Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development:...

58
Touchpoints of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II Joshua Sparrow, MD Harvard Medical Children's Boston www.touchpoints.org joshua.sparrow@ childrens.harvard.edu

Transcript of Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development:...

Page 1: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

Touchpoints of Infant Toddler Preschool Development Foundations for Strong COlmmunities PART II

Joshua Sparrow MD Harvard Medical S(~hool Childrens Hospital~ Boston wwwtouchpointsorg joshuasparrow childrensharvardedu

Children Learn through Relationships Processes that require relationships

bull Attachment

bull Self Regulation

bull Mutual Regulation

bull Social ReferencingCommunication

bull Shared Subjectivity

Processes thlat require emotional availability

of child parent teacher

Touchpoints Relational Model of Development

Learnng and Growing in Relationships

bull Attachment

bull State regulation

bull Mutual regullation

bull Social referE~ncingCommunication

bull Shared subjectivity (understanding each other)

bull Self-esteem

Key elements

bull Developmental

bull Preventiive

bull Relationlal

bull Strengthsshybased empowermentl self-advocacy

L ___ _ ____________________ ~~~__________J_____________________I L__

bull Systems-theory

bull Culturally informed

bull Reflective practice

bull Evidence-based

n~G)_ raquo

I w IO -- I 0)3 0 m

-c J ~ -c n CD lt ~ CD T - -cbull I (Q 3 -- c -shy o CDD1 n ~ T __ JC) I

How do louchpoints Principles and Assumptions Help with Gatekeeping

bull An attitudinal framework to support the paradigm shift

bull A set of mantras to turn to in times of uncertainty conflict and challenge

_~__~______ - __~ _ _ ____ L L - - ___bull___bullbullbull__ 1 L~

Not just information Touchpoints Strategies for Learning in relationships

~Use the chilltjs behavior as your language to make your r~9lationship with the family shared observation and discovery

bull Meaning malking meaning of attachment behaviors to parents

bull Recognize vvhat you bring to the interaction

-u I

0Q) (J)CD C I U Q) -c

0 -s

Q) CJ) I

CD lt

r 0 0 =

I 0 0 -c -c 0 - C J

bull I bull

CD CJ)

enr-+CD J CC--lr-+o shy-en C

I C) CJJ 0)-0en 0CD - shyo~oCJl =-=-0J -shy-- J () ()0) __ --0 en-r-+CD bull bull 0)r-+CD

CC lt

shy-

i

_1 __ __ _ _ __ _~_________ ___J _ ____ bullL ___ _

Touch oSelected I-d

Smiddot

Artist Juli age 6Parent Assumptions Cit

bull The parent (extended family community) is the expert on hishertheir child

bull All parents (extended family community) want to do well by their child

bull Parenting is a process built on trial and error

bull bull

C1 Iru I CD

p

Q)-CJ Q) C1 c rC1CD bull

Q) I

lt CD I J0 I

Threats to )~ttachment bull Physical separation bull Threats to survival (baby parent other family

members) - including inadequate resources

bull Parental challenges eg postpartum depression PTSD

bull Child challenges eg small fc)r gestational dates

autism spectrum disorders poor hE~althmalnutrition impairing attachnnent behaviors

Key elements

bull Developmental bull Systems-theory bull Preventiive bull Culturall~ bull Relationlal informed

bull Strengthsshy bull Reflective based practice (em~owermentl bull Evidence-based self-advocac~l

--I T CD Q) ICD J CD 0shy

~ --I TT CDCD J -u

CD(J) shyC --1

lt CJ)

0lt - I 1

Q)

raquo-CJ) II

Q) 0 T 3 CD J I

0 CD Q) I

T

lt ~

I shyT 0 C I

~ CD CD

-C-shyJ co

shy

Attachment bull Who have you been attached to

bull What are yo~ur attachment behaviors with these people

bull Who is atta~~hed to you

bull What are th1eir attachment behaviors with you

Attachrnent and Temperament Goodness of Fit

bull Think abolut your temperament Think about the other persons temperament

bull What asp1ects of your temperament support y()ur attachment What aspects of your tem~~erament challenge it

__cl ________ ~___________c_L__ ~~c- bullbull___ l _JL __~_

Attachment

bull Think of all the children in your care one at a time

bull Who did you think of first Second Third bull Next to last Last

bull Describe wlhat the first three children you thought of ~lo to endear themselves to you

bull Describe wlhat the last three children do that makes thenn less endearing

bull Which of these attributes are ones you can help with IHow

a (J) en CD J lt -- CD Jl J

~lt a CJ c 1

a en

aCDC)en J Ol J~-C -- OlJI )1 CJa shyen~c

- Ol c c c c CD CD

r i

~

L

TOUCHpIOINTS A RELATIONAL MODEL OF DEVELOPMENT shy

Growing and learning in relationships

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referE~ncing

bull Shared subjectivity (understanding each other)

bull Self-esteem

States - estados de consciencia

bull Deep sleE~p - sueno profundo

bull Light sleep - sueno ligero bull Drowsine~ss - somnoliento bull Alert - allerta bull Fussy - incomodo

bull Crying - lIanto

(de la escala Brazelton y Prechtl)

State Regulation regulacion de los estc3dos de consciencia

bull Cada estaldo de consciencia tiene sus costos y sus ben~eficios que deben ser equilibrados

bull Diferentes~ estados de consciencia permiten un equilibrio entre las necesidades del nino y las demarldas del medio ambiente

bull Estado de alerta Ie permite al nino comunicarse con las personas que 10 cuidan mientras (~ue los estados de sueno 10 protegen (~ontra la sobre estimulaciorl

__-__shy

State Regulation

bull Each state c)f consciousness has costs and benefits to be balanced

bull States of cOlnsciousness allow for different balances between the infants needs and the environments demands

bull Alert states ~allow the infant to commlunicate with caretakers while sleep states protect against over-stimulation

en -I raquo-I m c m C) c rshyraquo --I o z

--

raquo-CD + en Q)-+

b CD en bull bull

llCD 0 03 CD enco C Q)- Q) CD

0 0 J CD

co C-Q)

o J

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 2: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

Children Learn through Relationships Processes that require relationships

bull Attachment

bull Self Regulation

bull Mutual Regulation

bull Social ReferencingCommunication

bull Shared Subjectivity

Processes thlat require emotional availability

of child parent teacher

Touchpoints Relational Model of Development

Learnng and Growing in Relationships

bull Attachment

bull State regulation

bull Mutual regullation

bull Social referE~ncingCommunication

bull Shared subjectivity (understanding each other)

bull Self-esteem

Key elements

bull Developmental

bull Preventiive

bull Relationlal

bull Strengthsshybased empowermentl self-advocacy

L ___ _ ____________________ ~~~__________J_____________________I L__

bull Systems-theory

bull Culturally informed

bull Reflective practice

bull Evidence-based

n~G)_ raquo

I w IO -- I 0)3 0 m

-c J ~ -c n CD lt ~ CD T - -cbull I (Q 3 -- c -shy o CDD1 n ~ T __ JC) I

How do louchpoints Principles and Assumptions Help with Gatekeeping

bull An attitudinal framework to support the paradigm shift

bull A set of mantras to turn to in times of uncertainty conflict and challenge

_~__~______ - __~ _ _ ____ L L - - ___bull___bullbullbull__ 1 L~

Not just information Touchpoints Strategies for Learning in relationships

~Use the chilltjs behavior as your language to make your r~9lationship with the family shared observation and discovery

bull Meaning malking meaning of attachment behaviors to parents

bull Recognize vvhat you bring to the interaction

-u I

0Q) (J)CD C I U Q) -c

0 -s

Q) CJ) I

CD lt

r 0 0 =

I 0 0 -c -c 0 - C J

bull I bull

CD CJ)

enr-+CD J CC--lr-+o shy-en C

I C) CJJ 0)-0en 0CD - shyo~oCJl =-=-0J -shy-- J () ()0) __ --0 en-r-+CD bull bull 0)r-+CD

CC lt

shy-

i

_1 __ __ _ _ __ _~_________ ___J _ ____ bullL ___ _

Touch oSelected I-d

Smiddot

Artist Juli age 6Parent Assumptions Cit

bull The parent (extended family community) is the expert on hishertheir child

bull All parents (extended family community) want to do well by their child

bull Parenting is a process built on trial and error

bull bull

C1 Iru I CD

p

Q)-CJ Q) C1 c rC1CD bull

Q) I

lt CD I J0 I

Threats to )~ttachment bull Physical separation bull Threats to survival (baby parent other family

members) - including inadequate resources

bull Parental challenges eg postpartum depression PTSD

bull Child challenges eg small fc)r gestational dates

autism spectrum disorders poor hE~althmalnutrition impairing attachnnent behaviors

Key elements

bull Developmental bull Systems-theory bull Preventiive bull Culturall~ bull Relationlal informed

bull Strengthsshy bull Reflective based practice (em~owermentl bull Evidence-based self-advocac~l

--I T CD Q) ICD J CD 0shy

~ --I TT CDCD J -u

CD(J) shyC --1

lt CJ)

0lt - I 1

Q)

raquo-CJ) II

Q) 0 T 3 CD J I

0 CD Q) I

T

lt ~

I shyT 0 C I

~ CD CD

-C-shyJ co

shy

Attachment bull Who have you been attached to

bull What are yo~ur attachment behaviors with these people

bull Who is atta~~hed to you

bull What are th1eir attachment behaviors with you

Attachrnent and Temperament Goodness of Fit

bull Think abolut your temperament Think about the other persons temperament

bull What asp1ects of your temperament support y()ur attachment What aspects of your tem~~erament challenge it

