Experiencing trauma in childhood, whether it is due to neglect, abuse, stressful domestic situations, or medical trauma, can leave a lasting imprint on a child. Many children who have lived in traumatic environments have never had the opportunity to develop skill in the primary occupation of childhood, play. Studies have shown that children learn through play more rapidly than through teaching trials, with children naturally acquiring sensory, motor, language, and social-emotional skills through play with trusted adults and peers. Children who are in a frequent state of fight or flight in response to trauma are often not able to make these connections. Additionally, this stress can result in retained primitive reflexes, impacting a child’s overall sensory, motor, behavioral, social-emotional, and attentional development due to an immature nervous system. An occupational therapy evaluation to ensure primitive reflexes are fully integrated and evaluate a child’s sensory challenges will assist in the development of a therapy program designed to build skills through play for children of any age who have endured trauma.