The Winnipeg Conference on Behavioural, Developmental & Emotional Challenges
W h O S h OULD ATTEND
Education & Clinical Professionals: All education and mental health or healthcare professionals who work with children or youth including, but not limited to K–12 Classroom Teachers, School Counsellors, Learning Assistance/Resource Teachers, School Administrators, School Paraprofessionals including Special Education Assistants, Classroom Assistants and Childcare Workers.
All other professionals who support behavioural challenges and complex learning needs including but not limited to: Nurses, Social Workers, Psychologists, Clinical Counsellors, Family Therapists, Occupational Therapists, Speech Language Pathologists, Addiction Counsellors, Youth Workers, Mental Health Workers, Probation Officers and Community Police Officers.
L IVE I N -P ERSON
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This conference will be live streaming from Winnipeg, MB to online participants on November 18–20, 2024 from 8:30am – 4:00pm CT
Recorded footage and all course content will be available until December 20, 2024. Please allow 3–5 business days after the conference has ended for recorded footage to become available.
Behavioural, Developmental & Emotional Challenges with Children & Adolescents
November 18–20, 2024
Monday to Wednesday 8:30am to 4:00pm ü Addressing the Root Causes of Anxiety in Children and Adolescence
ü After the Meltdown: 20 Practical Prevention & Intervention Strategies to Improve Self-Regulation, Executive Function & Explosive Behaviour
ü Supporting Students: Understanding and Addressing Mental Health in the Classroom
ü Positive Paths: Transforming Behaviour In Children & Adolescents with Essential Behaviour Modification Techniques
THE WINNIPEG CONFERENCE ON BEHAVIOURAL, DEVELOPMENTAL & EMOTIONAL CHALLENGES WITH CHILDREN & ADOLESCENTS
Presented by Jack Hirose & Associates. Sponsored by Sunshine Coast Health Centre and Georgia Strait Women’s Clinic
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12:45pm – 2:15pm Afternoon Sessions Begin 2:15pm – 2:30pm Mid-Afternoon Break (Refreshments Provided) 2:45pm – 4:00pm Workshop in Session 4:00pm Complete Evaluation Forms (Use QR Code Above) & Sign-Out (CPA Members Only)
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• A new policy requires you to request a form from your on-site coordinator, which must be submitted directly to the association.
• Please sign in after lunch and sign out at the end of the day. Early departures result in the loss of CPA credits.
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Addressing the Root Causes of Anxiety in Children and Adolescence
After the Meltdown: 20 Practical Prevention & Intervention Strategies to Improve Self-Regulation, Executive Function & Explosive Behaviour
Supporting Students: Understanding and Addressing Mental Health in the Classroom
Positive Paths: Transforming Behaviour In Children & Adolescents with Essential Behaviour Modification Techniques
- an a%achment-based developmental approach - in children and adolescents
Gordon Neufeld, Ph.D. Clinical & Developmental Psychologist
Vancouver, Canada
A JACK HIROSE SEMINAR Winnipeg, Manitoba November 18, 2024
Copyright 2024 Gordon Neufeld, Ph.D. All rights reserved.
The handout is intended for registered par?cipants of this seminar only.
Please do notduplicate this document without permission.For more informa?on regarding the Neufeld Ins?tute or Dr. Neufeld and his work, please consult the website.
www. neufeldins,tute.org
ANXIETY
in children and adolescents
addressing the root causes of - an a%achment-based developmental approach -
Gordon Neufeld, Ph.D Developmental & Clinical Psychologist Vancouver,
Canada
ANXIETY
What is anxiety?
… a vague sense of unsafety and unease, characterized by apprehension and restlessness
… one’s subjective experience of an activated ALARM system
• headquartered in the emoKonal or LIMBIC SYSTEM of the brain
• mediated by the SYMPATHETIC branch of the autonomic nervous system
• has high priority in funcKoning, affecKng AROUSAL and hijacking ATTENTION
alarm system
• acKvates the ENDOCRINE and IMMUNE systems and affects most every system
• mediated through special NEUROTRANSMITTERS in the nervous system
• begins operaKng in the FETUS at about six months aRer concepKon
ATTACHMENT is our preeminent need so SEPARATION is our greatest threat
• aTachment is about the drive towards TOGETHERNESS in all its various forms
• the primary purpose of aTachment is move us to take CARE of each other – a"achment replaces survival in mammals
• aTachment is powerful, primal, primordial and PREEMINENT – the first of three basic drives (play and achievement)
• triggered by where aTached facing separation
• it follows that facing separaKon is our greatest threat and the essence of STRESS
• alarm is one of three primal emoKons evoked to aTempt an instant FIX to the separaKon problem (the other two being frustra2on and separa2on-triggered pursuit)
• the NATURE of the separaKon faced is directly derived from the nature of one’s aTachments facing separation can’t be with ... not special to ... notunderstoodby... BETRAYED NOT LIKED BY ... feelingunlovedby... replacedby... isolation rejecKon not wanted discounted by ... lack of belonging can’tconnectwith... can’t hold on when apart feelingdifferent losing face not important to ... not recognized by ... threats to identity
NEGLECTED NOT HELD ON TO BY ... being alone not belonging not maTering to ...
• alarm is a PRIMAL emoKon that can exist without any awareness or cogniKve input or involvement
• is meant to take care of us by moving us to CAUTION
• once acKvated, alarm seeks RESOLUTION in one way or another. Failure to resolve alarm results in RESIDUAL alarm
• alarm and its effect may or may not be FELT, or be felt in different ways
• when felt, has a significant TEMPERING effect on behaviour
• is oRen PROVOKED by adults as a way of managing behaviour alarm emotion as an
• alarm can DISPLACE other emoKons as drivers of behaviour when more intense
• alarm is a very VULNERABLE emoKon to feel as it brings us face to face with what threatens us
• triggered by where aTached
• headquartered in the emoKonal or LIMBIC SYSTEM of the brain
• mediated by the SYMPATHETIC branch of the autonomic nervous system
• has high priority in funcKoning, affecKng AROUSAL and hijacking ATTENTION
• acKvates the ENDOCRINE and IMMUNE systems and affects most every system
• mediated through special NEUROTRANSMITTERS in the nervous system
• begins operaKng in the FETUS at about six months aRer concepKon
• both the separaKon and alarm must be for the alarm system to funcKon properly
ABOUT FEELINGS AND ALARM
1. One can BE alarmed without FEELING alarmed. - just as one can BE sick, hurt, hungry, 2red, frustrated, angry, a"ached, in love, pregnant – without feeling it at any given moment or even at all for that ma"er
2. We only FEEL alarmed if the cogniKve brain receives the feedback coming back into the brain from the body, and interprets it as alarm. - this feedback does NOT have high priority for processing, is LESS likely when the brain is under stress or has other work to do, must be TIMELY for the links to be made, and can be defensively INHIBITED
3. The more directly one FEELS the alarm as separaFon alarm, the more likely the links will be made, seang the stage for alarm to be resolved.
