Table 2.

Chartered data of 13 final peer-reviewed articles

Publication & Origin	Research Design	Participants	Purpose	Type of Trauma	Identification of SMD	Treatment of SMD	Core Principles of Ayres Sensory Integration®	Outcomes and Conclusions	Discipline
Warner et al. (2013) New York.	Description of program, exploratory conceptual paper.	Children & Adolescence	To develop trauma specific treatment modes for children and adolescence with complex trauma in residential treatment, whose affect and behavioral dysregulation disrupts daily living.	Multiple traumas e.g. early loss, disturbed caregiver systems, emotional, physical & sexual abuse & various forms of neglect.	None	Sensory Rooms and the SMART program was developed (Sensory Motor Arousal Regulation Treatment)	Ayres Sensory Integration and Psychotherapy modules.	Sensory Integration theory & sensory modulation techniques supported by appropriate staff training and consultation offers innovative strategies for improving affect and behavior regulation in traumatized adolescence. Removal of restraints	Occupational Therapy & Psychotherapy
Warner et al. (2009) Boston	Descriptive	None	Discusses trauma as a state change disorder in children.	Emotional Abuse, Neglect, Attachment disruptions, Physical Abuse, Sexual Abuse	None	SMART (Sensory Motor Arousal Regulation Treatment)	Yes	With improved arousal regulation children show, greater expression of feelings, greater self observation, increased social engagement, greater empathy.	Occupational Therapy & Psychotherapy
B. J. Atchison (2007) Michigan, Kalamazoo	Descriptive paper & evidence - based literature reviewed.	Children	Present definitions and concepts about sensory modulation, behavioral aspects of Sensory Modulation Dysfunction, framework for assessment and intervention, advances in research.	Alcohol Fetal Syndrome, pre and postnatal exposure to physical and emotional trauma, i.e.. Abuse & neglect.	Neurodevelopmental assessments, Psychosocial assessments, Interviews, Sensory Profile (Dunn 1999), Observation.	SI-STEP (Sensation Task Environment Predictability) (Sensory Integration Model of Intervention)	Yes	Sensory Modulation is a desired state of emotional and physical wellbeing. The connection between trauma experiences and brain development holds significant implications for speech and language development.	Speech & Language Pathologist
LeBel et al. (2010) USA	Descriptive Paper Part 2	Children & Adolescence	Description of services that promote healing and wellness to give individuals the necessary supports and skills to promote self-awareness, self-regulation, occupational performance and recovery.	Not specified: Mental Illness and trauma with symptoms of anxiety, depression, dementia, histories of trauma, posttraumatic stress disorder, self-injurious behaviour.	Not specified but sensory based assessments and development of sensory interventions is part of evaluation process.	Sensory Approaches and interventions used for calming & self-soothing include ice applied to wrists, breathing techniques, weighted blankets & vests.	Incorporates Ayres SI together with psychotherapy	Significant decrease in inpatient length of stay, staff sick time, consumer injuries, 99% reduction in workers compensation claims. Specific occupational therapy expertise has been invaluable to positive benefits of treatment.	Occupational Therapy & Psychology
LeBel and Champagne (2010) USA	Descriptive Paper Part 1	Children & Adolescence	Article establishes the value and relevance of integrating sensory-based, trauma-informed interventions in the delivery of mental health services.	Not specified but indicated as children and adolescence with trauma histories.	Not specified but indicates that proper diagnostic tools, assessments and training necessary to ensure the understanding of trauma, prevalence & symptoms.	Individuals recognize and regulate sensory experiences using sensory-modulation-related interventions e.g. How does your engine run? (Williams and Shellenberger 1996 & Sensory Modulation & Environment (Champagne 2008).	Ayres & psychological approaches e.g. Dialectical Behaviour Therapy and use of Cognitive Behavioural Therapy.	The use of sensory approaches provides more nurturing, healing and a positive trauma-informed culture care.	Occupational Therapy & Psychiatry
C.C. Whiting (2018) Massachusetts	Descriptive paper	Children in an educational setting who have trauma histories.	Highlights how occupational therapists working in public schools play a unique supportive role using a trauma-informed sensory approach.	Loss of consistent caregiver, neglect different forms of abuse & maltreatment.	Analyzing environments, tasks, routines. Specific tests not mentioned.	Focuses on “Just right challenges” in a playful, engaging, sensory-rich environment. Designing of individual sensory diets. Aim of therapy is to move from acting out when dysregulated to using proactive strategies to participate effectively in education.	Yes	Occupational Therapist collaborate with professionals from other disciplines to develop comprehensive integrated programming and intervention for students. Programs need to be based on assessments as symptoms related to trauma varies. Progress in reducing the impact of trauma, needs to be seen in education, social interaction and play.	Occupational Therapy
