Neuropsychology of Social, Emotional, and Behavioral Challenges Margaret A. Sedor, NCSP ABSNP, LEP 2015 WSPA Spring Convention March 26, 2015 WHAT’S UP? Mendes, E. (2003). Empty the Cup…Before you Fill It up: Relationship-Building Activities to Promote Effective Learning Environments. Mendes Training & Consulting, Inc., Carlsbad, CA. Learning Objectives • Understand the brain structure and implications for academic and social development. • Learn of the interplay between genetics and environmental factors for social emotional literacy. • Review the psychiatric medications most commonly used for youth. • Learn prevention strategies within a positive school climate framework. • Discover a range of neuroscience based interventions. Acronyms Aren’t Just for Special Ed. Anymore UDL The Violence Continuum adapted from the National School Safety Center Murder Suicide Rape Hostages Gangs Hate Crimes Weapons Fights Vandalism Threats Sexual Harassment Verbal Harassment Trash Talk Insults Put Downs Brock & Reeves, 2013 Our Students and MENTAL HEALTH • The Surgeon General’s report on mental health 20% of children need active mental health interventions, 11% have significant impairment, and 5% have extreme functional impairment. • School de facto mental health system for children in this country. • Schools are critical in the provision of the breadth of mental and behavioral health services. • Schools can reduce barriers to access for children and families, such as stigma and affordability. • Schools provide maximal coverage for universal prevention and early intervention programs. (Kutash, et. al. 2006) Prevalence of Child and Adolescent Mental Disorders • • • • 50% of Lifetime cases of Mental Disorders Begin by Age 14 20% of Children Identified with Mental Disorders Receive Treatment 50% of Students 14 and Older Living with Mental Illness Drop out of school 21% of 9-17 Year Olds Have a Diagnosable Mental or Addictive Disorder (U.S. Surgeon General Report 2000) Psychological Distress • Going through a rough time • Starting to show signs of mental disorders • 21% of 9 to 17 year olds have a mental disorder causing at least mild functional impairment. • 5-9% estimated to have severe impairment. Adverse Childhood Experience Study • Center for Disease Control & Kaiser Hospital • 17,000 Patients participated between 1995-1997 • Measured 10 childhood traumas • Key findings are that adverse childhood experiences: o Vastly more common than recognized or acknowledged o 3-6 time higher rate of academic failure, chronic truancy, behavior problems, poor health o Powerful relation to adult health a half-century later. ACE Study “Secondary prevention of the effects of adverse childhood experiences will first require increased recognition of their occurrence and second, an effective understanding of the behavioral coping devices that commonly are adopted to reduce the emotional impact of these experiences.” Kaiser ACE Study (1997) http://www.cdc.gov/violenceprevention/acestudy/ Essentials for Childhood Framework http://www.cdc.gov/violenceprevention/pdf/efc-building-community-commitment.pdf.pdf Framework for Safe & Successful Schools • • • • • • • • • • • Supportive school environment Evidence-based Coordinated/comprehensive Engagement/Evaluation Consistency/Sustainability Families/Community involvement Access to School Psychologists School Safety Team Staff Training Positive Discipline Policies Assess School Climate Nasp, 2013 12 What MTSS is not… From To Adapted from Dan Reschly, 2002 MTSS Defined MTSS is a coherent continuum of evidence based, system-wide practices to support a rapid response to student needs, with frequent data-based monitoring to inform decision- making and Empower each student to achieve their potential. What does MTSS Look Like? Universal Prevention All Students • • • • • • • • • Core Instruction Preventive Proactive Common Rules & Expectations Common Referral System Common Core First Instruction Life Skills Career Readiness 1-5% 7-15% 80% Intensive Intervention Few Students • Individualized • Function-based • High intensity • Direct Skills Development Targeted Intervention Some Students • Supplemental (reduce risk) • High Efficiency • Rapid Response All students in school MTSS for Student Wellness School ~District ~ Community Prevention Social Emotional Wellness Suicide Prevention Behavioral Regulation Positive Discipline School Engagement Attendance Tier I: Universal Interventions All Students Eliminating Barriers to Learning Kognito NAMI on Campus Teaching Resilience Universal Design for Learning Empty the Cup… Before You Fill It Up Engage 4 Learning Brain