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SNT 1 Terminology and Diagnoses
© 2013 Deborah A. Beasley, All rights reserved
Terminology and Diagnoses
Disorders and Special Needs
This training is about treating and parenting difficult, severe behaviors in
adopted, fostered, and special needs children, yet it is equally a work about love and
healing the parent/child relationship in the most challenging of circumstances, including
long-term effects of developmental and situational trauma.
We view the list of disorders below in terms of the frequency and intensity of
manifested symptoms within each diagnosis. Symptoms sometimes present with
profuse ranges of co-morbid conditions and behaviors, and eventually may simplify to
include symptoms and traits of a prominent condition or cluster of conditions. Disorders
listed below are not the sum of diagnoses for childhood disorders or disabilities that
influence behavior; however, I believe these are common disorders coaches and
therapists face in their work with special needs children, and parents face with their
child.
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ADD - Attention Deficit Disorder
ADHD - Attention Deficit Hyperactivity Disorder
OCD - Obsessive Compulsive Disorder
ODD - Oppositional Defiant Disorder
PDDNOS - Pervasive Developmental Disorder Not Otherwise Specified
(Note that the newest edition of the Diagnostic Manual has removed the
determination of NOS from all diagnoses)
AS - Asperger’s Syndrome
ASD - Autism Spectrum Disorder
GAD - Generalized Anxiety Disorder
Social Anxiety Disorder
Separation Anxiety
IC - Impulse Control Disorder
PICA – Craving for and eating non-food, such as dirt, paper, detergent,
drywall, sand, etc.
Hoarding Disorder - Newly classified disorder
Other Eating Disorders
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SNT 1 Terminology and Diagnoses
© 2013 Deborah A. Beasley, All rights reserved
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BP - Bipolar
BP SPECTRUM
SPD - Sensory Processing Disorder
Intermittent Explosive Disorder
CD - Conduct Disorder
SM - Selective Mutism
AD - Attachment Disorder
RAD - Reactive Attachment Disorder
NSSI - Non-Suicidal Self-Injury – cutting, pulling out of hair, eye lashes,
eyebrows, etc. (Note: Newly classified disorder)
PTSD - Post Traumatic Stress Disorder (Note: First time criteria for a
subtype of PTSD for children 6 years old and younger, with criteria for
adolescents and adults).
Each disorder listed above has a relational, developmental, and environmental
factor in common, which contributes to the disintegration of body, mind, or emotional
function. Open Heart parenting equally utilizes relational, developmental, and
environmental factors to integrate body, mind, and emotional function. Regardless of
cause of the disorder or diagnosis, we approach all behavior and relational difficulties
effectively using the Open Heart approach.
The above list is not exhaustive.
Affect –Regulation – The capacity for regulation of emotion (affect), as it relates to attachment,
and stress modulation and is dependent upon the organized neuronal development of the right
brain.
Affect – Dysregulation – The incapacity to regulate emotion (affect), as it relates to relational
and environmental stress, insecure or traumatic attachment.
Attachment – Generally, an emotional bond developed through love, devotion, and affection
and strengthened through fidelity and loyalty to a person, animal, cause, or thing.
Parent/Child Attachment 
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Healthy or maladapted attachment patterns form within the critical timeline of the first 3 5 years.
The early templates of healthy or maladaptive attachment patterns create future internal
models of organization/regulation or disorganization/dysregulation.
Healthy attachment is the outcome of repeated, appropriate, solicitous, safe and loving
care toward the child, meeting physical and emotional needs in a timely caring manner
The timely meeting of the child’s needs allows development of appropriate levels of
neuro-biological, and emotional regulation
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SNT 1 Terminology and Diagnoses
© 2013 Deborah A. Beasley, All rights reserved
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The parents ability to meet child’s needs, and the child’s experience of having needs
met, forms the reciprocal attachment between caregiver and child
Organized/Regulated - the result of the child’s ability to process thoughts, feelings, and
emotions into conscious thoughtful actions. These responses provide us a window into the
child’s ability to adapt and cope with everyday stressors. Behavioral responses are governed by
the child’s ability to access their cognitive logical brain, thereby, overriding the negative impact
of everyday stressors.
Disorganized/Dysregulated - The result of the child’s inability to process thoughts, feelings,
and emotions into conscious thoughtful actions. In this case, behavior reflects the unconscious,
autonomic reactions initiated in the survival systems of the brain and body. These reactions
provide us a window into the child’s inability to adapt and cope with everyday stressors.
Continuum of Stress – a model of symptoms that occur when the mind and body have
difficulty with or cannot integrate what it encounters in the environment.
Stress – a shortened term for distress, or a neurophysiologic state of body/mind imbalance and
overwhelm experienced by the child at an unconscious body level. Positive and negative
behavior is the result of stress in the body/brain/mind system.
Arousal States - the body/mind/brain reaction to positive and negative stress in the
environment.
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Hypo (under) aroused – A neurophysiologic state of shut down or under responsiveness
to a stimulus in the environment. Examples of hypo aroused behavior exhibit as
withdrawn, flat affect (little or no emotional response), physically slow, uninvolved,
disconnected, low energy
Hyper (over) aroused – A neurophysiologic state of hyper responsiveness to a stimulus
in the environment. Examples of hyper aroused behavior exhibit as the term implies;
hyper, wild, giddy, into everything, poor attention, high energy
Trigger - A trigger is a person, place, activity, emotional memory, perception, feeling, or thing,
which elicits a strong neurophysiologic (brain/body) behavioral response in adults or children.
The behavioral response may be positive or negative. As in, a pleasant memory which triggers
warm feelings and a comforting smile, or seeing the picture of an abuser which triggers intense
fear and internal alarm.
