1 00:00:02,160 --> 00:00:05,480 In this episode, Doctor Elaine McCulloch, Chartered Clinical 2 00:00:05,480 --> 00:00:09,080 Psychologist and independent consultant for Family Futures, 3 00:00:09,480 --> 00:00:12,200 explains and explores the thinking behind the Family 4 00:00:12,200 --> 00:00:15,600 Futures therapy model, neurophysiological psychotherapy 5 00:00:15,800 --> 00:00:18,760 or NPP, and the research that underpins it. 6 00:00:19,400 --> 00:00:22,000 We discussed the physical and emotional impact of 7 00:00:22,000 --> 00:00:25,560 developmental trauma on the nervous system, how safety and 8 00:00:25,560 --> 00:00:29,000 Co regulation are at the heart of healing, and what the latest 9 00:00:29,000 --> 00:00:31,840 findings show about long term outcomes for children and 10 00:00:31,840 --> 00:00:35,160 families. Elaine explains how the MPP 11 00:00:35,160 --> 00:00:38,640 model supports developmentally traumatized children and young 12 00:00:38,640 --> 00:00:42,000 people to access calm, connection and cognitive growth. 13 00:00:42,760 --> 00:00:46,480 It's a powerful conversation about trauma and neurobiology. 14 00:00:47,280 --> 00:00:50,000 You can find the time stamp, topic guide and glossary of 15 00:00:50,000 --> 00:00:53,040 terms in the show notes. To find out more about Family 16 00:00:53,040 --> 00:00:59,000 Futures or our research, visit www.familyfutures.co.uk. 17 00:00:59,360 --> 00:01:05,519 Thanks for listening. I am Doctor Elaine McCulloch. 18 00:01:05,560 --> 00:01:09,640 I am a clinical psychologist. I'm also ADDP practitioner and 19 00:01:09,640 --> 00:01:13,480 consultant. I worked for Family Futures for 20 00:01:13,480 --> 00:01:15,720 about 7 years. I was the first clinical 21 00:01:15,720 --> 00:01:23,080 psychologist and I helped, I set up as part of that fantastic 22 00:01:23,080 --> 00:01:26,800 experience of learning about the MPP model. 23 00:01:28,200 --> 00:01:32,520 I helped, I led on their research. 24 00:01:32,600 --> 00:01:37,880 And so I have since I am. So since then, I have since 25 00:01:37,880 --> 00:01:40,280 moved away and I I'm an independent practitioner, but I 26 00:01:40,280 --> 00:01:43,800 remain A consultant to family features and and supervisor 27 00:01:43,800 --> 00:01:48,000 psychology staff, but also I lead continue to lead on the 28 00:01:48,000 --> 00:01:51,160 research there as well. So I think what would be really 29 00:01:51,160 --> 00:01:56,280 helpful for people to know is an overview of what is the MPP 30 00:01:56,280 --> 00:01:59,560 model in the, it's, I know it can be quite hard to sort of 31 00:01:59,880 --> 00:02:05,080 briefly explain, but if you could, what is MPP, what does it 32 00:02:05,080 --> 00:02:08,039 mean? And for anyone listening here 33 00:02:08,039 --> 00:02:10,080 has absolutely no idea what we're talking about or about to 34 00:02:10,080 --> 00:02:13,160 be talking about. OK. 35 00:02:13,160 --> 00:02:17,320 So I think you probably have done other podcasts on MPP, so 36 00:02:17,320 --> 00:02:18,760 they probably have. Yes. 37 00:02:19,280 --> 00:02:24,080 And so the probably people will have gone into the model in more 38 00:02:24,080 --> 00:02:27,000 depth than I think we have time for here. 39 00:02:27,520 --> 00:02:29,920 Yeah, just an overview. Yeah. 40 00:02:30,120 --> 00:02:36,000 But for me, the MPP model is essentially a model that's 41 00:02:36,040 --> 00:02:42,520 about, it's a relational model that focuses on Co regulation 42 00:02:43,080 --> 00:02:47,520 and that can be and essentially it's a somatos sense, somatos 43 00:02:47,520 --> 00:02:51,000 sensory. So it works with the body and 44 00:02:51,040 --> 00:02:57,720 the sensory system in helping children and young people who 45 00:02:57,960 --> 00:03:02,520 have experienced developmental trauma to feel safe and to be 46 00:03:02,520 --> 00:03:07,480 regulated and in the context of the relationship, in the context 47 00:03:07,480 --> 00:03:12,240 of the dyad with the parent. So the focus is always on 48 00:03:12,240 --> 00:03:17,920 meeting the child where they're at and helping them to regulate 49 00:03:17,920 --> 00:03:23,040 so that they come in to a place where they've got a balanced 50 00:03:23,040 --> 00:03:27,560 nervous system and they're in a state of of regulation. 51 00:03:27,840 --> 00:03:33,320 And it's in that place, in that window of tolerance that they 52 00:03:33,320 --> 00:03:37,600 can begin to make connections. So it's only when you get, when 53 00:03:37,600 --> 00:03:41,680 a child is help, when you're able to use porges and you know, 54 00:03:41,680 --> 00:03:45,520 to use his polyvagal theory, what we're doing is activating 55 00:03:45,840 --> 00:03:48,800 the ventral vagus nerves. So the nerve that's present when 56 00:03:48,800 --> 00:03:52,960 the parasympathetic nervous system is is, is activated, 57 00:03:53,160 --> 00:03:57,720 which helps us bring in, bring on board that sense of safety. 58 00:03:58,080 --> 00:04:01,720 And then we can then do all the other work in terms of 59 00:04:01,720 --> 00:04:05,880 connecting up, you know, and doing the talking, making 60 00:04:05,880 --> 00:04:09,760 connections with helping the child connect, make sense of 61 00:04:09,760 --> 00:04:14,400 their experience, bringing their attention to this sense of, you 62 00:04:14,400 --> 00:04:19,000 know, I'm, I'm OK, and I'm here with my parent and they're 63 00:04:19,000 --> 00:04:22,040 helping me to feel safe. And they, they get me. 64 00:04:22,560 --> 00:04:25,960 And what in that sense of safety, they can really then 65 00:04:27,560 --> 00:04:33,080 begin to make more connections. And that's where the that's when 66 00:04:33,080 --> 00:04:35,000 the learning happens, if that makes sense. 67 00:04:35,640 --> 00:04:40,400 That does make sense. You have said a few terms that 68 00:04:40,400 --> 00:04:44,160 I'm not so familiar with, so could you? 69 00:04:44,360 --> 00:04:48,640 You were talking about the vagus nerve and the paravagus nerve. 70 00:04:49,280 --> 00:04:52,560 So the Poly vagal theory, Poly vagal theory, vagus nerve. 71 00:04:53,000 --> 00:05:00,400 So when I talk about the autonomic nervous system, I'm 72 00:05:00,400 --> 00:05:04,040 referring to the the sympathetic nervous system, which is the 73 00:05:04,040 --> 00:05:08,240 part that we, that is activated when we go, when we are excited 74 00:05:08,240 --> 00:05:12,600 or when we are going to fight or flight, when we get hyper 75 00:05:12,600 --> 00:05:15,120 aroused. And most people will be familiar 76 00:05:15,120 --> 00:05:18,080 with that. That's, that's quite common in 77 00:05:18,080 --> 00:05:20,560 our that that's quite familiar to most people. 78 00:05:21,520 --> 00:05:24,040 And, and then the parasympathetic branch of the 79 00:05:24,040 --> 00:05:28,400 autonomic nervous system is the part that helps us to go into 80 00:05:28,400 --> 00:05:35,120 rest and restore. What it's the part that when 81 00:05:35,120 --> 00:05:38,280 we're, we're sitting down watching a film that that will 82 00:05:38,280 --> 00:05:41,240 be activated, that will be in that zone. 83 00:05:41,920 --> 00:05:50,640 And, and one of the things that enables us to go into rest and 84 00:05:50,640 --> 00:05:53,720 restore or, or even to be excited. 85 00:05:53,720 --> 00:05:58,800 And it is that sense of safety. You know, we, so, so it's the 86 00:05:58,800 --> 00:06:05,560 sense of safety is activated by the ventral vagus nerve, which 87 00:06:05,560 --> 00:06:07,160 is cranial. I don't want to go into it too 88 00:06:07,160 --> 00:06:11,360 much, but it's a cranial nerve that connects up with our with 89 00:06:11,360 --> 00:06:13,480 our heart and our lungs and our organs. 90 00:06:13,880 --> 00:06:16,160 And when it's above our diaphragm, it's the ventral 91 00:06:16,160 --> 00:06:19,000 vagal. And when that particular vagus, 92 00:06:19,040 --> 00:06:21,840 that vagus nerve, it goes beneath the diagram and 93 00:06:21,840 --> 00:06:24,400 diaphragm. Look for this story, I'm really 94 00:06:24,400 --> 00:06:27,720 testing you here. Like it's really interesting 95 00:06:27,720 --> 00:06:33,200 when you break it down that it's a, we're looking at two things. 96 00:06:33,200 --> 00:06:35,680 It's physical. It's really, really physical. 97 00:06:35,680 --> 00:06:39,240 What's happening in your body, what's actively your body is 98 00:06:39,240 --> 00:06:41,040 doing and how it's responding to that. 99 00:06:41,040 --> 00:06:44,080 And correct me if I've got any of this wrong, how you're 100 00:06:44,080 --> 00:06:49,160 responding to the situation and it's emotional. 101 00:06:50,640 --> 00:06:54,200 It's also how you know how you're feeling as well, which I 102 00:06:54,200 --> 00:06:59,360 think is, is So what is so interesting about NPP and what 103 00:06:59,360 --> 00:07:02,960 also when we're talking about it, because we talk, you talk 104 00:07:02,960 --> 00:07:05,240 about a lot more than me, but I talk about it as well. 105 00:07:05,560 --> 00:07:10,000 And it's easy to kind of you explaining it now in such detail 106 00:07:10,000 --> 00:07:12,280 about the physiological part of it. 107 00:07:12,680 --> 00:07:15,600 She sort of forget because we talk a lot about feelings. 