Description

Clients impacted by trauma and disrupted attachment often present with complex patterns of sensory, emotional, and relational dysregulation. As occupational therapists, we sit at the intersection of the nervous system, the environment, the body, and the relational world. As multiple trauma-informed trainings offer something unique to this complex topic; this workshop series in a three-tiered pathway unites the psychological, relational, and sensory domains into a clear, OT-specific framework. This first in the pathway series was developed by occupational therapists for occupational therapists who want a strong, current, neurobiologically informed foundation in attachment and trauma. Although it is the starting point in the ATTACh OT Certificate tiered pathway, it is intentionally designed for clinicians with experience, those who are already using sensory, developmental, or relational models and want to integrate them into a cohesive trauma-responsive approach. This on-demand, four-part series goes beyond the “basics” of trauma. It synthesizes current neuroscience, updated attachment research, and OT-specific therapeutic strategies into a clear frame that prepares you for more advanced assessment and intervention in subsequent pathways 2 and 3. 

By completing this on-demand first training, you will: 

• Build a current, integrated understanding of attachment, trauma, and sensory regulation 

• Develop sharper insights into why clients respond the way they do 

• Strengthen therapeutic use of self as a co-regulating partner 

• Learn updated strategies for creating safety, supporting state regulation, and responding to survival-driven behaviors 

• Establish the conceptual foundation needed for the practical assessment training in the second of the tiered pathway series 

This is not an introductory course; it is a recalibration. A chance to align your clinical reasoning with the newest research and shared language that will anchor your growth in the ATTACh OT Certificate pathway. 

Designed for experienced therapists 

Participants are typically OTs who: 

• Work with adoption/foster care, neurodivergent children, or complex developmental histories 

• Use sensory integration, DIRFloortime, or relational frameworks 

• Want deeper clarity about how trauma intersects with occupational performance 

• Seek a more coherent and neurobiologically informed approach to practice 

Outline / Agenda:

Session 1: Foundations of Attachment & Trauma in OT Practice 

• What attachment is: a neurobiological system for safety, survival, and co-regulation 

• Updated attachment science: 

• Attachment as an adaptive system 

• Disorganized attachment reframed as survival, not pathology 

• Attachment throughout the lifespan 

• Trauma definitions and evolving research 

• Acute trauma vs. chronic trauma vs. developmental trauma 

• Complex trauma, relational trauma, and toxic stress 

• Impact of cumulative micro-traumas 

• How attachment and trauma influence occupational participation 

• Therapist mindset: becoming a safe relational partner 

• The importance of co-regulation as the foundation of intervention 

Session 2: Neurobiology of Trauma, Regulation, and Safety 

• Stress physiology and the child's survival systems 

• Fight, flight, freeze, collapse, fawn 

• Neurochemical effects of chronic stress 

• Understanding neuroception and the body's detection of safety/threat 

• Updated neuroscience on sensory processing & trauma 

• Links between sensory defensiveness, shutdown, and state regulation 

• How trauma disrupts interoception and bodily awareness 

• Interoception and embodied self-awareness 

• Polyvagal-informed perspectives (without oversimplification) 

• State-dependent functioning 

• Connection between autonomic states and participation 

• The role of the environment in supporting safety 

• Therapist regulation and presence: 

• Recognizing your own state shifts 

• How therapist state impacts client neuroception 

Session 3: Trauma-Informed Occupational Therapy – Core Principles & Therapeutic Use of Self 

• Trauma-informed care updated frameworks 

• The therapeutic relationship as the primary intervention 

• Creating safety through predictable routines and relational repair 

• Reframing behaviors: 

• “Maladaptive behaviors” as protective survival responses 

• Supporting the child’s capacity for engagement, not compliance 

• Bottom-up vs. top-down processing in therapy 

• The process of rupture and repair 

• Why it matters 

• How to navigate it in therapy sessions 

• The therapist’s internal work: 

• Countertransference 

• Implicit bias 

• Managing vicarious trauma 

• Maintaining compassionate curiosity 

• Cultural responsiveness in trauma-informed OT 

• Supporting identity-safe interactions for diverse families 

Session 4: Sensory, Environmental, and Relational Strategies for Trauma-Informed OT 

• Integrating sensory and attachment perspectives 

• Sensory safety: 

• Creating a sensory-friendly therapeutic environment 

• Understanding sensory overload and shutdown in trauma 

• Bottom-up regulation strategies 

• Movement 

• Breath and rhythm 

• Deep pressure and proprioceptive input 

• Co-regulatory sequencing 

• The role of co-regulation with the child and caregiver 

• Relational scaffolding and supporting engagement 

• Supporting families: 

• Caregiver regulation 

• Gentle collaborative approaches 

• Building resilience and relational capacity 

• Case-based vignettes 

• Behavioral observations linked to state-regulation thinking 

• Examples of sensory regulation and relational support integration 

• Ethical considerations in trauma-informed treatment 

Learning Objectives:

Session 1: Foundations of Attachment & Trauma in OT Practice 

1. Describe key concepts of attachment and developmental trauma as they relate to occupational participation and co-regulation. 

