CONSULTATION
Consultation on the Neurodevelopmental Skills and Demands (NDSD) model typically begins with a short conversation regarding your current unsolved problems. An initial face-to-face meeting follows and an individualized consultation strategy is developed and articulated. This can include a site visit, wherein your program, center or school can be reviewed through the NDLens. Recommendations will then be provided to assist in the development and refinement of the NDSD model. The principles for classrooms and schools/agencies are articulated as follows:
Neurodevelopmental Skills and Demands Programming
The Basic Concepts
1. Identify the population to be served
2. Review the literature regarding potential lagging skill deficits and demands that may overwhelm those skills
3. Refine the lagging skills inventory
4. Refine the demands inventory
5. Complete aggregate skills and demands inventories
6. Identify program goals and objectives
7. Operationally define the scope and sequence of the demands to be met in order to achieve the program goals and objectives
8. Identify the aggregate incompatibilities between the skills and demands
9. Develop program structures, routines, schedules, etc., to decrease the incompatibilities between aggregate skills and demands
10. Determine strategies regarding implementation of environmental structures, embedded skills training and direct skills training in the day-to-day programming
Neurodevelopmental Skills and Demand Programming:
9 steps toward an NDSD classroom
1. We start with the Collaborative Problem Solving (CPS) mantra, “Kids do well if they can,” and are extremely focused on the pristine development of an individual student’s neurodevelopmental skill package and the demands that overwhelm those skills.
2. Often, skills from the CPS Thinking Skills Inventory “overshoots” our students, so we assess foundational neurodevelopmental skills. We have found that we often generate skills-demands incompatibility (hence dys-regulation and challenging behavior) with these “overshoots”. By focusing on accurately describing a student’s neurodevelopmental skills we help them re-stabilize and get back on the skill-developmental track. This neurodevelopmental skills assessment strategy is also sensitive to the skill deficits often observed with students who have a history of Adverse Childhood Experiences (high “ACEs”).
3. Since we are working with students in a group setting, we also conduct an aggregate neurodevelopmental skills assessment for the students within (a) the class, (b) an activity and (c) the program at large.
4. Based on the aggregate neurodevelopmental skills assessment, we construct the classroom ecology to minimize the incompatibility of student skills and classroom demands. This analysis is conducted meticulously and continuously.
5. Our routines and rituals, consistent adult responses, care-giver affect management strategies and attunement skills are based on this analysis. We know we have hit the mark with skills-demands compatibility when we have challenging behaviors at a level that allows students to feel safe and optimally utilize their thinking skills. This thinking template is highlighted in the book Treating Traumatic Stress in Children and Adolescents by Margaret E. Blaustein and Kristine M. Kinniburgh (2010). The thinking template is consistent with Bruce Perry M.D., Ph.D.’s Neuro-Sequential Model of Therapeutics/Education Models (NMT/NME), which emphasizes patterned, repetitive, rhythmic routines in a relationally safe environment. These strategies are further enhanced via principles from Interpersonal Neurobiology, articulated by Daniel Siegel, M.D., and colleagues.
6. We utilize strategies to embed skills instruction in the daily routine based on the Traumatic Brain Injury literature (e.g., Mark Yvilsaker), Executive Skill literature (e.g., Dawson & Guare) and the “Pre-executive” skills described by Russell Barkley).
7. With respect to direct instruction, several strategies have been utilized to assist students in developing “foundational” skills. For example, Michelle Garcia Winners’, Social Thinking curricula, have been adapted for use with our students. Her colleague, Leah Kuypers developed The Zones of Regulation program that has also been utilized in programming for our dys-regulated students.
8. Patterned, repetitive regulating activities are interspersed throughout the school day. With these group and individually tailored activities, consistent with the NMT/NME models, we are striving for “top down” regulation; however, we use “bottom up” regulation strategies to help students with “cortical modulation” when needed.
9. After implementing these strategies, most students consistently meet adult expectations and develop numerous “foundation” skills. The direct and embedded skills training processes allows for sufficient “repetition” to support change. This approach reduces the likelihood of utilizing Emergency Plan B and allows us to focus on Proactive Plan B, used with individual students, and at times with a class or small group of students. In addition, these strategies help us establish an interpersonal template with our “high ACES” students, allowing them to more readily accept a Plan B Invitation without becoming hyper-aroused or dissociated.