Book of the Month September 2020 - Building Sensorimotor Systems in Children with Developmental Trauma

Review of “Building Sensorimotor Systems in Children with Developmental Trauma: A Model for Practice” by Sarah Lloyd
 
Sarah Lloyd brings her rich experience as a Specialist Occupational Therapist and Play Therapist working in children’s mental health services to the fore in this comprehensive and passionate book for families and practitioners working with children who have experienced early adversity and trauma. 
 
Her innovative BUSS model considers that these children have not simply missed out on nurturing relationships, but also the physical movements which complement these relationships. It’s important to note that this book is not designed as a manual for treatment, but rather a number of ideas and suggestions which can be adapted to meet the needs of your own child or a child you are working with in a health or educational context. It also differentiates between the functional sensory processing disorders which are typically found in neurodevelopmental conditions and the under-developed sensory systems resulting from developmental trauma. The BUSS model fits nicely with established models of trauma and development, such as the work of Bruce Perry, Dan Hughes and Kim Golding.
 
Sarah writes in a clear and accessible manner, particularly when describing the early stages of motor development, and this is greatly supported by lovely illustrations of infants and practical examples of what these stages might look like in your own house. When considering the sensorimotor challenges which children may face in everyday life, she asks us to concentrate not just on “what” is difficult, but also “how” the child functions. There is a clear theme about the need to spend time noticing how children move and gathering information about their particular needs, before considering intervention.
 
Perhaps one of the most positive aspects of the book is the idea that these sensorimotor systems are “underdeveloped, but not broken”. Several of the chapter headings refer to “rebuilding”; that the children described within the case studies lack the essential foundations of bodily awareness and emotional regulation and thus have to exert a great deal of attention and effort to get their bodies to do what they want them to do. This empathetic perspective is crucial in placing the emphasis firmly on the need to build the capacity of these systems.
 
The book offers a range of fun activities and games which can be utilised to rebuild the various systems, such as touch, core strength and stability, taste and movement. I particularly like the focus on getting things “just right”. For example, if a child with an underdeveloped sense of touch struggles to discriminate between objects in a feely bag, an alternative suggestion is to hide objects in a bath with lots of bubbles. Sarah has clearly put a lot of thought into these hands-on activities and considered the need to take a step back and gradually increase the level of challenge.
 
While a number of case studies are referred to throughout the book, she helpfully summarises these studies in a “catch up” chapter later on; outlining the key points from each child’s assessment, the kind of activities used in the first four weeks of intervention and the initial review with the child’s parents. The fact that the final part of the book is dedicated to parents’ own experiences of applying the model - offering a range of top tips from everyday practice - means that we finish as we started: with a hopeful and optimistic perspective about growth and rebuilding.
 
Dr Christopher Moore
Educational Psychologist

---