Damage to the Brain

In the last Newsletter I discussed the various forms of abuse and neglect.  In this essay I will discuss how these duel forms of maltreatment impact on the neural formation of the brain and how that shapes the child’s academic and behavioural performance. 

In recent years there has been an acceptance that the resulting cognitive alteration resulting from abuse and neglect constitutes a real physical disability however, there has not yet been a community appetite to eliminate the cause of these preventable brain injuries and the rate of both abuse and neglect continue to rise in our society.

The following is an examination of those impairments.  To summarize, the cognitive damage comes from:

• Broad scale reduction in the neural density caused by the lack of appropriate stimulation at the pertinent times and the corresponding excess pruning.  This is a direct result of neglect; these children do not receive the stimulus required to construct the necessary neural pathways at the time conditions are optimal for that to happen.  When those windows of opportunity pass the brain removes unused material to increase efficiency.  These cannot be replaced and their elimination makes later attempts to learn those behaviours much more difficult.
• There is a loss of neural material in the very part of the brain that creates memories, the hippocampus; this reduced in size by up to 10% becoming less effective.  It is the hippocampus that not only initiates the formation of memories it also selects what to remember and then coordinates them across the cerebrum and to the frontal lobe. This is critical because it is the coordination of various memories that support high order thinking.
• The lack of neural density is more prominent in the frontal lobes estimate at being as much a 20% thus reducing its effectiveness.  The frontal lobes are considered to be the executive heart of our critical analysis and long-term decision making.
• There is an increase in the size of the amygdala because of the amount of ‘use’ it gets in the early years.  The amygdala is critical in first initiating high levels of stress and then protective behaviours.  This increase results in the children being   hypersensitive to any potential threat.  These children find trust difficult making the establishment of teacher student relationships much more difficult.
• There is a decrease in the size of the cerebellum, an area of the brain that has long been associated with our motor skills but in recent years it is emerging as a most important component of all cognitive activities.
• Finally, the size of the corpus collosum is reduced in size which hinders the coordination between the hemispheres of the brain.

If this physical damage to a child’s brain came from another source than early childhood abuse perpetrated by adults the public outcry would be deafening however this mutilation imposed on innocent children continues to be tolerated.

The illustration below is quite well known and is the product of MRI examinations of a ‘normal’ child, referred to as neuro-typical and that of a child who was raise in the notorious Romanian orphanages.  Not only is the reduced size startling but the increase occurrence of the dark shadows in the Romanian child indicates the death of neural material.  The discovery of these children shocked the world and the follow-up research on potential rehabilitation is depressing; these kids are damaged for life.  Unfortunately, in today’s society, too many kids are raised in conditions that have the same cognitive impact, authorities ignore this but teachers are left to deal with these disabilities that are a result of that abuse and neglect.

I have always held learning is memory and hi-order thinking, the goal of education is the coordination and application of memories; that is our ability to gain and integrate pieces of evidence into an existing scheme of information, our memories to address a problem is our working memory.  The very definition of learning is the establishment and modification of this process.

Children who have suffered early childhood abuse and neglect have a real disadvantage both in the deficit in the memories stored across the cerebrum and the lack of neuron material in the frontal lobes to integrate what is available.  This is the real ‘physical’ disability that affects their learning but that cognitive incapacity is not obvious, they look the same as all the other kids.  For example, if a child who is blind trips over a chair and makes a noise they are forgiven and encouraged to try again.  If a child, with the disabilities outlined here picks up a chair and throws it out the window they are punished and rejected by everyone.  In a sense they are abused again!

It is little wonder these children do not succeed, not only at school but also in the community.  They have trouble interpreting all exchanges with the outside world.  Their apparent naivety or defiance is often a lack of comprehension.  Teachers can misinterpret this as insubordination when really it is their disability that determines their behaviour.

A further physical issue involving the frontal lobe is its interaction with the limbic system, particularly the amygdala.  Amongst the functions of the amygdala is the regulation of emotions.  As mentioned above, we have seen in an abusive environment the amygdala becomes more powerful which means it is much more sensitive to stimulus that may represent a potential threat.  Because of this over-active response to stress these kids will over-react when they even think they are being ‘attacked’.  They have an underdeveloped ability to critically assess the risk of any stressful situation. 

To make matters worse, in normal development the frontal lobes reach a stage of development where they assume the role of arbitrating the emotional content of the environment.  This means that, with the exception of real and imminent danger children get a bit of time to assess the situation before deciding about their actions.  This short period of time is at the heart of most cognitive interventions that deal with behaviour modification.  One particular program best illustrates the futility of this ‘thinking’ approach.  Stop – Think – Do is, or was a program popular in schools.  It ‘teaches’ children to stop before they react to a challenging situation and then think about what would be the best response. 

Kids with this type of brain injury can’t ‘stop’ they are too finely tuned and immediately react to any perceived threat.  It is obvious that the combination of a damaged frontal lobe coupled with a very powerful amygdala means cognition, carefully assessing what to do is a tactic that is just not available.  These kids will do what they have always done. The chance of any cognitive intervention being of much use for these children when they are threatened is extremely unlikely.  As a result, in the classroom they are highly reactive and to further complicate matters when they are super-aroused plus they will take a much longer time to recover their self-control. 

Teachers and school counselors often see this as the student not applying the ‘lessons’ they have patiently taught them, like Stop – Think – Do and give up.  They see the kids as not bothering to apply the ‘perfectly logical practice’ that just makes sense. They don’t see that these children at the time of arousal do not have access to ‘perfectly logical practice’; what they have is a brain that is super alert to danger. 

The condition of these children’s cognitive must be considered when thinking about the behaviour of these children and what we can do to help; teachers have no other option.  These essays will not only describe the process that results in this damage but will provide strategies that will help them optimize their own learning and minimize the impact their behaviour has on others.