Newsletter #177 for Internationally Adopting Parents
February 21, 2017
PAL Center Inc.

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The "Zones of Regulation" as a remedial program for internationally adopted children with complex childhood trauma

Boris Gindis, Ph.D.

For internationally adopted children, development has been mediated by complex childhood trauma. Many, if not all of them, demonstrate, in different degrees, the signs of what was defined as Developmental Trauma Disorder (Van der Kolk, B.A. 2005. "Developmental Trauma Disorder," Psychiatric Annals, 401-408): emotional reactivity, inability to temper emotional responses, behavior impulsivity and the like. Children with difficulties interpreting emotions, paired with impulsivity, may be at risk for aggressive behavior (W. D'Andrea, J. Ford, J. Spinazzola and B. van der Kolk, 2012, "Understanding Interpersonal Trauma in Children: Why We Need a Developmentally Appropriate Trauma Diagnosis," American Journal of Orthopsychiatry, Vol. 82, No. 2, 187-200). Mixed maturity is at the base of many internationally adopted children's psychological profiles, together with sensory integration issues, underdeveloped language as a regulatory mechanism, delayed social cognition, limitation in executive functions (B. Gindis, 2005, "Cognitive, Language, and Educational Issues of Children Adopted from Overseas Orphanages," Journal of Cognitive Education and Psychology, Vol.4, No 3, 291-315). All these attributes require direct therapeutic interventions with appropriate methodology.

Within the last 10-12 years, a number of training programs aiming to remediate children with difficulties with self-regulation were created. These programs, being basically cognitive/behavioral techniques, are designed for children of different ages and different medical conditions. To the best of my knowledge, none of these programs address the trauma issues. Among those programs, the well known are the Alert Program (www.alertprogram.com/), which focuses on sensory integration as a major means of regulating alertness; the Incredible 5-Point Scale program (www.5pointscale.com/5-point_scale_paper.pdf), created initially for autistic children, but now widely used for children with ADHD and behavior and emotional issues; and the multitude of the Behavior Management Programs.

The most recent addition to this host of existing programs for developing self-regulation in children is The Zones of Regulation. As of now, it exists in a book format called "The Zones of Regulation: A Curriculum Designed to Foster Self-Regulation and Emotional Control." The author is Leah Kuypers, an occupational therapist by training, who is a specialist in the autism spectrum disorder (ASD) field. The program, released in 2011, became rather popular among school personnel and private therapists and counselors. There is a good reason for this: The Zones of Regulation methodology is sequentially organized, logically structured, multisensory in nature, and very practical. The multisensory approach is at the base of the curriculum (visual, auditory, tactile, kinesthetic, role-play and imagery) and is used to develop emotional control, sensory regulation, and executive functions in preschoolers through middle-school students with social and behavioral difficulties. The program is clearly school-oriented: the author prefers to call her program a "curriculum" and her therapy/instructional sessions are named "lessons."

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