Allan Schore writes that there is a need to act at the individual, family and culture levels to provide an optimal context for mental and physical health. In addition to fostering cognitive development there is a need to support social-emotional development via right-brain functions of intersubjectivity, empathy, affect process and interactive regulation of stress. Research on the critical survival functions of the right brain can be applied to cultures as well as individuals. There is converging evidence that we can maximise the impact of interventions by focusing on the early critical period of the brain growth spurt.
During prenatal and postnatal critical periods 40,000 new synapses are being formed every second. This is known as the brain growth spurt, a period of maximal plasticity. Total brain volume increases 101% in the first year and there is a 15% increase in the second year. This large increase in brain volume suggests that this is a critical period. Disruption of developmental processes as a result of innate genetic abnormalities or that comes from insults from the environment can have long-lasting or permanent impacts on the structure and function of the brain. Thus, the first year of life is a period of vulnerability but also a period during which therapeutic interventions could have the greatest positive affect. The subcortical volume increases 130% in the first years and 14% in the second. This growth is not just genetically encoded but epigenetically influences and requires human interaction.
Variations in maternal caregiving and caregiver maltreatment can be seen as epigenetic modifications regulating gene activity. Clinicians must assess the quality of the attachment relationship and provide interventions when they are needed. Early emotional processing seems to begin in utero so it is critical to assess the emotional well-being of the mother-to-be in pregnancy. The best description of the path to neurodevelopment is that it is malleable. The attachment relationship shapes, for better or worse, the child’s capacity for resilience or a predisposition for psychopathology. When these outcomes are negative, they have an adverse impact not just on the individual and their community, but on society as a whole.