S2 E5: Regulation Strategies That Fit in with Your Family

It can be an overwhelming process working with a therapist to help your child's sensory differences. Sure, they have the expertise to offer invaluable strategies to help your child, but how does the home programme fit in with you and your child's needs day-to-day? Could you start by focusing on fewer techniques rather than overloading yourself? We unpick these ideas in this conversation, and we raise important questions to ask you and your child once you begin your home plan. We emphasize self-care and provide small and tangible methods to regulate yourself through everyday activities.

Transcript

Speaker: Hello, and welcome to this episode of Sensory Chat, the podcast for parents and others interested in all things sensory integration.

Speaker: Hi, I'm Amy Stevens, and I'm calling in from Salisbury in the southwest of England, a speech and language therapist and an advanced practitioner in sensory integration.

Speaker: Hello, I'm Emer Broderick. I am an Occupational Therapist based in London, in the UK, and I am also an advanced practitioner in Ayressensory integration.

Speaker: Hi, I'm Emma Snowden, and I am a children's physiotherapist. I'm also an advanced practitioner in sensory integration.

Speaker: Hi, my name is Angela. I am an Occupational Therapist based in Melbourne, Australia. I'm also an advanced sensory integration practitioner.

Speaker: Hello, I’m Lelanie Brewer, I'm a children's occupational therapist, academic, and researcher, based in Bahrain.

Speaker: Following on from our last episode, where we started to talk a lot about regulation, self-regulation, co-regulation, we thought today we'd talk a little bit about strategies that can help. I've been having a think back about-- Over the last 15 or 16 years, I've been working as an occupational therapist, supporting children and families who have difficulties, maybe regulation, sensory processing, and I was thinking about how, quite often, what happens is, a family will attend a therapy appointment.

They will identify that thing, really like to work on a child's regulation. What happens sometimes, is that they are given a list of strategies, a long list of strategies that quite often include things like proprioceptive activites, heavy work, we call them activities that use our muscles and our joints, or deep pressure activities. I've just been thinking about that, because although we know that these activities can be really regulating for many children in themselves, they may not be.

We need to think about maybe how they fit into a child's life, daily life, day to day. Also, what sort of social contexts, maybe, even, that they're in. Should they have helping them or supporting them with this, how the child feels in relation to carrying out these strategies, and even whether they enjoy them or not enjoy them, and things like that? I was just thinking about how that may or may not be actually supporting these children. I was just wondering about what, maybe, any of you thought about that.

Speaker: Yes, I really liked that idea, Emma, that sense of the strategies here, that we know what they can be helpful. What are the pieces that have to be in place, or could be in place, to make those strategies work, to make those strategies effective? Is there other stuff that parents and families can do that aren't specific follow their strategies, which are generally going to be helpful for everybody to function really well? Lelanie, what do you think?

Speaker: I'm coming in from this as my time as a community paeds OT in a very busy part of London, and then going working in private practice. I think one thing that parents often found really unhelpful was if the home program or the list of activities created extra work, because by the point somebody comes to you, they're desperate for help, they want something that's going to improve their situation, not make it worse.

If your list includes activities, that can be amazing, but out of the way, something that you don't have access to, your stress and anxiety levels are going to go really high, and it's actually not going to make the situation better. The other thing, especially with the current cost of living crisis, I would just think of what recommendations we make, is it actually affordable? If you make recommendations for expensive toys, trampoline, a piece of equipment that is not affordable, you can actually make people feel worse about themselves.

They're thinking, "I should help my child, I should buy that." Actually, no, you don't need to buy that. There are things we can do. There's lots of free activities we have access to in our daily lives that can actually make a huge difference. There's something that I have seen work a charm many times, it's actually quite fun. It doesn't sound fun initially, because the idea of going to a busy shopping center, but there are little children sized shopping trolleys, they can while you do grocery shopping.

There you go, heavy work activity available, keeps your child organised and focused, and it actually can make a shopping trip a lot more pleasant for everyone. That is something that you're really going to,Tesco, Sainsbury's, Asda, or wherever you're going. You're not going out of your way trying to fit something else in, and there's an activity there that you can do. Laundry, or pushing a heavy laundry basket.

Little ones often like to help in the house. Again, free activity that you can turn into a game, might spend two or three minutes longer on the job, but you can do something there.

Speaker: I absolutely agree Lelanie.That idea of you don't need to buy equipment to work on sensory processing. If it fits into the routines of the day, it's much more effective. I think there's a piece there, that maybe we need to talk about, that-- If you are dysregulated, or if your child is dysregulated, then even the best strategies in the world are not going to work and not going to help. What could we do?

What are the priorities to get to that place of ready for takeoff, ready to start? Was the core stuff to get us to regulation enough to put strategies in place? Emma, what do you think?

Speaker: Probably going to sound, really, like I'm coming at this from a very different place, but for me, as a parent, a therapist, or a teacher, whoever I am working with, a child that's got those sensory needs, for me, the first point has got to be my self-care, my regulation, and everyone's probably sitting there, parents that are struggling or going, "I haven't got time for self-care," then I think, "Stop." Okay? Get yourself on Facebook, Google self-care.