108 00:07:15,880 --> 00:07:17,760 We talk about how you're feeling in the body. 109 00:07:18,160 --> 00:07:22,520 But I guess what I'm sort of oddly surprised by is how 110 00:07:22,560 --> 00:07:27,280 physiological is how is really what is happening in your body 111 00:07:27,280 --> 00:07:32,320 and how that is presenting and that and that kind of minute 112 00:07:32,320 --> 00:07:35,600 level that we're thinking about it of what's going on, which is 113 00:07:35,600 --> 00:07:37,160 so interesting. Yeah. 114 00:07:37,640 --> 00:07:42,920 And that's what what I mean. So, so presence or absence after 115 00:07:42,920 --> 00:07:46,280 the ventral, there's a vagus nerve and the ventral part of it 116 00:07:46,280 --> 00:07:50,800 is the part that runs that from our heart, you know, above our 117 00:07:50,800 --> 00:07:55,000 diaphragm. And when that's activated, it 118 00:07:55,000 --> 00:07:59,600 means that it brings a pop, it brings in a sense of safety. 119 00:08:00,040 --> 00:08:04,920 And often it's activated in the context of of of a relationship 120 00:08:04,920 --> 00:08:08,440 of when we get cues of safety. OK. 121 00:08:09,000 --> 00:08:15,240 And so in the MPP model, we're always working with bringing on 122 00:08:15,240 --> 00:08:19,840 board that ventral, we call the Ventral Vegas break bringing 123 00:08:19,840 --> 00:08:22,480 that on board. And often we have to work with 124 00:08:22,600 --> 00:08:26,800 we, we're always working with the nervous system to give the 125 00:08:26,800 --> 00:08:30,880 nervous system cues of safety. So, so that can be through play. 126 00:08:32,159 --> 00:08:35,559 I talked about this amount of sensory work that can be through 127 00:08:35,840 --> 00:08:38,720 sensory integration because of course, lots of the children 128 00:08:38,720 --> 00:08:42,480 that come to family futures do have sensory processing 129 00:08:42,480 --> 00:08:46,520 difficulties because of the, the over stimulation or the under 130 00:08:46,520 --> 00:08:51,680 stimulation that they experienced in, in, in their 131 00:08:51,680 --> 00:08:55,040 infancy. So giving, so they're often 132 00:08:55,040 --> 00:08:57,240 overwhelmed. There's their, their nervous 133 00:08:57,240 --> 00:09:02,520 system is often overwhelmed by the, the inability to process 134 00:09:02,560 --> 00:09:08,040 all of that sensory input. And so the MPP model works with 135 00:09:08,200 --> 00:09:12,280 the sensory system to help the child to process all of that. 136 00:09:12,720 --> 00:09:17,320 And, and that brings a, you know, that triggers that sense 137 00:09:17,320 --> 00:09:21,520 of safety. And we do that in the context of 138 00:09:21,760 --> 00:09:25,640 the relationship with the parent, where the parent is a 139 00:09:25,680 --> 00:09:28,600 safe person. So and the parent and the child 140 00:09:28,600 --> 00:09:33,080 also gets to see that the parent gets them essentially that the 141 00:09:33,080 --> 00:09:37,040 parent understands their experience and can help them. 142 00:09:37,680 --> 00:09:45,480 So, so that sense of safety that is that we work in with and that 143 00:09:45,480 --> 00:09:49,080 we that happens in the that's brought upon using the MPP model 144 00:09:49,560 --> 00:09:57,040 is then we kind of garner that we take advantage of that to 145 00:09:57,040 --> 00:09:59,880 them to make those connections. If that makes sense to fit them 146 00:09:59,880 --> 00:10:03,120 to do the thinking bit, which is why we would never go straight 147 00:10:03,120 --> 00:10:06,080 in and do a talking therapy with a developmentally traumatized 148 00:10:06,080 --> 00:10:09,040 child. Because they can't access that 149 00:10:09,040 --> 00:10:11,680 higher order part of their brain, that part of their brain 150 00:10:11,680 --> 00:10:17,840 executive control system is shut down when, when the body, when 151 00:10:17,840 --> 00:10:23,120 the nervous system is dominated by the sympathetic nervous 152 00:10:23,120 --> 00:10:26,040 system response, by the fight flight response. 153 00:10:27,080 --> 00:10:29,920 So we can't think, you know, none of us can really think 154 00:10:29,960 --> 00:10:32,480 clearly. Even now I'm not thinking so 155 00:10:32,480 --> 00:10:34,400 clearly because I'm having because we're doing, you're 156 00:10:34,400 --> 00:10:35,760 recording, really explaining. No. 157 00:10:36,760 --> 00:10:39,600 Because you're recording me. And I'm quizzing you at all 158 00:10:39,600 --> 00:10:41,640 these times that you're then having to. 159 00:10:42,280 --> 00:10:45,920 Yeah, exactly so. So we need to calm that. 160 00:10:45,920 --> 00:10:49,120 We need to calm that sympathetic nervous system response by 161 00:10:49,120 --> 00:10:57,240 giving cues to safety. And we work with lots of 162 00:10:57,280 --> 00:11:00,360 flooded, aren't they by sensations and emotions and 163 00:11:00,360 --> 00:11:02,720 feelings. They're not thinking, Oh yes, 164 00:11:02,720 --> 00:11:06,720 my, my, my, my sympathetic nervous system is activated 165 00:11:06,720 --> 00:11:08,520 here. I need to do this, that they're 166 00:11:08,520 --> 00:11:12,640 just in that state, aren't they? So what we're doing all the time 167 00:11:12,640 --> 00:11:16,280 with the MPP model is really being acutely. 168 00:11:16,280 --> 00:11:18,440 That's a lovely thing. That's one of the lovely things 169 00:11:18,440 --> 00:11:22,480 about family futures is that all of the staff, they might have 170 00:11:22,480 --> 00:11:25,200 their own modalities. So they might be, there might 171 00:11:25,200 --> 00:11:29,720 be, you know, an art therapist or a clinical psychologist or a 172 00:11:29,720 --> 00:11:33,360 drama therapist or you know, we're whatever their own 173 00:11:33,360 --> 00:11:37,640 modality, everyone is trained in in the model. 174 00:11:38,200 --> 00:11:42,120 So once you have specialist and sensory integration 175 00:11:42,120 --> 00:11:46,080 practitioners, everyone will have some training in that. 176 00:11:46,080 --> 00:11:48,200 So when they're working with a child, they're looking at what 177 00:11:48,200 --> 00:11:50,920 does this child need to feel safe? 178 00:11:51,760 --> 00:11:55,120 Do they need more proprioceptive inputs or do they use need to be 179 00:11:55,120 --> 00:11:57,600 getting more information into their muscles and joints? 180 00:11:58,200 --> 00:12:03,400 Do they need less stimulation? Do we need to just slow it down, 181 00:12:03,400 --> 00:12:07,000 calm it down? You know, sometimes we need to 182 00:12:07,000 --> 00:12:11,640 up regulate children, children who are more dissociated and 183 00:12:11,640 --> 00:12:16,000 shut down, who are in what we would call it coming back to 184 00:12:16,000 --> 00:12:22,360 the, the Vegas system, the the dorsal vagal dominant part 185 00:12:22,480 --> 00:12:25,800 nervous system response. So we need to up regulate and 186 00:12:25,800 --> 00:12:28,560 bring them in, up into the window of tolerance. 187 00:12:28,560 --> 00:12:33,800 So every member of staff is trained to understand what's 188 00:12:33,800 --> 00:12:37,000 happening in the body and to go, OK, I know what to do here. 189 00:12:37,480 --> 00:12:44,440 And before I can help this child to to really reflect on their 190 00:12:44,440 --> 00:12:48,200 experience, to deepen their understanding, to bring it to 191 00:12:48,200 --> 00:12:52,560 even to bring attention to this different state of calmness. 192 00:12:53,360 --> 00:12:55,600 Does that make sense? Yeah, that totally. 193 00:12:55,640 --> 00:13:01,800 And the I'm going to get it wrong now, the dorsal vein, 194 00:13:02,480 --> 00:13:06,240 dorsal Vegas. Branch of the Yeah, the of the 195 00:13:06,320 --> 00:13:07,080 vagus. Nerve. 