Three Core Concepts in Early Development - Center on the Developing Child at Harvard University

Here is a series of three short videos from the Center on the Developing Child at Harvard University on the early development of the brain. Pretty basic information, but also a nice primer on early neural development.

Three Core Concepts in Early Development

Center on the Developing Child at Harvard University

Healthy development in the early years provides the building blocks for educational achievement, economic productivity, responsible citizenship, lifelong health, strong communities, and successful parenting of the next generation. This three-part video series from the Center and the National Scientific Council on the Developing Child depicts how advances in neuroscience, molecular biology, and genomics now give us a much better understanding of how early experiences are built into our bodies and brains, for better or for worse.

For more information, please visit: http://developingchild.harvard.edu

Video #1: Experiences Build Brain Architecture

The basic architecture of the brain is constructed through a process that begins early in life and continues into adulthood. Simpler circuits come first and more complex brain circuits build on them later. Genes provide the basic blueprint, but experiences influence how or whether genes are expressed. Together, they shape the quality of brain architecture and establish either a sturdy or a fragile foundation for all of the learning, health, and behavior that follow. Plasticity, or the ability for the brain to reorganize and adapt, is greatest in the first years of life and decreases with age.

Video #2: Serve & Return Interaction Shapes Brain Circuitry

One of the most essential experiences in shaping the architecture of the developing brain is "serve and return" interaction between children and significant adults in their lives. Young children naturally reach out for interaction through babbling, facial expressions, and gestures, and adults respond with the same kind of vocalizing and gesturing back at them. This back-and-forth process is fundamental to the wiring of the brain, especially in the earliest years.  

Video #3: Toxic Stress Derails Healthy Development 

Learning how to cope with adversity is an important part of healthy development. While moderate, short-lived stress responses in the body can promote growth, toxic stress is the strong, unrelieved activation of the body's stress management system in the absence of protective adult support. Without caring adults to buffer children, the unrelenting stress caused by extreme poverty, neglect, abuse, or severe maternal depression can weaken the architecture of the developing brain, with long-term consequences for learning, behavior, and both physical and mental health.

The study summarized below was conducted on rats, but parent-child bonding at the physiological level is pretty much the same in all mammals - so this does translate well to humans.

The study found that the presence and nurturing behaviors of the mother (or father, or primary care-giver) toward the newborn directly shapes the wiring and function of the infant's brain. This is the first study to show this process (which is well-known) WHILE it is happening.

Pretty cool. The paper itself, of course, is behind a paywall, so below is the summary from Science Daily, followed by the abstract of the original article.

Measuring nurture: Study shows how 'good mothering' hardwires infant brain

Date: July 17, 2014
Source: NYU Langone Medical Center
 
Summary:
By carefully watching nearly a hundred hours of video showing mother rats protecting, warming, and feeding their young pups, and then matching up what they saw to real-time electrical readings from the pups’ brains, researchers have found that the mother’s presence and social interactions — her nurturing role — directly molds the early neural activity and growth of her offsprings’ brain.

Mother rat carrying her baby in her mouth, 5 days old (stock image). Researchers at NYU Langone Medical Center have found that the mother's presence and nurturing directly molds the early neural activity and growth of her offsprings' brain.

By carefully watching nearly a hundred hours of video showing mother rats protecting, warming, and feeding their young pups, and then matching up what they saw to real-time electrical readings from the pups' brains, researchers at NYU Langone Medical Center have found that the mother's presence and social interactions -- her nurturing role -- directly molds the early neural activity and growth of her offsprings' brain.

Reporting in the July 21 edition of the journal Current Biology, the NYU Langone team showed that the mother's presence in the nest regulated and controlled electrical signaling in the infant pup's brain.

Although scientists have known for decades that maternal-infant bonding affects neural development, the NYU Langone team's latest findings are believed to be the first to show -- as it is happening -- how such natural, early maternal attachment behaviors, including nesting, nursing, and grooming of pups, impact key stages in postnatal brain development.

Researchers say the so-called slow-wave, neural signaling patterns seen during the initial phases of mammalian brain development -- between age 12 and 20 days in rats -- closely resembled the electrical patterns seen in humans for meditation and conscious and unconscious sleep-wake cycles, and during highly focused attention. These early stages are when permanent neural communication pathways are known to form in the infant brain, and when increasing numbers of nerve axons become sheathed, or myelinated, to speed neural signaling.

According to senior study investigator and neurobiologist Regina Sullivan, PhD, whose previous research in animals showed how maternal interactions influenced gene activity in the infant brain, the latest study offers an even more profound perspective on maternal caregiving.

"Our research shows how in mammals the mother's sensory stimulation helps sculpt and mold the infant's growing brain and helps define the role played by 'nurturing' in healthy brain development, and offers overall greater insight into what constitutes good mothering," says Sullivan, a professor at the NYU School of Medicine and its affiliated Nathan S. Kline Institute for Psychiatric Research. "The study also helps explain how differences in the way mothers nurture their young could account, in part, for the wide variation in infant behavior among animals, including people, with similar backgrounds, or in uniform, tightly knit cultures."

"There are so many factors that go into rearing children," says lead study investigator Emma Sarro, PhD, a postdoctoral research fellow at NYU Langone. "Our findings will help scientists and clinicians better understand the whole-brain implications of quality interactions and bonding between mothers and infants so closely after birth, and how these biological attachment behaviors frame the brain's hard wiring."

For the study, a half-dozen rat mothers and their litters, of usually a dozen pups, were watched and videotaped from infancy for preset times during the day as they naturally developed. One pup from each litter was outfitted with a miniature wireless transmitter, invisibly placed under the skin and next to the brain to record its electrical patterns.

Specifically, study results showed that when rat mothers left their pups alone in the nest, infant cortical brain electrical activity, measured as local field potentials, jumped 50 percent to 100 percent, and brain wave patterns became more erratic, or desynchronous. Researchers point out that such periodic desynchronization is key to healthy brain growth and communication across different brain regions.

During nursing, infant rat pups calmed down after attaching themselves to their mother's nipple. Brain activity also slowed and became more synchronous, with clearly identifiable electrical patterns.

Slow-wave infant brain activity increased by 30 percent, while readings of higher brain-wave frequencies decreased by 30 percent. Milk delivery led to intermittent bursts of electrical brain activity that were double or five times higher than before.

Similar spikes in rat brain activity of more than 100 percent were observed when mothers naturally groomed their infant pups.

