BUSS Therapy with Us

In-person or Virtual – the choice is yours

You have a choice about how to receive BUSS.  Both have been carefully developed to provide the best outcomes for you and your loved ones. Both formats provide secure and in-depth support in a positive environment so children, families, and carers receive all the tools they need.

  • In-person is called the “4 Stage Model” and it involves families coming to see us at the Oakdale Centre in Harrogate (HG2 0JH)
  • Remote BUSS makes it possible for families who live further afield to access the intervention without having to travel

Read more about both below

Ready to complete a referral? Download the form now.

Completed referrals can be returned to info@bussmodel.org

At Oakdale, we provide the BUSS intervention as a Four Stage Model. This encompasses a combination of psychoeducation, individual assessments, personalised exercise and activity plans, follow ups, reviews and reports. The purpose of the intervention is to improve the sensory integration of the child, develop good bodily regulation and build parent and child relationships. This provides a platform for the development of emotional regulation, relationships and learning.

Involving the team around the child works well for nursery and school age children because, while the most active participants are parents and carers, it can be helpful for schools or nurseries to be involved.  Professionals already working with the family (if children are adopted this is usually the  adoption support workers or if children are looked after, then it’s usually the child’s social worker) are asked to support parents and carers in completing a BUSS screening tool to help them understand more about the intervention and to help them begin to notice bodily regulation and movement.


 A Description of the Four Stage Model

We’re always happy to talk with parents or professionals before a referral is made. Once a referral has been received by the Centre, a member of the BUSS team will have a telephone consultation with the family. This is to partly check that BUSS is the right therapy at this time, but mostly to begin to understand what the families’ hopes and expectations of the intervention are. It’s also an opportunity to learn more about the child or young person who has been referred and therapists will ask what is known about the child’s early life and experiences, how things are currently and what the concerns of the family are, as well as discuss the screening tool upon completion.


Introduction to the BUSS model –  a psychoeducation day for parents of the children who have been referred for BUSS, and the team around that child. This may include the child’s school and adoption support worker for children who have been adopted.

The morning part of the session introduces the model, increasing understanding of the development of the foundation sensorimotor systems in typical development, and exploring the impact of early neglect and adversity on a child’s development.  Participants are encouraged to think about their children on a bodily level, tuning in to how they move and the information this gives about their foundation sensorimotor systems.

During the lunch break parents have an opportunity to meet the BUSS practitioners they will be working with and other parents who they might see as part of doing this work with their child.

The afternoon session gives parents and educators the chance to practise some of the games and activities that they’ll be using with their child, think more about child development as a sequential process, as well as an opportunity to think about what support they might need to be able to do this work.


The assessment happens within a week or two of the training day and a BUSS accredited practitioner meets with the child / young person and their parent(s) or carer(s) to look more closely at the child’s foundation systems.  This is very much a collaborative approach, encouraging parents to use what they learned at the training day and to think together about their child’s vestibular, proprioceptive and tactile systems.  Generally, parents come to this assessment with a sense of how things are for their child and there is discussion about what the BUSS practitioner is noticing and how this fits with the parents’ ideas.

The BUSS practitioner then writes a summary of their observations and a comprehensive programme of activities for the parents (and the identified person at school, if they’ve attended the training day) and child to work on over the next month.  Families are asked to keep a video diary, taking pictures or film at least twice during the four week period.

This follow-up session takes place one month after the assessment.  It takes the form of a two-hour group session facilitated by the BUSS practitioner for up to four sets of parents.  Parents and carers are encouraged to talk about their child’s progress and challenges in relation to the BUSS programme and share videos of their children.  The practitioner then writes an individual programme of the next steps for each child.


The reassessment session takes place two months after the original assessment.  It follows a similar format to the original assessment session.  For most families, this will be as much support as they need – they will have made significant progress in rebuilding their child’s underdeveloped sensorimotor systems and feel confident to continue with some guidance (in the form of a written report) from the BUSS practitioner.  A small number of families, usually families where the child has been significantly impacted by FASD or drug use in utero, may need ongoing support.  For Leeds children, this may be provided through a weekly gymnastic club that Sarah Lloyd runs in conjunction with Leeds Gymnastics Club.  Children and families can continue to attend sessions here for as long as is helpful (the longest so far has been three years, the shortest two terms).  Schools are encouraged to attend once a term to make sure that they’re familiar with the activities the child is doing and have enough support to continue with them in school.


