Definitions: Self-Regulation, Arousal and Inhibition
Self-regulation is hard to explain, because it's something that often occurs naturally; and when it happens naturally, we don't even realize it. However, when it does not occur naturally, we definitely understand that there is a need for self-regulation strategies. The easiest and best definition that I was able to find for self-regulation comes from Mary Sue Williams and Sherry Shellenberger, creators of the program “How Does Your Engine Run” (1994):
Self-regulation is the ability to attain, maintain and adjust arousal levels appropriately depending on the situation and the stimuli presented.
Arousal can be considered the range of the nervous system, describing how alert one feels. When difficulties in self-regulation occur, a student will have trouble changing arousal levels which directly affect optimal functioning and learning.
Arousal Levels
There are three main arousal levels: low, normal/just right and high. For example, when I wake up in the morning, I'm feeling pretty low until I have one or two cups of coffee and start moving. By the time I'm at work, I'm ready to go; my level is just right or normal. However, if I hit traffic in the morning and I'm running several minutes late, my level is going to be a little higher. Being able to change and fluctuate in between those is something that we do naturally every day. It becomes a problem when a student’s inability to self-regulate impacts their daily skills. We're all going to have those times of nervousness or sluggishness, and we know what to do about it; however, students with regulation difficulties are unable to change the degree of alertness they feel, and therefore their function is impaired. This can lead to sensory defensiveness, which can cause flight, fright or fight.
Inhibition Levels
There are two different inhibition levels that allow you to change arousal level: top-down approach and bottom-up approach. As adults, we often use the top down approach, which is efficient for temporary concentration or self-regulation. It's being able to say, "Okay, you know what? I'm running late. It's not the end of the world. I'm not going to get fired if I'm stuck in traffic and late for five or 10 minutes." Young students are not able to understand that one bad situation is not the end of the world. They have a tendency to make a mountain out of a molehill. It isn't a successful strategy to use for the whole day. What you're doing is activating the cortex, the thinking center of the brain. The cortex communicates to the limbic system and says, "It's okay. You can calm down. We're good" (or vice versa, if you need to speed it up if your arousal level is running low).
A bottom up approach is a more long-term strategy. It requires the deep proprioceptive input. It hits the cerebellum, the midbrain, the proprioception center of the brain. Deep proprioceptive input very rarely overloads the nervous system. Using heavy work to get this information into the brain and make those long-term changes is essential for our little ones. Heavy work can include whole body actions, such as pushing, pulling, and lifting. It also includes oral actions, such as chewing, and the use of hands for squeezing, pinching or fidgeting. This resistive input obtained through heavy work activities can improve attention, arousal level, body awareness and muscle tone, as well as decreasing defensiveness.
Heavy Work Strategies: Home
Some of the strategies I like to suggest at home include pushing and pulling games, such as tug of war. If you have a pet dog at home, give them that tug of war toy and let the child go ahead and play with them. Wrestling, football or just general roughhousing are great heavy work strategies. Others are raking leaves, digging in the garden, or anything that's allowing them to use those big muscles and work. Pushing weighted carts. I like to use laundry baskets; I'll put a heavy box inside of a laundry basket and put puzzle pieces at one end of the hallway and the puzzle on the other end. Then, the student has to go back and forth, putting one piece at a time into the puzzle, then obtaining another piece. These are very functional, but easy heavy work strategies that don’t require a lot of money or effort to put together.
Heavy Work Strategies: Classroom
It's a little different in the classroom, because we can't have these children pushing laundry baskets around. One strategy for the classroom is to have the students push the palms of their hands together. Also effective are pushups against the wall, as well as chair pushups where the child gets their bottom up off the chair. Conversely, they can do chair pull ups, where they pull their bottom into the chair. We will talk more about chewing gum and chew tools a little bit later. Then of course, our hand fidget tools that everyone should know about.
Changing Arousal Levels
Changing arousal levels is an unconscious process. How do we teach it to our students? I can't stress enough how important it is to take the time to observe the children. We're so goal driven with the Common Core curriculum, everyone needing results all the time, and being required to meet IEP goals. However, I have found that if we take a step back and spend time watching that student, we can see what strategies they're using for self-regulation. Then we have a basis; we know what they need and how to make appropriate suggestions to implement actions that are more appropriate. Everyone has an innate drive to seek and receive needed sensory input into their bodies and minds. Frequently, children aren't going to be seeking the right type of input, and that's where we play a crucial role in helping them.
Sensory Diet
We all need a sensory diet. As adults, we don’t cortically think about our sensory diet. If it's three o'clock in the afternoon, and I'm feeling sleepy, I'm going to get myself a soda, a cup of coffee, or a piece of chocolate, something to perk me up a little bit. We do that naturally for ourselves. If we are two hours in to an IEP meeting, and we're not anywhere close to signing the documents, what's happening? We may see adults exhibit socially appropriate sensory diet types of activities (e.g., fiddling with jewelry, shifting in chairs, tapping pencils on paper). Our children don't know how to be that subtle yet. With students, you will likely see inappropriate, sensory diet activities. You're going to see them chewing on their collar or on their pencils. They're rocking back in their chairs. They're up and walking around. They're spinning around on the carpet at circle time. They're eating their hair. We can clearly see that they need sensory input.
For years, schools have used the classroom model of students sitting still at a desk, facing forward, and listening to the teacher. Recently, we have discovered that we're not supposed to be sitting still. Now, many people use treadmill desks and standing desks because we understand that sitting at a desk is not the best for our health, or the best way to learn. However, many schools still adhere to the traditional model: students need to be in their seats, focused, and goal-driven. As OTs, we need to raise awareness that these children can benefit from getting up and moving around. We need to educate our administrators and our teachers about developmentally appropriate learning. We must assure teachers that they can still use the same curriculum; however, by allowing the students to move around more in the classroom, they will likely see even better results.