Rewiring the Young Brain: How Infant and Toddler Occupational Therapy Supports Healing After Early Stress

By Heather Hodgins-Chan, OT Reg. (Ont.), Psychotherapist
On The Ball Pediatric Physio and Occupational Therapy serving families in Kanata and Orleans, Ottawa

The infant brain is remarkably adaptable. With the right support, relationships, and sensory experiences, young children can reorganize their nervous systems and build healthier pathways for regulation and learning.

Neuroplasticity in the Infant Brain: Why Early Experiences Shape Development

In the earliest years of life, the brain is developing at an extraordinary pace. Neural pathways are being formed every moment as infants experience movement, touch, sound, emotional connection, and interaction with their caregivers. Because the brain is developing so rapidly during this time, it is also highly adaptable. This adaptability is known as neuroplasticity, which refers to the brain’s ability to change and reorganize in response to experience.

Research over the past decade has increasingly shown that early experiences, particularly stressful or overwhelming ones, can influence the organization of the developing brain and nervous system. For example, Bick, Nelson, and Fox (2017) describe how early adversity can influence neural development, stress regulation systems, and emotional processing during infancy and early childhood.

When infants experience prolonged stress or traumatic events early in life, their developing nervous systems can become organized around patterns of heightened alertness, dysregulation, or withdrawal. Some children may have experienced medical trauma, early separation from caregivers, time in neonatal intensive care units, exposure to substances before birth, or early caregiving disruptions such as foster care placements or adoption transitions. These experiences can influence how the nervous system learns to respond to the world.

Trauma in infancy does not always involve physical injury. Sometimes an event may appear minor from an adult perspective but can still be overwhelming for a developing nervous system. For example, a young child may experience a frightening fall down the stairs or be involved in a motor vehicle accident. Even when the child is physically unharmed, the sudden surge of stress hormones and intense sensory experience can leave an imprint on the nervous system. Some children may become more sensitive to movement, sound, or touch following these types of events.

Birth experiences can also influence early sensory and nervous system organization. Cesarean sections are often medically necessary and can be life saving for both mother and baby. At the same time, they differ from vaginal delivery in terms of the sensory experiences that occur during birth. During vaginal delivery, babies experience deep pressure and compression as they pass through the birth canal. These sensations stimulate multiple sensory systems and may help activate early regulatory responses in the newborn. When babies are delivered by cesarean section, these compressive experiences are reduced or absent. While many babies born by cesarean delivery regulate beautifully, some clinicians observe that certain infants may benefit from additional sensory input and movement experiences to help organize early regulation patterns.

Prematurity and neonatal intensive care experiences can also influence the development of the sensory and stress regulation systems. Although neonatal intensive care units provide lifesaving medical support, the sensory environment can be very different from the womb. Infants may be exposed to bright lights, alarms, medical procedures, and frequent handling at a time when the nervous system is still rapidly developing.

In the womb, babies are typically positioned in a flexed, contained posture and experience constant rhythmic movement from the mother's body. In contrast, infants in neonatal units may spend extended periods lying on their backs with monitors and medical equipment that make it difficult to maintain this natural flexed posture. Research suggests that these early sensory environments can influence neurodevelopmental outcomes. Pineda and colleagues (2017) found that differences in NICU environments were associated with differences in brain structure and developmental outcomes in preterm infants. Additional research by Grunau (2019) has demonstrated that early medical stress and pain exposure in preterm infants can influence later stress regulation systems.

Medical conditions during the newborn period can also contribute to neurodevelopmental vulnerability. Neonatal jaundice is common in early infancy and is usually treated successfully with phototherapy. However, research has examined possible associations between significant hyperbilirubinemia and later developmental outcomes. For example, Jangaard and colleagues (2018) reported that elevated bilirubin levels in infancy can be associated with differences in later neurodevelopmental outcomes in some children.

Taken together, current research supports the understanding that infants who spend time in neonatal intensive care units have higher rates of neurodevelopmental vulnerability. Preterm infants also show increased risk of sensory processing differences, and studies have explored associations between neonatal hyperbilirubinemia and later neurodevelopmental outcomes (Pineda et al., 2017; Grunau, 2019; Jangaard et al., 2018).

For some infants and toddlers, these early experiences may lead to difficulties with sleep, feeding, sensory sensitivities, emotional regulation, or motor development. Children may startle easily, have difficulty calming, resist transitions, or appear constantly on edge. Other children may appear quiet, withdrawn, or less responsive to their environment. These behaviors are not signs of defiance or personality traits; they are often reflections of how the nervous system has learned to adapt to early experiences.

