican.com/apr2013/orphans, accessed May 11, 2013.

Attachment Focused Treatment Institute Growing

The Attachment Focused Treatment Institute's Certification is growing by leaps and bounds. We have quite a large group on the listserv. Of that group there are about 20 Certified Attachment-Focused Psychotherapists and Family Therapists and five certified Attachment-Focused Consultants. There are two Certified Attachment-Focused Organizations and three in process. The Institute, based at the Academy for Human Development, a University in Singapore, is the one of the few certification programs that is University based. The program certifies therapists who practice Attachment-Focused Treatments, such as Dyadic Developmental Psychotherapy.

Attachment-Focused Treatment Institute

A collaboration between the Academy for Human Development's Graduate Counseling program (a University in Singapore) and the Center for Family Development. This Institute provides training and certification in Attachment-Focused Therapy, Attachment-Focused Family Therapy, and certification as an Attachment-Focused Professional (for residential treatment center milieu staff, teachers, therapeutic foster parents, occupational therapists, and others who wish to use attachment-facilitating methods in their work. In addition, the Institute providers certification for organizations (Group Homes, Foster Care agencies, Residential Treatment Centers, Wilderness Program, and Therapeutic Boarding Schools as a Certified Attachment-Focused Organization. See the Institute's Facebook page.

The Dyadic Developmental Psychotherapy Primer

The Dyadic Developmental Psychotherapy Primer is now out in print and Kindle at Amazon. This book describes the principles of Attachment-Focused Treatment, the components of treatment, and the differential use of those 14 components in the five phases of treatment. It is essential a treatment manual, with many clinical examples, describing the essential elements of attachment-focused family therapy.

Attachment Focused Treatment Institute

The Center for Family Development, in conjunction with a University, the Academy of Human Development in Singapore, has opened the Attachment-Focused Treatment Institute. The Institute offers three levels of certification:
Attachment-Focused Therapist
Attachment-Focused Family Therapist
Attachment-Focused Professional


The Attachment-Focused Treatment Institute was founded to provide training and certification in treatment methods based on attachment theory. Attachment-Focused Treatment includes psychotherapy, family therapy, and work by other professionals using the principles of attachment theory to guide interventions, treatment, and programs.

Certification is offered in conjunction with the Academy of Human Development, a university in Singapore, and The Center for Family Development. CEU’s are awarded through the University and the Board of Psychology, Indiana.

There are three Certifications offered: Certified Attachment-Focused Therapist, Certified Attachment-Focused Family Therapist, and Certified Attachment-Focused Professional. The Therapist Certification is for mental health providers. The Professional Certification is for residential treatment center staff, therapeutic foster carers, educators, and others who wish to use Dyadic Developmental Psychotherapy and Attachment-Focused Treatment methods in their work.

Certification by the Institute means that the professional has completed a comprehensive course of advanced study in the application of attachment theory and the latest advances in interpersonal neurobiology to treatment, parenting, programming, and practice.

Attachment-Focused Treatment is grounded in attachment theory, the neurobiology of interpersonal experience, and uses methods and principles from Dyadic Developmental Psychotherapy.

Dyadic Developmental Psychotherapy is an evidence-based, effective, and empirically validated treatment that is grounded in current thinking and research on the etiology and treatment of Complex Trauma or Developmental Trauma Disorder and disorders of attachment. It is now recognized as a general approach to treatment. Treatment is primarily experiential. Teaching parents about attachment-facilitating parenting methods and the importance of attunement and responsive, sensitive parenting is essential.
STEPS TO BECOME CERTIFIED
There are two components to certification. The first is completion of the required number of approved training hours (48), which can be completed through the SKYPE Master Class. The second is the consultation component in which the applicant's work is reviewed to assess how the material is being applied in practice.

Attachment-Focused Therapist & Attachment-Focused Family Therapist
1. Complete 48 hours of training
2. Provide evidence that you are authorized to practice in your jurisdiction, evidence of applicable insurance, singed attestation form.
3. Completion of the Consultation-Practicum: review of a minimum of six DVDs.