196 00:13:07,080 --> 00:13:11,280 Yeah, the vagus nerve, the dorsal Vegas branch that needs 197 00:13:11,280 --> 00:13:15,960 to be activated. Is it a little bit like kind of 198 00:13:15,960 --> 00:13:20,320 muscle memory in a way, or is it, is it a combination so that 199 00:13:20,920 --> 00:13:24,240 if your child who's grown up in an unsafe environment and you 200 00:13:24,240 --> 00:13:27,480 haven't often accessed that, that hasn't been working, you 201 00:13:27,480 --> 00:13:31,200 haven't felt safe? Is it something, it's obviously 202 00:13:31,200 --> 00:13:34,520 something you learn to do through repetition and through 203 00:13:34,520 --> 00:13:39,160 finding that safe person, that parent who can model that or 204 00:13:39,160 --> 00:13:44,920 help you get to that safe place? Is that the more that that you 205 00:13:45,000 --> 00:13:48,600 you do that work, the easier it becomes for that child or young 206 00:13:48,600 --> 00:13:52,560 person? So, so, yeah, so, so just to go 207 00:13:52,560 --> 00:13:56,120 back, the dorsal Vegas, the branch of the Vegas system that 208 00:13:56,120 --> 00:14:00,160 is the dorsal vagus nerve is, is not what we want to be 209 00:14:00,160 --> 00:14:02,280 activated. We want to activate the ventral 210 00:14:02,560 --> 00:14:03,760 that's the upper. Part. 211 00:14:04,320 --> 00:14:07,880 So that's the part that brings and when we activate that we put 212 00:14:07,880 --> 00:14:13,960 the Vegas brake on, that's the bit that triggers a sense of 213 00:14:13,960 --> 00:14:17,880 safety. So, yeah, so the more so the 214 00:14:17,880 --> 00:14:24,760 more that that a child experiences that state of 215 00:14:24,920 --> 00:14:30,440 feeling safe and they're and in those states, they're able to 216 00:14:31,760 --> 00:14:39,640 experience their parent or carer as someone who who can bring 217 00:14:39,640 --> 00:14:43,480 about that sense of safety. They can notice because they've 218 00:14:43,480 --> 00:14:47,480 got access in that moment to their higher order executive 219 00:14:47,480 --> 00:14:48,720 control. Because remember, that's 220 00:14:48,720 --> 00:14:51,920 switched off, shot down when we're in sympathetic. 221 00:14:52,680 --> 00:14:56,560 So they've got high, they've got a greater access to that part of 222 00:14:56,560 --> 00:14:59,200 their brain. And so they can notice, hey, 223 00:14:59,200 --> 00:15:02,920 here's my you know, here's my mom or my dad or my my foster 224 00:15:02,920 --> 00:15:04,720 carer. And and they're here for me and 225 00:15:04,720 --> 00:15:06,960 they're not. And and they're not hurting me. 226 00:15:07,520 --> 00:15:09,720 They're keeping me safe and they're understanding me and 227 00:15:09,720 --> 00:15:13,400 they're coming, you know, and, and they're and they're loving 228 00:15:13,400 --> 00:15:17,280 me. So yes, absolutely. 229 00:15:17,280 --> 00:15:22,240 I think we they do build for memories of that. 230 00:15:22,240 --> 00:15:26,600 And over time, that sense of that internalized sense of 231 00:15:26,600 --> 00:15:32,240 safety with this parental carer builds and they build. 232 00:15:32,240 --> 00:15:35,240 What we're hoping is that they're building neural. 233 00:15:35,880 --> 00:15:40,280 They're the neurons are, are firing and wiring around those 234 00:15:40,280 --> 00:15:44,040 experiences. And alongside that, they're also 235 00:15:44,040 --> 00:15:49,240 build building pathways between those lower order systems. 236 00:15:49,240 --> 00:15:53,320 Well, that that trigger the fight flight responses and the 237 00:15:53,320 --> 00:15:57,920 higher order executive brain, the controlling part of the 238 00:15:57,920 --> 00:16:00,080 brain that goes, hey, we've been here before. 239 00:16:00,280 --> 00:16:03,120 This is OK. Actually, this is this is my 240 00:16:03,120 --> 00:16:04,760 mum. She's a safe person. 241 00:16:04,760 --> 00:16:07,200 She's not going to hurt me. And they can. 242 00:16:07,400 --> 00:16:10,880 So they can think in those moments and go, actually, this 243 00:16:10,880 --> 00:16:13,800 is OK. I know, I know what I need here. 244 00:16:15,240 --> 00:16:19,080 So for sure, yeah, in a sense, a bit like muscle memory that that 245 00:16:19,520 --> 00:16:22,960 they can access, that they build those memories and those 246 00:16:22,960 --> 00:16:25,640 connections are building in the window of tolerance. 247 00:16:27,040 --> 00:16:30,200 So our job as therapist is always to create as much safety 248 00:16:30,200 --> 00:16:35,880 as possible, connecting with the child, where they're at in that 249 00:16:35,880 --> 00:16:40,640 moment and providing Co regulation, whether that's 250 00:16:40,640 --> 00:16:46,400 through sensory or somatic work or through the use of ourselves 251 00:16:46,400 --> 00:16:50,440 and our tone of voice and offering our empathy or holding 252 00:16:50,440 --> 00:16:54,080 back on empathy because it's too much for some children. 253 00:16:55,640 --> 00:16:58,440 Whatever it takes to bring about that sense of safety. 254 00:16:58,960 --> 00:17:01,120 And I think that's one of the lovely things, as I said before 255 00:17:01,120 --> 00:17:04,480 about Family Futures is that all the staff are trained in the 256 00:17:04,480 --> 00:17:08,520 model. So it's not as though they'll go 257 00:17:08,520 --> 00:17:12,040 and have, you know, this intervention with one therapist 258 00:17:12,040 --> 00:17:14,119 and then this intervention with another therapist. 259 00:17:14,119 --> 00:17:17,800 And they will to some degree, some, some will have a series 260 00:17:17,800 --> 00:17:22,599 of, of sensory integration and sessions and some will have 261 00:17:22,599 --> 00:17:24,720 therapy. But it's very rare that you 262 00:17:24,720 --> 00:17:27,240 wouldn't have someone who's offering therapy, you know, that 263 00:17:27,240 --> 00:17:29,560 they wouldn't also be thinking what's happening in this child 264 00:17:29,560 --> 00:17:31,960 sensory system and what do I need to do? 265 00:17:31,960 --> 00:17:35,440 And integrating those and holding, you know, the 266 00:17:35,440 --> 00:17:38,760 principles of DDP and having a paceful attitude in those 267 00:17:38,760 --> 00:17:41,480 moments. So and that might be all that 268 00:17:41,480 --> 00:17:45,760 that child can tolerate at that, at that stage. 269 00:17:45,760 --> 00:17:49,080 In those early stages, we might move from sensory integration 270 00:17:49,600 --> 00:17:55,920 with theraplay into something that's much more when they feel 271 00:17:55,920 --> 00:18:01,120 calmer and safer in their body, moving much more into adiadic 272 00:18:01,120 --> 00:18:05,760 therapy and working with the parent and child engaging in and 273 00:18:06,720 --> 00:18:10,680 more traditional talking therapy in that sense. 274 00:18:10,960 --> 00:18:16,320 And that's where, you know, I mean, featured where staff would 275 00:18:16,320 --> 00:18:21,600 be drawing more on DDP, but they might still use some Thera play 276 00:18:21,600 --> 00:18:24,520 games. They might still be get be using 277 00:18:26,560 --> 00:18:29,600 strategies from sensory integration because they'll have 278 00:18:29,600 --> 00:18:32,960 a sensory profile of that child and they'll know what helps that 279 00:18:32,960 --> 00:18:37,560 child to feel safe. So it but it always starts with 280 00:18:37,560 --> 00:18:41,280 that thinking about the MPP model and using that model to 281 00:18:41,280 --> 00:18:45,400 make them feel safe in the room before they can get to that. 282 00:18:45,400 --> 00:18:48,480 So it's step one. Yeah, absolutely. 283 00:18:48,480 --> 00:18:50,560 Wherever they are in the stage of the model. 284 00:18:50,560 --> 00:18:55,320 So whilst the model is neuro sequential, it's not linear. 285 00:18:55,320 --> 00:18:57,520 It's not like we do this and then we do that and we do this. 286 00:18:57,720 --> 00:19:01,240 We might be working neuro sequentially in the room in the 287 00:19:01,240 --> 00:19:02,880 moment. Well. 288 00:19:03,920 --> 00:19:06,880 We would be. Yeah, we are. 289 00:19:06,960 --> 00:19:12,480 We do. So why did it feel important or 290 00:19:12,480 --> 00:19:16,000 how did this what we're here, although I could talk about this 291 00:19:16,000 --> 00:19:21,080 for ages, it's so interesting, but we're talking about the 292 00:19:21,080 --> 00:19:23,800 research that we've done on the MPP model. 293 00:19:25,800 --> 00:19:31,360 And why did it feel important to explore the outcomes and to 294 00:19:31,360 --> 00:19:35,200 explore the MPP model? Because the first round of 295 00:19:35,200 --> 00:19:39,400 research was in 2016, I believe, and that was when it was 296 00:19:39,400 --> 00:19:40,960 published. So you must have started quite 297 00:19:40,960 --> 00:19:43,920 some time before that. So how did that come about? 298 00:19:44,960 --> 00:19:47,280 Absolutely. So that came about. 299 00:19:48,720 --> 00:19:54,120 I joined, I'm guess I'm guessing here, I think I joined Family 300 00:19:54,120 --> 00:20:01,280 Futures back in about 20, 11/20/12 and what I was noticing 301 00:20:01,280 --> 00:20:08,160 was that hey, these are some of the most traumatised children 302 00:20:09,800 --> 00:20:17,080 and with huge complex needs, really challenging behaviour in 303 00:20:17,080 --> 00:20:19,840 terms of the levels of dysregulation that they were 304 00:20:19,840 --> 00:20:22,240 presenting with at the time, Family features was. 305 00:20:22,720 --> 00:20:25,600 Almost like a national service. They were taking referrals from 306 00:20:25,600 --> 00:20:28,880 all over the country. They there weren't other 307 00:20:28,880 --> 00:20:33,320 organisations like it. So it was a specialist service. 