All forms of therapy have their place and where we start is entirely dependent on what you, or your child, need in the current moment.

Neurosequential Model of Therapeutic Metrics

This metric assesses the impact of developmental trauma on the brain, which in-turn impacts day-to-day functioning of your child. If your child has sensory issues, memory and learning challenges, emotional outbursts, social challenges, academic challenges, or they just seem younger than their physical age, there may be a brain reason. 

This assessment process was developed by Dr. Bruce Perry, Senior Fellow of the ChildTrauma Academy. These metrics assess for developmental risk during the child’s life, from the intrauterine experience to the child’s current age, taking into account epigenetic factors, and genetics. Based on the developmental risk experienced by the child, the relational health, and current functioning, these metrics show the child’s current developmental age, which is typically younger than their physical age due to the trauma experienced. Based on the regions of the brain affected, it offers therapeutic recommendations of where to start interventions because in order for us to make the most progress, we have to tailor interventions at the lowest part of the brain first. That may be sensory interventions, self-regulation interventions, relational, or cognitive.

What is it?

The Neurosequential Model of Therapeutics is a way of understanding the impact of early childhood trauma. The assessment looks at the individual’s developmental history, relational history, and current levels of functioning. The outcome of the assessment gives an estimation of the child’s developmental age, and shows how they’re functioning in four domains: sensory integration, self-regulation, and cognitive. This informs where it would be most beneficial to start therapy. Many kids who have developmental trauma have tried counseling, but with little progress, that’s because counseling (not play therapy) is a cognitive intervention. Based on NMT, we might want to start with sensory integration because the goal is to work from the bottom up—the same way the brain develops.

Who is it for?

NMT assessments are for kids with developmental trauma. The purpose of the assessment is to help parents and school professionals understand the child, and to guide choices for therapeutic work.

How can we help?

Sometimes challenges are situational—maybe it’s bullying, a divorce, family dynamics, or academic frustrations. Most of the time parents can identify those issues. But sometimes it’s not a situational problem at all. The lack of concentration or the fits are at home, school, mom’s house, dad’s house, everywhere. When parents have that gut level feeling that despite the child’s intelligence, or despite how kind their child is, or despite their child’s ability to be mature when calm, when he or she flips that switch, it’s like all of that goes out the window. That’s often times a brain-based issue.

Depending on the severity of sensory processing dysfunction, your child will either be referred to an Occupational Therapist or we will integrate sensory interventions in session.

At this stage of intervention we will work with parents and child to develop a plan for regulation. Kids with regulation issues are quick to go into the lower regions of the brain: they’re reactive, emotional, and language goes offline, so it’s not about what you say, but what you do to help them regulate. Neurofeedback is also incredibly beneficial for self-regulation. We’re working directly with the brain. See the Neurofeeback page to learn more.

Kids are socialized in stages: one-on-one with adults, one-on-one with kids, and finally, groups. For many kids with developmental trauma, they do well with adults or at home, but struggle in the school setting. Groups can be incredibly overwhelming. Friendships matter greatly and it can also be a source of incredible stress for kids. They may also be overstimulating causing hyperactivity, impulsivity, or meltdowns. In sessions, we’ll practice learning to feel safe with someone new. We’ll process what goes well in their relationships and what they could do differently. It’s a lot of side-by-side play, regulatory activities, and learning to identify and communicate emotions. We want to provide a place where they can begin to share about their lives and connect with others.
Last is a cognitive approach, so traditional talk therapy. It goes one step beyond talking about life and connecting with others. This is when we start to challenge thinking patterns and beliefs. We want to learn how to be flexible thinkers, how to challenge narratives, and understand how our experiences impacted our beliefs about ourselves, others, and the world.
All forms of therapy have their place and where we start is entirely dependent on where your child is developmentally. To see change and development, we have to go in order. The brain decides the approach.


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