Attachment-Focused Professional
1. Complete 48 hours of training.
2. Letter from your supervisor approving your participation in the Institute's certification program.
3. Completion of the Consultation-Practicum: review or observation of a minimum of four DVDs.

Certification is valid for three years. Re-certification requirements include either attending an Advanced Practice Seminar (3 hours) or having one DVD illustrating your work reviewed by a consultant.

Presentation at CALO

I Will be presenting at CALO in April as their keynote speaker for their annual conference. See:
http://caloteens.com/blog/post/Professional-Conference.aspx
This is their annual conference and will be held April 12 & 13 2012.

Assessing Complex Trauma: Webinar

Assessing Complex Trauma

This workshop will describe a three session model for the assessment of Complex Trauma (aka Developmental Trauma Disorder). A brief description of what is Complex Trauma and its effects on child development and the importance of parenting will be followed by a presentation of the assessment protocol. This assessment protocol is multi-modal and uses data from records, caregivers, various psychometric instruments. Screening of the various domains of possible impairment is an essential element of this protocol.

This workshop will only be available through Webinar (instructions on how to access the Webinar will be provided upon registration)

Date: June 15th, 2012 10:00am – 11:30am

Workshop Leaders:

Arthur Becker-Weidman, Ph.D., Center for Family Development

Emily Becker-Weidman, PhD, Child Study Center, New York University





To register, please complete the attached registration form and send to Maribel Cruz

