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             July 2011 CTA Newsletter
Eye Movement and the Brain
New NMT Training Certification Programs Begin in September







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Over the past month, we have been working very hard to prepare for the September launch of our newly updated NMT Training Certification Program for Individuals and for Sites, but we have also been busy enhancing other aspects of our work.  Some of our recent projects have included updating a user workbook for the NMT Clinical Practice Tools, moving the Clinical Practice Tools from Beta Testing into V.1, and working towards the implementation of research projects with data gleaned from the NMT Clinical Practice Tools. We are also developing ways to enhance collaboration amongst our NMT Partner Sites, including the establishment of a monthly inter-agency conference call, and are working towards a similar collaborative program for CTA's Fellows. All this to say that we are continuously looking for ways to improve how we share our work with others and the way in which we as an organization foster and participate in productive discussion with others in our field.  This is an exciting time at CTA, and we appreciate your encouragement and support.   
Eye Movement and the Brain

One of the most useful windows to the human brain is the eye.  Vision is a primary sensory modality in humans.  A significant portion of the brain is dedicated to sensing, processing and acting on visual input.  There are many ways that the eyes can give us hints about how an individual's brain is organized; simple shifts in emotional state such as desire, fear, pleasure and pain are reflected by changes in the size of the pupil. Tracking how an individual focuses on an image  (pupillometry) can indicate a variety of developmental and cognitive features of the brain; in schizophrenia and autism, for example, visual tracking measures are very abnormal.  Extraocular eye movements (EEOM) - i.e., moving your eyes (but not your head) up, down, to the side - just like your physician does during a simple exam - can 'test' the cranial nerves  III, IV and VI (C3, C4 and C6).  In turn, these cranial nerves originate in the brainstem and diencephalon, allowing EEOM to provide some indirect information on the integrity of these key brain areas.
This EEOM 'window' to the brain has been found to be a useful and simple physical sign of the capacity to dissociate.  A key component of Dr. Spiegel's Stanford Susceptibility Index is the Eye-Roll Sign (ERS).  The simple task of rolling the eyes up is a sign that indicates capacity for dissociation; the higher a individual can roll their eyes up, the more likely they are to be capable of dissociation.  Dissociation is not a pathological capacity; as we have written about previously, dissociation is a pervasive and adaptive capacity that can become sensitized and dysregulated in extreme, often traumatic circumstances.  More on this in future Newsletters - for now, consider this useful observation when attempting to distinguish between a psychotic presentation and an extreme dissociative response - the ERS for schizophrenia is typically less than 2 and for dissociation typically over 3.5.  While not foolproof, of course, a low heart rate, low blink rate and ERS over 3.5 is very consistent with dissociation and very atypical of a psychotic episode. The misdiagnosis of children with complicated clinical presentations following developmental trauma, chaos and neglect is common.  A few simple physical signs can help the clinician struggling with these complex presentations.   


For more reading: Trance and Treatment: Clinical Uses of Hypnosis, Herbert Spiegel, Ph.D., and Daniel Spiegel,Ph.D. (American Psychiatric Press, 1987)

Ms. Bronwyn McNamara Honored for Excellence


This Spring Canisius College in Buffalo, NY recognized Ms. Bronwyn McNamara as the recipient of the Bruce. D. Perry Outstanding Senior Award in Early Childhood Education for 2011.  CTA congratulates Ms. McNamara for her excellent work, especially in her final student teaching placement. We know that she will be a wonderful colleague and we wish her the best in her continuing professional development.  Special thanks and recognition are due to Dr. Nicki Calabrese and her faculty for their leadership in developing and delivering high quality education in early childhood education and child development. 

NEW NMT Training Certification Programs Begin in September - Register Now!

As previously announced, CTA will be expanding the NMT Training Certification Programs beginning this September.  We will run two program start dates per year: September 1st and February 1st.


In order to meet the overwhelming interest in the NMT and our Clinical Practice Tools (also known as the NMT Metrics), we have enhanced our Site and Individual Training Certification programs. The new programs are modeled after the current training certification programs and will include

access to 10 specialized Case-based training conferences, CTA training materials (DVDs, Multimedia and Reading materials), access to a full year of our NMT Case-based Training Series recordings, and live, interactive case discussions with Dr. Perry on a quarterly basis.  For Training Certification for Organizations, there will be a specialized Case-based Training series and a monthly opportunity for cross-institutional discussion and conversation. 




**Please Note:  Participants must meet application criteria, including participation in at least 1 Case-based Training Series.  If you have not yet been part of a Series, you may still register to receive Recordings of the Spring 2011 Series, and all recordings must be viewed by September 1st.  Or, register for the Fall 2011 NMT Series, Live or Recordings Only, and begin NMT Training Certification in February 2012.  

Finally, we'd like to thank those of you who participated in our 1st Australian NMT Case-Based Training Series which has just concluded.  It was a great success, and we look forward to the next Australian Series to come in 2012.

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Bruce D. Perry, M.D., Ph.D.
The ChildTrauma Academy