Date of Award


Document Type

Critically Appraised Topic


Occupational Therapy

First Advisor

Anne Haskins

Second Advisor

Breann Lamborn

Third Advisor

Gail Bass/Devon Olson Lambert


Complex trauma is defined as the long-term effects of repeated exposure to severe traumatic events (Fraser, McKenzie & Versnel, 2019). Children who have experienced complex trauma have a decreased ability to regulate their emotions (Warner, Spinazzola, Westcott, Gunn & Hodgdon, 2014). Not being able to process and regulate one’s emotions leads to a lack of occupational participation (Fraser et al., 2019; Warner et al., 2014). These impacts can be seen in adolescents’ daily occupations such as play, education, leisure activities, and social interactions both at home and in the community (Fraser et al., 2019; Warner et al., 2014). This type of repeated stress caused by complex trauma also impacts physiological development of the sensory cortex and limbic system (Finn, Warner, Price & Spinazzola, 2018; Rinne-Albers, van der Wee, Lamers-Winkelman & Vermeiren, 2013). The limbic system is in control of emotions while the sensory systems impact functions. Thus, trauma impacts physiological development which inhibits adolescents’ abilities to self-regulate and to integrate sensory input (Rinne-Albers et al., 2013). Sensory integration is the ability to appropriately process and respond to input from one ’s environment based on internal cues, and self-regulation is the ability to appropriately respond to sensory cues (Fraser et al., 2017).