As part of our multi-disciplinary service here at Beacon House, we offer a comprehensive and specialist children’s Occupational Therapy Service.
We primarily work with children and young people whose presentation has been impacted by disrupted attachment and early trauma, and always involve parents/carers in this process. We work with children to look at how their sensory systems and motor skills are impacted by their early trauma. As we explore these challenges, we look at the interplay of how their body manifests fight and flight responses and the impact of stress triggers on daily life at home, school and play.
We work to help build healthy co-regulation and strengthen attachment. Together with parents or primary carers, we work out strategies to cope with these challenges so that there is carry through at home and school. As Occupational Therapists, our overall goals are always to facilitate better engagement in family life, play, self-care and learning activities.
Whilst our Occupational Therapy service is open to self-funding families, we primarily work with children referred by Local Authorities or specialist teams in education.
Our Occupational Therapy provision is overseen by Ruth Stephens, Specialist Occupational Therapist, and is delivered by a team of enthusiastic, skilled and energetic OTs. We offer a bespoke therapy room in Cuckfield with specialist Sensory Integration equipment, and our Chichester clinic has a wide range of specialist equipment that can be arranged according to individual children’s needs.
Often, sensory processing difficulties are linked to exposure to early childhood trauma or “adverse childhood experiences”, including the under-stimulation often associated with neglect. Because of the strong relationship between integration of the senses and attachment, it makes sense to look at children with sensory issues through an attachment perspective. Infants have not developed the necessary language with which to categorise memories by. However infants DO remember what happens to them in their senses.
These sensory memories are imprinted in the autonomic system of the brain. The child may then remain activated into a fight or flight response when a sensory system is triggered. For example if they hear a particular sound, or even smell something, that reminds them of their early experiences they may instinctively react as if the trauma were happening all over again. Early trauma and neglect may also mean that a child lacks that all-important nurturing contact or those movement sensory experiences that enable their coordination to develop.
You can read more about the connections between trauma, attachment and sensory processing difficulties from an Occupational Therapy lens in our comprehensive article.
Our work always begins with an assessment and this often results in phased, sequential treatment where a Sensory Attachment Intervention approach with an OT is often offered first in order to help the child to become better regulated; before psychological therapy is offered, focussing on their emotional and cognitive abilities.
We offer specialist assessments which explore the link between early trauma and your child’s motor skills, functional skills (including handwriting,) sensory processing and daily living skills. Our assessment will normally involve some standardised assessments where possible as well as functional and clinical observations. We then make a plan tailored to fit your child’s individual needs.
We might suggest specialist ongoing therapy and advice to promote improvement in your child’s sensory, motor and daily living skills using video work to think about how you can co-regulate better with your child. Once an assessment has been completed our OTs will draw from their wide range of training and experience to use the most suitable model of therapy for your child.
Once the assessment is underway, we will ask the parent/carer to complete a sensory profile or sensory attachment questionnaire prior to our first meeting. This means that we can begin our assessment of your child with a lot of preliminary information.
Assessments usually include a meeting with the parent/carer(s) alone, and a direct assessment of the child. The appointments involve lots of playing, some standardised assessments and also some observations about the relationship between you and your child. Children usually describe our OT assessments as fun, and are keen to come back afterwards!
Our OT assessment looks at the following areas of difficulty:
A full written report will be provided when the Occupational Therapist has gathered and considered all the information. This will contain suggestions for areas of intervention and ideas of how you as parents/carers and your child’s teachers can best help your child. Where appropriate, referral to other professionals may be suggested and Beacon House can point you in the right direction.
After the assessment is completed, a feedback session will be held to outline the findings of our assessment and look at goals for the therapy recommended.
Once we have completed our assessment, we can offer ongoing therapy with children, young people and their families.
We will choose the most appropriate model of therapy for your family but mostly we use the Sensory Attachment Intervention model. This therapy draws from the theory of Sensory Integration and attachment. The goals of this therapy are to help form good attachment and promote calm, regulated families who can enjoy each other. Our OTs are all trained by the originator or Sensory Attachment Intervention, Éadaoin Bhreathnach. You can read all about this approach on her website
Here is a little more information about both Sensory Integration and Sensory Attachment Intervention:
The Founder of Sensory Integration theory is Dr. Jean Ayres, who devised this theory of brain behaviour relationships. It is based on the theory that enhancing and modifying sensory input creates adaptive responses and then improves ability to process sensation and enhance learning and behaviour. It is a developmental approach, therefore unless the basic sensory systems have been functioning correctly and stimulated appropriately in early life, there will be difficulty forming higher skills such as:
Sensory Attachment Intervention (SAI)
SAI is a method of treatment pioneered by Occupational Therapist Éadaoin Bhreathnach, which aims to “enable parents and children to learn the art of self-regulation through the use of sensory and engagement strategies” (Bhreathnach 2013).
Sensory Attachment Therapy is based on the principle that our attachment patterns are linked to our early sensory experiences. It combines the theory of attachment with Sensory Integration theory, because strong links have been shown between sensory processing difficulties and attachment. Many children who have attachment difficulties also experience sensory processing difficulties, which affect their ability to self-regulate and in turn move in a coordinated way and carry out skills of daily life. These children also have difficulties with staying calm and alert, finding engagement in the classroom difficult.
Having the correct sensory input can enable a child to regulate. Therapy sessions value parents/carers as key to co-regulation with their child, and therapy sessions may provide sensory experiences which help your child to replace unhelpful sensory experiences from his or her early traumas with new, kinder, sensory memories.
Often sessions are videotaped to enhance the effectiveness of the therapy. The therapist will go over the video footage with parents/carers to facilitate optimum co-regulation. There will be high importance given to nurturing activities such as deep pressure (proprioceptive) to promote calming. Many children are functioning at a high arousal state due to past trauma, and the priority in treatment is to “facilitate a controlled and regulated response to sensory stimuli and engagement with others” (Bhreathnach 2013).
When parents also have an understanding of the child’s (and their own) regulating patterns they can be an effective tool in facilitating regulation and helping the child maintain a calm alert state. A sensory diet (strategies for healthy sensory input) may be worked out with you to help your child regulate his or her arousal levels. This may need to include the therapist going into the child’s school to help key staff who work with your child to know how they can help with sensory modulation and regulation.
Our Specialist Occupational Therapists provide tailor made services to schools across Sussex. We pride ourselves in creating a package that suits the needs of your school and your pupils, and we will happily talk you through all possible options. We specialise in providing training in how trauma impacts a child’s engagement during the school day and therefore cover topics such as regulating and attention.
Services frequently offered to local schools include:
We regularly see children who, due to their experiences of trauma, have difficulty modulating their attention and regulating their emotional state. Following an initial assessment, we provide a report to the parents and the school which includes a clear and pragmatic summary of the findings, together with creative strategies which can bridge support from both home and school. Interventions can be in the form of group work or individual work for a series of sessions.
Examples of school training packages:
Most children benefitting from our specialist Occupational Therapy service are able to access funding. If the child is adopted or cared for under a Special Guardianship Order they may be eligible for the Adoption Support Fund. Other children are able to access funds via their Pupil Premium, their EHCP therapy allowance, the SEND Commissioning Team or their Clinical Commissioning Group.
Unfortunately, we have very limited capacity to accept self-funding families.