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

The Meltdown kids: Sensory solutions to everyday situations
[Box Set of 7 books]
By Linda Plowden OT and Hugo Plowden, illustrations by Peter McNaney

Reviewed by Lucky Lucy, a sensory challenged 22 1/2  year old.

First up, this is the story of my school life in a box! I found school really really hard even though I went to a very good school and these books explain some of the reasons why. I picked up the books because the title was intriguing. I laughed at it at first and then got annoyed. The books described me, but if anybody had used the term ‘meltdown’ to describe my behaviour when I was growing up they would really have seen what a meltdown was. Meltdown implies a bit of a strop, like just not getting your own way, it doesn’t convey the level of distress involved for the kids in these stories. There are seven books in the box covering the seven days of the week- why not just call it The Sensory Seven?

Mayhem Monday is completely relatable. The wee girl Jody has to get up for school on a Monday morning and because her mum, dad and sister all hound her to get out of bed and get dressed for school she loses it with them all. That’s spot on. What people don’t get is that wearing scratchy or uncomfortable clothes feel so overwhelming it completely dominates your thinking so if somebody talks to you at the same time as your clothes are irritating you it feels like the voice is part of the irritation - you can’t shout at your clothes so the person talking to you gets a mouthful. I always took it out on my mum because she was the one getting me up in the morning and you don’t want to leave your cosy bed, which is your safe place.
​People don’t understand how stiff and uncomfortable school uniforms are. We had plastic bits in the shirt collars, we had to keep the top button closed and we had to wear a tie – seriously, that feels like you are hanging, especially when the shirts are new or freshly ironed. Then you get that weird static feeling from acrylic jumper like its clinging to your skin. It is so claustrophobic you can’t think of anything else. I used to open my top button so I could breathe and then I’d get a note. If you got three bad notes in a week you’d get a detention. Can you imagine what it feels like to do the one thing you know will help you feel better and then get punished for it? Schools need to understand that when you feel better you learn more.

Tricky Tuesday. Just reading this makes me feel what William is going through. I would have hated all that change. Having a new teacher coming up and touching me would instantly make me feel 100 times more alert. You just don’t come up behind somebody and touch them, especially if you are bigger, more powerful and a stranger! I need to see someone face on so I can size them up. The teacher also expected William to sit in the middle of the room.
Kids like William and me need to sit with a wall behind us or in a corner, so you can see everyone, nobody can come up behind you and you know where the door is if you have to leave quickly. Where you sit makes a big difference to how vigilant you need to be in class. When William goes into survival mode and climbs the tree, Mr Shah says he will climb up and get him because it is not safe up there. But William is up there because it feels a lot safer than being on the ground. The tree becomes William’s safe space, and it is never okay to go into somebody’s safe space? You always ask permission. William’s mum gets called to the school. Mum gives him some crunchy cheese and crackers to bring him back to his senses and water in his sports bottle. Brilliant! I mean who doesn’t love a flip-up lid? It is a perfectly disguised, socially acceptable baby bottle – an instant soother and you can have a wee chew on it if you need to. 

Wobbly Wednesday. In brief, Wobbly Wednesday is about PE. I hated PE so I identify with Ben daydreaming in goal. Like him, I couldn’t be expected to concentrate when all the action was down the other end of the pitch. Also, why stand up on your own when you can sit down, make daisy chains and look for lady bugs like I did?  Anyway, goal is too much pressure. Practising does make a difference and encouragement from your friends really makes you want to do well. Friends make all the difference to school. 
Of course PE is also about the uniform issue again. As if it’s not annoying enough to put your uniform on in the morning, you have just broken yourself into it when you have to take it off, put on a PE kit with shorts! Not even jogging bottoms! And that horrible plasticky elastic around your waist, yuck. Then, when you are all sweaty you have to put your uniform on again and get back to school work. Let me explain what that feels like. It’s like putting a tight tee shirt on back to front and then wriggly around inside it to get it turned round but it doesn’t move properly. It feels like that all day after PE. It should be mandatory that PE comes at the end of the day, so you can go home in your kit and change into something comfortable.

