school-based interventions through a neurodevelopmental lens nwpbis november 10, 2015

SCHOOL-BASED INTERVENTIONS THROUGH

A NEURODEVELOPMENTAL LENS

NWPBIS

NOVEMBER 10, 2015

HISTORY AND EVOLUTIONOF THE NEURO-DEVELOPMENTAL SKILLS AND DEMANDS (NDSD)

MODEL

THE PROBLEM TO BE SOLVED:“DYS-REGULATON”

THE CONSILIENT SOLUTION:“INTEGRATION”

Robinson & Ashby 2015

INTEGRATION

Daniel J. Siegel, M.D., a principal architect of the the field of Interpersonal Neurobiology (IPNB), describes con-silience as “the discovery of common findings from independent disci-plines.” • Neuroscience, developmental psychology, psychiatry, anthropology and other

domains of study provide the theoretical and empirical underpinnings of IPNB.

• The concept of integration, defined as the “linkage of differentiated parts of a sys-tem” is central to the

IPBN view of “well-being.”

• Integration results in “flexible, adaptive, coherent, energized and stable function-ing.”

• Regulation involves monitoring and modifying processes across time, for example, affect and emotion,

physiology and motor movement or communication. In essence, “Integration leads to optimal regulation.”


NEURODEVELOPMENTAL SKILLS AND DEMANDS MODEL

1. Incorporates core neurodevelopmental concepts:· Principles of sequential neurodevelopment· Brain organization and the functions mediated by brain structures

· Memory functions· The stress response system and arousal continuum

2. Involves an assessment of neurodevelopmental skills and environmental demands and:· Utilizes a neurodevelopmental skills assessment worksheet· Utilizes an environmental demands worksheet· The development of a functional hypothesis based on neurodevelopmental skills and demands incompatibilities

· Considers predictability and safety as the primary drivers of behavior for children with a history of adversity

· The development of a neurodevelopmental support and skills training plan

3. Utilizes key concepts in educational/therapeutic programming:·Core elements of the environment·Kids do well if they can·Regulation deficits underlie behavior problems·The nervous system develops in a “use dependent” fashion

· Learning takes place through engagement with relevant instruction

4. Utilizes the ARC template as a conceptual model for the sequential development of competencies (NDSD Environmental Green Zone Framework: Routines/Rituals; Consistent Response; Attunement; Care-giver Affect)

Structure, Routine,

Embedded Skills

Consistent Response Affect Attunement

CLASSROOM

STRUCTURE-

The NDSD Pyramid

Green Zone


THE EVIDENCE THAT INFORMS OUR PRACTICE:

EPIDEMIOLOGY

ACES Study Preview-3:00

http://www.avahealth.org/ace_study/ace_study_dvd_institutional_license/

The ACES Study-Vincent Fellitti, M.D., and Robert Anda,Ph.D




ADVERSE CHILDHOOD EXPERIENCES10 Categories of Experiences up to 18 Years Olds-The

ACES Study

Childhood Abuse:Emotional, physical or sexual

Childhood Neglect:Physical, emotional

Growing-up with:Domestic violenceSubstance abuse (alcohol or drugs)Mental illnessParental discordCrime

ACES & HIGH SCHOOL SOPHOMORES & SENIORSWashington School Classroom (30 students)Washington Family Policy Council

6 Students with no ACES5 Students with 1 ACE6 Students with 2 ACES3 Students with 3 ACES7 Students with 4 or 5 ACES3 Students with 6 or more ACES

THE EVIDENCE THAT INFORMS OUR PRACTICE:

NEUROSCIENCE

Jack Shonkoff. M.D.-The Science of Early Childhood Development, Center for the Developing Child-Harvard

University

http://www.youtube.com/watch?v=tLiP4b-TPCA


http://www.youtube.com/watch?v=tLiP4b-TPCA

KEY CONCEPTS IN DEVELOPING A “REGULATED” LEARNING ENVIRONMENT

Core Elements of the Environment

Kids do Well if They Can

Regulation

Use Dependent Development

Engagement in Relevant Instruction


CORE ELEMENTS OF THE ENVIRONMENT

• Relational (safe)• Relevant (developmentally-matched)• Repetitive (patterned)• Rewarding (pleasurable)• Rhythmic (resonant with neural patterns)• Respectful (child, family, culture)

The ChildTrauma Academy – Bruce Perry, MD, Ph.D., © 2010 www.ChildTrauma.org

Robinson 2015

KIDS DO WELL IF THEY CAN-Ross Greene, Ph.D., Level 1 Advanced Training-Collaborative Problem Solviing-2010

Lagging SkillsEnvironmental

Demand

“Challenging Behavior occurs when the cognitive demand being placed upon a person outstrip the person’s capacity to respond

adaptively”

“Unsolved Problems: Specific conditions in which the demands being placed upon a person exceed the person’s capacity to

respond adaptively.”

