An occupational therapy approach that helps young children, their families, and communities build the safety, regulation, and resilience skills needed to thrive
Trauma-informed OT for the whole child
The Five Pillars of BRIDGE
1 Building Safety & Stability
2 Resilience Skills Development
3 Integrated Sensorimotor Processing
4 Development- and Family-Centered
5 Grounded Occupation & Engagement
BRIDGE integrates nine evidence-based frameworks
Trauma-Informed Care | Sensory Integration Theory
Polyvagal Theory | Attachment Theory
Mindfulness & Yoga | Integrated Family Systems
Sensorimotor Processing | Self-Regulation Theory
Interoception
Integrated for occupation-based, strengths-focused practice
BRIDGE: A Dual Approach to Trauma-Informed OT
Bottom-Up (Body Systems-First)
- Starts with the nervous system, sensory processing, and body-based regulation
- Asks: Is this child’s nervous system ready to engage? What sensorimotor supports are needed first?
- Pillars 1, 2 & 3 anchor this perspective: safety, interoception, and sensorimotor processing build the physiological and psychosocial foundations
- Grounded in Polyvagal Theory, Sensory Integration, social and emotional learning, psychological and interoceptive awareness research
- Goal:physiological, psychological readiness, positive mental health that makes meaningful occupational engagement possible
Top-Down (Occupation-First)
- Starts with the child’s occupational roles, routines, and participation goals
- Asks: What does this child need to DO? What matters to this family?
- Pillars 4 & 5 anchor this perspective: development-centered engagement and grounded occupation situate every intervention in meaningful context
- Aligns with the OTPF: client-centered, occupation-based goals drive the treatment plan
- Goal: meaningful occupational participation in roles that matter to the child and family
REferences
BRIDGE pulls from and builds on the work from many authors and respected theories in OT:
Clark, E., Brown, T., & Yu, M. L. (2025). Interoception and its application to paediatricoccupational therapy: A scoping review. Australian occupational therapy journal, 72(1), e12997.
Haeyen, S. (2024). A theoretical exploration of polyvagal theory in creative arts and psychomotor therapies for emotion regulation in stress and trauma. Frontiers in Psychology, 15, 1382007.
Lage, C. R., Wright, S., Monteiro, R. G. D. S., Aragão, L., & Boshoff, K. (2024). Collaborative practice with parents in occupational therapy for children: A scoping review. Australian Occupational Therapy Journal, 71(5), 833-850.
Kiser, L. J., Donohue, A., Hodgkinson, S., Medoff, D., & Black, M. M. (2010). Strengthening family coping resources: The feasibility of a multifamily group intervention for families exposed to trauma. Journal of traumatic stress, 23(6), 802-806. https://doi.org/10.1002/jts.20587
Matson, R., Barnes-Brown, V., & Stonall, R. (2024). The impact of childhood trauma on sensory processing and connected motor planning and skills: a scoping review. Journal of Child & Adolescent Trauma, 17(2), 447-456.
Ortiz, R., & Sibinga, E. M. (2017). The role of mindfulness in reducing the adverse effects of childhood stress and trauma. Children, 4(3), 16.
