T H E
L E C T U R E S E R I E S
Inaugural Lecture by
Bruce D. Perry, M.D., Ph.D.
Maltreatment and
the Developing Child:
How Early Childhood Experience
Shapes Child and Culture
Dr. Perry is an internationally recognized authority on child trauma and the effects
of child maltreatment. His work is instrumental in understanding the impact of
traumatic experiences and neglect on the neurobiology of the developing brain.
He presented the inaugural Margaret McCain lecture on September 23, 2004
We seek to make the world a better must appreciate the remarkable In utero and during the first four years
malleability of our species and the
place. No matter our profession or
of life, a child s rapidly developing brain
unique role played by the human brain.
vocation, we share the desire  and the
organizes to reflect the child s
ability  to make a difference in a child s life.
environment. This is because neurons,
The Developing Brain
Humans are complex creatures. While
neural systems, and the brain change in
The human brain mediates our
having the capacity to be humane, we
a  use-dependent way. Physical
movements, our senses, our thinking,
also have the capacity to be cruel. Why?
connections between neurons  synaptic
feeling and behaving. The amazing,
What determines whether a child grows
connections  increase and strengthen
complex neural systems in our brain,
up to be compassionate, thoughtful,
through repetition, or wither through
which determine who we become, are
and productive? Or, impulsive,
shaped early. disuse. It follows, therefore, that each
aggressive, hateful, and non-productive?
brain adapts uniquely to the unique set
Is it genetic?
of stimuli and experiences of each child s
Likely not. Human beings become a
world. Early life experiences, therefore,
reflection of the world in which they
determine how genetic potential is
develop. If that world is safe, predictable,
and characterized by relationally and expressed, or not.
cognitively enriched opportunities, the
As the brain organizes, the lower more
child can grow to be self-regulating,
regulatory systems develop first. During
thoughtful, and a productive member
the first years of life, the higher parts of
of family, community, and society. In
the brain become organized and more
contrast, if the developing child s world is
functionally capable. Brain growth and
chaotic, threatening, and devoid of kind
development is profoundly  front loaded
words and supportive relationships, a
such that by age four, a child s brain is
child may become impulsive, aggressive,
90% adult size! This time of great
inattentive, and have difficulties with
The brainstem controls heart rate, body
opportunity is a biological gift. In a
relationships. That child may require
temperature, and other survival-related
nurturing environment, a child can grow
special educational services, mental health
functions. It also stores anxiety or arousal states
to achieve the full potential pre-ordained
associated with a traumatic event. Moving
or even criminal justice intervention.
outward towards the neocortex, complexity of
by underlying genetics. We can promote
The challenge for us is to help each
functions increases. The limbic system stores
this by fostering conditions of optimal
child reach his or her potential to be
emotional information and the neocortex
humane. To better understand how, we controls abstract thought and cognitive memory. development.
Sharing ideas to help children thrive www.lfcc.on.ca
T H E
L E CT U R E S E R I E S
A hyperarousal response is more
Optimal Development
common in older children, males, and
A child is most likely to reach her full
in circumstances where trauma involves
potential if she experiences consistent,
witnessing or playing an active role in
predictable, enriched, and stimulating
the event.
interactions in a context of attentive
The dissociative response involves
and nurturing relationships. Aided
avoidance or psychological flight,
by many relational interactions 
withdrawing from the outside world
perhaps with mother, father, sibling,
and focusing on the inner. The intensity
grandparent, neighbour and more 
of dissociation varies with the intensity
young children learn to walk, talk,
These images illustrate the negative impact of of the trauma. Children may be
self-regulate, share, and solve problems.
neglect on the developing brain. The CT scan
detached, numb, and have a low heart
Every child will face new and
on the left is from a healthy three-year-old
rate. In extreme cases, they may
challenging situations. These stress- with an average head size. The image on the
withdraw into a fantasy world. A
right is from a three-year-33old child suffering
inducing experiences per se need not
dissociative child is often compliant
from severe sensory-deprivation neglect. This
be problematic. Moderate, predictable
child s brain is significantly smaller and has
(even robotic), displays rhythmic self-
stress, triggering moderate activation of
abnormal development of cortex.