Rules MindUP Brainology & Mindset Positive Environments, Network of Trainers http://www.pent.ca.gov/ Effect Size o o o o o Magnitude of the effect of a particular intervention Positive values= GOOD results Negative values= BAD results Effect sizes > 0.50 considered large Changes in behavior and performance are noticeable by the lay person Browning Wright, 2014 Treatments that DON’T Work Treatment/Intervention o Meeting with student o Punitive discipline o Alternative placement o Special education *Effect sizes > 0.50 considered large Effect Size .00 -.13 to +.06 -.10 to +.04 -.03 Browning Wright, 2014 Popular Treatments that DO Work Treatment/Interventions o o o o o o Positive Behavioral Supports Social skills Training Group-Based Contingency Token Economy Social Emotional Learning Formative Evaluation + Graphing + Reinforcement o Mentor-based Program (CICO) Effect Size +.90 +.68 +.81 +.60 +1.00 +1.20 +1.00 *Effect sizes > 0.50 considered large Browning Wright, 2014 Behavior Management • Stimulus –Response Seek-Avoid • Challenging behavior stems from lack of incentive to behave properly • Promotes specific task performance • Practical for managing classroom behavior K-12 • Overreliance on reinforces • Conditions self-centeredness (What’s in it for me?) • Rarely generalizable • Can be harmful with some emotional conditions, not stemming from reinforcement Feifer, 2012 Paradigm Shift Behavior Management is Effective to MANAGE behavior….. We need to move beyond manage and TREAT behavior Feifer, 2012 Temperamental Sensitivity • 1 of 5 children born with temperamental sensitivity. • Difficulty self-soothing & regulating physiological arousal. • Low frustration tolerance • Longer time to recover, need time to cope and implement skills. Browning Wright 2013 Hi-Lo’s • Changes learner states • Provides for venting • Builds connections with classmates Mendes, E. (2003). Empty the Cup…Before you Fill It up: Relationship-Building Activities to Promote Effective Learning Environments. Mendes Training & Consulting, Inc., Carlsbad, CA. What is Neuropsychology? The study of brain-behavioral relationships with respect to learning and behavior. Amazing Facts About Your Brain • Two Rapid Growth Spurts o Before birth to age 3 o Age 11 to Age 12 • Sleep and Freeze • Powering your Brain • Neurons at Work MindUP Curriculum: Grades 6-8. The Hawn Foundation, Scholastic Teaching Resources. Networks of Learning • Recognition Network: The WHAT of Learning Multiple Means of Representation • Strategic Network: The HOW of Learning Multiple Means of action and experience • Affective Network: The WHY of Learning Multiple Means of engagement www.udlcenter.org Universal Design for Learning udlcenter.org Brain Structure • The brain has three main parts: 1. Cerebrum 2. Cerebellum 3. Brain Stem • The brain is divided into regions that control specific functions. How the Brain Works Balance, Respiratory Cerebrum • • • • • • • Frontal Lobe Parietal Lobe Occipital Lobe Temporal Lobe Right Hemisphere Left Hemisphere Corpus Callosum Cerebrum ~ Frontal lobe • Behavior • Abstract thought processes • Problem solving • Attention • Creative thought • Some emotion • Intellect • Reflection • Judgment • Initiative • Inhibition • Coordination of movements • Generalized and mass movements • Some eye movements • Sense of smell • Muscle movements • Skilled movements • Some motor skills • Physical reaction • Libido (sexual urges) Cerebrum ~ Parietal Lobe • • • • • • Sense of touch (tactile sensation) Appreciation of form through touch (stereognosis) Response to internal stimuli (proprioception) Sensory combination and comprehension Some language and reading functions Some visual functions Cerebrum ~ Occipital Lobe • Visual • Reading Cerebrum ~ Temporal Lobe • • • • • • • • • • • Auditory memories Some hearing Visual memories Some vision pathways Other memory Music Fear Some language Some speech Some behavior& emotions Sense of identity Brain Structure & Function • Right Hemisphere-representational hemisphere controls the left side of the body Temporal and spatial relationships Analyzing nonverbal information Communicating emotion • Left Hemisphere-categorical hemisphere controls the right side of the body Produce and understand language • Corpus Callosum Super highway- bridge of communication between the left and right side of the brain Brain Structure & Function THE CEREBELLUM Lower part of the back of the brain Balance Posture Cardiac, respiratory, & vasomotor centers THE BRAIN STEM Lowest part of the brain Consists of midbrain Motor and sensory pathway to body and face Vital centers: cardiac, respiratory, vasomotor