Tag Archives: Jerome Kagan

Why is Temperament Important to Parents and Teachers?

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Roughly 10-20% Caucasian children are shy and hesitant in unfamiliar situations. Another 10-20% are sociable and intrepid in response to novelty. The underlying features of these predispositions usually referred to as “temperament”, remain remarkably consistent over time. It has also been found that the caregiving environment in the early years can significantly influence the behaviors characteristic of these temperaments. That makes the study of temperament particularly relevant to this blog.

Nancy Snidman, a colleague of the pioneer researcher in temperament, defines temperament as a “predisposition to respond to the environment in certain ways” (lecture to UMB IPMHPCP, March 6, 2016). The baby comes into the world with certain temperamental qualities. These temperamental qualities may be due to genetics or epigenetics – influences from the environment in the womb. Children’s temperament influences the way they react to their environment – physical, social, and emotional. For example, a child’s temperament affects the way they react to novelty, sensory stimulation, or transitions. How does temperament at infancy translate to temperamental characteristics such as shyness in a preschool child? What does the “shy” infant look like as an older child or adult? Snidman and Kagan did a series of longitudinal studies to try to answer these questions.

Kagan and Snidman studied 400, 4-month old babies and classified them as high reactive (HR) and low reactive (LR) on the basis of their response to auditory, visual, and olfactory stimuli. They observed the babies’ responses in the form of heart rate increase, motor arousal (such as limb flexion and extension, motor tension, and back arch) and fretting or crying. They looked for the extremes of HR and LR babies and started to follow them.

They postulated that the HR children had inherited a low threshold of excitability in the amygdala; a part of the mid-brain called the limbic system, and the related limbic areas. The amygdala sends signals to the autonomic nervous system, communicating a sense of threat in the environment.

They studied the babies’ physiology and behavior in response to a number of laboratory procedures, from 9 months to 15 years. Some of these procedures were mild, such as puppets or tasting sweet and sour liquids, and some were more challenging, such as a toy robot and a stranger approaching wearing a lab coat and a gas mask. The two extreme styles of temperament, HR or LR, or behaviorally inhibited (BI) – shy, wary of novelty, slow to approach, or behaviorally uninhibited (BU) – sociable, comfortable with novelty, were remarkably consistent over the years.

Interestingly, the researchers found that as the kids got older the physiological markers were more important than the behavioral ones. This was because the children were taught to be polite. It was less the general behavior to strangers that distinguished the HR from the LR kids, and more the smiles and spontaneous comments. When children are presented with the same stimuli in repeated exposures, for example when they are shown invalid pictures (a horse head on a fish body), they usually habituate to the stimulus. That means their reaction becomes smaller with repeated exposures. In the case of HR kids, however, there is no habituation! That means that although they look more and more like their LR peers in terms of social behavior, their heart rate, pupillary dilatation, muscle tension, and stress hormones remain more reactive.

This is very interesting to me in my work with children and families. For more than two decades, Attachment Theory has dominated research in child psychology. This way of understanding child development minimizes the contribution of temperament. Yet, I have found temperament a very useful way of making sense of some of the problems that parents bring to me regarding their children’s behavior. It is also helpful to me when I consult to preschool teachers. In the next blog posting I will describe how I use ideas of temperament to help parents and teachers understand the children in their care.

Readings

Schwartz C, Snidman N, Kagan J (1999). Adolescent social anxiety as an outcome of inhibited temperament in childhood, JAACAP 38(8):1008-1015.

Kagan J (1997) Temperament and the reactions to unfamiliarity, Child Development 68(1):139-143.

Kagan J (1989). Temperamental contributions to social behavior, American Psychologist 44(4):668-674.

How to Talk to Your Child About Complex Subjects

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At a gathering of family and close friends recently, a young couple asked me a question about their almost 3-year old son. I had observed the child and had found him to be intelligent, charming, and warmly connected to his parents. He also seemed sensitive, perhaps one of Kagan’s “inhibited” children (Kagan & Moss, 1983). The child, whom I will call “David” (not his real name), had been anxiously asking his parents about whether he might be put in jail, about whether he was a “bad guy”. He seemed to associate these fears to bible stories he was hearing in Sunday school, particularly the stories of Daniel and the Lion’s Den, and the story of Jesus being arrested. This was confusing to his parents, because in their understanding of these narratives, it was the “good guys” who were arrested. His parents told me that they constantly reassure him that he is a good boy, that they love him, and that he is safe. David’s parents further explained that he seems to ask these questions about being thrown in jail whenever a stranger is in the house, asking whether that person is going to throw him in jail. His parents decided to avoid stories about jail and to limit the bible stories since many of the concepts seemed too complex for him to process at this age. They asked me what I thought.