“Behind every challenging behavior is a lagging skill and a demand for that skill”


REGULATION AND INTEGRATION

Daniel J. Siegel, M.D., a principal architect of the the field of Interpersonal Neurobiology (IPNB), which includes neu-roscience, developmental psychology, psychiatry, anthropology and other domainsof study, describes Regulation as follows:

• The concept of integration, defined as the “linkage of differentiated parts of a system” is central to the IPNB view of “well-being.”

• Regulation involves monitoring and modifying processes across time, for example, affect

and emotion, physiology and motor movement or communication.

In essence, “Integration leads to optimal regulation.” Integration results in “flexible, adaptive, coherent, energized and stable functioning.”Robinson & Ashby

2015

REGULATION-Adele Diamond

• “Executive functions is a term referring to a set of cognitive functions involved in the top down control of behavior in the service of a goal. They are needed whenever ‘going on automatic’ would be insufficient or detrimental.”

• “Self-regulation refers primarily to emotional control and regulation…self-regulation also embraces the importance of motivation and alertness. Self-regulation researchers view emotions as equal partners in the learning process and in the achievement of one’s goals.”


USE DEPENDENT DEVELOPMENT-Bruce Perry, M.D.

“Neurons and neural systems are designed to change in a “use-dependent” fashion…Healthy organization depends on the pattern, frequency, and timing of key experiences during development. Patterned, repetitive activity changes the brain…Repetition, repetition, repetition: Neural systems, and children, change with repetition.”


ENGAGEMENT IN RELEVANT INSTRUCTION

Theory of School Learning:

“The only way schools can increase learning is to increase the amount of relevant instructional time delivered.”

Relevant Instruction-Defined:

“Instruction that can be understood, attended to, and involves topics that have not already been learned and that are mandated by the curriculum (which assumes the existence of tests that match the curriculum as well).”

• From R. Barker Bausell, Ph.D. Too Simple to Fail-A Case for Educational Change, 2011.Robinson & Ashby 2015

www.Thinkkids.org The Collaborative Problem Solving Approach: Outcomes Across Settings. Alisha Pollastri, Larry Epstein, Georgina Heath, & J. Stuart Ablon, 2013.

Consider this-in order to meet adult expectations, a child must have an adequately developed set of cognitive skills allowing him to:

• Accurately comprehend and interpret the expectations• To flexibly respond to different expectations in different situations • To consider a range of responses• To predict consequences of each of those responses• To express his or her needs or difficulties in meeting expectations• And to tolerate frustration in the face of unexpected results.

Collaborative Problem Solving asserts that if a child is lacking one or more of these skills, he or she will be unable to adaptively respond to demands and that, as a result, maladaptive behavior (defiance, outbursts, and so on) will ensue.

SKILLS TO MEET ADULT EXPECTATIONS


http://www.Thinkkids.org/

THE NEURODEVELOPMENTAL LENSSHIFTS FUNCTION

Get/Avoid

To

Safety/Needs


NDSD ASSESSMENT AND INTAKE

1. The Neurodevelopmental Skills and Demands (NDSD) Assessment Process

• Complete NDSD Assessment Tools• Complete NDSD Skills Development/Support Plan• Complete NDSD Student Arousal Continuum• Complete NDSD Regulation Quadrants

2. The NDSD Vigilant Intake Process (establish purpose and outcomes for each element)

• “Due Process” Flow• Referral Packet Checklist• File Review• Intake Meeting Agenda

Routines & Rituals

Routines & Rituals

Consistent

Response

Consistent

Response

Caregiver Affect

Management

Caregiver Affect

Management

Attunement

Attunement

Affect

Identification

Affect

Identification

Modulation

Modulation

Affect Expressio

n

Affect Expressio

n

Executive

Functions

Executive

Functions

Self-Develop

ment

And Identity

Self-Develop

ment

And Identity

Trauma

Experience

Integration

Trauma

Experience

Integration

CLASSROOM STRUCTURE-FOUNDATIONS IN THE LITERATURE-THE ARC

MODEL

Blaustein, M. E., & Kinniburgh, K. M. (2010). Treating Traumatic Stress in Children and Adolescents: How to Foster Resilience through Attachment, Self-Regulation, and Competency (First ed., pp. 35-41). New York, NY: The Guildford Press


This work conducted by our

Mental Health Collaborators &

Partners

CLASSROOM STRUCTURE-FOUNDATIONS IN THE LITERATURE-THE ARC

MODEL

Blaustein, M. E., & Kinniburgh, K. M. (2010). Treating Traumatic Stress in Children and Adolescents: How to Foster Resilience through Attachment, Self-Regulation, and Competency (First ed., pp. 35-41). New York, NY: The Guildford Press


Attachment-The attachment system is built by the earliest rela-tionship(s) between achild and his/her caregiver(s). The attachment system provides: a model for allother relationships, the earliest training ground for coping with and expressingemotions and safe base for healthy development.