Subconscious control mechanisms: anger, fear, thirst, love, hate…. Success Focus Mendes, E. (2003). Empty the Cup…Before you Fill It up: Relationship-Building Activities to Promote Effective Learning Environments. Mendes Training & Consulting, Inc., Carlsbad, CA. BRAIN STRUCTURE & EMOTIONAL FUNCTION Self Regulation Types o Behavioral Self-Regulation poor inhibition of impulses and motor control o Emotional Self-Regulation an inability to regulate moods & reactions to social situations. o Attention Self-Regulation an inability to modulate and sustain attention. Feifer, 2012 Neurobiological Architecture of Emotions • Presumes that a child’s ability to adapt to the social demands of their environment begins with the functional organization of the brain. • Observable behavior is a striving for homeostasis and balance occurring in the brain. • Treatment for behavioral and emotional disorders should focus on both intrinsic & extrinsic factors. • Trigger may be internal. Feifer, 2012 The Cerebral Orchestra of Emotions: Subcortical Region 1. 2. 3. 4. 5. 6. Amygdala Hippocampus Nucleus Accumbens Orbitofrontal Cortex Ventrolateral prefrontal cortex Anterior Cingulate Cortex Feifer, 2012 The Stressed Brain ~ Amygdala • Brain’s response to stress; linked to Amygdala • Information filter regulated by our emotional state • Fight-Flight-Freeze stress hormones atrophy area that controls emotional development. The MindUp Curriculum, The Hawn Foundation, Scholastic Teaching Resources Happy Brain • Work better • Flushed with Dopamine • Dopamine highest when students are fully engaged with their learning & filled with positive feelings (optimism, hope, gratitude). • Released when indulging in high-risk activities (drug use, drive fast, promiscuity). The MindUp Curriculum, The Hawn Foundation, Scholastic Teaching Resources The Mindful Brain Awareness of impulses, thoughts, feelings, and behavior which enhances confidence, pleasure, and sense of agency in own learning process. The MindUp Curriculum, The Hawn Foundation, Scholastic Teaching Resources Subcortical Region ~ Amygdala • Responds to unexpected and unfamiliar events (Kagan, 2007). • Ascribes emotional valence to stimuli. • Primarily responsible for fear conditioning by providing a rapid, precognitive assessment of the situation. • Serotonin can calm. • SSRIs ~ Prozac, Zoloft, Paxil, Luvox, Celexa, Lexapro Feifer, 2012 Subcortical Region ~ Hippocampus Located in the medial temporal lobe and responsible for facilitating memory functioning. This structure also involved with o Emotional learning o Chronic stress from abuse or neglect o Hypervigilant hippocampus Feifer, 2012 Subcortical Region ~ Nucleus Accumbens • Located in the forebrain and part of the basal ganglia. o Reward center of brain which is activated in anticipation of reward. o Most recreational drugs including cocaine and amphetamines increase dopamine in this area. o Involved in task motivation and rewards. o Under-activity of reward center of our brain associated with anhedonia (inability to feel pleasure) and depression. Feifer, 2012 Cortical Region ~ Orbitofrontal Cortex • Region of the brain responsible for ascribing an emotional valence or value judgment to another’s feelings. Often triggers an automatic social skill response (Rolls, 2004). o Has rich interconnections with the limbic system. o Responsible for emotional executive functioning. o Self-Regulation of behavior as highest levels of emotional decision making dictated by this brain region. o Medications and cognitive behavior therapy needed; learn to deal with physical/emotional situation; adaptive response. Feifer, 2012 Cortical Region ~ Ventrolateral Prefrontal Cortex • Ventro (bottom) / Lateral (side) • Behind frontal orbital cortex • Responsible for response inhibition and emotional regulation. o o o o Rich interconnections with the limbic system. Also involved with emotional executive functioning. Situated adjacent to the oritofrontal cortex Involved in the ability to take another’s perspective on an emotional event (theory of mind). o Example: rapid Zero to 100, can’t self soothe/calm. Student has issues with self regulation, interrupts teacher, no impulse control, no ability to inhibit. Feifer, 2012 Cortical Region ~ Anterior Cingulate Cortex • Front part of cingulate cortex • Task motivation and reward based decision making. Severe damage leads to akinetic mutism. o Selective attention allows us to shift our focus from the outside world of objects and events toward the inside world of thoughts and ideas (self awareness). o Helps provide constraint over behavior o The brain gear shifter