308 00:20:33,320 --> 00:20:36,760 It's a specialist service and but they but because it was so 309 00:20:36,760 --> 00:20:40,120 specialist, often local authorities, this was pre the 310 00:20:40,120 --> 00:20:44,160 regional adoption agency, the local authorities when they 311 00:20:44,160 --> 00:20:52,480 really had, you know, exhausted all of their local services in 312 00:20:52,480 --> 00:20:55,520 terms and they and they and they didn't know what else to do. 313 00:20:55,520 --> 00:20:58,640 Often they would refer to family futures or sometimes parents 314 00:20:58,640 --> 00:21:02,440 would know this is what I want and I and would argue and make 315 00:21:02,440 --> 00:21:05,280 the case for the children to be set to be referred to family 316 00:21:05,280 --> 00:21:09,520 futures so that they, the children would typically present 317 00:21:09,520 --> 00:21:11,440 with a high level of complex needs. 318 00:21:11,440 --> 00:21:15,240 And often there'd be a, you know, part of a sibling pair or 319 00:21:15,240 --> 00:21:17,840 maybe there would be 3, sometimes even four children who 320 00:21:17,840 --> 00:21:21,000 have been adopted and experienced developmental trauma 321 00:21:21,000 --> 00:21:23,200 and those in their birth families. 322 00:21:23,640 --> 00:21:29,160 So what I was noticing was that despite this complexity, you 323 00:21:29,200 --> 00:21:33,560 know, the team were making real differences and I could see that 324 00:21:33,560 --> 00:21:37,480 they were really staying with, they were really alongside those 325 00:21:37,480 --> 00:21:41,000 children and those parents. Most important to me, because I 326 00:21:41,000 --> 00:21:44,040 think parents are often the are they often the agents have 327 00:21:44,040 --> 00:21:46,720 changed because they're the ones that have to go, they go home 328 00:21:46,720 --> 00:21:52,440 and parent and these children. So it was through that real 329 00:21:52,440 --> 00:21:55,400 connectedness with the children and parents and staying 330 00:21:55,400 --> 00:22:02,000 alongside and offering this model and, and I was seeing, I 331 00:22:02,000 --> 00:22:05,560 was noticing clinic within the clinic, you know, changes, 332 00:22:05,560 --> 00:22:07,760 clinical changes. And I was thinking, well, are 333 00:22:07,760 --> 00:22:10,440 we, are we getting this? Are we, are we, how are we 334 00:22:10,440 --> 00:22:12,720 harnessing these changes? Are how it was sharp. 335 00:22:12,720 --> 00:22:16,400 Let's let's just do an audit. So that's what happened. 336 00:22:17,000 --> 00:22:25,280 So we just did a simple, you know, outcomes test really 337 00:22:25,520 --> 00:22:32,800 analysis rather for those children who had the whole of 338 00:22:32,800 --> 00:22:34,720 the model. So some families might not have 339 00:22:34,720 --> 00:22:37,960 had all of the model. So we just and for those 340 00:22:37,960 --> 00:22:41,440 children who had baseline measures because I think when 341 00:22:41,440 --> 00:22:42,400 family. Features the whole of the, 342 00:22:42,880 --> 00:22:45,400 sorry, the whole of the model. What does that? 343 00:22:46,320 --> 00:22:49,480 Mean so so all of the levels. So they would have had some 344 00:22:49,600 --> 00:22:52,960 somatosensory work, so they would have had sensory 345 00:22:52,960 --> 00:22:57,280 integration work or or somatic experience work. 346 00:22:57,560 --> 00:23:02,240 They would have had theraplay DDP, therapeutic life story 347 00:23:02,240 --> 00:23:04,240 work. So they would have had all 348 00:23:04,240 --> 00:23:09,560 parts. So, so though that was one of 349 00:23:09,560 --> 00:23:13,960 the inclusion criteria, another was that they had baseline 350 00:23:13,960 --> 00:23:16,120 measures. So when they come in for an 351 00:23:16,120 --> 00:23:19,680 assessment, they would have had they would have been screened 352 00:23:19,680 --> 00:23:22,160 using certain psychometric tools. 353 00:23:23,760 --> 00:23:27,160 Yeah. And most people are familiar 354 00:23:27,160 --> 00:23:29,960 with those and most people are familiar with the SDQ. 355 00:23:30,080 --> 00:23:32,960 We family features don't use the SDQ, they use the child 356 00:23:32,960 --> 00:23:37,480 behaviour checklist and the brief, which is a measure of 357 00:23:37,480 --> 00:23:40,920 executive functioning. And we can talk about that a bit 358 00:23:40,920 --> 00:23:43,160 more. So not all the families in the 359 00:23:43,160 --> 00:23:46,040 early stages of the development of family features had those 360 00:23:46,040 --> 00:23:48,680 baseline measures. So that reduced our numbers. 361 00:23:49,600 --> 00:23:52,520 But for those that had and for those who had all parts of the 362 00:23:52,520 --> 00:23:57,400 treatment we just looked at, we just compared their baseline 363 00:23:57,560 --> 00:24:04,560 outcomes with their their outcomes following the 364 00:24:04,560 --> 00:24:08,800 intervention. And what we found were 365 00:24:09,200 --> 00:24:15,920 significant differences in areas of executive control and 366 00:24:15,920 --> 00:24:23,520 behaviour, mostly aggressive behaviour and we found positive 367 00:24:23,520 --> 00:24:28,680 long term outcomes. So the child, you know, 368 00:24:29,760 --> 00:24:33,440 predominantly they remained in school, they were able to access 369 00:24:33,440 --> 00:24:36,880 the curriculum and they weren't involved with the criminal 370 00:24:36,880 --> 00:24:40,360 justice system. They weren't referred to 371 00:24:40,400 --> 00:24:43,280 multiple, you know, other agencies. 372 00:24:43,840 --> 00:24:49,560 And so and they had better relationships with their parents 373 00:24:49,560 --> 00:24:52,320 and with peers, which is very important. 374 00:24:52,760 --> 00:24:56,040 And so, yeah, so that's where it started. 375 00:24:56,200 --> 00:25:01,760 Wow, wow. And the first research paper 376 00:25:01,760 --> 00:25:07,520 that came out in 2016 and I mean, I've seen what we have on 377 00:25:07,520 --> 00:25:11,680 our website and the kind of the outcomes and how that's 378 00:25:11,680 --> 00:25:13,840 displayed. And then what prompted the 379 00:25:13,840 --> 00:25:16,360 second round of research in 2019? 380 00:25:17,760 --> 00:25:22,160 So, so. It was always in our minds that 381 00:25:22,160 --> 00:25:27,120 if if just with this simple pre post intervention and testing, 382 00:25:27,120 --> 00:25:31,840 if the outcomes were positive and suggested indicated that 383 00:25:31,840 --> 00:25:36,560 this was an effective intervention as we knew 384 00:25:36,560 --> 00:25:43,360 anecdotally that it was, then you know, let's compare it to 385 00:25:43,360 --> 00:25:45,960 those who didn't have the intervention. 386 00:25:48,680 --> 00:25:53,720 So there was a natural control group in the form of those 387 00:25:53,840 --> 00:25:57,240 families that had come in for an assessment. 388 00:25:57,880 --> 00:25:59,880 So they would have had the same level of presenting 389 00:25:59,880 --> 00:26:04,120 difficulties, same types of presentation as the other 390 00:26:04,120 --> 00:26:09,800 children who had the treatment model but didn't for various 391 00:26:09,800 --> 00:26:13,360 reasons receive the model, whether that was due to costs, 392 00:26:13,360 --> 00:26:16,040 location, the fact that they were referred on to other 393 00:26:16,040 --> 00:26:21,320 services such as CAMS, etcetera. But so that was what prompted 394 00:26:21,320 --> 00:26:22,760 it. We always had it in our minds, 395 00:26:22,760 --> 00:26:25,600 but we needed that first bit of evidence because, you know, 396 00:26:25,920 --> 00:26:27,400 carrying out research was costly. 397 00:26:29,440 --> 00:26:32,320 So we did that. And so then those years between 398 00:26:32,320 --> 00:26:36,400 2016 and the publishing of the paper in 2019 was spent 399 00:26:39,040 --> 00:26:42,520 identifying the control group, contacting them, recruiting 400 00:26:42,520 --> 00:26:47,120 them, and then carrying out the same interviews and getting them 401 00:26:47,120 --> 00:26:49,880 to complete the same psychometric screening tools. 402 00:26:51,320 --> 00:26:55,560 And what was the findings then in the 2019? 403 00:26:55,560 --> 00:26:57,520 Can you just give an overview of the comparison? 404 00:26:58,000 --> 00:27:05,160 Sure. So what we find were that there 405 00:27:05,160 --> 00:27:12,400 were significant differences and those were on again, which is 406 00:27:12,800 --> 00:27:15,080 for me the most, one of the most exciting things is that that 407 00:27:15,120 --> 00:27:18,520 those differences lay within executive control. 408 00:27:19,240 --> 00:27:25,320 So the ability to inhibit responses, to monitor, self 409 00:27:25,320 --> 00:27:33,880 monitor to, to plan, to organise oneself to yeah. 410 00:27:35,440 --> 00:27:38,760 And then consequently, which would be linked to that would be 411 00:27:38,840 --> 00:27:42,320 aggressive behaviour as well. Externalising behaviour. 412 00:27:42,320 --> 00:27:44,360 There's difference in externalising behaviour. 