(p) 212-660-1318

(f) 212-660-1319

Email: MaribelC@nyfoundling.org

Vincent J. Fontana Center for Child Protection

27 Christopher Street, New York, NY 10014
The New York State
Chapter of American
Professional Society on the Abuse of Children
Presents
The 2011/2012
Child Abuse
Workshop Series
Co-Sponsored by
The New York Foundling
Vincent J. Fontana Center for Child Protection
Villano Conference Center
27 Christopher Street
New York, New York 10014
www.nyfoundling.org/fontana-center
Workshops
1. Preventing Foster Home Disruption: A Programmatic Approach
This workshop is for mental health clinicians, case planners, supervisors and administrators working in the child welfare system. The workshop will identify the risk factors that contribute to foster home disruption and describe clinical and social service interventions designed to
stabilize the foster home and prevent disruption of the foster home.
Date/Time: October 24, 2011 10:00am to 11:30am
Workshop Leader: Mel Schneiderman, Ph.D
Director of Mental Health Services
New York Foundling
Co-founder Vincent J. Fontana Center for Child Protection
2. Forensically Defensible Child Sexual Abuse Evaluations
This workshop, presented by a defense attorney, will focus on issues which arise in the context of child sexual abuse litigation including Parental Alienation “Syndrome,” the suggestibility of children, allegations of child sexual abuse in the context of divorce/custody proceedings, proper forensic interviewing, the professional ethics of mental health professionals maintaining proper records, and other issues.
Date/Time: December 5, 2011 10:00am to 12pm
Workshop Leader: Lawrence Jay Braunstein Esq.
Partner in the Firm of Braunstein & Zuckerman, Esq.
3. Common Myths and Clinical Realities of Child Maltreatment
Child abuse is the physical, sexual, emotional mistreatment or neglect of children. This
workshop will provide a multi-disciplinary forum to explore commonly held beliefs that can
often derail the process of obtaining the best outcomes for a child who has experienced any of these forms of child abuse. Through case-based discussion interspersed with brief didactics we will explore common myths as they relate to each of the forms of child maltreatment while
integrating findings from the literature in the field.
Date/Time: February 3, 2012 10am to 12pm
Workshop Leader: Ingrid Walker-Descartes, MD, MPH, FAAP
Maimonides Infants and Children’s Hospital of Brooklyn Child Abuse Pediatrician
Attending - Pediatric Ambulatory Division
Program Director - Pediatric Residency Training Program
4. Evidence-Based Mental Health Interventions for Child Abuse
This workshop will describe the current state of evidence-based mental health interventions for childhood abuse. Childhood models of PTSD and other sequelae will be described briefly. Em-pirically supported treatment for child sexual abuse, physical abuse and emotional/psychological abuse will be reviewed. Critical issues in treating youth will be described and finally national and state dissemination efforts will be noted, with focus on how New York State can adopt best prac-tices for the treatment of abused children.
Date/Time: April 2, 2012 10am to 11:30am
Workshop Leader: Komal Sharma-Patel, PhD
Assistant Director of Research
PARTNERS Program
St. John’s University
5. Integrating Prevention into Your Practice: American Professional Society on the Abuse of Children Prevention Guidelines
While much of professional practice has the objective of preventing further maltreatment, it is often difficult to understand how to best incorporate prevention activities into our work. This workshop will be hosted by a member of the American Professional Society on the Abuse of Children Board Prevention Task Force who will review current evidence and best practices in the child maltreatment field and discuss guidelines to assist professionals in integrating preven-tion into their work.
Date/Time: May 1, 2012 10am to 11:30am
Workshop Leader: Vincent J. Palusci, MD MS
Professor of Pediatrics at NYU School of Medicine
Child Abuse Pediatrician at the Frances L. Loeb Child
Protection and Developmental Center at Bellevue Hospital
6. Assessing Complex Trauma
This workshop will describe a three session model for the assessment of Complex Trauma (aka Developmental Trauma Disorder). A brief description of what is Complex Trauma and its effects on child development and the importance of parenting will be followed by a presentation of the assessment protocol. This assessment protocol is multi-modal and uses data from records, care-givers, various psychometric instruments. Screening of the various domains of possible impair-ment is an essential element of this protocol.
This workshop will only be available through Webinar
Date and Time to be announced
Workshop Leaders: Arthur Becker-Weidman, Ph.D.
Center for Family Development
Emily Becker-Weidman, PhD
Child Study Center, New York University
The New York State Chapter of
American Professional Society on the
Abuse of Children
The New York State Chapter of the American Professional Society on the Abuse of Children provides an opportunity for professionals in New York State to meet, share ideas and experiences, develop strategies for improving
professional services to clients, influence public policy and educate the public, other professionals, and policy makers about child maltreatment.
The New York Foundling
Vincent J. Fontana Center
for Child Protection
The Fontana Center supports the mission and values of The New York Foundling by serving as the advocacy,
public policy, research, professional and community
education arm of the agency.
The Center’s mission is to eliminate child maltreatment through the identification and promotion of evidence based primary prevention and treatment strategies. To achieve this objective, The Fontana Center engages in
research, professional training, community education and advocacy.
Registration Form
Please, indicate which workshop you would like to register for below.
1._____Preventing Foster Home Disruption: A Programmatic Approach
(October 24, 2011 10:00am to 11:30am)
2. Forensically Defensible Child Sexual Abuse Evaluations
(December 5, 2011 10:00am to 12pm)
3._____Common Myths and Clinical Realities of Child Maltreatment
(February 3, 2012 10am to 12pm)
4._____Evidence-Based Mental Health Interventions for Child Abuse
(April 2, 2012 10am to 11:30am)
5. Integrating Prevention into Your Practice: APSAC Prevention Guidelines (May 1, 2012 10am to 11:30am)
6._____Assessing Complex Trauma: Webinar Only
(Date: TBA)
There is no fee for New York State APSAC members or for NY Foundling staff.
There is a $10.00 fee for all non NYS APSAC members.
Please make check payable to:
Vincent J. Fontana Center for Child Protection
All workshops will be held at the Vincent J. Fontana Center for Child Protection
at 27 Christopher Street in Manhattan.
Subway stops: West 4th (A,C, E, F, B, D, M trains) or Christopher Street (1 train)
Send check and registration form to Maribel Cruz at:
maribelc@nyfoundling.org
Vincent J. Fontana Center for Child Protection
27 Christopher Street, New York, NY 10014
Phone: 212-660-1318

Working with culturally diverse groups

I've been reading and thinking, recently, about work with culturally diverse groups and wonder if any of you do and what your experience has been.

