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
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."