1. Identify how attachment disruptions and early relational adversity influence sensory, emotional, and behavioral patterns in children. 

Session 2: Neurobiology of Trauma, Regulation, and Safety 

1. Explain the neurobiological processes underlying stress responses, neuroception, and autonomic state shifts in children with trauma histories. 

1. Differentiate between various survival responses (fight, flight, freeze, collapse) and relate these responses to occupational engagement and regulation needs. 

Session 3: Trauma-Informed Occupational Therapy – Core Principles & Therapeutic Use of Self 

1. Apply trauma-informed care principles to therapeutic interactions by integrating safety, predictability, and co-regulation into OT practice 

1. Demonstrate strategies for therapeutic use of self, including managing countertransference, supporting relational repair, and promoting identity-safe interactions. 

Session 4: Sensory, Environmental, and Relational Strategies for Trauma-Informed OT 

1. Select trauma-responsive sensory and environmental strategies that support safety, regulation, and engagement during OT intervention. 

1. Implement relational and co-regulatory approaches that promote participation and adaptive functioning in children impacted by trauma. 

Bibliography: 

1. Matson, R., Barnes-Brown, V., & Stonall, R. (2023). 

The Impact of Childhood Trauma on Sensory Processing and Connected Motor Planning and Skills: A Scoping Review. Journal of Child & Adolescent Trauma, 17, 447–456. 
DOI: https://doi.org/10.1007/s40653-023-00598-y 
Focus: Emerging evidence about how childhood trauma affects sensory processing and motor planning—key for understanding sensory dysregulation in OT practice.  

2. Cox, A., Heron, T., & Frederico, M. (2024). 

Sensory Processing Assessment and Feedback in the Treatment of Complex Developmental Trauma. Journal of Child & Adolescent Trauma, 17, 677–690. 
DOI: https://doi.org/10.1007/s40653-023-00607-0  
Focus: An OT-relevant exploratory study on sensory assessment and trauma, highlighting occupational performance and intervention outcomes.  

3. Fonagy, P., Campbell, C., & Luyten, P. (2023). 

Attachment, Mentalizing and Trauma: Then (1992) and Now (2022). Brain Sciences, 13(3), 459. 
DOI: https://doi.org/10.3390/brainsci13030459  
Focus: Up-to-date review of attachment research and its relevance to trauma, including neurobiological and relational mechanisms.  

4.  Laricchiuta, D., Panuccio, A., Picerni, E., Biondo, D., Genovesi, B., & Petrosini, L. (2023). 

The Body Keeps the Score: The Neurobiological Profile of Traumatized Adolescents. Neuroscience & Biobehavioral Reviews. 
DOI: https://doi.org/10.1016/j.neubiorev.2023.105033 
Focus: A comprehensive neurobiological overview of trauma effects on the brain and body—connecting survival systems, regulation, and behavioral outcomes.  

5. Lehr, V., Sullivan, A. F., Champagne, T., & Szklut, S. E. (2023) 

Trauma-Informed, Sensory-Based Pediatric OT Interventions: A Systematic Review. The American Journal of Occupational Therapy, 77(Suppl_2), 7711505060p1. 
DOI: https://doi.org/10.5014/ajot.2023.77S2-PO60  
Focus: Systematic review supporting trauma-informed, sensory-based OT approaches for children with complex trauma histories.  

Assessment: Completion of a 20-question assessment 

Provider Name: ATTACh 

Presenter: Maude Le Roux, OTR/L, SIPT, ADHD-RSP, DIR Champion and Expert Training Leader 

Bio: Maude Le Roux is a global trainer in multiple methodologies and a mentor to therapists from multidisciplinary teams. She opened her practice, A Total Approach in Glen Mills, PA, USA in 2001. Maude started her training career in 2007 and opened her online academy in 2019. She has designed the Developmental Pathways Model (DPM), which she applies to her own unique assessment and intervention protocol for major diagnosis such as Dyspraxia, ADHD and Executive Functions, Autism, Reading and Writing Disorders, and Trauma and Attachment. Maude served 9 years on the Board of Directors for ATTACh and currently serves on their Advisory Board. She also serves on the Advisory Board for LSWorks (Neuralign program). She is a co-author of two books and more recently wrote a chapter on Trauma and the Body in “Healing Connections” which launched in September 2024. Maude received an award for “Continued child advocacy” through the ATTACh organization in September 2024. She also received the Champion Award through ICDL in November 2024. Maude has a “whole child” approach to care and intervention and equipping the child, while empowering the parent is at the core of who she is as a clinician and trainer. 

Target Audience: Occupational Therapists, Speech Language Pathologists, Physical Therapists 

Educational Level: Intermediary 

Instructional Methods: PowerPoint, Video 

Contact Hours: 6 hours 

Contact: https://attach.org/training/