413 00:27:45,200 --> 00:27:48,160 And interestingly, we repeated the well, there was also a 414 00:27:48,160 --> 00:27:52,720 difference between on on teachers report for the brief as 415 00:27:52,720 --> 00:27:55,240 well for the executive control. Oh. 416 00:27:55,400 --> 00:27:57,640 Really. Yeah, which was really 417 00:27:57,640 --> 00:28:00,920 interesting. And you know, there is a there's 418 00:28:00,920 --> 00:28:03,600 some weakness there because there would be obviously there 419 00:28:03,600 --> 00:28:08,000 would be a different teacher reporting because of some years 420 00:28:08,000 --> 00:28:13,400 have passed. However, you know, they, that's 421 00:28:13,400 --> 00:28:16,280 where they, you know, there's greatest demand upon the 422 00:28:16,280 --> 00:28:20,720 executive system is in school and why our children really do 423 00:28:21,480 --> 00:28:25,760 can struggle in, in mainstream schools because there's a, 424 00:28:25,760 --> 00:28:27,840 there's a cognitive demand, isn't there? 425 00:28:28,440 --> 00:28:31,920 You know, and also there's a demand on the, on the, on the 426 00:28:31,920 --> 00:28:33,920 body. It's not just to sit, you know, 427 00:28:33,920 --> 00:28:37,600 to be still, to concentrate, all of those things that we know are 428 00:28:37,600 --> 00:28:43,320 difficult for our children who are prone to dysregulation. 429 00:28:43,920 --> 00:28:48,480 And so we find differences in the teachers report for 430 00:28:48,480 --> 00:28:51,240 executive control as well, which was really encouraging. 431 00:28:53,280 --> 00:28:58,800 And I think, I mean, you can see the, the outcomes on our 432 00:28:58,800 --> 00:29:02,640 website, but there's, I've been looking through these when I 433 00:29:02,640 --> 00:29:06,320 first joined and there's they're quite profound. 434 00:29:06,320 --> 00:29:08,480 They're quite shocking the comparison. 435 00:29:09,800 --> 00:29:13,720 I'll just go through a couple of them now just while people are 436 00:29:13,720 --> 00:29:15,920 listening. But obviously I would include a 437 00:29:15,920 --> 00:29:19,480 link as well. So the child relationships, as 438 00:29:19,480 --> 00:29:24,240 you said, so parent child relationships for the children 439 00:29:24,400 --> 00:29:26,040 and young people that received treatment. 440 00:29:26,040 --> 00:29:31,520 So they've received the full model, 94% had an improved 441 00:29:31,960 --> 00:29:36,120 relationship with the parent child relationship compared to 442 00:29:36,120 --> 00:29:44,560 the control group where 57% improved the relationship, 29% 443 00:29:44,720 --> 00:29:49,200 the relationship deteriorated and 14% it stayed the same. 444 00:29:51,040 --> 00:29:54,600 Some other really shocking ones as well is placement disruption. 445 00:29:55,480 --> 00:30:00,160 So for our treatment group, so that is they received a full MPP 446 00:30:00,160 --> 00:30:09,360 model, 91% stayed together and for the control group, 33% 447 00:30:09,360 --> 00:30:12,400 disrupted, which is really, really, really high. 448 00:30:12,400 --> 00:30:15,800 And we're always, you know, talking about, you know, the 449 00:30:16,400 --> 00:30:18,840 making, we're keeping families together. 450 00:30:19,320 --> 00:30:22,760 And that's what everyone who's, you know, working in this this 451 00:30:22,760 --> 00:30:25,160 industry and supporting families is trying to keep families 452 00:30:25,160 --> 00:30:29,080 together. And 33% is so high. 453 00:30:29,880 --> 00:30:33,040 And there's some other ones as well as we've got child mental 454 00:30:33,040 --> 00:30:36,360 health being prescribed medication for their mental 455 00:30:36,360 --> 00:30:40,040 health. So our treatment group 81% 456 00:30:40,520 --> 00:30:46,000 weren't prescribed medication as a full of treatment and then for 457 00:30:46,000 --> 00:30:51,040 the control group, 62% were prescribed medication. 458 00:30:51,040 --> 00:30:54,560 That's really, really high. And a lot of what this that we 459 00:30:54,560 --> 00:30:57,120 have obviously results for the education system as well. 460 00:30:57,120 --> 00:31:02,760 So access mainstream education again 76% access mainstream 461 00:31:02,760 --> 00:31:11,040 education compared to 58% not accessing mainstream education. 462 00:31:11,880 --> 00:31:17,600 And a lot of what this evidence is, is pressure put on other 463 00:31:17,600 --> 00:31:20,360 services. And I don't want to get too 464 00:31:20,360 --> 00:31:24,200 political, but I think it's a really interesting comparison of 465 00:31:25,320 --> 00:31:28,960 what we all talk about so much is early intervention and but 466 00:31:28,960 --> 00:31:34,040 the right intervention and how that has a has an effect on, you 467 00:31:34,040 --> 00:31:36,800 know, society in general. But also, like I said, the the 468 00:31:36,800 --> 00:31:40,440 pressure on other services and the outcomes for these children 469 00:31:40,440 --> 00:31:43,800 and young people. And that's what's so 470 00:31:43,800 --> 00:31:47,120 interesting. And I know that you're we're 471 00:31:47,120 --> 00:31:48,680 doing that. We have another round of 472 00:31:48,680 --> 00:31:53,200 research that is going to be due to be coming out or published 473 00:31:53,200 --> 00:31:54,960 next year at the end of this year. 474 00:31:55,280 --> 00:31:59,160 And well, hopefully the end of this year or next year, yeah. 475 00:32:00,120 --> 00:32:03,560 And I've just done a kind of whistle drop tour of shocking 476 00:32:03,560 --> 00:32:08,360 statistics that I've read out. Is there anything that sticks 477 00:32:08,360 --> 00:32:12,720 out greatly to you from the previous rounds of research? 478 00:32:13,320 --> 00:32:17,400 Or maybe you could talk a bit about why we've done this, this 479 00:32:17,400 --> 00:32:19,640 third round of research, why that was important? 480 00:32:20,080 --> 00:32:24,360 I think, yeah, I can definitely answer both of those questions. 481 00:32:25,960 --> 00:32:28,520 I mean, all the things that you said stick out for sure. 482 00:32:28,520 --> 00:32:31,320 I think those. It's hard to choose one when 483 00:32:31,320 --> 00:32:38,200 you're looking at it because it is also shocking I guess. 484 00:32:38,240 --> 00:32:39,840 Yeah, I mean, it's, it's shocking. 485 00:32:39,840 --> 00:32:43,960 It's it's exciting. I. 486 00:32:45,560 --> 00:32:48,480 Mean from a theoretical perspective, you know, we would 487 00:32:48,480 --> 00:32:53,680 hope to see because there's so much focus on on Co regulation 488 00:32:53,680 --> 00:32:57,720 and supporting that the access to, you know, the executive 489 00:32:57,720 --> 00:33:01,360 functioning systems, the higher order brain. 490 00:33:02,120 --> 00:33:06,920 So we would hope to see changes in, in, in executive control and 491 00:33:06,920 --> 00:33:11,560 we saw that and therefore a reduction in, in externalising 492 00:33:11,560 --> 00:33:13,400 behaviour. So that was really exciting. 493 00:33:13,840 --> 00:33:18,520 But then to hear, but then to, to have the actual child and 494 00:33:18,520 --> 00:33:23,200 parents report on their own experiences and their own 495 00:33:23,200 --> 00:33:27,840 outcomes was really exciting to see that, you know, you know, 496 00:33:28,120 --> 00:33:31,280 none of the, none of the parents separated and, or got divorced. 497 00:33:31,280 --> 00:33:36,520 You know, that was that was amazing really. 498 00:33:38,520 --> 00:33:42,520 And to see that most of the children were able to remain in 499 00:33:42,520 --> 00:33:46,960 in, in education and there were fewer exclusions. 500 00:33:47,240 --> 00:33:50,760 And also, you know, when you think you were talking about 501 00:33:50,760 --> 00:33:54,280 cost to society in terms of additional diagnosis, access to 502 00:33:54,280 --> 00:33:58,400 other mental health services and the demand upon society, you 503 00:33:58,400 --> 00:34:02,280 know, the majority of children, I think at the time, and I put 504 00:34:02,280 --> 00:34:07,320 it in the, in the paper, none of the children and young people 505 00:34:07,320 --> 00:34:11,520 who had gone through the treatment model had been, had 506 00:34:11,520 --> 00:34:15,679 received any sort of formal caution or charge or had been 507 00:34:15,840 --> 00:34:21,199 imprisoned, which is amazing given the level of their 508 00:34:21,440 --> 00:34:25,400 dysregulation and the challenging behavioural 509 00:34:25,400 --> 00:34:28,639 difficulties. So so. 510 00:34:28,920 --> 00:34:32,480 I think and the statistics for children who've been through the 511 00:34:32,480 --> 00:34:34,360 care system in. General as well. 512 00:34:34,400 --> 00:34:39,280 Absolutely, absolutely. I think I think that statistic 513 00:34:39,280 --> 00:34:42,679 has changed since we did that. I think one person has, and 514 00:34:42,679 --> 00:34:49,239 they, you know, and a young person came to us already out 515 00:34:49,239 --> 00:34:52,880 of, you know, who they were already not with their adoptive 516 00:34:52,880 --> 00:34:55,800 parents and had been in, in, you know, in another, in another 517 00:34:55,800 --> 00:35:01,680 care provision at the time and was an older young person at the 518 00:35:01,680 --> 00:35:05,320 time a referral. So we can and we can understand 519 00:35:05,320 --> 00:35:08,920 that exception. But otherwise, you know, it's 520 00:35:08,920 --> 00:35:12,000 remarkable. And for me, you know, I, I 521 00:35:12,000 --> 00:35:14,800 think, well, why are we not having a constant, you know, a 522 00:35:14,800 --> 00:35:19,200 cost analysis. You know, I've, I've, I have 523 00:35:19,240 --> 00:35:23,480 invited some people to, to look at this and, and we've had no 524 00:35:23,480 --> 00:35:25,560 takers. And I just think, well, surely 525 00:35:25,560 --> 00:35:30,920 if you want, if you were to invest in providing this wrap 526 00:35:30,920 --> 00:35:35,560 around support that we know can make real differences to 527 00:35:35,560 --> 00:35:41,040 children's outcomes, including going, you know, more, you know, 528 00:35:41,720 --> 00:35:44,800 you know, access more mental health, you know, putting a 529 00:35:44,800 --> 00:35:46,880 demand on mental health services, putting, you know, 530 00:35:46,880 --> 00:35:48,760 being involved in the criminal justice system. 