Research and Resources

Level 3 Module


All BUSS® clinical work uses before and after measures to review efficacy. These include the BUSS® screening tool, Strength and Difficulties Questionnaires, Goal Based Outcomes and children’s human figure drawings.

As an innovative methodology, we are keen to develop research around BUSS®. As such, we’ll usually ask if you’re happy to be involved in any research programmes that are being undertaken at that point. A decision to participate or not to participate has no bearing on treatment.

Below is a summary of the research. Alternatively, to download a PDF summary of this research, please click here.

2018/2019, Katherine Grindheim, Second Year Clinical Psychologist in Training at Leeds University – Service Evaluation Project entitled: ‘The BUSS® Programme – an evaluation of the experience of foster carers and social workers.

In this project, Kat used a qualitative methodology to explore the participants’ experiences of the BUSS® programme. These were face-to-face interviews with 5 foster carers and 5 Social Workers working in the Therapeutic Social Work team in Leeds where the intervention was being delivered.

Key themes that emerged from the project were:

  1. You can’t build a house on wobbly foundations – BUSS® was like the missing piece of the jigsaw, the chance to go back and build foundations again to give a firm foundation for possible psychological work.
  2. These children’s needs are multi-faceted – this was a recurring theme amongst foster carers, who could see that the child’s physical difficulties (e.g. not being able to stand without support) made ordinary activities like sitting at the table using cutlery or drinking from a bottle, or making and keeping friends, all led to a sense of hopelessness. They felt that the very practical emphasis of BUSS® gave them a place to start and hope.
  3. Lots of ingredients make it work – this really reflected the hard work that this intervention involves for foster carers, i.e. the repetition, making it fun, and also for Social Workers; the idea that it looks simple but actually it’s quite complicated.
  4. Gains are wide ranging and match the needs – improvements were wide ranging and mapped onto the multifaceted needs described earlier – bodily awareness and regulation, self-esteem and friendships.
  5. It’s not the answer to everything – the needs of the children are complex and while for some children, BUSS® was enough for them to make good progress, for others it was helpful to consider a psychological intervention following this.


The full evaluation project is available here. 

2020, Harriet Haslam, Senior Practitioner, Social Work, as part of a Masters at University of Huddersfield – Innovations in Professional Practice, understood a study entitled: ‘An exploratory study of the impact of the BUSS model on the therapeutic skills set of carers.

In this study, 4 foster carers who had completed the BUSS® intervention with the children they were caring for were interviewed. The findings of this research were that participation in BUSS® enabled the carers to better understand the neurosequential impact of trauma, which in turn improved their ability to interpret the physical and emotional presentation of the children, leading to more attuned caregiving. A key component in this was the carers role as the main agents of change in the intervention, which strengthened the carer–child relationship and increased the foster carers’ feelings of self-esteem, because they could see tangible changes and link these to the work that they’d been doing.

2021, Chloe Robinson – Third Year Clinical Psychologist in Training, at the University of Hull undertook her doctoral thesis entitled: ‘Learning from adoptive families: What are their experiences of children’s development and the support they receive?

Results were divided into 4 key themes:

  1. Cognitive abilities – 8/10 parents described a marked increase in their child’s memory and attention. Parents felt that by building underdeveloped systems, children developed their skills and capacity to engage with cognitive tasks.
  2. Emotional, social, and behavioural development – Parents felt that improved bodily regulation led to increased emotional regulation. Parents talked about their child’s increased self-esteem and confidence, some suggesting this was because the child was able to attend to the whole picture – parents talked about their children being increasingly able to reason and think things through.
  3. 5/10 parents reported improvements in their child’s language and expressive skills. All parents reported improvement in their child’s flexibility of thought and imagination, an area that the majority of parents had felt their child really struggled with.
  4. Understanding of development – 9/10 parents talked about their greater level of understanding of their child’s development.


Working with 10 adoptive families who had been through the BUSS® programme. The full dissertation is available here

2021, Natalie Jones, Second Year Clinical Psychologist in Training at the University of Leeds, undertook a Service Evaluation Project (SEP) over one year, entitled: ‘An evaluation of the LEAPlets programme an interagency school readiness programme for children who are looked after based on the BUSS® model.

