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Themed Breakout: Understanding the Emergent Learning in Attachment Early Years Collaborative Learning Session Two Day 2 Dr Helen Minnis Senior Lecturer in Child and Adolescent Psychiatry University of Glasgow Elizabeth N King Principal Psychologist South Lanarkshire Council

Themed Breakout: Understanding the Emergent Learning in Attachment Early Years Collaborative Learning Session Two Day 2 Dr Helen Minnis Senior Lecturer

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Page 1: Themed Breakout: Understanding the Emergent Learning in Attachment Early Years Collaborative Learning Session Two Day 2 Dr Helen Minnis Senior Lecturer

Themed Breakout: Understanding the Emergent Learning in

Attachment

Early Years Collaborative Learning Session TwoDay 2

Dr Helen MinnisSenior Lecturer in Child and Adolescent Psychiatry

University of Glasgow

Elizabeth N KingPrincipal Psychologist

South Lanarkshire Council

Page 2: Themed Breakout: Understanding the Emergent Learning in Attachment Early Years Collaborative Learning Session Two Day 2 Dr Helen Minnis Senior Lecturer

Definition of Attachment

We are all born with attachment seeking behaviours such as crying, clinging, imitation and smiling. These behaviours are designed to keep carers close ensuring that the baby’s needs for survival, safety and sensitive care are met.

Page 3: Themed Breakout: Understanding the Emergent Learning in Attachment Early Years Collaborative Learning Session Two Day 2 Dr Helen Minnis Senior Lecturer

Definition of Attachment

Attachment is a process. When a baby needs something – food, comfort, play – he feels stressed and signals his discomfort through, for example, crying, seeking to have his needs met. Parents/carers ‘tune in’ (attune) to their baby’s unique cries and signals for different needs. This ongoing attachment process, in the first few years of life, is crucial in shaping how we grow and develop through childhood and into adulthood – neurologically, physically, emotionally, socially and psychologically.

Page 4: Themed Breakout: Understanding the Emergent Learning in Attachment Early Years Collaborative Learning Session Two Day 2 Dr Helen Minnis Senior Lecturer

Attachment theory and Attachment Informed Practice promote Stretch Aims 2 and 3

To ensure that 85% of all children within each Community Planning Partnership have reached all of the expected developmental milestones at the time of the child’s 27-30 month child health review, by end-2016.

To ensure that 90% of all children within each Community Planning Partnership have reached all of the expected developmental milestones at the time the child starts primary school, by end-2017.

Linking to the Stretch Aim

Page 5: Themed Breakout: Understanding the Emergent Learning in Attachment Early Years Collaborative Learning Session Two Day 2 Dr Helen Minnis Senior Lecturer

Neuro-science revolution

Most complex structure…on earth

• Human brain has …one hundred billion neurons, which are collectively over two million miles long.

• Each neuron has an average of ten thousand connections that directly link itself to other neurons. • Thus there are thought to be about one million billion of these connections, making it “the most complex structure, natural or artificial, on earth” (Green et al, 1998). 

Page 6: Themed Breakout: Understanding the Emergent Learning in Attachment Early Years Collaborative Learning Session Two Day 2 Dr Helen Minnis Senior Lecturer

Rapid Development in Early YearsWe can’t do what makes us human from within the womb – it has to be done in the context of attunement with special adults: • Our brain doubles in weight in first 12 months

• 3 year old’s brain is 2.5 times more active than adults (Sunderland, 2007)

• 4 year old’s brain is 80% of adults’ size (Perry, 1997)

• Cortex develops almost entirely post-natally

• Brain continues to develop but neveras rapidly or effortlessly.

Page 7: Themed Breakout: Understanding the Emergent Learning in Attachment Early Years Collaborative Learning Session Two Day 2 Dr Helen Minnis Senior Lecturer

Experience-Dependent Development

• Brain is being organised during early years• Neurons that fire together,

wire together• Periods of growth are also

periods of vulnerability • Sequential development• Hence early years’ experiences have life-long impact (Perry 2006, 2012)

Page 8: Themed Breakout: Understanding the Emergent Learning in Attachment Early Years Collaborative Learning Session Two Day 2 Dr Helen Minnis Senior Lecturer

What if early experience is harsh or neglectful?

