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NONVERBAL CUES IN REGULATION BY MARILEE BURGESON, MA. CCC-DIR®SLP

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What We Will Learn to Inform Our Care 2 in Trauma

• Recognize Non verbal Affect cues

• Regulation and Brain Development

• DIR®Floortime model

• Case Study Reflection

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THE POWER OF AFFECT

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BABIES FEEL BEFORE THEY THINK!

4 5 WHAT ARE NON VERBAL AFFECT CUES?

REFLECTION OF THE FELT EXPERIENCE!

Affect is the experience of feeling or .

Affect is a key part of the process of an organism's interaction with stimuli.

The word also refers sometimes to affect display, which is "a facial, vocal, or gestural behavior that serves as an indicator of affect" (APA 2006).

en.wikipedia.org

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Affect is mediated through co regulation 7

• Regulation: infants ability to modulate the intensity of sensation and remain interested in full range of sensations. • Self Regulation: function that arises from co-regulating interactions between parents and infants. • Intense Mutual Gaze: a mutual regulatory system of that allows for parent and child to move together from a state of neutral affect and low arousal to heightened positive emotion yet modulated arousal • Affect Cueing: ability to express intention through subtle vocal and motor acts, and to read the vocal motor cues by others to express their intent or state. Osten, Beth, A Comprehensive Overview of the DIR®approach, Profectum, Assessment as Intervention, 2012.

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8 REGULATION

! mutual regulation self regulation !

emotional regulation

8 9 THE AFFECT DIATHESIS GREENSPAN

AFFECT MOTOR MOTOR PLANNING SEQUENCING EMERGING SYMBOL FORMATION

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10 STABLE LEARNING PROCESSES THAT HAVE PASSED THROUGH TIME signal attend relate with

The survival of humans depends on the social capacity for intimacy, , reflective thinking and a shared sense of humanity and reality.

Stanley Greenspan, The First Idea.

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Trauma-Informed Care! 11

! • strengths-based ! ! • responsive ! ! • safe! ! • rebuilds! ! ! ! !

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12 Parallel Process We Want to Create with Families strengths based safe

responsive create meaning

12 13 AFFECT TRANSFORMS THROUGH SHARED EXPERIENCES

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14 NON VERBAL AFFECT CUES

EMOTIONS HAVE HISTORICALLY BEEN VIEWED AS:

• OUTLETS FOR EXTREME PASSION

• SUBJECTIVE STATES OF FEELING

• INTERPERSONAL SOCIAL CUES

STANLEY GREENSPAN THE AFFECT DIATHESIS HYPOSTHESIS , JOURNAL OF DEVELOPMENTAL AND LEARNING DISORDERS

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15 AFFECT EVOLVES!

• SIMPLE AFFECT STATES

• RANGE OF AFFECTS: SURPRISE, FEAR, CAUTION, JOY, HAPPINESS, ENTHUSIASM, CURIOSITY

• SHARED EXPERIENCES

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Stanley Greenspan

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AFFECT SPEAKS LOUDER THAN WORDS!

16 17 I SEE AND FEEL THROUGH

SYNCHRONY RESPONSIVENESS APPRAISAL REGULATION

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19 TRANSFORMATIONS….

Though their progressive transformations, emotions, which can be experienced in an almost infinite number of subtle variations, can organize and give meaning to experience. They can therefore serve as the as the architect, orchestra leader for the mind’s many functions at each stage in the pathway function. At each stage in the pathway to intelligence, emotions orchestrate cognitive language ,motor,sensory and social experience.” (Greenspan & Shankar,2004,p51)

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Tiny progressive transformations build emotional stability

20 21 REGULATION OF EMOTION SELF OTHER

• appraisal (reflecting on our emotion and understanding the affect cues of others)

• physiological ( arousal) (feeling emotion in the body…intensity sets meaning)

(involuntary/intentional)

• socialization( how others react)

Barry Prizant, SCERTS MODEL, 2006

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22 WE MAKE MEANING THROUGH WHAT IS NOT SAID…

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23 Affect cues Patterns to Observe:

• synchronous movement

• rhythm with mother’s affect: voice inflections, facial expressions, body movements

• interactive rhythm of gestural, vocal or verbal communication

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Babies experience emotions in the physiologic sensory system and become the vehicles of interpersonal development. Stanley Greenspan (2004)

24 25 AFFECT INVESTS

• shared meaning to sounds words and behaviors

• processing of motor planning and visual spatial capacity

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WIRED TO LOVE ATTACHMENT AND ATTUNEMENT

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WHY DO WE HAVE AFFECT CUES?

28 29 MIRROR NEURONS

The survival value of being able to “read minds” in a social setting to determine another’s status as friend or foe is profound. Hence we are with a legacy of empathy and the capacity for mind sight rooted in our evolution.”

Dan Siegal

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30 SURVIVAL!

RIGHT BRAIN ATTACHMENT SYSTEM

MOTHER REGULATES SOCIAL EMOTIONAL ENVIRONMENT

• EMOTIONAL ATTACHMENT TO MOTHER

• REGULATION OF WITHDRAWAL

• INTEGRATION OF AFFECT

DANIEL SHORE

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BRAIN POWER SERVE AND RETURN

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WOW!