You'll get many different cheesy quotes. They're cheesy, but they're true. We can't pour from an empty cup, if we've got nothing to give, we got nothing to give. If our batteries are depleted, we can't support anyone else, we can barely support ourselves. Self-care is essential, not a luxury. When I'm talking about self-care, I'm not talking about booking yourself two weeks at the local health spa, because that is not going to be realistic.

We're talking about just tuning in to where we are, what we need. As a busy parent, often, we don't eat, we don't stop for a drink, we barely stop to go to the toilet, sometimes. If that is ringing true, then that needs to stop. We need those few moments. If we don't take care of ourselves, we have absolutely no ability to take care of somebody else. The problem is, we live in a society where we seem to have forgotten this, and we seem to not appreciate this. It is true.

Anyone that's thinking that they don't have time for themselves, we've got to switch that mindset. It isn't being selfish by taking care of yourself, well, it shouldn't be your basic needs of going to the toilet, it shouldn't be more than that. If you're not doing that, that is the place to start to look after yourself. We can't possibly be expected to regulate another person if we're not regulated ourselves. Personally, for me, some of my strategies to self-regulate are breathing.

Taking the breath. Now, everyone's different with this, people struggle with breathing, but for me, the bit that worked is just taking a really slow, long out-breath, the neuroscience behind that is when our out-breath is longer than our in-breath, it switches us back into a regulated state. I like a bit of visualisation. When I'm doing my out-breath, I see that switch being pressed, and it resets me. For me, my breath is something I've always got with me. I can do that wherever I am. Just tuning in to my body and its needs.

Do I need water? It's going to take me a few seconds to rehydrate myself, but physiologically, I'll be back on track. Self-care is really, really important. We need to get ourselves into a state where that becomes habitual. That becomes regular. My advice to parents who are struggling is, just take it one bit at a time, take it slowly, just make one small promise to yourself that you're going to stop and breathe, or you're going to hydrate yourself today.

That's all it needs to take it. It's not going to happen overnight, we have to train ourselves to get back to looking after ourselves. Next bit, for me, would be that connection piece that we've really got to recognise that any challenges our child has is going to put them into that state of stress, as well, that we've been in. Once we can regulate ourselves, we're going to focus back on our child. Connect with our child, try and meet them, try to meet them where they are.

I use a model called PACE, which is from attachment theory, and it comes from Dan Hughes. PACE stands for Playfulness, Acceptance, Curiosity, and Empathy. It's a way of being, and it's very much how we are naturally with newborn children, really. If you think about how we are with a newborn child, with playfulness, we accept that newborn child isn't going to be able to look after themselves, or regulate themselves.

We take on that acceptance of being able to do it. We're curious about what's wrong with them. If they're crying, well, what's wrong with you? What's there? What can we do to make it better? We go through the motions to try and make it better. We empathize. I think we can empathize with somebody a lot easier when we know they haven't got the capacity to do it themselves. If we followed that way of being around everybody, really, it doesn't have to just be children.

We can do it to our colleagues, to our partners, we can do it with ourself as well. Then, actually, that allows us to connect with people. Once we've looked after ourselves and we can connect with other people, then I think is when we can start to look at that regulation from the sensory perspective as well. We can do those sensory activities that we've been giving them, our big list, but do them with a child, whatever they may be.

We talk about linear vestibular as being a regulating activity, and the best way to explain what we mean by linear vestibular is think about what we do with a baby when we soothe them. We rock a baby. We don't rock a baby on their own. We rock ourselves while we are doing it. We are getting that linear vestibular movement. Now, if your child's anything over 3, 4, 5, well, we can still get them on our lap and do it, but a bigger child, what can we do?

This is where those sensory things come in, like the swing, or what have you, or sitting on a gym ball. If you can put that child on your lap, if you can do it with them, rock with your child. Other things we can do, deep pressure. We squeeze our child, we swallow our baby. How can we do that with an older child? How can we put that deep pressure in, to soothe them? I always remember I have a nephew who's got some very quite significant sensory needs, he gets very overwhelmed, and he was really struggling.

We had a big family play day. There was a lot of noise and he was really struggling with a headache. He was overwhelmed. I just took him really nicely with his dad and said, "Just lie down on the seat there." I said to Dad, "Would you just lie on him?" You're putting some deep pressure on him. I just said, "Is that okay? Are you all feeling comfortable?" I said, "Well, I'm just going to go to the toilet. Just stay there for a bit and see how it feels."

By the time I came back, I took a bit of time doing some deep breathing in the toilet, [chuckles] which is my time for myself on the toilet. Came back and I said, "How are you feeling now?" I'm connecting with him. I was at his level and he said, "I feel a lot better now." That deep pressure was there, which is the sensory bit, but that connection with dad, who you feel safe with, was there as well. It's about how we put these sensory strategies in, I think, is really, really important.