In this project, Nat interviewed 8 foster carers, all of whom were carers for children aged between 3 and 5 years old. Nat used a qualitative methodology, and grouped findings into 3 themes:

  1. Changes for the child – themes that emerged here were a range of social (being part of something, being able to build relationships, increasing curiosity about the world), relational (greater enjoyment and participation in family life, confidence, self-belief, nurturing, regulating) and physical (filling in gaps, strengthening body, catching up with peers).
  2. Changes for carer – the recurring theme here was pride, that it had been a rewarding experience for carers who really valued the support of other foster carers and the specialist support of BUSS®. Carers talked openly about their scepticism about the programme when it was presented to them and said that they wouldn’t have believed the kinds of changes were possible if they hadn’t seen it with their own eyes.
  3. Characteristics of the group – carers experience was positive, feeling that the group was run according to the individual needs of the children. They felt it was a unique programme, where staff go the extra mile to support them and the children. Carers also valued the fact that the group ran every week, and the routine and structure of the group was the same each week.

Another theme that emerged from this SEP was carers wanting to know more and wanting to be able to carry on the work at home in a way that was more targeted to their individual child. Therefore, as a result of this SEP, we arranged to write programmes for carers and children to carry on at home.

The full evaluation project is available here

2022, Danielle Smith, Second Year Clinical Psychologist in Training at the University of Leeds, undertook a one-year Service Evaluation Project (SEP) on the BUSS® group for new adopters and their children.

This study used a qualitative design involving semi-structured interviews with 7 adoptive parents who had attended the Early Years BUSS® group-work programme. Questions focused on parents’ experiences of the group, changes in their child / children’s sensorimotor systems, and the role of the BUSS® groups in early adoption family life.

The results showed that adopted children attending the BUSS® group experienced significant improvements in their sensorimotor systems and social and emotional development, had a mostly positive experience of the group, and felt the group was beneficial in early adoption family life.

Parents described several benefits of the BUSS® group for themselves, their children, and for their relationship with their children. 4 parents described that the group had helped develop their relationships with their children as it provided dedicated family time together each week, and opportunities for bonding and strengthening attachments. Parents also described how the group had been very validating for them in confirming their observations of their child/children’s sensorimotor difficulties, and how they had benefitted from the acceptance and understanding of other adoptive parents in the group.

Valuable suggestions were also offered by participants on how to improve the group. These included providing brief explanations at the start of each activity to remind parents which areas / systems the activity is targeting, and providing explanations of how activities could be done at home.

The full evaluation project is available here.



Improving Sensory Processing in Traumatised Children

By Sarah Lloyd (2016).

This is a good starting point in learning the model. It is written to be especially useful for foster carers, kinship carers, special guardians, and adoptive parents. 

This can purchased from CairnsMoir, Amazon, or JKP Books.


Building Sensorimotor Systems in Children with Developmental Trauma: A Model for Practice

By Sarah Lloyd (2020).

This book provides a more in-depth understanding of the BUSS model. Brian Rock, Dean of the Tavistock Clinic, wrote in the book’s foreword:

“She brings concepts and ideas together, drawing on what appear to be antithetical traditions, in the service of providing an accessible and effective set of interventions that make a real difference to people’s lives. Here there is much innovation and development for which we should be grateful.”

This can purchased from CairnsMoir, Amazon, or JKP Books.

An innovative approach to working with children who have experienced developmental trauma: An Introduction to the Building Underdeveloped Sensorimotor Systems (BUSS) Model.

By Sarah Lloyd (2023). Published in Adoption & Fostering.

Adoption & Fostering is a quarterly peer reviewed journal which has been at the cutting edge of debate on childcare issues for over 50 years. As the official journal of the CoramBAAF Adoption & Fostering Academy, the UK’s leading adoption and fostering charity, the journal supports CoramBAAF’s aims of promoting the highest standards of practice in adoption, fostering and childcare services, to increase public understanding of the issues and to provide an independent voice for children and families, disseminating new research and practice developments, informing and influencing policy-makers, all those responsible for children and young people, and public opinion at large.

Sarah has also joined the Adoption & Fostering Journal for ‘An Introduction to the BUSS Model with Sarah Lloyd’, Episode 5 of their podcast. You can listen here!