Self-regulation-Involves the capacity to effectively manage experi-ence on many levels: cognitive, emotional, physiological and be-havioral. This likely involves many processesincluding awareness of internal states, tolerance of a range of arousal and affect, the ability to engage in action or cognition to modulate arousal and af-fective states, understanding the connections between internal states (sensa-tions, feelings, thoughts & behavior), understanding factors that in-fluence internal experience and the ability to communicate one’s experience with others.

Competency-The building of internal and external resources that al-low for ongoinghealthy development and positive functioning across domains of competency, including social connections, community involvement, and aca-demic achievement.

KEY INGREDIENTS FOR PROMOTING STUDENTS’

REGULATION SKILLS

INGREDIENT 1-CLASSROOM STRUCTURE AND ROUTINESClassroom Skills are then developed through:Environmental SupportsImbedded Skills TrainingDirect Skills Training

And most importantly, Thinking/Regulation Skills are developed through patterned, repetitive practice, at the point of performance in a Relationally safe environment

INGREDIENT 2-FACILITATIVE STUDENT TEACHER RELATION-SHIPSAttunementConsistent ResponseManagement of Affect (Emotion)


INGREDIENT 1-CLASSROOM STRUCTURE AND ROU-

TINES:THE BASIC TOOLS

Classroom Skills Assessment

Classroom Ecology

Classroom Schedules

Classroom Expectations

Classroom Routines• Macro-Routines, Micro-Routines, Sub-Routines• “Process” Routines (GSP, Space and Pace)• Transition Routines• Instructional Routines• Routines to Change Routines• Unexpected Event Routines• Regulation Routines (interspersed, break, individual, group activities)

Robinson & Ashby, 2015

INGREDIENT 2-FACILITATIVE STUDENT TEACHER RELA-

TIONSHIPS

Attunement

Consistent Response

Management of Affect (Emotion)


CHANGE IN C

OMPLEX

SYSTE

MS

TO

OL S

FR

OM

IM

PL E

ME

NT A

TI O

N S

CI E

NC

E

RE

SE

AR

CH

WHERE TO START

Use tools such as:

THE HEXAGON PLANNING TOOL

http://implementation.fpg.unc.edu/sites/implementation.fpg.unc.edu/files/resources/NIRN-Education-TheHexagonTool.pdf

THE PBIS BLUEPRIINT

Implementation Blueprint and Self-Assessment Positive Behavioral Interventions and Supports Technical Assistance Center on Positive Behavioral Interventions and Supports U. S. Department of Education, Office of Special Education

Programs September 25, 2010



START SLOW TO GO FAST

Understand Stages of Implementation

Exploration Installation Implementation Full Implementation with improvement cycles

RESEARCH DERIVED DRIVERS

Organizational Variables Systems intervention Facilitative leadership Data system for informed decision making

Competency Variables Selection Training Coaching

Leadership Variables Adaptive Technical

http://implementation.fpg.unc.edu/sites/implementation.fpg.unc.edu/files/resources/

AIModules-Activity-1-3-ImplementationDrivers.pdf

COMPETENCY DRIVERS• Selection: Precise job description

Interview process to include role playing,Recruit and hire based on mutual goodness of fit

• Training: Create time for initial and successive training of all staffto ensure alignment on core features and skills for the program.

• Coaching: Peer coaching and technical assistance coachingFocus on fluency: Classroom skills assessment

Transition routinesInstructional routines

AttunementModulation

ORGANIZATION DRIVERS

• Systems Intervention

• Facilitative Leadership

• Data system for decision making

SYSTEMS INTERVENTION

Who has influence in the system such that they can collaborate to build and sustain the culture, the formal expectations and practices, and the funding plan or model that predict successful installation and sustainable full implementation.

FACILITATIVE LEADERSHIP

Leadership behavior (system influencing) that is vigilant, and responsive in removing barriers to successful implementation

Engendering a culture of unrelenting straight talk, reciprocity in action, and constantly surfacing the dissonance in the service of sustainable implementation.

NATIONAL IMPLEMENTATION RESEARCH NETWORK (NIRN)

http://nirn.fpg.unc.edu/

http://www.pbis.org/blueprint/implementation-blueprint

Positive Behavior and Intervention Supports OSEP Technical Assistance Center

http://NIRN/

CONTACT INFORMATION:

VERNE FERGUSON, [email protected]

RICK ROBINSON, PH.D. [email protected]

SHANNON ASHBY, [email protected]


school-based interventions through a neurodevelopmental lens nwpbis november 10, 2015

Documents

neurodevelopmental support

demands model

neurodevelopmental skills

aces study childhood

skills training plan3

drobinson ashby

integrationrobinson

aces studyvincent fellitti