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The fact that the brain develops sequentially - and also so rapidly in the first years of life - explains why extremely young children are at such great risk of suffering lasting effects of trauma: their brains are still developing.
Bruce Perry (2006)
Dr Bruce Perry, a fellow at the ChildTrauma Academydeveloped the Neurosequential Model (NM), a developmentally sensitive and neurobiological-informed model of the brain that has been applied to therapy (NMT), and more recently, education (NME). A Neurosequential Model in Early Childhood (NM-EC) and caregiving (NMC) is also in development.
The Neurosequential Model conceptualises the brain as an upside-down triangle consisting of 4 parts: the Brainstem, Diencephalon (& Cerebellum), Limbic System and Neocortex.
There are several principles of neurodevelopment that are central to the Neurosequential Model.
The human brain is born premature and is shaped by the quality of the caregiving it receives. In essence the caregiver "turns on" the infant brain releasing chemicals, proteins, enzymes and other elements that shape both the structure and capacity of the brain (Levine & Kline, 2007).
The brain is experience expectant and experience dependent. A baby's brain is born with the expectation that it's stress will be managed for it by another. A deprivation of early experiences due to neglect, or the presence of abnormal experiences due to abuse, will have a detrimental impact on brain development (Perry, 2006).
The brain develops in a hierarchical and sequential manner from the 'bottom' simpler areas of the brain to the 'higher' more complex cortical areas (Perry, 2006; 2009). Adverse experiences that occur during the development of the lower brain regions will impact on the development of higher brain regions (Perry, 2006).
The brain is plastic or malleable which means that it has the capacity to change throughout life, however the brain grows rapidly during the first 3 years of life and is most malleable during this time. Once the lower parts of the brain are formed, these brain regions are less malleable and require more repetition to change than higher brain regions (Perry, 2006).
The brain changes in a use dependent way. You cannot change a part of the brain that you're not activating (Perry, 2006). When planning enrichment or therapeutic activities you need to think about what parts of the brain need to be targeted and what interventions are best suited to integrating these parts of the brain.
This has a special application to trauma work. Perry (2006) asserts that the part of the brain developing at the time of the trauma is where treatment must start. For example, a child who has experienced trauma in-utero or during the first months of life, while the brainstem is developing, will first need repetitive, rhythmic, sensory-motor base interventions designed to regulate the lower brain.
In the following video Perry identifies six core strengths of healthy development that become possible as the brain develops from the bottom up: attachment (making relationships), self-regulation (containing impulses), affiliation (being part of a group), attunement (being aware of others), tolerance (accepting differences) and diversity (valuing differences).
Perry also proposes 6 core elements that comprise healthy or positive neurodevelopmental experiences. Experiences must be relevant, repetitive, relational, rhythmic, rewarding and respectful.
Read the following article by Rick Gaskill (2019) for a more detailed explanation of Perry's R's Neuroscience Helps Play Therapists Go Low So Children Can Aim High.pdf
This article applies the six R's to play therapy. How could you also apply the six R's to your current context and work with children? Share your ideas to the Padlet below.
Levine, P. A., & Kline, M. (2007). Trauma through a child's eyes: Awakening the ordinary miracle of healing. North Atlantic Books.
Malchiodi, C. A., & Crenshaw, D. A. (2013). Creative Arts and Play Therapy for Attachment Problems. Guilford Publications.
Perry, B., & Szalavitz, M. (2006). The boy who was raised as a dog : and other stories from a child psychiatrist’s notebook : what traumatized children can teach us about loss, love, and healing. Basic Books.
Perry, B. (2006). The neurosequential model of therapeutics: Applying principles of neuroscience to clinical work with traumatized and maltreated children. In N. Boyd Webb (Ed.), Working with traumatized youth in child welfare (pp. 27–52). New York: Guilford Press.
Perry, B. (2009). Examining child maltreatment through a neurodevelopmental lens: clinical applications of the neurosequential model of therapeutics. Journal of Loss & Trauma, 14(4), 240–255. https://doi.org/10.1080/15325020903004350
Prendiville, E., & Howard, J. (Eds.). (2016). Creative psychotherapy : Applying the principles of neurobiology to play and expressive arts-based practice. ProQuest Ebook Central https://ebookcentral.proquest.com