between cognition and emotion. When stuck, can result in obsessive and ritualistic types of behaviors, as well as cognitive inflexibility (Swingle, 2007). o Key brain region in developing “theory of mind” Feifer, 2012 MENTAL HEALTH & WELLNESS Disruptive Mood Dysregulation Disorders • Mainly stems from over-arousal in lower brain regions (limbic region) coupled with under-aroused higher brain regions (prefrontal cortex) leading to poor emotional selfregulation skills. • Behaviorally, top-down cognitive control occurs between 36 years of age and continues through adulthood. • Language is a necessary, but not sufficient condition younger children to regulate emotion. • Children with emotional regulation disorders often have authoritarian parents. • Security of attachment at 24 months and ability to delay gratification often key predictors of emotional stability by the time a child has reached school age. Feifer, 2012 Bipolar Disorder ~ 4 Brain Regions Involved Amygdala smaller amygdala size is a consistent finding. Plays role in the perception of threatening information, the appraisal of social signals that convey a threat, and the acquisition of fear condition responses. Responds to unexpected or unfamiliar events. Hippocampus smaller volume is evident in depression, and prolonged periods of emotional stress. ** The hippocampus and amygdala are interdependent emotional memory systems. Feifer, 2012 Bipolar Disorder ~ Brain Region Cingulate Gyrus The anterior portion of the cingulate gyrus provides constraint over emotion and cognition, and is also involved in task motivation and effortful control. Smaller in volume for individual diagnosed with bipolar disorder, the left anterior cingulate. Basal Ganglia Individuals diagnosed with bipolar disorder have an enlarged right nucleus accumbens, an area housed within the basal ganglia. It has rich interconnections with the limbic system, and plays a central role in the reward circuit of the brain and manic behavior. Feifer, 2012 Bipolar Disorder ~ Treatments Lithium First mood-stabilizer medication with FDA approval for treatment of mania, very effective in manic and depressive episodes. Side effects include acne, hair loss, and weight gain. Anticonvulsant medications Such as depakote, Tegretol, can have a mood stabilizing effect and maybe be especially useful for difficult to treat bipolar episodes. Newer meds: Lamictal, Neurontin, Topamax. Interacts with GABA to inhibit neural firing. Feifer, 2012 Bipolar Disorder ~ Treatments Atypical antipsychotics Abilify, Risperdal, Clozapine, and Seroquel. Functions to enhance dopamine in mesocortical regions. Antidepressants (SSRIs) Zoloft and Prozac. Functions to enhance serotonin, though can increase mania. Feifer, 2012 Theories of Depression Biological Depletion of the monoamine neurotransmitters including dopamine, serotonin, and norepinephrine. Neuropsychological Under activity in the prefrontal cortex, particularly in the motivation regions of the brain (anterior cingulate gyrus) and positive reward centers of the brain (nucleus accumbens). Feifer, 2012 Generalized Anxiety Disorders • Elevated amygdala activity • Anterior cingulate cortex primarily functions as the brain’s gear shifter • Children may be too fixated at monitoring their own internal states. Social Anxiety Disorders • Two Fear Systems: o Initial flash of fear, primarily reflective. Amygdala brain region for responsible to process & generate behavioral response. o Second fear functions to keep first fear alive, at cerebral level, automatic negative thoughts (ANTS). Social Anxiety Disorders ~ Interventions • Cognitive Behavior Therapy (CBT) involving: o Psychoeducation o Exposure Therapy o Skill Building Tasks o Homework Assignments • Treatment of Choice Anxiety Disorders ~ Treatments • SSRIs for disorders occurring outside of conscious control. • Shortage of serotonin: o Anxiety o Panic o Phobias o PTSD o Obsessions o Compulsions o Eating Disorders Anxiety Disorders ~ Treatments • Exposure Therapy quiets overactive amygdala • Strong interpersonal attachments to caregivers increases resiliency to stress. • Cognitive Behavior Therapy • Structured class settings • Neurofeedback aimed to diminish arousal Neurofeedback • A learning paradigm which helps develop control over the brain functions regulated autonomously. • Provides excellent way to treat the underlying causes of emotional dysregulation from an inside-to-outside manner. • Student learns to self-regulate their own brain functioning, increased “availability for therapy & behavioral interventions. • Allows brain to re-set itself in an optimal emotional