Brain Story for the next chapter

Dr Katy Smart on a community initiative to help protect our long-term mental health.

The pandemic has brought with it not only symptoms of physical illness associated with the coronavirus but also growing concerns around our future mental health. The social and educational impacts of the lockdown, such as home-schooling, home-working, loss of personal interaction with family and friends, constant discussion of illness and death in the news and on social media, raise fears for the long-term psychological health of children, young people and adults. As psychologists what can we do to minimise the risk of any long-term damage? The University of Oxford are leading a project to unify the endeavours of professionals and communities from very different backgrounds to collectively move forward to improve long term physical and mental health.

The Brain Story is a community-wide initiative that uses scientific understanding of the neuroscience of child development and its implication for lifelong health and improve outcomes for children, young people and adults. It can also help promote the awareness of why some individuals may struggle with executive functioning skills, including prioritising tasks, planning and impulsive behaviour.  

The Brain Story provides a knowledge-based platform, for professionals and the public, which presents the science that underpins how our earliest experiences can change the way our brains are built. It puts scientific concepts around developmental neurobiology, epigenetics, health and addictions into a social context and demonstrates how these pathways intersect. This understanding is important for policy makers and for practice across communities in education, health, social services and the criminal justice system; it is also information that needs to be shared with the wider community.

The Brain Story is not an intervention: its aim is to improve people’s knowledge and understanding of the importance and long-term impact of our childhood experiences on mental and physical health through a collection of free resources and an online certification course. 

A key resource to sharing this science is through the Brain Story Certification Course. This is a free, self-paced, online course delivered by leading experts in the fields of child development and neuroscienceThe course is divided into modules that focus on different Brain Story concepts and how they relate to the real world. It demonstrates the impact of adversity and how this can increase the risk of not only mental and physical health but also emotional and behavioural problems, including addiction.

Although there is a focus on the importance of the impact of early experiences, the implications of the long-term effect of early adversity are relevant to professionals working with all ages and in a wide range of contexts. Modules provide knowledge on the impact of parenting and the effects of Adverse Childhood Experiences (ACEs) on mental and physical health as well as social outcomes. Presentations reveal how prolonged early stress, which is not buffered by supportive adult relationships, can alter how a child’s brain develops and how this in turn can alter the development of the nervous, hormonal and immunological systems. When the body’s stress response system is repeatedly activated during childhood, epigenetic changes can occur which impact on physiological and psychological processes. Persistent activation of this system can lead to ‘wear and tear’ on the body (or allostatic load), which may include longer term difficulties with hypertension, heart disease or mental health problems. Further modules on addiction help us understand the main brain structures and functions involved in why some people develop addictive behaviours.   

To encourage widespread understanding of the five-key principles of brain development and associated physiological and psychological functioning, the Brain Story uses a series of metaphors that have been developed by the Frameworks Institute. These metaphors provide a shared language that promotes communication between professionals and individuals on the importance of: neurodevelopment (Brain Architecture), contingent responsiveness (Serve and Return), Executive Function (Air Traffic Control), Adverse Childhood Experiences (Toxic Stress) and Resilience. Each of these metaphors presents a complex concept in a way that makes it accessible to the wider community.

Serve and Return is used as a metaphor for contingent responsiveness; the finely-tuned interaction between a child and its caregiver. Like a game of tennis, the child serves through a vocalisation, touch or gaze. The caregiver then returns the serve in a way that is suitable to the child’s developmental stage. Contingent responsiveness is key to providing children with opportunities to develop and practise cognitive, social and emotional skills; these repeated interactions strengthen essential neural circuits that are vital to building a healthy foundation for all future development. The Serve and Return metaphor can help parents or other caregivers understand the significance of their role in the development of their child’s brain and how they can promote healthy development. 

Understanding the neuroscience behind child development enables us to better appreciate the long term impact of early experiences; the lifespan approach powerfully connects the contribution of different agencies, services and professionals to build resilience at an individual and community level. Engaging policy makers with the science will help drive system change and by working together this shared knowledge could help break the intergenerational cycle of adversity and improve long-term mental and physical health outcomes.

- Dr Katy Smart CPsychol AFBPsS, Department of Psychiatry, University of Oxford

[email protected]

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