4. Alarm can ALSO be felt vaguely as anxiety (unsafe, uneasy, apprehensive), indirectly as agitaFon or restlessness (the arousal system) or energeKcally as an adrenalin rush
alarming separa2on must be correctly FELT for cau2on to be effec2ve
the fu2lity of avoiding alarming separa2on must be FELT for adapta2on to occur
ALARMING SEPARATION WHERE AVOIDANCE IS FUTILE
• bedKme, loss and mortality
• separaKon resulKng from going to school, moving, divorce of parents, parents working, hospitalizaKon, etc, etc
• the dawning realizaKon of the inevitability of loss and losing
• always being wanted, chosen and preferred by those whom we want, choose or prefer
• being liked by everyone or avoiding rejecKon
• the lack of invitaKon to exist in another’s presence
• the loss of affecKon or significance to another
• securing the contact and closeness in an aTachment
To a"ach is to face separa2on, but we must a"ach and so facing separa2on cannot ever be truly avoided
Adapting to Alarming Separation that Cannot be Avoided
• RESOLVES alarm, providing some REST and RELIEF from the primal emoKon
• develops the RESILIENCE to handle a world full of separaKon alarm
• enables RECOVERY from alarming events and alarming aTachments
alarming separa2on must be correctly FELT for cau2on to be effec2ve
inner conflict must be FELT for alarm to be tempered
the fu2lity of avoiding alarming separa2on must be FELT for adapta2on to occur
ALARM DESIRE
to engage in an activity to be away from home to take part in some fun to be laughed at to ask one’s question to appear stupid to stand up for a friend to lose popularity
ALARM & DESIRE
to pursue a passion
to be oneself
to have to let go to get attached & involved to wear what one prefers to be seen as different to share one’s story to not be interesting to meet disapproval to express one’s opinion
to not measure up
to be alone
The capacity for COURAGE is developed through feeling conflicted
• the capacity for registering more than one feeling at a Kme begins to develop between 5 to 7 YEARS of age. The more intense the feelings, the longer it takes.
• the development of the prefrontal cortex is SPONTANEOUS but not inevitable – child must first be full of feelings and then court the inner conflict
• the prefrontal cortex takes years to become fully funcKonal. The capacity for consideraKon has a LENGTHY gestaKon period.
• the primary reason for the failure to develop a working prefrontal cortex (and thus the capacity to consider) is a LACK of tender feelings
• feelings of CARING & ALARM are the primary source or cause of inner conflict, dissonance or fricKon
TRAITS DERIVED FROM A WELL-FUNCTIONING ALARM SYSTEM
• CAREFUL
• CAUTIOUS
• CONCERNED
• CONSCIENTIOUS
• REFLECTIVE
• characterized by a conflicted RELATIONSHIP with alarm
• RESOLUTE –not controlled by alarm
• RESTFUL (from finding RELIEF & RESOLUTION re alarm)
• RESILIENT (from having RECOVERED from alarming events and having adapted to an alarm-filled life)
A funcKoning alarm system should move us …
… to CAUTION if that is possible
… to ‘CRY’ if that is fuKle
… to take COURAGE if what alarms is in the way
PART II
ANXIETY as part of a conQnuum of ALARM-BASED PROBLEMS caused by the failure to feel sufficiently
cau2on that does exist is misplaced & thus ineffec2ve, OR not moved to cau2on at all m i s
WHEN FEELINGS ARE LACKING
the fu2lity of avoiding the alarming separa2on is NOT felt
inner conflict is NOT felt and so avoidance impulses are not tempered
LEVEL 1 – ANXIETY PROBLEMS
- FLIGHT from alarming things and situaFons – involves obsessions and compulsions, which can include phobias and paranoia, as well as a preoccupaKon with staying out of trouble
LEVEL 2 – AGITATION & ATTENTION PROBLEMS
- FLIGHT from apprehension and a%ending to what alarms - results in significant aTenKon deficits, not being able to stay out of trouble, not being moved to cauKon, recklessness and carelessness
LEVEL 3 – ADRENALIN SEEKING PROBLEMS
- FLIGHT from any sense of vulnerability whatsoever – the adrenalin rush involved in doing alarming things when devoid of a sense of vulnerability results in being aTracted to what alarms and a predisposiKon for being a trouble-maker
The Continuum of ALARM Problems
alarm is displaced
ANXIETY problems (obsessions & compulsions)
felt vaguely as unsafe, uneasy or apprehensive
alarm is dysfunc2onal
AGITATION, ATTENTION, & DISCIPLINE problems
alarm is perverted
ADRENALIN SEEKING problems
felt indirectly as agitaFon or restlessness but lacking apprehension
felt only as adrenalin and lacking other vulnerable feelings
The Continuum of ALARM Problems
alarm is displaced
ANXIETY problems (obsessions & compulsions)
felt vaguely as unsafe, uneasy or apprehensive
alarm is dysfunc2onal
alarm is perverted
AGITATION, ATTENTION, & DISCIPLINE problems
felt indirectly as agitaFon or restlessness but lacking apprehension
ADRENALIN SEEKING problems
ANXIETY - based
felt only as adrenalin and lacking other vulnerable feelings
AlarmedbutDefendedAgainstit
A Continuum of Defendedeness
The defensive inhibiKon of feelings is sufficient enough to interfere with linking the feelings of alarm to the separaKon faced, but NOT enough to keep from feeling nervous. The result is anxiety
AGITATION - based
The defensive inhibiKon of feelings is significant enough to keep from feeling nervous but NOT enough to keep from feeling agitated or restless. In addiKon, defensiveness in aTenKon results in a blindness to that which truly alarms. The result is agitaFon without apprehension plus significant deficits in a%enFon.
