In Part 1 of our Gesell Lectures – Light series yesterday, we saw how Dr. Nathan Fox’s development of measures of brain activity in infants and children has led to a greater understanding of brain development, and which types of experiences impact this development.
Today, we’ll see the clinical value of Dr. Fox’s work: how basic science informs clinical practice.
Alongside his studies of brain development, throughout his career Dr. Fox has studied children’s temperament. Dr. Fox’s graduate mentor, Jerome Kagan, MD, ’54 is best known for his pioneering work on temperament, which he and others define as the stable, distinctive behavioral and emotional reactions that appear early in life and are influenced in part by genetics. Dr. Kagan was the first to describe a particular type of temperament in children: behavioral inhibition. About 15% of children are behaviorally inhibited (BI) and are characterized by heightened vigilance and attention to novelty and greater withdrawal and/or distress in novel situations, both social and nonsocial. BI children and adolescents also show unique brain activity and distinct physiological profiles.
Dr. Fox’s research has demonstrated that some children persist and even intensify in their BI across development into young adulthood, and these are the kids at greater lifetime risk for anxiety. Individual differences in temperament can be identified early, in the first year or two of life, that seem to be associated with development of psychopathology. Dr. Fox’s research has shown that the children who maintain BI exhibit two distinct types of cognitive processes. BI children show greater executive control and monitoring of errors on cognitive tasks, and they show a greater attention bias (i.e., vigilance) to threatening stimuli – even as young as 5 years old.
So how can psychologists, clinicians, and therapists take this scientific evidence and use it to develop interventions for anxious children? Dr. Fox and his colleagues used this foundational work to develop a “brain training” therapy for clinically anxious youth. In a randomized control trial, children underwent a 4-week training period, where each week they were given attention bias modification (ABM) tasks to shift their attention away from threatening stimuli. Simply put, Dr. Fox’s group trained anxious children away from threat. And, compared to anxious children received a placebo (no training) or training with only neutral stimuli, those who took the ABM training showed a reduction in the number and severity of anxiety symptoms:
Dr. Fox’s research is now focusing on refining these types of attention training therapies for kids with anxiety, as well as studying the effectiveness of such therapies compared to, or in conjunction with, current available therapies including pharmacological and cognitive behavioral therapies (CBT), among others.
Watch this video to see Dr. Fox detailing this body of work in a presentation he gave to the Alberta Family Wellness Initiative in 2012.