HSO711 - Podcast AUdio presentation Louise Vaccaro

This podcast discusses how trauma impacts biopsychosocial development and play. It emphasizes the importance of considering all the factors that shape a child's life. The biopsychosocial model examines the biological, psychological, and social factors that affect development. Good nutrition, genetics, and brain function are examples of biological factors. Psychological forces include cognitive and emotional development, while social factors include interactions with others and cultural influences. Play is a crucial aspect of human development, promoting brain development and emotional well-being. Attachment plays a key role in play development, as a secure attachment allows children to explore and interact with their surroundings. Trauma, especially neglect, can significantly affect development, including the ability to engage in play. It may lead to difficulties in forming relationships and acquiring social skills. Understanding the impact of trauma on development and play is essentia Hi and welcome to today's podcast. Today we are going to take a look at how trauma impacts on biopsychosocial development and the ability to play. I'd like to begin with an acknowledgement of country. In a spirit of reconciliation, I'd like to acknowledge the traditional custodians of the land on which we meet today, the Wurundjeri people. I pay my respects to all of the elders past, present and emerging. Human development is a fascinating thing to stop and consider the way we as human beings grow and develop. It's a cycle, a journey, with many forces shaping and impacting the life as it grows. When we as professionals consider the children we work with, we must take into account all of the forces that shape their lives and make them who they are today. As caregivers of children, my hope today is that you walk away with a deeper understanding of trauma and how it affects biopsychosocial development and play. When we talk about biopsychosocial development, we're talking about a holistic approach to understanding health and development and the interplay between the biological, the psychological and the social factors that affect the health and growth of an individual. When we think about the way a child grows, there are many factors that influence their growth and development. It's not just genetics or the environment, nor is it simply nature versus nurture. It isn't one thing in isolation that determines development. Rather, it is a multi-layered construct of different functions interplaying with each other, each one shaping and impacting an individual's growth and wellbeing. Here is Dr. Gabriel Marte, whose work will be drawn upon throughout the podcast, describing biopsychosocial development. Everything depends on everything else. He says the one contains the many and the many contains the one. You can't understand anything in isolation from its environment. The leaf contains the sun, the sky and the earth, obviously. This has not been shown to be true, of course, all around, and specifically when it comes to human development. The modern scientific term for it is the biopsychosocial nature of human development, which says that the biology of human beings depends very much on their interaction with the social and psychological environment. So let's break down the biopsychosocial model a bit closer. As mentioned, the BPS model examines the biological, psychological and social factors affecting an individual's development. The biocomponent of BPS looks at aspects of biology that affect a person's health and development. Most of us understand biological growth returns to the physiological changes one experiences as their body grows. It includes things like brain function, genetics, DNA, endocrine functioning, gender, physical health and body chemistry. It encompasses the functioning of major body organs and the motor system. Good nutrition is one aspect of biological function. Our bodies need certain nutrients to grow. Even in the womb, a growing baby needs vitamins to ensure healthy development. If a baby doesn't get enough folic acid, for example, in its early stages of growth, they have a higher risk of birth defects such as spina bifida. Genetics also play a part in development. Things like eye colour, weight, height and even behavioural patterns are all influenced by genetics. A child's biology can have major implications on their development. So the more we understand the science behind a child's mind and body, the better we are able to nurture them to their full potential. The psychocomponent of BPS examines the psychological mechanisms that impact growth and development. It encompasses our cognitive, emotional, intellectual and social development. Psychological forces include the development of thoughts, emotions and behaviours. As we grow up, we experience life and we begin to understand the world in a complex place. Our thoughts are formed, our personalities are shaped and choices are made. The psychological functions include how we learn, the coping skills we use, our temperament and how we adapt. There are many theories that underpin this psychological development. John Piaget's theory of cognitive development is one. His description of the psychological development of a child suggests four stages of cognitive development, with each stage describing how children learn and assimilate the information they receive in the early years. Piaget argues that intelligence grows and develops through a series of stages. That development is not just about acquiring knowledge, but that children have to develop a concept or mental model of the world. He believes all children, regardless of culture, move through each stage in the same order. Another theory influencing psychological development is that of attachment. First described by John Bowlby, attachment theory highlights the significance of the two-way bond between baby and mother and its effect on the infant's long-term social and emotional wellbeing. Bowlby suggested that the most important thing a young child needs is to develop a close relationship with at least one primary caregiver. Once established, the attachment bond acts as a secure base for the