However, these brain surges progressively declined during weaning, as infant pups gained independence from their mothers, leaving the nest and seeking food on their own as they grew past two weeks of age.

Additional experiments with a neural-signaling blocking agent, propranolol, confirmed that maternal effects were controlled in part by secretion of norepinephrine, a key neurotransmitter and hormone involved in most basic brain and body functions, including regulation of heart rate and cognition. Noradrenergic blocking in infant rats mostly dampened all previously observed effects induced by their mothers.

Sullivan says her team next plans similar experiments to look at how behavioral variations by the mother affect infant rat brain development, with the added goal of mapping any differences in brain development.

Long term, they say, they hope to develop diagnostic tools and therapies for people whose brains may have been impaired or simply underdeveloped during infancy.

Sarro says more research is also under way to investigate what other, nonadrenergic biological mechanisms might also be involved in controlling maternal sensory stimulation of the infant brain.

Story Source:
The above story is based on materials provided by NYU Langone Medical Center. Note: Materials may be edited for content and length.

Journal Reference:
Sarro, EC, Wilson, DA, Sullivan, RM. (2014, Jul 3). Maternal Regulation of Infant Brain State. Current Biology; Epub before print. DOI: 10.1016/j.cub.2014.06.017

* * * * *

Maternal Regulation of Infant Brain State

Emma C. Sarro, Donald A. Wilson, Regina M. Sullivan
DOI: http://dx.doi.org/10.1016/j.cub.2014.06.017
Publication stage: In Press Corrected Proof

Highlights

• The mother’s presence reduces infant rat cortical desynchronization
• Maternal behaviors (e.g., milk ejection and grooming) increase desynchronization
• Maternal effects on infant cortical activity decline with age
• Norepinephrine receptor blockade reduces impact of dam on infant cortical activity

Summary

Patterns of neural activity are critical for sculpting the immature brain, and disrupting this activity is believed to underlie neurodevelopmental disorders [ 1–3 ]. Neural circuits undergo extensive activity-dependent postnatal structural and functional changes [ 4–6 ]. The different forms of neural plasticity [ 7–9 ] underlying these changes have been linked to specific patterns of spatiotemporal activity. Since maternal behavior is the mammalian infant’s major source of sensory-driven environmental stimulation and the quality of this care can dramatically affect neurobehavioral development [ 10 ], we explored, for the first time, whether infant cortical activity is influenced directly by interactions with the mother within the natural nest environment. We recorded spontaneous neocortical local field potentials in freely behaving infant rats during natural interactions with their mother on postnatal days ∼12–19. We showed that maternal absence from the nest increased cortical desynchrony. Further isolating the pup by removing littermates induced further desynchronization. The mother’s return to the nest reduced this desynchrony, and nipple attachment induced a further reduction but increased slow-wave activity. However, maternal simulation of pups (e.g., grooming and milk ejection) consistently produced rapid, transient cortical desynchrony. The magnitude of these maternal effects decreased with age. Finally, systemic blockade of noradrenergic beta receptors led to reduced maternal regulation of infant cortical activity. Our results demonstrate that during early development, mother-infant interactions can immediately affect infant brain activity, in part via a noradrenergic mechanism, suggesting a powerful influence of the maternal behavior and presence on circuit development.

Attachment and Resilience: The Power of One: Dr. Erica Liu Wollin at TEDxHongKong2013

Nice TEDx Talk on the nature of attachment failures in very young children.

Attachment and Resilience: The Power of One: Dr. Erica Liu Wollin at TEDxHongKong 2013
 
Erica Wollin

Currently based in Hong Kong, Dr. Erica Liu Wollin is a board-licensed psychologist in California and a registered psychologist in Hong Kong. She has been a clinical supervisor for the doctoral program at Alliant International University/City University of Hong Kong since 2007. Trained in Eye Movement Desensitization and Reprocessing (EMDR), an effective treatment for traumas and phobias, Dr. Wollin holds counseling interests in therapy, adoption and attachment, grief and loss, eating disorders, and mental health. Raised in the US, Dr. Wollin received her Psy.D. and M.A. in Clinical Psychology from Wheaton College. Dr. Wollin will be speaking about the power of attachment, which is our `connection with early caregivers. With this year’s theme revolving around relationships, her discussion will focus on the psychological side of human relationships, for when attachment does not occur effectively, a number of challenges can arise. She will also discuss the protective factors which nurture human resilience in the face of adversity, including the power of the presence of one who cares about us.

Here are three brief talks (about 20 minutes each) on Theory of Mind (the ability to ascribe mental states to another person and then use one's sense of those states to explain and predict the actions of the other person). Theory of Mind (ToM) is is also referred to as mindreading, mentalizing, or mentalistic abilities. ToM is one of the key skills necessary for intersubjectivity and empathy - most children begin to develop the skill around age 3.

CARTA: What is Theory of Mind? - Theory of Mind in Human Babies - The Social Brain in Adolescence

Published on Nov 26, 2013


(Visit: http://www.uctv.tv) This CARTA series explores the evolution of "Theory of Mind" (ToM), the ability to impute mental states such as beliefs, desires, and intentions to oneself and others, and how ToM makes us uniquely human.

• Ralph Adolphs (Caltech) begins with a discussion about the definition of ToM
• Jessica Sommerville (Univ of Washington) speaks on the Emergence of Theory of Mind in Human Babies
• Sarah-Jayne Blakemore (University College London) speaks on The Social Brain in Adolescence

Recorded on 10/18/2013. Series: "CARTA - Center for Academic Research and Training in Anthropogeny" [12/2013].

Speakers

Ralph Adolphs is the Bren Professor of Pychology and Neuroscience, as well as a professor of biology at the California Institute for Technology (Caltech). Dr. Adolphs received his bachelor's degree from Stanford University, and his Ph.D. in neurobiology from Caltech. He did post-doctoral work with Antonio Damasio at the University of Iowa, beginning his studies in human neuropsychology, with a focus on the recognition of emotional facial expressions. Dr. Adolphs also holds an adjunct appointment in the Department of Neurology at the University of Iowa.

Jessica Sommerville is an associate professor in the Department of Psychology, and associate director of the Center for Child and Family Wellbeing, at the University of Washington. She completed her B.Sc. at the University of Toronto in 1997 and her Ph.D. at the University of Chicago in 2002. Following a post-doctoral fellowship, she took her first faculty position in 2003. In 2007, Sommerville was named a Kavli Foundation Fellow. Her research focuses on the origins of social cognition in infancy and early childhood. Sommerville currently receives funding from the National Institute of Child Health and Development and the John Templeton Foundation.

