Outline for a presentation to the Loveland Special Needs Hoseback Riding Program in Lincoln, Mass.

1. David D Nowell PhD
www.DrNowell.com
Understanding the Top-
Down and Bottom-Up of
Executive and Sensory
Functioning

2. www.DrNowell.com
DavidNowellSeminars
DavidNowell

3. Overview
• Top-down and bottom-up
• Points of impairment
• Curious compassionate nonjudgmental
evaluation
• HËDŸDT?
• Joie de vivre and “magic moments”
• Living in the gap
• Q&A&D

5. www.slideshare.net/dnowell

7. TOP DOWN AND BOTTOM UP

8. What’s wrong with this brain model?

9. What’s wrong with this brain model?

10. What’s wrong with this brain model?

11. POINTS OF IMPAIRMENT

12. Points of impairment
• Intellectual development
• Autistic spectrum
• ADHD / executive dysfunction
• Attachment disorders
• Trauma-related disorders
• Cerebral palsy

13. CURIOUS COMPASSIONATE
NONJUDGMENTAL EVALUATION

14. Skillfully eliciting the chief complaint
• Too much of what? Or too little of what?
• Invoking the Pediatric Fairy (or the Psychiatric
Genie)

15. HËDŸDT?
• How exactly did you do that?
– Everybody’s doing the best he/she can
– Every behavior problem is either
• Skills deficit
• Contingency problem

16. Forming a diagnostic impression
• Where do you see it the most? And where do
you see it the least?
• Two disorders = two stories

17. Documenting and communicating your
conclusions
• The footprints in the butter
• Defend your diagnosis

18. STRATEGIC BEHAVIORAL INQUIRY

20. Objectives of SBI
• Specific behavioral strategy
• What was the feeling-goal?
• Motivational level on a scale from 1-10

21. Benefits of SBI
• Affirms the value of clients’ unique internal
experience
• Emphasizes the culture of self-regulation
• Encourages metacognition

22. Assumptions of SBI
• Everybody’s doing the best they can
• Behavior is not incomprehensible or random
• Behavior follows patterns which reveal
themselves to the curious observer free of
prejudice or blame or theory

23. How to do SBI
“How exactly did you do that?”
“How did you know it was time to _____?”
“How long had you been thinking about ____?”

24. JOIE DE VIVRE AND MAGIC
MOMENTS

25. The end goal of treatment:
joie de vivre
Dr. Lucy Jane Miller

26. “Magic moments”

27. LIVING IN THE GAP

30. Let’s stay in touch!
 Join my e-newsletter list:
 Fill out a card today and drop it in the box.
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 Visit us on the web: www.DrNowell.com
@davidnowell David Nowell Seminars

31. Q & A & D