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Anthropology Neurobiology Developmental Psychology
Developmental Neuroscience
Neurosequential Model in
Caregiving (NMC)
Neurosequential Model
Neurosequential Model in
Education (NME)
Neurosequential Model of Therapeutics (NMT)
Clinical Practices/Settings
Caregiving Practices & Settings
Educational Practices & Settings
Sociology
Essentially, all models are wrong, but some are useful.
--- George E. P. Box, in Norman R. Draper (1987). Empirical Model-Building and Response Surfaces, p. 424, Wiley. ISBN 0471810339
Core!elements!of!posi2ve!developmental,!educa2onal!and!therapeu2c!experiences!!
!• Rela&onal!(safe)!• Relevant!(developmentally3matched)!• Repe&&ve!(pa6erned)!• Rewarding!(pleasurable)!• Rhythmic!(resonant!with!neural!pa6erns)!• Respec=ul!(child,!family,!culture)!
All rights reserved © 2007-2015 Bruce D. Perry
Understanding core principles of neuroscience, including neuroplasticity and neurodevelopment, can help us better
understand ourselves and others.
Neurosequential Model
The brain mediates our thoughts, feelings, actions and connections to others
and the world.
Cell!Body!
Dendrites!
Myelin!Sheath!
Axon!
The Neuron Synapses!
All rights reserved © 2007-2015 Bruce D. Perry
All rights reserved © 2010-2013 Bruce D. Perry !
Cortex
Limbic
Diencephalon Cerebellum
Brainstem
Abstract & Reflective Cognition
Concrete Cognition
Affiliation
Attachment/Reward
Sexual Behavior
Emotional Reactivity
Arousal
Appetite/Satiety
Blood Pressure
Heart Rate
Body Temperature
Sleep
Motor Regulation
NE#DA#
ANS - body
SER#
Efferent Distribution of Primary Regulatory Networks
Sequential Neurodevelopment
• The brain is undeveloped at birth • The brain organizes from the �bottom� up -
brainstem to cortex and from the inside out • Organization and functional capacity of
neural systems is sequential • Experiences do not have equal �valence�
throughout development
All rights reserved © 2007-2015 Bruce D. Perry
Complexity! Plas&city!
Neocortex!
Limbic!
Diencephalon!
Brainstem!
All rights reserved © 2007-2015 Bruce D. Perry
Bruce D Perry, MD, PhD © 2010-2013 www.ChildTrauma.org
Cognition Abstract Concrete Emotional Reactive Reflexive Mental State CALM ALARM FEAR ALERT TERROR
Primary secondary
Brain Areas
NEOCORTEX Subcortex
SUBCORTEX Limbic
LIMBIC Midbrain
MIDBRAIN Brainstem
BRAINSTEM Autonomic
Sense of Time
Days Hours
Hours Minutes
Extended Future
Minutes Seconds
Loss of Sense of
Time
Terror%
Fear%
Alarm%
Alert%
Calm%
Time
Child
Teacher
Co-dysregulation: Reactive child and overwhelmed teacher
Present,!overwhelmed,!frustrated,!angry…escalates3incidents/!restraint!
All rights reserved © 2007-2015 Bruce D. Perry
Terror%
Fear%
Alarm%
Alert%
Calm%
Time
Child
Teacher
Co-regulation: Reactive child and well-regulated teacher
Present,!parallel,!pa&ent,!!3!allow!mul&sensory,!repe&&ve!ac&vity!!!
All rights reserved © 2007-2015 Bruce D. Perry
20!All rights reserved © 2012 Bruce D. Perry
We do not think ourselves into a new way of living, but we live ourselves into a new way of thinking
Father Richard Rohr
22!All rights reserved © 2012 Bruce D. Perry
Every single human encounter is an opportunity to create a template of positive human interaction.
All rights reserved © 2006-2012 Bruce D. Perry
Intimacy Barrier
History of Relational
Interactions
Casual - Routine - Personal - Intimate
Core!elements!of!posi2ve!developmental,!educa2onal!and!therapeu2c!experiences!!
!• Rela&onal!(safe)!• Relevant!(developmentally3matched)!• Repe&&ve!(pa6erned)!• Rewarding!(pleasurable)!• Rhythmic!(resonant!with!neural!pa6erns)!• Respec=ul!(child,!family,!culture)!
All rights reserved © 2007-2015 Bruce D. Perry
Pre-K
Typical
Age Targeted Programs (Education, Mental Health, Caregiving):
Early Childhood
Developmental lag – the younger you are, the easier it is tolerate the “lag”
All rights reserved © 2007-2015 Bruce D. Perry
Age Targeted Programs (Education, Mental Health, Caregiving):
Childhood
Typical
Grade 5
Developmental lag – as you get older, the skills “lag” becomes viewed through various lens – (e.g., ADHD,
oppositional defiant, “reading” disorder)
All rights reserved © 2007-2015 Bruce D. Perry
Age Targeted Programs (Education, Mental Health, Caregiving):
Youth
Grade 11
Developmental lag – and, ultimately, these skill “lags” can result in- and are viewed as - ‘anti-social’ or even criminal.
All rights reserved © 2007-2015 Bruce D. Perry
Children Who Start Behind Stay Behind Of 50 Children Who Have Trouble Reading in First
Grade 44 Will Still Have Trouble in Fourth Grade
First Graders Fourth Graders
BECAUSE WE HAVE MINIMAL EARLY IDENTIFICATION AND INTERVENTION
Differential “State” Reactivity
All rights reserved © 2007-2015 Bruce D. Perry
Terror
Fear
Alarm
Alert
Calm
Baseline! Stress ! Extreme Stress
Resilient
Neurotypical
Sensitized
Neocortex
Diencephalon
Brainstem
Limbic
Cognitive Predominant
All rights reserved © 2007-2014 Bruce D. Perry
Neocortex
Diencephalon
Brainstem
Limbic
Relational Predominant
All rights reserved © 2007-2014 Bruce D. Perry
Neocortex
Diencephalon
Brainstem
Limbic
Regulation Predominant
All rights reserved © 2007-2014 Bruce D. Perry
Neocortex
Diencephalon
Brainstem
Limbic
Sensory Integration Predominant
All rights reserved © 2007-2014 Bruce D. Perry
Stage-dependent Learning
• What a child �learns� in any experience is dependent upon their stage of development
• The infant, toddler and adolescent will perceive and store different information from the same experience
• Learning – physical, emotional, social and cognitive – is always related to stage of development
All rights reserved © 2007-2015 Bruce D. Perry
Practical Principles of NME
• Work where the child is - • Chronological age may not match the
emotional, cognitive or social �age� • Emotional, cognitive and social �age�
are context and state-dependent • Remember -- parts of the brain that are
not being �used� do not change
All rights reserved © 2007-2015 Bruce D. Perry
Curiosity
Exploration
Discovery
Practice
Pleasure
The Cycle of Learning
Mastery
Confidence
All rights reserved © 2007-2015 Bruce D. Perry
Curiosity results in Exploration Exploration results in Discovery
Discovery results in Pleasure
Pleasure results in Repetition Repetition results in Mastery
Mastery results in New skills
New skills lead to Confidence Confidence contributes to Self esteem
Self esteem increases Sense of security
Security results in More exploration All rights reserved © 2007-2015 Bruce D. Perry