Understanding Development Through A Neurodevelopmental Lens

The Neurosequential Model of Therapeutics (NMT) is a developmentally informed approach to clinical assessment and problem-solving. It brings together a person’s developmental history, experiences of adversity, relational health, current functioning, and individual strengths to create a more organized picture of how development may be influencing the way they function today.

The brain develops over time, with different neural systems developing and organizing in a sequence. Experiences occurring during different developmental periods can influence that process, particularly when stress is intense, prolonged, unpredictable, or occurs without enough consistent relational support. NMT allows us to look at both sides of that developmental history: experiences that may have created vulnerability and relationships or experiences that supported resilience.

This is one of the reasons I find NMT particularly valuable in my work. A behavior, emotional response, learning difficulty, relationship pattern, or struggle with regulation makes more sense when we understand the developmental systems involved and the experiences that helped shape them.

Looking Beyond What Is Happening To Ask Why

People are often referred for help because of what can be seen on the surface. A child may have difficulty with attention, transitions, sleep, learning, aggression, relationships, or managing strong emotions. An adult may understand intellectually what they want to do differently while finding that their body, emotions, or automatic responses continue to move in another direction.

NMT gives us another way of organizing those questions. Rather than looking only at symptoms or diagnostic labels, the assessment considers developmental history alongside current functioning across areas associated with sensory integration, self-regulation, relational functioning, and cognition.

That broader picture can help us understand where functioning is relatively strong, where additional developmental support may be useful, and what kinds of experiences may be most appropriate to prioritize. The goal is to develop recommendations that make sense for the individual rather than simply adding more interventions to an already crowded treatment plan.

Adverse Experiences And Relational Health Both Matter

One of the things NMT considers across development is the relationship between adverse experiences and relational health. Your history is more than a list of difficult things that happened to you. It also includes the relationships, caregiving experiences, environments, and supports that were available while development was taking place.

This matters because relational experiences can contribute to resilience across development. Two people can experience significant adversity and have very different developmental pathways depending on timing, duration, intensity, individual differences, and the relational supports available to them.

In the NMT process, developmental history is therefore organized across specific periods rather than reduced to a single trauma score. The clinical materials examine adverse experiences and relational health beginning with intrauterine and perinatal development and continuing through infancy, early childhood, childhood, adolescence, and adulthood when applicable.

That developmental timeline helps us ask a more useful question: What experiences were occurring while particular systems were developing, and what might that help us understand about functioning today?

What The NMT Helps Us Understand

The NMT Metric brings developmental history together with information about current functioning to create a neurodevelopmentally informed picture. It considers multiple areas of functioning, including sensory integration, self-regulation, relational functioning, and cognition, while also examining more specific capacities associated with sleep, attention, arousal, dissociation, affect regulation, attachment, learning, communication, impulse modulation, and other areas of development.

The resulting information can help identify areas of relative strength as well as areas where functioning may need additional support. This becomes particularly useful when someone has received treatment before and there is still uncertainty about why particular difficulties continue, why certain interventions have had limited impact, or what should be prioritized next.

NMT recommendations are designed to provide broad direction for the selection and sequencing of developmentally appropriate therapeutic, educational, relational, and enrichment experiences. The recommendations are then considered alongside the person's circumstances, existing treatment, relationships, resources, and the clinical judgment of the professionals involved.

NMT Is Not A Diagnosis

The NMT is a clinical problem-solving approach and assessment tool. It is not a stand-alone psychological, neuropsychological, psychiatric, or psychoeducational evaluation, and it does not replace evaluations that may be needed for diagnosis, educational eligibility, medication management, or other specialized purposes.

Instead, NMT adds a neurodevelopmental lens to information that may already exist. Psychological testing, occupational therapy evaluations, medical information, educational records, previous diagnoses, treatment history, and observations from people who know the individual well may all become relevant pieces of the larger developmental picture. Your Napa NMT clinical abstract specifically incorporates current educational, neurodevelopmental, neuropsychiatric, medical, and therapeutic information into that formulation.

For families and treatment teams, this can create a shared framework for understanding why certain patterns may be occurring and what kinds of support make developmental sense moving forward.

The NMT Assessment With Me

The assessment process involves gathering enough information to understand developmental history and current functioning before completing and interpreting the NMT Metric. The exact information I need depends on the person being assessed, their age, the questions we are trying to answer, their history, and the other professionals or systems involved.