soothing such as rocking, or may faint if
the stress response, helps create a
feeling extreme distress. Dissociation is
capable and strong stress-response
The Adaptive
more common in young children,
capacity, in other words, resilience. The
females, and during traumatic events
Response to Threat
first day of kindergarten, for example, is
characterized by pain or inability to
stressful for children. Those embedded
When a child is exposed to any threat,
escape.
in a safe and stable home base
his brain will activate a set of adaptive
overcome the stress of this new
Differential  State
responses designed to help him survive.
situation, able to embrace the
There is a continuum of adaptive
Reactivity
challenges of learning.
responses to threat and different
A child with a brain adapted for an
children have different adaptive styles.
Disrupted Development
environment of chaos, unpredictability,
Some use a hyperarousal response (e.g.,
While most children experience safe threat, and distress is ill-suited to the
fight or flight) and some a dissociative
and stable upbringings, we know all too modern classroom or playground. It is
response (essentially  tuning out the
well that many children do not. an unfortunate reality that the very
impending threat). In most traumatic
The very biological gifts that make adaptive responses that help the child
events, a combination of the two is
early childhood a time of great survive and cope in a chaotic and
used.
opportunity also make children very unpredictable environment puts the
vulnerable to negative experiences: child at a disadvantage when outside
inappropriate or abusive caregiving, a that context.
Traumatic Event
lack of nurturing, chaotic and When children experience repetitive
cognitively or relationally impoverished activation of the stress response
Prolonged
environments, unpredictable stress, systems, their baseline state of arousal is
persisting fear, and persisting physical altered. The result is that even when
Alarm Reaction
threat. These adverse effects could be there is no external threat or demand,
associated with stressed, inexperienced, they are physiologically in a state of
ill-informed, pre-occupied or isolated Altered Neural alarm, of  fight or flight. When a
caregivers, parental substance abuse stressor arises, perhaps an argument
Systems
and/or alcoholism, social isolation, or with a peer or a demanding school task,
family violence. Chronic exposure is they can escalate to a state of fear very
A child adopting a hyperarousal
more problematic than episodic quickly. When faced with a typical
response may display defiance, easily
exposure. exchange with an adult, perhaps a
misinterpreted as wilful opposition.
In the most extreme and tragic cases teacher in a slightly frustrated mood,
These children may be resistant or
of profound neglect, such as when the child may over-read the non-verbal
even aggressive. They are locked in
children are raised by animals, the cues such as eye contact or touch.
a persistent  fight or flight state.
damage to the developing brain  and Compared to their peers, therefore,
They often display hypervigilance,
child  is severe, chronic, and resistant traumatized children may have less
anxiety, panic, or increased heart rate.
to interventions later in life. capacity to tolerate the normal
demands and stresses of school, home, caring. Children will learn that not all enriching cognitive, emotional, social,
and social life. When faced with a adults are inattentive, abusive, and physical experiences for children.
challenge, for example, resilient children unpredictable, or violent. The challenge is how best to do this.
are likely to stay calm. Normal children It is paramount that we provide Understanding fundamental principles
in the same situation may become of healthy development will move us
environments which are relationally
vigilant or perhaps slightly anxious. beyond good intentions to help shape
enriched, safe, predictable, and
Vulnerable children will react with fear sensitive caregiving in homes, early
nurturing. Failing this, our conventional
or terror. childhood settings, and schools.
therapies are doomed to be ineffective.
Research is key. Public education must
If a child is in a therapeutic
Fear Changes
be informed by good research and by
relationship, we can help him better
the Way We Think
the implementation and testing of
understand the feelings and behaviours
educational and intervention programs.
that are the legacy of abuse and
Children in a state of fear retrieve
An important component of public
neglect. Information helps. A
information from the world differently
understanding must be awareness of
traumatized child may act impulsively
than children who feel calm.
the power of the media over children.
and misunderstand why  perhaps
In a state of calm, we use the higher,
What to do? Integrate key principles
believing she is stupid, bad, selfish or
more complex parts of our brain to
of brain development, child
damaged. We can also teach adults in a
process and act on information. In a
development and caregiving into public
child s life about how traumatized
state of fear, we use the lower, more
education. We presently require more
children think, feel, and behave.
