Hockey Rebecca, Philpott-Robinson Kelsey, Haracz Kirsti, Ray Karen
School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.
Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia.
Aust Occup Ther J. 2025 Jun;72(3):e70027. doi: 10.1111/1440-1630.70027.
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.
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.
No consumers were involved in study design or analysis.
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.
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.
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.
创伤在学龄前儿童中很常见，会对其发育、心理健康以及儿童期的日常活动参与产生重大影响。有证据表明，创伤会影响感觉统合，进而影响日常活动的参与度。学前教育环境可以通过提供社交和发展机会来抵消创伤的影响。职业治疗可以在组织和个体层面为学前教育中的创伤提供干预措施。关于创伤知情（组织层面）的学前教育方法的证据有限，但正在增加；然而，对于基于感觉统合（个体层面）的实践了解甚少。本研究的目的是回顾学前教育环境中创伤知情和基于感觉统合的实践，包括实施情况和评估。
系统评价和Meta分析扩展综述的首选报告项目（PRISMA-ScR）指导了对六个数据库的检索，以查找关于学前教育环境中针对儿童和/或教育工作者的创伤知情和/或基于感觉统合实践的同行评审的原始研究。
本研究设计和分析未纳入消费者参与。
本综述纳入了18项研究（美国发表的有17项）。研究涉及学龄前儿童（7项）、学前教育工作者（8项）或学龄前儿童和教育工作者两者（3项）。纳入的研究报告了创伤知情实践（11项）、基于感觉统合的干预措施（6项）或两者结合（1项）。干预措施的实施是多学科的；然而，职业治疗的参与度最低。干预措施有特定的持续时间（明确规定）或融入日常活动（嵌入），明确规定的干预措施主要用于基于感觉统合的实践。干预措施主要在班级和/或全校范围内应用（9项）。评估涵盖儿童、工作人员和组织层面的结果；然而，随访评估很少。
需要对学前教育环境中创伤知情和/或基于感觉统合的实践进行进一步研究，重点关注实施方法和长期随访评估。职业治疗师实施干预措施的情况有限，但这凸显了他们在未来研究中发挥更积极作用的机会，包括咨询和个体干预方法。
创伤会影响幼儿处理感觉信息的方式，并对日常活动产生重大影响。学前教育机构在帮助减少幼儿创伤负面影响方面起着关键作用。目前对于创伤知情实践的了解比对基于感觉统合的实践以及它们如何帮助学龄前儿童参与日常活动的了解更多。我们查阅了以往的研究，以了解目前对这些支持措施的认识、谁在使用它们以及它们是如何被使用和评估 的。我们遵循特定的指南（PRISMA-ScR）在六个数据库中查找研究文章。我们感兴趣的是关于针对学龄前儿童的创伤知情和/或基于感觉统合实践的文章。我们找到了18篇相关的期刊文章，大部分来自美国。大多数研究是关于融入学前日常活动的创伤知情方法。较少有研究使用基于感觉统合的干预措施，且这些措施大多在一段特定时间内实施。大多数支持措施是针对整个班级或学校的，但很少进行评估，这意味着尚不清楚这些支持措施是否有效。需要更多研究来确定创伤知情和/或基于感觉统合的实践对经历过创伤的学龄前儿童是否有帮助。我们建议未来的研究关注这些支持措施的使用方式以及它们在短期和长期内是否有帮助。了解创伤史如何影响学龄前儿童参与日常活动的职业治疗师，在研究制定和评估支持参与的策略方面可能发挥关键作用。