__cl ________ ~___________c_L__ ~~c- bullbull___ l _JL __~_

Attachment

bull Think of all the children in your care one at a time

bull Who did you think of first Second Third bull Next to last Last

bull Describe wlhat the first three children you thought of ~lo to endear themselves to you

bull Describe wlhat the last three children do that makes thenn less endearing

bull Which of these attributes are ones you can help with IHow

a (J) en CD J lt -- CD Jl J

~lt a CJ c 1

a en

aCDC)en J Ol J~-C -- OlJI )1 CJa shyen~c

- Ol c c c c CD CD

r i

~

L

TOUCHpIOINTS A RELATIONAL MODEL OF DEVELOPMENT shy

Growing and learning in relationships

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referE~ncing

bull Shared subjectivity (understanding each other)

bull Self-esteem

States - estados de consciencia

bull Deep sleE~p - sueno profundo

bull Light sleep - sueno ligero bull Drowsine~ss - somnoliento bull Alert - allerta bull Fussy - incomodo

bull Crying - lIanto

(de la escala Brazelton y Prechtl)

State Regulation regulacion de los estc3dos de consciencia

bull Cada estaldo de consciencia tiene sus costos y sus ben~eficios que deben ser equilibrados

bull Diferentes~ estados de consciencia permiten un equilibrio entre las necesidades del nino y las demarldas del medio ambiente

bull Estado de alerta Ie permite al nino comunicarse con las personas que 10 cuidan mientras (~ue los estados de sueno 10 protegen (~ontra la sobre estimulaciorl

__-__shy

State Regulation

bull Each state c)f consciousness has costs and benefits to be balanced

bull States of cOlnsciousness allow for different balances between the infants needs and the environments demands

bull Alert states ~allow the infant to commlunicate with caretakers while sleep states protect against over-stimulation

en -I raquo-I m c m C) c rshyraquo --I o z

--

raquo-CD + en Q)-+

b CD en bull bull

llCD 0 03 CD enco C Q)- Q) CD

0 0 J CD

co C-Q)

o J

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 3: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

Touchpoints Relational Model of Development

Learnng and Growing in Relationships

bull Attachment

bull State regulation

bull Mutual regullation

bull Social referE~ncingCommunication

bull Shared subjectivity (understanding each other)

bull Self-esteem

Key elements

bull Developmental

bull Preventiive

bull Relationlal

bull Strengthsshybased empowermentl self-advocacy

L ___ _ ____________________ ~~~__________J_____________________I L__

bull Systems-theory

bull Culturally informed

bull Reflective practice

bull Evidence-based

n~G)_ raquo

I w IO -- I 0)3 0 m

-c J ~ -c n CD lt ~ CD T - -cbull I (Q 3 -- c -shy o CDD1 n ~ T __ JC) I

How do louchpoints Principles and Assumptions Help with Gatekeeping

bull An attitudinal framework to support the paradigm shift

bull A set of mantras to turn to in times of uncertainty conflict and challenge

_~__~______ - __~ _ _ ____ L L - - ___bull___bullbullbull__ 1 L~

Not just information Touchpoints Strategies for Learning in relationships

~Use the chilltjs behavior as your language to make your r~9lationship with the family shared observation and discovery

bull Meaning malking meaning of attachment behaviors to parents

bull Recognize vvhat you bring to the interaction

-u I

0Q) (J)CD C I U Q) -c

0 -s

Q) CJ) I

CD lt

r 0 0 =

I 0 0 -c -c 0 - C J

bull I bull

CD CJ)

enr-+CD J CC--lr-+o shy-en C

I C) CJJ 0)-0en 0CD - shyo~oCJl =-=-0J -shy-- J () ()0) __ --0 en-r-+CD bull bull 0)r-+CD

CC lt

shy-

i

_1 __ __ _ _ __ _~_________ ___J _ ____ bullL ___ _

Touch oSelected I-d

Smiddot

Artist Juli age 6Parent Assumptions Cit

bull The parent (extended family community) is the expert on hishertheir child

bull All parents (extended family community) want to do well by their child

bull Parenting is a process built on trial and error

bull bull

C1 Iru I CD

p

Q)-CJ Q) C1 c rC1CD bull

Q) I

lt CD I J0 I

Threats to )~ttachment bull Physical separation bull Threats to survival (baby parent other family

members) - including inadequate resources

bull Parental challenges eg postpartum depression PTSD

bull Child challenges eg small fc)r gestational dates

autism spectrum disorders poor hE~althmalnutrition impairing attachnnent behaviors

Key elements

bull Developmental bull Systems-theory bull Preventiive bull Culturall~ bull Relationlal informed

bull Strengthsshy bull Reflective based practice (em~owermentl bull Evidence-based self-advocac~l

--I T CD Q) ICD J CD 0shy

~ --I TT CDCD J -u

CD(J) shyC --1

lt CJ)

0lt - I 1

Q)

raquo-CJ) II

Q) 0 T 3 CD J I

0 CD Q) I

T

lt ~

I shyT 0 C I

~ CD CD

-C-shyJ co

shy

Attachment bull Who have you been attached to

bull What are yo~ur attachment behaviors with these people

bull Who is atta~~hed to you

bull What are th1eir attachment behaviors with you

Attachrnent and Temperament Goodness of Fit

bull Think abolut your temperament Think about the other persons temperament

bull What asp1ects of your temperament support y()ur attachment What aspects of your tem~~erament challenge it

__cl ________ ~___________c_L__ ~~c- bullbull___ l _JL __~_

Attachment

bull Think of all the children in your care one at a time

bull Who did you think of first Second Third bull Next to last Last

bull Describe wlhat the first three children you thought of ~lo to endear themselves to you

bull Describe wlhat the last three children do that makes thenn less endearing

bull Which of these attributes are ones you can help with IHow

a (J) en CD J lt -- CD Jl J

~lt a CJ c 1

a en

aCDC)en J Ol J~-C -- OlJI )1 CJa shyen~c

- Ol c c c c CD CD

r i

~

L

TOUCHpIOINTS A RELATIONAL MODEL OF DEVELOPMENT shy

Growing and learning in relationships

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referE~ncing

bull Shared subjectivity (understanding each other)

bull Self-esteem

States - estados de consciencia

bull Deep sleE~p - sueno profundo

bull Light sleep - sueno ligero bull Drowsine~ss - somnoliento bull Alert - allerta bull Fussy - incomodo

bull Crying - lIanto

(de la escala Brazelton y Prechtl)

State Regulation regulacion de los estc3dos de consciencia

bull Cada estaldo de consciencia tiene sus costos y sus ben~eficios que deben ser equilibrados

bull Diferentes~ estados de consciencia permiten un equilibrio entre las necesidades del nino y las demarldas del medio ambiente

bull Estado de alerta Ie permite al nino comunicarse con las personas que 10 cuidan mientras (~ue los estados de sueno 10 protegen (~ontra la sobre estimulaciorl

__-__shy

State Regulation

bull Each state c)f consciousness has costs and benefits to be balanced

bull States of cOlnsciousness allow for different balances between the infants needs and the environments demands

bull Alert states ~allow the infant to commlunicate with caretakers while sleep states protect against over-stimulation

en -I raquo-I m c m C) c rshyraquo --I o z

--

raquo-CD + en Q)-+

b CD en bull bull

llCD 0 03 CD enco C Q)- Q) CD

0 0 J CD

co C-Q)

o J

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 4: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

Key elements

bull Developmental

bull Preventiive

bull Relationlal

bull Strengthsshybased empowermentl self-advocacy

L ___ _ ____________________ ~~~__________J_____________________I L__

bull Systems-theory

bull Culturally informed

bull Reflective practice

bull Evidence-based

n~G)_ raquo

I w IO -- I 0)3 0 m

-c J ~ -c n CD lt ~ CD T - -cbull I (Q 3 -- c -shy o CDD1 n ~ T __ JC) I

How do louchpoints Principles and Assumptions Help with Gatekeeping

bull An attitudinal framework to support the paradigm shift

bull A set of mantras to turn to in times of uncertainty conflict and challenge

_~__~______ - __~ _ _ ____ L L - - ___bull___bullbullbull__ 1 L~

Not just information Touchpoints Strategies for Learning in relationships

~Use the chilltjs behavior as your language to make your r~9lationship with the family shared observation and discovery

bull Meaning malking meaning of attachment behaviors to parents

bull Recognize vvhat you bring to the interaction

-u I

0Q) (J)CD C I U Q) -c

0 -s

Q) CJ) I

CD lt

r 0 0 =

I 0 0 -c -c 0 - C J

bull I bull

CD CJ)

enr-+CD J CC--lr-+o shy-en C

I C) CJJ 0)-0en 0CD - shyo~oCJl =-=-0J -shy-- J () ()0) __ --0 en-r-+CD bull bull 0)r-+CD

CC lt

shy-

i

_1 __ __ _ _ __ _~_________ ___J _ ____ bullL ___ _

Touch oSelected I-d

Smiddot

Artist Juli age 6Parent Assumptions Cit

bull The parent (extended family community) is the expert on hishertheir child

bull All parents (extended family community) want to do well by their child

bull Parenting is a process built on trial and error

bull bull

C1 Iru I CD

p

Q)-CJ Q) C1 c rC1CD bull

Q) I

lt CD I J0 I

Threats to )~ttachment bull Physical separation bull Threats to survival (baby parent other family

members) - including inadequate resources

bull Parental challenges eg postpartum depression PTSD

bull Child challenges eg small fc)r gestational dates

autism spectrum disorders poor hE~althmalnutrition impairing attachnnent behaviors

Key elements

bull Developmental bull Systems-theory bull Preventiive bull Culturall~ bull Relationlal informed

bull Strengthsshy bull Reflective based practice (em~owermentl bull Evidence-based self-advocac~l

--I T CD Q) ICD J CD 0shy

~ --I TT CDCD J -u

CD(J) shyC --1

lt CJ)

