Research conducted at Erasmus University Rotterdam reveals that a child's brain changes in the event of persistent behavioural problems. Windesheim University of Applied Sciences translates this type of new knowledge into the educational situation.

The longer serious behavioural problems exist in the children, the higher the chance that their brains change. This was demonstrated by neurobiological research carried out at Erasmus University Rotterdam. Windesheim University of Applied Sciences is working on embedding this type of new knowledge in the courses it offers to youth and legal professionals.

‘Our aim is to improve the lives of children and families’, says child and youth psychiatrist Tonya White. At the Erasmus University Rotterdam, she is head of brain imaging in Generation R, a large-scale population study into children and young people in Rotterdam. Children with severe behavioural problems and severe mental health problems run a higher risk of developing a mental health disorder as adults, says White. This disorder is not necessarily the same as that experienced in childhood and can, for example, manifest as addiction, personality or mood disorders. ‘Clearly there is something in the brain that gives a higher risk for all of these disorders’, says White. That "something" is what she wants to gain a clear picture of in this research.

Visible and invisible differences

White is therefore now investigating how the brain in children with severe anxiety, depression, aggression and attention problems (in summary: a dysregulation profile) develops. On scans from the youngest group, aged 6 to 9 years, she found almost no difference in the brains of the children with and without problems. However, in the following measurement, in children aged 9 to 11 years, these differences were present. They were visible in the white matter (that makes the connections between the different areas of the brain), the thickness of the adrenal cortex and in the areas involved in higher cognitive functions. The learning ability of the children with a dysregulation profile, corrected for genetic influences, was an average eight points lower.

Stable behavioural problems

‘Behavioural problems in children aged six years are far less predictive than in older children’, concludes White. ‘The stability of behavioural problems increases with the age of the child. If behaviour is continuously repeated, then the brain starts to behave differently.’ The psychiatrist is therefore in favour of early interventions. These could contribute to the brain continuing to develop more according to normal patterns. However, intervention research is first of all needed before we can know that for certain, says White. ‘The cause of the problems can vary. That requires different types of interventions. For some children, behavioural therapy is good, whereas others need family therapy.’ Knowledge exchange with professionals would be good, concludes White, who would prefer nothing more than that the insights from her research find their way into professional practice.

Exchange

The project “Unfamiliarity breeds suspicion” that Windesheim University of Applied Sciences carries out in collaboration with Utrecht University of Applied Sciences, NeuroLabNL and two academic workplaces for youth, is in line with that wish. The aim is to translate existing neurobiological and psychosocial knowledge about problematic antisocial and criminal behaviour of young people to the higher vocational education setting, including the study programme “Social Work and the minor. Working in a constrained context”. Unlike universities, knowledge does not always reach the curriculum of higher vocational education courses for future coaches and care providers, says project leader and lector Youth Dorien Graas. These professionals in training often know too little about recent scientific insights and the significance of these for their work. ‘Whereas that is often so desperately needed for these young people with often persistent problems.’

Three steps

The project will start in May this year by bringing together existing knowledge. That includes evidenced-based insights as well as knowledge from professional practice and people with relevant experience. In the next step, the knowledge collected will be translated into education modules for future professionals and professionals already working in the field. This will be done using the method of Design Thinking. ‘We will first develop a prototype together with university of applied sciences lecturers, people with relevant experience, young people and researchers. We will subsequently refine each prototype into an optimal module.’ Step three concerns a dynamic development to rapidly incorporate new knowledge into existing modules. Otherwise professions will continue to work with outdated insights.

Scepticism

The modules will also tackle how people view neurobiological insights and their attitude towards these, says Graas, ‘This is because, among professionals as equally young people and their parents, we see an overestimation and underestimation of the role biological factors play. Those perceptions partly determine what will happen with the insights. Therefore we first want to know which knowledge the professionals have and how they view this. During the development of new modules, we want to pay close attention to that.’

No third line of action

The integration of existing sociological, psychological and neurological knowledge is another ambition of the project. Graas: ‘In the past, the emphasis was first on the social factors and then on the psychological factors. With the neurobiology, we do not want to add a third line of action, but rather link the explanations this offers to the other explanatory models. We want people to realise that these three levels are associated with each other.’ The lector already looks forward to future exchanges with researchers like Tonya White. ‘With our approach we are taking a fantastic step towards the implementation of knowledge. Thanks to our broad collaboration we can continue to guarantee the knowledge transfer and with that the expertise of our future professionals.’

Author: Veronique Huijbregts, Mediator 34

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