For children, adolescents, and dependent adults, I gather information from caregivers and from the person being assessed when developmentally appropriate. Teachers, therapists, physicians, occupational therapists, social workers, or other professionals may also have information that helps create a more complete picture. The NMT clinical process itself considers family and developmental history, adverse experiences, relational health, educational history, previous interventions, current therapeutic services, medical and neurodevelopmental information, strengths, current challenges, and the primary questions we are trying to understand.

For adults, our meetings focus more extensively on your own developmental and relational history, current functioning, experiences across different developmental periods, strengths, concerns, previous treatment, and the patterns or questions that led you to seek an assessment.

For Minors Under 18 And Dependent Adults

4-hour minimum: $1,100 total

This includes:

• One session with the parent(s) or caregiver(s)
• One session with the child or person being assessed
• One session with a teacher, provider, or other person who can contribute relevant information when appropriate
• Completion and analysis of the NMT Metric and its recommendations
• A final meeting to review the findings and individualized recommendations together

During these meetings, I gather information about developmental history, relational experiences, current functioning, strengths, concerns, and the environments and relationships surrounding the person being assessed.

A 50% deposit is required before the assessment process begins. The remaining balance is due at the final session. Financial arrangements may be available to accommodate your family's needs, and you are welcome to ask about this during the inquiry process.

For Adults 18 And Older

4-hour minimum: $1,110 total

This includes:

• Two to three sessions with you to gather developmental and relational history and understand your current functioning and the questions bringing you to the assessment
• Completion and analysis of the NMT Metric and its recommendations
• A final meeting to review the findings and individualized recommendations together

A 50% deposit is required before the assessment process begins. The remaining balance is due at the final session. Financial arrangements may be available, and you are welcome to ask about this during the inquiry process.

When Additional Time Or Collaboration Is Needed

Four hours is the minimum assessment structure. Some assessments require additional time depending on the complexity of the history, the questions being explored, the records that need to be reviewed, and the number of people involved in providing relevant information.

There may also be times when consultation with another professional who knows you or your child is clinically useful. This might include a therapist, psychologist, psychiatrist, physician, occupational therapist, social worker, teacher, or another provider involved in care.

After the assessment is completed, some people also ask me to speak directly with their treating provider or another professional about the results and recommendations. When this is requested and appropriate, we can discuss consultation as an additional service outside the standard NMT assessment fee.

How To Begin An NMT Assessment

An NMT assessment begins with a written inquiry. This gives me an opportunity to understand who the assessment is for, what has led you to seek NMT, and the questions you are hoping the assessment may help answer.

Because NMT is an individualized assessment process, the scope may vary depending on age, developmental history, current concerns, available records, and the complexity of the questions being explored. I review each inquiry before recommending the next step so that you understand what the assessment would involve before deciding whether to proceed.

What Happens Next

1. Submit An NMT Inquiry

   Complete the secure inquiry form with basic information about who the assessment is for, the current concerns, and what you are hoping to better understand.

2. I Review Your Inquiry

   I personally review the information you provide to determine whether NMT appears appropriate for the questions you are hoping to answer. I may respond with a few follow-up questions or offer a brief call when clarification is needed.

3. You Receive The Scope And Fee

   I explain the proposed scope of the assessment, whether additional records or interviews may be needed, any additional fees beyond the four-hour minimum when applicable, and the anticipated timeline.

4. Complete The Agreement And Deposit

   When you decide to proceed, you complete the service agreement and submit the 50% deposit before the assessment process begins.

5. Complete The Assessment Process

   We gather the developmental, relational, clinical, educational, and other relevant information needed to complete the assessment and NMT Metric.

6. Receive The Findings And Recommendations

   Once the assessment is complete, we meet to review the findings together. We discuss what the developmental picture may help us understand and how the recommendations can inform treatment, caregiving, educational support, relationships, regulation, and other appropriate next steps.

Ask About An NMT Assessment

If you are wondering whether an NMT assessment may help answer questions about yourself, your child, or someone you support professionally, begin with the secure inquiry form. Tell me what has led you to consider NMT and what you are hoping to better understand, and I will personally review your inquiry before recommending the next step.