REGULATION. In D.I.R.: Regulation as a Developmental Process. October Regulation as a Developmental Stage (1) Regulation as a Diagnostic Feature

Transcription

1 REGULATION Regulation is the most widely used construct in current developmental research that still awaits a comprehensive definition. Feldman 2007 In D.I.R.: Regulation as a Developmental Stage (1) Regulation as a Diagnostic Feature Regulation as a Goal Regulation as a Developmental Process External Regulation (1-3 months) Stage 1 Mutual (CO) Regulation (4-24 months) Stages 2,3,4 Self Regulation (24-36 months and on ) Stages 5,6,7,8,9 Level 1: Regulation and Shared Attention 0-3 m Level 2: Engaging and Relating/Mutual Engagement 4-5 m Level 3: Purposeful Emotional Interaction/Two-Way Purposeful Communication 6-9 m Level 4: Shared Problem Solving/Sense of Self 9-18 m Level 5: Symbolic Thinking/Creating Ideas m Level 6: Building Bridges/Emotional Thinking m Level 7: Multicausal and Triangular thinking Level 8: Comparative and Gray Area Thinking Level 9: Reflective Thinking/Growing Sense of Self/Stable Internal Standard 1

2 Regulation - Definition In essence, regulation refers to the organization of discrete components into a unified system, the cycling of that system between processes of excitation and inhibition, and the integration of physiological, behavioral, and mental processes into a goal-directed action which is then internalized as mental representation Adaptive Response System Defiance Aggression Fear/Defensivene ss Hyper-arousal Excessive Activation Self reliance Exploration Approach Gazing at Orientation Arousal Alertness Arousal Attention Affect Action Seek Help Reassurance Avoidance Gazing Away Habituation Quieting Sleepiness Activation Inhibition Tolerance Range Physiological Regulation Sensory-Motor Functioning Integration and Processing of Experience Communicative Signals Papousek, M., Scheiche, M., Wurmser, H., 2008 Dependency Clinginess Fear/ Withdrawal Avoids eye contact Unresponsiveness Excessive sleeping Excessive Inhibition EXTERNAL REGULATION maternal (parental) proximity and interactive behavior serve an external regulatory function for the organization of neurobiological, sensory, perceptual, emotional, physical, and relational systems Development is thus grounded in relationships and this initial dependence of the infant on the mother s body opens the lifelong neurobiological possibility that one person can serve an external regulatory function to the physiological systems of another through timely adaptations to distress and social cues 2

3 Over time, autonomic, neurological, and endocrinology systems in each partner are sensitized to the temporal patterns of the other, leading to the formation of a unique bond Mothers usually synchronize these behaviors with the neonate s scant moment of alertness. Postpartum Behaviors Postpartum maternal repertoire in humans includes gaze at the infant s face, motherese high pitched vocalizations, affectionate touch and careful adaptation to the infant s state and signals Feldman 2007 Emerging Contingency By coordinating social behavior with the infant state, mothers capitalize on the neonate's innate capacity to detect contingencies between discrete events in the environment, between different modalities in the infant s own behavior, and between the behaviors of self and other. Such inborn contingency can be seen by neonates movement of limbs in coordination with adult s speech. 3

4 MUTUAL REGULATION Between the ages of 2 and 3 months, parentinfant interactions begin to show a clear temporal structure, in terms of behavior matching, sequential relations, and time-series parameters. Interactions at this age involve repetitiverhythmic cycles of behaviors in different modalities, including gaze, touch, affective expression, body orientation, manual actions, and arousal indicators. Specific combinations of interactive behaviors become more frequent and turn into repetitive, almost automatic configurations, constellations of behaviors, which, from a dynamic systems perspective are viewed as attractor states interpersonal patterns that appear frequently and are likely to shape neural pathways. Feldman 2007 Sequential relations between maternal and child behaviors often lead to rhythmic chains of interactive behaviors Mothers tend to frame the infants actions with social attention and positive affect. In using such framing methods, mothers augment the infant s attention by maintaining the balance between the familiar and the novel and setting the play stage as an important arena for cognitive growth. 4

