The Brain Story in Practice: CUPS Child Development Centre

March 24, 2022

The Brain Story in Practice: CUPS Child Development Centre

Dr. Janice C. Heard, MD, FRCPC, Paediatrician, Assistant Clinical Professor, Department of Paediatrics, Cumming School of Medicine, U of Calgary

Dr. Serena Jenkins, PhD, Scientific Associate, Palix Foundation

Dr. Michael Giuffre, MD, MBA, FRCPC, Paediatric Cardiologist, Clinical Professor of Cardiology and Pediatrics, Cumming School of Medicine, U of Calgary

The Brain Story explains how brains are built over time through responsive serve and return interactions with stable, caring adults, especially during early childhood and adolescence. However, brain development begins within the first month post-conception. Therefore, experiences that occur during gestation are among the first to influence the architecture of the developing brain. Positive experiences, such as a balanced diet that delivers all essential vitamins and minerals, provide a sturdy foundation, whereas negative experiences, such as exposure to drugs of abuse, toxic stress, and a nutrient-deficient diet, can impair the organization and integrity of the developing fetal brain. Brain function follows from structure, so any experience that derails early brain development can exert lasting effects on behavior.

The Brain Story can help us understand cases like Misty, a 4-year-old girl seen by a pediatrician at CUPS Calgary. CUPS has embraced the Brain Story and all staff are required to complete the certification. Misty is overweight and displays an unhealthy relationship with food, often hoarding food and then eating uncontrollably and antisocially. She has difficulty with emotional and behavioral regulation; she cries easily, often needs multiple adults to soothe her when she becomes upset, and “tunes out” when there is any mild commotion. She also shows a tendency to “parent” smaller children and even her mother. Her mother is a single parent; Misty’s father was abusive during the pregnancy and is now incarcerated and no longer involved. Misty’s mother acknowledges the pregnancy was not healthy – in addition to the abuse, her diet was deficient and she was receiving various social supports. She was also newly recovering from a heroin addiction that she began treating with methadone when she learned she was pregnant. Now 23-years-old, Misty’s mother is proudly clean, receiving counselling, employed, and pursuing a career in addictions counselling. 

While in utero, Misty was exposed harmful substances, high levels of stress hormones, and less than ideal prenatal care and maternal diet. All of these adverse events ultimately affected her brain’s architectural foundation beginning at the formation of the neural tube. Now 4-years-old, Misty’s abilities to regulate her emotions and use her air traffic control system are compromised.

The good news is that Misty is still in one of the sensitive periods when positive serve and return interactions with caring adults have the most impact, and she will have another opportunity in adolescence. Her mother and the staff at CUPS, armed Brain Story knowledge, know to take advantage of these windows of increased neuroplasticity to build resilience and ensure the best possible long-term outcomes for Misty.