Emotional-Behavioral-Relational Disorders

About the Client



Age at Intake:



Sam's Story

Sam’s family came to Jacob’s Ladder seeking support for their oldest son. Sam was described as bright and exceptionally curious, but he also experienced significant challenges with anxiety, stuttering, impulsivity, and behavioral meltdowns. Sam had challenges controlling himself when he became frustrated and would vacillate between lashing out and crying. His fear paralysis response was so significant that he would shut down completely, losing the ability to vocalize or write his thoughts and needs. He also had considerable attention challenges, leading to difficulty completing tasks, maintaining attention for more than a few minutes, and completing tasks independently. His family described him as appearing “dazed” at times, needing constant reminders to stay on track. Sam also had severe challenges accessing language, generating responses, maintaining conversations, and recalling past events. He was also experiencing academic challenges correlated to inattention, handwriting, and math skills. 


Sam had significant challenges with sequential processing, working memory, and early reflex integration through the evaluation process. Sam also had a mixed dominance profile and severe difficulties with emotional-behavioral-relational processing, experiencing feelings of performance-based anxiety, decreased perspective-taking, and lowered distress tolerance abilities. Although he was believed to have academic challenges, his academic scores were assessed and found to be above his age level. Still, his challenges with inattention, anxiety, and emotional regulation overshadowed his exceptional strengths. Sam’s family lived several hours from the Roswell, GA campus; however, they found the means to allow him to live in Roswell throughout the week, and he traveled back home on the weekends. The family made incredible sacrifices to get their son the care he needed. 


Sam made tremendous gains after approximately three years of full-time enrollment in the Hope School program. The Interpersonal Whole-Brain Model of Care® (IWBMC™) worked to understand Sam as a whole person rather than focusing solely on his externalized behavior. It highlighted his strengths rather than weaknesses, allowing him to actualize what his family, community, and team at Jacob’s Ladder knew he could achieve. A previously reserved, anxious, and self-doubting boy flourished into an engaging, positive, and social teen. Sam’s individualized program targeted deficits with auditory and visual processing, executive functioning, reflex integration, and interhemispheric communication, with a global emphasis on developing a healthy self-concept and learning within a safe and welcoming classroom with a culture of Hope, Truth, and Love.


Sam’s individualized goals helped him build a self-regulation toolbox, giving him tools to access during moments of anxiety or frustration. He learned to use these effectively and transitioned from Jacob’s Ladder to a well-known private college-preparatory academy, where he is now in his senior year and is applying to traditional university programs.

Challenges Before Enrollment

Successes After Enrollment

Incoming Evaluation Results

Sam was kind and reserved during his evaluation but had significant moments of sadness, especially when describing his thoughts, feelings about himself, and social relationships. Sam described feeling under pressure, wishing he was braver, and fearing getting behind in school. Sam had challenges focusing and frequently fidgeted by tapping his fingers and toes. He relied heavily on prompts to complete tasks in full and spoke with a significant stutter and use of filler words. Sam had substantial challenges with generating spoken and written language, needing additional time to write sentences, generate thoughts, and make simple decisions. During testing, when the content reached Sam’s challenge point, he froze completely – unable to decide or complete the task without heavy prompting and modeling. 


Sam had significant challenges with auditory sequential processing and working memory skills. His scores fell in the Below Average and Low ranges, likely correlating to his left ear dominance and difficulties with interhemispheric communication. Further, the Early Reflex Integration assessment indicated poor development and connectivity within foundational brain regions, noted by the integration of only 11 out of 19 reflexes.

Results at Program Completion

Sam participated in intensive completion of the IWBMC™ within the Hope School program for approximately three years. During this time, he worked tirelessly to address his individualized goals, specifically Emotional-Behavioral-Relational and Neurodevelopmental deficits.


At the time of his transition, Sam’s processing and Working Memory abilities skyrocketed up to the Superior range, and functionally, he could complete sequences of tasks with little to no support needed. Despite his prior difficulties accessing language, he scored in the Very Superior Range for receptive and expressive abilities during the Test Of Language Development (TOLD-I:4) assessment, which measures language development compared to the client’s age. Sam functionally engaged in frequent conversational exchanges and classroom conversations. With his participation in the intensive model of care, Sam developed the neuronal pathways in the brain that allowed him to access language and articulate his needs, even in moments of heightened emotionality. Further, as Sam worked to address neurodevelopmental barriers, he showed proficiency with integrating 16 out of 19 early reflexes. 


Most notably, Sam developed the skills to manage his performance-based anxiety, including self-confidence, perspective-taking skills, and a positive mindset. He also learned to overcome his persistent fear of failure, allowing him to become a more active participant with others and develop long-lasting, meaningful relationships. Sam’s inner dialogue shifted from one of self-doubt and fear to that of an optimistic and engaging young man. 


After transitioning from Jacob’s Ladder, Sam went to a well-known, private college-preparatory school, where he completed his last two high school years and is applying for traditional university programs. Sam’s family has witnessed tremendous improvements since his time at Jacob’s Ladder, even noting his desire to share the skills he learned with others who are struggling.

These qEEG images show the electrical activity occurring within the brain. Areas with insufficient activity are noted by cool colors (blue and teal), whereas areas with too much activity are indicated by warm colors (lime green, yellow, red, and orange). The blank spots or white colors indicate any areas with activity occurring within the normal range. All data is collected from raw EEG data and is compared to a normative database based on the client’s age, gender, and handedness.

At Sam’s initial evaluation, dysregulated activity was noted in the brain areas responsible for verbal expression, receptive language, impulse control, cognitive processing, sensory processing, and perseveration. Although Sam was diagnosed with ADHD, which is a frontal lobe disorder, dysregulated activity in the frontal lobes was minimal. More notable were the challenges in the parietal and sensorimotor regions, which enable the frontal lobes to function effectively from an outward perspective. Most significantly, the deficient activity in the communication between brain regions, explicitly showing the lack of neuronal pathways between spoken language and emotional processing, directly correlated to his functional challenges with stuttering and accessing language when emotionally dysregulated. 


Sam showed tremendous functional improvements when he transitioned in addition to the concrete data measures collected within the qEEG. The previous deficient activity, which indicated insufficient resources within the brain, was resolved, and the language-accessing area of the brain cleared tremendously. Further, when considering communication between brain regions, areas of excessive activity cleared entirely, and deficiencies significantly decreased in quantity and significance. 

Listen to how Jacob's Ladder helped Sam.

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