In thinking about treatment it seems that family and DDP therapists (who are primarily European-American) may tend to:
* Allow and encourage expressing emotions freely and openly
* View each member as having a right to the member's own unique self: to individuate from the family as a primary unit of identity
* Strive for equal division of labor among members of the family
* Consider egalitarian role relationships between spouses as preferred
* Focus on the nuclear family as the standard.
* Value a present-future time perspective

A variety of other cultures have differing values and orientations (Asian, South-Asian, Black American, First Nations/Native American, Hispanic, to name a few).

It might be interesting to have a discussion about working with culturally diverse groups...if any of us do work with such groups (I do, so that's what prompted my readings and thinking).

regards

art

Spanking lowers IQ scores

A comprehensive study of the literature in the Canadian Medical Journal finds that spanking children results in poor outcomes: lower IQ scores.

The arguments against spanking and corporal punishment are even stronger when considering its re-traumatizing effects on children who have experienced complex trauma.

Attachment Therapy Companion

The book I wrote with 2 colleagues, Attachment Therapy Companion, will be out in July an is now listed on the Norton website:

http://books.wwnorton.com/books/Attachment-focused-Therapy/

The book is meant to be a statement of best practice in the provision of attachment focused therapy. It described the theory base for this approach, appropriate and evidence-based principles for evaluation and treatment, and ethical principles of practice.

It is a must read for anyone practicing treatment grounded in attachment theory.

Training in Complex Trauma for Value Behavioral Health Providers

I'm in Pittsburgh now, November 17, 2011. I'll be doing a presentation for Value Behavioral Health about evaluating and treatment Complex Trauma tomorrow. VBH manages the Medicaid contract for the State of PA for Western PA, so there will be about 350 providers at the training.

Attachment Therapy Companion

I've just heard that a book I wrote with two colleagues,
The Attachment Therapy Companion: Key Practices for Treating Children
& Families
is now in production and should be out in early 2012. The book
describes what are the standards of care for this treatment.
From the Introduction:

This book is an important contribution to the field of trauma
treatment and attachment-focused the therapy. It provides the
clinician with a framework to assess, develop treatment plans, and
provide treatment in a comprehensive and integrated manner. College
professors are afforded a guide for classroom instruction. The book
will provide consumers with the necessary tools and information to
make better informed decisions regarding the adequacy of care they are
getting. College professors will find this book a useful adjunct for
family therapy, treatment, and ethics classes and the study guide will
assist in classroom instruction. Finally the book will provide judges,
child welfare professionals, insurance companies, and others with a
framework for evaluating proposed plans of care. It is my belief that
this book will mark a new stage in the development of attachment-
focused therapy by delineating what are the standards of care for the
treatment of attachment and trauma disorders.

Tips for parents

Tips for parents on Halloween safety:

http://www.huffingtonpost.com/mary-l-pulido-phd/protecting-kids-first-a-s_b_991354.html

New Book on the Practice of Attachment-Focused Therapy

Dr. Becker-Weidman is one of the editors of a new book to be published early in 2012 on the professional practice of attachment-focused therapy. The two other editors are Lois Ehrmann and Denise LeBow. The book will serve as a practice manual defining standards of care. The book will be a valuable resource for social workers, psychologists, mental health practitioners, departments of social services, child welfare organizations, judges, and attorneys. The book's table of contents will be:
Chapter 1: Terminology and Diagnosis
Chapter 2: Purposes and Scope of Guide
Chapter 3: Overview of Attachment Theory: Synopsis of Key Concepts
CHAPTER 4: Overview of Attachment-Focused Therapy
CHAPTER 5: Core Concepts of Trauma and Trauma Focused Therapy
CHAPTER 6: Intake, Screening, & Referral
CHAPTER 7: Assessment of Children With Attachment Issues
CHAPTER 8: Treatment Planning
CHAPTER 9: Considerations in Behavior Management
CHAPTER 10: Training, Consultation, and Competency
CHAPTER 11: Ethical Considerations in Attachment Focused Therapy
CHAPTER 12: Vicarious Trauma and the Clinician’s Responsibility for Self Care
References
Glossary
Appendix A: Paper on Coercion in Treatment
Appendix B: Screening and Assessment Tools
Appendix C: Out-of Home Placements
Appendix D: Study Guide

Dr. Becker-Weidman to present two days in Northern California

Dr. Becker-Weidman will be presenting a workshop, "Healing Trauma and Attachment Disorders" at two locations in Northern California Oct 14 & 15.

