In this episode, Amy, Emer, Emma, Angela and Lelanie discuss regulation, defining the term and sharing the neurology of being regulated and dysregulated. They dive into how we as individuals experience this through our senses as well as through our emotions. In this conversation, they also highlight co-regulation and how co-regulation can support individuals who may need the support of another to regulate their nervous system.

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. I'm a speech and language therapist and an advanced practitioner in Ayres sensory integration.

Speaker: Hello, I am Emer Broderick and I am an occupational therapist based in London in the UK. I am also an advanced practitioner in Ayres Sensory Integration.

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

Speaker: Hi, my name's Angela. I am an occupational therapist based in Melbourne, Australia and I'm also an advanced sensory integration practitioner.

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

Speaker: Today we thought we would move on slightly from our last episode. We talked in our last episode about our sensory preferences, and we introduced the idea that actually rather than there being anything wrong and that sensory processing, there's something wrong with that, we all process sensory information and we all have our preferences. We talked about maybe some of the difficulties that we experience in our families and with our children, not because there's something wrong with our child, but that we have different preferences that may clash or not necessarily sit together really well.

That led us into thinking about regulation, and what we mean by regulation and self-regulation and the importance of co-regulation with the parent-child interaction, that parent-child bond when they're really little to help lead us and to be able to self-regulate. We thought that we would have a discussion about that for this episode.

When thinking about regulation, I think we all have an idea what regulation is in our mind. I think we can certainly recognize when we are not regulated, but what do we mean? For me, I always take this back to the neurology, and I don't get into really serious sciencey stuff here, but really simplistically, let's take this to what we would consider as stress. When we are stressed, we are not regulated, we are not calm, we are not in a state where we can function efficiently. For me, that's what regulation is.

We can look at regulation in terms of our senses. Are we sensory-regulated? Are our senses working in a way that is going to allow us to function? We can look at it in terms of our emotions as well. Emotionally, if something really bad happened to us that impacts how we are feeling and how calm and how focused we are able to be. For me what's really important is those two things are really, really closely linked.

If our senses are not regulated very well and they're not in balance and they're not allowing a dysfunction, that is really going to impact how we emotionally feel, but vice versa as well. If something really awful has happened to us or something really exciting has happened to us, that's going to impact how our senses will feel as well and how we will process the sensory information that's coming in.

Just to give you an example of that is a time in my life when I was really, really stressed, taking too much on as you do as a working parent. It was those times that I started to notice that actually I couldn't cope so well with noises around me and I couldn't cope with bright lights in supermarkets. The big thing for me is I worked up, I just couldn't cope driving because that was just too much of a sensory demand.

I think this helps us to realize that this is actually, when I'm working with children and sensory difficulties, it always comes back to regulation. Let's focus on where we are, how we are, and how our child is. That is the bit that I like to start with. If we think about co-regulation and where does this ability come from to be able to regulate ourselves? That comes right back from when our babies were actually in our womb or those early days. This is what we mean by attachment.

Normal child development happens that we nurture, we comfort, we keep our children safe so we meet all of their needs, and our child will learn that their needs will get met consistently. Obviously, there's situations where this doesn't happen and we know that that leads to difficulties in later life. Let's imagine that this has happened. Our child is safe, we nurture our child, typical child development. Our child then gets confident and they start to explore the world. They go out, they'll play happily, but something will invariably happen. It may be they fall over, it may be another child comes and steals their toy, but that will dysregulate them, that will upset them when something goes wrong.

Typically, that child will return to you and we give them nurture and we give them comfort and we regulate them. That is co-regulation. That is two people, one person helping to regulate another person to get them back to that point where they need to be, and then they go off and explore the world again. That is what happens throughout life.

For some reason, I think once babies have grown up, we think we don't need to do that anymore. We do that with everybody, we do that with our partners, we do that with our children. I'm nearly 50 and yet if something goes wrong, I still call my mom. This is not something that is just for children, this is something that happens throughout life.

This is where regulation comes from. This is where we learn how to regulate ourselves. Ultimately, the goal is that we get to what we call self-regulation. What we mean by self-regulation is that we have that ability to be able to change our arousal levels so that we can do what we need to do. I had to get up early this morning and I had to do something to increase my arousal levels, otherwise, I wouldn't even be talking right now. I had swift cup of coffee and moved around quite quickly. Similarly, if I need to get to sleep tonight, I need to lower my arousal levels so that I can do that.