• Childhood aggression is strongly associated with harsh parenting and the 10% of children with early onset persistent aggression, as adults, commit 50% of the crime Moffit and Caspi 2001

• Children with conduct disorder cost society 10 times as much by adulthood Scott and Knapp 2001

• Young offenders have 10 times the “all cause mortality” compared to general population Coffey et al 2003

• The risk of psychosis in adult life is increased almost 3 fold for those who have been maltreated in early life Varese et al 2012

Page 9: Themed Breakout: Understanding the Emergent Learning in Attachment Early Years Collaborative Learning Session Two Day 2 Dr Helen Minnis Senior Lecturer

Our brain is a relational organ

(Perry 1996)

Page 10: Themed Breakout: Understanding the Emergent Learning in Attachment Early Years Collaborative Learning Session Two Day 2 Dr Helen Minnis Senior Lecturer

Scottish Attachment in Action

Scottish Attachment in Action (SAIA) is a multi-professional group constituted in August 2009. It is committed to promoting better experiences of attachment in the Scottish population and effecting positive changes in social policy, education and mental health. The group believes that altering the existing understanding of, and attitudes towards attachment, is essential for improving Scotland’s current record on poor health and socially destructive behaviours.

http://www.saia.org.uk/

Page 11: Themed Breakout: Understanding the Emergent Learning in Attachment Early Years Collaborative Learning Session Two Day 2 Dr Helen Minnis Senior Lecturer

SAIA aims to: promote positive experiences of attachment in Scotland. advocate for attachment theory and practice to be a fundamental element of the education of all professionals. develop training opportunities on attachment. advance effective attachment-informed practice. develop, promote and disseminate research into attachment.

Scottish Attachment in Action

Page 12: Themed Breakout: Understanding the Emergent Learning in Attachment Early Years Collaborative Learning Session Two Day 2 Dr Helen Minnis Senior Lecturer

Attachment Matters For AllAn Attachment Mapping Exercise

for Children's Services in Scotland, commissioned by the Scottish Government 2012

Recommendations and conclusions

A greater focus on understanding attachment and supporting attachment informed practice can support the delivery of key Scottish

central and local government policies (page 5)

Developing an attachment informed approach for all professionals working with children, including those within the universal services, offers the best prospect for effective early intervention for children

whatever their age and family situation (page 6).

Page 13: Themed Breakout: Understanding the Emergent Learning in Attachment Early Years Collaborative Learning Session Two Day 2 Dr Helen Minnis Senior Lecturer

Attachment Matters For AllAn Attachment Mapping Exercise

for Children's Services in Scotland, commissioned by the Scottish Government 2012

Attachment theory should form a core underpinning framework for all work with children in universal services as well as specialist provision

(page 54).

Wherever possible birth parents should be supported in developing the capacity to become secure attachment figures for their children. This requires investment in attachment focused parenting programmes for the most vulnerable parents rather than an emphasis on behavioural

methods (page 57).

Page 14: Themed Breakout: Understanding the Emergent Learning in Attachment Early Years Collaborative Learning Session Two Day 2 Dr Helen Minnis Senior Lecturer

What’s new?

A total population of children aged 6 and 7 in 29 Glasgow primary schools were screened for attachment disorders.

Very deprived part of the city

Despite this, the great majority of children had normal mental health

The prevalence of attachment disorder was 1.4% - much higher than previously realised

Minnis et al 2013

Page 15: Themed Breakout: Understanding the Emergent Learning in Attachment Early Years Collaborative Learning Session Two Day 2 Dr Helen Minnis Senior Lecturer

1.4%

Of those children with Attachment disorder:•ALL had at least one other diagnosis including•ADHD (54%)•PTSD (15%)

What’s new?

RAD prevalence study

Page 16: Themed Breakout: Understanding the Emergent Learning in Attachment Early Years Collaborative Learning Session Two Day 2 Dr Helen Minnis Senior Lecturer

What’s new?

A randomised controlled trial of an attachment-informed infant mental health service is going on in Glasgow (Best Services Trial)

A randomised controlled trial of the attachment-informed therapeutic intervention for maltreated children, Dyadic Developmental Psychotherapy, is at the planning stage in Glasgow and Lanarkshire

Watch this space!

Page 17: Themed Breakout: Understanding the Emergent Learning in Attachment Early Years Collaborative Learning Session Two Day 2 Dr Helen Minnis Senior Lecturer

What’s new?

Research in South Lanarkshire Council into the most effective methods of building capacity in the workforce with regard to attachment informed practice

PDSA in one primary school nursery class - How Early Attachment Relationships support Transition (H.E.A.R.T.)

Multi agency steering group overseeing H.E.A.R.T., looking at training and practice in attachment informed practice

Benchmarking with the Jeely Piece Club in Glasgow

For information: email [email protected]

Page 18: Themed Breakout: Understanding the Emergent Learning in Attachment Early Years Collaborative Learning Session Two Day 2 Dr Helen Minnis Senior Lecturer

Measures

What can we test?

•Information sharing regarding attachment difficulties, especially at point of transition•Common language regarding attachment used in communicating the needs of children•Impact of awareness-raising raining on Attachment Informed Practice•Impact of attachment focused parenting programmes and therapies