0lt - I 1

Q)

raquo-CJ) II

Q) 0 T 3 CD J I

0 CD Q) I

T

lt ~

I shyT 0 C I

~ CD CD

-C-shyJ co

shy

Attachment bull Who have you been attached to

bull What are yo~ur attachment behaviors with these people

bull Who is atta~~hed to you

bull What are th1eir attachment behaviors with you

Attachrnent and Temperament Goodness of Fit

bull Think abolut your temperament Think about the other persons temperament

bull What asp1ects of your temperament support y()ur attachment What aspects of your tem~~erament challenge it

__cl ________ ~___________c_L__ ~~c- bullbull___ l _JL __~_

Attachment

bull Think of all the children in your care one at a time

bull Who did you think of first Second Third bull Next to last Last

bull Describe wlhat the first three children you thought of ~lo to endear themselves to you

bull Describe wlhat the last three children do that makes thenn less endearing

bull Which of these attributes are ones you can help with IHow

a (J) en CD J lt -- CD Jl J

~lt a CJ c 1

a en

aCDC)en J Ol J~-C -- OlJI )1 CJa shyen~c

- Ol c c c c CD CD

r i

~

L

TOUCHpIOINTS A RELATIONAL MODEL OF DEVELOPMENT shy

Growing and learning in relationships

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referE~ncing

bull Shared subjectivity (understanding each other)

bull Self-esteem

States - estados de consciencia

bull Deep sleE~p - sueno profundo

bull Light sleep - sueno ligero bull Drowsine~ss - somnoliento bull Alert - allerta bull Fussy - incomodo

bull Crying - lIanto

(de la escala Brazelton y Prechtl)

State Regulation regulacion de los estc3dos de consciencia

bull Cada estaldo de consciencia tiene sus costos y sus ben~eficios que deben ser equilibrados

bull Diferentes~ estados de consciencia permiten un equilibrio entre las necesidades del nino y las demarldas del medio ambiente

bull Estado de alerta Ie permite al nino comunicarse con las personas que 10 cuidan mientras (~ue los estados de sueno 10 protegen (~ontra la sobre estimulaciorl

__-__shy

State Regulation

bull Each state c)f consciousness has costs and benefits to be balanced

bull States of cOlnsciousness allow for different balances between the infants needs and the environments demands

bull Alert states ~allow the infant to commlunicate with caretakers while sleep states protect against over-stimulation

en -I raquo-I m c m C) c rshyraquo --I o z

--

raquo-CD + en Q)-+

b CD en bull bull

llCD 0 03 CD enco C Q)- Q) CD

0 0 J CD

co C-Q)

o J

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 5: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

n~G)_ raquo

I w IO -- I 0)3 0 m

-c J ~ -c n CD lt ~ CD T - -cbull I (Q 3 -- c -shy o CDD1 n ~ T __ JC) I

How do louchpoints Principles and Assumptions Help with Gatekeeping

bull An attitudinal framework to support the paradigm shift

bull A set of mantras to turn to in times of uncertainty conflict and challenge

_~__~______ - __~ _ _ ____ L L - - ___bull___bullbullbull__ 1 L~

Not just information Touchpoints Strategies for Learning in relationships

~Use the chilltjs behavior as your language to make your r~9lationship with the family shared observation and discovery

bull Meaning malking meaning of attachment behaviors to parents

bull Recognize vvhat you bring to the interaction

-u I

0Q) (J)CD C I U Q) -c

0 -s

Q) CJ) I

CD lt

r 0 0 =

I 0 0 -c -c 0 - C J

bull I bull

CD CJ)

enr-+CD J CC--lr-+o shy-en C

I C) CJJ 0)-0en 0CD - shyo~oCJl =-=-0J -shy-- J () ()0) __ --0 en-r-+CD bull bull 0)r-+CD

CC lt

shy-

i

_1 __ __ _ _ __ _~_________ ___J _ ____ bullL ___ _

Touch oSelected I-d

Smiddot

Artist Juli age 6Parent Assumptions Cit

bull The parent (extended family community) is the expert on hishertheir child

bull All parents (extended family community) want to do well by their child

bull Parenting is a process built on trial and error

bull bull

C1 Iru I CD

p

Q)-CJ Q) C1 c rC1CD bull

Q) I

lt CD I J0 I

Threats to )~ttachment bull Physical separation bull Threats to survival (baby parent other family

members) - including inadequate resources

bull Parental challenges eg postpartum depression PTSD

bull Child challenges eg small fc)r gestational dates

autism spectrum disorders poor hE~althmalnutrition impairing attachnnent behaviors

Key elements

bull Developmental bull Systems-theory bull Preventiive bull Culturall~ bull Relationlal informed

bull Strengthsshy bull Reflective based practice (em~owermentl bull Evidence-based self-advocac~l

--I T CD Q) ICD J CD 0shy

~ --I TT CDCD J -u

CD(J) shyC --1

lt CJ)

0lt - I 1

Q)

raquo-CJ) II

Q) 0 T 3 CD J I

0 CD Q) I

T

lt ~

I shyT 0 C I

~ CD CD

-C-shyJ co

shy

Attachment bull Who have you been attached to

bull What are yo~ur attachment behaviors with these people

bull Who is atta~~hed to you

bull What are th1eir attachment behaviors with you

Attachrnent and Temperament Goodness of Fit

bull Think abolut your temperament Think about the other persons temperament

bull What asp1ects of your temperament support y()ur attachment What aspects of your tem~~erament challenge it

__cl ________ ~___________c_L__ ~~c- bullbull___ l _JL __~_

Attachment

bull Think of all the children in your care one at a time

bull Who did you think of first Second Third bull Next to last Last

bull Describe wlhat the first three children you thought of ~lo to endear themselves to you

bull Describe wlhat the last three children do that makes thenn less endearing

bull Which of these attributes are ones you can help with IHow

a (J) en CD J lt -- CD Jl J

~lt a CJ c 1

a en

aCDC)en J Ol J~-C -- OlJI )1 CJa shyen~c

- Ol c c c c CD CD

r i

~

L

TOUCHpIOINTS A RELATIONAL MODEL OF DEVELOPMENT shy

Growing and learning in relationships

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referE~ncing

bull Shared subjectivity (understanding each other)

bull Self-esteem

States - estados de consciencia

bull Deep sleE~p - sueno profundo

bull Light sleep - sueno ligero bull Drowsine~ss - somnoliento bull Alert - allerta bull Fussy - incomodo

bull Crying - lIanto

(de la escala Brazelton y Prechtl)

State Regulation regulacion de los estc3dos de consciencia

bull Cada estaldo de consciencia tiene sus costos y sus ben~eficios que deben ser equilibrados

bull Diferentes~ estados de consciencia permiten un equilibrio entre las necesidades del nino y las demarldas del medio ambiente

bull Estado de alerta Ie permite al nino comunicarse con las personas que 10 cuidan mientras (~ue los estados de sueno 10 protegen (~ontra la sobre estimulaciorl

__-__shy

State Regulation

bull Each state c)f consciousness has costs and benefits to be balanced

bull States of cOlnsciousness allow for different balances between the infants needs and the environments demands

bull Alert states ~allow the infant to commlunicate with caretakers while sleep states protect against over-stimulation

en -I raquo-I m c m C) c rshyraquo --I o z

--

raquo-CD + en Q)-+

b CD en bull bull

llCD 0 03 CD enco C Q)- Q) CD

0 0 J CD

co C-Q)

o J

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 6: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

How do louchpoints Principles and Assumptions Help with Gatekeeping

bull An attitudinal framework to support the paradigm shift

bull A set of mantras to turn to in times of uncertainty conflict and challenge

_~__~______ - __~ _ _ ____ L L - - ___bull___bullbullbull__ 1 L~

Not just information Touchpoints Strategies for Learning in relationships

~Use the chilltjs behavior as your language to make your r~9lationship with the family shared observation and discovery

bull Meaning malking meaning of attachment behaviors to parents

bull Recognize vvhat you bring to the interaction

-u I

0Q) (J)CD C I U Q) -c

0 -s

Q) CJ) I

CD lt

r 0 0 =

I 0 0 -c -c 0 - C J

bull I bull

CD CJ)

enr-+CD J CC--lr-+o shy-en C

I C) CJJ 0)-0en 0CD - shyo~oCJl =-=-0J -shy-- J () ()0) __ --0 en-r-+CD bull bull 0)r-+CD

CC lt

shy-

i

_1 __ __ _ _ __ _~_________ ___J _ ____ bullL ___ _

Touch oSelected I-d

Smiddot

Artist Juli age 6Parent Assumptions Cit

bull The parent (extended family community) is the expert on hishertheir child

bull All parents (extended family community) want to do well by their child

bull Parenting is a process built on trial and error

bull bull

C1 Iru I CD

p

Q)-CJ Q) C1 c rC1CD bull

Q) I

lt CD I J0 I

Threats to )~ttachment bull Physical separation bull Threats to survival (baby parent other family

members) - including inadequate resources

bull Parental challenges eg postpartum depression PTSD

bull Child challenges eg small fc)r gestational dates

autism spectrum disorders poor hE~althmalnutrition impairing attachnnent behaviors

Key elements

bull Developmental bull Systems-theory bull Preventiive bull Culturall~ bull Relationlal informed

bull Strengthsshy bull Reflective based practice (em~owermentl bull Evidence-based self-advocac~l

--I T CD Q) ICD J CD 0shy

~ --I TT CDCD J -u

CD(J) shyC --1

lt CJ)

0lt - I 1

Q)

raquo-CJ) II

Q) 0 T 3 CD J I

0 CD Q) I

T

lt ~

I shyT 0 C I

~ CD CD

-C-shyJ co

shy

Attachment bull Who have you been attached to

bull What are yo~ur attachment behaviors with these people

bull Who is atta~~hed to you

bull What are th1eir attachment behaviors with you

Attachrnent and Temperament Goodness of Fit

bull Think abolut your temperament Think about the other persons temperament

bull What asp1ects of your temperament support y()ur attachment What aspects of your tem~~erament challenge it

