(精选)【医学英文课件】 Keeping children’s minds in mind ：Mental health needs of children in care教学课件.pptVIP

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2018-03-21 发布于天津
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(精选)【医学英文课件】 Keeping children’s minds in mind ：Mental health needs of children in care教学课件.ppt

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Keeping children’s minds in mind:Mental health needs of children in care * Brain and neurobiological development. How might this change the way we think and what we do? How does early adversity and developmental trauma impact upon us as adults? Implications for Court, clinicians and services. * These images illustrate the negative impact of neglect on the developing brain. The CT scans on the left are from healthy three year old children with an average head size (50th percentile). The image on the right is from a series of three, three year old children following severe sensory-deprivation neglect in early childhood. Each child’s brain is significantly smaller than average and each has abnormal development of cortex (cortical atrophy) and other abnormalities suggesting abnormal development of the brain. From Perry, B. D. (2002) Childhood experience and the expression of genetic potential: What childhood neglect tells us about nature and nurture. Brain and Mind, 3: 79-100 * Hypothalamus-Pituitary-Adrenal (HPA) Axis Complex system controlling reactions to stress. Linked to release of adrenaline, increased heart rate, blood pressure and cortisol. Dysregulation/sensitivity if individual has suffered significant abuse (Dozier et al., 2006; Fisher and Stoolmiller, 2008). * Orbitofrontal cortex Executive functioning Last region to fully develop, implicated in inhibition, self-regulation, emotional recognition Maltreated children present with reduced grey matter in medial orbitofrontal cortex * Polyvagal theory Evolution of nervous system. First developed immobilised defensive responses (parasympathetic), then evolved to enable mobilised responses (sympathetic), and final branch regulates physiological state during social interactions. These responses in children are hierarchical, depending upon the success of more evolved responses. * How might this change the way we think? The most important task is to develop a clinically informed framework for understandi