This question is fascinating from several points of view. First of all, it highlights the difference between the meanings an adult makes of certain narratives and those made by a preschool child. Second, it underscores the often discrepant levels of maturation of different developmental capacities in the same child. Third, it reveals aspects of a crucial cultural context that forms the way narratives transmit important beliefs and values in a society. Consideration of these factors may help parents in their efforts to talk to their children about complex subjects. 

What about what Tronick calls the “age possible” meanings that two people of different developmental ages make of the same story (Tronick, 2007)? An example is offered by the 4-year old whose mother was trying to explain to her the generational relationship of people at a family reunion. The mother explained, “Your nana is your daddy’s mommy.” The little girl thought for a moment and then asked in wonder, “But how did she get him into the car seat?” I am also reminded of a little patient, a 3-year old who witnessed people jumping from the World Trade Towers on television and in a play session suggested to me that children could “jump big” in a playground because it is “softer” (Harrison & Tronick, 2007). I took her to be referring to a “soft landing”, though I knew that no number of soft mattresses at the foot of the WTT could have cushioned the fall of the jumpers. In David’s case, the meaning he derived from “being put in jail” was that you were a bad guy, period. He was not able to consider a nuanced meaning in which a good guy was unjustly jailed. It is clear that good guys and bad guys are on his mind these days. Remember the “terrible two’s”?. His age-typical anxiety about the result of noncompliance to parental demands (whether real acts of noncompliance or imagined ones) led him to fear that his “bad guy” feelings and thoughts would brand him as a bad guy and cause someone to throw him in jail. A “stranger” is a preferable enforcer of that terrible punishment, because a stranger can be seen as “all bad”.  If it were one of his beloved parents who threatened him with jail, how could he manage the stress of fearing one that he also loved and depended on? 

The second issue is that of discrepant developmental capacities. Human development is not a smooth, linear process. It occurs in a messy process of hits and misses, halts and bumps forward, and reiterative efforts to master. In many children, this messy process occurs at very different rates and in different ways in different domains of competency. For example, some children have precocious motor coordination but are slow to speak. Others speak sophisticated sentences early but struggle to do one rung of the monkey bars or are insecure about climbing and jumping. If you have significant discrepancies in your developmental capacities, you are left with a subjective sense of inner imbalance, sometimes even of incipient chaos, in the background. It does not always bother you, but when you experience a threat, it can emerge. This could be called “anxiety”, but that is a rather crude description of a complicated subjective experience. I do not know David well enough to guess about whether he has a discrepant developmental profile. The inheritance of “inhibited” genes is another possibility. However, I do know many children who fit this picture of uneven development.

Finally, there is the interesting factor of culture. In an earlier posting, I wrote about how another 3-year old sat through a 6-hour wedding dinner with a minimum of fuss. I described what I saw his French parents do in order to teach him to sit at the table for long stretches. In any culture many core beliefs are transmitted by narratives. Children hear these narratives repeated over and over from early on and learn the culturally shared meanings that their parents convey to them. However, the meaning is not transmitted by language alone. Peter Fonagy talks about this process. He says, “Human communication is specifically adapted to allow the transmission of cognitively opaque cultural knowledge, kind-generalizable generic knowledge, and shared cultural knowledge” (Fonagy, lecture IPMH, May, 2012). This knowledge is transmitted by what he calls “ostensive communication cues” such as eye contact, turn taking with contingent reactivity, and special vocal tones. In a study Fonagy cited, infants of 18 months old were asked by the researcher to pass an object, a doll. In the control group, the researcher gave no cues directed to the infant, but in the study group, the researcher first smiled and said hello to the infant. Then in both groups, the researcher smiled at one doll and made a disgust face at the other. At that point, another researcher came into the room and the baby was asked to give the second person a doll. Only in the group in which the experimenter had smiled and said hello, did the babies give the second person the doll the first experimenter had smiled at, the doll designated as desirable . In other words, the researcher had initiated a relationship with the baby and in that context, the baby attended to the “ostensive cues” (smiling or disgust face) she then gave him. The infant trusted the researcher who smiled and said hello and then judged the information she gave him to be reliable.  

So, in response to my young friends’ question, I would say that I support their decision to protect David from anxiety provoking bible stories for the present. In avoiding certain bible stories they are acknowledging a dysynchrony between the dominant contemporary middle class U.S. culture and a culture in which bible stories are a primary means of transmitting beliefs. In the latter culture, bible stories would not just be read but from early on would be told as stories, with accompanying “ostensive cues”. In that culture, the parent would communicate – with eye contact, turn taking rhythms, and tone of voice – who the bad guys and who the good guys are in every story, over and over.  In that way, David would learn the salient meanings – with associated values – of his culture. Of course, he might still have fears of being a bad guy, because of his age-typical struggles with his aggression and negativity. It is less likely, though, that his fears would focus on bible stories.