__cl ________ ~___________c_L__ ~~c- bullbull___ l _JL __~_

Attachment

bull Think of all the children in your care one at a time

bull Who did you think of first Second Third bull Next to last Last

bull Describe wlhat the first three children you thought of ~lo to endear themselves to you

bull Describe wlhat the last three children do that makes thenn less endearing

bull Which of these attributes are ones you can help with IHow

a (J) en CD J lt -- CD Jl J

~lt a CJ c 1

a en

aCDC)en J Ol J~-C -- OlJI )1 CJa shyen~c

- Ol c c c c CD CD

r i

~

L

TOUCHpIOINTS A RELATIONAL MODEL OF DEVELOPMENT shy

Growing and learning in relationships

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referE~ncing

bull Shared subjectivity (understanding each other)

bull Self-esteem

States - estados de consciencia

bull Deep sleE~p - sueno profundo

bull Light sleep - sueno ligero bull Drowsine~ss - somnoliento bull Alert - allerta bull Fussy - incomodo

bull Crying - lIanto

(de la escala Brazelton y Prechtl)

State Regulation regulacion de los estc3dos de consciencia

bull Cada estaldo de consciencia tiene sus costos y sus ben~eficios que deben ser equilibrados

bull Diferentes~ estados de consciencia permiten un equilibrio entre las necesidades del nino y las demarldas del medio ambiente

bull Estado de alerta Ie permite al nino comunicarse con las personas que 10 cuidan mientras (~ue los estados de sueno 10 protegen (~ontra la sobre estimulaciorl

__-__shy

State Regulation

bull Each state c)f consciousness has costs and benefits to be balanced

bull States of cOlnsciousness allow for different balances between the infants needs and the environments demands

bull Alert states ~allow the infant to commlunicate with caretakers while sleep states protect against over-stimulation

en -I raquo-I m c m C) c rshyraquo --I o z

--

raquo-CD + en Q)-+

b CD en bull bull

llCD 0 03 CD enco C Q)- Q) CD

0 0 J CD

co C-Q)

o J

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 7: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

_~__~______ - __~ _ _ ____ L L - - ___bull___bullbullbull__ 1 L~

Not just information Touchpoints Strategies for Learning in relationships

~Use the chilltjs behavior as your language to make your r~9lationship with the family shared observation and discovery

bull Meaning malking meaning of attachment behaviors to parents

bull Recognize vvhat you bring to the interaction

-u I

0Q) (J)CD C I U Q) -c

0 -s

Q) CJ) I

CD lt

r 0 0 =

I 0 0 -c -c 0 - C J

bull I bull

CD CJ)

enr-+CD J CC--lr-+o shy-en C

I C) CJJ 0)-0en 0CD - shyo~oCJl =-=-0J -shy-- J () ()0) __ --0 en-r-+CD bull bull 0)r-+CD

CC lt

shy-

i

_1 __ __ _ _ __ _~_________ ___J _ ____ bullL ___ _

Touch oSelected I-d

Smiddot

Artist Juli age 6Parent Assumptions Cit

bull The parent (extended family community) is the expert on hishertheir child

bull All parents (extended family community) want to do well by their child

bull Parenting is a process built on trial and error

bull bull

C1 Iru I CD

p

Q)-CJ Q) C1 c rC1CD bull

Q) I

lt CD I J0 I

Threats to )~ttachment bull Physical separation bull Threats to survival (baby parent other family

members) - including inadequate resources

bull Parental challenges eg postpartum depression PTSD

bull Child challenges eg small fc)r gestational dates

autism spectrum disorders poor hE~althmalnutrition impairing attachnnent behaviors

Key elements

bull Developmental bull Systems-theory bull Preventiive bull Culturall~ bull Relationlal informed

bull Strengthsshy bull Reflective based practice (em~owermentl bull Evidence-based self-advocac~l

--I T CD Q) ICD J CD 0shy

~ --I TT CDCD J -u

CD(J) shyC --1

lt CJ)

0lt - I 1

Q)

raquo-CJ) II

Q) 0 T 3 CD J I

0 CD Q) I

T

lt ~

I shyT 0 C I

~ CD CD

-C-shyJ co

shy

Attachment bull Who have you been attached to

bull What are yo~ur attachment behaviors with these people

bull Who is atta~~hed to you

bull What are th1eir attachment behaviors with you

Attachrnent and Temperament Goodness of Fit

bull Think abolut your temperament Think about the other persons temperament

bull What asp1ects of your temperament support y()ur attachment What aspects of your tem~~erament challenge it

__cl ________ ~___________c_L__ ~~c- bullbull___ l _JL __~_

Attachment

bull Think of all the children in your care one at a time

bull Who did you think of first Second Third bull Next to last Last

bull Describe wlhat the first three children you thought of ~lo to endear themselves to you

bull Describe wlhat the last three children do that makes thenn less endearing

bull Which of these attributes are ones you can help with IHow

a (J) en CD J lt -- CD Jl J

~lt a CJ c 1

a en

aCDC)en J Ol J~-C -- OlJI )1 CJa shyen~c

- Ol c c c c CD CD

r i

~

L

TOUCHpIOINTS A RELATIONAL MODEL OF DEVELOPMENT shy

Growing and learning in relationships

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referE~ncing

bull Shared subjectivity (understanding each other)

bull Self-esteem

States - estados de consciencia

bull Deep sleE~p - sueno profundo

bull Light sleep - sueno ligero bull Drowsine~ss - somnoliento bull Alert - allerta bull Fussy - incomodo

bull Crying - lIanto

(de la escala Brazelton y Prechtl)

State Regulation regulacion de los estc3dos de consciencia

bull Cada estaldo de consciencia tiene sus costos y sus ben~eficios que deben ser equilibrados

bull Diferentes~ estados de consciencia permiten un equilibrio entre las necesidades del nino y las demarldas del medio ambiente

bull Estado de alerta Ie permite al nino comunicarse con las personas que 10 cuidan mientras (~ue los estados de sueno 10 protegen (~ontra la sobre estimulaciorl

__-__shy

State Regulation

bull Each state c)f consciousness has costs and benefits to be balanced

bull States of cOlnsciousness allow for different balances between the infants needs and the environments demands

bull Alert states ~allow the infant to commlunicate with caretakers while sleep states protect against over-stimulation

en -I raquo-I m c m C) c rshyraquo --I o z

--

raquo-CD + en Q)-+

b CD en bull bull

llCD 0 03 CD enco C Q)- Q) CD

0 0 J CD

co C-Q)

o J

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 8: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

-u I

0Q) (J)CD C I U Q) -c

0 -s

Q) CJ) I

CD lt

r 0 0 =

I 0 0 -c -c 0 - C J

bull I bull

CD CJ)

enr-+CD J CC--lr-+o shy-en C

I C) CJJ 0)-0en 0CD - shyo~oCJl =-=-0J -shy-- J () ()0) __ --0 en-r-+CD bull bull 0)r-+CD

CC lt

shy-

i

_1 __ __ _ _ __ _~_________ ___J _ ____ bullL ___ _

Touch oSelected I-d

Smiddot

Artist Juli age 6Parent Assumptions Cit

bull The parent (extended family community) is the expert on hishertheir child

bull All parents (extended family community) want to do well by their child

bull Parenting is a process built on trial and error

bull bull

C1 Iru I CD

p

Q)-CJ Q) C1 c rC1CD bull

Q) I

lt CD I J0 I

Threats to )~ttachment bull Physical separation bull Threats to survival (baby parent other family

members) - including inadequate resources

bull Parental challenges eg postpartum depression PTSD

bull Child challenges eg small fc)r gestational dates

autism spectrum disorders poor hE~althmalnutrition impairing attachnnent behaviors

Key elements

bull Developmental bull Systems-theory bull Preventiive bull Culturall~ bull Relationlal informed

bull Strengthsshy bull Reflective based practice (em~owermentl bull Evidence-based self-advocac~l

--I T CD Q) ICD J CD 0shy

~ --I TT CDCD J -u

CD(J) shyC --1

lt CJ)

0lt - I 1

Q)

raquo-CJ) II

Q) 0 T 3 CD J I

0 CD Q) I

T

lt ~

I shyT 0 C I

~ CD CD

-C-shyJ co

shy

Attachment bull Who have you been attached to

bull What are yo~ur attachment behaviors with these people

bull Who is atta~~hed to you

bull What are th1eir attachment behaviors with you

Attachrnent and Temperament Goodness of Fit

bull Think abolut your temperament Think about the other persons temperament

bull What asp1ects of your temperament support y()ur attachment What aspects of your tem~~erament challenge it

__cl ________ ~___________c_L__ ~~c- bullbull___ l _JL __~_

Attachment

bull Think of all the children in your care one at a time

bull Who did you think of first Second Third bull Next to last Last

bull Describe wlhat the first three children you thought of ~lo to endear themselves to you

bull Describe wlhat the last three children do that makes thenn less endearing

bull Which of these attributes are ones you can help with IHow

a (J) en CD J lt -- CD Jl J

~lt a CJ c 1

a en

aCDC)en J Ol J~-C -- OlJI )1 CJa shyen~c

- Ol c c c c CD CD

r i

~

L

TOUCHpIOINTS A RELATIONAL MODEL OF DEVELOPMENT shy

Growing and learning in relationships

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referE~ncing

bull Shared subjectivity (understanding each other)

bull Self-esteem

States - estados de consciencia

bull Deep sleE~p - sueno profundo

bull Light sleep - sueno ligero bull Drowsine~ss - somnoliento bull Alert - allerta bull Fussy - incomodo

bull Crying - lIanto

(de la escala Brazelton y Prechtl)

State Regulation regulacion de los estc3dos de consciencia

bull Cada estaldo de consciencia tiene sus costos y sus ben~eficios que deben ser equilibrados

bull Diferentes~ estados de consciencia permiten un equilibrio entre las necesidades del nino y las demarldas del medio ambiente

bull Estado de alerta Ie permite al nino comunicarse con las personas que 10 cuidan mientras (~ue los estados de sueno 10 protegen (~ontra la sobre estimulaciorl