5 From Biological Rhythms to Social Rhythms During play infants cycle between states of attention and non-attention and between episodes of positive and neutral affect the tendency to cycle between states regardless of the partner s behavior (indicates) that internal rhythmicity is an important determinant of social interactions across life. Early communication systems, therefore, appear to develop through the on-going integration of biological, emotional, and contextual components which provides a temporal framework for the organization of the infant s cognitive and affective experiences. Infants with more mature biological rhythms at term age showed higher levels of mother-infant synchrony at 3 month. More biologically regulated children elicit more reciprocal interactions from their caregivers, but are also likely to develop self-regulatory and social-adaptive competencies. When infants can provide moment-by-moment cues, and their caregivers can pick those up, they (the caregivers) tend to be less anxious or depressed. 5

6 Synchrony of heart rates during motherinfant play and 3 and 6 months Results suggest synchrony in the acceleration or deceleration of heart rate within a lag of 3 seconds. interpersonal match between mother and child may transcend the behavioral level to the biological level. This may suggest that within an attachment relationship, the individual s biological rhythms may be integrated into shared timing. Mutual Gaze At the 3 months, the sharing of social gaze between parent and child becomes the central modality of coordinated interactions at 4 months only a stimulus involving the human face gazing directly at the infant, not a face gazing elsewhere, activated the social brain circuitry Mutual gaze also provides the framework for coordinated behaviors in other modalities Co-vocalizations, moments in which parent and child vocalize in unison, begin to appear at that age and often occur during episodes of shared gaze Synchrony and Attachment Security Jaffe and colleagues (2001) found that vocal coordination between mother and infant at 4 months predicted attachment security at one year. mid-range levels of synchrony were more conducive than a tightly-fitting match or an uncoordinated play in promoting security. experience of synchrony must leave room for unpredictability, mismatched states, and random events, and to contain both order and variability, stability and change, theme and variations. 6

7 Coordinated Interpersonal Timing (CIT) 1. Match between temporal ranges of infant auditory discrimination ( s) and sound-silence durations of adult-infant interaction (largely less then 1 s) this reflects a coherent perceptual-motor system 2. A ratio of 1:2 of vocalization to silence has been found to occur regardless of tempo this is considered a method mothers use to keep the infant from habituating 3. Predictions of attachment and cognition were most correlated with the switching pause which is uniquely dyadic 4. At any particular moment, on average, each partner was most contingent on what the other did seconds before Match-Mismatch-Repair in analyzing the unfolding dance between matched and mismatched states, Tronick pointed out that mother and child spend most of their playtime in mismatched, rather than matched states, yet most of the mismatch is repaired in the next step. the way(s) dyads repair moments of miscoordination (is therefore) the central component of intimate relationships A major function of the co-regulatory process, therefore, is the self-correcting capacities of the dyad and the infant s growing appreciation that relationships are not always fully attuned to one s needs Repair as a Regulatory Experience It is in the repair of the mismatch where crucial learning occurs. If the infant can tolerate the breech and stay regulated he learns reconnection is possible. Eventually the infant initiates the repair. This is possible because of what the infant has learned and come to expect as an outcome of his actions within the interaction. A sense of agency develops, this has implications for motor planning 7

8 From Regulation to Symbolic Capacities The development of symbolic representations, emerging towards the end of the first year, is based upon the perceptual, motor, affective experiences of the infant, in particular the ability to organize perceptions and actions into coherent structures The acquisition of symbols, a specific domain of cognitive development, is thought to be particularly related to the mental acts of organizing, grouping, and ordering of repeatedly encountered perceptual, motor, and affective experiences. The development of Symbols Symbols emerge within an interactive context during positive moments between caregiver and child. Symbols are initially acquired through non-symbolic imitation games and these imitative schemes gradually assume symbolic meaning and grow independent of the social context. symbols create coherences by reducing, grouping, and abstracting the shared characteristics of the represented phenomenon into a single concept while overlooking minor differences. Symbols develop on the basis of repetitive encounters with similar experiences and the ability to abstract order amid variability. 8