Sarah-Jayne Blakemore is a Royal Society University Research Fellow and professor in cognitive neuroscience at University College London (UCL). She is leader of the Developmental Cognitive Neuroscience Group, which focuses on brain development in human adolescence. She studied experimental psychology at Oxford University (1993-1996) and received her Ph.D. (1996-2000) at UCL, investigating self-monitoring in schizophrenia. She co-authored The Learning Brain: Lessons for Education (Wiley-Blackwell, 2005), with Professor Uta Frith, and sits on the Royal Society Vision Committee for Science and Mathematics Education. Blakemore is editor-in-chief of Developmental Cognitive Neuroscience.

A Developmental Perspective on Intersubjectivity from Birth Onward (Daniel N. Stern)

 

Daniel N. Stern was the author of The Interpersonal World Of The Infant A View From Psychoanalysis And Developmental Psychology (2000/1985), one of the most profound books on the healthy and unhealthy development of the infant available. Stern's model is in line with current trends in postmodern psychoanalysis - it's based in attachment theory, relationality, intersubjectivity, and neuroscience. 

Along with Allan Schore, Stern is must reading for anyone who wants to understand the development and pathologies of development in children - the foundation for trauma therapy.

Stern passed away in 2012 - among his other books are The Present Moment in Psychotherapy and Everyday Life (Norton Series on Interpersonal Neurobiology) (2010) and Diary Of A Baby: What Your Child Sees, Feels, And Experiences (1992), told from the baby's point of view.

50 Jahre SFI - A Developmental Perspective on Intersubjectivity from Birth on (Daniel N. Stern)

Published on May 22, 2013


50 Jahre Sigmund-Freud-Institut - 50 Jahre "Forschen und Heilen"

Daniel N. Stern (Boston/Genf)
A developmental perspective on intersubjectivity from birth on

Festakt zum 50-jährigen Bestehen des Sigmund-Freud-Instituts am 24. April 2010 auf dem Campus Westend der Goethe Universität Frankfurt am Main.

Longitudinal Study - Influence of Early Regulatory Problems in Infants on Their Development at 12 Months

There is copious evidence that challenges during infancy, especially maternal dysregulation (distress, mood disorders, personality disorders, and so on), can have serious development impact on the emotional and regulatory health of the infants. In the study below, the researchers noted regulatory issues in a group of infants at 4 and 6 months and then at 12 months to see if there is any prediction power of problems in the first 6 months for social and interpersonal function at one year.

Regulatory problems that persist longer than the first 3 to 4 months, present an unfavorable factor for further childhood development. The persistence and “broadening” of the child’s regulatory problems into other areas of behavior contribute to an increased risk for further social-emotional and cognitive development in infancy.

One of the leading researchers in this realm is Dr. Allan Schore, whose trilogy of Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development (1994), Affect Dysregulation and Disorders of the Self (2003), and Affect Regulation and the Repair of the Self (2003), are the best and most comprehensive books on early childhood development, how the brain develops, and how attachment patterns between infant and caregiver shape both of these.

Dr. Schore has received the 2013 Award for Outstanding Contributions to Practice in Trauma Psychology from Division 56 (Trauma Psychology) of the American Psychological Association. He has also been awarded Honorary Membership by the American Psychoanalytic Association for his outstanding contribution to psychoanalysis.
Anyway, the article below is interesting and important information. It's open access, but it's also quite long so I am only including the introductory material.

Full Citation:
Sidor, A, Fischer, C, Eickhorst, A, and Cierpka, M. (2013, Oct 12). Influence of early regulatory problems in infants on their development at 12 months: a longitudinal study in a high-risk sample. Child and Adolescent Psychiatry and Mental Health, 7:35 doi:10.1186/1753-2000-7-35

Influence of early regulatory problems in infants on their development at 12 months: a longitudinal study in a high-risk sample

Anna Sidor, Cristina Fischer, Andreas Eickhorst, and Manfred Cierpka
Author Affiliations

Abstract (provisional)

Background

This study examined the extent to which regulatory problems in infants at 4 and 6 months influence childhood development at 12 months. The second aim of the study was to examine the influence maternal distress has on 4-month-old children's subsequent development as well as gender differences with regard to regulatory problems and development.

Methods

153 mother-child dyads enrolled in the family support research project "Nobody slips through the net" constituted the comparison group. These families faced psychosocial risks (e.g. poverty, excessive demands on the mother, and mental health disorders of the mother, measured with the risk screening instrument Heidelberger Belastungsskala - HBS) and maternal stress, determined with the Parental Stress Index (PSI-SF). The children's developmental levels and possible early regulatory problems were evaluated by means of the Ages and Stages Questionnaires (ASQ) and a German questionnaire assessing problems of excessive crying along with sleeping and feeding difficulties (SFS).

Results

A statistically significant but only low, inverse association between excessive crying, whining and sleep problems at 4 and 6 months and the social development of one-year-olds (accounting for 5% and 8% of the variance respectively) was found. Feeding problems had no effect on development. Although regulatory problems in infants were accompanied by increased maternal stress level, these did not serve as a predictor of the child's social development at 12 months. One-year-old girls reached a higher level of development in social and fine motor skills. No gender differences were found with regard to regulatory problems, nor any moderating effect of gender on the relation between regulatory problems and level of development.

Conclusions

Our results reinforce existing knowledge pertaining to the transactional association between regulatory problems in infants, maternal distress and dysfunctionality of mother-child interactions. They also provide evidence of a slight but distinct negative influence of crying and sleeping problems on children's subsequent social development. Easily accessible support services provided by family health visitors (particularly to the so-called "at-risk families") are strongly recommended to help prevent the broadening of children's early regulatory problems into other areas of behavior.

Background

Early regulatory problems are understood as difficulties infants have in adjusting to the environment, regulating their behavior and arousal and in self-calming. These difficulties reveal themselves in symptoms characteristic of age and developmental stages such as crying or sleeping and feeding problems [1]. Crying in the first three months is regarded as the expression of the usual difficulty experienced in initial adjustment to childhood development [2]. However, according to the guidelines of the German Association for Child and Youth Psychiatry [3], excessive crying / whining beyond the first 3 to 4 months of life is seen as a regulatory problem in early infancy pertaining to interaction and regulatory contexts such as self-calming, sleeping and feeding. In such a case, the infant would fuss or cry inconsolably and to an excessive degree. The symptoms typically appear two weeks postnatal, peaking in the sixth week, and generally decreasing at the end of the third month [4,5]. As for the prevalence of excessive crying in the first three months, frequencies between 5 and 19% were determined [6]. Persistence of crying beyond the third month was reported in 5.8% of the cases and beyond the sixth month in 2.5% of them [7]. An estimated 5% of all excessive crying cases have organic causes, such as gastrointestinal problems (gastrointestinal reflux, colic), atopy or neuropediatric disorders [5].