Harrison, Alexandra & Tronick, Ed (2007). Now we have a playground: Emerging new ideas of therapeutic action”, J Amer Psychoanal Assoc., 55/3: 853-874.

 Kagan, Jerome & Moss, Howard A (1983) From Birth to Maturity: A Study in Psychological Development, Yale University Press. 

Tronick, Ed (2007). The Neurobehavioral and Social-Emotional of Infants and Children, WW Norton.

 

photograph by Joshua Sparrow

 

 

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March IPMH Meeting: Epigenetics II

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(Continuation of Barry Lester’s presentation with discussion)

What are some long-term prenatal stressors that affect placental genes? These risk factors may play a role in future problems but do not predict the future. What they can do is alter the HPA system set points and affect the way the newborn responds to stress. This in turn could influence the baby’s regulation.  One could hypothesize that potentially this could lead to dis-inhibition, psychopathology, cognitive problems, and adolescent substance abuse. Of course, there are many steps along the way and many forks in the road. We are only talking about risk factors in a very complex set of processes. We don’t know what these pathways are that lead to problems down the road. We only see correlations. 

Let’s look at cocaine using mothers. It becomes difficult to isolate a particular risk factor in the lives of these women. But the cocaine exposed babies showed higher reactivity to stress. What are the other stressors in the picture? In addition to cocaine use, there is also a relationship of the babies’ high reactivity to the number of caregiver changes. The important point is that you are looking at how the drug interacts with adversity in the postnatal environment, not just the effect of the drug itself.

Which epigenetic changes will be passed on?  Ed (Tonick) says that nutritional studies show that it takes two more generations after the parent generation to clear out some of the nutritional effects in the generation of the grandparents. Do these pass through the mother’s line only? (There are also those who dispute the intergenerational transmission.) If the changes that are passed on represent a guess about the environment, then that is important. How stable are these epigenetic changes anyway? It is possible that they are short lived but that the environment reinstates them. Suppose you are a 2-yo and you are neglected and so you methylate your GR receptors (stress regulatory system). Then you get neglected again, so you methylate them again. There then may be changes in your hippocampus that in effect become a damaged part of your stress regulatory system. Is it causality or association? It seems unlikely that methylation of one gene is going to cause the changes we are talking about. 

It is essential to keep in mind that the connections we are talking about do not represent the actual events of the real world. Ed says that “simple” and “sovereign” is always wrong. We tend to find a new paradigm, and the situation always becomes more complicated the more you look at it. We always find a new paradigm and it gets more complicated the more you look at it. If you look at the Dutch famine study, think about the mothers who were pregnant during a war in which the whole country was starving. The famine ends, but people have died, fetuses have been aborted, the babies who are born are smaller and more irritable. The women who mother them are traumatized. We talk about the famine but do not seriously take into consideration all the other horrible factors that were involved. These amplifying and reinforcing factors were still going on even after the war.

The magnitude of effects – the effect size of all these factors – is small.  It is interesting that you get this variability in the relationship between methylation and behavior in healthy babies, and it makes you wonder what would happen if you look at “at risk” populations; in that case, do you magnify the effects? Within the normal range you can find the same relationship between birth rate and behavior in a study done by Ed Tronick and Barry Lester. You need to consider the whole range – babies who weigh 8 pounds and those who weigh 6 pounds – will the bigger babies have a little better organized behavior? 

There is a new NICU at Brown with single rooms. The changes taking place include more breast feeding, more kangaroo care, etc. An Italian colleague of Ed’s, Rosario, did a study in which he looked at the quality of care in 24 different NICU’s in Italy. He categorized them and gave them assessments, and the babies in the better NICU’s had better scores than those in the least good ones. You are then discharging a baby who is medically in better shape and also neurobehaviorally in better shape. Also, the higher the level of neurodevelopmental care, the lower the incidence of depression in the mothers. All of these NICU’s ascribe to a particular care policy, but in fact they vary. Some of the things that are done in developmental care are thought of as “neuro-protective”. Ideas of developmental care have shifted. 

Schizophrenia – what is the epigenetic issue? There are people who are studying epigenetic changes related to schizophrenia and autism. There is not a lot published yet, but it seems there are prenatal effects that are related to schizophrenia. We also need to look at the relationship between epigenetic changes and genotype. 