state. Feifer, 2012 Depression • Twice as likely in women, 3 times higher in families with positive history, highest for unmarried males and married females. • Not common for younger children, more common in adolescence (5%), implicates prefrontal cortex. • 35-50% depressed make suicide attempt. • 15% severely depressed complete suicide. • Prozac (SSRI) is only FDA approved antidepressant for children over age 8. • 4% of children on Prozac have suicidal ideation, twice that of placebo. Depression ~ Treatments • • • • • Cognitive Behavioral Therapy Play Therapy Neurofeedback Psychopharmacological approaches (SSRIs) Increased number of interpersonal connections Depression ~ Treatments Psychodynamic A sense of loss, either by death of loved one, or rejection of loved one, where self-loathing emerges due to an overwhelming sense of being responsible for the loss. Cognitive Behavioral Failure and hopelessness becomes an accepted way of life. Depression ~ Treatments Neurofeedback Techniques aimed at diminishing the amplitude of theta (slow) waves in the cortex area. Psychopharmacological approaches (SSRIs) Increasing the number of interpersonal connections in a child’s life. Common Medications • • • • • • • • • • • • Stimulants Non Stimulant Anti-hypertensives Antidepressants SSRIs Atypical MAOs Antipsychotics Mood Stabilizers Anxiety-Breaking Benzodiazepines Atypical Vyvanse, Dexedrine, Ritalin, Concerta, Adderall Strattera Tenex, Intuniv, Propranolol, Clonidine Imipramine, Norpramin, Nortiptyline, Elavil (rare w/Kids) Fluoxetine, Prozac, Zoloft, Paxil, Lexapro, Celexa, Luvox Wellbutrin, Effexor, Cymbalta, Remeron, Trazadone Nardil, Parnate Risperdal, Zyprexa, Seroquel, Abilify, Geodon Lithium, Tegretol, Trileptal, Neurontin, Lamictal, Topamax Benadryl, Vistaril, Atarax Klonopin, Xanax, Halcion, Ativan, Serax, Valium Buspar, Ambien, Sonata Common Medications Treatments Medications • • • • • • • • • • • • Stimulants Non Stimulant Anti-hypertensives Antidepressants SSRIs Atypical MAOs Antipsychotics Mood Stabilizers Anxiety-Breaking Benzodiazepines Atypical • • • • ADHD ADHD ADHD, Tourette’s, Sleep, Autism ADHD, OCD, Anxiety, Tics, Enuresis • • • • • Depression, Anxiety, panic disorder, ADHD Mood lability, severe aggression, schizophrenia Mood lability, bi-polar disorder, self-injury Anxiety, panic disorder-worry, nervousness Sedative & Symptoms of alcohol withdrawal Synapse • “right place” between neurons • “right time” when neuron wants to activate or inhibit it’s neighbor neuron Receptor site • Lock n Key concept • Each type of neurotransmitter will react with one specific type of receptor site & no other • Neurotransmitters: Component in the nerve cell that makes chemicals. (40 different chemicals act as neurotransmitters). • Presynaptic neuron: Makes the neurotransmitters (chemicals) and secretes/dumps them into the right place at the right time. Common Neurotransmitters Serotonin • Function usually inhibitory, helps control moods, influences sleep & inhibits pain pathways in the spinal cord. • Disorder such as depression, headache, diarrhea, constipation, sexual dysfunction. • Medications used-SSRI (Selective Serotonin reuptake inhibitors), most common are antidepressants, work specifically on the neurotransmitter system Common Neurotransmitters Dopamine • Function usually inhibitory, basal ganglia in the subcortical area of the brain • Disorder in the dopamine system-psychotic disorders, meds work on dopamine receptors • Medications used-antipsychotic and antidepressants Common Neurotransmitters Norepinephrine • Function usually excitatory, some inhibitory, in subcortical area, controlling wakefulness, overall activity & mood. • Disorder such as depression; autonomic nervous system • Medications used-anti-depressants which work on the neurotransmitters and receptor sites NEUROBASED INTERVENTIONS The Learning Brain http://www.youtube.com/attribution_link?a=gV_9NGQhcB4&u=/watch%3Fv%3DcgLYkV689s4%26feature%3Dem -share_video_user Universal Design For Learning “I don’t know” The left prefrontal cortex appears to be the brake center for impulses, and the neurons are not fully myelinated (developed) until late adolescence or early adulthood. Key Concepts • Adolescent brain still developing, environment shaping • Prefrontal Cortex most growth during adolescent • Gray matter declines in adolescents in prefrontal cortex, connected to synaptic pruning Used= strengthen Not used= eliminated/fine tunes • Limbic System- emotions, “kick” of risk taking. • Issues are developmental, careful with stigmatizing. Blakemore, TED.com PREVENTION ~ POSITIVE SCHOOL CLIMATE FRAMEWORK Academic