531 00:35:49,520 --> 00:35:52,400 Why would we not? Why would we not look at the 532 00:35:52,400 --> 00:35:55,520 cost of this and think, what is there a cost saving here? 533 00:35:55,520 --> 00:35:58,760 Is it better to invest? It's always better to invest in 534 00:35:58,760 --> 00:36:04,120 children's lives early on rather than to have to, you know, you 535 00:36:04,120 --> 00:36:08,120 know, just on a societal cost level, it's more costly if we, 536 00:36:08,360 --> 00:36:12,400 you know, later on. But on a human level, why 537 00:36:12,400 --> 00:36:15,200 wouldn't we want to give these children and young people a 538 00:36:15,200 --> 00:36:18,160 better chance in life and to make the quality of their life 539 00:36:18,200 --> 00:36:22,400 better and hopefully to stop intergenerational trauma 540 00:36:22,880 --> 00:36:27,600 continuing? It's a new brain, I'm nodding. 541 00:36:27,840 --> 00:36:29,160 I'm nodding. People can't. 542 00:36:29,320 --> 00:36:29,840 I'm. Not doing? 543 00:36:29,840 --> 00:36:30,600 Yeah. So. 544 00:36:30,920 --> 00:36:34,840 So that was what excited me and also frustrated me because it 545 00:36:34,840 --> 00:36:40,520 was really hard to get any further interest in that, you 546 00:36:40,520 --> 00:36:41,480 know, a lot. Yeah. 547 00:36:41,480 --> 00:36:43,120 I'm not going to get into the politics of it. 548 00:36:43,560 --> 00:36:46,960 So the other part of your question was why then did we 549 00:36:47,440 --> 00:36:49,760 look at prenatal alcohol exposure? 550 00:36:50,200 --> 00:36:52,280 And I think. That that's the next. 551 00:36:52,480 --> 00:36:55,680 That was the. Next, this is the current round 552 00:36:55,680 --> 00:36:59,560 of research. So that's our research linking 553 00:36:59,560 --> 00:37:04,200 to prenatal alcohol exposure. Yes, OK. 554 00:37:04,400 --> 00:37:08,120 Right. So, so I think how that came 555 00:37:08,120 --> 00:37:15,760 about was that because a lot of the children presenting have, 556 00:37:16,560 --> 00:37:20,440 you know, neurodevelopmental trauma, but also 557 00:37:21,560 --> 00:37:26,600 neurodevelopmental issues as well. 558 00:37:26,600 --> 00:37:30,720 We have a, we have a, a clinic that tries to differentiate what 559 00:37:30,720 --> 00:37:35,440 is developmental trauma and what is say for example, ASC or 560 00:37:35,800 --> 00:37:42,560 autism or or ADHD. And then also looking at giving 561 00:37:42,680 --> 00:37:48,240 the fact that a lot of, I think it's adoption UK site statistic 562 00:37:48,240 --> 00:37:56,160 that 27% of children who are adopted have had prenatal 563 00:37:56,160 --> 00:37:58,680 alcohol exposure. I need to check that. 564 00:38:00,320 --> 00:38:05,160 Where is it FASD? But however, but we know and we 565 00:38:05,160 --> 00:38:08,360 we do in depth file searches when a family come into 566 00:38:08,360 --> 00:38:11,320 treatment. So we know that a lot of the 567 00:38:11,320 --> 00:38:15,240 children who have been referred into the service have 568 00:38:15,240 --> 00:38:18,320 experienced prenatal alcohol exposure. 569 00:38:19,680 --> 00:38:25,480 So of course we know from all the research on that and that 570 00:38:25,480 --> 00:38:30,760 can cause structural deficits. And so the obvious question and 571 00:38:30,760 --> 00:38:34,080 I think it came, I think the question might have come from 572 00:38:36,320 --> 00:38:40,520 Raja Mukherjee, who's the national lead for FASD in the 573 00:38:40,520 --> 00:38:45,280 country. And he might, I think he 574 00:38:45,280 --> 00:38:48,640 suggested to Jay, our clinic, your clinical director. 575 00:38:49,040 --> 00:38:55,240 And you know, why don't you look at PAE and see whether the 576 00:38:55,240 --> 00:38:58,840 outcomes are, are the same. And, and that's what we've done. 577 00:38:58,840 --> 00:39:01,400 And we were able to go back through the files and then 578 00:39:01,400 --> 00:39:07,720 categorise the children as to into categories as to whether 579 00:39:07,720 --> 00:39:11,160 they had definitely had PAE or whether it was strongly 580 00:39:11,160 --> 00:39:16,680 indicated or really not very clear or there was no indication 581 00:39:16,680 --> 00:39:21,280 or no reference to alcohol. So, and that's what we did and 582 00:39:21,280 --> 00:39:26,360 then to look at whether the outcomes were the same. 583 00:39:28,800 --> 00:39:32,560 So there were two parts of that research because we had a bigger 584 00:39:33,440 --> 00:39:35,560 treatment group, group, cohort, cohort. 585 00:39:35,560 --> 00:39:40,640 So the last time we did any retesting was back in, you know, 586 00:39:40,640 --> 00:39:45,440 2018, 20/17/2018. So we had more families to 587 00:39:45,440 --> 00:39:48,440 follow up who had completed treatment since then. 588 00:39:48,440 --> 00:39:51,960 So we did that so with and the exciting part about, so we did 589 00:39:51,960 --> 00:39:55,200 the, we did the analysis again the comparison between treatment 590 00:39:55,200 --> 00:39:58,840 and control group and we found even better results. 591 00:39:58,840 --> 00:40:07,360 We now had evidence that the intervention supported better 592 00:40:07,360 --> 00:40:12,200 emotional control as well as other aspects of the executive 593 00:40:12,200 --> 00:40:15,280 control and functioning that we'd find before. 594 00:40:15,560 --> 00:40:20,720 So that was really positive and. And then we were able to, then 595 00:40:20,720 --> 00:40:25,760 what we did was we categorised those treatment, that treatment 596 00:40:25,760 --> 00:40:29,480 group and just did a simple, so far what we've done is just a 597 00:40:29,480 --> 00:40:36,680 simple pre treatment, post treatment comparison for those, 598 00:40:36,840 --> 00:40:43,400 for those groups. And what we found was that well, 599 00:40:43,400 --> 00:40:46,440 first of all, what we did was we controlled for PAE when we did 600 00:40:46,440 --> 00:40:48,360 the analysis. So we did the whole analysis 601 00:40:48,360 --> 00:40:53,600 again and taking out controlling for which is the presence or 602 00:40:53,600 --> 00:40:57,440 absence of prenatal alcohol exposure and find that the 603 00:40:57,440 --> 00:41:01,440 presence or absence didn't make any difference to the outcomes. 604 00:41:02,480 --> 00:41:04,760 So. That's huge. 605 00:41:05,080 --> 00:41:09,280 So to me that's as well that that suggests that if if PAE is 606 00:41:09,280 --> 00:41:11,480 president that the outcomes will remain the same. 607 00:41:11,480 --> 00:41:16,880 And essentially our our pre and post analysis have have 608 00:41:16,880 --> 00:41:20,880 supported that. So when we have just have 609 00:41:20,880 --> 00:41:24,400 definite PAE, we do the analysis, we find that the the 610 00:41:24,560 --> 00:41:28,320 the changes that we reported earlier remain present for that 611 00:41:28,320 --> 00:41:33,040 group and when we are strongly indicated that the effects or 612 00:41:33,040 --> 00:41:36,160 the differences become even stronger and so on. 613 00:41:37,720 --> 00:41:43,040 So that's really encouraging. So, so the treatment model works 614 00:41:44,440 --> 00:41:49,120 especially well for children and young people who've experienced 615 00:41:49,120 --> 00:41:52,880 prenatal alcohol exposure. I'm just trying to. 616 00:41:53,320 --> 00:41:56,360 Well, it's interesting you should say that because actually 617 00:41:56,360 --> 00:42:01,080 for the definite group, this the the the 100. 