Steve Suomi  has done cross fostering studies of rhesus monkeys. He took inhibited and uninhibited babies and cross fostered them, and found that there was evidence of temperament coming through in addition to the environment. Barry Lester thinks of temperament as a protective factor. Nancy Snidman asked about individual differences in the pups – not all the pups get licked, do they? Everyone agreed that there are probably individual differences among the pups that influence how much they get licked. Ed pointed out that just because these models have to do with stress, it doesn’t mean that stress is all bad. We don’t know what appropriate levels of stress are. What about the stress and temperament interaction – is it possible that stress for a highly reactive kid can lead to a blow out, whereas stress for a low reactor can be facilitating? Yes, but it also depends on what you mean by stress. These kids have different thresholds for reactivity. Some people get a rush that is positive, and others feel a negative reaction immediately.

If you have an acute stressful event and it finishes and is done, and yet you ruminate about it, that self-amplifies the stress.  This is where a psychodynamic factor plays an important role. In the case that the individual makes a harmful, self-critical meaning of the stress, then when stress happens, things deteriorate. Stress reactivity by itself, the cortisol effect, is a nonspecific model that could go many different ways. The Kagan model is more specific – it is reaction to novelty – across the lifespan. Stress reactivity and care is a different model. There are many paths that fussiness in a baby can take. Nancy and Kagan were looking at reaction to novelty, and they wanted to get the system aroused to see the physiological systems respond. There were a lot of things they could not include that have to do with caretaking. The amygdala approach-withdrawal reaction – is specific in its relation to novelty. They started with older children. How could they bring that reaction down to infancy and what was going on in the brain? They do see SES differences. Nancy reminds us that most kids are a mix of the temperamental features they are talking about. They were studying mainly the extremes. 

This kind of research is also constrained by the use of checklists. Remember that it is not only parental translation to what these words like “seldom” and “often” mean; it is also what we mean. In the checklist we have to interpret the answers, and what was “trouble” when the checklist was developed and what it is now sometimes has changed. The reason you use CBCL is that the parent has a thick relationship with the child and you may not see all these things for 15 min in the lab. It is also true that the more extreme anything is, the greater effect you will see from it. So that you will see a greater effect the more abnormal the caretaking is. In the case of the relationship between temperament and training in dogs, it is harder to train certain breeds to be aggressive than others, but you can do it. You could probably override most traits. 

In the discussion, one fellow talked about a home placement program in which a child who has not been able to develop certain skills is put into a supportive foster home. Then, when he is better, he is sent back into the home, and they cannot manage. It is typical for kids to do well in structured environments but do poorly at home, and the school says. There is a tendency to dismiss the fact that the child does better in one context because of the regulatory support context.

In the next blog, I will report on the presentation about Attachment Theory. 

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March Infant Parent Mental Health Weekend: Temperament

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 We began the weekend with Dr.Nancy Snidman, a colleague of Dr. Jerome Kagan who talked to us about temperament. She defined temperament as “what a child brings to the interaction with the environment to create personality”, pointing out that nowadays we tend to talk about “individual differences” instead of temperament, but that individual differences tends to be a “blend of temperament and environment”.  Nancy talked to us about the differences in reactivity of children related to different thresholds of reactivity in the amydala. In their study of the amydala output effects, such as sympathetic responses, output to the larynx (crying), and output to the skeletal motor system, the research group identified a group of “timid” children who had inherited a low threshold of reactivity of the amydala.

It turns out that if you look at the sensory integration scale and the temperament scale, you find a lot of overlap, and some people think they are not so different. Nancy said that if part of your definition of sensory integration disorder is that there is an overwhelming response to sensory information that the child is born with, you could call it temperament. 

Nancy showed us videos of two 4-month old infants responding to a mobile. One baby was highly reactive to the stimulus, and the other was not. The research group chose babies who were high reactive and low reactive in terms of motor behavior and crying modes of reactivity and they followed them over time. Starting at 21 months the researchers saw a lot of consistency. 

The high reactive girls at 21 months started to look shy, a trait that diminished later on. As the children grew older, the best behavioral indicator of their status was spontaneous smiles and comments. The cognitive style related to high reactivity is associated with high levels of response inhibition and over control. The most cohesive group was low reactive boys. 

Socialization differences did have an impact. Interestingly, the low reactive boys tended to seek out risky behavior, whereas the (more “timid”) high reactive boys were often encouraged by their parents to get into sports, against their initial inclination. When these high reactive boys were older they would often end up in individual sports such as swimming, which is a team sport but may avoid some of the rough and tumble aggression characterizing the others.  As the kids got older, it was novelty that would trigger the threat. In preschool, when they became familiar with the school, they were fine. There were some high reactive boys who were doing very well in high school but couldn’t manage the transition (the novelty) to college. 

Nancy sees temperament as underlying all that gets created in the interaction between the individual and the environment. What is the environment that the child finds him or herself in?  If you were counseling parents, you might think – in the case of a high reactive child – to suggest that the parent take more time with transitions. In the case of a low reactive boy, you might try to protect the child against a tendency towards risky behavior. 

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