46 You are going to read an article“Learning to live”. For questions 42-46, choose the answer (A, B, C or D) which you think fits best according to the text.Where brainpower is concerned, the old edict of “use it or lose it” holds true from the start. Babies who receive love and encouragement from their parents develop the neural connections they need to get on in life. But what happens to those who fail to get this support? Do they grow up to be less bright than their nurtured peers?It would be comforting to believe that deprived children escape from long term damage by being too young to speak, or know any different, but the evidence suggests otherwise.At a recent meeting of the Royal Society of Medicine, medics were shown slides taken with a powerful scanner comparing the brains of “normal” three-year-olds with those who had been raised in deprivation or in orphanages.The work was done by Dr Bruce Perry of the Child Trauma Academy in Houston, Texas. The scans showed that the frontal-temporal areas of the brain, those responsible for personality and enabling a person to display and regulate emotions, showed little activity.For years scientists have known that animals reared in rich environments have larger and more complex brains, than animals that grow up in deprivation, so experts like Perry anticipated that the same would hold true for humans. However, it is only now thanks to powerful scanners that allow this theory to be put to the test, that the damage is clearly visible. Perry explains the reason for the abnormality is that the brain develops in a “use dependent way”, growing, organising, working according to experience. With the right stimulation, the brain makes the connections it needs. Without it, synapses, junctions between the neurons used to transport the brain’s messages, literally dissolve. “Adverse experiences play a vital role in organising the neural system in the developing brain,” says Perry”; in other words, ill-tratment in infancy leads to faulty wiring in the brain. Significantly, the rate at which new synapses form is gratest in the first eight months of life.Fortunately, different parts of the brain develop at a varying pace, so the damage may be confined to the parts that were actively organising at the time of stress or neglect. Perry describes these times as “windows of opportunity” that exist for different brain functions. If the connections between neurons are not developed at the critical period, they may not develop at all. Synapses assocated with vision are most active when a child is two to eight months old. A baby born with cataracts, removed at the age of two, will remain blind, as the window of opportunity has passed.The frontal cortex, the part that deals with personality and emotions, organisis itself at around eight months. With correct nurturing the child learns to regulate emotions and becomes empathetic, recognising that other people are also thinking and feeling beings. But, because complex functions, such as abstract thoughts, are wired in the brain later in childhood, between the ages of 11 and 13, emotionally deprived children still score normally on IQ tests.”Children who do not get consistently attentive, loving care in the first year may still receive appropriate cognitive stimulation as they grow. Although these children have profound attachment problems, they are often very bright’” says Perry.Interaction between the child and its carers is vital to teach the brain to function normally. By playing with and talking to the child the mother distracts the infant from a bombardment of competing noises. This communication trains a section of the brain to regulate emotions so the child is able to function day-to-day without being a hostage to impulses and feelings.Just as the sections of the brain associated with “normal” emotional regulation are understimulated in the deprived child, the areas linked to stress are often overstimulated. “The result is a child who is hypersensitive to stress whose flight or fight mechanism is costantly active. This low-level but constant state of fear can lead to increased muscle tone, profound sleep disturbances and abnormalities in cardiovascular regulation,” warns Perry.Yet, despite the damage caused by stress and trauma in childhood, Perry, like most clinicians, is optimistic that intervention can help, as the cortex, the grey matter responsible for high level brain function, is malleable and capable of changing. He is supported in his belief by child psychiatrist, Dr Dora Black, founder of the Traumatic Stress Clinic in London, who works with severely traumatised children. She claims neurological evidence is available that shows that, although trauma can affect the speech area in the brain, this function can return if the child receives help early enough. “Unfortunately”, admits Perry, “what we do not know is how much deprivation is needed to prevent the recovery of normal expression of various emotional, cognitive or social skills.”Why is it important to interact with very young children?