Around the third month, most children's self-regulation abilities improve in a surge of development. Excessive crying can be replaced during the course of early childhood development by other symptoms (e.g. sleep disorders) [8]. A study by Kries and colleagues [7] showed that ongoing sleep and feeding problems among children who still cried excessively at 6 months had increased by a factor of 6 to 9.

As with increased crying, the temporary problems relating to the sleep-wake cycle represent normal postnatal adjustment difficulties. According to the guidelines for the diagnosis of regulatory disorders, non-organic sleep disorders are only diagnosed from the 6th month since the day-night and sleep-wake cycles are still establishing themselves in the first half of the first year of life [6]. In the second half of the first year (between the 7th and the 9th months), the so-called reorganisation processes set in, which lead to an accumulation of sleep problems involving waking and crying at night [9]. Characteristic problems include falling and/or staying asleep (generally accompanied by crying). Sleeping problems are seen as being related to parental support for falling (and re-falling) asleep: the children are unable to fall asleep on their own. The estimated prevalence of early sleeping disorders in the first two years of life ranges between 10 and 30% [6,10].

Feeding problems are also frequently temporary disorders that occur during weaning and introduction of puréed and solid food to the diet. According to the guidelines of the German Association for Child and Youth Psychiatry, a feeding disorder is said to be present when feeding is perceived by the parents as stressful, a meal requires more than 45 minutes and/or the interval between meals is less than 2 hours [3]. The parent–child interaction during feeding is also strained. Due to fear of malnutrition, parents put pressure on the child, contributing to the perpetuation of feeding problems. Since meals in such cases require a great deal of time, the child is fed very frequently, and even during sleep, which results in infants/toddlers lacking hunger as a motivation to eat [6]. Zero to Three [1], a diagnostic system that classifies psychopathological pictures in the first three years of life, distinguished six diagnostic subtypes of feeding disorders, defined by symptoms and clinical course: “feeding disorder of state regulation”, “feeding disorder of caregiver-infant reciprocity”, “infantile anorexia”, “sensory food aversion”, “posttraumatic feeding disorder” and “feeding disorder associated with a concurrent medical condition”.

The prevalence of mild to moderate feeding disorders in the first two years of life is estimated at approx. 15-25% and of serious disorders at 3-10% [11].

Regulatory problems and parental distress

Excessive crying that continues after the first 3 to 4 months and is often accompanied by sleep-wake-cycle disorders, presents a challenge. It puts a strain on parents and can be a risk factor for the child’s further development [12-14]. In families that are considered to be psychosocially at risk and with access to relatively few resources, early regulation disorders in the children can lead to an escalation and perpetuation of symptoms as well as persistence of regulatory problems in other areas [4]. Von Hofacker and colleagues [3,9] were able to show that the relationship between parents and infant can be seriously influenced by persistent problems coupled with psychosocial pressures. The authors associate “regulatory problems” in early infancy with a triad of symptoms consisting of (1) the influence of the child’s behavior regulation, (2) the occurrence of dysfunctional interaction patterns between the infant and care-giver and (3) parents’ mental and physical stress levels, which are often linked to a current or chronic sleep deprivation. The most significant risk factor comes from interruption of sleep at night owing to irregular childhood sleeping, waking and eating cycles [15-18]. In particular, persistent crying and sleep problems in early infancy affect both the well-being of parents and the relationship between parents and infant [9]. The inability to settle their children and the feelings of helplessness, chronic fatigue, loss of self-confidence and excessive demands cause fears of failure and self-doubt among mothers and fathers with respect to their parental role [19]. Definitions of parental exhaustion vary between extreme fatigue caused by several sleepless nights, which can be remedied by making up for lost sleep, and exhaustion characterised by the fact that it persists even when there is full compensation for the lack of sleep [17]. Since childhood development takes place within the context of a relationship, both difficulties and problems in the relationship as well as the state of the attachment figure can have an effect on development, especially social-emotional development. Salomonsson and Sleed [20] found a strong association between maternal distress and the socio-emotional development of children in the first 16 months of life.

Influence of regulatory problems on childhood development

Regulatory problems that persist longer than the first 3 to 4 months, present an unfavorable factor for further childhood development. The persistence and “broadening” of the child’s regulatory problems into other areas of behavior contribute to an increased risk for further social-emotional and cognitive development in infancy. With regard to later behavioral problems in children, there are various findings. According to the meta-analysis conducted by Hemmi and colleagues [21], persistent excessive crying has the greatest effect on subsequent symptoms: on externalized problems (d = 0.51) and internalized problems (d = 0.50) and on ADHD (d = 0.42). Feeding problems (d = 0.21) and multiple regulatory disorders (d = 0.45) were only held in connection with general behavioral problems. Infant sleeping problems in this study had only a small influence on internalized disorders (d = 0.24) and general behavioral disorders (d = 0.42), while the effect for ADHD was great (d = 1.30).

Wurmser and colleagues [8] reported that infants who had received a diagnosis of excessive crying were also judged to be temperamentally “more challenging” at 30 months in comparison to other children. In addition, a greater frequency of both externalizing and internalizing disorders were found in mid-childhood among children who had cried excessively as babies. Desantis and colleagues [22] found an association between duration of whining and unease in the first weeks of life, emotional reactivity and externalizing disorders from the ages of 3 to 8.

In a study by Schmid and colleagues [13], persistent multiple regulatory disorders (increased crying, sleeping and feeding problems in the 5th month) were a predictor of adjustment difficulties and a negative predictor of social skills for pre-school children (56 months). However, this association applied only to boys. The results of the Mannheim Child Risk Study [23] point to an overall more favorable prognosis for an isolated regulatory problem: the behavioral problems rate in later childhood was only slightly higher than among children from the control group. Children with multiple regulatory disorders showed significantly higher rates of subsequent disorders, both internalizing and externalizing. These multiple regulatory disorders nevertheless played a minor role in comparison to the psychosocial pressures on the families involved in the study: the highest rate of mental abnormalities was found among children who had suffered multiple regulatory disorders as infants and who were also subject to high psychosocial risks.