ADRENALIN -based
The defensive inhibiKon of feelings is severe enough to keep from feeling nervous, agitated or vulnerable, resulKng in feeling ONLY the chemistry of alarm. The result is being a%racted to what alarms
What is anxiety?
… a vague sense of unsafety and unease, characterized by apprehension and restlessness
… one’s subjective experience of an activated ALARM system
… a response to facing separation where the FEELINGS that link the alarm with the separation faced are missing
… a state of alarm-driven AVOIDANCE characterized by a FLIGHT from what our thinking brain has mistakenly assumed is the reason for alarm
CAUTION is SKEWED or MISPLACED
ALARM IS VAGUELY FELT AND FALSELY ATTRIBUTED
UNTEMPERED – inner conflict is NOT felt
... the MISTAKEN SOURCES OF ALARM
TRAITS DERIVED FROM AN ANXIETY-BASED ALARM PROBLEM
• obsessive
• compulsive
• overly cauKous & conscienKous
• can be impulsive & reacKve
• lacking a relaKonship with alarm
• beliefs do not calm alarm
• not given to sadness or grieving (especially around the alarming separaKons that were or are unavoidable )
• someone or something is out to hurt me or to get me
• something is wrong with my health or my functioning or is going to make me sick
• something is out of order or out of place
• something is wrong with my body or with how I look
• some places or situations are dangerous or unsafe
• something has been left undone
• one is ‘too much’ or ‘not enough’
RESULTING COMPULSIONS (to avoid or reduce alarm)
work at avoiding the monsters and scary creatures, avoid getting conned, uncover people’s plots work at keeping things clean, at not getting sick, at avoiding germs, at avoiding contamination work at putting things in order and their place work at improving one’s appearance or at changing one’s shape work at avoiding that which makes one feel unsafe (ie, phobias)
work at remembering to complete one’s tasks
work at editing or enhancing, diminishing or improving oneself
ACTIONS & ACTIVITIES THAT PROVIDE MOMENTARY RELIEF - can develop into compulsions or addicFons -
• drug-taking – depressants (eg - alcohol for alarm, marijuana for agitaKon, myriad of anK-anxiety drugs & medicaKons)
• drug-taking – sQmulants to evoke a return swing of the pendulum – caffeine, nicoKne, Ritalin, etc
• emoQonal playgrounds where alarm is de-acKvated – eg, music, drama, art, dance, movement, stories, silliness, humour, games, cultural rituals
ALARM NOT FELT DIRECTLY
UNTEMPERED – inner conflict is NOT felt
... ATTENDING TO WHAT TRULY ALARMS
TRAITS DERIVED FROM AN AGITATION-BASED ALARM PROBLEM
• restless, tense or hyperacKve
• predisposed to agitaKon reducKon &/or expression (eg, drugs, physical exerKon, freneKc acKviKes or sKmulaKon)
• lacking apprehension
• can’t stay out of trouble or harm’s way
• overly gregarious & talkaKve
• doesn’t learn from mistakes and failure
• predisposed to learning disabiliKes
• impulsive & reacKve
• aTenKon deficits where alarmed
• lack of memory for alarming events
• scaTered aTenKon where alarmed
stuck in the iniKal either-or mode of aTenKon instead of progressing to the advanced this-and mode
a%achment - based
not properly aTached to, or engaged by, those aTempKng to command aTenKon
COMMON ATTENTION PROBLEMS immaturity -based
hypersensiFvity -based
signal overload due to dysfuncKonal aTenKonal filters
ALARM-based
A]enQon is hijacked by alarm, creaQng significant deficits and concentraQon problems. A]enQon is sca]ered because of compeQng biases – to a]end to what alarms and avoid looking at what alarms.
about alarm-based a"en2on problems
• key signs are ‘highly agitated’ as IF highly alarmed but ‘without apprehension’ as if not at all alarmed
• aTenKon system receives mixed messages from the brain: pay a"en2on to what alarms and don’t look at what alarms
• the two primary symptoms are sca%ered a%enFon and significant a%enFonal deficits around alarming situaKons (eg, can’t see trouble coming, can’t stay out of harm’s way, more gregarious than would be appropriate, somewhat reckless and careless, poor memory for alarming situaKons)
• typically will qualify for an a%enFon deficit diagnosis as the syndrome meets the three criteria: difficulty concentraKng, restlessness or agitaKon, and impulsiveness (only two of the three are required for the diagnosis)
a%racted to, & engaged by, WHAT ALARMS
ALARM, AGITATION & VULNERABILITY NOT FELT
UNTEMPERED – inner conflict is NOT felt ... ALL VULNERABLE FEELINGS
TRAITS DERIVED FROM AN ADRENALIN-BASED ALARM PROBLEM
• does alarming things (eg, risk-taking, cuang, burning)
• seems relaKvely unaffected by what should alarm
• FEARLESS
• risk-taking
• can become a troublemaker
• can lack a conscience
• more able to engage in ‘cold’ cauKon
• unreflecKve
• unconflicted
• inconsiderate
• unfeeling
• TEARLESS – lacking in sadness and devoid of grief
• adversity hardens rather than soRens
Some aTracKons of the highly defended …
• scary rides and horror movies
• breaking taboos and out-of-bound behaviour
• dangerous acQviQes
• daredevil stunts
• delinquent acQvity and being ‘bad’
• extreme sports
• cucng and burning
nervous
does alarming things
OBSESSIONS compulsions
panic
ATTRACTED TO WHAT ALARMS
tension
can’t stay out of trouble AGITATION
over- conscienQous
ANXIETY
reckless & careless
worry
unable to stay out of harm’s way SCATTERED ATTENTION concentraFon problems lacking curiosity
facing separation
FEARLESS
ADRENALIN- SEEKING
cucng & burning hair-pulling
Qcs stu%ering
RESTLESSNESS
unease phobias
ANXIETY
addressing the root causes of in children and adolescents
PART III
A closer examinaQon of the ROOT CAUSES of ESCALATING ALARM in our children and youth
WHY TODAY’S CHILDREN ARE MORE ALARMED and less able to deal with it
• premature separaKon
• failure to develop the capacity for relaKonship
• peer orientaKon
FACING MORE SEPARATION
LOSING THEIR FEELINGS
• the sense of connecKon or togetherness needs to be relaKvely conKnuous for development to unfold
premature separaQon = physical separa2on before a child has developed more mature rela2onship-based ways of holding on when apart • today’s children typically experience being apart from the adults they are aTached to, both earlier and longer than in previous generaKons
TODAY’S CHILDREN FACE MORE SEPARATION