Success…. Mental Health Matters Congressional Briefing: 1st Anniversary Sandy Hook Elementary Take Away Messages Nelba Marquez-Greene Founder Sandy Hook Promise Lost a child at Sandy Hook Elementary NASP, 2014 • Preventative measures • Identifying warning signs • Access to Mental Health Services • Overcoming Stigma • Teach the new R ~ Resilience Nationwide Discipline Initiative • Council of State Governments Justice Center & Public Policy Research Institute of Texas A & M University • School to Prison Pipeline • Zero Tolerance Discipline Policies • Disproportionality African American Males • Promotion of positive school climate • Nation-wide research initiative • David Osher Fable, T., Thompson, M. D., Plotkin, M., Carmichael, D., Marchbanks, M. P. III, and Booth E. A. (2011). Breaking schools’ rules: A statewide study of how school discipline relates to students’ success and juvenile justice involvement.New York , NY; College Station, TX: Council of State Governments Justice Center; Public Policy Research Institute of Texas A&M University. http://justicecenter.csg.org/files/Breaking_Schools_Rules_Report_Final.pdf A Paradigm Shift Traditional Discipline Goal: • Stop undesirable behavior through punishment Focus: • The student is the problem Conceptual Framework: Retributive • Misbehavior should be punished • Removal of offender, exclusive • Reactive approach School-Wide PBIS Goal: • Replace problem behavior with appropriate behavior • Adapt the System Focus: • Prevention and Intervention Conceptual Framework: Restorative • Reparative • Inclusive • Pro-active approach 92 Foundation of Learning Self regulated state of balance in the nervous system required for Learning and adaptive behavior Dr. Regalena Melrose • We ALL display problematic behavior in response to this unnatural pressure. • Often misunderstood symptoms of disorders. • Need to understand cumulative effect of stress/trauma on nervous system over time. Dr. Regalena Melrose Interventions that DO NOT work • • • • • • • Anger management Reasoning/talking Power Struggle Time-out Loss of points/privileges Punching a pillow Isolation Dr. Regalena Melrose Interventions that DO work: Social Emotional Literacy • • • • • • • A relatively quiet safe place Compassionate containment Community and belonging Earning/keeping rewards Time-away “take a break” Few words Chances to start over/repair Dr. Regalena Melrose What Works cont.…. • • • • Positive acknowledgment Success and competency Building resources (external, internal) Positive communication with parents Dr. Regalena Melrose Positive Encouragement Why School-wide Framework? For Common Core State Standards to fulfill their potential, schools need strong teachers focused on the whole child, aligned with a unified and comprehensive system for addressing barriers to learning and teaching and re-engaging disconnected students. Adelman & Taylor, 2013 99 Facts about Social & Emotional Issues • Social, emotional, and behavior issues interfere with learning • Boys engage in higher rates of social & emotional issues than females (4:1) • Certain students have a genetic predisposition to social, emotional, and behavioral problems but, many must be turned on by environmental factors (60% genetic/40% environment) Diana Browning Wright 2013 Neuroscience of Optimal functioning of brain and body • • • • • Decrease heart rate, blood pressure, stress hormone levels (cortisol) Sleep Nature Play Nutrition Water Dr. Regalena Melrose Creating Necessary Conditions Physical Space • • • • • • • Order & organization Color Coding & Schedule Limits & boundaries A relatively quiet space A safe place in the room “time-away” Pictures of Nature Sensory Materials Dr. Regalena Melrose MTSS and Brain Changes • Neural plasticity brain can change structurally and functionally as a result of input from environmental interventions. • School-based supports can alter the way students’ brains are structured and function. Browning Wright 2013 Mirror Neurons • Neurons which fire when another person acts; thus the neuron “mirrors” the behavior of the other (smile, yawn). • Implications: o Students learn via modeling from educators/peers o Student will treat us how we treat them o Work on ourselves first before working with students o Those who smile more often live 7 years longer Browning Wright 2013 Myelination • Myelin Sheath an electrical layer that forms around a neuron that helps it fire faster and more smoothly (rubber coating around neuron). • Practicing a skill leads to myelination or the development of fluent/automatic firing autopilot less cognitive effort needed to perform skill when called