__-__shy

State Regulation

bull Each state c)f consciousness has costs and benefits to be balanced

bull States of cOlnsciousness allow for different balances between the infants needs and the environments demands

bull Alert states ~allow the infant to commlunicate with caretakers while sleep states protect against over-stimulation

en -I raquo-I m c m C) c rshyraquo --I o z

--

raquo-CD + en Q)-+

b CD en bull bull

llCD 0 03 CD enco C Q)- Q) CD

0 0 J CD

co C-Q)

o J

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 9: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

_1 __ __ _ _ __ _~_________ ___J _ ____ bullL ___ _

Touch oSelected I-d

Smiddot

Artist Juli age 6Parent Assumptions Cit

bull The parent (extended family community) is the expert on hishertheir child

bull All parents (extended family community) want to do well by their child

bull Parenting is a process built on trial and error

bull bull

C1 Iru I CD

p

Q)-CJ Q) C1 c rC1CD bull

Q) I

lt CD I J0 I

Threats to )~ttachment bull Physical separation bull Threats to survival (baby parent other family

members) - including inadequate resources

bull Parental challenges eg postpartum depression PTSD

bull Child challenges eg small fc)r gestational dates

autism spectrum disorders poor hE~althmalnutrition impairing attachnnent behaviors

Key elements

bull Developmental bull Systems-theory bull Preventiive bull Culturall~ bull Relationlal informed

bull Strengthsshy bull Reflective based practice (em~owermentl bull Evidence-based self-advocac~l

--I T CD Q) ICD J CD 0shy

~ --I TT CDCD J -u

CD(J) shyC --1

lt CJ)

0lt - I 1

Q)

raquo-CJ) II

Q) 0 T 3 CD J I

0 CD Q) I

T

lt ~

I shyT 0 C I

~ CD CD

-C-shyJ co

shy

Attachment bull Who have you been attached to

bull What are yo~ur attachment behaviors with these people

bull Who is atta~~hed to you

bull What are th1eir attachment behaviors with you

Attachrnent and Temperament Goodness of Fit

bull Think abolut your temperament Think about the other persons temperament

bull What asp1ects of your temperament support y()ur attachment What aspects of your tem~~erament challenge it

__cl ________ ~___________c_L__ ~~c- bullbull___ l _JL __~_

Attachment

bull Think of all the children in your care one at a time

bull Who did you think of first Second Third bull Next to last Last

bull Describe wlhat the first three children you thought of ~lo to endear themselves to you

bull Describe wlhat the last three children do that makes thenn less endearing

bull Which of these attributes are ones you can help with IHow

a (J) en CD J lt -- CD Jl J

~lt a CJ c 1

a en

aCDC)en J Ol J~-C -- OlJI )1 CJa shyen~c

- Ol c c c c CD CD

r i

~

L

TOUCHpIOINTS A RELATIONAL MODEL OF DEVELOPMENT shy

Growing and learning in relationships

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referE~ncing

bull Shared subjectivity (understanding each other)

bull Self-esteem

States - estados de consciencia

bull Deep sleE~p - sueno profundo

bull Light sleep - sueno ligero bull Drowsine~ss - somnoliento bull Alert - allerta bull Fussy - incomodo

bull Crying - lIanto

(de la escala Brazelton y Prechtl)

State Regulation regulacion de los estc3dos de consciencia

bull Cada estaldo de consciencia tiene sus costos y sus ben~eficios que deben ser equilibrados

bull Diferentes~ estados de consciencia permiten un equilibrio entre las necesidades del nino y las demarldas del medio ambiente

bull Estado de alerta Ie permite al nino comunicarse con las personas que 10 cuidan mientras (~ue los estados de sueno 10 protegen (~ontra la sobre estimulaciorl

__-__shy

State Regulation

bull Each state c)f consciousness has costs and benefits to be balanced

bull States of cOlnsciousness allow for different balances between the infants needs and the environments demands

bull Alert states ~allow the infant to commlunicate with caretakers while sleep states protect against over-stimulation

en -I raquo-I m c m C) c rshyraquo --I o z

--

raquo-CD + en Q)-+

b CD en bull bull

llCD 0 03 CD enco C Q)- Q) CD

0 0 J CD

co C-Q)

o J

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 10: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

bull bull

C1 Iru I CD

p

Q)-CJ Q) C1 c rC1CD bull

Q) I

lt CD I J0 I

Threats to )~ttachment bull Physical separation bull Threats to survival (baby parent other family

members) - including inadequate resources

bull Parental challenges eg postpartum depression PTSD

bull Child challenges eg small fc)r gestational dates

autism spectrum disorders poor hE~althmalnutrition impairing attachnnent behaviors

Key elements

bull Developmental bull Systems-theory bull Preventiive bull Culturall~ bull Relationlal informed

bull Strengthsshy bull Reflective based practice (em~owermentl bull Evidence-based self-advocac~l

--I T CD Q) ICD J CD 0shy

~ --I TT CDCD J -u

CD(J) shyC --1

lt CJ)

0lt - I 1

Q)

raquo-CJ) II

Q) 0 T 3 CD J I

0 CD Q) I

T

lt ~

I shyT 0 C I

~ CD CD

-C-shyJ co

shy

Attachment bull Who have you been attached to

bull What are yo~ur attachment behaviors with these people

bull Who is atta~~hed to you

bull What are th1eir attachment behaviors with you

Attachrnent and Temperament Goodness of Fit

bull Think abolut your temperament Think about the other persons temperament

bull What asp1ects of your temperament support y()ur attachment What aspects of your tem~~erament challenge it

__cl ________ ~___________c_L__ ~~c- bullbull___ l _JL __~_

Attachment

bull Think of all the children in your care one at a time

bull Who did you think of first Second Third bull Next to last Last

bull Describe wlhat the first three children you thought of ~lo to endear themselves to you

bull Describe wlhat the last three children do that makes thenn less endearing

bull Which of these attributes are ones you can help with IHow

a (J) en CD J lt -- CD Jl J

~lt a CJ c 1

a en

aCDC)en J Ol J~-C -- OlJI )1 CJa shyen~c

- Ol c c c c CD CD

r i

~

L

TOUCHpIOINTS A RELATIONAL MODEL OF DEVELOPMENT shy

Growing and learning in relationships

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referE~ncing

bull Shared subjectivity (understanding each other)

bull Self-esteem

States - estados de consciencia

bull Deep sleE~p - sueno profundo

bull Light sleep - sueno ligero bull Drowsine~ss - somnoliento bull Alert - allerta bull Fussy - incomodo

bull Crying - lIanto

(de la escala Brazelton y Prechtl)

State Regulation regulacion de los estc3dos de consciencia

bull Cada estaldo de consciencia tiene sus costos y sus ben~eficios que deben ser equilibrados

bull Diferentes~ estados de consciencia permiten un equilibrio entre las necesidades del nino y las demarldas del medio ambiente

bull Estado de alerta Ie permite al nino comunicarse con las personas que 10 cuidan mientras (~ue los estados de sueno 10 protegen (~ontra la sobre estimulaciorl

__-__shy

State Regulation

bull Each state c)f consciousness has costs and benefits to be balanced

bull States of cOlnsciousness allow for different balances between the infants needs and the environments demands

bull Alert states ~allow the infant to commlunicate with caretakers while sleep states protect against over-stimulation

en -I raquo-I m c m C) c rshyraquo --I o z

--

raquo-CD + en Q)-+

b CD en bull bull

llCD 0 03 CD enco C Q)- Q) CD

0 0 J CD

co C-Q)

o J

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 11: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

Threats to )~ttachment bull Physical separation bull Threats to survival (baby parent other family

members) - including inadequate resources

bull Parental challenges eg postpartum depression PTSD

bull Child challenges eg small fc)r gestational dates

autism spectrum disorders poor hE~althmalnutrition impairing attachnnent behaviors

Key elements

bull Developmental bull Systems-theory bull Preventiive bull Culturall~ bull Relationlal informed

bull Strengthsshy bull Reflective based practice (em~owermentl bull Evidence-based self-advocac~l

--I T CD Q) ICD J CD 0shy

~ --I TT CDCD J -u

CD(J) shyC --1

lt CJ)

0lt - I 1

Q)

raquo-CJ) II

Q) 0 T 3 CD J I

0 CD Q) I

T

lt ~

I shyT 0 C I

~ CD CD

-C-shyJ co

shy

Attachment bull Who have you been attached to

bull What are yo~ur attachment behaviors with these people

bull Who is atta~~hed to you

bull What are th1eir attachment behaviors with you

Attachrnent and Temperament Goodness of Fit

bull Think abolut your temperament Think about the other persons temperament

bull What asp1ects of your temperament support y()ur attachment What aspects of your tem~~erament challenge it

__cl ________ ~___________c_L__ ~~c- bullbull___ l _JL __~_

Attachment

bull Think of all the children in your care one at a time

bull Who did you think of first Second Third bull Next to last Last

bull Describe wlhat the first three children you thought of ~lo to endear themselves to you

bull Describe wlhat the last three children do that makes thenn less endearing

bull Which of these attributes are ones you can help with IHow

a (J) en CD J lt -- CD Jl J

~lt a CJ c 1

a en

aCDC)en J Ol J~-C -- OlJI )1 CJa shyen~c

- Ol c c c c CD CD

r i

~

L

TOUCHpIOINTS A RELATIONAL MODEL OF DEVELOPMENT shy

Growing and learning in relationships

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referE~ncing

bull Shared subjectivity (understanding each other)

bull Self-esteem

States - estados de consciencia

bull Deep sleE~p - sueno profundo

bull Light sleep - sueno ligero bull Drowsine~ss - somnoliento bull Alert - allerta bull Fussy - incomodo

bull Crying - lIanto

(de la escala Brazelton y Prechtl)

