SUCCESS STORIES

Trauma-Related Disorders

About the Client

Name:

Thomas

Age at Intake:

10

Diagnoses:

Thomas' Story

Thomas’ family found Jacob’s Ladder after experiencing a complete disruption in his education after Thomas experienced severe trauma from an improper restraint at a previous school when he was just six years old. Thomas was described as bright and engaging but could not separate from his mother, had highly explosive outbursts, and experienced severe deficits in creating healthy relationships with peers and adults.

Thomas’ parents reported a high degree of anxiety, which would escalate to heightened emotional outbursts, an inability to communicate his thoughts, and periods of shutting down completely. His meltdowns included screaming, crying, hitting, kicking, and fleeing the location. Thomas was often triggered by his schoolwork, physiological needs – such as being hungry or tired – or if he sensed any lack of safety or control in the given situation.

After 16 months of full-time enrollment, Thomas made significant gains. He participated in academic activities, learned he could feel safe when separated from his mother, and built healthy and trusting relationships with his peers and providers at Jacob’s Ladder. The Interpersonal Whole-Brain Model of Care® (IWBMC™) worked to deeply understand Thomas’ root difficulties rather than focusing solely on his externalized behavior. Highlighting his strengths rather than weaknesses allowed him to actualize what his family, community, and team at Jacob’s Ladder knew he was always meant to accomplish. 

When the brain undergoes perceived trauma, the lower brain regions perceive much of everyday life as a continued threat, and a child will react accordingly. Childhood adversity causes neurobiological changes that significantly affect long-term neurological development and overall functioning, with lasting physical, mental, emotional, and behavioral challenges.

Challenges Before Enrollment

Successes After Enrollment

Incoming Evaluation Results

Thomas came to Jacob’s Ladder experiencing challenges with explosive outbursts, following directions, and avoiding tasks. He lacked a sense of self-awareness and control and could not maintain regulation despite the actions of others. Thomas mirrored the energy and affect of those around him, including becoming overly excited and dysregulated when given emphatic positive praise. Thomas also engaged in significant moments of refusal. As tasks increased in complexity and challenge, Thomas would shut down and refuse to participate while also engaging in negative self-talk. Academically, he could only complete two of the six academic assessments due to refusal and shutting down, and the scores collected were significantly below his age-equivalent grade level.

 

Further, when we initially attempted to collect the qEEG, Thomas became heightened and had a total meltdown, including screaming, crying, and attempted aggression. Thomas could not regulate himself amidst the stressors of the environment and was in a constant state of fight or flight.

Results at Program Completion

Thomas enrolled at Jacob’s Ladder as a full-time student in the Hope School program. Due to his unique needs and significant challenges with past educational placements, Thomas required significant adaptations and modifications to the school day to meet his individual needs. Thomas’ individualized day was specialized to build success gradually over time. 

 

Specific accommodations included a dedicated safe space on campus where he could regulate when needed and explicit instruction on how to partner with this family if he escalated to ensure he ended each day positively. Further, all academic content was presented untraditionally to break Thomas’ association of academic learning and past negative experiences. 

 

Thomas’ providers completed his academic coursework in novel environments on campus, including the hammock swing, tree house, soccer field, and outdoor patio. These modifications to the traditional school day reflect the incorporation of the IWBMC™ Trauma Support Model, reiterating that we must acknowledge each person’s past experiences and significant life events, providing clients with a safe environment, opportunities for collaboration, and intentional opportunities to increase trustworthiness and make choices. 

 

After 16 months of full-time enrollment, Thomas made significant gains. He could participate in his classroom activities with few modifications and had developed a robust self-regulation toolbox with specific strategies he could access to maintain regulation throughout the day. Thomas learned to advocate for himself, requesting support or breaks appropriately. 

 

Further, Thomas’ distress tolerance and perception of academic activities improved drastically. He could participate in all the academic assessments, and his output skyrocketed, increasing his assessment results by more than three grade levels. Thomas learned he could feel safe when separated from his mother and built healthy and trusting relationships with his peers and providers at Jacob’s Ladder.

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 Thomas’ initial evaluation, patterns of dysregulation were noted in the temporal regions and the right frontal area, as seen by the orange spots in the beta and high beta frequencies. Dysregulation in these areas correlates to challenges with impulse control, sense of self, impulsivity, anxiety, emotional understanding, vocal expression, and long-term memory, and the severity indicates dysregulation more than two standard deviations from the mean. Within the coherence measure, patterns of deficient communication between brain regions, as indicated by the blue lines, are seen between the regions responsible for vocal expression, emotional processing, social appropriateness, and logical attention. 

 

After 16 months of intensive programming within the Hope School program, patterns of excessive activity in the temporal and frontal regions have normalized, as noted by the absence of orange areas in the beta and high beta frequencies. Further, the blue lines within coherence that previously indicated a lack of communication between brain regions had been addressed. Although some areas show increased compensatory activity, these changes indicate vast improvements in the key brain regions associated with post-traumatic stress disorder. 

Listen to how Jacob's Ladder helped Thomas.

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