1) more likely to be APART from their parents for reasons of divorce, schooling, parental employment, out-of-home care, aRer-school acKviKes, and digital preoccupaKons
2) when apart from their parents, NOT as likely to be ATTACHED to the ADULTS responsible for them (contribu2ng factors include smaller nuclear families, loss of extended families, loss of the village of a"achment, gradual driGing of school outside the a"achment village, loss of culture that would foster the needed child-adult a"achments, lack of focus on student-teacher rela2onships)
3) more likely to become PEER ORIENTED as a result of falling through the aTachment cracks of today’s society
PEER ORIENTATION
Children taking their cues from each other as to how to act, what to do, how to talk, what to wear, how to express oneself, what is valued, what is expected, what is right and what is wrong
The compeQng nature of most peer a]achments today (ie, can’t be close to both peers and adults simultaneously) pulls children out of orbit from around the adults responsible for them
PEER ORIENTATION FUELS ALARM
• peer aTachments are inherently INSECURE – the more one’s peers maTer, the more separaKon is being faced by default
• robs adults of the power they need to keep social interacKon safe
• powerless adults, in turn, resort to alarmbased methods of behaviour management, fueling alarm further
• the peer-oriented can be cruel and uncaring to those outside their ‘tribe’, fueling alarm
• peer orientaKon robs children of the shielding and protecKon they need to live in an alarming world
• drives alarm under- ground as fearlessness is venerated by the peer-oriented and any show of alarm can be shamed or exploited
• the peer oriented are drawn to social media where alarming interacKon is the norm
• peer orientaKon breeds ALPHA children, fueling alarm even further
WHY TODAY’S CHILDREN ARE MORE ALARMED and less able to deal with it
• premature separaKon
• failure to develop the capacity for relaKonship
• peer orientaKon
FACING MORE SEPARATION
BECOMING MORE ALPHA
LOSING THEIR FEELINGS
• failure of adults to inspire dependence
• not safe to depend
• peer orientaKon
Common ManifestaQons of ALPHA Children
• predisposed to take charge, to take over, to take the lead
• inclined to command aTenKon, to take centre stage
• moved to talk louder, to talk over, to talk for another
• tend to demand deference, to give orders, to take command
• compelled to be first, to be the best, to be on the top
• insist on being the one to give direcKons and define the meanings
• compelled to trump interacKon, to have the last word
• oRen need to be in the know, to be the most knowledgeable
EscalaQng Cycle of ALPHA and ALARM
ALARMED CHILDREN BECOME MORE ALPHA
- alarming events can trigger alpha as defense as the adults they depended upon could not keep them safe. The resulKng alpha locks them into alarm.
ALPHA CHILDREN BECOME MORE ALARMED
- a lack of dependent trusKng relaKonship robs them of a place of refuge, safety and shielding in an alarming world
- alpha children are difficult to ‘hold’ in an experience of fuKlity, blocking adaptaKon to an alarming world
ALPHA CHILDREN ALARM OTHERS
- general alarm is increased as alpha children who are defended against alarm take pleasure in asserKng their dominance by triggering alarm in others through threats and inKmidaKon
Why Today’s Children are Becoming More ALPHA
• is a natural response to stress (ie, facing more separaKon)
• today’s parents and teachers are more childled, puang the child in the alpha role by default
• dependence is not as likely to be invited by today’s parents and teachers
• today’s parents and teachers seem to have more difficulty assuming an alpha posture, resulKng in children filling that void
‘you won’t be able to stay with us if you don’t behave’ responses
‘go to your room’ or ‘get out of my sight’ responses
• increasing peer orientaKon renders it unsafe to depend as well as unclear as to who is to take care of whom
• dependence is more likely to be an aversive experience, including using alarm and what children care about, against them
any form of separation or isolation or love withdrawal or the anticipation of such ‘I need a break from you’ or ‘you’re too much to handle’ responses
Ways we push children’s faces into SEPARATION
ignoring and the silent treatment responses
includes contracts and ultimatums that involve separation as a possible outcome
includes using what children care about against them
WHY TODAY’S CHILDREN ARE MORE ALARMED and less able to deal with it
• premature separaKon
• failure to develop the capacity for relaKonship
• peer orientaKon
FACING MORE SEPARATION
BECOMING MORE ALPHA
LOSING THEIR FEELINGS
• failure of adults to inspire dependence
• not safe to depend
• peer orientaKon
alarm must be FELT to be moved to cau2on the fu2lity of avoiding alarming separa2on must be FELT for adapta2on to occur
inner conflict must be FELT for alarm to be tempered
Stress Response
Feelings that would interfere with performing or funcKoning in stressful circumstances are inhibited
Resilience Response
Feelings that have been inhibited bounce back to enable opKmal funcKoning and the realizaKon of full potenKal
TIME (in hours ideally)
SAFETY is key
Sanctuaries for the Recovery of Feelings
shielding a%achments to caring adults
emoFonal playgrounds feelings
expressive
WHERE emotions like to PLAY
EmoQons are not at work, so the inhibiQon of feelings is reversed
Play is safe so feelings won’t get hurt
EmoQons are freer to move and so more likely to be felt and idenQfied
EmoQons are easier to feel when one step removed from real life
Words or their lack, do not get in the way
Feelings of fuQlity are much easier to access
Feelings are recovered when emotions are at play
ENCOUNTERS WITH FUTILITY
Sanctuaries for the Recovery of Feelings
a%achments to caring adults
emoFonal playgrounds
WHY TODAY’S CHILDREN ARE MORE ALARMED and less able to deal with it
• premature separaKon
• failure to develop the capacity for relaKonship
• peer orientaKon
FACING MORE SEPARATION
BECOMING MORE ALPHA
LOSING THEIR FEELINGS
• failure of adults to inspire dependence
• not safe to depend
• peer orientaKon
• loss of the safe spaces for feelings to recover
• increased peer orientaKon and digital preoccupaKon
