Self-regulations interventions and strategies

Teresa Garland's Self-Regulation Interventions and Strategies: Keeping the Body, Mind, & Emotions on Task in Children with Autism, ADHD, or Sensory Disorders is a book I wish I had when my son was little. He was highly sensitive to smell, very oral- he chewed on everything, did not recognize when he was hungry, tactile defensive around people he did not know or when stressed, did not recognize when he was cold, a picky eater and the list goes on. Amazingly enough, when he was due for a reevaluation for special ed services, I asked for a sensory evaluation and his very helpful (yes, I use that term with sarcasm) OT did not perform one because she did not see it. Everyone else, except the equally helpful PT, looked amazed and the meeting went on. We had to figure it out interventions in the days before the internet explosion of information. This book does a great job of describing examples of challenges and what to do about them. It reviews commercial programs and presents lots of simple at home ideas for helping children.

One important comment that she makes is that many of our kids are developmentally delayed when it comes to sensory integration. That means that for some of our kids time is a component of the answer. However, you cannot wait and hope. Interventions can make children more calm and happy in the here and now. Some interventions involve teaching children the signs that they are becoming overwhelmed and how to take a break to allow them to return to baseline. As they age they do not become overwhelmed so easily, but, in the here and now, they need strategies to not explode. Managing the environment through noise canceling head phones or access to fidgets can truly help our kids successful socialize and participate in activities.

One thing she repeatedly references is that these children often need grounding. Strategies to accomplish this include

• heavy work- rake leaves, push furniture around, carry a  backpack, toss a weighted ball, wear a weighted vest
• massage- formal ones, loofah, Qigong
• yoga- especially the tree pose
• breathing exercises
• deep pressure- weighted blankets, joint pressure, body socks, pressure vest or suits

Some of the strategies require training. Where available, she lists online and print resources. If particular equipment is suggested, she points out where to locate them.

The chapter on sensory modulation is broken into sections by sense. She addresses oversensitive, undersensitive and cravings of touch, smell, vision, auditory, vestibular (balance), proprioception (body sense, movement) and interoception (sense of internal states- hunger, pain, temperature,...). I liked the idea of using a metronome to help coordinate movements and work on self-regulation. Much to my irritation, she will make a list and then address things in a different order.

She does provide some case studies and vignettes. These enhance the text. More would have been useful.