Trauma-Informed Care Best Practices in a Pediatric Setting

Abstract Background: Pediatric occupational therapists (OTs) frequently treat children with trauma histories yet often lack formal training in trauma-informed care (TIC). Uncertainty about evidence-based interventions and OT’s role on multidisciplinary trauma teams contributes to underutilization of OT services in pediatric settings. Objective: This capstone project aimed to (1) assess practicing pediatric OTs’ baseline knowledge, confidence, and perceptions regarding TIC; (2) develop and deliver a targeted educational intervention; and (3) evaluate its impact on therapists’ self reported competencies. ACOTE Area: The primary ACOTE standard addressed within this capstone project is program development and evaluation. The capstone centered on designing, implementing, and assessing an in-service educational program. The program also reflects an educational component with the creation and delivery of the trauma-informed care training itself. Methods: A needs assessment was conducted via a Qualtrics survey distributed to OTs at a single outpatient pediatric clinic (pre-test N=10). An in-service was then provided, synthesizing current literature on trauma types, behavioral manifestations, OT’s role in TIC, and evidence-based interventions available. A post test survey, mirroring the pre test needs assessment items, was administered to attendees (N = 8). Likert scale responses (1 = strongly disagree to 5 = strongly agree) were converted to numeric values. Descriptive statistics and Mann Whitney U tests assessed changes in mean scores between pre and post intervention. Results: Nine of 11 survey items showed statistically significant increases (p < .05) post intervention, including confidence in identifying acute, complex, and cumulative trauma; understanding trauma’s effects on brain development and behavior; and familiarity with OT specific evidence based TIC interventions. Two items—perceived importance of TIC and understanding lifespan impact of childhood trauma—did not reach significance. Conclusion: A concise, evidence based in service significantly enhanced pediatric OTs’ self reported TIC competencies. Future research should involve larger, multi site samples and examine long term clinical outcomes. Advocacy for formal recognition of OTs as Qualified Mental Health Professionals is recommended to solidify their role on trauma response teams.