• increased drugs and medicaKons
ANXIETY
addressing the root causes of in children and adolescents
PART IV
ADDRESSING the ROOT CAUSES of all ALARM-BASED PROBLEMS including anxiety
reduce the separation they are facing
FACING MORE SEPARATION
BECOMING MORE ALPHA
LOSING THEIR FEELINGS
make it safe to feel
embed in cascading care
ACTIONS & ACTIVITIES THAT PROVIDE MOMENTARY RELIEF - can develop into compulsions or addic2ons -
rhythmic acQvity and pa]erning (rocking, pacing, rhythmic beat, drumming, swinging, worry beads, flickering fire, watching waves, hand wringing, etc )
of alarm and interferes with its natural RESOLUTION through cauQon, sadness or courage
• drug-taking – depressants (eg - alcohol for alarm, marijuana for agitaKon, myriad of anK-anxiety drugs & medicaKons)
• drug-taking – sQmulants to evoke a return swing of the pendulum – caffeine, nicoKne, Ritalin, etc
• emoQonal playgrounds where alarm is de-acKvated – eg, music, drama, art, dance, movement, stories, silliness, humour, games, cultural rituals the problem with conQnuously seeking temporary RELIEFis that it ignores the ROOTS
Approaches that treat the child DIRECTLY and are NOT informed regarding ALARM or its purpose
BEHAVIOUR FOCUS
address behaviour problems stemming from being alarmed or defended against it – avoidance, agita2on, geIng into trouble, adrenalin-seeking
MEDICAL APPROACH
diagnose for mental illness and use medica2ons to counter the effects of alarm on the mind and body
REMEDIAL LEARNING
address learning problems stemming from the effect of alarm on a"en2on, mo2va2on curiosity, and performance
SKILL-BASED APPROACH
teach skills to calm the alarm – eg, self-regula2on, breathing, medita2ng, self-affirma2ons
COGNITIVE APPROACH
confront the irra2onality of alarm-fueled obsessions
MEDICAL APPROACH
COGNITIVE APPROACH
BEHAVIOUR FOCUS
PLAY-BASED intervenQons aimed at development and remediaQon, including restoring tender feelings
SKILL-BASED APPROACH
REMEDIAL LEARNING
alarm system dysfuncQon resulQng from lack of feelings RELATIONSHIPBASED intervenQons aimed at altering a]achments, reducing the separaQon faced, and restoring tender feelings
highly alarmed from facing separaQon
EVIDENCE-BASED, POWERFUL and SAFE
INDIRECT and NON-INTRUSIVE
ADULT-FOCUSED – adults are the ones RESPONSIBLE
NATURAL and INTUITIVE (given supporKng insight)
RELATIONAL & PLAY-BASED intervenQons
UNIVERSAL in APPLICATION
do NOT require PROGRAMS for execuKon
do NOT require EXPERTS or specialized training
are NOT dependent upon medical DIAGNOSES or the construct of mental illness
The ulKmate challenge in addressing alarm problems is to REDUCE the SEPARATION being faced and RESTORE the FEELINGS of separaKon and alarm, to the point where the alarm system can more easily move the child …
- to take the alarm out of a"achment, making it safe to a"ach
- to caring adults and emoFonal playgrounds in order to provide safe refuge from alarm and safe sanctuary for their feelings
When facing separation, preserve the connection by drawing attention to the next point of contact or to what stays the same.
Embed in Cascading Care
• to ADDRESS peer orientaKon and alpha stuckness in order to reverse their impact on alarm
• to create a REFUGE as well as a safe place for feelings to BOUNCE BACK
• to EMPOWER adults to help culKvate a child’s relaKonship with alarm and resolve it via cauKon or sadness or courage
• to give adults more CONTROL over the wounding and alarming social interacKon between children
• to SHIELD a child against the impact of alarming interacKon
• taking care of younger children provides a suitable & non-alarming OUTLET for children’s own ALPHA insKncts
- hierarchical rela2onships with caring adults as well as younger children in need of their care and protec2on -
- by taking care of them in some way or another
- by coming alongside
- by having them on your radar
INVITE DEPENDENCE CONVEY CARING
- make it SAFE to depend
- provide SPACES for feelings to recover
assume a CARING ALPHA role and posture
ANSWER ATTACHMENT NEEDS
- inspire TRUST
- for sameness, belonging and significance - for an invita2on to exist in one’s presence - for a sense of togetherness that is not threatened
• SCRIPT cauKous behaviour when needed
• teach the LANGUAGE of alarm indirectly through reflecKve mirroring
• prime SADNESS if possible, indirectly and one step removed, if needed
• foster a RELATIONSHIP with ALARM, starKng with accepKng its inevitability
from a place of trusting dependence
• MODEL a healthy relaKonship with alarm including the opKons of cauKon, ‘crying’ and courage
• lead into MIXED FEELINGS if inner conflict exists
• serve as TRAFFIC DIRECTOR if you can, helping to a resoluKon that is most suitable to the situaKon
Addressing ALARM through PLAY
• playfully alarming DEVELOPS the alarm system and BUILDS tolerance of alarm
• play provides temporary REST and RELIEF from alarm
• RE-PLAY of alarming scenarios can lead to eventual resoluQon
• alarm can be MASTERED in play
• play can provide SAFE DISCHARGE for alarm-fueled compulsions, agitaQon and adrenalin-seeking
• SADNESS is much easier accessed in the play mode
• play is the perfect scenario for the ‘DRAGON & TREASURE’ experience
• obsessions and compulsions can be DEFUSED in play
• ATTENTION problems are best addressed through play
PLAYING with ALARM
• peek-a-boo play
• startle play
• ambush games
• ‘falling’ play
• rescue play
• safe-at-home play
• safe hide-away play
• dare games
• monsters & scary creature play
• scary stories, games and acQviQes
Playing with facing separation
• GAMES
• TRAGIC STORIES
• MUSIC
facing separation
• POETRY & ART
• HUMOUR
• CULTURAL FESTIVALS
Bringing obsessions and compulsions into play
When my son was younger, around 4 or 5, he developed rituals upon walking from room to room, from inside the car to outside and so on. He would walk one step forward and then back and then forward and then back again a certain number of 2mes. At some point I began taking his hand and “dancing” back and forth with him - which made him smile. AGer some 2me, I would lead him - get there first and eventually began to add new mo2ons to his “dance”. That turned it into a game and at some point, I’m not even sure when, this habit disappeared.