Terrible Thursday. Oh what? This is definitely a week in the life of Lucy! Seriously, this is genuinely my life. Katie goes to the supermarket with her aunt, who sends her to look for four things. I couldn’t do that. One thing at a time please! Also, sending Katie for things where there is a lot of choice is a non-starter. She needs a description, or even better, like in the book, pictures. Bright lights are off putting – they’re not a huge deal for me but I can see why they would bother Katie. Sucking the lolly is a great idea because it regulates you. As the shop was new to Katie, her aunt should have done a walk around with her first so it wasn’t so frightening.
When I was at school, I wouldn’t walk the corridors between classes on my own. I was lucky because my friends understood my quirks and there was always somebody to walk with me, which anchored me. In shops, my mum used to say if we ever got separated just stay in the shop and she would find me because she would never leave without me. That helped when we did get separated because you can very quickly feel forgotten. Busy places with lots of people still scare me.

Frightening Friday. The restaurant scene. Again, the seating issue comes up. Sit in a corner or against a wall and look into the face of someone you know. In this story, things get so heated in the restaurant that Jack ends up under the table and his step dad tries to pull him out by the ankle. NO, NO, NO! I am pulling my feet under me as I read this. You don’t ever grab anybody by the ankle or the wrist. I don’t know what it is about it but its like having someone’s hands round your neck – it is terrifying! I would have stabbed him with my fork!
On a more positive note scoping the restaurant when its quiet is a good idea, previewing the menu – we do that! It sounds silly to some people but a new menu is not a pleasant surprise it is the suspense of the unknown – check it out first. Even seeing what the food looks like is a good idea. I mean I love gravy, but there’s all different kinds of gravy and I don’t want it poured all over my food. Restaurants can be intimidating, its not like being at home where your mum can scrape off the weird bits or pick out the green things, which can be a bit embarrassing, especially when you’re 22, LOL.  It made a big difference to Jack that the adults tried to understand what was difficult for him and helped him out. It is always calming driving around in the car and remember people need time to feel comfortable in a new place. If you are rushed into settling, you never settle.

Scary Saturday. I don’t have a lot to say about this book except I identify with the clothes thing. Also, don’t force a child to join in at parties, let him do his own thing until he finds his way. Any big exciting events can make you feel a bit wobbly so prepare children for change and excitement and the sensory environment of a birthday party. The scene where Nathan stuffs his hands into Danny’s birthday cake could easily be read as jealousy but I think its more about Nathan thinking if all the attention is on Danny, they’ll forget about me. It really helps to include Nathan in the preparation as the excitement can be overwhelming.
When me and my sister had birthdays my grandma always used to give the other one an “unbirthday” card and an “unbirthday” present. Blowing up the balloons is also a good idea.
  
Stressful Sunday. Sunday’s are always stressful because it’s the day before going back to school. Homework doesn’t help. But here’s the thing parents, don’t point out the obvious – we know we should tell you sooner that we have homework but we don’t want to do it so if we don’t write it down or talk about it then we can pretend it isn’t real until of course we are forced to do it. But going on about it will make us want to tell you less.
I completely identify with Ryan. I don’t think anybody gets how hard homework is – it’s not laziness, it’s mental exhaustion. I felt bad about not doing homework but I just couldn’t. However hard work is in school it is 100 times harder at homework time – even when it’s things you can do reasonably well at school – it’s like doing all your schoolwork in a different language. Ryan’s parents doing his homework for him reminds me of my mum. The colour coding and strategies from the senco also help, but more in school than at home.

I like these books. They highlight how difficult everyday things are for children with sensory challenges through simple stories and clear examples. They flag up the problem, why it might have occurred and offer easy solutions. Children with sensory difficulties are not bad kids, we do our best – we want to go shopping, do PE and join in but it’s not that simple. It’s pointless saying, “calm down”. Believe me, if we could we would! Adults need to recognise that when children have ‘meltdowns’ there’s nothing wrong with the child, there is something wrong with the situation so just take a step back, breathe and reflect. I also like that the adults in the books ask for help. I think it’s easy for parents and teachers to feel overwhelmed when they don’t understand the situation. It’s not the parents’ fault, it’s not the child’s fault, it just is what it is. We all need to help each other out.

Lucky Lucy
A sensory challenged 22 1/2  year old