With regard to the long-term effects of early regulatory problems on cognitive development, there is only limited evidence to date and the studies that have been carried out thus far have shown only small or very small effects. Rao and colleagues [12] found a comparatively low cognitive performance (IQ recorded with WPPSI-R) in areas of verbal communication and interaction among five-year-old children with a history of prolonged excessive crying as babies. These children also scored less on fine motor skill development in comparison to other children of the same age. Increased crying only in the first 12 weeks, on the other hand, had no effect on cognitive development.

Wolke and colleagues [14] reported a lower level of development among 20-month-old infants who at the age of 5 months had been diagnosed with multiple regulatory disorders, in comparison to other infants. This association was more pronounced among boys (small effect) than among girls (very small effect) but was significant for both genders. Among 56-month-old girls, a direct inverse association was found between early regulatory problems and cognitive development. In boys, multiple regulatory problems predicted lower mental development at 20 months. The negative influence of early regulatory problems on cognitive development was nevertheless very small. In another study [22], an association was found between duration of whining and unease during the first 12 weeks and sensory perception/stimulus processing at 3 to 8 years old, but no effects of excessive crying were observed.

The etiological mechanisms involved in the long-term effects of early regulatory problems on subsequent emotional and cognitive development in children remain unclear. Excessive crying beyond 3 months is regarded as an indicator of dysfunctional regulatory capacities and potentially low behavioral inhibition, and as an overall predictor of subsequent behavioral abnormalities. It is suspected that ineffective regulatory mechanisms, stimulus hypersensitivity and deficits in behavior regulation play distinct roles in the formation of regulatory disorders (see overview in [21]).

The present study involved children raised in high-risk families, and thus more vulnerable to further stressors and maladaptive outcomes (i.e. [24]). Laucht and colleagues (2004) found the highest rate of mental problems among children who had suffered multiple regulatory disorders as infants; they were also found to be susceptible to high psychosocial risks [23].

Study aims and hypothesis

This study investigates how and to what extent regulatory problems in 4- and 6-month-old infants affect the children's development at 12 months. Given the limited evidence in the literature, we hypothesize a week association. A differential influence on various aspects of infant’s development, such as motor skills, problem-solving skills and social development is also investigated. On the basis of previous findings, regulatory disorders in the first six months are expected to be associated with a lower level of childhood development at one year. Compared to previous studies [12,14], which used only one measure of cognitive development or general development, the strength of this study is that it seeks to investigate different facets of infant development in the context of regulatory disorders. Due to the paucity of evidence in the literature, the differential influence among the developmental scales is investigated only exploratively.

In addition, given the slight gender-based differences in the link between regulatory disorders and developmental levels [14], we expect to observe a more pronounced association in boys. Based on other findings [20], we expect, also, to see a link between maternal distress during the children’s 4th month and their subsequent social development at 12 months. On the basis of the concept of “triad of symptoms” [3,9], we anticipate an association between regulatory problems in infants, maternal distress and dysfunctionality of mother-child interaction.

As the children involved in our study are raised in high-risk families, we seek to investigate to what extent the occurrence of psychosocial risks, such as poverty or low maternal education levels, have an additional effect on the child`s development. If any evidence of a negative impact of early regulatory problems on a child’s development could be found around the infant's first birthday, it would emphasize the importance of early preventive measures in the first year of the child`s life, particularly for those in high-risk families. The present study builds uniquely upon previous research by examining different facets of infant development in the context of regulatory disorders in a group of younger children raised in high-risk families up to the age of 12 months.

Read the whole article (pdf).

Tobias Grossmann - The Role of the Medial Prefrontal Cortex in Early Social Cognition

The medial prefrontal cortex (mPFC) is primarily involved in processing, representing, and integrating social and affective information. We know now that it is one of the last brain areas to be fully developed (with some now suggesting that it can continue to develop throughout the lifespan), reaching maturity for many people in their late 30s.

A 2001 study by Gusnard, Akbudak, Shulman, and Raichle, looked at the role of mPFC in self-referential mental activity.

[The] dorsal and ventral MPFC are differentially influenced by attention demanding tasks and explicitly self-referential tasks. The presence of self-referential mental activity appears to be associated with increases from the baseline in dorsal MPFC. Reductions in ventral MPFC occurred consistent with the fact that attention-demanding tasks attenuate emotional processing. We posit that both self-referential mental activity and emotional processing represent elements of the default state as represented by activity in MPFC. We suggest that a useful way to explore the neurobiology of the self is to explore the nature of default state activity.

One of the primary roles of the mPFC is "executive function," as outlined in this section from the Wikipedia entry on the frontal cortex.

Executive functions

The original studies of Fuster and of Goldman-Rakic emphasized the fundamental ability of the prefrontal cortex to represent information not currently in the environment, and the central role of this function in creating the "mental sketch pad". Goldman-Rakic spoke of how this representational knowledge was used to intelligently guide thought, action, and emotion, including the inhibition of inappropriate thoughts, distractions, actions, and feelings.[25] In this way, working memory can be seen as fundamental to attention and behavioral inhibition. Fuster speaks of how this prefrontal ability allows the wedding of past to future, allowing both cross-temporal and cross-modal associations in the creation of goal-directed, perception-action cycles.[26] This ability to represent underlies all other higher executive functions.

Shimamura proposed Dynamic Filtering Theory to describe the role of the prefrontal cortex in executive functions. The prefrontal cortex is presumed to act as a high-level gating or filtering mechanism that enhances goal-directed activations and inhibits irrelevant activations. This filtering mechanism enables executive control at various levels of processing, including selecting, maintaining, updating, and rerouting activations. It has also been used to explain emotional regulation.[27]

Miller and Cohen proposed an Integrative Theory of Prefrontal Cortex Function, that arises from the original work of Goldman-Rakic and Fuster. The two theorize that “cognitive control stems from the active maintenance of patterns of activity in the prefrontal cortex that represents goals and means to achieve them. They provide bias signals to other brain structures whose net effect is to guide the flow of activity along neural pathways that establish the proper mappings between inputs, internal states, and outputs needed to perform a given task”.[28] In essence, the two theorize that the prefrontal cortex guides the inputs and connections, which allows for cognitive control of our actions.

