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             March 2012 CTA Newsletter
IN THIS ISSUE
New CTA Publications
Sexual Abuse in Young Children

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The ChildTrauma Academy is pleased to update you on some of our ongoing training, research and program development activities.  As most of you know we have been working hard over the last five years to create an exportable, evidence-based approach to clinical work that is both developmentally sensitive and trauma-informed.  The Neurosequential Model of Therapeutics (NMT) is that approach and to date, dozens of individuals and over six large clinical programs have completed full certification in the NMT.  Certification is a very time-intensive process and requires a strong commitment on the part of our participants.  This investment pays off.  We have received universal positive feedback about improved outcomes for clients as well as a variety of unintended positive effects on staff engagement, enthusiasm and effectiveness.  Preparing these outcomes for publication is in progress. In addition, we continue to develop and improve our NMT Certification Online Application, the Clinical Practice Tools, and collaboration and communication between our Certification participants.
Recent Publications of CTA Staff and Partners

Several articles and chapters about our work have been published over this last few months. Here are a few of the highlights:

     Ludy-Dobson, C. & Perry, B.D. The role of healthy relational interactions in buffering the impact of childhood trauma in Working with Children to Heal Interpersonal Trauma in (E. Gil, Ed.) pp 26-44 The Guilford Press, New York, 2010 

     Barfield, S., Gaskill, R., Dobson, C. & Perry, B.D. Neurosequential Model of Therapeutics© in a Therapeutic Preschool:  Implications for Work with Children with Complex Neuropsychiatric Problems. International Journal of Play Therapy   Online First Publication, October 31, 2011. Doi:10.1037/a0025955 

     Zarnegar, Z. Learning the dance of connection: Helping a foster mother and child with Fetal Alcohol Spectrum Disorder. Zero to Three Journal, July, 2011

      Gaskill. R. L. & Perry, B.D. Child sexual abuse, traumatic experiences and their effect on the developing brain in (P. Goodyear-Brown, ed) Handbook of Child Sexual Abuse: Identification, Assessment and Treatment pp. 29-49 John Wiley & Sons, Hoboken, 2012


 

Sexual Abuse in Early Childhood

     A major challenge in traumatology is our capacity to identify and treat trauma of early childhood. Sexual abuse prevalence rates, for example, are around 25% in women and 15% in men. The numbers of individuals who have sexualized trauma from early childhood is likely very high. This poses a variety of clinical challenges.

     Sexually abused preverbal children are particularly difficult to work with because they are usually unable to recognize and/or express the origin of their fears, even once they obtain verbal skills. They may present as constantly fearful, and their fear quickly turns into panic in situations that contain cues related to their sexual abuse. Further, because sexual abuse is extremely intimate in nature (and often occurs in the home, especially with females), young children who are sexually abused often use dissociation as a primary mode of adaptation and may have attachment disruptions to caregivers, thus resulting in a cascade of relational issues that disrupt normal development and the capacity to engage in therapeutic experiences.

     Sexually abused children show a plethora of divergent behavioral and emotional symptoms. They can have cognitive delays (such as language), decreased social interaction, increased dependence on the caregiver, hyperactivity, inexplicable irritability/crying, difficulty sleeping, enuresis or encopresis, and masturbation or increased sexual knowledge. Possible symptoms are so broad that sexual abuse may not usually be the first thing suspected, as these children are certainly unable to verbalize their abuse. Even if abuse is expected, medical exams have not proven to help substantiate abuse in the majority of cases-a normal medical exam in a sexually abused child is, in fact, normal. Further, many people, including experts, have assumed for years that infants are incapable of remembering their abuse and therefore are resilient to its effects. This is not true.

     Recent research provides strong evidence that infants can encode, retrieve, and be affected by early traumatic memories. Early memories are even more salient than later memories because they are some of the first associations infants make concerning social interactions as they are organizing their conceptualization of the world. (see Perry, 2009) Therefore, while sexually abused children are placing novel stimuli into categories of "fearful" vs. "pleasurable" (as these are the two most primal, guiding emotions infants have) they label sexual feelings and human beings as fearful, and thus create a maladaptive schema of their environment.

     Some children can later pair words with sexual scenes they encoded nonverbally and replicated during play. Other children can never label the origin of their fears. In children who can later pinpoint details of their abuse, helping them work through these details in a safe environment can help reduce their fearfulness. In children who cannot, building a safe environment with multiple trustworthy caregivers may be one of the only ways to slowly allay their fears and restore their ability to trust.

 

Perry, B.D. (2009) How we remember. CYC-Online, 122, April, 2009 (www.cyc-net.org/cyconline/cyconline-apr2009-perry.html)


CTA Welcomes Four New Organizations to Site Certification Training  

  

In February we welcomed four new organizations into our NMT Training Certification Program for Sites: The Village Network in Ohio, San Mateo County Behavioral Health and Recovery Services in California, Teambuilders Counseling in New Mexico, and The Dalwood Spilstead Centre in Sydney, Australia.  We are honored and very excited about the work we have begun with these four organizations and look forward to a year of collaboration and learning together!

 

We also want to welcome 14 new Individuals to NMT Certification: Rhonda Kent, Deborah Pettitt, James McAllister, Jill Hoben, Kristin Spiegel, April Byers, Robbyn Peters Bennett, Lesley Sugden, Edith Moore, Jan Ference, Zeta Anich, Kirsty Brown, Lesley Ryan, and Angela Earley.  

 

 

Onsite Training Opportunities

 

We have recently added quite a few onsite training opportunities to our calendar, including a three-week speaking tour in Australia by Dr. Perry this coming August.  We post a list of events open to the public on our website and update the list monthly. Here are some events coming up soon:

 

  • March 7 - Omaha, NE - Speaking of Children Conference - Perry
  • March 23 - Houston, TX - Juvenile Defenders Conference 2012 - Perry
  • March 30 - Berlin, Germany - ESTD Annual Conference - Perry
  • April 3 - Regina, Saskatchewan - Treaty 4 Education Conference - Davis
  • April 11 - Charlotte, NC - Charlotte Area Heath Center Conf. and Luncheon - Perry
  • April 12 - Birmingham, AL - Children's Aid SocietyTraining - Perry
  • April 18 - Midway, UT - Utah Foster Care 3rd Annual Sumposium - Perry
  • April 19 - CPCAN Child Abuse Awareness Month Annual Event - Perry

Click here to view our training page and a complete list of events and their registration contacts.  

 

Thank you for your time.   Our Winter 2012 and Australian 2012 NMT Case-based Training Series are now fully underway, you can still register to participate via our Recordings Only package.  Click here for more information.   

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Sincerely,


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