Transcript of Early Ripples Module 5

Slide 1: Carol West: Hello, I'm Carol West from the Child Development department at Humboldt State University, and this is Module Five of Early Ripples: The effects of ACEs on children zero to five.  Module Five is The Power of Relationships.

Slide 2: Carol West: The learning objectives for this module are: That process participants will be able to understand the significance of relationships in experiencing adverse childhood experiences, understand the impact of relationships on young children's development as well as their mental and physical health, and they will be able to describe how relationships can act as a protective factor for very young children.

Slide 3: Carol West: Relationships are a fundamental aspect of human development and a protective factor in resilience.  Very young children are immensely vulnerable because they are completely dependent on adults for their very survival and their development is in a particularly sensitive state.   Even before children are born, they are connecting with important people in their environment. They hear the voices of their mother and people in their home, the sounds of pets, music, or conflict. The mother's emotional state impacts the child's before they have even met.

Slide 4: Carol West: Very young children's developmental status makes them particularly vulnerable to adverse childhood experiences. Bruce Perry said, “The same miraculous plasticity that allows young brains to quickly learn love and language unfortunately also makes them a highly susceptible to negative experiences as well.  The structure and function of the developing brain is dependent upon connection with caregivers.”

Slide 5: Carol West: Relationships are essential for development for well-being and for resilience.  Attachment relationships are significant to children's social and emotional development. This attachment relationship is also fundamental to the child's development of self-regulation, which is involved in a number of life skills like toilet training, taking turns, impulse control, and appropriate expression of strong emotions. The attachment relationship is formed and sustained over time by consistent timely nurturing care of the infant. The serve and return interaction pattern that begins developing soon after birth is the basis for attachment.

Slide 6: Carol West: A growing body of research is identifying the positive impacts of relational health on neuro-endocrine- immune -metabolic function.  Regarding the HPA axis and cortisol, responsive caregiving has been shown to inhibit HPA axis reactivity in the presence of stressors.  Interventions that promote responsive parenting have been shown to improve cortisol patterns and mitigate some of the negative effects of ACEs. Supportive partners can also improve cortisol regulation for their significant other. In terms of cardiovascular reactivity, social support is associated with lower blood pressure and a decreased risk for cardiovascular disease.  Supportive relationships have been shown to buffer stress-induced cardiovascular reactivity and are associated with lower plasma and urinary catecholamine (stress hormone) levels. In terms of oxytocin, in animals, the amygdala has been found to have oxytocin receptors, allowing oxytocin to inhibit the amygdala-induced stress response. Oxytocin is produced in the hypothalamus and enhances bonding. inhibits the stress response, protects against stress-induced cell death, has anti-inflammatory effects, enhances metabolic homeostasis and protects vascular endothelium. And in terms of the immune system, social support has been found to predict natural killer cells, helper T cells and IL-6 levels as well as improved wound healing. Social support and positive childhood events have also been associated with decreased asthma symptoms and improved immune responses, including inhibiting inflammation, providing protection against infection, and promoting wound healing. Increased numbers of social connections have been associated with less susceptibility to the common cold and viral specific antibody levels across two viruses.  Another study by the same group found that hugging had a stress-buffering, immune-protective effect and explained 32% of the attenuating effect of support on infection risk.

Slide 7: Carol West:  There have been a number of pediatric interventions that improve social relationships and can improve with stress hormones and health.  Slopen in 2014 found that interventions designed to improve social relationships, environments or psychosocial functioning in children were associated with improved cortisol activity. Marie-Mitchell in 2018 found that multicomponent interventions, including parenting education, mental health support, and social service referrals were associated with improvements in parent child relationship and behavioral and mental health problems.  This paralleled Purewal Boparai’s 2018 findings.  They found three key intervention elements: a focus on strong parenting skills, earlier intervention placement, and greater intervention engagement improved or even normalized stress hormone profiles and decreased the impact of stress on brain development and epigenetic regulation.

Slide 8: Carol West: This is a short video on serve and return from the Harvard Center on the Developing Child whose resources can be valuable for creating awareness of the critical nature of responsive care for infants and toddlers.

Slide 9: Carol West: This graphic shows evidence-based strategies for toxic stress mitigation. Employing the evidence-based strategies for toxic stress regulation can help patients reduce stress and build resilience. One of the evidence-based strategies for toxic stress regulation is supportive relationships. Supportive relationships with regard to very young children refers to caregivers who provide responsive, nurturing care.

Slide 10: Carol West: Caregiver health is child health. Since very young children cannot survive without caregivers, their well-being is inextricably connected with caregivers’ well-being.  The Centers for Disease Control and Prevention recommendations for preventing ACEs includes supporting parents with family friendly workplace policies, and, by promoting household financial security, as well as teaching skills like parenting education and family relationship approaches. Infant health and well-being and the well-being of the caregiver are intertwined. When parents have the skills to be responsive to the needs of the of their young children, they are more likely to do so.

Slide11: Carol West: Attending to the social support of parents will improve parent health. A study of longitudinal data from four nationally representative studies evaluated social integration and social support in adolescence, young adulthood and late adulthood. Social integration, which refers to parent contact, friend count, religious attendance, and activities participation, was associated in a double dose dependent manner for adolescents and late adults with: lower C-reactive protein, lower systolic blood pressure, lower waist circumference, lower body-mass index in adolescence and higher body mass index in late adulthood. In figure two, prospective associations of social integration with biomarkers of physiological functioning over the life course.  Results based on ordinary least squares models of biomarkers at follow up regressed on baseline social integration adjusting for age, sex and race. 

Slide 12:  Carol West: Some of the most startling work in this area has been done by Dr Juliane Holt-Lunstad and her team, who have shown the impact that social integration and social support have on our mortality and survival. From two of her most important Meta analysis studies we know: individuals with adequate social relationships have a 50% greater likelihood of survival compared to those with poor or insufficient social relationships The magnitude of this effect is comparable to quitting smoking and it exceeds many well-known risk factors for mortality like obesity and physical activity.  If you look at the second and third bars, social support and social integration have a larger impact on our mortality than alcohol consumption, physical activity, BMI, and smoking up to 14 cigarettes a day!  Holt-Lunstad also found data across 308,000 849 individuals followed for an average of seven and a half years, indicating that individuals with adequate social relationships have a 50% greater likelihood of survival compared to those with poor or insufficient social relationships.

Slide 13: Carol West: Community resource resources can also support caregiver well-being. Resources that offer support to caregivers such as parents support groups, parent education, respite care, etc.  can benefit parents and caregivers as well as children. First Five Humboldt playgroups, Changing Tides parents support and the Nurse Family Partnership are a few examples of such resources.

Slide 14: Carol West: To summarize Module Five, young children's development, physical health, and well-being are largely dependent on the relationship with their caregivers. The well-being of caregivers is inextricably connected to the well-being of children.  A healthy relationship with a caregiver can serve as a protective factor when toxic stress is experienced. Support for caregivers’ well-being promotes the well-being of young children.

Slide 15: Carol West: Here are the references for Module Five.  We thank you for your participation in Module Five and we appreciate your interest in ACEs and the experiences of young children zero to five.  Thank you.

English (United States)