primitive parts of our brain. As the
formal education and training to drive a
Among the possible therapeutic
perceived threat level goes up, the less
car than to be a parent. More research
options to help maltreated and
thoughtful and the more reactive our
in child development and basic
traumatized children are cognitive-
responses become. Actions in this state
neurobiology is needed to guide
behavioural therapy, individual insight-
may be governed by emotional and
sensible changes in policy, programs
oriented psychotherapy, family therapy,
reactive thinking styles.
and practice.
group therapy, play or art therapy, eye-
As noted above, when children
movement desensitization and re-
experience repetitive activation of the
2) Respect the gifts of early childhood
programming (EMDR), and
stress response systems, their baseline
Enriching environments do exist.
pharmacotherapy. Each of these has
state of arousal is altered. The
Many homes and high-quality, early
some promising results and many
traumatized child lives in an aroused
childhood educational settings provide
disappointments.
state, ill-prepared to learn from social,
the safe, predictable, and nurturing
Therapy with maltreated children is
emotional, and other life experiences.
experiences needed by young children.
difficult for many reasons. In the long
She is living in the minute and may not
Unfortunately, we often squander the
fully appreciate the consequences of term, the wisest strategy is to prevent
wonderful opportunity of early
her actions. Add alcohol to the mix, or abusive, neglectful, and chaotic
childhood.
other drugs, and the effect is magnified. caregiving. In that way, fewer children
At a time when the brain is most
will require therapy.
easily shaped  infancy and early
Decreasing
childhood  we spend the fewest public
Prevention
the Alarm State
dollars to influence brain development.
and Solutions
It is important to understand that the However, expenditures on programs
designed to change the brain
brain altered in destructive ways by We are the product of our childhoods.
trauma and neglect can also be altered dramatically increase for later stages of
The health and creativity of a
in reparative, healing ways. Exposing development (e.g., mental health,
community is renewed each generation
the child, over and over again, to substance abuse or juvenile justice
through its children. The family,
developmentally appropriate interventions).
community, or society that understands
experiences is the key. With adequate Investing in high-quality early
and values its children thrives; the
repetition, this therapeutic healing childhood programs could avoid the
society that does not is destined to fail.
process will influence those parts of the expensive, often inefficient or
To truly help our children meet their
brain altered by developmental trauma. ineffective, interventions required later.
potential, we must adapt and change
Unfortunately most of our therapeutic Unfortunately, these expensive
our world. Some ways to do this follow:
efforts fall short of this. interventions can be reactive,
1) Promote education about
We can also be good role models: in fragmented, chaotic, disrespectful and,
brain and child development
all our interactions with children we can sadly, sometimes traumatic. Our public
be attentive, respectful, honest, and We must as a society provide systems may recreate the mess that
many abused and neglected children school can help: limiting television use, teacher interactions. Specific ways
find in their families. having family meals, playing games to foster strengths at home and
What to do? Innovative and effective together, including neighbours, at school are suggested on The
early intervention and enrichment extended family and the elderly in the ChildTrauma Academy s website:
models exist. Integrate them into the lives of children, and bringing retired www.ChildTrauma.org
policy and practices in your community. volunteers into schools to create multi-
Conclusion
Help the most isolated, at-risk young age educational activities.
parents connect with community
The effects of maltreating and
4) Foster healthy
resources, both pre-natally and post-
traumatizing children have a complex
developmental strengths
partum. Demand and support high
impact on society. Because our species
Certain skills and attitudes help
standards for child care, foster care,
is always changing, better
children meet the inevitable challenges
education, and child protective service.
understanding of these issues would
of life. They may even inoculate children
help us develop more effective
against the adverse effects of violence.
solutions.
Brain's Spending on
A child who develops six core strengths
The human brain is designed for life
Capacity Programs to
to Change  Change the will be resourceful, successful in social
in small, relationally healthy groups.