The prefrontal cortex is of significant importance when top-down processing is needed. Top-down processing by definition is when behavior is guided by internal states or intentions. According to the two, “The PFC is critical in situations when the mappings between sensory inputs, thoughts, and actions either are weakly established relative to other existing ones or are rapidly changing”.[28] An example of this can be portrayed in the Wisconsin Card Sorting Test (WCST). Subjects engaging in this task are instructed to sort cards according to the shape, color, or number of symbols appearing on them. The thought is that any given card can be associated with a number of actions and no single stimulus-response mapping will work. Human subjects with PFC damage are able to sort the card in the initial simple tasks, but unable to do so as the rules of classification change.

Miller and Cohen conclude that the implications of their theory can explain how much of a role the PFC has in guiding control of cognitive actions. In the researchers' own words, they claim that, “depending on their target of influence, representations in the PFC can function variously as attentional templates, rules, or goals by providing top-down bias signals to other parts of the brain that guide the flow of activity along the pathways needed to perform a task”.[28]

Experimental data indicate a role for the prefrontal cortex in mediating normal sleep physiology, dreaming and sleep-deprivation phenomena.[29]

When analyzing and thinking about attributes of other individuals, the medial prefrontal cortex is activated. However, it is not activated when contemplating about the characteristics of inanimate objects.[30] As of recent, researchers have used neuroimaging techniques to find that along with the basal ganglia, the prefrontal cortex is involved with learning exemplars, which is part of theexemplar theory, one of the three main ways our mind categorizes things. The exemplar theory states that we categorize judgements by comparing it to a similar past experience within our stored memories. [31]

With all of this background, we still know very little about the mPFC in infants, how it develops and what roles it plays in affect and early social cognition. This new study looks at what is known about the mPFC in infants.

The role of medial prefrontal cortex in early social cognition

Tobias Grossmann
Early Social Development Group, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany

One major function of our brain is to enable us to behave with respect to socially relevant information. Much research on how the adult human brain processes the social world has shown that there is a network of specific brain areas, also called the social brain, preferentially involved during social cognition. Among the specific brain areas involved in the adult social brain, functional activity in prefrontal cortex (PFC), particularly the medial prefrontal cortex (mPFC), is of special importance for human social cognition and behavior. However, from a developmental perspective, it has long been thought that PFC is functionally silent during infancy (first year of life), and until recently, little was known about the role of PFC in the early development of social cognition. I shall present an emerging body of recent neuroimaging studies with infants that provide evidence that mPFC exhibits functional activation much earlier than previously thought, suggesting that the mPFC is involved in social information processing from early in life. This review will highlight work examining infant mPFC function across a range of social contexts. The reviewed findings will illustrate that the human brain is fundamentally adapted to develop within a social context.

Full Citation: 

Grossmann T. (2013, May 6). The role of medial prefrontal cortex in early social cognition. Frontiers in Human Neuroscience; 7:340. doi: 10.3389/fnhum.2013.00340

Introduction

Humans possess a number of higher cognitive skills vital for language, reasoning, planning, and complex social behavior. The prefrontal cortex (PFC) can be seen as the neural substrate that underpins much of this higher cognition (Wood and Grafman, 2003). PFC refers to the regions of the cerebral cortex that are anterior to premotor cortex and the supplementary motor area (Zelazo and Müller, 2002). Based on its neuroanatomical connections, the PFC can be broadly divided into two sections: (a) the medial PFC (mPFC) and (b) the lateral PFC (lPFC) (Wood and Grafman, 2003; Fuster, 2008). The mPFC includes the medial portions of Brodmann areas (BA) 9–12, and BA 25, and has reciprocal connections with brain regions that are implicated in emotional processing (amygdala), memory (hippocampus) and higher-order sensory regions (within temporal cortex) (for more detailed information see, Wood and Grafman, 2003; Fuster, 2008). The lPFC includes the lateral portions of Brodmann areas (BA) 9–12, BA 44, 45 and BA 46, and has reciprocal connections with brain regions that are implicated in motor control (basal ganglia, premotor cortex, supplementary motor area), performance monitoring (cingulate cortex) and higher-order sensory processing (within temporal and parietal cortex) (for more detailed information see, Wood and Grafman, 2003; Fuster, 2008).

Critically, the distinction between lPFC and mPFC in neuroanatomical terms maps onto general differences in brain function. Namely, while mPFC is thought to be mainly involved in processing, representing and integrating social and affective information, lPFC is thought to support cognitive control process (Wood and Grafman, 2003; Fuster, 2008). This general functional distinction between mPFC and lPFC can already be seen early in development during infancy (Grossmann, 2013), thus representing a developmentally continuous organization principle of PFC function. As far as brain function is concerned, mPFC has been shown to play a fundamental role in a wide range of social cognitive abilities such as self-reflection, person perception, and theory of mind/mentalizing (Amodio and Frith, 2006). This involvement of mPFC in social cognition and interaction has lead to the notion that mPFC serves as a key region in understanding self and others (Frith and Frith, 2006). Although this is not the focus of this review, it should be noted that apart from its implication in social cognitive functions in adults, mPFC has been shown to be more generally involved in a number of processes related to decision making in adults (e.g., Heekeren et al., 2008). In particular, most recently, a unifying model has been proposed that views mPFC as a region concerned with learning and predicting the likely outcomes of actions (Alexander and Brown, 2011).

Only very little is known concerning the role of the mPFC in the development of social cognition. This is particularly true for the earliest steps of postnatal development, namely during infancy (the first year of life). Addressing the question of whether mPFC plays a role in infant social cognition and if it does, to theorize about what role this might be is the goal of this review. Such a look at early social cognition during infancy through the lenses of social neuroscience is critical because it allows us (a) to understand the nature and developmental origins of mPFC function, and (b) to close a gap between the extensive behavioral work showing rather sophisticated infant social cognitive skills (Spelke and Kinzler, 2007; Woodward, 2009; Baillargeon et al., 2010) and the social neuroscience work with adults studying mature mPFC functioning (Amodio and Frith, 2006; Lieberman, 2006).

