OTA The Koomar Center is committed to working with individuals who have emotional based diagnoses such as trauma and attachment disorder. Many of our therapists have received specialized training in working with children, adolescents and adults with trauma and attachment difficulties.
After recognizing many clients receiving services at OTA also had trauma and attachment histories, our president, Dr. Koomar, began to seek out collaborative partnerships with colleagues across disciplines to establish effective treatments models to best support our clients.
The therapists at OTA receive twice-a-month consultations from Dr. Deborah Rozelle, a psychotherapist with an in-depth background in trauma. Many therapists have also received extensive training from Dr. Dan Hughes, a clinical psychologist who has devised the Dyadic Developmental Psychotherapy model, an attachment-focused treatment that relies heavily on the theories and research of attachment and intersubjectivity to guide his model of treatment and parenting.
Dr. Hughes and the late Dr. Koomar presented together across the country teaching their SAFE PLACE model Sensory Attunement Focused Environments + Playfulness Love Acceptance Curiosity Empathy – Parenting Strategies for Facilitating Attachment and Sensory Regulation. Their DVD is available for purchase.
Dr. Koomar was also a coauthor of the Trauma Center/JRI SMART Approach Manual, a child trauma psychotherapy model involving OT training and initial supervision when employing the SMART model. The addition of sensory integration principles for regulation within child psychotherapy has been observed to significantly improve the efficacy of the child psychotherapy model.
Children with Developmental Trauma Disorder
OTA provides occupational and speech therapy with a sensory integration approach. Many children with trauma and attachment diagnoses also can be diagnosed with Sensory Processing Disorder (also referred to as Sensory Integration Dysfunction). Sensory processing problems occur in two dimensions. The first, sensory modulation problems, result in regulatory issues and sensory over-responsiveness that contribute to emotional and behavioral difficulties. The second is sensory discrimination or perceptual problems that result in motor coordination and planning, or praxis, problems affecting oral, eye-hand and/or body skills such as eating, handwriting and sports participation.
It can be difficult to know sometimes if the sensory modulation problems are the result of trauma or something that has occurred since birth due to genetic, environmental or birthing process issues. Sensory Modulation problems from birth may contribute to the child’s vulnerability in developing traumatic symptoms.
Detail the sensory integration issues, providing a more complete profile in combination with trauma assessments and neuropsychological assessments.
Addresses regulatory needs affecting social emotional development and many daily activities as well as improvement of body scheme and development of perceptual and motor skills. Intervention provides sensory motor experiences that lay the foundation for all other areas of development.
Occupational therapy with a sensory integrative approach is based on ten core principles:
- a physically and emotionally safe environment
- rich sensory opportunities, especially for the body-based senses that provide us with a sense of self
- arousal regulation
- postural, ocular, oral and bilateral integration development
- praxis and organization of behavior
- tailor the activities to present the just-right challenge
- collaborate with the child on the activity choice
- ensure activities are successful
- foster a context of play
- foster a therapeutic alliance with the therapist
It is important for children who have experienced trauma to experience success. In occupational therapy with a sensory integration approach, as the just-right challenge is created both on a physical and emotional level, children may experience a fully embodied sense of success. Mastering new plans and skills allows them to have pleasure along with building a foundation for success in all of their daily occupations.
Many children with Developmental Trauma Disorder need immense amounts of strong movement-based experiences to help them regulate and improve their body awareness. The abundant opportunities for swinging, climbing, jumping, crashing, and pulling and pushing experiences in a sensory integration-based OT clinic allow for this neurological need to be met, and over time, fully satiated, so the child’s focus can turn to other aspects of their healing, growth and development.
Our referral process starts with the completion of an on-line questionnaire or by speaking with our Intake Coordinator to determine if there is an appropriate foundation for a referral. If you have questions about our intake process or the services we provide, please contact us at firstname.lastname@example.org.
Adult and Adolescent Services
OTA The Koomar Center offers the highest quality evaluation and treatment to adolescents and adults. Many adolescents and adults have sensory processing disorders that make daily activities challenging or even impossible. For example, auditory sensitivities may interfere with the ability to work, ride public transportation, and participate in family activities. Tactile defensiveness is often related to difficulties with intimacy with a spouse or significant other and frequently affects interpersonal relations with friends, co-workers, and family. Vestibular processing problems affect the ability to drive, ride in airplanes, and engage in daily activities such as descending stairs, riding a bike, walking on uneven surfaces.
OTA is very happy to work in conjunction with psychotherapists to orchestrate the process of an assessment and intervention plan so that it works well for each individual client. Some psychotherapists accompany their clients to the initial session.
We tailor the initial consult, evaluation and treatment approach to meet the individual’s needs. A free initial consult can take place over the phone or in the clinic. The therapist will decide with the individual the best approach for a comprehensive evaluation, which typically takes the form of a consultation or interview. During this process the therapist will obtain an in-depth clinical history to determine the type and nature of the client’s sensory integration and motor problems and how those difficulties are affecting participation and occupations, as well as the client’s social-emotional state. Please contact Melanie Salort, our intake coordinator, for more information at email@example.com.
Therapy may include specific programs such as listening therapy or cranial sacral therapy. OTA provides three different choices following a listening assessment at various price points.
1. Therapeutic Listening
2. The Listening Program
3. Integrated Listening Systems
For more information on our listening programs, click here.
After the assessment a home program with consultation or direct weekly therapy may be recommended. Typically intervention is most effective if it can be started with an intensive period of treatment where the individual can observe significant changes in sensory processing over a several-week period. If possible clients are typically seen three to five times per week for three weeks, with some clients maintaining this frequency for more than four or five weeks. This intensive program, which consists of both home and clinic activities, typically results in notable changes. Some health plans, such as Harvard Pilgrim and Harvard Vanguard, design their plans to provide up to three sessions per week for 60 days.