Other Useful Resources

These resources all cover working with Developmental Trauma, Attachment, and Building Relationships, and may be of interest. Here are some books:

Booth, P. (2009). Theraplay: Helping Parents and Children Build Better Relationships through Attachment Based Play. Jossey-Bass

Gerhardt, S. (2014). Why Love Matters: How Affection Shapes a Baby’s Brain. Routledge

Golding, K. and Hughes, D. (2012). Creating Loving Attachments: Parenting with PACE to Nurture Confidence and Security in the Troubled Child. Jessica Kingsley Publishers, London and Philadelphia

Guerney, L. and Ryan, V. (2013). Group Filial Therapy:  The Complete Guide to Teaching Parents to Play Therapeutically with their Children. Jessica Kingsley Publications

Hughes, D.  and Baylin, J. (2012). Brain – Based Parenting: The Science of Caregiving for Healthy Attachment.  New York, NY: W.W. Norton & Co

Hughes, D.A., Golding, K.S., Hudson, J. (2019). Healing Relational Trauma with Attachment Focused Interventions. WW Norton, NY and London

Perry, B. (2006). The Boy Who Was Raised as a Dog.  Basic Books

Here are some online resources:

In Brief: The Impact of Early Adversity on Children’s Development. This is a very readable overview, with picture and an accompanying video. Click here to access this.

The Beacon House website – a fantastic collection of brilliant resources, information and advice  for children, families and schools. Click here to access it.

The Beacon House video on Window Of Tolerance can be found here

The Child Trauma Academy website, which has lots of good resources. Click here to access it.

They also have other resources, including videos, such as The Human Brain videocast by Bruce Perry (2013) as part of their Seven slide series. Click here to watch it.

Ruby Jo Walker has some excellent resources on her website. I think this resource on Polyvagal theory that manages to have both the essence of it but put it in a simple form is really useful. Click here to access it.


Here are some resources to do with Child Development that I think are useful. Firstly here are some books:

Murray, L. and Andrews, L. (2000). The Social Baby. CP Publishing, Richmond, Surrey, UK

Music, G. (2011). Nurturing Natures: Attachment and Children’s Emotional, Sociocultural and Brain Development. Psychology Press

Sharma, A. and Cockerill, H. (2014). Mary Sheridan’s from Birth to Five Years: Children’s Developmental Progress. Routledge

Tredgett, S. (2015). Learning through Movement in the Early Years. Critical Publishing

Here are some online resources:

There are some great websites developed by Children’s OTs, outlining ages and stages of development and with lots of useful links and ideas. I find these two especially useful-  click here to access the “mama OT” website and click here to access the “CanDoKiddo” website.

The First 1001 Days Movement website has some really good resources about early development. Click here to access it.


Training in sensory integration therapy is open to Occupational Therapists and Physiotherapists. More information is available on the sensory integration website – Most books about sensory integration describe sensory processing disorders and their treatment. If you are interested in finding out more about this, these books are popular and provide an introduction to the subject.

Ayres, Jean A. (2005).  Sensory Integration and The Child  (25th Anniversary Edition). Western Psychological Services

Bhrethnach, E. and Bhrethnach, S. (2011). The Scared Gang. Alder Tree Press

Kocsinski, C. (2017). Sensorimotor Interventions. Arlington, TX; Future Horizon Incorporated

Lane, S.J. and Schaaf, R.C. (2010). Examining the Neuroscience Evidence for Sensory-Driven Neuroplasticity: Implications for Sensory-Based Occupational Therapy for Children and Adolescents. American Journal of Occupational Therapy, 64, 375-390.


These are some books for younger children which are a combination of a great story and also have lots of animals in them – perfect for all that crawling, commando crawling and bear walking!

Campbell, R. (2010). Dear Zoo. MacMillan Publications

Carle, E. (1994). The Very Hungry Caterpillar. Puffin Books

Donaldson, J. (2017). The Gruffalo. MacMillan Publications

Donaldson, J. (2018). The Snail and The Whale. MacMillan Publications

Donaldson, J. (2017). A Squash and a Squeeze. MacMillan Publications

Rose, M. (2015). We’re going on a Bear Hunt. Walker Books

Voake, C. (2008). Ginger. Walker Books


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