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adverse childhood experiences, trauma, early childhood educators, program development, trauma-informed training, sensory integration


Presentation: 22:45

Presentation completed in partial fulfillment of a Post Professional Occupational Therapy Doctorate degree at Thomas Jefferson University.


Introduction: Adverse childhood experiences create challenges in sensory integration (Perry, 2006) impacting preschoolers’ participation and occupational performance (May-Benson, 2016). Professional development in trauma-informed sensory training is essential to support early childhood educators working with this population (Loomis, 2018; Perry, 2006).

Objectives: To develop a trauma-informed sensory training and evaluate its validity and usefulness for early childhood educators.

Methods: We used a modified Delphi method to evaluate the training’s adherence to Ayres Sensory Integration® and trauma-informed care principles of practice and usefulness for early childhood educators. A convenience sample of three expert groups reviewed the training and completed surveys to gather feedback on the training’s content and usefulness: (1) Ayres Sensory Integration (n=3); (2) trauma-informed care (n=4); (3) early-childhood educators (n=3). A comprehensive literature review and a knowledge translation framework guided the training’s content development and design. We included and adapted portions of Guarino and Chagnon’s (2018) Trauma Smart School Training package and added content guided by Ayres Sensory Integration® theory to create the HOPE training program. We used descriptive statistics and survey methodology to evaluate the training and achieve agreement on >80% of survey items by all participants.

Results: All experts (n=10) agreed to all survey items, suggesting the content is consistent with current evidence, easy to understand, and offers content to improve knowledge and skills in trauma-informed-sensory practices to facilitate students’ participation in preschool.

Conclusion: Experts support the HOPE program’s content as valid and useful to early childhood educators. Further research is needed to evaluate the training’s effectiveness in supporting children with trauma in preschool.


  • Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245–258.
  • Loomis, A. M. (2018). The role of preschool as a point of intervention and prevention for trauma-exposed children: Recommendations for practice, policy, and research. Topics in Early Childhood Special Education, 38(3), 134–145.
  • Guarino, K., & Chagnon, E. (2018). Trauma-sensitive schools training package. Washington, DC: National Center on Safe Supportive Learning Environments.
  • May-Benson, T. (2016). A sensory integration-based perspective to trauma-informed care for children. OTA The Koomar Center.
  • Perry, B. D. (2006). Applying principles of neurodevelopment to clinical work with maltreated and traumatized children: The neurosequential model of therapeutics. In N. B. Webb (Ed.), Working with Traumatized Youth in Child Welfare (p. 27–52). The Guilford Press.
  • Ryan, K., Lane, S. J., & Powers. D. (2017). A multidisciplinary model for treating complex trauma in early childhood. International Journal of Play Therapy, 26(2), 111-123.

Synopsis: Adverse childhood experiences (ACEs) are most prevalent in young children and can have lasting negative effects on brain development impacting health and wellness (Felitti et al., 1998; Perry, 2006). Sensory challenges are also common and associated with negative behaviors impacting children’s participation in preschool (May-Benson, 2016; Perry, 2006; Ryan et al., 2017). This study evaluates HOPE, a trauma-informed sensory training for preschool teachers. Three expert groups evaluated the program using surveys and agreed that HOPE is valid and useful for teachers. However, more research is needed to determine HOPE’s effectiveness on teachers’ learning and influence on children’s preschool participation.

Acknowledgments: The authors would like to acknowledge those members who contributed to this manuscript and research study: Mentor Dr. Cecilia Roan, OTD, OTR/L; Advisor Dr. Susan Toth-Cohen, PhD, OTR/L; Content Expert; Dr. Margaret Ingolia, OTD, OTR/L; Fellowship Committee; Dr. Amy Carroll, OTD, OTR/L, Dr. Roseanne Schaaf, PhD, OTR/L FAOTA; Editor; Ms. Elizabeth Declan, Professor; Dr. Kathy Piersol, PhD, OTR/L, FAOTA.