All families undergoing the 4-stage model are invited to complete before and after measures.  Over the time that these have been being used, they have shown significant improvement in a child’s bodily awareness / proprioception, core strength and stability, co-ordination and ease of movement. These changes in bodily regulation have facilitated positive changes in emotional regulation and relationships, as can be seen in the accounts written by parents and carers.

As this is a relatively new  model for practice, a lot of the children and families that we work with have already been through more traditional psychological therapies. We would argue that building bodily regulation is a good starting point for any intervention and find that, where children have been engaged in psychological therapies, they are better able to make use of these once they are more regulated on a bodily level. This makes sense in terms of brain function and development and the earlier in the life of the child that we are able to intervene, the shorter the intervention tends to be.

As well as providing a face-to-face service with the BUSS model, the team have developed Remote BUSS, an accessible means of acquiring the same high-level of care without leaving the home. For some families, being able to do things from their own home might work better for them, perhaps because they live a long way away from a BUSS practitioner or because it might be a better fit for their family. In the wake of the Covid Pandemic, this is especially relevant.

It is important to note that families taking part in a Remote BUSS intervention have to be motivated for it to be successful. In order to deliver this system of therapy effectively, regular contact with both BUSS practitioners and parent mentors is crucial. As well as this, however, regular updates have to be sent to the BUSS team in order to monitor progress and be able to formulate the best plan for the child. To facilitate this, the team possesses a BUSS Dropbox for families to send videos to us securely (confidentiality is paramount: please refer to our privacy policy for more detail). If families do not feel comfortable sending videos, or if children are very resistant to being filmed by their parents, then a face-to-face intervention is recommended.

All families who are referred to the BUSS team at the Oakdale Centre complete a screening tool, and for families who do not already possess it we will send a copy of the book: Improving Sensory Processing in Traumatised Children (Lloyd, 2016). This will give a brief understanding of the BUSS model before an intervention begins.

Parents and Social Workers can also watch a recorded 45 minute webinar which gives a brief introduction to the BUSS model. Any questions from any of these information sessions can be answered at the first consultation session.

The first contact will comprise of a phone consultation between a BUSS practitioner and parents. This will allow for a dialogue to be opened between these two parties, working collaboratively to create a preliminary sketch of a future BUSS-oriented therapy plan.  Adoption-support Social Workers are welcome to be involved at this stage. This will also give the first inclination of whether the parents would like to pursue this method of therapy.

In order to build an accurate picture of a child’s developmental state, the BUSS practitioner will ask for a family to capture and send video footage of their child performing simple tasks, such as writing, drawing or walking up and down stairs. A link to the BUSS team’s Dropbox will be provided for any prospective parents. For the practitioner, the footage will illustrate what status the child’s foundational systems are in, judging what possible intervention method could be enacted. For families unsure of what activities they should document, the BUSS team can provide examples to help. 

Combining the information gleaned from the first contact and video footage provided by the family, the BUSS practitioner will compose a personalised programme for the family and child to follow over a fortnight. Nominally, this will include a written report of the status of the child’s sensorimotor systems, a brief summary of the BUSS model and an outline of the activities to be accomplished in the future. Videos of the activities outlined will also be provided. A second phone consultation can be arranged to discuss the initial report.   

Progress within the BUSS model will be monitored through the contact that families maintain with their BUSS practitioner. Conventionally, this will involve further footage being sent to the BUSS Dropbox, the subject of which will be updates on the activities prescribed as part of the practitioners’ report. In order to maximise the aid given, the team would recommend bi-weekly updates with contact for practitioners to propose ideas, modifications and suggestions.

Part of this regular contact, a formal contact will be made, termed the ‘Midway’ call, to offer guidance with families about any changes the BUSS practitioner feels need to be changed. This will typically occur after three contact sessions have been made, but can be made earlier if the family specify to. At this point, new information regarding the child’s development will be tabled and new strategies will be constructed if needed.