9 longitudinal relations were found between mother-infant synchrony at 3 and 9 months with symbolic play and internal state talk at 2 years Internal state talk describes the child s use of words that refer to mental states, such as thoughts, feelings, or perceptions, and the attribution of these words to self and other. SELF REGULATION Kopp s model (1982) considers the antecedent of self-regulation from 3 months to 3 years, beginning with the mother-infant first coordinated interactions, enriched by the child s emerging motor skills and symbolic capacities, and culminating at the stage of self control at 2 years and self-regulation at 3 years, which imply the abilities to mobilize acts upon requests (Do) and inhibit actions upon demand (Don t). The Four A s of Infancy Action Arousal Sensory Integration & Modulation Affect Attention Lester, Freier, & LaGasse,1995; Williamson and Anzalone, 2001; Papousek, M., Scheiche, M., Wurmser, H.,

10 Recent research indicates that self-regulation, socialization, and moral internalization develop on the basis of the child s committed, selfregulated, and willing compliance to the parent s requests and prohibitions during the toddler and pre-school years, as observed in Do and Don t contexts. Self regulated compliance averaged across 2,4, and 6 years, was found to be predicted by the existence of mutual synchrony at 9 months, the lead-lag structure that marks the parent and child s mutual adaptation to shifts in the partner s affective state. Factors Affecting Self Regulation Genetic predisposition/temperament Individual sensory processing profile Biological vulnerabilities Physiological maturation Family dynamics Emerging adaptive capacities. Application for Treatment Regulation is a dyadic process and involvement of the parent is critical Treatment needs to address underlying processing challenges within the context of developmentally informed interaction Processing challenges impact regulation and require more precision around the degree of match and the repair of mismatches Parental factors impact regulation (depression, processing challenges) 10

11 Addressing Regulation in Treatment Attune and respond to the child s affective state Respond to the child at the developmental level in which they are currently functioning Use the language of that developmental level Calibrate responses to the individual child s sensory thresholds Use nonverbal communication: gestures, facial expressions timing and rhythmicity tone and speed body positioning touch/proximity Pay extra attention to the process of repair of mismatched states Bibliography and Resources Beebe, B., Jaffe, J., Markese, S., Buck, K., Chen, H., Cohen, P., Bahrick,L., Andrews, H. & Feldstein, S. (2010). The origins of 12-month attachment: A microanalysis of 4-month mother-infant interaction. Attachment & human development, 12: 1, DeGangi, G. (2000) Pediatric disorders of regulation in affect and behavior: a therapist s guide to assessment and treatment. San Diego: Academic Press. Feldman, R. (2007). Parent-infant synchrony and the construction of shared timing; physiological precursors, developmental outcomes and risk conditions. Journal of Child Psychology and Psychiatry,48:3/4, Feldman, R. (2007). Parent-infant synchrony: biological foundations and developmental outcomes. Current Directions in Psychological Science, 16:6, Greenspan, S.I.(1992). Infancy and early childhood: the practice of clinical assessment and intervention with emotional and developmental challenges. Madison, CT: International Universities Press. Greenspan, S.I., Wieder, S., Simons, R. (1998) The child with special needs: encouraging intellectual and emotional growth. Reading, MA: Addison-Wesley. Interdisciplinary Council on Developmental and Learning Disorders.(2005) Bibliography and Resources (cont.) Papoušek, M., Schieche, M. & Wurmser, H. (Eds.) (2008). Disorders of behavioral and emotional regulation in the first years of life. Washington D.C.: Zero to Three Tronick, E. (2007). The Neurobehavioral and Social-Emotional Development of Infants and Children. New York: W.W. Norton & Company. Williamson, G.G., Anzalone, M. (2001). Sensory integration and self- regulation in infants and toddlers: helping very young children interact with their environment. Washington, DC: Zero to Three. Zero to Three (2005). Diagnostic classification of mental health and developmental disorders of infancy and early Childhood: revised edition. Washington DC: Zero to Three. Williamson, G.G., Anzalone, M. (2001). Sensory integration and self- regulation in infants and toddlers: helping very young children interact with their environment. Washington, DC: Zero to Three. Zero to Three (2005). Diagnostic classification of mental health and developmental disorders of infancy and early Childhood: revised edition. Washington DC: Zero to Three. 11