The Connection Between Childhood Trauma and Sensory Processing: What Every OT Needs to Know - PART 1

A critical research review that validates what we see in our therapy rooms every day

The Research That Changes Everything

A groundbreaking scoping review by Matson, Barnes-Brown, and Stonall (2024) has finally put scientific backing behind what many of us have observed clinically: childhood trauma fundamentally alters sensory processing and motor development. This research validates the SenseUp Approach's emphasis on understanding the neuroscience connections between trauma, sensory integration, and functional capacity.

What the Research Revealed

The study identified six key findings that should transform how we think about our sensory clients:

1. Trauma Disrupts the Foundation Childhood trauma doesn't just affect behaviour—it literally rewires the brain's sensory processing systems. Areas like the hippocampus, amygdala, thalamus, and sensory cortex show measurable changes that directly impact how children process and integrate sensory information.
2. The Critical Window Trauma occurring before age 7 has the most devastating impact because it disrupts development during the primary sensorimotor formation period. This explains why early intervention is absolutely crucial.
3. It's Not Just About Regulation Whilst sensory modulation difficulties are well-documented, this research shows trauma also affects:

• Motor planning and praxis
• Body awareness and proprioception
• Visual-motor integration
• Bilateral coordination
• Postural control

4. The Layered Trauma Effect Many neurodivergent children experience what researchers term "layered trauma":

• Sensory trauma: Chronic overwhelm from everyday experiences
• Social trauma: Repeated misunderstanding and rejection
• Shame trauma: Learning that their sensory needs are "wrong"

5. The Brain-Body Disconnect Trauma creates a fundamental disconnection between brain and body, where normal sensory experiences become associated with threat rather than safety. This explains why traditional sensory strategies often fail with trauma-exposed children.
6. Bottom-Up Therapy Works The research supports sensorimotor approaches that focus on rebuilding body trust and nervous system safety before addressing higher-order skills.

Connecting This to Your OT Practice

This research perfectly validates the SenseUp Model's layered approach:

• Level 1 (Sensory Systems): Trauma disrupts foundational vestibular, proprioceptive, and tactile processing
• Level 2 (Sensory-Motor Integration): This creates cascading effects on body awareness, postural control, and motor planning
• Level 3 (Perceptual-Motor Skills): Leading to difficulties with fine motor, gross motor, and visual-spatial skills
• Level 4 (Functional Capacity): Ultimately impacting sleep, meals, toileting, and learning

The research confirms that you cannot effectively address the higher levels without first establishing safety and integration at the foundational sensory level.

Shift from "Fixing Behaviours" to "Building Body Trust"

Instead of: "This child seeks intense vestibular input—they need more proprioceptive activities to regulate."

New approach: "This child's seeking behaviour may indicate a desperate attempt to reconnect with their body and achieve regulation in a system that has learned to distrust internal sensations."

Practical application:

• Begin every session with a "body check-in" to help children reconnect with internal sensations
• Use child-controlled sensory experiences where they have complete autonomy over intensity and duration
• Celebrate their sensory responses as "important information from your clever body" rather than problems to fix

A Therapy Nugget to Implement This Week

Therapy Nugget #1: The "Safety First" Sensory Sandwich

What: Bookend any challenging sensory activity with co-regulating, child-controlled input

How to do it:

1. Start with connection: 2-3 minutes of child-chosen calming input (deep pressure, slow swinging, breathing together)
2. Gentle challenge: Introduce your therapeutic activity with full child control over stopping
3. End with integration: Return to calming, organising input whilst reflecting on the experience together

Why it works: This creates the neurobiological safety necessary for learning whilst honouring the child's nervous system needs.

The Bigger Picture

This research confirms that trauma-informed sensory practice isn't just about being gentle—it's about understanding that trauma literally changes how the nervous system processes and integrates sensory information. When we approach our clients through this lens, we're not just addressing sensory processing difficulties; we're supporting the fundamental neurobiological healing necessary for all other development.

If you are a past or present student of The SenseUp Approach Course, you're already equipped or equipping yourself with the framework to provide this level of care. This research simply validates what you're learning: that true sensory integration work must address the whole child, including their nervous system safety.

The children we serve deserve people in their lives who understand that their sensory challenges aren't just "wiring differences" but often represent their nervous system's brilliant adaptation to keep them safe in an overwhelming world. Our job is to help them learn that their body can be a safe place again.

What will you try differently in your next session?

Understanding Complex Sensory Presentations

This research highlights something many of us experience: complex sensory profiles often tell a deeper story. When assessment results show patterns across multiple quadrants or seem contradictory, we now understand this may reflect sophisticated nervous system adaptations.

The challenge? Standard reports document these patterns but don't always guide us toward understanding what they mean for intervention - especially when trauma may be a factor.

Developing clinical reasoning skills to interpret complex sensory presentations becomes essential when working with children whose assessment results initially seem puzzling.

If you're finding yourself wanting to deepen your ability to analyse complex assessment results and develop targeted strategies, our Sensory Profiling & Strategy Development Series (26 August & 2 September) explores exactly these systematic approaches to clinical reasoning and intervention planning.

Learn more about the Masterclass Series → 2025 Spring Masterclass 2Part Series

Because understanding complex sensory presentations - and knowing how to respond effectively - is at the heart of excellent occupational therapy practice.