Dr. Becker-Weidman in Saratoga Springs

Dr. Becker-Weidman will be presenting a community workshop, "Complex Trauma: A Community Approach"- Implications for Treatment, Parenting, Child Welfare, Family Court and Education"
in Saratoga Springs on October 20, 2011.

Dr. Becker-Weidman @ Justice For Children in Syracuse

Dr. Becker-Weidman will be presenting at the 2011 Building Justice for Children Conference in Syracuse October 25-27. He will be talking about Assessing Children's mental health and trauma issues.

A cool website for 3D images of the Brain

I found this cool website and thought you'd be interested in it.

3D Brain images


http://www.g2conline.org/2022

What is Attachment?

The attachment system, is a biologically based system that evolved to ensure the survival of the human infant. In simple terms, it is a proximity seeking system. When a child is threatened, the child will seek its primary caregiver who provides a sense of safety and security.

The organization ATTACh (Association for the Treatment and Training of Attachment in Children) gives the following lengthier definition of attachment:
“Attachment is a reciprocal process by which an emotional connection develops between an infant and his/her primary caregiver. It influences the child’s physical, neurological, cognitive, and psychological development. It becomes the basis for development of basic trust or mistrust, and shapes how the child will relate to the world, learn, and form relationships throughout life.”

Complex Trauma: A community Approach

Dr. Becker-Weidman will be presenting two day-long workshops in California:


Arthur Becker -Weidman, Ph.D.
Friday, October 14, 2011
9:00 AM—4:00 PM
Chi co Masonic Fami ly Cente r
1110 W. East Avenue , Chi co CA
Please RSVP to (530) 879-3861 or ldamschroder@sierraff.org
This FREE training is made available through the collaborative efforts of
Sierra Forever Families & California Department of Social Services
Childcare Reimbursement Available call Leslie 879-3861 for more information
Arthur Becker-Weidman, Ph.D. is a Diplomat in Child Psychology and Forensic Psychology, the American Board of Psychological Specialties. He is a Registered Clinician with the Association for the Treatment and Training in the Attachment of Children and is a Certified Therapist, Consultant, and Trainer of Dyadic Developmental treatment®. Dr.
Becker-Weidman has edited and authored four books: Creating Capacity for Attachment (2005/2008), Attachment Parenting (2010), Dyadic Developmental Psychotherapy: Essential Practices & Methods (2010), and The Dyadic Developmental Psychotherapy Casebook (2011). He has four DVD's. Dr. Becker-Weidman is on the Board of Directors of the Association for the Treatment and Training in the Attachment of Children where he serves on several committees. Dr. Becker-Weidman provides training and workshops to parents, professionals, and governments across the U.S. and internationally.
These learning objectives will be addressed:
Participants will be able to describe how parent-child attachment normally develops
Participants will identify the seven domains of impairment caused by Complex Trauma
Participants will be able to identify three general principles of parenting & treatment grounded in attachment-theory & Dyadic Developmental Psychotherapy
Participants will be able to use two new interventions to help parents with children with trauma and attachment disorders
Participants will be able to describe one key element of Dyadic Developmental Psychotherapy and be able to use it in their practice
Parents will be be able to describe the fundamental principles of attachment-facilitating parenting.
Parents will be able to implement at least two attachment facilitating interventions
Course meets qualifications for 6 hours continuing
education credit for MFT’s & LCSW’s as required by the Board of Behavioral Sciences