infant, who, once feeling safe and secure, has the confidence to move out and explore behaviours, engage in play and discover the world. Bowlby echoed these findings of Eric Erickson, who highlighted the importance of early relationships and the impact of these real-life experiences across the lifespan. Even within these theories, we can see the interplay between psychological, biological and social sciences influencing growth and development. Now let's look at the social component of BPS, which looks at the social factors that impact the health of an individual. So things like our interactions with others, our culture or a group of values, ideas and beliefs that influence our development. They might include religious groups that we're part of and the environments that we're growing up in. Examples of this force include morals, habits and practices. It includes our ideas about self and what we believe and the systems we are a part of. Vygotsky and theories highlight the role of social interaction in human development and cognition. Vygotsky believed that communities play a central role in the process of making meaning and understanding. He suggested that human development is a socially negotiated process with children acquiring values, beliefs, problem-solving strategies through collaborative dialogues and experiences with people in society. Part of the social component of the BPS model might consider the argument for nature versus nurture. In psychology there's been a long-standing debate over the formation of a person's character and behaviour and whether it's determined by nature, so biology and genetics, predetermined factors, or if it is nurture, our experience and interaction with the environment we're in. Science has shown that it is not a matter of either, but rather it is a combination of both forces interacting and influencing each other. To echo what Gabor said earlier, the biology of human beings depends on their interaction with the social and psychological environment. You can't understand anything in isolation from its environment. Everything is connected. With all that information about biopsychosocial development, let us now turn the lens on play development. Play is an important part of life and according to the Journal of Play it is a primary function of human development. From the minute life begins, play is there to teach us, shape us and help us learn and grow. Even in the animal kingdom we see newborn animals actively exploring the world, wrestling, chasing, tumbling, pouncing and engaging in play. It is natural and instinctive to almost all living things. Why Gotsky believed that play holds a central role in promoting brain development and abstract thought, he proposed that children's abilities could be perfected through play. As children play, they put their abilities into practice without even realising it. Thus playfulness is strongly connected to cognitive development and emotional wellbeing. As mentioned earlier, attachment is deeply connected to play. When a child feels secure with their caregiver and good attachment is developed, he or she will feel safe to explore the world around them. Knowing that there is a secure base to return to at any time, a child will engage in new behaviours and activities as they go out, explore and interact with their surrounds. And much of this exploration and self-discovery in their early years happens through play. So here we can see how attachment intersects with play development. The bond between a primary caregiver and infant is a powerful force. In play therapy, we recognise this force and acknowledge that it is relationships that are the agent for change. The power of human connection seen in the parent-child attachment that is driven by love, care and unconditional positive regard are vital for optimal development. They impact brain development, social development and emotional development. In terms of therapeutic interventions, these therapeutic qualities can be found in play. We call them the therapeutic powers of play. In her work, Judy Parsons of Deakin University has categorised these 20 therapeutic powers of play, showing that play fosters emotional wellness, facilitates communication, increases personal strength and enhances social relationships. When we think about play development, it is important then to consider it is tracking alongside all the other areas of growth that is taking place. The embodiment role projection model shows this holistic approach to play development well. The model shows the different stages of play that a child will go through as they grow, from somatic sensory play in the womb to attachment, then embodiment sensory play to projective small world play, on to drama role play and then play integration. This model takes into account the bio-cycle social development that is happening simultaneously. So while play is developing, all the other developmental processes are happening alongside it. If you can imagine a graph, all those things are tracking together. In the ERP model, we see the neurobiological development that is happening, how the brain is growing and functioning. At the same time, we can see the cognitive development at work. We see Erickson's eight stages of psychosocial development. We see that play is developing and changing at each of these stages. Each area of development interplay with one another and move sequentially as the child grows. Given this is a podcast, I can't show you the graphic, but if we can zoom in on one stage to highlight how these bio-psychosocial development stages all work together alongside play. Imagine, if you will, a newborn baby, its tiny forms and newness of life, the smell, the softness. Now let's think about the development that is happening. Right now that baby's brain stem is rapidly growing. When an infant is born, they have billions of neurons in their brain. However, many of them are not yet connected. Connections happen when the baby receives information from their experiences. So every encounter that a baby has, every touch, feel, sound, smell, stimulate those neurons connecting. We can see why attachment is so important. Bruce Perry outlines this in his Neurosequential Model of Development. I