618 00:42:01,120 --> 00:42:04,720 Percent no. We'd absolutely know that there 619 00:42:04,720 --> 00:42:10,520 was pre alcohol exposure. So for that group that the the 620 00:42:10,520 --> 00:42:16,320 differences were actually stronger than for the highly 621 00:42:16,320 --> 00:42:20,680 indicated, strongly indicated. But that's because though, you 622 00:42:20,680 --> 00:42:23,320 know, my sense was that for the strongly indicated, there were 623 00:42:23,360 --> 00:42:26,720 there were a few, there were a couple of outliers, but when we 624 00:42:27,160 --> 00:42:34,560 grouped them together that that that became that those outcomes 625 00:42:34,560 --> 00:42:38,920 remained present. So, so it doesn't say that it 626 00:42:38,920 --> 00:42:44,200 that it's even better for for the for the presence for those 627 00:42:44,200 --> 00:42:49,600 who had to be Natal alcohol exposure, but it certainly 628 00:42:49,600 --> 00:42:55,680 suggests that it makes can still make a difference, a significant 629 00:42:55,680 --> 00:43:00,440 difference even when there has been prenatal alcohol exposure 630 00:43:01,640 --> 00:43:05,160 and prenatal. Alcohol exposure I've I'm 631 00:43:05,160 --> 00:43:10,160 assuming I think I know that just means when when mum is 632 00:43:10,160 --> 00:43:11,960 pregnant she's been having alcohol. 633 00:43:12,560 --> 00:43:14,080 That's right. Yeah, OK. 634 00:43:16,120 --> 00:43:19,920 So and part of that, you mentioned the clinic, there's so 635 00:43:19,920 --> 00:43:22,920 much that unpick here and I'm aware of the time and we've been 636 00:43:22,920 --> 00:43:25,840 talking for quite some time. But you mentioned the clinic 637 00:43:27,120 --> 00:43:30,920 looking at children who've experienced developmental trauma 638 00:43:31,520 --> 00:43:34,960 and looking at what part of their presentation, again, just 639 00:43:34,960 --> 00:43:36,720 correct me if I've got this wrong, What part of their 640 00:43:36,720 --> 00:43:43,080 presentation is developmental trauma, is neurodiversity, so 641 00:43:43,080 --> 00:43:49,840 ASD or ADHD or is FASD? Yeah. 642 00:43:50,800 --> 00:43:55,120 And do we have any kind of indication, maybe it might be a 643 00:43:55,120 --> 00:43:57,000 kind of worms here? Do we have any kind of 644 00:43:57,000 --> 00:44:02,640 indication of the effects of the model, the outcomes of the model 645 00:44:02,640 --> 00:44:07,720 with children who are neurodiverse as well as and I 646 00:44:07,720 --> 00:44:10,640 imagine that's quite hard, a hard thing throwing loads of 647 00:44:10,640 --> 00:44:12,880 questions that you hear, but imagine that's quite a hard 648 00:44:12,880 --> 00:44:16,800 thing to unpick of what is mental trauma and then what is 649 00:44:16,800 --> 00:44:23,680 the presentation of, you know, diversity for FASD yes, the. 650 00:44:23,680 --> 00:44:28,080 Differentiation of those can be difficult, but it also can be 651 00:44:28,080 --> 00:44:34,120 conclusive for some where ASC is clearly indicated. 652 00:44:35,600 --> 00:44:41,440 I would say that a lot of our children meet criteria for ADHD. 653 00:44:43,040 --> 00:44:50,160 And so one of the the issues is, is really teasing out what is AD 654 00:44:50,160 --> 00:44:55,800 if you're ADHD and what is, you know, development of trauma 655 00:44:56,160 --> 00:45:00,520 with, you know, significant sensory processing difficulties 656 00:45:00,520 --> 00:45:05,480 that, you know, so a child really struggles to sit still. 657 00:45:05,480 --> 00:45:08,680 It needs lots of pro receptive input that's over stimulated by 658 00:45:08,680 --> 00:45:14,400 the sound in the classroom and that who's easily triggered into 659 00:45:14,400 --> 00:45:17,480 dysregulated sympathetic nervous system state. 660 00:45:17,960 --> 00:45:22,360 And I mean, that's that's that's really tricky. 661 00:45:22,360 --> 00:45:26,040 I mean, it's interesting looking at the statistic where the 662 00:45:26,040 --> 00:45:28,400 children who were in the treatment model didn't go on to 663 00:45:28,400 --> 00:45:36,040 get as many of their diagnosis or or as the control group or 664 00:45:36,440 --> 00:45:39,800 receive the same level of medication. 665 00:45:40,320 --> 00:45:42,400 And that. So it makes me wonder whether 666 00:45:42,520 --> 00:45:45,640 the fact that we're focusing on Co regulation, focusing on the 667 00:45:45,880 --> 00:45:49,840 development of self regulation, of working with the sensory 668 00:45:49,840 --> 00:45:51,560 system, working with the nervous system. 669 00:45:51,840 --> 00:45:55,880 And actually that meant that intervention meant that that 670 00:45:56,080 --> 00:45:58,320 those some of those children didn't end up getting that 671 00:45:58,320 --> 00:46:00,400 diagnosis and having to be prescribed. 672 00:46:00,600 --> 00:46:02,120 I don't know. That's a different. 673 00:46:02,120 --> 00:46:02,960 That's the. Bigger. 674 00:46:02,960 --> 00:46:05,640 It's quite interesting though, isn't it, that to think that 675 00:46:07,000 --> 00:46:09,840 both things present very similarly to the point where 676 00:46:09,840 --> 00:46:13,360 it's hard to unpick which is which, or challenging to unpitch 677 00:46:13,360 --> 00:46:16,720 which is which. But the intervention works very 678 00:46:16,720 --> 00:46:24,080 well for children, young people who that have Eve either or. 679 00:46:24,160 --> 00:46:27,040 I don't want to generalize too much, but yeah, I. 680 00:46:27,040 --> 00:46:28,480 Don't want to make, I don't want. 681 00:46:29,760 --> 00:46:32,560 To. To make claims that are not 682 00:46:32,560 --> 00:46:36,600 substantiated. But I guess it's a good research 683 00:46:36,600 --> 00:46:38,120 question. I mean, I wouldn't say there's 684 00:46:38,120 --> 00:46:40,880 nothing, you know, it's not curative in terms of the, you 685 00:46:40,880 --> 00:46:45,200 know, for example, you know, you know, I wouldn't say that this 686 00:46:45,200 --> 00:46:47,520 is a treatment model for children with ASC. 687 00:46:47,760 --> 00:46:51,000 However, is this a model for children with ASC who have 688 00:46:51,000 --> 00:46:53,040 experienced developmental trauma? 689 00:46:53,360 --> 00:46:56,040 For sure. Now, you have to also remember 690 00:46:56,040 --> 00:47:00,920 that when we did the research, we, we took out those with a 691 00:47:00,920 --> 00:47:07,400 diagnosis of, of ASD. At the time, there weren't that 692 00:47:07,400 --> 00:47:09,000 many. I can't remember off the top of 693 00:47:09,000 --> 00:47:10,880 my head how many we, we excluded. 694 00:47:10,880 --> 00:47:16,360 But now we're going to include all of those children because I 695 00:47:16,360 --> 00:47:21,560 think for those children, you know, there will be, you know, 696 00:47:21,560 --> 00:47:27,360 children, children who have FASD might also, there's an overlap 697 00:47:27,360 --> 00:47:29,920 between their presentation and the presentation of children 698 00:47:29,920 --> 00:47:35,040 with ADHD and ASC. So amongst that group, there 699 00:47:35,040 --> 00:47:37,920 will be some children who definitely have prenatal alcohol 700 00:47:37,920 --> 00:47:40,840 exposure and may even have a diagnosis of FASD. 701 00:47:41,320 --> 00:47:46,320 So it would just be interesting to get to follow those young 702 00:47:46,360 --> 00:47:49,840 people up. Yeah. 703 00:47:49,960 --> 00:47:54,240 So I'm not making any claims about the the model in terms of 704 00:47:54,240 --> 00:48:02,720 its efficacy for neurodevelopmental disorders and 705 00:48:02,800 --> 00:48:06,600 I'm not. But what I am saying is that, 706 00:48:07,760 --> 00:48:11,480 you know, the focus on Co regulation and the sensory 707 00:48:11,480 --> 00:48:15,480 system could therefore impact on how to make a difference for 708 00:48:15,480 --> 00:48:19,480 those who would otherwise meet criteria for ADHDI am curious 709 00:48:19,480 --> 00:48:22,320 about that. Quite an interesting question. 710 00:48:22,320 --> 00:48:27,880 I mean, my final question is probably quite hard one because 711 00:48:28,480 --> 00:48:30,880 as we spoke about everything still with the research, the 712 00:48:30,880 --> 00:48:34,920 model and the outcomes, it's all very interesting and exciting. 713 00:48:36,640 --> 00:48:40,280 Is there anything with this that you are particularly interested 714 00:48:40,280 --> 00:48:43,320 and excited about or any kind of final thoughts that you'd like 715 00:48:43,320 --> 00:48:47,880 to, if they leave this discussion, but maybe pause this 716 00:48:47,880 --> 00:48:50,400 discussion because I feel like we could do a whole other 717 00:48:50,760 --> 00:48:54,240 broadcast. I do think that it is important 718 00:48:54,240 --> 00:48:57,800 to talk about what next and I guess you know what, what's our 719 00:48:57,800 --> 00:49:01,000 learning? What's the hypothesis about, 720 00:49:03,120 --> 00:49:08,240 about the fact that this intervention for, well, the the 721 00:49:08,240 --> 00:49:14,040 outcomes so far suggest that it's as effective for children 722 00:49:14,040 --> 00:49:22,080 who had PAE as those who didn't. So that makes me wonder, I mean, 723 00:49:22,080 --> 00:49:26,160 some of how many of those meet criteria for FASD, They won't 724 00:49:26,160 --> 00:49:29,600 all have been seen at the FASD clinic. 