The Boy Who Was Hit in the Face: Somatic Regulation and Processing of Preverbal Complex Trauma

Sensory Processing Assessment and Feedback in the Treatment of Complex Developmental Trauma

This study explored the impact of a sensory processing assessment, recommendations and feedback process on the functioning at school and after-hours environments of children who had been traumatised by abuse. A mixed methods design (Schoonenboom & Johnson, 2017) was utilized incorporating pre (12 months prior) and post (four to eight months after the report) repeated child focused measure, alongside thematic analysis of participants qualitative survey feedback. The methodology included two stages: firstly, an occupational therapy assessment of young people referred by Own Organisation clinicians for a sensory processing assessment and secondly, an evaluation was conducted of the impact of occupational therapy on the young person's behaviour and their carers. The study found significant improvement in family life and relationships as well as a reduction in impairment as evidenced by decreases in HoNOSCA scores across problems with family life and relationships, non-accidental self-injury, problems with emotional and related symptoms, poor school attendance and on the social subscale. These findings were supported by clinician participant reports. A sensory processing assessment provided young people, their carers and teachers with information which contributed to environmental adaptations. These environmental adaptations were associated with improved functioning and behaviour of young people impacted by child abuse. It is recommended future research attempt to replicate and extend our understanding of how sensory processing assessments and interventions can increase children's wellbeing.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40653-023-00607-0.

The Impact of Childhood Trauma on Sensory Processing and Connected Motor Planning and Skills: A Scoping Review

Background

Traumatic experiences during childhood have been suggested to alter the course of sensory and motor development due to the impact on neural connections within the brain at integral periods. This connection has been alluded to in literature and is discussed anecdotally by practitioners suggesting the impact is commonly seen in practice. Previous scoping reviews in this area have focused solely on the process of sensory modulation without exploring the connection to motor planning.

Objective

This scoping review considers what is known from the existing literature about the impact of childhood trauma on sensory processing and motor skills.

Method

This scoping review followed the JBI methodology for scoping reviews (Peters et al., 2020), searching CINAHL plus, Proquest, Scopus, PsycINFO, EThOS, as well as a search of the reference lists of the articles and citation chaining, to locate both published and unpublished sources. Articles were reviewed by two reviewers independently, with a third reviewer verifying those that met inclusion criteria where there was disagreement.

Results

Six articles were identified that met the inclusion criteria for the study. While all included studies suggested the concurrence of sensory processing and motor difficulties in individuals who have experienced childhood trauma they did not conclusively make the link between the two suggesting an overall low level of evidence. Commonalities were identified in relation to the areas of the brain impacted and the nature of difficulties experienced with some suggestion of this varying according to stage of development and the specific nature of the trauma.

Conclusions

This study suggests emerging evidence in relation to the connection between trauma, sensory processing and motor development but that further empirical research is needed to verify this and inform practice.

The brain-body disconnect: A somatic sensory basis for trauma-related disorders

Although the manifestation of trauma in the body is a phenomenon well-endorsed by clinicians and traumatized individuals, the neurobiological underpinnings of this manifestation remain unclear. The notion of somatic sensory processing, which encompasses vestibular and somatosensory processing and relates to the sensory systems concerned with how the physical body exists in and relates to physical space, is introduced as a major contributor to overall regulatory, social-emotional, and self-referential functioning. From a phylogenetically and ontogenetically informed perspective, trauma-related symptomology is conceptualized to be grounded in brainstem-level somatic sensory processing dysfunction and its cascading influences on physiological arousal modulation, affect regulation, and higher-order capacities. Lastly, we introduce a novel hierarchical model bridging somatic sensory processes with limbic and neocortical mechanisms regulating an individual's emotional experience and sense of a relational, agentive self. This model provides a working framework for the neurobiologically informed assessment and treatment of trauma-related conditions from a somatic sensory processing perspective.

Definition and attributes of the emotional memory images underlying psychophysiological dis-ease

BACKGROUND

Previously, we proposed a "Split-second Unlearning" model to explain how emotional memories could be preventing clients from adapting to the stressors of daily living, thus forming a barrier to learning, health and well-being. We suggested that these emotional memories were mental images stored inside the mind as 'emotional memory images' (EMIs).

OBJECTIVE

To elaborate on the nature of these emotional memory images within the context of split-second learning and unlearning and the broader field of psychoanalysis, to initiate a conversation among scholars concerning the path that future healthcare research, practice, and policy should take.

METHOD

A narrative review of the attributes of EMIs utilizing relevant and contentious research and/or scholarly publications on the topic, facilitated by observations and approaches used in clinical practice. Results: We propose a refined definition of EMIs as Trauma induced, non-conscious, contiguously formed multimodal mental imagery, which triggers an amnesic, anachronistic, stress response within a split-second. The systematic appraisal of each attribute of an EMI supports the idea that the EMI is distinct from similar entities described in literature, enabling further sophistication of our Split-second Unlearning model of psychophysiological dis-ease.

CONCLUSION

Exploration of the concept of EMIs provides further insight on mechanisms associated with psychophysiological dis-ease and opportunities for therapeutic approaches.

Ethogram of non-verbal behaviours associated with emotional regulation and stress response in children and adolescents with complex trauma

Complex trauma is a clinical concept developed to address the nature and effects of interpersonal traumatic experiences over the development of children and adolescents. To contribute to the development of ecologically valid diagnostic tools and a better understanding of the effects of complex trauma, an ethogram of emotional regulation and stress response behaviours was proposed and used as the main instrument in the Crossed-Puzzles Game. In total 84 children and adolescents aged 6–14 (50% of children with complex trauma in state protective care) were selected from institutions and the community. Both groups were matched by age, sex, and socioeconomic status. PCA, PERMANOVA, Mann-Whitney’s U, Pearson correlations, and logistic regression analyses were performed. The ethogram’s category ‘Externalising of frustration’ was identified as one of the strongest predictors for the complex trauma group. The ethogram’s validity as a research and assessment instrument from a clinical ethology perspective of complex trauma in psychology was discussed.