Play Holds the Most Promise
• PLAY is the best CONTEXT for the aTenKon system to develop, repair, or find ‘work-arounds’
• aTachment and alarm are at REST, allowing aTenKon some free Kme to play
• CURIOSITY is the best ANTIDOTE to any aTenKon problem, as it can pull the child through in their area of interest
• defensive filters are SUSPENDED in the play mode, stopping the mixed messages in alarm-based aTenKon problems
• aTenKon is DRAWN rather than driven in play, allowing for opKmal funcKoning
• play facilitates prefrontal cortex development, resolving impulsiveness and MATURING the aTenKon system
ADDRESSING THE ROOT CAUSES OF ALARM
USING RELATIONAL & PLAY-BASED INTERVENTIONS
reduce the separation they are facing
FACING MORE SEPARATION
BECOMING MORE ALPHA
LOSING THEIR FEELINGS
embed in cascading care
make it safe for children to feel
addressing the root causes of
ANXIETY
in children and adolescents
- an a%achment-based developmental approach -
Gordon Neufeld, Ph.D. Developmental & Clinical Psychologist Vancouver, Canada
Laughter oxygenates the brain
AGENDA
8:00ISH WELCOME/OVERVIEW
SCHEDULES
TRANSITION MARKERS
SURPRISE CARDS
EXECUTIVE FUNCTIONS
10:00ISH BREAK
NEUROANATOMY
PSYCHOLOGICAL/DEVELOPMENTAL DISORDERS
VIDEO OF MELTDOWN
LEVELS OF TALKING POWER CARDS
KEYCHAIN RULES
12:00 - 1:00 LUNCH
METACOGNITIVE STRATEGIES
2:00ISH BREAK
SELF REGULATION STRATEGIES
4:00 ADIOS
Research on autism:
Studies have documented that schedules and routines influence children's emotional, cognitive, and social development.
Predictable and consistent schedules in classrooms help students feel secure and comfortable.
Schedules and routines help children understand the expectations of the environment and reduce the frequency of behavior problems, such as tantrums and acts of aggression.
- Ostrosky, Jung, Hemmeter, Thomas
What does research say?
Using an agenda of the d a y ’ s lesson makes learning more relevant to students and takes the mystery out of what is going to happen
Schedule & Transi0on Marker
Surprise
I can handle it.
I’ll remember that it may be a surprise to others as well.
''John Cena says surpri ses are O.K.!''
` SURPRISES ARE OK
Sometimes…
•
-Lisa Rogers
WHAT ARE EXECUTIVE FUNCTIONS?
NO FORMALLY AGREED UPON DEFINITION.
TheConductoror CEOoftheBrain
This theory states that EFs are a single, unitary cognitive control process that directs all thought and behavior
(McCloskey, Perkins, & Van Divner, 2009)
EF’S AS CO - CONDUCTORS OF THE BRAIN’S ORCHESTRA
• Set of multiple cognitive capacities that act in a coordinated manner
(McCloskey, Perkins, & Van Divner, 2009)
Multi-dimensional Construct
(McCloskey, Perkins, & Van Divner, 2009)
Overarching developmental cognitive neuropsychological construct that is used to represent a set of neural mechanisms that are responsible for cueing, directing, and coordinating multiple aspects of perception, emotion, cognition and action
METACOGNITION
Awareness and u n d e r sta n d in g of one's own thought processes.
Includes-
Goal setting
Planning and strategizing
Sequencing
Organization
Time management
Task initiation
Executive attention
FOLLOWING
JOSH…
A Day in the Life of a Students with Executive Functioning Issues
Meet Josh: 6th grade
7A.M.
• Forgets his cleats
• Runs back inside to get them
• Ends up leaving his backpack at home as he races toward the bus
• Sprints past the checklist his mom left for him
• Oops, missed the bus!
11A.M.
• Teacher asks, “Who has a good answer to the first question I gave you yesterday about last night’s assignment?”
• Josh squirms. Hopes she doesn’t call on him.
• He didn’t write the questions in his planner and hasn’t a clue how to answer them.
1 P.M.
LUNCH TIME
Josh’s favorite time
• Hogs the conversation, talking way too loud
• Talks only about his video games and does not allow anyone else to partake in conversation
• Friends are getting annoyed but he does not notice
3 P.M.
SOCCER
• Josh is so focused on getting the ball that he doesn’t keep in mind which direction he’s supposed to run.
• Heads for the nearest goal
• Oops! Kicks the ball right into his own home net.
6 P.M. DINNER TIME
• Josh is not too happy when his Mom tells him to turn off the TV and set the table.
• When he thinks he is done, his sister tattles that he’s forgotten to give each person a cup.
• Frustrated with his sister and missing his TV show, he loses his cool and yells at her.
8 P.M. HOMEWORK TIME
After much prodding by his mother, he sits down to do his homework.
He doesn’t know where to start. Too overwhelmed by the many assignments.
Instead of doing his book report or math problems due tomorrow, he surfs the web looking for a topic for science report due next week.
Takes a break to play a video game
10 P.M.
• When Josh finally begins the book report, his mind keeps jumping from one thought to another.
• He only gets one sentence down on paper before he gives up for the night.
• He thinks he can do more on the way to school tomorrow (though he’s never completed anything while riding the bus with his friends!)
Executive Function Breakdowns:
Executive Attention
Task Persistance Organizing
12 A.M.
WAY PAST JOSH’S BEDTIME
• He’s exhausted and can’t go to sleep.
• He tries but can’t shut off his brain.
• He keeps worrying about disappointing the teacher with his incomplete book report.
• He also worries about getting teased by his teammates for kicking the ball into the wrong goal.
Self regulation Anxiety Management Emotional Control
Modified by the work of Thomas E. Brown, Ph.D. understood.org
Executive Function Breakdown
Executive Function Weaknesses
• Conceptual reasoning abilities may be stronger than their output and productivity
• Consequently, these students are inefficient with their work and have difficulty showing what they know in the classroom
• Study skills and test performance are compromised
• Academic grades may not reflect actual intellectual ability
NEUROANATOMY
• frontal lobes
• prefrontal lobes (associated with behavioral and personality changes)
The brain develops back to front so the prefrontal cortex is not fully mature till age 25.