State Regulation regulacion de los estc3dos de consciencia

bull Cada estaldo de consciencia tiene sus costos y sus ben~eficios que deben ser equilibrados

bull Diferentes~ estados de consciencia permiten un equilibrio entre las necesidades del nino y las demarldas del medio ambiente

bull Estado de alerta Ie permite al nino comunicarse con las personas que 10 cuidan mientras (~ue los estados de sueno 10 protegen (~ontra la sobre estimulaciorl

__-__shy

State Regulation

bull Each state c)f consciousness has costs and benefits to be balanced

bull States of cOlnsciousness allow for different balances between the infants needs and the environments demands

bull Alert states ~allow the infant to commlunicate with caretakers while sleep states protect against over-stimulation

en -I raquo-I m c m C) c rshyraquo --I o z

--

raquo-CD + en Q)-+

b CD en bull bull

llCD 0 03 CD enco C Q)- Q) CD

0 0 J CD

co C-Q)

o J

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 12: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

Key elements

bull Developmental bull Systems-theory bull Preventiive bull Culturall~ bull Relationlal informed

bull Strengthsshy bull Reflective based practice (em~owermentl bull Evidence-based self-advocac~l

--I T CD Q) ICD J CD 0shy

~ --I TT CDCD J -u

CD(J) shyC --1

lt CJ)

0lt - I 1

Q)

raquo-CJ) II

Q) 0 T 3 CD J I

0 CD Q) I

T

lt ~

I shyT 0 C I

~ CD CD

-C-shyJ co

shy

Attachment bull Who have you been attached to

bull What are yo~ur attachment behaviors with these people

bull Who is atta~~hed to you

bull What are th1eir attachment behaviors with you

Attachrnent and Temperament Goodness of Fit

bull Think abolut your temperament Think about the other persons temperament

bull What asp1ects of your temperament support y()ur attachment What aspects of your tem~~erament challenge it

__cl ________ ~___________c_L__ ~~c- bullbull___ l _JL __~_

Attachment

bull Think of all the children in your care one at a time

bull Who did you think of first Second Third bull Next to last Last

bull Describe wlhat the first three children you thought of ~lo to endear themselves to you

bull Describe wlhat the last three children do that makes thenn less endearing

bull Which of these attributes are ones you can help with IHow

a (J) en CD J lt -- CD Jl J

~lt a CJ c 1

a en

aCDC)en J Ol J~-C -- OlJI )1 CJa shyen~c

- Ol c c c c CD CD

r i

~

L

TOUCHpIOINTS A RELATIONAL MODEL OF DEVELOPMENT shy

Growing and learning in relationships

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referE~ncing

bull Shared subjectivity (understanding each other)

bull Self-esteem

States - estados de consciencia

bull Deep sleE~p - sueno profundo

bull Light sleep - sueno ligero bull Drowsine~ss - somnoliento bull Alert - allerta bull Fussy - incomodo

bull Crying - lIanto

(de la escala Brazelton y Prechtl)

State Regulation regulacion de los estc3dos de consciencia

bull Cada estaldo de consciencia tiene sus costos y sus ben~eficios que deben ser equilibrados

bull Diferentes~ estados de consciencia permiten un equilibrio entre las necesidades del nino y las demarldas del medio ambiente

bull Estado de alerta Ie permite al nino comunicarse con las personas que 10 cuidan mientras (~ue los estados de sueno 10 protegen (~ontra la sobre estimulaciorl

__-__shy

State Regulation

bull Each state c)f consciousness has costs and benefits to be balanced

bull States of cOlnsciousness allow for different balances between the infants needs and the environments demands

bull Alert states ~allow the infant to commlunicate with caretakers while sleep states protect against over-stimulation

en -I raquo-I m c m C) c rshyraquo --I o z

--

raquo-CD + en Q)-+

b CD en bull bull

llCD 0 03 CD enco C Q)- Q) CD

0 0 J CD

co C-Q)

o J

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 13: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

--I T CD Q) ICD J CD 0shy

~ --I TT CDCD J -u

CD(J) shyC --1

lt CJ)

0lt - I 1

Q)

raquo-CJ) II

Q) 0 T 3 CD J I

0 CD Q) I

T

lt ~

I shyT 0 C I

~ CD CD

-C-shyJ co

shy

Attachment bull Who have you been attached to

bull What are yo~ur attachment behaviors with these people

bull Who is atta~~hed to you

bull What are th1eir attachment behaviors with you

Attachrnent and Temperament Goodness of Fit

bull Think abolut your temperament Think about the other persons temperament

bull What asp1ects of your temperament support y()ur attachment What aspects of your tem~~erament challenge it

__cl ________ ~___________c_L__ ~~c- bullbull___ l _JL __~_

Attachment

bull Think of all the children in your care one at a time

bull Who did you think of first Second Third bull Next to last Last

bull Describe wlhat the first three children you thought of ~lo to endear themselves to you

bull Describe wlhat the last three children do that makes thenn less endearing

bull Which of these attributes are ones you can help with IHow

a (J) en CD J lt -- CD Jl J

~lt a CJ c 1

a en

aCDC)en J Ol J~-C -- OlJI )1 CJa shyen~c

- Ol c c c c CD CD

r i

~

L

TOUCHpIOINTS A RELATIONAL MODEL OF DEVELOPMENT shy

Growing and learning in relationships

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referE~ncing

bull Shared subjectivity (understanding each other)

bull Self-esteem

States - estados de consciencia

bull Deep sleE~p - sueno profundo

bull Light sleep - sueno ligero bull Drowsine~ss - somnoliento bull Alert - allerta bull Fussy - incomodo

bull Crying - lIanto

(de la escala Brazelton y Prechtl)

State Regulation regulacion de los estc3dos de consciencia

bull Cada estaldo de consciencia tiene sus costos y sus ben~eficios que deben ser equilibrados

bull Diferentes~ estados de consciencia permiten un equilibrio entre las necesidades del nino y las demarldas del medio ambiente

bull Estado de alerta Ie permite al nino comunicarse con las personas que 10 cuidan mientras (~ue los estados de sueno 10 protegen (~ontra la sobre estimulaciorl

__-__shy

State Regulation

bull Each state c)f consciousness has costs and benefits to be balanced

bull States of cOlnsciousness allow for different balances between the infants needs and the environments demands

bull Alert states ~allow the infant to commlunicate with caretakers while sleep states protect against over-stimulation

en -I raquo-I m c m C) c rshyraquo --I o z

--

raquo-CD + en Q)-+

b CD en bull bull

llCD 0 03 CD enco C Q)- Q) CD

0 0 J CD

co C-Q)

o J

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 14: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

Attachment bull Who have you been attached to

bull What are yo~ur attachment behaviors with these people

bull Who is atta~~hed to you

bull What are th1eir attachment behaviors with you

Attachrnent and Temperament Goodness of Fit

bull Think abolut your temperament Think about the other persons temperament

bull What asp1ects of your temperament support y()ur attachment What aspects of your tem~~erament challenge it

__cl ________ ~___________c_L__ ~~c- bullbull___ l _JL __~_

Attachment

bull Think of all the children in your care one at a time

bull Who did you think of first Second Third bull Next to last Last

bull Describe wlhat the first three children you thought of ~lo to endear themselves to you

bull Describe wlhat the last three children do that makes thenn less endearing

bull Which of these attributes are ones you can help with IHow

a (J) en CD J lt -- CD Jl J

~lt a CJ c 1

a en

aCDC)en J Ol J~-C -- OlJI )1 CJa shyen~c

- Ol c c c c CD CD

r i

~

L

TOUCHpIOINTS A RELATIONAL MODEL OF DEVELOPMENT shy

Growing and learning in relationships

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referE~ncing

bull Shared subjectivity (understanding each other)

bull Self-esteem

States - estados de consciencia

bull Deep sleE~p - sueno profundo

bull Light sleep - sueno ligero bull Drowsine~ss - somnoliento bull Alert - allerta bull Fussy - incomodo

bull Crying - lIanto

(de la escala Brazelton y Prechtl)

State Regulation regulacion de los estc3dos de consciencia

bull Cada estaldo de consciencia tiene sus costos y sus ben~eficios que deben ser equilibrados

bull Diferentes~ estados de consciencia permiten un equilibrio entre las necesidades del nino y las demarldas del medio ambiente

bull Estado de alerta Ie permite al nino comunicarse con las personas que 10 cuidan mientras (~ue los estados de sueno 10 protegen (~ontra la sobre estimulaciorl

__-__shy

State Regulation

bull Each state c)f consciousness has costs and benefits to be balanced

bull States of cOlnsciousness allow for different balances between the infants needs and the environments demands

bull Alert states ~allow the infant to commlunicate with caretakers while sleep states protect against over-stimulation

en -I raquo-I m c m C) c rshyraquo --I o z

--

raquo-CD + en Q)-+

b CD en bull bull

llCD 0 03 CD enco C Q)- Q) CD

0 0 J CD

co C-Q)

o J

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 15: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

Attachrnent and Temperament Goodness of Fit

bull Think abolut your temperament Think about the other persons temperament

bull What asp1ects of your temperament support y()ur attachment What aspects of your tem~~erament challenge it

__cl ________ ~___________c_L__ ~~c- bullbull___ l _JL __~_

Attachment

bull Think of all the children in your care one at a time

bull Who did you think of first Second Third bull Next to last Last

bull Describe wlhat the first three children you thought of ~lo to endear themselves to you

bull Describe wlhat the last three children do that makes thenn less endearing

bull Which of these attributes are ones you can help with IHow

a (J) en CD J lt -- CD Jl J

~lt a CJ c 1

a en

aCDC)en J Ol J~-C -- OlJI )1 CJa shyen~c

- Ol c c c c CD CD

r i

~

L

TOUCHpIOINTS A RELATIONAL MODEL OF DEVELOPMENT shy

Growing and learning in relationships

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referE~ncing

bull Shared subjectivity (understanding each other)

bull Self-esteem

States - estados de consciencia

bull Deep sleE~p - sueno profundo

bull Light sleep - sueno ligero bull Drowsine~ss - somnoliento bull Alert - allerta bull Fussy - incomodo

bull Crying - lIanto

(de la escala Brazelton y Prechtl)