Brain
situations, resilient, and may recover
Law, policy and practice that are
quickly from stressors and traumatic
biologically respectful are more
incidents.
effective and enduring. Unfortunately,
When one or more core strengths
many trends in caregiving, education,
does not develop normally, the child
Age 0 3 l 6 l 12 l 20
child protection and mental health are
....Mental Health........Juvenile Justice..
may be vulnerable (for example, to
...Headstart.........Public Education..........Substance Abuse Tx... disrespectful of our biological gifts and
bullying and/or being a bully) and may
limitations, fostering poverty of
cope less well with stressors. These
relationships. If society ignores the laws
strengths develop sequentially during
3) Address the relational of biology, there will inevitably be
the child s life, so every year brings
neurodevelopmental consequences. If,
poverty in our modern world
opportunities for their expansion and
on the other hand, we choose to
We are designed for a different world
modification.
continue researching, educating and
than we have created for ourselves.
What to do? The major providers
creating problem-solving models, we
Humankind has spent 99 percent of its
of early childhood experiences are
can shape optimal developmental
history living in small, intergenerational
parents. Supporting and strengthening
experiences for our children. The result
groups. A child s day brought many
the family will increase the likelihood
will be no less than a realization of our
opportunities to interact with the
of optimal childhood experiences.
full potential as a humane society.
variety of caregivers available to protect,
Also important will be peer and
nurture, enrich, and educate. But, the
relational landscape is changing.
Today, with our smaller families, we
Dr. Bruce Perry s Six Core Strengths for Children:
have less connection with extended
A Vaccine Against Violence
families and fewer opportunities to
interact with neighbours. Children
being able to form and maintain healthy emotional
ATTACHMENT:
spend a great deal of time watching
bonds and relationships
television. While we in the western
containing impulses, the ability to notice and control
SELF-REGULATION:
world are materially wealthy, we are
primary urges as well as feelings such as frustration
relationally impoverished. Far too many
AFFILIATION: being able to join and contribute to a group
children grow up without the number
and quality of relational opportunities
being aware of others, recognizing the needs,
ATTUNEMENT:
needed to organize fully the neural
interests, strengths and values of others
networks to mediate important socio-
TOLERANCE: understanding and accepting differences in others
emotional characteristics such as
empathy. finding value in differences, appreciating worth
RESPECT:
in yourself and others
What to do? Increase opportunities
for children to interact with others,
For more information on the Six Core Strengths, visit the  Meet Dr. Bruce Perry
especially those who are good role
page at http://teacher.scholastic.com/professional/bruceperry
models. Simple changes at home and
Margaret Norrie McCain The Lecture Series
I n September, we held the first of an annual series of lectures
The Honourable
addressing topics of interest shared by Margaret and our
Margaret N. McCain was
Centre, such as the early years and the effects of violence on
co-chair with Dr. Fraser
Mustard of the highly children. All proceeds go to the Centre's Upstream Endowment
regarded Early Years campaign. We are delighted that Margaret has agreed to lend
Study: Reversing the Real
her name to our new lecture series. We greatly admire her
Brain Drain (1999) and is
dedication to children s interests. We are also pleased that Dr.
the Children's Champion
Bruce Perry agreed to be the inaugural speaker. An audience of
at Voices for Children.
over 300 watched his lecture at the London Convention Centre.
Among her many
His approach is in harmony with our own in many ways: begin
accomplishments, she is
early, apply a developmental framework, understand how
a founding member of
children cope with adversities, support caregivers to support
the Muriel McQueen
children, and help professionals understand how children think,
Fergusson Foundation in
feel and learn. For those not able to join us for the inaugural
New Brunswick whose
lecture, we are providing here a summary of Dr. Perry s talk. We
mission is the elimination
hope you can join us at the next lecture.
of family violence
Linda Baker
through public education
Ph.D., C.Psych., Executive Director
and research.
Centre for Children & Families in the Justice System.
I am delighted that Dr. Bruce Perry was invited to give the
inaugural Margaret McCain Lecture because he is a person
whose work I have long admired. His research and writing
on the effects of family violence on children have had an
enormous influence on me. In fact, they led to my decision
to focus my time and energy on early child development.
Dr. Perry should be listened to by all politicians and policy
makers at the highest levels. The information he presents is
Margaret is seen
powerful and irrefutable and it could change dramatically
here between
the lives of children and families.