Yes, Your Teen is Crazy! Michael J. Bradley, 2002
PSYCHOLOGICAL AND DEVELOPMENTAL DISORDERS ASSOCIATED WITH EF DEFICITS
ADHD
Learning Disabilities
Autism Spectrum Disorders
Mood Disorders
Obsessive Compulsive Disorders
Tourette’s Syndrome
Schizophrenia
Antisocial Personality Disorders
Borderline
Laughter oxygenates the brain
2009
Supporting frontal lobe or executive skills
Directives, Rules,
Keychain Rules
Structuring the Environment:
Supporting frontal lobe or executive skills
Directives, Rules,
Levels
Keychain
Reminder
Structuring the
Power Cards
1. A brief scenario or character sketch describing how the hero solves the problem.
2. The POWER CARD which recaps how the child can use the same strategy to solve a similar interest.
The following 4 slides are from Ron Haggerton, principal from Highland MiddleSchool, Hobbs, NM
Luke Skywalker changed You can change too. Change is coming today.
When Luke gets frustrated, he sees Obi-Wan.
Brendan's Jedi Power Card
I am Luke Skywalker and I have some great ideas to share with others. I like to raise my hand and answer the question.
The teacher needs to call on other students so that they can share their ideas, too. I want my friends to have a chance to answer.
To become a Jedi requires the deepest commitment and most serious mind. It is not a venture to be undertaken lightly. As such, Jedi instruction is rigidly structured and codified to enforce discipline and hinder transgressions.
Brendan's Jedi Power Card
When the teacher calls on someone else in class, Luke Skywalker wants you to remember that you can do one of the following things:
o Wait and listen
oTake one or two deep breaths
o Write your answer down on paper
oOther:
May the force be with you, Brendan!
Hey friends, my name is George. It’s time for lunch!
I’m going to share with you how I eat lunch at school.
First, I wash my hands to get all the germs
I raise my hand and wait if I need something opened or if I have a question.
I am willing to try something new that I haven’t eaten before.
I
George says, “It’s time for lunch! There are a few simple rules we have to follow at lunch time,
NAPS WITH CURIOUS GEORE
George says, “Sawyer, it’s time for a nap.” I’ll show you how I take a nap at school.
First I lay down on my nap mat.
Next I get myself comfortable with my blanket and pillow.
Last I close my eyes and go to sleep.
George says taking a nap will make your body feel better! Let’s take a nap together!
Power Cards= Interest = Success
Ju s t like m e.
I may not have “signed up” to be a student But, I will be like Miley and be a professional.
Drew's Fabulous Interview
Miley Cyrus is a TV & movie sta r.
She had to go to many inte r views to get these jobs and become famous.
Sometimes, she used to get a little nervous about meeting new people and talking to them at the inte r view.
Miley would try to remember that an inte r view is just a chance to meet new people and tell them about h e r s el f.
When you get all dressed up and smile, the inte r view can be lots of fun!!!!
You can have fun at your interview if you just do these things:
1. Take a deep breath 2. Smile 3. Be your great self You can do it, Drew!
Dean and Sam
Dean and Sam Winchester traveled all over the US hunting for ghosts. They must now stay home. Just like me. They want to stay safe. Just like me.
Supporting frontal lobe or executive skills
Directives, Rules, Limits:
Surprise cards/Change of schedule
Power Cards
Structuring the Environment:
Keychain Rules
Reminder Cards
Social Stories
T-charts
SOCCSS
Physical Structure
Labeling
Keychain Rules
Read when calm
Read multiple times
Refer to them when he demonstrates rules as reinforcement
Refer to early in the escalation phase
Keychain Rules
Rule #7: Teachers can call on other students even if you know the answer. In fact, it is her job to call on a variety of students.
lobe or executive skills
My T - Chart to help me learn
Jamie-32 years old
“She never brings casseroles to the
Ignore
Kid
During science class
Making
He doesn’t like me; he thinks I’m stupid.
He
frontal lobe or
skills
Directives,
Keychain
Reminder
Importance of Physical Structure
Physical structure helps students understand work expectations by indicating that being in a particular area or location means:
• Time to work with others
• Time to work alone
• Time for a break
• Time for transition
Beware of the traditional “all desks in a row” syndrome! (Sprick, 1997)
Research re: Student Engagement
• Circles produced the greatest number of ontask comments, oral responses, and on-task behaviors
• Clusters produced a greater number of on -task behaviors and more handraising than rows
• Students seated in rows produced a greater number of withdrawal responses than circles or clusters
Source: Rosenfield, P., et al. (1985). Desk arrangement effects on pupil classroom behavior. Journal of educational psychology. Vol 77, No 1, pp 101-108.
Ability to predict what will happen in each area is comforting and allows better learning
Minimizes distractions and highlights what is important
Leisure Area/Break time
lobe or executive skills
Directives,
Keychain
Structuring
Supporting frontal lobe or executive skills
Directives, Rules, Limits:
Surprise cards/Change of schedule
Power Cards
Keychain Rules
Reminder Cards
Social Stories
T-charts
SOCCSS
Structuring the Environment:
Physical Structure
Visual Cues
Goal-setting
The ability to set clearly defined goals and appropriate goals and then follow through to achieve the goals
Dawson and Guare, 2012
Exhibited behaviors: Difficulty in identifying long range goals
Fails to complete assignments due to difficulties with prioritizing aspects of the assignment
Kaufman, 2010
LONG TIME PROJECTS, GOAL SETTING AND TIME MANAGEMENT
Exhibited behaviors:
Written work lacks flow and organization
Difficulties breaking down larger assignments into small units
Planning and Strategizing
Classroom work reflects a lack of consistent planning and appears student is “winging it”. Kaufman, 2010
The ability to create a blueprint to achieve goals or in completing a task Dawson and Guare, 2012
BACKWARD PLANNING
Sequencing
Exhibited behaviors:
The ability to put information in a logical and familiar order.
Dawson and Guare, 2012
Difficulties with details and sequence of assignments
Overwhelmed by task demands that require sequencing
Difficulties with reading comprehension
Difficulties solving math problems that require sequencing Kaufman, 2010
Work System [Mini-schedule]
My Checklist
1st 2nd 3rd 4th 5th 6th 7th
Organization
The ability to maintain and create systems to keep track of information or materials. Dawson and Guare, 2012
Check when done
Exhibited behaviors: Difficulties with developing outlines or completing graphic organizers Folders, backpacks and lockers are messy Written work lacks organization Kaufman, 2010
ORGANIZING BINDERS
Using graphic organizers
Analogy Organizer
Time Management
The ability to estimate how much time one has, how to allocate it, and how to stay within time limits Sense of time is also imperative with time management.