State Regulation regulacion de los estc3dos de consciencia

bull Cada estaldo de consciencia tiene sus costos y sus ben~eficios que deben ser equilibrados

bull Diferentes~ estados de consciencia permiten un equilibrio entre las necesidades del nino y las demarldas del medio ambiente

bull Estado de alerta Ie permite al nino comunicarse con las personas que 10 cuidan mientras (~ue los estados de sueno 10 protegen (~ontra la sobre estimulaciorl

__-__shy

State Regulation

bull Each state c)f consciousness has costs and benefits to be balanced

bull States of cOlnsciousness allow for different balances between the infants needs and the environments demands

bull Alert states ~allow the infant to commlunicate with caretakers while sleep states protect against over-stimulation

en -I raquo-I m c m C) c rshyraquo --I o z

--

raquo-CD + en Q)-+

b CD en bull bull

llCD 0 03 CD enco C Q)- Q) CD

0 0 J CD

co C-Q)

o J

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 16: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

__cl ________ ~___________c_L__ ~~c- bullbull___ l _JL __~_

Attachment

bull Think of all the children in your care one at a time

bull Who did you think of first Second Third bull Next to last Last

bull Describe wlhat the first three children you thought of ~lo to endear themselves to you

bull Describe wlhat the last three children do that makes thenn less endearing

bull Which of these attributes are ones you can help with IHow

a (J) en CD J lt -- CD Jl J

~lt a CJ c 1

a en

aCDC)en J Ol J~-C -- OlJI )1 CJa shyen~c

- Ol c c c c CD CD

r i

~

L

TOUCHpIOINTS A RELATIONAL MODEL OF DEVELOPMENT shy

Growing and learning in relationships

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referE~ncing

bull Shared subjectivity (understanding each other)

bull Self-esteem

States - estados de consciencia

bull Deep sleE~p - sueno profundo

bull Light sleep - sueno ligero bull Drowsine~ss - somnoliento bull Alert - allerta bull Fussy - incomodo

bull Crying - lIanto

(de la escala Brazelton y Prechtl)

State Regulation regulacion de los estc3dos de consciencia

bull Cada estaldo de consciencia tiene sus costos y sus ben~eficios que deben ser equilibrados

bull Diferentes~ estados de consciencia permiten un equilibrio entre las necesidades del nino y las demarldas del medio ambiente

bull Estado de alerta Ie permite al nino comunicarse con las personas que 10 cuidan mientras (~ue los estados de sueno 10 protegen (~ontra la sobre estimulaciorl

__-__shy

State Regulation

bull Each state c)f consciousness has costs and benefits to be balanced

bull States of cOlnsciousness allow for different balances between the infants needs and the environments demands

bull Alert states ~allow the infant to commlunicate with caretakers while sleep states protect against over-stimulation

en -I raquo-I m c m C) c rshyraquo --I o z

--

raquo-CD + en Q)-+

b CD en bull bull

llCD 0 03 CD enco C Q)- Q) CD

0 0 J CD

co C-Q)

o J

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 17: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

a (J) en CD J lt -- CD Jl J

~lt a CJ c 1

a en

aCDC)en J Ol J~-C -- OlJI )1 CJa shyen~c

- Ol c c c c CD CD

r i

~

L

TOUCHpIOINTS A RELATIONAL MODEL OF DEVELOPMENT shy

Growing and learning in relationships

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referE~ncing

bull Shared subjectivity (understanding each other)

bull Self-esteem

States - estados de consciencia

bull Deep sleE~p - sueno profundo

bull Light sleep - sueno ligero bull Drowsine~ss - somnoliento bull Alert - allerta bull Fussy - incomodo

bull Crying - lIanto

(de la escala Brazelton y Prechtl)

State Regulation regulacion de los estc3dos de consciencia

bull Cada estaldo de consciencia tiene sus costos y sus ben~eficios que deben ser equilibrados

bull Diferentes~ estados de consciencia permiten un equilibrio entre las necesidades del nino y las demarldas del medio ambiente

bull Estado de alerta Ie permite al nino comunicarse con las personas que 10 cuidan mientras (~ue los estados de sueno 10 protegen (~ontra la sobre estimulaciorl

__-__shy

State Regulation

bull Each state c)f consciousness has costs and benefits to be balanced

bull States of cOlnsciousness allow for different balances between the infants needs and the environments demands

bull Alert states ~allow the infant to commlunicate with caretakers while sleep states protect against over-stimulation

en -I raquo-I m c m C) c rshyraquo --I o z

--

raquo-CD + en Q)-+

b CD en bull bull

llCD 0 03 CD enco C Q)- Q) CD

0 0 J CD

co C-Q)

o J

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 18: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

L

TOUCHpIOINTS A RELATIONAL MODEL OF DEVELOPMENT shy

Growing and learning in relationships

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referE~ncing

bull Shared subjectivity (understanding each other)

bull Self-esteem

States - estados de consciencia

bull Deep sleE~p - sueno profundo

bull Light sleep - sueno ligero bull Drowsine~ss - somnoliento bull Alert - allerta bull Fussy - incomodo

bull Crying - lIanto

(de la escala Brazelton y Prechtl)

State Regulation regulacion de los estc3dos de consciencia

bull Cada estaldo de consciencia tiene sus costos y sus ben~eficios que deben ser equilibrados

bull Diferentes~ estados de consciencia permiten un equilibrio entre las necesidades del nino y las demarldas del medio ambiente

bull Estado de alerta Ie permite al nino comunicarse con las personas que 10 cuidan mientras (~ue los estados de sueno 10 protegen (~ontra la sobre estimulaciorl

__-__shy

State Regulation

bull Each state c)f consciousness has costs and benefits to be balanced

bull States of cOlnsciousness allow for different balances between the infants needs and the environments demands

bull Alert states ~allow the infant to commlunicate with caretakers while sleep states protect against over-stimulation

en -I raquo-I m c m C) c rshyraquo --I o z

--

raquo-CD + en Q)-+

b CD en bull bull

llCD 0 03 CD enco C Q)- Q) CD

0 0 J CD

co C-Q)

o J

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 19: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

States - estados de consciencia

bull Deep sleE~p - sueno profundo

bull Light sleep - sueno ligero bull Drowsine~ss - somnoliento bull Alert - allerta bull Fussy - incomodo

bull Crying - lIanto

(de la escala Brazelton y Prechtl)

State Regulation regulacion de los estc3dos de consciencia

bull Cada estaldo de consciencia tiene sus costos y sus ben~eficios que deben ser equilibrados

bull Diferentes~ estados de consciencia permiten un equilibrio entre las necesidades del nino y las demarldas del medio ambiente

bull Estado de alerta Ie permite al nino comunicarse con las personas que 10 cuidan mientras (~ue los estados de sueno 10 protegen (~ontra la sobre estimulaciorl

__-__shy

State Regulation

bull Each state c)f consciousness has costs and benefits to be balanced

bull States of cOlnsciousness allow for different balances between the infants needs and the environments demands

bull Alert states ~allow the infant to commlunicate with caretakers while sleep states protect against over-stimulation

en -I raquo-I m c m C) c rshyraquo --I o z

--

raquo-CD + en Q)-+

b CD en bull bull

llCD 0 03 CD enco C Q)- Q) CD

0 0 J CD

co C-Q)

o J

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 20: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

State Regulation regulacion de los estc3dos de consciencia

bull Cada estaldo de consciencia tiene sus costos y sus ben~eficios que deben ser equilibrados

bull Diferentes~ estados de consciencia permiten un equilibrio entre las necesidades del nino y las demarldas del medio ambiente

bull Estado de alerta Ie permite al nino comunicarse con las personas que 10 cuidan mientras (~ue los estados de sueno 10 protegen (~ontra la sobre estimulaciorl

__-__shy

State Regulation

bull Each state c)f consciousness has costs and benefits to be balanced

bull States of cOlnsciousness allow for different balances between the infants needs and the environments demands

bull Alert states ~allow the infant to commlunicate with caretakers while sleep states protect against over-stimulation

en -I raquo-I m c m C) c rshyraquo --I o z

--

raquo-CD + en Q)-+

b CD en bull bull

llCD 0 03 CD enco C Q)- Q) CD

0 0 J CD

co C-Q)

o J

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 21: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

__-__shy

State Regulation

bull Each state c)f consciousness has costs and benefits to be balanced

bull States of cOlnsciousness allow for different balances between the infants needs and the environments demands

bull Alert states ~allow the infant to commlunicate with caretakers while sleep states protect against over-stimulation

en -I raquo-I m c m C) c rshyraquo --I o z

--

raquo-CD + en Q)-+

b CD en bull bull

llCD 0 03 CD enco C Q)- Q) CD

0 0 J CD

co C-Q)

o J

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 22: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

en -I raquo-I m c m C) c rshyraquo --I o z

--

raquo-CD + en Q)-+

b CD en bull bull

llCD 0 03 CD enco C Q)- Q) CD

0 0 J CD

co C-Q)

o J

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 23: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

--

raquo-CD + en Q)-+

b CD en bull bull

llCD 0 03 CD enco C Q)- Q) CD

0 0 J CD

co C-Q)

o J

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 24: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

() Q) -c Q)

Q en r-+- r-+shylt Q) r-+-r-+shyo CD 00 CD CD

CCCC _ c ~Q)CD ~ -s 0 -UJ -s o r-+shyCD CIJ r-+shy

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 25: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

--

--

(I) n AJ3 D) (I) o-ccc

os

D)n iIIIII -- Dr0 n

D) D) - shy-cO D) -c s Q1D)o __ (I) -D)

~-c 0__ en =0 II

lt (I) en en os-~ D)= (I)

