An innovative approach to working with children who have experienced developmental trauma: An introduction to the Building Underdeveloped Sensorimotor Systems (BUSS®) model

BUSS® (Building Underdeveloped Sensorimotor Systems) is an innovative treatment model for children who have experienced developmental trauma. It is based on an understanding that just as a baby needs responsive, attuned and empathic relationships to grow and develop psychologically, attention needs to be given to the impact of the absence of these kinds of relationships on a child’s bodily development and regulation. The premise underpinning BUSS® is that these two processes – the need for an attuned caregiver and the progression through predictable stages of motor development – are inextricably linked; one cannot happen without the other. A case study is used to illustrate this innovation in practice, its frame of reference, methods and evaluation. Improvements were seen in physical development, parent–child relationships, cognitive functioning, self-esteem and confidence in parenting capacity. Consideration is given to how this model fits alongside therapies for children who have experienced developmental trauma and their families. This early evidence suggests that BUSS® is a clinically effective and cost-effective intervention that has positive benefits on physical and psychological development for children who have been impacted by early trauma. Further research will be required to establish both the consistency of outcomes and the mechanisms underlying its efficacy, especially in relation to psychological changes. Plain language summary Babies need predictable, loving care to develop physically and emotionally. They need the grown-ups in their lives to protect them from harm or stress. As newborns, babies are entirely dependent on those adult relationships for their survival – they can’t feed themselves and they don’t have control of their head or limbs. They need to be held, carried, cared for and played with to grow into their bodies, so that by the end of the first year of life, they’re able to move around and are beginning to explore their world and the people in it. Babies in frightening or stressful situations (during pregnancy and once they’re born), miss out on these crucial experiences and, as a result, the normal development of their brain and central nervous system is disrupted. This affects how children move and the sense they have of themselves and their bodies – what we call bodily regulation. Good bodily regulation is knowing where our body is without having to think about it, knowing how much pressure or force to use when we’re doing something like giving someone a hug or hanging our coat up on a peg. It’s knowing that our arms and legs will work together in a helpful way when we’re running or climbing. We’re much more used to thinking about how early adversity affects a child’s emotional or psychological wellbeing, and we haven’t paid as much attention to how this affects bodily regulation. BUSS® is designed to bridge that gap – where there has been disruption to these earliest stages of development it’s possible to go back and fill in those touch, nurture and movement experiences that have been missed. This paper explores the BUSS® model and hears from a parent about their experience of using the model with their child.