That mPFC plays an important role in the development of social cognition is evident in work examining mPFC lesions. For example, there is work comparing early onset (during infancy) and adult onset lesions to mPFC (Anderson et al., 1999). This work shows that, despite typical basic cognitive abilities, patients with mPFC lesions had severely impaired social behavior. More specifically, regardless of when the mPFC lesion had occurred, there are symptoms shared across patients with mPFC damage, including an insensitivity to future consequences of actions, defective autonomic responses to punishment contingencies, and failure to respond to interventions that would change behavior (Anderson et al., 1999). Critically, this study revealed that over and above the shared symptomatology, acquired damage to mPFC during infancy had a much more severe impact on social functioning signified by striking defects concerning social and moral reasoning, leading to a syndrome that closely resembled psychopathy. In this study, it was found that early onset damage to mPFC was related to antisocial behaviors such as stealing, violence against persons and property, severe impairment of social-moral reasoning and verbal generation of responses to social situations. Specifically, in adults with early onset lesions to mPFC, moral reasoning was conducted at a much lower level than expected by their age, such that moral dilemmas were mainly approached from an egocentric perspective characterized by avoiding punishment. Furthermore, early onset damage of mPFC was related to a limited consideration of the emotional implications of one owns behavior for others and much fewer responses generated to resolve interpersonal conflict. This suggests that mPFC plays a critical role in the acquisition of social and moral behaviors already early during ontogeny. It further suggests that in contrast to many other brain regions where damage and especially damage early in ontogeny can be compensated (Thomas and Johnson, 2008), mPFC appears to be less plastic or more vulnerable. This in turn indicates that there might be a sensitive period in development during which mPFC is required to develop and learn socially and morally appropriate behaviors. Even though the study of patients with lesions to the mPFC is of great importance in illuminating mPFC function, patients with circumscribed mPFC lesions acquired during infancy, as reported by Anderson and colleagues (1999), are extremely rare and can hence only provide limited insights into these early stages of developing mPFC function. It is therefore all the more important to employ functional neuroimaging to shed light on the development of mPFC function during infancy if we wish to better understand its role in early social cognition.

Recent advances in applying functional imaging technology to infants, specifically, the advent of using functional near-infrared spectroscopy (fNIRS) has made it possible to study the infant brain at work. fNIRS is an optical imaging method that measures hemodynamic responses from cortical regions, permitting for the localization of brain activation (Lloyd-Fox et al., 2010). Other neuroimaging techniques that are well established in adults are limited in their use with infants because of methodological concerns. For example, functional magnetic resonance imaging (fMRI) requires the participant to remain very still and exposes them to a noisy environment. Although fMRI has been used with infants, this work is restricted to the study of sleeping, sedated or very young infants. The method of fNIRS is better suited for infant research because it can accommodate a good degree of movement from the infants, enabling them to sit upright on their parent's lap and behave relatively freely while watching or listening to certain stimuli. In addition, unlike fMRI, fNIRS systems are portable. Finally, despite its inferior spatial resolution also in terms of obtaining responses from deeper (subcortical) brain structures, fNIRS, like fMRI, measures localized patterns of hemodynamic responses in cortical regions, thus allowing for a comparison of infant fNIRS data with adult fMRI data. In the last decade, there has been a surge of fNIRS studies with infants, including a number of studies that have looked at PFC activation during a wide range of experimental tasks (for review, see Grossmann, 2013). In the following sections, I shall review the available experimental evidence that implicate mPFC in infant social cognition. This review is aimed at providing an overview of the range of social contexts during which infants employ the mPFC. The review of the empirical work is organized according to the two main sensory modalities (audition and vision) in which social stimuli were presented to infants. Following the presentation of the experimental evidence, I will discuss a number of issues that arise from these studies. Finally, based on these findings, I will outline an account of what role mPFC plays in the early development of social cognition during infancy.

With all we know about attachment theory and interpersonal neurobiology, this result is not at all surprising. For example, we know that breast feeding creates a deeper mother-child bond, and that it promotes quicker development of interpersonal skills (emotional intelligence begins in this stage of development).

However, I worry about how studies like this will impact those mothers who cannot breast feed, either because it's too painful, or an absence of sufficient milk production, or beacuse the baby does not cooperate. These women are bound to experience some guilt or shame, that somehow they are disabling their children. While the research is useful and important, we need to be aware of how it will affect others.

However, my guess is that good attachment-focused parenting can counteract any negatives from not being able (or willing) to breast feed a child, so those women should not feel any guilt or shame.

Below this article are the citation and the abstract - the full article is behind a paywall (because Elsevier is evil).

MRI Study: Breastfeeding Boosts Babies' Brain Growth

June 6, 2013 — A study using brain images from "quiet" MRI machines adds to the growing body of evidence that breastfeeding improves brain development in infants. Breastfeeding alone produced better brain development than a combination of breastfeeding and formula, which produced better development than formula alone.

MRI images, taken while children were asleep, showed that infants who were exclusively breastfed for at least three months had enhanced development in key parts of the brain compared to children who were fed formula or a combination of formula and breastmilk. Images show development of myelization by age, left to right. (Credit: Baby Imaging Lab/Brown University)

A new study by researchers from Brown University finds more evidence that breastfeeding is good for babies' brains.

The study made use of specialized, baby-friendly magnetic resonance imaging (MRI) to look at the brain growth in a sample of children under the age of 4. The research found that by age 2, babies who had been breastfed exclusively for at least three months had enhanced development in key parts of the brain compared to children who were fed formula exclusively or who were fed a combination of formula and breastmilk. The extra growth was most pronounced in parts of the brain associated with language, emotional function, and cognition, the research showed.

This isn't the first study to suggest that breastfeeding aids babies' brain development. Behavioral studies have previously associated breastfeeding with better cognitive outcomes in older adolescents and adults. But this is the first imaging study that looked for differences associated with breastfeeding in the brains of very young and healthy children, said Sean Deoni, assistant professor of engineering at Brown and the study's lead author.

"We wanted to see how early these changes in brain development actually occur," Deoni said. "We show that they're there almost right off the bat."

The findings are in press in the journal NeuroImage and available now online.

Deoni leads Brown's Advanced Baby Imaging Lab. He and his colleagues use quiet MRI machines that image babies' brains as they sleep. The MRI technique Deoni has developed looks at the microstructure of the brain's white matter, the tissue that contains long nerve fibers and helps different parts of the brain communicate with each other. Specifically, the technique looks for amounts of myelin, the fatty material that insulates nerve fibers and speeds electrical signals as they zip around the brain.

Deoni and his team looked at 133 babies ranging in ages from 10 months to four years. All of the babies had normal gestation times, and all came from families with similar socioeconomic statuses. The researchers split the babies into three groups: those whose mothers reported they exclusively breastfed for at least three months, those fed a combination of breastmilk and formula, and those fed formula alone. The researchers compared the older kids to the younger kids to establish growth trajectories in white matter for each group.