725 00:49:29,600 --> 00:49:33,120 And it's not always conclusive. Often there's not enough and 726 00:49:33,120 --> 00:49:35,320 about mental history information, we don't know for 727 00:49:35,320 --> 00:49:41,120 sure whether alcohol was taken during pregnancy and to what 728 00:49:41,120 --> 00:49:44,800 extent. And also we know that that not 729 00:49:44,800 --> 00:49:49,720 all the children will have the facial markers for FASD. 730 00:49:50,360 --> 00:49:59,680 But we, what we do know is FASD can create structural deficits 731 00:49:59,960 --> 00:50:04,600 in the brain, which impacts on cognitive functioning and 732 00:50:04,640 --> 00:50:10,160 adaptive functioning. So the actual functioning of the 733 00:50:10,160 --> 00:50:13,880 child in terms of relationships and being able to, to just get 734 00:50:13,880 --> 00:50:20,880 on and with their everyday life. So I, I suppose I'm interested 735 00:50:20,880 --> 00:50:26,160 in what's that's, where's those structural deficits cannot be 736 00:50:26,160 --> 00:50:30,240 changed. How much of this support with 737 00:50:30,240 --> 00:50:35,600 coal regulation is helping alternative pathways to develop 738 00:50:36,080 --> 00:50:41,280 through the, the those neural connections being made a new 739 00:50:41,280 --> 00:50:46,720 wiring occurring? Are there, you know, pathways 740 00:50:46,720 --> 00:50:51,040 being created that support those deficits that enable this 741 00:50:51,040 --> 00:50:53,320 executive control to, to to develop? 742 00:50:56,360 --> 00:50:58,440 You know, I don't know. That's, that's what I'm, I'm 743 00:50:58,440 --> 00:51:00,480 curious about. That's what we we're 744 00:51:00,480 --> 00:51:03,840 hypothesising for for the non PAE group, but does it also 745 00:51:03,840 --> 00:51:14,000 happen for for the PAE group? Wow, that's a big exciting 746 00:51:14,000 --> 00:51:19,120 question. It is, it is and the only way, I 747 00:51:19,120 --> 00:51:21,320 guess. I have reached out to some 748 00:51:21,320 --> 00:51:26,240 neuroscientists to say, you know, well, it's what, what 749 00:51:26,240 --> 00:51:28,400 would that look like? How could you test that, You 750 00:51:28,400 --> 00:51:31,000 know, do would neuroimaging test that? 751 00:51:31,000 --> 00:51:39,000 I mean, we know that even with IPA that the neglects can cause 752 00:51:39,000 --> 00:51:45,600 huge atrophy on the brain. So we're neglecting and, and 753 00:51:45,600 --> 00:51:48,600 abuse and, you know, has huge impact on the developing brain. 754 00:51:48,600 --> 00:51:52,480 Of course we know that. So there are neuro, there are 755 00:51:53,840 --> 00:52:00,040 neuroimaging and images of the atrophy that's caused by by by 756 00:52:00,040 --> 00:52:06,440 that. So I'm curious as to what, you 757 00:52:06,440 --> 00:52:10,120 know, a pre and post brain scan of, you know, following the 758 00:52:10,120 --> 00:52:13,960 intervention whether we would see any differences. 759 00:52:14,280 --> 00:52:16,840 Yeah, I don't even know whether I'm asking the right question 760 00:52:16,840 --> 00:52:18,360 because I'm not a neuroscientist. 761 00:52:18,680 --> 00:52:23,160 But there's a lot. Well, I've been looking at, I've 762 00:52:23,160 --> 00:52:25,560 been to doing some, some other stuff, looking at the history of 763 00:52:25,560 --> 00:52:32,000 FF and I saw something, you know, in the research that was 764 00:52:32,000 --> 00:52:36,320 done or some research, not this research that was done on 765 00:52:36,320 --> 00:52:38,440 children. I'm going to have to link it 766 00:52:38,440 --> 00:52:41,400 because I'm not going to get all the information correct here in 767 00:52:41,400 --> 00:52:43,000 terms of who did the research or not. 768 00:52:43,400 --> 00:52:46,640 But it basically it showed that children who've been through 769 00:52:46,640 --> 00:52:52,000 developmental trauma when they had brain scans, it was very 770 00:52:52,080 --> 00:52:57,040 similar physical damage to children who'd been in car 771 00:52:57,040 --> 00:53:00,960 accidents. And when that was explained to 772 00:53:00,960 --> 00:53:04,640 me or mentioned at some point in some internal training, some 773 00:53:04,640 --> 00:53:07,640 discussion, that really, really stuck out to me. 774 00:53:07,640 --> 00:53:11,000 And again, it's taken back to what we were talking about 775 00:53:11,000 --> 00:53:16,760 initially in in our discussion was the very real physical 776 00:53:17,000 --> 00:53:18,960 impact of trauma. And I think a lot of people 777 00:53:18,960 --> 00:53:24,200 think about it as a sort of emotional trauma that you can 778 00:53:24,680 --> 00:53:28,880 work through, which yes, to understand is true, but it's the 779 00:53:28,880 --> 00:53:32,400 physical damage. It's actual physical damage that 780 00:53:32,400 --> 00:53:37,160 is done when children are not given the right care and are not 781 00:53:37,160 --> 00:53:40,120 able to be provided with the right care and to create that 782 00:53:40,120 --> 00:53:43,400 emotional safe space. I think that's what is so 783 00:53:44,720 --> 00:53:47,920 incredible that it causes actual physical damage. 784 00:53:47,920 --> 00:53:50,320 And I know we talk about the brain being plastic, and I think 785 00:53:50,400 --> 00:53:52,640 you've evidenced that quite well in the beginning of the 786 00:53:52,640 --> 00:53:57,440 discussion about how pathways can be created and recreated. 787 00:53:58,240 --> 00:54:02,360 But yeah, I think it's incredible that it's physical 788 00:54:02,360 --> 00:54:06,440 damage that is caused, but that there is some repair that can 789 00:54:06,440 --> 00:54:10,680 happen through the right intervention, through 790 00:54:10,680 --> 00:54:14,040 specifically this intervention, which we have proven, you have 791 00:54:14,040 --> 00:54:18,320 proven through the research. I think that was just a 792 00:54:18,320 --> 00:54:19,520 statement rather than a question. 793 00:54:20,600 --> 00:54:24,000 Proven is a is a big claim, but what we're showing is that yeah, 794 00:54:25,760 --> 00:54:31,720 yeah, what what it indicates is that sure there are there are 795 00:54:31,840 --> 00:54:34,680 these improvements in an executive control and in 796 00:54:34,680 --> 00:54:39,280 behavior and in relationships suggest that something is has 797 00:54:39,280 --> 00:54:47,800 you know, it is happening on a on an on a on a on a on within 798 00:54:47,800 --> 00:54:50,840 the brain. And it's as you say, it's not 799 00:54:50,840 --> 00:54:56,200 just it's not just a cognitive psychological issue. 800 00:54:56,200 --> 00:55:02,320 It's a it's a that's felt sense of safety that ability to access 801 00:55:02,320 --> 00:55:07,960 it, you know, quickly in the moment information that I am 802 00:55:07,960 --> 00:55:10,280 safe. This isn't happening to me 803 00:55:10,280 --> 00:55:13,400 anymore. I am, I am loved. 804 00:55:13,440 --> 00:55:18,320 I am worthwhile. I have you know, I, I can do 805 00:55:18,320 --> 00:55:20,680 this. And that ability to have 806 00:55:20,680 --> 00:55:27,800 self-control is is huge. So one would assume that that 807 00:55:27,800 --> 00:55:34,000 was either that some repair had occurred and or that new 808 00:55:34,000 --> 00:55:40,960 pathways had been created in this relational context of Co 809 00:55:40,960 --> 00:55:43,600 regular scaffolding and Co regulation. 810 00:55:45,000 --> 00:55:47,640 That's what we all hope. All of us who work with 811 00:55:47,840 --> 00:55:51,160 developmentally traumatized children are, you know, hope 812 00:55:51,160 --> 00:55:52,960 that that that is what's happening. 813 00:55:52,960 --> 00:55:55,760 And that's what we see. We definitely see it for sure. 814 00:55:55,760 --> 00:55:59,680 And that's not to say that you know, that they they won't get 815 00:55:59,680 --> 00:56:01,920 distressed or they won't get dysregulated. 816 00:56:01,920 --> 00:56:05,160 It just means that they have access to something alternative 817 00:56:05,560 --> 00:56:10,200 to the adaptive information that will, you know, all around. 818 00:56:10,200 --> 00:56:12,760 Actually, in this moment here I am OK. 819 00:56:14,560 --> 00:56:20,080 And it, I mean, the outcomes show that that that ability and, 820 00:56:20,080 --> 00:56:24,560 you know, going from thrive from survive to thrive. 821 00:56:24,920 --> 00:56:27,840 Yeah. And I think that's what's so 822 00:56:27,840 --> 00:56:31,000 exciting. Thanks. 823 00:56:31,000 --> 00:56:34,000 For listening to this episode of the Family Features podcast 824 00:56:34,000 --> 00:56:38,040 series Pondering Pods, to find out more about family futures 825 00:56:38,040 --> 00:56:42,840 and the work we do, visit www.familyfutures.co.uk.