Speaker: Yes, I've been thinking about perhaps some more strategies for the parents that are listening. Emma talked about this idea of self-care being a necessity and something that we shouldn't feel guilty about doing. How do we do it in a way that it doesn't feel we're doing something extra? I've been thinking about tasks that we do throughout our day, like hand washing after going to the toilet, or after doing dishes.

We can do this very mundane task in different ways. This idea of deep pressure, we can wash our hands really, really briskly, and do it really, really quickly, which is going to increase our arousal levels, or we can do this task by doing it slowly, with deep pressure. We can grab some breaths while we are doing it at the same time, and so, in that moment, we're actually providing ourself with some regulating touch.

I was then thinking about showering, our preferences for smell and texture, and how showering is an activity where we can bring some of our preferences in by choosing a soap that we love the smell of. Again, by getting these little hits of a pleasurable smell that, in and of itself, can just, for a micro-moment, interrupt our stress. I think it's really important to think about these daily activities that we do to reduce our stress, and make us more available for the children that we support and that we look after.

Speaker: I was just thinking to share a way I describe it when I support junior therapists who are just coming into the profession. There's often therapists who are learning how to do this work, they feel quite confident about, "I know 400 things which could help, and I want to share that knowledge and information. I'm going to give the parent everything I know about getting regulated."

Sometimes, I've described it this way, as this metaphor that the destination is regulation. When you give people strategies, you give them a hundred different routes on a map to get to regulation. It doesn't matter which route they take, so long as they get to the regulation. They don't need to try all of the routes. They need to find one that works for them, and use that consistently, but nobody is going anywhere if there's no petrol in the car.

If your focus is on the destination and the roots, and you overlook the facts that, in this metaphor, the person who's going to get the child to the destination is the parent, the car, and there is no petrol in the car, you can't even get going. If you are bombarded with a list of strategies, but nobody is supporting you to get yourself calm, organised, and ready to be that external support to your child, throw it back. Can't do that. I need help. I need support to get to that place.

Speaker: That's a really lovely analogy, isn't it? It's so true as well, that we can give you all the strategies in the world to get there, but until you find your own personal way to fuel yourself and put petrol in your own car, you are not going to get anywhere, are you? It is a really lovely example of how self-care is one of those first things that we need to think about.

Speaker: During lockdown, I always used to have sanitiser, the hand gel, in my car, and I would be constantly going on it when I got in my car. If I was visiting kinder schools, and beyond, once we transitioned back into a normal way of working. Now, I have hand cream in my car, and I've figured out what type of hand cream I really like, one that doesn't leave a film on my hand, it needs to be absorbed.

Then this idea of sweet almonds and vanilla, again, is something that I really like, but that's become a ritual now. This idea of driving to work now has this lovely little regulating piece that I do each day. It makes me happy when I do this.

Speaker: What I find really helpful is, when I start supporting families, really just getting a really in-depth idea of their daily routine, what they do most days, then you know the environments they're in, you know what's available within that environment, and you start to see where the needs come in at different parts of the day. Help us come up with more specific strategies at specific times, in a specific environment, when we know what's available within that.

Speaker: I'm going to say that, really, what we are giving parents permission to do here, and in fact, encouraging parents, is to say to therapists who are giving them lots of strategy, "This is too much, this isn't going to work. Help me to find one that fits into my life, my daily routine." Challenging your therapist to help you create routines that work within your family rather than just bombarded with more, more, more, more, more strategies.

Speaker: I just want to add an extra point here. Sometimes we feel that, as parents, we need to listen to the experts, this therapist, but actually, you're the expert in yourself, and your child is the expert in themselves, and you're the experts of your family. Don't feel that you need to listen to other experts, because you know yourself best.

Speaker: Well, it feels like we've covered quite a lot today, focusing in on that idea that strategies can be helpful, that they can only work in the context of you feeling regulated as the parent, and the child being as regulated as they can be. That part of what allows that to happen is the co-regulation, that's built on your emotional relationship of trust with your child, as well as any physical strategies that you do, and that more strategies isn't better, or works better.

It's just different ways to get to the same point. The stuff that's going to work best is the stuff that's part of your everyday life. At core, what it comes down to is you feeling confident about using yourself as part of the therapy by investing in your self-regulation, your calm, alert, organised self-care. Thanks so much for joining us, everybody. We hope we found this useful. We'd love to hear from you. Do please feedback to us on our social media channels, Sensory Integration Education.

We're on Twitter, we are on Instagram, we're on Facebook. We'd love to hear from you. If there's a topic that you would like us to think about, if you'd like to listen to some thoughts and ideas, just let us know, and we'd be happy to pick those up as a future episode of Sensory Chat. Thank you so much for joining us, and we look forward to speaking to you again soon. Bye.

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Speaker: Sensory Chat is produced by Sensory Integration Education. In each episode, qualified sensory integration practitioners share their personal opinions and ideas, with parents and families in mind. We would love to hear from you. You could find us on Facebook and Instagram, @SensoryIntegrationEducation. Please note that for specific advice for your child, a sensory integration assessment would be needed.

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