The study showed that the exclusively breastfed group had the fastest growth in myelinated white matter of the three groups, with the increase in white matter volume becoming substantial by age 2. The group fed both breastmilk and formula had more growth than the exclusively formula-fed group, but less than the breastmilk-only group.

"We're finding the difference [in white matter growth] is on the order of 20 to 30 percent, comparing the breastfed and the non-breastfed kids," said Deoni. "I think it's astounding that you could have that much difference so early."

Deoni and his team then backed up their imaging data with a set of basic cognitive tests on the older children. Those tests found increased language performance, visual reception, and motor control performance in the breastfed group.

The study also looked at the effects of the duration of breastfeeding. The researchers compared babies who were breastfed for more than a year with those breastfed less than a year, and found significantly enhanced brain growth in the babies who were breastfed longer -- especially in areas of the brain dealing with motor function.

Deoni says the findings add to a substantial body of research that finds positive associations between breastfeeding and children's brain health.

"I think I would argue that combined with all the other evidence, it seems like breastfeeding is absolutely beneficial," he said.

Other authors on the study were Douglas Dean, Irene Piryatinsky, Jonathan O'Muircheartaigh, Lindsay Walker, Nicole Waskiewicz, Katie Lehman, Michelle Han and Holly Dirks, who all work with Deoni in the Baby Imaging Lab. The work was funded by the National Institutes of Mental Health.

Full Citation:
Sean C.L. Deoni, Douglas C. Dean, Irene Piryatinksy, Jonathan O'Muircheartaigh, Nicole Waskiewicz, Katie Lehman, Michelle Han, Holly Dirks. (2013). Breastfeeding and early white matter development: A cross-sectional study. NeuroImage; DOI:10.1016/j.neuroimage.2013.05.090

Breastfeeding and early white matter development: A cross-sectional study

Sean C.L. Deonia, Douglas C. Dean III, Irene Piryatinksya, Jonathan O'Muircheartaigha, Nicole Waskiewicz, Katie Lehman, Michelle Han, Holly Dirks

• http://dx.doi.org/10.1016/j.neuroimage.2013.05.090, 
• How to Cite or Link Using DOI
• Purchase $31.50

Highlights

• First investigation of breast-feeding and early infant brain myelination.
• Breastfed infants shown improved brain development by 2 years of age.
• Duration of breastfeeding is positively associated with behavioral performance.

Abstract

Does breastfeeding alter early brain development? The prevailing consensus from large epidemiological studies posits that early exclusive breastfeeding is associated with improved measures of IQ and cognitive functioning in later childhood and adolescence. Prior morphometric brain imaging studies support these findings, revealing increased white matter and sub-cortical gray matter volume, and parietal lobe cortical thickness, associated with IQ, in adolescents who were breastfed as infants compared to those who were exclusively formula-fed. Yet it remains unknown when these structural differences first manifest and when developmental differences that predict later performance improvements can be detected. In this study, we used quiet magnetic resonance imaging (MRI) scans to compare measures of white matter microstructure (mcDESPOT measures of myelin water fraction) in 133 healthy children from 10 months through 4 years of age, who were either exclusively breastfed a minimum of 3 months; exclusively formula-fed; or received a mixture of breast milk and formula. We also examined the relationship between breastfeeding duration and white matter microstructure. Breastfed children exhibited increased white matter development in later maturing frontal and association brain regions. Positive relationships between white matter microstructure and breastfeeding duration are also exhibited in several brain regions, that are anatomically consistent with observed improvements in cognitive and behavioral performance measures. While the mechanisms underlying these structural differences remains unclear, our findings provide new insight into the earliest developmental advantages associated with breastfeeding, and support the hypothesis that breast milk constituents promote healthy neural growth and white matter development.

Alison Gopnik is Professor of Psychology and Philosophy at Berkeley and an internationally recognized leader in the study of children's learning and development. She was the first to argue that children's minds could help us understand deep philosophical questions. She was one of the founders of the study of "theory of mind," illuminating how children come to understand the minds of others, and she formulated the "theory theory," the idea that children learn in the same way that scientists do.

Among her many books are The Philosophical Baby: What Children's Minds Tell Us About Truth, Love, and the Meaning of Life (2010), The Scientist in the Crib: What Early Learning Tells Us About the Mind (2000), and Words, Thoughts, and Theories (Learning, Development, and Conceptual Change) (1998).

Alison Gopnik and the Science of Play

Alison Gopnik and the Science of Play from EG on FORA.tv
Alison Gopnik takes her study of children's play and compares them to scientists performing experiments and thinking about counterfactual realities.

Alison is a Professor of Psychology and Philosophy at Berkeley, and one of the most prominent researchers in the effects of language on thought. She is renowned for her work on cognitive development in babies.

Shrink Rap Radio #339 – Infant Research & Neuroscience Implications for Psychotherapy with Judith Rustin

Judith Rustin is one of the leading figures in the "new" psychoanalysis, the intersubjective systems theory approach first outlined by Robert Stolorow, George Atwood, and Donna Orange. Her most recent book is Infant Research & Neuroscience at Work in Psychotherapy: Expanding the Clinical Repertoire (Norton, 2012). She was this week's guest on the Shrink Rap Radio podcast, hosted by Dr. David Van Nuys.

Shrink Rap Radio #339 – Infant Research & Neuroscience Implications for Psychotherapy with Judith Rustin



Judith Rustin, LCSW is a faculty member and supervising psychoanalyst at the Institute for the Psychoanalytic Study of Subjectivity, New York City, The Psychoanalytic Psychotherapy Study Center, in New York City and The Chinese American Psychoanalytic Association. She has lectured nationally and internationally and published scholarly papers on self-psychology, intersubjectivity systems theory and more recently the interface of infant research and neuroscience with these two psychoanalytic theories. Her published scholarly papers cover these same subjects and areas of expertise with particular emphasis on their application to the therapeutic dyad and the clinical process. In 2005, Other Press published Forms of Intersubjectivity in Infant Research and Adult Treatment, written with collaborators, Beatrice Beebe, Steven Knoblauch and Dorienne Sorter.

Prior to becoming a Psychoanalyst, Judith was an Assistant Professor, (Field Faculty) at the Columbia University School of Social Work. During that tenure she helped to develop a program that integrated disabled students on a college campus and developed models of programs to insure permanency planning for children.

Currently, she maintains a private practice in New York City.

A psychology podcast by David Van Nuys, Ph.D.
Copyright 2013: David Van Nuys, Ph.D. 

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Posted on February 19, 2013

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