Trauma-informed or sensory-based practices in preschool settings: A scoping review

Introduction

Trauma is prevalent among preschool children and can significantly impact development, mental health, and engagement in childhood occupations. Evidence suggests trauma affects sensory processing, impacting engagement in everyday activities. Preschool settings may offset the impacts of trauma with social and developmental opportunities. Occupational therapy may provide interventions for trauma in preschools at both organisational and individual levels. Evidence for trauma-informed (organisational) preschool approaches is limited but growing; however, little is known about the use of sensory-based (individual) practices. The purpose of this study was to review trauma-informed and sensory-based practices in preschool settings, including implementation and evaluation.

Methods

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review (PRISMA-ScR) guided the search of six databases for peer-reviewed primary studies of trauma-informed and/or sensory-based practices with children and/or educators in preschool settings.

Consumer and Community Involvement

No consumers were involved in study design or analysis.

Results

Eighteen studies were included in this review (US publications n = 17). Studies involved preschool children (n = 7), preschool educators (n = 8), or both preschoolers and educators (n = 3). Included studies reported on trauma-informed practices (n = 11), sensory-based interventions (n = 6), or a combination of both (n = 1). Intervention implementation was multi-disciplinary; however, occupational therapy was minimally represented. Interventions were for specific durations (defined) or integrated into daily routines (embedded), with defined interventions used predominantly for sensory-based practices. Interventions were predominantly applied class and/or school-wide (n = 9). Evaluation encompassed child, staff, and organisational outcomes; however, follow-up evaluations were infrequent.

Conclusion

Further research on trauma-informed and/or sensory-based practices in preschool settings is needed, focussing on implementation methods and long-term follow-up evaluations. Limited implementation of interventions by occupational therapists highlights an opportunity to play a more active role in future research, including consultation and individual intervention approaches.

PLAIN LANGUAGE SUMMARY

Trauma can impact how young children process sensory information and significantly affects everyday activities. Preschools play a key role in helping reduce the negative effects of trauma in young children. There is more known about trauma-informed practices than sensory-based practices and how they help preschool-aged children participate in everyday activities. We looked at previous research to find out what is currently known about these supports, who is using them, and how they are being used and evaluated. We followed specific guidelines (the PRISMA-ScR) to find research articles in six databases. We were interested in articles on trauma-informed and/or sensory-based practices for preschool children. We found 18 relevant journal articles, mostly from the United States. Most studies were on trauma-informed approaches mixed into the daily preschool routine. Fewer studies used sensory-based interventions, and these were mostly implemented for a set period of time. Most supports were used for an entire classroom or school, but they were rarely evaluated, meaning it remains unclear if the supports worked or not. More research is needed to find out if trauma-informed and/or sensory-based practices are helpful for preschool children who have experienced trauma. We suggest that future studies look at how these supports are used and whether they are helpful both in the short and long term. Occupational therapists, who understand how trauma history affects preschoolers' engagement in daily activities, could play a key role in research that looks at developing and evaluating strategies that support participation.