Occupational therapists at Speech & Occupational Therapy of North Texas often treat children with sensory challenges. Helping families understand self-regulation and helping our clients develop better coping skills for sensory regulation leads to greater success with treatment goals and participation in daily life.
Self-regulation is the ability to control and direct one’s own feelings, thoughts, and actions. Infants are born with some form of self-regulation as when they get into the fetal position to sleep or search for their thumb to suck on to soothe themselves. As parents we assist with their regulation with swaddling, holding, pacifier as well as meeting their basic needs of feeding changing and sleeping.
As babies grow into toddlers, they may still reach for a pacifier, special stuffed animal or blanket when they are upset or twist their hair when they get sleepy. All parents have seen the self-regulation technique children use when they get overly tired of becoming hyper and out of control. This is a technique that works for them to stay awake but not a very pleasant one for those around them.
Many forms of sensory self-regulation children pick up are not usually appropriate or “good” choices. Many forms of self-regulation are due to alertness and how to remain alert or calm down. Some alerting behaviors are fidgeting, chewing on hair, inanimate objects such as pencils or toys or chewing on clothes. Calming choices seem to be more difficult for children and for those that get extremely “wound up” usually end up in a tantrum/melt down situation. These children can get worked up into the fight, flight, or fright syndrome.
Before children can learn how to better self-regulate they need to be taught about their feelings and what they are experiencing. Parents and caregivers should be discussing out loud how they are feeling such as “I’m sleepy!” (For younger children) or “I feel really tired right now and having a hard time paying attention” (for older children). On the flip side you could say, “I’m very excited right now!” or “I’m very upset right now”.
Then the parent or caregiver should begin expressing what it is they are seeing in their children. They should say something like “you look like you may be tired” or “you look like you are upset”. This is where The Alert Program®’s engine analogies come in handy with phrases such as “it looks like your engine is running on low” or “it looks like your engine is running at full speed”. Occupational therapists frequently use strategies and materials from the Alert Program at Speech & Occupational Therapy of North Texas. For more information about Alert, visit http://alertprogram.com/
Next comes teaching children strategies to use to help them get into the “just right engine speed” for either becoming more alert or calming. Again, parents will begin discussing how they use strategies to self-regulate themselves. For example, do you crunch your ice, drink caffeinated beverages, seek rocking chairs, look out windows or sing to yourself? These are all examples of calming or alerting strategies. Once you recognize your own strategies you will be able to verbalize them to children and help them with discovering their own strategies.
Once parents and children recognize when their “engine” is running high (fast) or low (slow) then they can begin experimenting with what works for changing the speed to attain the just right alertness level for the task at hand. Experimentation should be done in all categories of:
- Put something in your mouth
- Move
- Touch
- Look
- Listen
Young children and children with special needs may have a difficult time understanding these concepts and have difficulty with verbalizing what they are feeling and needing. I’m sure you have heard the story where a child hits another child totally out of the blue or for absolutely no reason (or so it appears). The child will be asked “Why on earth did you do that?” The child responds with “I don’t know” (and they don’t!) Or, they are unable to respond at all. This is because their feelings are happening at the cortical level. Usually when this happens it really begins much earlier, usually with a child whose engine runs on high most of the time. Something in the morning may have set him off such as the tag in his shirt or the seam on his sock is bothering him. (For the adult, think of stepping in a doggie mess when you first get up.) Next, maybe you ran out of his favorite breakfast cereal. (You spilled your coffee). On the way to dropping your child off at school you had to swerve drastically out of the way of a squirrel causing a vestibular assault for your child. (Same for you). All the while, you are taking deep breaths, listening to music or self-talk to keep yourself at an ideal state so you won’t lose your cool. For the child whose engine is running high he may not know what strategies to use to keep himself calm and may not even be aware his engine is in high gear and increasing. Then he gets to school and has to make his way through the hall to his classroom with all the noise and movements. In his classroom a child barely brushes up against him and his system is already on overload so his brain takes over and he is in full blown fight, flight or fright syndrome and he hits the child! (For no reason).
Providing a sensory diet for young children and children with special needs will help so the child can remain on a more even “just right” state throughout the day. Please note that each child’s sensory diet should be created in conjunction with a team of parents, teachers, caregivers and it’s best to have an Occupational Therapist help set up and lead the team. It should be tailored to meet each individual child’s needs. Components of an individualized sensory diet could include, lotion rubs, vibrating massage, swinging, jumping on a trampoline, and calming music, weighted lab blankets or vests and “heavy work”. Such as rolling a heavy ball or watering plants with a heavy jug.
When in doubt about which type of sensory input to use, remember that heavy work (Proprioception) works! The bottom part of the brain (brainstem), the back part of the brain (cerebellum), along with many other parts of the brain are stimulated through heavy work to muscles and joints (activities that involve pushing pulling lifting, hanging, climbing, tugging or towing). When engines are in high gear and participate in heavy work a message is sent to the rest of the brain and body that says, “Chill out…Calm down… We are not in danger here. We can relax and focus.” When engines are in low gear and participate in heavy work, a message is sent to the rest of the brain and body that says “Be alert! Wake up! We need to get going and focus!”
Mainly, the message is we can help our children recognize self-regulation behaviors. Then let children be children, engaged in a variety of activities that will help them get their sensory needs met during the day as they continue to develop appropriate self-regulation techniques.
Speech& Occupational Therapy of North Texas provides Occupational Therapy in Frisco, Plano, and McKinney. For more information about our services, please call 972-424-0148.