Sensory Attachment Intervention (SAI) is an assessment and treatment approach for children and adults who have suffered abuse or severe neglect. It was developed by Eadaoin Bhreathnach, Occupational Therapist and Attachment Counsellor, and aims to “enable parents and children to learn the art of self-regulation through the use of sensory and engagement strategies” (Bhreathnach 2013).
Negative experiences in utero and in early childhood impact on one’s capacity to cope with stress throughout life, leaving them easily triggered into survival states; fight, flight, freeze, dissociate. Sometimes children will fluctuate between these responses when there is a ‘hint’ of the trauma they experienced (conscious or unconscious). For example, someone brushing past them in the corridor may cause a ‘fight’ response as the tactile system has become ‘over responsive’ to tactile input that is not on their terms/ out of their control. Children are often defensive to nurturing touch. We often see hyper-vigilance, with their visual and auditory systems being over-responsive. The child is therefore unable to filter out the irrelevant stimuli around them. Some children may have missed out on movement opportunities and may struggle with their balance (vestibular) sense, and body awareness (proprioceptive) sense. Many children struggle with interoceptive feedback (regulating hunger, thirst, temperature etc). Children may also struggle with their taste and smell sense.
From an early age, children may develop behavioural strategies in order to survive their attachment environment. However, these behavioural strategies may persist even when the child is in a safe and secure environment.
The SAI approach targets the areas of the brain that are the source of the dysfunction, firstly focusing on the regulation of the Autonomic Nervous System, and ‘shifting the child’ from being ‘stuck’ in survival mode. Modulation of the body senses is facilitated via the just right combination of up regulating and down regulating experiences. This in turn enables higher level sensory, emotional and cognitive functioning.
Please note that some children will be under-responsive in one sense and over responsive in another sense. Children can also fluctuate in their response, depending on their level if regulation, environment and attachment figures.