Dr. Peter Jaffe
Margaret N. McCain and Dr. Linda Baker
...a Note from the Series Editor
Researchers repeatedly find statistical Simply put, the more obstacles in front different implications for intervention.
correlations between living with violence of a child, the harder time he or she has Dr. Perry posits another causal mechanism,
navigating the journey down the road
 at home and in the community  and hidden from view deep inside the brain.
of childhood, especially if progress is
problematic outcomes in children. The Traumatic features of a violent world 
judged against peers racing forward
most sophisticated studies show us how noise, chaos, fear, isolation, deprivation,
unencumbered by adversities What causally
the correlations are mediated and neglect  alter the developing brain of
links the  adversity package and poor child
fetuses, babies, and toddlers. Their brains
moderated by factors themselves
outcome? What mechanism or mechanisms
adapt appropriately to toxic environments,
correlated with violence, including
is at work to reduce a child s chances for
but these adaptations are at odds with
economic poverty, child maltreatment,
success in life?
requirements for school and social
emotional and physical neglect, parental
relationships. These children are primed
substance abuse, parental stress, and Finding those mechanisms
to survive their world, leaving them
parental mental illness.
is the key to designing
ill-prepared to achieve their full potential
effective prevention and
These large studies prove what front-line
in our world. This document is a brief
intervention strategies.
workers already know: children living with
summary of Dr. Perry s stimulating
adult domestic violence rarely experience
Some observers focus on learning
lecture, pointing readers to other
violence as the only life adversity. At the
and modelling, while others see
sources of information.
Centre, we call this the  adversity package ,
psycho-dynamic factors as important.
a term used by Dr. Robbie Rossman.
Feminist thought and gender analysis Alison Cunningham, M.A.(Crim.),
Dr. Perry calls it the  malignant have had a great impact on our collective
Director of Research & Planning,
combination of experience . understanding of violence. Each view has Centre for Children & Families in the Justice System
Dr. Perry served as the Thomas S. Trammel Research Professor of Child Psychiatry at
Baylor College of Medicine and Chief of Psychiatry at Texas Children s Hospital in
Houston, from 1992 to 2001. Dr. Perry consults on incidents involving traumatized
children, including the Columbine High School shootings, the Oklahoma City Bombing,
the Branch Davidian siege and the September 11 terrorist attacks. He has served as the
Director of Provincial Programs in Children s Mental Health for Alberta, and is the author
of more than 250 scientific articles and chapters. He is an internationally recognized
authority in the area of child maltreatment and the impact of trauma and neglect on the
developing brain. Dr. Perry attended medical and graduate school at Northwestern
University and completed a residency in general psychiatry at Yale University School of
Medicine and a fellowship in Child an Adolescent Psychiatry at the University of Chicago.
Bruce Perry
Readers interested in additional material by Dr. Perry can visit the Child Trauma Academy at:
M.D., Ph.D., Senior Fellow, www.childtrauma.org or www.childtraumaacademy.com (with free on-line courses)
Child Trauma Academy,
Bruce D. Perry (2004). Maltreated Children: Experience, Brain Development, and the Next Generation.
Houston, Texas New York: W.W. Norton.
Additional Resources Recommended by Dr. Perry
Marian Diamond & Janet Hopson (1999). Magic Trees of the Mind: How to Nurture Your Child's Intelligence,
Creativity and Healthy Emotions from Birth Through Adolescence. Plume Books.
Robin Fancourt (2001). Brainy Babies: Build and Develop Your Baby s Intelligence. Penguin.
Alison Gopnik, Andrew N. Meltzoff & Patricia Kuhl (2000). The Scientist in the Crib: Minds, Brains
and How Children Learn. Perennial.
Ronald Kotulak (1997). Inside the Brain: Revolutionary Discoveries of How the Mind Works.
Andrews McMeel Publishing.
Web Sites
Attachment Parenting International: www.attachmentparenting.org
Society for Neuroscience: www.sfn.org
National Association to Protect Children: www.protect.org
California Attorney General s Safe from the Start Initiative:
Reducing Children s Exposure to Violence: www.safefromthestart.org
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The Margaret McCain
with the justice system, as young offenders, victims of crime or abuse, the subjects of
Lecture Series
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go to the
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