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Neurosequential Model of Therapeutics (NMT)

The Neurosequential Model (also known as NMT) is a developmentally-informed, biologically-respectful approach to working with at-risk children (and sometimes with adults). NMT is used to create a brain map for children or adults who have experienced chronic or complex trauma. 

What is the Neurosequential Model of Therapeutics?

The Neurosequential Model of Therapeutics (NMT) is an assessment tool which measures an individuals adverse experiences and their relational health across the lifespan. The brain develops in a use dependent way and adverse experiences have a way of affecting the typical development of the brain. Adverse experiences (such as traumatic events) force the brain to focus on previous threats, creating neuronal memories designed to hone in on survival mechanisms, sometimes at the detriment of other important learning opportunities. Relational health, primarily during those first years in life can buffer some of the adverse experiences in a persons life. But if you have a high level of adverse experiences, especially during the first 5 critical years of life and you have low relational health, the likelihood that you will have gaps in key areas of brain development increases. For a typically developing brain there needs to be low adverse experiences and high relational health. This builds resiliency and strength-a flexible brain which in turn leads to a stress response cycle capable of handling day to day and even once in a while begin stressful situations.

How Does NMT Work?

The NMT uses your individualized history over your lifespan and looks at the areas of the brain that may be underdeveloped due to these early adverse experiences. The parts of the brain which need to be focused on and strengthen so that other parts can come on line and do their job as well. The assessment tool is evidenced based, neurobiological and trauma sensitively informed. It takes out the stigma and doesn’t pathologize the individual. But rather it gives them a key to understanding why they react the way they do, why they at times seem like they are drivenby their emotions and have no control over their behaviors. It helps them learn what they need to put the break on (cortical modulation) earlier, feel more in control over themselves and their behaviors. The NMT is not a therapeutic tool but it aids in the development of treatment for the individual.

Using NMT to Assess Brain Function

The Neurosequential Model helps therapists and families to understand four aspects of brain function:


Sensory Integration
The ability to sort information that enters the brain. If there are problems here, the child may have trouble regulating emotions, interacting with others, and developing academic skills.


The ability to manage sensory integration and respond appropriately. If there is a problem in this area the child may have difficulty controlling urges, may overreact to things, and have problems getting along with others.


Relational Ability
The capacity to relate, play, and talk with others. If there is a problem in this area, the child may find it difficult to get along, navigate social interactions, and show empathy for others.


Cognitive Skills
The skills that allow you to reason and solve problems. If this is a problem point, the child may have trouble in school, in learning new things, and in understanding basic abstract concepts.

Who Would Benefit From NMT?

There are a variety of children who would benefit from the use of an NMT model, including:

  • Children and teens who have experienced extreme or chronic trauma.

  • Young adults who experienced early life trauma or pervasive stress.

  • Foster or adopted children and teens, particularly those with behavioral difficulties such as self-harm, suicidal ideation, physical and verbal aggression, and difficulty in school.

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