Exhibited behaviors:
Requires more time to complete tasks than peers Is unable to gauge the amount of time to complete tasks
Is often surprised by due dates
Kaufman, 2010
Task Initiation
The ability to begin tasks without procrastination in a timely manner.
Exhibited behaviors: Difficulties starting task
Student may be sitting there while other students are working
If provided assistance with starting tasks, the tasks can be completed successfully.
Kaufman, 2010
Executive Attention
A self directed control and maintenance of attention
Dawson and Guare, 2012
Exhibited behaviors: Easily distracted by external or internal stimuli
Requires reminders to stay on task
Difficulties sustaining attention
Tendency to make careless errors
Kaufman, 2010
TEACHING EXECUTIVE ATTENTION
Positive Behavior Support
Task Persistence
The ability to keep at a task or goal till it is completed.
Dawson and Guare, 2012
Exhibited behaviors:
Starts task but is unable to keep working at it
Needs frequent teacher cues to keep working
May stop working if individualized help is not immediately available
Appears to fatigue quickly during academic activities
Kaufman, 2010
Working Memory
Exhibited behaviors: Unable to perform multiple step directions
The ability to hold information in memory while performing complex tasks.
Dawson and Guare, 2012
Forgets what he is about to say after talking
Forgets details of what is read, during or shortly after being read
Can answer factual/ explicit questions but has difficulty with details, making predictions, or drawing inferences
Kaufman, 2010
The ability to move between tasks
Dawson and Guare, 2012
Exhibited behaviors: Becomes frustrated over changes in routines or schedules
Tends to get stuck on steps of assignments
Has difficulty stopping one task to start another task
Kaufman, 2010
Transition Markers
Time to check your schedule
EMOTIONAL REGULATION
“Ability to respond to the ongoing demands of experiences with the range of emotions in a manner that is socially tolerable and sufficiently flexible to permit spontaneous reaction as well as the ability to delay spontaneous reactions as n ee de d.” (Cole, Michael, and Teti, 1994)
Working Memory
Inhibitory control
Mental Flexibility
WHY SELF REGULATION IS SO IMPORTANT
The Secret of School Success:
…”one of several findings in the growing body of research on self-regulation..people’s ability to stop, think, make a plan and control their impulses..it turns out that “these are really the same skills you need to do well in school and potentially in life.”
Professor Megan McClelland
Oregan State University
SELF REGULATION
• The ability to detect how you are feeling
• Match emotions to events
• Change level of behavior and emotion to match environment and cultural expectations
IT
MIGHT BE A SELF REGULATION PROBLEM IF…
• You think “she is just being stubborn…”
• You really feel you need to watch your every word.
• You think, ‘Here we go again..”
• You have to stop yourself from raising your voice.
• You are tempted to say, “Calm down, calm down” when you don’t know what else to do..
Never in the history of calming down has anyone ever calmed down by telling them to calm down..
MeMoves-first patented system for self-regulation
Stephen Porges’ polyvagal theory, one of the most celebrated new developments in neurobiology.
MeMoves’ faces with eye contact and expressive features of emotion, music supporting the same frequency as the female voice, and simple gestures perfectly align with the positive social engagement elements identified by Porges.
When to do MeMoves: Before a test Before stressful event
First period in the morning
Prior to quiet, indoor activity
Sensory Regulation Strategies
Working Memory Inhibitory control
Emotional Control
The ability to manage emotions to achieve goals, complete tasks, to control and direct behavior.
Dawson and Guare, 2012
Exhibited behaviors: Becomes frustrated in situations where peers would not Has a low frustration tolerance
Easily angered by behaviors of others May be overwhelmed by positive or negative emotions
Kaufman, 2010
Buckle your Seatbelt! Keep it Buckled
Large Group Structure
Structure at Home: Schedule
Posi0ve Behavior Flip Book: “Wait” at restaurants!
Friendships
Response Inhibition
The ability to think before acting; to resist the urge to say or do something that may not be a good choice.
Exhibited behaviors: Blurts out answers
Often says or does things that he or she regrets Often acts as if he is unencumbered by the thought process
Often has difficulty explaining why he or she does things Kaufman, 2010
Cartooning
Helpful for the visually oriented student to facilitate understanding of social situations and anticipated behaviors, as well as the thoughts of other people in a given situation.
Thought and speech bubbles, enable the individual with autism to get a sense of social interactions and the hidden rules that govern behaviors (Kerr & Durkin, 2004)
Comic Strip ConversationsTM, developed by Gray (1994).
By illustrating conversation through simple drawings, the strategy helps the student to identify “what other people say and do” and emphasizes “what other people may be thinking.”
Lighthall & Schetter
Laminated marker boards, paper, or chalkboards
Comic Strip ConversationsTM, developed by Gray (1994). By illustrating conversation through simple drawings, the strategy helps the student to identify “what other people say and do” and emphasizes “what other people may be thinking.”
Emotional Control
The ability to manage emotions to achieve goals, complete tasks, to control and direct behavior.
Dawson and Guare, 2012
Exhibited behaviors: Becomes frustrated in situations where peers would not Has a low frustration tolerance
Easily angered by behaviors of others May be overwhelmed by positive or negative emotions
Kaufman, 2010
I process information at a slower pace than average.
My brain is like a dial-up modem vs. a cable modem.
If I don’t remove myself from the situation, I go into sensory overload.
To someone watching, I appear to cop an attitude or fly into a rage.
When I’m in overload, I’m in fight or flight response.
Acting angry is a defense mechanism. It’s like my mind thinks it can “scare off” the source of my
Once I’m in full overload, there is nothing I can do but ride the meltdown until I’ve expelled all of my emotional energy.
I
just kinda lose my head and explode and then I’m fine.
LET’S HAVE A SNOWBALL FIGHT!
Keymakers
Some people see a closed door, and turn away.
Others see a closed door, try the knob if it doesn’t open . . . they turn away. Still others see a closed door, try the knob, If it doesn’t open, they find a key, if the key doesn’t fit . . . they turn away.
A rare few see a closed door, try the knob, if it doesn’t open, they find a key, if the key doesn’t fit . . . they make one.