The aim in life is that we move progressively towards being able to do that independently. Although I know that there's a group of people out there that would say we never actually get to that point and we are always going to be reliant on other people to help us do that. Whether that's our partner, whether that's our child, whether that's our friend, whether that's our pet dog.

This is what we're talking about and we want to really relate that to those sensory challenges that we might experience and how we can recognize when sensory challenges cause dysregulation, but also how we can use sensory strategies to help us with our regulation. Amy, what, what do you think about this?

Speaker: Emma, just picking up on something you said, just to clarify because I think you used a term which I think a lot of parents will have heard from therapists who support them, and just because it means something different in everyday language than it does to us as therapists. That's the word arousal. Just picking up, what do we mean by arousal because in everyday language, it would be something a bit saucy and we're absolutely not talking about that, are we? What we mean is nervous system arousal or alertness. Being sufficiently alert or engaged in order to recognize and take part in what's happening around you.

Speaker: Absolutely. Thanks for pointing that out. Actually, that's one of the reasons that we don't often use that word. Certainly not with a certain age group of client because it gets quite humorous at times.

Speaker: You've had the conversation with teenagers where you regret using the word arousal.

Speaker: I see. I certainly have.

Speaker: Me too. That's what we mean. We mean an alertness or feeling that you are able to make sense of what's happening to you without feeling overwhelmed by it. That place there, that sweet spot between feeling overwhelmed or, "Oh, it's a bit much," and actually feeling a bit low or sleepy or not quite in the zone, not quite firing or on all cylinders. That to me would be where being regulated is.

I wonder if that's the same for other people. I wonder if anybody would be able to pick up on something else that parents might have heard, which is a specific program called Zones of Regulation. I wonder if anybody would just mind to quickly just explain where zones of regulation might fit with what we're talking about.

Speaker: Zones of Regulation is a program that I've started to see used more and more, especially in schools. A lot of primary schools in the UK have it. Well, a basic version of it really. What it does is supporting children to recognize where their arousal stage or where they are feeling they are. They have five different zones that are identified by color. There's a green zone, which is I am happy, ready to learn, feeling calm and alert.

Then there's blue zone, which is, I'm feeling a bit sad or a bit tired, maybe a bit unwell. I'm not quite at the green zone where I want to be. Then you have the red zone, which is, I'm almost out of control. I just don't feel like I'm in control of my actions. I'm feeling very, very dysregulated. I'm not feeling calm, I'm feeling very, very stressed. The yellow zone is where you are before you get to that. The yellow zone will be, I'm starting to feel a bit anxious. I am maybe starting or maybe feeling a bit silly and feeling like I'm just a bit giddy. I'm finding it hard to sit still and finding it harder to be alert enough to sit and learn.

The idea is that children would be able to identify what zone they're in, and most importantly, use strategies that are specific to them and their needs and their regulation needs in order to bring them back to the green zone. There is a recognition that it's very normal to go through from zone to zone. We all do it throughout the day. The idea is that children would have strategies to get them back into the green zone when they need to be there. For example, in schools, they might, at the start of class, let's get ourselves back into the green zone because now we're sitting in learning, for example.

Speaker: Thank you so much, Eva. I think that's really useful for parents to understand because what that program relies on is a child being able to self-regulate. That's a child who has sufficient control over their nervous system that they can use external strategies to regulate themselves. I think we all work with so many children who aren't able to do that. If your child is not able to self-regulate, then zones of regulation is not going to be a helpful strategy. Angela, what do you think?

Speaker: I'm thinking the exact same thing. I've absolutely used the zones. It's also part of many school curriculums here in Australia, and it absolutely has merit, but I think like all programs that are manualized, the key to the success is really being able to individualize it for students. That's tricky to do in a whole classroom. I think just something to be mindful of, really, is that if we notice that this particular program is perhaps not successful, is thinking about what is this child's experience of co-regulation, and perhaps they need some more individualized support in this space.

Speaker: Yes, I completely agree, Angela. I think is a therapist, that works mostly in the field of trauma, and we're working with children have had difficulties with attachment. One of the things that I sort of holdin my head when I'm working is this thing about regulation. When children struggle to regulate, one of the things that works really useful is that connection based. What I mean by that is connecting with that child on an emotional level so that we try to understand that child. The child feels understood, connected to, and ultimately then feels safe. I think that can be the starting point sometimes as well.

