STRESS, TRAUMA,
& THE BRAIN:
How to Assess, Designate,
and Serve
Regalena “Reggie”
Melrose, Ph.D.
Self-Regulation
• The SINGLE MOST IMPORTANT capacity
for ALL of learning and adaptive behavior
• The INTERNAL balance between
excitation and relaxation
• Promotes the OPTIMAL ZONE of
AROUSAL necessary for achievement
• Mediated by both the CNS & ANS
•Neocortex
•Mid-Brain
•Brain Stem
•TRIUNE BRAIN
The CNS/The Brain
The Triune Brain:
• brain stem/reptilian brain – sensations
• limbic/mid-brain – AMYGDALA –
emotions
• neocortex – words
Self-regulation impaired when the brain
stem and limbic system become “stuck
on high” and the neocortex shuts down.
•Neocortex
•Mid-Brain
•Brain Stem
Development of the CNS
● At birth, we have only the brain stem
● From 0-3 and beyond, the limbic brain
and neocortex develop
● The brain develops in a USE-DEPENDENT
and HEIRARCHICAL fashion: the healthy
development of the neocortex depends
upon the healthy development of first,
the brain stem and then, the limbic brain
Three primary purposes of the
brain:
• Survival
• Procreation (for survival)
• Caring for dependents (for survival)
Many of our students are focused solely on
survival to the detriment of their
education.
Chronic Stress and/or Trauma
• A REAL or PERCEIVED threat of danger
• May be medical and/or psychological
• Always physiological
• Has direct, specific, observable, and
measurable impact on the CNS and ANS
The ANS
Two branches of the ANS:
● Sympathetic – excitation (fight/flight) –
all we have at birth
● Parasympathetic – relaxation – develops
after birth
AUTONOMIC DEREGULATION is what
distinguishes our more challenging
students from those who are not.
Chronic Stress and Trauma
in the “Stream of Life”
Two different patterns of responding
emerge:
● Overarousal – hypervigilance
(only looks like ADHD)
● Underarousal – shut down; numb (only
looks like depression)
•(Ogden & Minton, 2000)
“Stuck on High”
● Non-Linear relationship between stress
and anxiety
● Elevated baseline level of anxiety
● Due to “kindling effect” of AMYGDALA
● Behavioral outcomes include anger,
aggression, depression, hyperactivity,
mood swings, cutting, substance abuse,
promiscuity, anorexia/bulimia,
disengagement (in all forms!) and more.
Learning Outcomes
When AROUSAL is too high:
● Hippocampal damage - memory deficits
● Deficits in attention, recall, and
comprehension
● Poor problem-solving
Intervention
Increase SELF-REGULATION through:
● “Zone of Optimal Arousal” / “Window of
Tolerance”
● Resources
-Assess (resource inventory)
-Intervene (foster connections)
-Consult (psychoeducation)
•(Ogden & Minton, 2000)
Important Resources
● Safety – through structure (rules, routine,
rituals), order, and predictability, i.e. IFTHEN charts, schedule on desk, review
● Community – schools can provide ground,
center, connection, belongingness,
purpose, and chances to repair
● Competence – opportunities to succeed/
experience mastery, i.e. math
● Sensory Awareness – for learning &
behavior, i.e. Lindamood-Bell/timeout/empathy
What Does NOT Work
• Anger management
• Reasoning/talking
• Power struggles
• Using resources as a reward
• Time-out
• Loss of points/privileges
• Punching a pillow
What Works
• A relatively quiet safe place
• Compassionate containment
• Community and belonging
• Earning/keeping rewards
• Time-away
• Few words
• Chances to start over/repair
What Works (cont’d)
• Positive
acknowledgment/encouragement
• Success and competency
• Building resources (external, internal)
• Positive communication with parents
• Prevention through psychoeducation
• Early intervention (Pre-K, K, 1)
More “Non-specific” Ideas
• Large picture of nature in the room (vs.
problem on the board)
• Theme song/music for transitions
• Choice for sense of control, i.e. selfsoothing
• Mirroring statements EXACTLY
• Organization (order), i.e. desk clean-outs
• Extra response time for “ODD”
7-Step Paradigm
STEP 1 – YOU – before, during, and after
STEP 2 – CONDITIONS for learning/beh.
STEP 3 – IDENTIFICATION of students
STEP 4 – I.D. RESOURCES, i.e. observe, RI
STEP 5 – I.D. EARLY SIGNS for the need to
resource (beyond conditions in step 2)
STEP 6 – IMPLEMENT the resource
STEP 7 – Psychoeducate (everyone!)
Proposal
Within General Education:
● Prevention
● Early Intervention – Pre-K, K, 1
● Improved Intervention Plan
-Resource inventory
-Psychoeducation
-SRT
Proposal (cont’d)
Within Special Education
● Assessments – detailed developmental histories
(BASC-SDH), resource inventories
● Designations – TBI, OHI, DD
● Services – OT (sensory integration, the Alert
Program), Behaviorist, SRT as DIS
● Early Intervention (0-5) – DC: 0-3
Melrose Books
Why Students Underachieve (2006)
available at amazon.com. On c.d.
available only at www.drmelrose.com.
You Can Heal Your Child (2009) available
at amazon.com.
Melrose Books
Hope and Healing/Activities (2009)
available at amazon.com.
Hope and Healing/Parent Guide (Eng & Sp)
(2009) available at www.drmelrose.com.
For more information and
resources visit:
www.DrMelrose.com