upon. Kognito At-Risk simulation http://california.kognito.com/ HELPGUIDE.ORG http://www.helpguide.org/articles/depression/teen-depression-signs-help.htm National Suicide Prevention Lifeline http://www.suicidepreventionlifeline.org/ Suicide Prevention Resource Center http://www.sprc.org/featured_resources/customized/teachers.asp NAMI on Campus High School (NCHS) • NCHS Clubs on campuses with TETRIS/EBL trained staff or staff with Mental Health Background • Advisors are school staff members with an interest in helping change the campus climate towards mental health and wellness • NAMI California offers monthly Coaching Webinars for Advisors and a staff person to provide support and technical assistance • Building a framework in the district, the school, the staff and the students to support mental health and wellness Family and youth voice What NAMI California Affiliates Bring to EBL Trainings: • Connect schools to local community partners (NAMI) • Overview of Ending the Silence, a mental health education and stigma-reduction program for students • Information on how to bring ETS to their school • Direct contact through youth voice • Lived Experience • Provide information about resources for schools and families NAMI on Campus High School (NCHS) • Peer clubs led by an Advisor that bring mental health awareness to campus • Clubs open to all students, regardless of mental health status • Clubs promote mental health activities on campus • Strive to create a safe and stigma and discrimination-free environment on campus • Creates life-long mental health advocates Mental Health First Aid • 8-hour course that teaches you how to help someone who is developing a mental health problem or experiencing a mental health crisis • Helps you identify, understand, and respond to signs of mental illnesses and substance use disorders A ssess for risk of suicide or harm L isten nonjudgmentally G ive reassurance and information E ncourage appropriate professional help E ncourage self-help and other support strategies Reconnecting Youth 75 lessons in the RY curriculum. It is typically offered as a semesterlong, for-credit class by a teacher/facilitator RY program goals: • Increased school performance • Decreased drug involvement • Decreased emotional distress Activities Focus On • Self-esteem Enhancement • Decision Making • Personal Control • Interpersonal Communication Applied Suicide Intervention Skills Training ~ ASIST Applied Suicide Intervention Skills Training ASIST • For caregivers who want to feel more comfortable, confident and competent in helping to prevent the immediate risk of suicide • Two-day, highly interactive and practice-oriented workshop • Develop skills Learn how to communicate with a suicidal individual Recognize and review risk Intervene to prevent the immediate risk of suicide Understand resources available Dr. Regina Melrose Activity: 60 Seconds 1. 2. 3. 4. 5. 6. Feel your feet on the ground. Take in the support of the chair. Breathe in through your nose. Visualize yourself in a safe, beautiful place. Notice what is happening inside your body. Focus only on the pleasant, comfortable sensations that arise. 7. If thoughts or unpleasant sensations enter into your awareness, simply go back to the beginning of the exercise and do the steps again, as many times as need be. Dr. Regalena Melrose Empty the Cup ~ Dr. Ernie Mendes Create mental & emotional space for Learning Brain Based Interventions • An emotional event school-wide or classroom relevant • You hear thematic “off-task” conversations • After a long weekend or holiday break • At the beginning of class as a writing process • Excessive talking 20 Ways to Build Emotional Bank Account with STUDENTS • • • • • • • • • • Address student by name daily. Use their name, interests, skills & knowledge while instructing. Provide feedback with sandwich method; strength/improvement/positive. Acknowledge all student responses. Acknowledge their current strengths, as well as their potential Use eye contact. Share your own vision, passion, hobbies, for life in general. Listen without judgment. Know your student’s interests, get to know their values and beliefs. Make visual, auditory, and kinesthetic connections as they enter, during transitions, during seat work, etc. 20 Ways to Build Emotional Bank Account with STUDENTS • Practice empathy which each encounter, however, always hold them accountable. • Help them problem solve: listen and ask questions more often than speaking, lecturing, or advising. • Get their input on some decisions. • Eat lunch with students on occasion. • Greet them at the door. • Wish them well as they leave. • Be conscious of their bid attempts and respond toward their bids. • Hold high expectations. • Be aware of your nonverbal messages, i.e., the tone of your voice. • Avoid sarcasm and never put a student down, regardless of your own frustration. Brain Based Interventions • Writing about w t can improve s before m . • Writing about s___________ can boost your i___________ s_____________. Engage 4 Learning ~ Dr. Ernie Mendes Tap Brain’s 4 is BEST 1. C_________ System. 