Warner et al. (2014) Zurich	Quasi experimental pilot study	Adolescence & Children	Paper provides preliminary empirical support for the efficiency of sensory motor arousal regulation treatment (SMART), a treatment model which targets somatic regulation as an avenue to behavioural & emotional regulation.	Polyvictimized, complex trauma. Not specified.	Not specific to Sensory Modulation Dysfunction. CBCL (Child Behavior Checklist) Anxious/Depressed, Withdrawn/ Depressed & Somatic concern Subscale, PTSD-RI (Post Traumatic Stress Disorder Reaction Index), assessing symptoms of trauma (Achenbach and Ruffle 2000).	SMART Model	Ayres sensory integration principles & child psychiatry models.	Need expressed by clinical staff to extend usage of SMART Model and knowledge about regulation. Findings were a first step in addressing the lack of empirical evaluation of sensory motor based approaches to trauma intervention.	Psychology & Occupational Therapy
J.A. Koomar (2009) USA	Descriptive paper	Children & Adolescence	Article reviews current issues related to trauma, identifies overlapping characteristics of trauma disorders & sensory modulation disorders. Discusses the occupational therapists role in working with children who have experienced trauma.	Loss or lack of consistent caregivers, emotional, physical or sexual abuse, various forms of neglect, surgical and life-saving situations.	Not specified	Dysregulated state of arousal, hypersensitivity to sounds, touch and movement, express of flight, fight and freeze.	Ayres SI & SMART Model	Need for continued experimentation to combine therapies to create chanced healing of the child and the family.	Occupational Therapy & Psychotherapy
Sears et al. (2016) New Mexico. La Familia-Namaste, Treatment Foster Care Program.	Retrospective chart review with HRPO approval	26 children, 4–14 years	To provide quantitative evidence towards the body of literature supporting sensory processing deficits in children who have experienced trauma or neglect.	Trauma and neglect	Sensory processing measure completed by primary caregiver. Subscales: social participation, vision, hearing, touch, taste, smell, body awareness, balance and motion, planning and ideas.	No treatment only evaluation	Yes	Analysis showed a significant number of children (81%) to have a total t-score ranging in “Some Problems” to “Definite Dysfunction”	Occupational Therapy
Fraser et al. (2017) Canada	Scoping Review (Qualitative)	Children & Adolescence	With trauma-informed care and interventions becoming an emerging area of practice of OT, it is important that the affects of trauma in children and adolescence are understood to develop and provide effective interventions.	Complex Trauma defined as repeated abuse, witness of physical abuse, prolonged neglect.	Not explained	Sensory-based interventions based on practices by Occupational Therapists	Yes	There is limited empirical evidence but sensory-based interventions are important for treatment with complex trauma. It is one type of treatment as part of a multidisciplinary treatment program. Further research is needed to determine types of interventions that are effective.	Occupational Therapy
Gorman and Kohl (2016) University of Toledo. 13th Annual International Human Trafficking Conference	Descriptive Paper	Children &, Adolescence & Adults	Discussion on framework of sensory integration, discussion on relationship between sensory integration and trauma informed care, identify sensory approaches to integrate into practice.	Physical, Sexual and emotional abuse	Sensory Profile 2 (birth to 14 years), Adolescence/adults Sensory Profile (11 years and older).	Sensory diet interventions, Sensory rooms, Psychotherapy, Sensory Integration.	Ayres Sensory Integration and Psychotherapy	Sensory approaches can be used in reduction of seclusion and restraint, Reduction in psychotropic medications, preventions, strategy to counteract stress and reduce discomfort, improvise ADL and social skills.	Occupational Therapy & Psychiatry
K.L da Silva (2011) Rhode Island	Qualitative, Explorative Study using interviews.	Children & 4 Social Workers	Study focused on the sensory treatment approach for children with histories of trauma.	Abuse, Neglect	Not specified	Sensory diet tailored to meet each child’s needs to have sensory input to stay focused and controlled throughout the day.	Yes	Although there are various methods of treatment, sensory integration is an additional tool in treating child with trauma. There is a need for research and improved methods. The study provided social workers with valuable insight on the effects of trauma and the use of sensory integration.	Social Work
V. Alers (2008) SAISI Journal	Descriptive Paper	Children	A comparison of the neurophysiological aspects of trauma and sensory integration concepts.	Not specified, Trauma Survivors	Dysregulation, disorganized, insecure, avoidant, hypo-arousal, hyper-arousal, anxiety, tactile defensive, auditory defensive, aversion to movement or gravitational insecurity.	Sensory Modulation, Multisensory calming, Vestibular proprioceptive modulation	Yes	The stimulation of pleasure centers, especially vestibular proprioceptive stimulation will help process stress hormones and assist endorphin production. This is specific to healing in trauma victims.	Occupational Therapy