3 o o s en

0 I en

- shy

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 26: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

III III

lor I tat t tenci

Infants Selnses

bull are affected by her state

bull especially receptive to human in~)ut

bull even more receptive to mothers input

bull lead to e)(periences even before birth which cain be remembered and rE3ferred to later

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 27: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

bull bull -- --

--

I

r CD -shy3 0 W

bull

3

I

0 CD J

co Ol

co CD J

Z CD ~ cshy0 J

J OCD o CD CD 1 Ol CshyOl W J omiddot ru I ---cJ I

c-wCDCD r r -- CD OlOco lt ~ c o Ol I

o -shy

J

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 28: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

State Regulation and Sensory Functioning

bull Sensory slensitivity bull Sensory p~rocessing bull Sensory tl1resholds bull Multimodcll sensory processing bull Supramoejal sensorimotor functions bull Habituatictn - neural filtering bull Soothing self-soothing

Copyright 2009 by Joshua Sparrow All Rights Reserved

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 29: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

bull bull

~ T 0 T - ~I)

-c CJ)

C CJ)

CJ)

0 0 I

T CD-v

CD Q) I

bull 0

~ CJ) T

bull -c CJ)

()CD Q)cc c CD

ccQ) bull I ~

~

0 bull

CDJ CJ)

0 I J CDCD CDJ ccc

Q) CJ)

cc IQ)CD I

bull CD J

-u Q) CD J I

en Q) J c 0 IT CD

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 30: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

Meaning of childs behavior to parents and other caregivers

bull Observation bull Shared [)iscovery bull Co-construction of meaning Pre-requisites bull Emotional availability - in order to

observe bull Relationship - in order to share

observations construct meaning

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 31: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

--____ __j _____~_ Jgt _______ __________-1_____ l_J~middot_ __

Supports for Parents and Other Caregivers State Regulation

bull Social c~onnectedness bull Sense of competence efficacy

confidence

bull Experiences of empowerment

bull Caregiving that brings moments of pleasure and joy

bull Enduring hope

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 32: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

State Regulation

bull Think of tile last time you were in a fussy state What triggered the fussing

bull Made it worse Better bull What were you thinking while fussy bull New thoughts as you started feeling less

fussy bull In what ways did the quality of your

thinking change as you started fe~3ling less fussy

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 33: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

bull__________ J-__----_

State Regulation bull Think of a chil~d and what he or she did while in a

fussy state bull How could YOlJ tell - what did you observe- that the

child was in a fussy state bull What triggere(j the fussing bull Did anything nnake it worse Better bull Does the childl know what made it worse Better bull What do you think the child was thinking while feeling

fussy bull How did the Cllilds thoughts change as he or she

started feeling less fussy bull How did the q1uality of thinking change as he or she

felt less fussy

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 34: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

bull 1______ ______ ____~ --~-

All Behavior is State Dependent for ~-Iumans of All Ages

bull Behavior ~dependent on cognition is altered by

bull states of consciousness (eg drowsy alert) and by

bull emotional states (eg anxious angry serene slJspicious open etc)

bull Neurobiological correlates activity of areas of l~rain responsible for arousal emotion c3nd cognition are wired together and can support or overwhelm each other

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 35: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

____-1 _________ bull __ ____~

BUILDINGi BLOCKS of EMOTIONAL [)EVELOPMENT

LEARNIIlG IN RELATIONSHIPSmiddot

bull Attachment

bull State regulation

bull Mutual regulation

bull Social referencing

bull Shared subjectivity (understanding each other)

bull Self-esteem

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 36: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

~~ __ ~~~___ __~ __~~~~~~___~~~___~__~ ____J~~_~_____~

Emotional availability - to learn from ITlistakes

Cross-cultural variations in mutual regulation

Variaciones trc3nsculturales en regulacion mutua

Demandas del media ambiente y regulacion mutuc

Environmental Demands and Mutual Regulation

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 37: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

Mutual Regulation throughout the lifespan

bull In all of OLlr actions everyday with family friends cc)lIeagues and clients

bull Shaped by our states - of consciousness and emotion

bull Shaped by our cultures and cultural differences

Mutual regulation is how way get and feel conrlected

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 38: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

_____________________ ____ _________J __L _________ L-___L _____

Connections staying in touch bull Resnick et al laquo Protecting Adolescents From Harm shy

findings from the National Adolescent Longitudinal Health Study raquo JAMJ~ Sept 10 97-Vol 278 No 10) - 93000 adolescents in NC Minn

bull Parent-ch i Id closeness assessed laquo Most of 1the time your parent is warm

and lovillg to you raquo laquo You are satisfied with the way your

parent alnd you communicate with each othler raquo

laquo Overall you are satisfied with your relationship with your parent raquo

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 39: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

bull ____1____ bullbullbull bullbull_L_ bullbull _

Connections

Crucial metlsure of childs closeness to parent

bull 5 out of 7 meals as a family in past week

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 40: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

Connections Importance oif Parental Involvement

Smoking 42~o of 15 - 16 yo who dont feel close to parents smoke 26 smoke who do 34 who dc)nt eat dinner regularly with parents smc)ke 25 smoke who do

Drinking 2 x higher prevalence in 15 - 16 yo who dont f_~el close or do not have meals together as compared with those who do

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 41: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

________________________________________________

----

____________~ 1 ___bull ________________________L _____

Connections bull Drug us~ 50 of 15- 16 yo who

arent close to parents used MJ as opposed to 24 of those who are

bull Violenc_~ 40 involved in serious fights who arent close to parents 30 wh~o are

bull Suicide thoughts 3x more likely in teens wlho arent close attempts 2x more likely

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 42: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

bull

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 43: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

Reconocimiento de la expresion facial y referencia social

Facial Expression Recognition and Social Referencing

What you trying to tell me

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 44: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

--

--

--

3 I Q) I

o J Q) J 0

0 eo J I

--I () Q) bull I

o -shy

J

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 45: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

--

0 CD Q)-~

-c 0-Q)

lt-shyJ cc

en lt 3 tT 0-n -c-Q)

lt

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 46: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

bull bull

----

en CD

I I I

CD (1) I

CD CD 3

c c I

3 lt(J) CD

I Ishy

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 47: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

Shared subjectivity

bull Putting tog~9ther attachment state regulation self regulation mutual regulation and social referencing creates the possibility for the process in which two people meet experience connection~ work to make meaning together toward mutual understanding

bull This also rE~quires what is sometimes called laquo theory of mind raquo

bull This is the foundation for empathy cornpassion nonviolent ~cooperation on a peaceful ~)Ianet

Copyright 2009 by Joshua Sparrow All Rights Reserved

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 48: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

Key elements

bull Developmental bull Systems-theory bull Preventive bull Culturally bull Relational informed

bull Strengthsshy bull Reflective -based ~ractice

(empow~ermentl bull Evidence-based self-advocacy

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 49: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

Para enarmorarse de un nino los padres necesitan

bull Un sentido de competencia(somos expertos pero los paldres tambien)

bull Hacerlos sfsntir que tienen el poder para obtener 10 Imejor para sus ninos

bull Comunidaej y conexiones - una red de relaciones

bull Conexion con el pasado e identidad cultural bull Esperanza para el futuro- la capacidad para

proyectars43 a si mismo al nino y la familia con esperalnza para un futuro mejolr

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 50: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

To ffall in love with a child parents need emotional availability

bull A sense of competence (we are experts but parents are too

bull EmpowermE~nt bull Connectionst - a web of relationships to

community to cultural identity bull Hope - the capacity to envision ones self child

family with hope

WE CAN USE OUR RELATIONSHIPS WITH PARENTS 1-0 SUPPORT

THEIR RELATIONSHIPS WITH THEIR CHILDREN

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 51: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

Enhancing Parent Potential

bull Parental sene of competence efficacy self-agency iinternalized locus of control

bull Parental conl1ectedness to family friends social supports community

bull Parental opp~Drtunities for self-determination and empowerment

bull Hope

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 52: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

_ _____________~____J _ _____ bull1__

What parents need to be the kind of parents they want to be

for their children bull To perceife themselves as competent

bull To feel enlpowered to make a difference in their childrens lives

bull To feel connected to a web of supportive relationshiips - the village

bull To feel connected to their pasts to be emotionailly available in the present and to dare to hope for their childrens future

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 53: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

Nuestro papel en el desarrollo integral del nino

apoyar a toda la familia

bull Mas alia de ser expertos debemc)s estar emocionalmente presentes con los padres para apoyar la disponibilidad emocional de los padres en el desarrollo emocional de sus ninos

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 54: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

Reflective Practice Not enough 1time or Using the tinle we have differently

taking car~ of ourselves to take care of others

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 55: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

F~eflective Practice for Caregivers at Risk

bull Rescue falntasies bull Unreasonable expectations (both ways) bull Vicarious traumatization bull Fear frustration disappointment bull Feelings e)f failure and futility

bull Self doubt bull Burn out demoralization loss of task

orientatiorl bull Self blamE3 - turned against other~) bull Hopelesslless - the negative model

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 56: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

~_ 1 __ _ __ ________ ~__~~___L_ _L

Parents Need Emotionally Available Professional Caregivers

bull To share ttle care bull To honor E~licit and support parents

expertise alnd perspectives bull To support and strengthen parent-child ties (There is no such thing as quality education

without fanlily involvement)

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 57: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical

__lt ___________ 1- _1 ___ __

Professional Caregivers Need - in order to be emotionally available

bull Adequate pay benefits job security respect

bull Recogniti~Jn of their value and expertise bull Understanding of their challenges bull Emotionall support -including connections

to their colleagues- as they share the care with parerts entering into intimate emotional relationships with children necessary for learning

bull Opportuniities for continuous adult learning

Page 58: Touchpoints of Infant, Toddler, Preschool Development ... of Infant, Toddler, Preschool Development: Foundations for Strong COlmmunities: PART II . Joshua Sparrow, MD . Harvard Medical