Sensory modulation disorders are strongly associated with Post-Traumatic Stress Disorder “PTSD”. Research found over three quarters of youth with PTSD had sensory modulation disorders, compared to five percent in the general population. Sensory modulation disorders significantly associated with childhood trauma are: hyperarousal (including auditory defensiveness, tactile defensiveness, as well as gravitational insecurity), hypoarousal, and sensory avoidance. The specific sensory modulation disorder and sensory systems affected vary with the abuse or neglect experienced (Teicher et al., 2016; Howard et al., 2019).
Occupational therapy “OT” sensory assessment and intervention can help youth with PTSD address sensory modulation challenges that negatively impact behavior and improve occupational performance in school (McGreevy & Boland, 2019; Joseph et al., 2020). The Sensory Profile and Trigger & Coping Strategies form
can help determine specific sensory modulation challenges and sensory modality challenges and guide individualized intervention (Pagano, 2019). Trauma-informed sensory intervention offers unique value within the scope of practice of occupational therapy (Pagano & Cahill, 2021; Fraser et al., 2017).
Youth with PTSD and behavior challenges benefit from OT as part of their multidisciplinary treatment of their neurologically based sensory modulation challenges that are significantly related to behavior problems (Debellis et al., 2013; Cross et al., 2017).
Increasing awareness by teachers and mental health professionals of the need for sensory rooms and sensory modulation rooms has been helpful. However, it is important to also recognize the unique value of including occupational therapists on the team to assess and develop a transdisciplinary program that addresses the individual’s unique sensory challenges and preferences (Pagano, 2019).
Occupational therapy as part of transdisciplinary assessment and intervention helps best meet the individual needs of youth with PTSD and sensory modulation disorders (McGreevy & Boland, 2019; Whiting, 2018; Teicher et al., 2016).
REFERENCES
Cross D, Fani N, Powers A, Bradley B. Neurobiological development in the context of childhood trauma. Clinical Psychology: Science and Practice. 2017 Jun;24(2):111.
De Bellis MD, Woolley DP, Hooper SR. Neuropsychological findings in pediatric maltreatment: Relationship of PTSD, dissociative symptoms, and abuse/neglect indices to neurocognitive outcomes. Child maltreatment. 2013 Aug;18(3):171-83.
Edwards DJ, Pinna T. A systematic review of associations between interoception, vagal tone, and emotional regulation: Potential applications for mental health, wellbeing, psychological flexibility, and chronic conditions. Frontiers in Psychology. 2020 Aug 5;11:1792.
Fraser K, MacKenzie D, Versnel J. Complex trauma in children and youth: A scoping review of sensory-based interventions. Occupational Therapy in Mental Health. 2017 Jul 3;33(3):199-216.
Howard AR, Lynch AK, Call CD, Cross DR. Sensory processing in children with a history of maltreatment: an occupational therapy perspective. Vulnerable Children and Youth Studies. 2019 Nov 16:1-8.
Joseph RY, Casteleijn D, van der Linde J, Franzsen D. Sensory modulation dysfunction in child victims of trauma: a scoping review. Journal of Child & Adolescent Trauma. 2021 Dec;14(4):455-70.
McGreevy S, Boland P. Sensory-based interventions with adult and adolescent trauma survivors: An integrative review of the occupational therapy literature. Irish Journal of Occupational Therapy. 2020 Apr 9.
Pagano, J. FAB functionaly alert behavior strategies: Integrated behavioral, developmental, sensory, mindfulness & massage treatment. Connecticut: Pagano FAB Strategies, LLC: 2019.
Pagano J, Cahill S. School OT crisis response & prervention. AOTA Mental Health Toolkit, 2021.
Teicher MH, Samson JA, Anderson CM, Ohashi K. The effects of childhood maltreatment on brain structure, function and connectivity. Nature Reviews Neuroscience. 2016 Oct;17(10):652.
Whiting CC. Trauma and the role of the school-based occupational therapist. Journal of Occupational Therapy, Schools, Early Intervention. 2018 Jul 3;11(3):291-301.
