The Banff Centre will host the Second International Neurosequential Model Symposium for nearly 700 people from across the world working in the area of children's mental health, June 8-10.
The Banff Centre will host the Second International Neurosequential Model Symposium for nearly 700 people from across the world working in the area of children's mental health, June 8-10.
Calgary's Hull Services is co-hosting this international event for the second time. Hull Services is the flagship site in Canada for the neurosequential model of therapeutics (NMT) led by clinician Dr. Emily Wang in treating thousands of children and their families every year.
According to the ChildTrauma Academy (also co-hosting the symposium) NMT is a way to organize a child's history and current functioning. The goals of this approach are to structure assessment of a child, articulation of the primary problems, identification of key strengths and application of interventions (educational, enrichment and therapeutic) in a way that will help family, educators, therapists and related professionals best meet the needs of the child.
Hull Services works closely with Dr. Bruce D. Perry, senior fellow at the ChildTrauma Academy in Houston, Texas, an internationally renowned psychiatrist and neuroscientist who is changing how people understand the issue of traumatized children due to abuse and neglect.
“Over the years we've worked in a lot of different systems, so the specific application of NMT is different in each setting, for example, working with people in the juvenile justice system,” said Perry.
“We all know that if you review the history of these kids, it's almost unheard of to have a child in the juvenile justice system who has not been exposed to violence or usually had many different kinds of developmental adversities.” He added this includes direct physical abuse, and parents struggling with substance abuse.
“When those things occur and you're developing, you will have struggles that are usually first apparent to the public eye when you go to school,” Perry said. “You'll struggle with school, and as you get older if you don't get some kind of help to divert you out of this trajectory, and if your symptoms and problems compound, you can end up having serious mental health challenges.”
As the youth enters adulthood, issues can sometimes change from being high risk to antisocial behaviour and marginalization.
“If you don't succeed in school, and if you find alcohol helps you self medicate, then you end up having a combination of poor judgment and impulsivity and that gets you in trouble with the law,” Perry said.
“You end up in the juvenile justice system and, depending upon where you are in development, you're going to have a whole host of challenges with how well you function.”
Many from the groups Perry has worked with come to understand what has come to be called developmental adversity. Childhood adversities put youth at greater risks for health problems, school problems and mental health problems.
“Just about any bad outcome you can conceive of in adult life will increase due to childhood adversity,” Perry said.
Part of what ChildTrauma Academy has been doing is researching collaboratively internationally and systematically in collecting data from children and adults and people from all different developmental stages to get a developmental reconstruction of when their adversities took place, but also what were the buffering factors - were they connected to family? Were they connected to culture?
“One of the things we definitely know is the brain develops very rapidly in utero and over the first few years of life and because of this rapid growth, we, at that time of life, are much more malleable,” Perry said.
“We stay malleable, really, all the way through life, but it's easiest to influence in good ways and bad when you're young and this is why one of the major strategies of our working group is prevention.
“We really think we need to spend a little more time supporting young parents and addressing issues like income inequity, housing problems, employability and poverty. These things literally end up getting translated into the developmental environment for the infant and child - oddly enough, it is an early intervention.”
Hull Services and Dr. Wang have been working with the NMT model since 2011, seeing a huge shift in terms of the way they deal in working with children.
“Years before we were focused on trying to change behaviours; we still do focus on changing behaviours, but we know now the impact of what that means in terms of brain development,” Wang said.
“We focus more on what their (children) stress response system looks like, so in the early years we focus more on what happened to them that may have impacted the way their brain has developed, what's impacted the trajectory of their brain.”
This has led Hull Services to be more developmentally sensitive about the needs of children. Instead of specifically focusing on what's wrong with the child, they focus on what happened in the early years.
“We can try and fix the trajectory the brain has developed, and basically what that means for us is a big focus on relationships and the way those relationships developed,” Wang said. “Many of these kids have, not just in their first few years, a history of neglect, abuse and maltreatment, but they also have parents who have had trans-generational trauma of their own.”
She used the example of a parent who's had a child very young, and has not had good caregiving. It makes it a lot more challenging for them to know how to be appropriate caregivers for the children they then raise.
A big piece of what Hull Services focuses on is building capacity for relationships and social emotional development in these children.
“We feel it's created a more compassionate lens in the way we deal with kids,” Wang said. “We do feel we can change that trajectory for these kids.
“It's like learning to play basketball or ice-skate, the more you practice, the better you're going to get. The more we help these kids have positive relationships, the more likely they're going to be able to develop empathy, and building that empathy decreases the risk of antisocial personality - they'll be thinking about other people as opposed to just themselves.”
Both Perry and Wang agree childhood development has changed greatly since we were hunters and gatherers millennia ago.
“There was basically one child to three or four adults. Not only did they have more people they could have the capacity to build relationships with, there were no competing value systems,” Wang said. “Kids these days can often get on computers and they can look up whatever it is they want, whether it's part of the value system of the family or the community or not.
“We have kids now that get 50 likes on their Instagram photo and say, ‘Wow I'm really popular' as opposed to really understanding what an affiliated relationship is versus what an attachment relationship is.”