2. E _________ System. 3. P _________ System. 4. S _________ System. Engagement Matters Brain Based Interventions What’s Up? 3 Questions • • • • • • Thankful for right now? • Learned yesterday? • Promise for today? What’s pressing right now? What’s working (success) What’s not (challenge) Today’s topic? Anything else? B. E. M. Principle • Most important information f_______ • Use hands-on activity during the m ______ portion. • Provide a r_______ at the end of your class. • Teach in small c _______. Language Patterns • I don’t know (but what I do know is…) • I see your point • I hear what you’re saying …and… Emotions • C ____________ • L ____________ • D________ B ___________ Emotions • Negative ones are s_____________. • _____ are hardwired. • + ones are good for your h__________. Emotions Hardwired Emotions • Fear • Anger • Sadness • D _________ • S _________ • Joy Emotions Learned • • • • • • • • • Empathy Humility Sympathy Sharma Gratitude Optimism Compassion Patience cooperation Self-Control • Effects are p _________ • Self regulation can be t ___________ • Sensitivity to environmental cues affects suppression of action • Will power is depleted by usage (decision fatigue) …Self-Control • The fuel is g ________ • Low Levels of g_________ after an initial selfcontrol predict poor performance on a subsequent self-control task Application • Food or drink (raises blood sugar) • Movement (releases glucose stored as glycogen in the liver) • Strong emotions (trigger release of glucose) • Make things actionable for your brain to-do list only things that can be done asap (reduce depletion risk) Application • Meditate-mindfulness – 5 min • Exercise-even for 10 min (GABA) • Sleep-tired-brain cells loose ability to absorb glucose • Use wait-time-desire has ebb & flow wait 10 min • Forgive yourself- plan for next time Two-Step Composure 1. Two deep breaths 2. Calming Thought: State your name, “Just relax, you can handle this” To process, you can …. • • • • • Write about it Talk about it Move about it Stay open to it Change gears • • • Evidenced-based Curriculum 15 Neuroscience Based Lessons 4 Units; Students Learn About ~ o o • Increase Optimal Learning Capacity – o • Brain physiology & mindful attention Monitor senses, feelings, respond reflectively vs reflexively Academic Performance, Self Regulation, Mindful Engagement, Concentration, Perspective Taking, Empathy, Kindness, Complex Problem Solving Skills Teach CASEL 5-point Framework o Self Awareness, Self Management, Social Awareness, Relationship Skills, Relationship Decision Making http://thehawnfoundation.org/mindup/ The MindUP Curriculum: The Hawn Foundation, Scholastic Teaching Resources MindUp Curriculum • "brain-based" teaching has transformed teaching and learning in countless classrooms, explains, – “Asking kids to visualize success on an upcoming skill or knowledge set is no ‘new Age’ strategy. When done well, mental practice is known not only to make physical changes in the brain but also to improve task performance (Pascual-Leone et al., 2005)” (2010). Brainology & Growth Mindset Brainology Curriculum http://www.mindsetworks.com/brainology/ Growth Mindset http://www.mindsetworks.com/webnav/whatismindset.aspx Resources • • • • • • • • • • • Dr. Steven Feifer, www.schoolneuropsychpress.com Dr. Regalena Melrose, Brain Charge, www.drmelrose.com Dr. Ernest Mendes, Engaged 4 Learning, www.erniemendes.com Dr. Ernest Mendes, Empty The Cup…Before you Fill It Up, www.erniemendes.com John Medina, Brain Rules, National Center on Universal Design for Learning www.udlcenter.org Collaborative for Academic, Social and Emotional Learning, www.CASEL.org Dr. Diana Browning Wright, Positive Environment Network of Trainers, www.PENT.ca.gov International Society for Neurofeedback & Research (ISNR) www.isnr.org MindUP Curriculum: Brain-Focused Strategies for Learning and Living. Scholastic, Hawn Foundation, http://thehawnfoundation.org/mindup/ Brainology Curriculum, http://www.mindsetworks.com/brainology/ Dr. Carol Dweck, Mindset: The New Psychology of Success, How we can learn to fulfill our potential, http://www.mindsetworks.com/webnav/whatismindset.aspx