After 20 years as a pediatric occupational therapist, I got a job as Mental Health Coordinator at Head Start and immediately discovered that children with behavioral problems and an early trauma history respond dramatically to developmental and sensory integration interventions. Many of my children who had childhood trauma and behavioral problems showed sensory discrimination, as well as “numbing”, and “hyper-arousal” sensory modulation challenges. These children respond well behaviorally to environmental adaptations and intervention strategies addressing their sensory discrimination (body awareness), low registration (lack of sensory responsiveness), sensory sensitivity (over sensitivity), and self-regulation (sensory modulation and self-control) challenges.
Over the next ten years working as an occupational therapist in pediatric psychiatry I’ve been continuing to develop research based interventions that improve behavior in children and adolescents with an early trauma history. Research shows significantly more sensory processing problems in children with early trauma histories, and I’m finding a synthesis of developmental, sensory, and behavioral problems is effective in reducing aggression in these youngsters. The slides below show that early childhood trauma is related to significant neurological challenges (slides 1-3), and sensory challenges (slide 4), that can benefit from an environmental sensory strategy of first decreasing then increasing sensory input (slide 5).
The final slide above illustrates an effective practical strategy for helping children who are too low or high energy to behave and learn appropriately. First, decrease all stimulation (noise, touch, movement, visual input) and see if that improves their ability to achieve a calm alert state. If that doesn’t help continue to incrementally increase sensory input in a social acceptable manner until a quiet alert state is achieved. Regardless of sensory modulation style or cause, if children are too hypo and/or hyper-sensitive to learn (including children who have sensory processing problems affected by trauma), you can initiallty reduce all sensory input, then if needed increase sensory stimulation in a socially acceptable manner until a quiet alert state is reached. This strategy frequently helps regardless of their current sensory modulation problem.
Strategies to Improve Sensory Discrimination include massage, mindfulness, and movement games (e.g., Put your finger on your nose, Hokey-Pokey, Head, Shoulders, Knees and Toes). To promote self-regulation teachers and therapists can help kids identify their initial state of arousal using energy meters or other tools, then direct them in decreasing or increasing their energy level as needed. Activities combining linear movement with deep body pressure help promote self-control by enabling children to modulate their arousal state. This can include taking a walk, biking, scooters, swimming, basketball, soccer, dancing, and structured playground tasks.
These movement and pressure activities can be adapted for the classroom through having children take walks to get drinks or deliver messages, set table, move mats, move tables, and pass out books. For bright children who are unable to be still, having them roll across the room then read several pages or do a math sheet, then roll back and do more combines movement and pressure with academics. FAB Strategies that help promote self-regulation include Freeze dance, Freeze shake, Giant steps, Simon says, Red light, Social role playing, and implementing a Plan-Do-Review process. Resources to improve self-regulation are available at <www.fabstrategies.com> <www.spdnetwork.org> and <www.challengingbehavior.org>