Trauma - A single or repeated event, perceived by the mind and brain, and felt by the
body, as life threatening and catastrophic, or perceived as a threat of bodily harm to the
integrity of the person or another person (family member, child), witness to or victim of
violence, or other emotionally shocking events.
THE LIMBIC SYSTEM
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SNT 1 Terminology and Diagnoses
© 2013 Deborah A. Beasley, All rights reserved
Brain structures involved in dealing with Fear, Stress,
Trauma, and Survival.
Intense behavior is the body’s attempt to release the sudden surge of energy
flooding in from the endocrine system and the epicenter of fear, and regain balance and
organization. Additional structures and systems comprise the whole brain, yet the limbic
structures provide the system that integrates cognitive areas with sensory motor
systems and these are important in understanding the origins of behavior.
Flight, Fight, and Freeze – The ultimate body/brain survival response. The Brain on
Fire! The flight, fight, and freeze response is a neurophysiologic sequence of
interactions triggered and controlled by chemical signals in the brain when danger or
threat is perceived in the environment, resulting in complex responses throughout the
body and brain which cause the person to run away, freeze or hide, or prepare to fight
for their life.
Limbic System – The Life Preserver – Function of the Limbic System
 Organizes neurophysiologic (brain/body) life-saving responses to threats
The limbic system, also called the primitive brain, governs all autonomic and
primitive survival reactions. The limbic system is the Life Preserver of the body and
mind in the high water of fear and trauma. Its sole function is to safeguard and preserve
the integration of the whole person and personality. The components of the limbic
system comprise a complex synergy of neural communication that protects physical,
emotional, and psychological integrity during and after extreme distress, threat, trauma,
and fear.
Frontal Cortex – The Decision Maker - Function of the Pre-Frontal Cortex
 Specializes in higher levels of functioning that involve complex abilities of
organization and regulation
Sometimes called the new brain with functions to help govern personal and social
behavior and inhibit impulsive or inappropriate behaviors that result in difficulties related
to social interaction. Stephen Porges refers to the pre-frontal cortex as the Social
Engagement System.i The pre-frontal cortex is responsible for critical executive
functions such as,
 Determining actions (as through trial and error),
 Reconfiguring options to change one’s actions (adaptation and coping),
 And decision-making (choice), which affects goal-oriented behavior.
The Pre-Frontal Cortex
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Influences memory,
The ability for multi-tasking,
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SNT 1 Terminology and Diagnoses
© 2013 Deborah A. Beasley, All rights reserved
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Changing directional focus, or
An ability to persevere when a task becomes difficult, rather than to throw ones
hands up in futility.
The frontal cortex also receives and processes visual information. Executive
functioning additionally allows for the management and organization of stress and
change in everyday life. The pre-frontal cortex is critically involved in the self-regulation
of behavior. The pre-frontal cortex sits at the front of the brain.ii
Amygdala - The Fire Alarm - Function of the Amygdala
 The amygdala is the epicenter of the root emotion of fear. It is a primal and
subconscious alert mechanism, which continuously scans the environment and
initiates the DANGER alarm to all other systems.
The amygdala has held primary focus in the neurosciences for 30+ years. No other
area of brain functioning has received more interest and study. I refer to the amygdala
as the fire alarm because it serves as the singular locus of detection for a person’s fear
and danger. Once alerted to danger in the environment, the amygdala activates all body
and mind systems for survival. The fire alarm signals that the Limbic System is fully
engaged and ready to protect.
In other words, the brain is on fire. The amygdala sits in the right and left hemisphere,
just above the brain stem at the back of the brain.
Hippocampus - The Memory Keeper - Function of the Hippocampus
 Responsible for forming, organizing, and storing short and long-term memories,
matches new memories with prior outcomes of similar events, and triggers
effective emotional responses
Much of the how the limbic system works involves emotion and memory. The
hippocampus is associated with storing memories in context with emotions and senses,
such as when the smell of homemade cookies brings back a memory of baking with a
grandparent when you were a child, or a particular song reminds you of when you first
fell in love. The hippocampus is also responsible for spatial awareness, which is a
sense of, or ability to make a physical determination of where one is in relation to the
objects around them. The hippocampus sits adjacent to, and on each side of the
amygdala.
Hypothalamus - The Soother - Function of the Hypothalamus
 Acts to mitigate the effects of stress in the brain body survival response process
and enhances regulatory patterns
The hypothalamus acts as cool quenching water to the amygdala’s flame, through
the consolidated effort of the hypothalamic-pituitary-adrenal connection and the
secretion of cortisol. Cortisol is the stress hormone, produced by adrenal glands
positioned above the kidneys. Note the body mind connection.
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SNT 1 Terminology and Diagnoses
© 2013 Deborah A. Beasley, All rights reserved
Cortisol helps regulate the accessibility of quick energy stores in the body, such
as fats, sugars, and proteins. The natural release of cortisol follows a 24-hour rhythm
called a Circadian Rhythm, and is responsible for balancing basic drives, like sleep
wake patterns. Circadian Rhythms also influence sexual drives and eating patterns. In a
properly functioning system, cortisol is the brains answer to soothe the overload of
stress responses in the body, and helps restore energy levels after stressful events. The
hypothalamus sits appropriately above the amygdala.
i
Social Engagement and Attachment A Phylogenetic Perspective, Stephen E. Porges,
University of Illinois at Chicago, Department of Psychiatry Ann. N.Y. Acad. Sci. 1008: 31 - 47
(2003). © New York Academy of Sciences. Doi: 10.1196/anals.1201.004
ii
Siddiqui SV, Chatterjee U, Kumar D, Siddiqui A, Goyal N. Neuropsychology of prefrontal
cortex. Indian Journal of Psychiatry. 2008;50(3):202-208. doi:10.4103/0019-5545.43634.
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