From first-hand research, an average of seven contact sessions have been sufficient for families and children to attain as much input as they require. When the family are confident that no further intervention is needed, the BUSS practitioner will write a summary report comprising of any further advice and work that they feel may be helpful for the family to practise. If any additional BUSS sessions are required or indicated the prospect will be discussed with families and adoption social workers.

Whether you are thinking about the  Four-Stage Model or the Remote BUSS program, these next sections will be applicable to you:

The BUSS (Building Underdeveloped Sensory Systems) model is based on the understanding that early adversity means that, while babies and young children have missed out on good, nurturing relationships, it’s likely that their bodies have also missed the sorts of movements that go hand in hand with those relationships.  Babies who feel safe and happy do lots of moving and have lots of good experiences of touch and nurture. Babies in frightening situations (in utero and once they’re born) don’t have these same touch experiences and because they’re not thriving and being stimulated, they don’t move nearly as much as typically developing children and as such their systems can be compromised.  These systems are what help us to feel confident in our movements; they mean that we’ve good head, neck and shoulder strength as well as a strong core.  Our movements are generally fairly smooth and well co-ordinated and we might use our eyes to look where we’re going, but we don’t have to watch our feet when we’re coming downstairs or our hand when we’re writing to check they’re doing the right thing. Click here to find out more about stages of early motor development and how they form a foundation for later stages of development.

Noticing gaps in a child’s foundational systems

Sometimes children and young people can talk about how they feel their body works for them.  More often, children learn ways to compensate and use other parts of their bodies to make up for the parts that don’t work as well.  It’s useful to begin to notice how your child is doing things.  We’re really good at noticing what they’re doing, but it’s good to get used to noticing how they’re doing it. This is harder than it sounds  and isn’t something that we’re used to doing – we’re used to children just being able to ‘do’ things and progress from one stage of development to the next without having to really analyse how they’re doing it, so don’t worry if it takes a while to adjust to doing this.

Sometimes it’s easier to start with yourself – notice what your body is doing as you sit or stand reading this. Where are you getting your stability from? If you’re sitting down, are you leaning against something? If you are, just try sitting up and notice what changes. I’m hoping that you can sit up, with your feet on the floor, and aren’t having to use any other parts of your body to get enough stability to stay in that position. Hopefully you’re not needing to lean across the table to hold yourself up or move around lots to just help your body know where it is.

If you can, just get up now and try and analyse how you did that.  If you’re sitting at a table, did you use the table to push yourself up from ? Where did the power for the movement come from? If you did push up, just sit down again and try again, this time just using your body to get up. Again think about that – which part of your body would you say ‘led’ the movement? Sometimes I think it’s useful to visualise a ‘line’ like the one you see on a TV screen when it’s a photo finish of a race and they’re analysing which runner crossed the line first. If you had an imaginary line when you’re standing up, which part of your body would cross the line first? Last? All of these things can be helpful in beginning to notice how we’re moving.

Once you’ve got used to noticing how you move Jjst to try and observe how your child is moving, perhaps when they’re playing outside or at a playground with peers (without developmental trauma) and see how they’re holding themselves and moving about.  You can get good information from noticing everyday things at home; like how they come downstairs, carry a glass of juice, sit at the table to eat dinner, write, walk and run around.

It’s helpful to notice what the quality of the movement is like.  Do they move in a fluid, well-coordinated way?  Does their body work in a well synchronised way so they’re able to do what they want to do without bumping into things or tripping over?  Is there a smoothness about the movement? Sometimes it’s helpful to start by thinking about yourself and how you move – because we’re so used to children progressing from one stage of development to the next without us really having to give it any conscious

It’s also useful to think about whether their body is giving good, reliable signals about things like whether they’re hungry; when they’re full; if they can taste what they’re eating and enjoy a range of different tastes and textures. Other clues can come from thinking about what sort of state of mind they’re in most of the time – are they able to stay in the moment of an experience and enjoy what’s happening or cope when they don’t know something; do they seem quite comfortable in themselves; or do they seem vigilant and stressed, as if they’re expecting something bad to happen.