encourage you to have a look at his work. It's very insightful. The quality and number of these experiences are what hardwire the brain. And if these experiences are positive, they can lead to lifelong healthy connections. If they are negative or infrequent, the connections can be lost and health compromised. Many of these connections for an infant are happening through the senses and also through play. As the EPR model shows, at this stage of early development, play is developing based on attachment and sensory play. When a baby is sung to or tickled or is gently rocked, the brain receives that information and neural connections are formed. The more they are repeated, the stronger these connections become. At this first stage of development, we see the infant is at what Erikson describes in his Psychosocial Model as trust versus mistrust stage. At this stage, infants develop a sense of trust when caregivers provide consistent, reliable care and love. When a baby goos and gahs, the majority of mothers will respond with delight and positive regard and they will goo back. The baby learns that he can impact the world. And these repeated interactions enforce feelings of safety and that people can be trusted. However, mistrust will form if a caregiver fails to provide adequate care and love. The child will feel they cannot trust or depend upon the adults in their life. And when there is no or little response from the goos and gahs, the child will begin to feel alone and that the world is not a safe place and people can't be trusted. This can be overwhelming and disempowering for an infant, which in turn affects their overall development and well-being. It is here that we see the impact that trauma has on biopsychosocial development and the ability to play. Here is Nadine Burke talking about trauma. In high doses, it affects brain development, the immune system, hormonal systems, and even the way our DNA is read and transcribed. Folks who are exposed in very high doses have tripled their lifetime risk of heart disease and lung cancer and a 20-year difference in life expectancy. And yet doctors today are not trained in routine screening or treatment. Now the exposure I'm talking about is not a pesticide or a packaging chemical. It's childhood trauma. It is important to first define trauma. The definition of trauma has evolved over the years as more has become known about it. In its simplest form, trauma is the body's response to an adverse event. Trauma can be classified into different types. Some psychologists have referred to it as small T and capital T trauma. Capital T trauma are those things that are extreme and leave us feeling threatened, at risk, and in danger. Events like natural disasters, war, witnessing death, or illness, abuse, neglect, and abandonment. Small T trauma refers to events that don't usually involve disaster and violence, but do create significant stress. Events such as bullying, the death of a pet, being rejected by friends. Events that generate shame, fear, guilt, and anxiety. If we think back to the newborn baby, if the trauma is experienced in the form of neglect, the impact that it has on the child's development can be significant. The impact it has on the brain alone can cause lifelong changes. As discussed earlier, the neural pathways forming and connecting rely on positive repeated experiences. When the infant feels love and safety, the brain is able to grow in a healthy sequential manner. But when the brain is put under significant stress, for example, if the baby is neglected and the carer is non-responsive to its cues, it triggers the stress response, leaving the baby feeling unsafe and in a state of hyper or hyper arousal. If a caregiver is not attuned to the baby's needs, the cries for food or comfort, for physical touch and connection, the baby's brain will remain under stress. This causes feelings of mistrust to develop. When a child's foundations are shaken through traumatic events such as neglect, maladaptive coping mechanisms can form as the child looks for ways to cope. If healthy attachment is not formed during this time, babies are likely to have problems in many areas in later life. They may have difficulty developing trust in their relationships and may have poor social and educational skills. They may also have difficulty with play. According to the EPR model, early forms of play happen through attachment. If insecure attachment is experienced, play is often hindered. Those early sensory experiences such as a mother singing to her baby, playing peek-a-boo, tickling and rocking, all teach the child about human interaction. They encourage confidence, security and create the desire to explore the world around them. When a child is neglected and insecure attachment is formed, they are not willing to engage in play. Many developmental opportunities are missed and difficulty in future relationships can occur. Play encourages self-regulation and the dynamics of working together with another person. If a child misses out on these experiences, they may not acquire the skills needed for play. A child that experiences neglect can become withdrawn and anxious. They may develop feelings of fear and be unsure of how to relate to others around them. A child that misses out on the embodiment stage of play and sensory play may lack the ability to be able to engage in projective small world play, thus limit their ability to play with others. Games with rules could be difficult as the anxiety and feelings of rejection may trigger the stress response. Children who have limited opportunities to engage in play can struggle with speech and language acquisition. Much of our early language occurs through play. As Vygotsky suggested, play contributes to a child's development of language and their ability to control their own cognitive and emotional expressions. We see therefore that a child who has experienced early trauma and insecure attachment will often show signs of mistrust, shame and doubt, feelings that impact the ability to engage in and enjoy in meaningful play. I hope that this podcast has been helpful and that you have gained a further understanding of the effects of trauma on biopsychosocial development and play.