This is why it's really helpful for us to understand where self-regulation ultimately comes from, or regulation comes from. It comes from that very early connection that we have with children, that very early attachment. I agree that there's a lot of tools out there to help children to recognize where they are, but if they don't have that capacity to be able to regulate, then that's when I think we need to really think about how we as the person that ultimately is got to self-regulate, whether you're a parent or you're a teacher or whatever your role is, what can we do.

At that point, it's down to us to be able to recognize that that child is dysregulated and to help regulate that child. Whether that is with sensory strategies, or whether that is then supporting the child to access the appropriate ones, or whether that is simply connection and doing that connection piece where we meet that child where they are and accept that child where they are and we share curiosity and we connect with that child. It's surprising that when we do that, how regulated that child can become just with that co-regulation piece.

Speaker: Emma, just listening to you speak took me back to a previous point you made when we were talking about sensory preferences. You do a log of your own experiences thinking what makes you feel good. For the child who has difficulties with self-regulation, we always have to do these observations for them and to help them. Thinking about zones of regulation, whether it's a teacher or a childminder, what situations triggers the child, and what situations are more calming because the child might not realize what works for them. It becomes a little log that we keep for them and trying out different things as well. That can be a lot of trial and error.

Speaker: It's a really interesting point. I sometimes do a very loose narrative when I'm working with children. I don't like to give them a narrative. I don't want to tell them how they're feeling and I don't want to tell them what's working for them, but I do a lot of wandering. You seem to look really happy doing that, or that seems to make you feel okay, or that seems to make you feel good, or you seem to be enjoying that. I'm doing that induce narrative so that hopefully, that's dripping in that actually this activity makes me feel good, vice versa really.

Speaker: One of the things, Emma, that's coming out from what you're saying and also what from what Leilani was saying there too is, it really emphasizes that co-regulation comes before self-regulation. Co-regulation requires that the child know you and trust you, that essentially, it would be very hard for a stranger to co-regulate a child. It has to be someone that the child feels that trust and connection with.

You can see how very hard that might be in nursery and in school where perhaps you had different staff members supporting the child in kindergarten or things, that at home, it's likely to be the lead parent who is the key co-regulating figure. That's quite a big demand, a big ask that you not only manage your own sensory preferences and needs, but that you're also responsible for the sensory co-regulation and emotional co-regulation of your children as well. I think we should not underestimate the demand that co-regulating places on you, as a parent.

Speaker: Building on that a bit, Amy, also is that it's very difficult to co-regulate if you yourself aren't regulated. You were speaking about the demand of co-regulating, we also must be aware of our own regulation that another demand and our own regulation, as well as the child's regulation because if we are not regulated, it's pretty much impossible to co-regulate a child if we're very dysregulated.

Speaker: That's got to be the trickiest piece. In a moment of your child's distress, you need to be actively trying to keep your own nervous system calm, your face, your body, perhaps neutral or welcoming, while you're actually feeling something completely different. It's a really, really difficult thing to do.

Speaker: That is so true. It's not quite relevant but it links to this topic is, I've recently analyzed some data on parents and their children during the COVID-19 lockdown restrictions. I felt that what I was looking for was how children were doing in terms of their self-care during the lockdown. What actually came out as a much stronger thing was the mental impact that had on the parents, and how actually, the more dysregulated the child became, the anxiety levels of the parents, and they triggered each other. It actually has some really interesting repercussions that's actually going to affect-- We're going to see that probably in our camps and mental health services for a while.

Speaker: That's really interesting. It's really useful. Hot off the press research, Leilani, that the impact of that stress and anxiety on parents' nervous systems and emotional regulation, as well as the impact on children.

We're out of time for today's episode, but I'm wondering if maybe for the next episode, we might start to think about what strategies could parents use. What are some of the things that we know from a sensory perspective, as well as from an emotional perspective, can be really helpful to put yourself in that place of feeling calm and alert and regulated so that you can co-regulate your child. If you're happy to do that, should we do that for our next episode?

Speaker: That's brilliant.

Speaker: Great.

Speaker: Lovely to talk to you today, guys, and see you again soon.

Speaker: Take care.

Speaker: Bye.

Speaker: 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 at Sensory Integration Education. Please note that for specific advice for your child, a sensory integration assessment will be needed.

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