The encouraging news is that the young brain remains highly capable of change. With supportive relationships and the right types of experiences, the nervous system can reorganize itself over time.

How Infant and Toddler Occupational Therapy Supports Nervous System Regulation

Infant and toddler occupational therapy focuses on helping to reshape these early regulatory pathways through sensory, motor, and relational experiences. Occupational therapists work with both the child and the caregiver to support nervous system regulation, strengthen the parent child relationship, and create predictable patterns that promote safety and stability.

One of the primary ways occupational therapists help support nervous system reorganization is through sensory based interventions. Sensory integration therapy helps the brain process and respond to sensory input more effectively. Through carefully designed play activities involving movement, deep pressure, rhythm, and body awareness, therapists help provide the types of sensory experiences that support regulation and organization of the nervous system.

Movement is one of the most powerful tools for supporting early brain development. Rocking, swinging, crawling, climbing, and coordinated play activities stimulate the vestibular and proprioceptive systems, which are closely connected to emotional regulation and body awareness. These experiences help strengthen neural pathways that support balance, coordination, attention, and self regulation.

A typical infant or toddler occupational therapy session may include a variety of gentle sensory and movement experiences designed to help organize the nervous system. Therapists may use vestibular activities such as slow swinging, rocking, or bouncing on therapy balls to provide calming rhythmic input. Proprioceptive activities may include gentle joint compression, supported crawling, pushing into soft surfaces, or deep pressure through playful movement.

Some therapists incorporate infant massage techniques or calming pressure points that support vagal regulation and relaxation. Rhythmic movement activities such as rocking in a caregiver’s arms, swaying side to side, or bouncing on large therapy balls provide predictable sensory input that can help regulate the nervous system.

Therapy sessions often include equipment such as platform swings, soft mats, exercise balls, and sensory play materials that encourage movement, exploration, and body awareness. These activities are carefully selected experiences designed to strengthen neural connections involved in regulation, coordination, and sensory processing.

Equally important is the role of the caregiver relationship in helping the brain reorganize. Infants and toddlers learn regulation through co regulation, which means they borrow the calm nervous system of a caregiver when they feel overwhelmed. Occupational therapists work closely with parents to help them understand their child’s cues, identify early signs of dysregulation, and develop soothing routines that support regulation.

Parent education is an essential part of therapy. Therapists may help families organize predictable daily routines based on patterns such as eat, play, and sleep cycles. Parents may learn how to structure transitions throughout the day, how to support calming bedtime routines, and how to adjust sensory input in the home environment.

Caregivers are also supported in becoming aware of how their own nervous system influences their child. Babies are highly sensitive to the emotional tone of their caregivers. When parents feel calm and supported, their nervous systems help regulate their child’s nervous system as well.

Through guided interaction, therapists may help parents practice slow rhythmic movement, calming touch, responsive communication, and predictable routines. These experiences help children gradually develop the internal capacity to regulate their own emotions and physiological states.

Over time, repeated experiences of safety, predictability, and supportive interaction allow the nervous system to reorganize. Neural pathways that were shaped by early stress can gradually be replaced with new pathways that support calm engagement, curiosity, and connection.

Infant and Toddler Occupational Therapy in Kanata and Orleans

This process does not happen overnight. However, the early years offer a powerful window of opportunity. Because the brain remains so adaptable during infancy and toddlerhood, small changes in experience can lead to meaningful shifts in development.

When families receive support early, children who have experienced difficult beginnings can still develop strong foundations for emotional health, learning, and relationships.

The goal of infant and toddler occupational therapy is not simply to reduce challenging behaviors. The goal is to help the child’s nervous system feel safe enough to explore, connect, learn, and thrive.

Families in Kanata, Orleans, and the greater Ottawa community who are concerned about early stress, sensory sensitivities, or developmental regulation can connect with the team at On The Ball Pediatric Physio and Occupational Therapy. Our pediatric occupational therapists support infants and toddlers through evidence-informed therapy that focuses on nervous system regulation, sensory integration, and strengthening the parent child relationship.

With the right support, the young brain has an incredible capacity to heal.

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References

Bick, J., Nelson, C. A., & Fox, N. A. (2017). Early adverse experiences and the developing brain. Neuropsychopharmacology.

Pineda, R., et al. (2017). Alterations in brain structure and neurodevelopmental outcome in preterm infants hospitalized in different neonatal intensive care unit environments. Journal of Pediatrics.

Grunau, R. (2019). Early life pain and stress in preterm infants and neurodevelopmental outcomes. Pain.

Jangaard, K., et al. (2018). Neonatal hyperbilirubinemia and neurodevelopmental outcomes. Pediatrics.