32 33 SELF REGULATION IS ESSENTIAL TO ADAPT TO:

• CHALLENGING SOCIAL SITUATIONS

• BIDS FOR INTERACTIONS

• DISORGANIZING ENVIRONMENTAL STIMULATION

• VIOLATION OF EXPECTATIONS

Barry Prizant, SCERTS, 2006

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EXPERIENCE SHAPES THE BRAIN

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BRUCE PERRY: NEURODEVELOPMENTAL SEQUENCE OF PLAY

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36 PEEK A BOO IS A DEVELOPMENTAL PROCESS

• separation/individuation

• constancy

• maintaining attachment across space

• shared experiences and meaning

• concept of mom is growing

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THE IMPORTANCE OF PEEKABOO

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38 Bring awareness to the nonverbal signals

“ Babies come into the world equipped with a wide range of sensory, informaon-processing and motor-control capacies. Caregivers have to learn which rhythms, touches and sounds calm an infant effecvely and conversely, they must discover the sorts of animated voices, facial expressions, body movements, and that will smulate an infant’s desire to interact socially or to explore her world. Stanley Greenspan, The First Idea, 2004

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FOSTERING SECURE ATTACHMENT 39

DAN SIEGAL, WHOLE BRAIN CHILD

• SEEN

• SAFE

• SOOTHED

• SECURE

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A BABY SMILE ENCOURAGES MATERNAL CARE

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42 WHEN BASIC NEEDS ARE NOT CONSISTENTLY MET, WE SEE

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• lack of confidence and autonomy

• lack of agency

• poor regulation of emotion

• anticipation of failure

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Intervention

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DIR®FLOORTIME MODEL BRIDGES ACES

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The Dyad

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46 DIR®Floortime Model

Emotional Thinking

Emotional Ideas

Shared Problem Solving

Intentional Two Way Communication Engagement or Falling in Love Regulation and Functional Developmental Levels Shared Attention

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Relationship

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48 The$Mutual$Regulatory$ Influence$on$$ the$Four$A’s$ Action Arousal

Sensory( Integra-on(and( Modula-on(

Affect Attention

Williamson)&)Anzalone,)2001)

Individual Processing48 Differences 49

REGULATION AND SHARED ATTENTION DIR® Level One

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50 IF THE CAREGIVER IS CALM, THE CHILD IS CALM

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REGULATION CALM ENOUGH TO TAKE IN THE WORLD.

Calm enough to 51take in the world

52 REGULATION OF THE BODY

• adaptive capacity

• self regulation….co regulation

• homeostasis: calm body provides the foundation to take in others

• biological synchrony

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Optimal State of Arousal

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ENGAGEMENT OR FALLING IN LOVE DIR® LEVEL TWO

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TWO WAY INTENTIONAL COMMUNICATION DIR®LEVEL THREE

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SHARED SOCIAL PROBLEM SOLVING DIR® LEVEL 4

56 57 AFFECTIVE SYNCHRONY

affective synchrony modulates negative arousal fundamental building blocks ! of attachment and interaction repair associated emotions.

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Famous Pairs

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59 Strategies to Support a Synchronous Dyad

• Modify demand

! • Enhance coping

! • Providing Contingent Feedback Gordon Williamson

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60 SPECIFICALLY FITTED INTERACTION

“Resilience in stressful or new experiences is the ultimate indicator of attachment security.”

Allan Shore

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Break and Repair: Ed Tronick

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HOW COMFORTABLE ARE YOU WITH THE DISCOMFORT?

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63 Look Listen Feel with Care

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What one thing will you try to encourage your understanding of nonverbal cues in affect regulation?

64 65 Greenspan, Stanley, MD., andReferences Shanker, Stuart, D.Phil. The First Idea: how Symbols, Language, and Intelligence evolved from Our Primate Ancestors to Modern Humans.DeCapo Press, 2004! Greenspan, Stanley, The Affect Diathesis Hypothesis: The Role of Emotions in the Core Deficit in Autism and in the Development of Intelligence and Social Skills, Journal of Developmental and Learning Disorders, ! Nelson, Katherine, Young Minds in Social Worlds, Experience, Meaning and Memory,Harvard University Press, 2007.! Osten, Beth, Assessment as Intervention, Profectum Introductory Course: OVerview of the DIR®Model, 2012.! Prizant, Barry M., Wetherby Amy, Rubin Emily, Laurent, Amy C., Rydell, Patrick J., The Scerts™Model, A Comprehensive educational approach for Children with Autism Spectrum Disorders, Volume 1 Assessment, Brooke’s Publishing, 2006! Siegal, Daniel and Hartzell Mary, Parenting from the Inside Out, Penguin Publishing, 2003.! Wetherby, Amy, Communication and Language Intervention for Preschool Children, Florida State University, EDUCOM, 1992! Williamson, G.Gordon, Enhancing Adaptation and Resilience in Infants and Toddlers, IDA, California!

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Lily: a case study

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Assessment

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Power of Movement and Positioning

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Mom Takes the Lead

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Small Transformations

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FALLING IN LOVE

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REGULATION

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WHERE’S MOMMY?

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BREAK AND REPAIR

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Signaling Getting Stronger

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I See you!

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DEVELOPING A RHYTHM

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FROM OBJECTS TO MOMMY

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TAKING INITIATIVE

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