Age range

Sarah and her team work with children and young people from babies onward. We’re always keen to intervene as early in the life of a child / family as possible. For babies and children whose experience of the intrauterine environment might have been a stressful one, it’s never too early or too soon!


We have examples of early, middle childhood, and adolescence interventions, which you can find here

While every BUSS intervention will be unique to each child undertaking it, we thought it might be helpful to have a flavour of some of the activities that may be used. Sarah, along with her daughter Ally, have made several videos that we hope will give you some idea of what a BUSS intervention might include. 

BUSS Activity- Bubble Mountain!

Reflecting on this activity, Sarah says, “I rarely meet children who have had early experiences of abuse and neglect who possess good feeding experiences. The whole festival of feeding and weaning is a very complex interaction and the BUSS model tries to break the activity down into its component parts. Very simply, we could think of feeding as nourishment, but also a way of building oral strength and strengthening the parent-child relationship. The BUSS model uses games like this to build oral strength and to put experiences of fun and nurture alongside earlier feeding experiences. As you’ll see, it is a short, easy activity that is designed to be fun for parents and children to do together and may be part of a wider programme of activities.”

BUSS Activity: Getting Started with Commando Crawling

Commando crawling can be a great way of building upper-body strength and in getting the body to work as an integrated unit – the right- and left-side of the body working together. However, it’s important to make sure that this activity is at the right level for each child and that they have the pre-requisite skills for this to be the right level of challenge. There’s more information about why the BUSS model uses ‘Commando crawling‘ in this section. 

All families undergoing the Four-Stage Model are invited to complete before and after measures.  Over the time that these have been being used, they have shown significant improvement in a child’s bodily awareness / proprioception, core strength and stability, co-ordination and ease of movement. These changes in bodily regulation have facilitated positive changes in emotional regulation and relationships, as can be seen in the accounts written by parents and carers.

As this is a relatively new  model for practice, a lot of the children and families that we work with have already been through more traditional psychological therapies. We would argue that building bodily regulation is a good starting point for any intervention and find that, where children have been engaged in psychological therapies, they are better able to make use of these once they are more regulated on a bodily level. This makes sense in terms of brain function and development and the earlier in the life of the child that we are able to intervene, the shorter the intervention tends to be.

Please contact us at info@bussmodel.org for information about fees.

Other therapeutic support

There are occasions when neither the four stage model nor Remote BUSS are the best fit for a family and we are happy to discuss alternatives. You can get in contact with us by emailing info@BUSSmodel.org.

Feedback from parents who have been through the BUSS Model:

“The impact so far on our daughter is remarkable. Our main concerns were around the way she manages her emotions, mainly at school and when playing with other children. She can feel very angry very quickly at seemingly small things. She also struggles to sit still and can’t cope with unpredictability. These were impacting on her friendships and her learning.”

Adoptive Parent

“We were struggling to understand how this physical work could help her emotionally, but the improvement so far has been remarkable. We have noticed that her reactions to unexpected situations are much more measured, school has fed back that she is calmer when she is there and that they can reason with her much more easily, she seems to be able to stay in the moment a little longer and generally seems less angry and frustrated all round. We will be continuing with great gusto and hoping that the improvements will continue!”

Adoptive Parent

“My own personal understanding of what’s going on with my child and what they need is incredible. I have learned so much in the last few months and become really creative in how to use the sensory integration techniques in everyday life. Taste tests, exercise balls, balancing and combat crawling fun games that have been adapted to suit my child.”

Foster Carer

“For her to feel comfortable walking down the stairs without being afraid was the biggest accomplishment I can think of, and in a very short space of time. I would definitely highly recommend this work; an essential understanding of what has been missed or gotten stuck and how it affects the body.”

Adoptive Parent

"I think it's worked brilliantly and I've found it easier to fit into my life in terms of childcare and work commitments.

A Parent that has done Remote BUSS

“It’s amazing that something that’s so completely life changing can be so much fun!”

Foster Carer

If you would like to search for anything on our website, please type here and click ‘search’