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Self-Regulation
As occupational therapists, we teach that self-regulation is the ability to change how alert we feel. In the Alert Program®, we tell children and their parents, “if your body is like a car engine, sometimes it runs on high, sometimes it runs on low, and sometimes it runs just right.”

We self-regulate every hour of every day. Self- regulation is the foundation of everything we do; it affects how well we interact with others and our environment, but typically we never think about our “engines” or how our level of alertness affects our ability to function. Say you need to type a report at work. If your “engine” is in a high state (you’re feeling hyper), it will be more difficult to do your best work. If your “engine” is in a low state (you’re feeling lethargic), writing the report may take longer. If your “engine” is in a “just right” state (you’re feeling alert and focused), you will be more likely to complete the report quickly and effectively.

The same is true for children, those developing typically and those with autism or other special needs. When using the Alert Program® (with children or adults), the goal is not for our engines to be “just right” all day long. The goal is be able to change how alert we feel so we can be “just right” (in an optimal alert state) for whatever we want to do: learning, working, playing, relaxing, or interacting with friends and family.

We all have engines. Some of our engines just rev a little higher or lower than others, and some need a little more help to attain a “just right” state of alertness. One of the best things about helping children to obtain an optimal state using the Alert Program® is how we talk with them. Instead of fall back phrases like: “Calm down, you’re out of control,” the Alert Program® emphasizes the use of non-judgmental language and helps children choose engine strategies: “Gee, looks like your engine’s in high gear. Shall we jump ten times or take some deep breaths together?” (Read on to learn how the program can be adapted for children who are non-verbal or for whom the concept of an engine would be too abstract to understand.)

Overview of the Alert Program®

jumperWe developed our first book, “How Does Your Engine Run?”® A Leader’s Guide to the Alert Program® for Self-Regulation for parents, teachers, therapists and children to learn about the importance of self-regulation. The Alert Program® is a practical approach to help all team members choose strategies to change or maintain appropriate states of alertness at home, school, or other settings.

The Alert Program® is based on how the body processes sensory information. You may be familiar with the “sensory diet” concept (www.Avanit-ed.com). Just as we need a nutritional diet, we need a sensory diet with input from our traditional senses, as well as movement and gravity. In the Alert Program®, we explain the sensory diet concept by teaching that there are five ways to change how alert we feel: put something in your mouth, move, touch, look, and listen.

Let’s look at an example of how we, as adults, use engine strategies (part of our sensory diet) to self-regulate. When sitting in a dark movie theater, where we would have the tendency to drop into a low state, we might crunch on popcorn (mouth), drink an ice cold drink (mouth), rock in the chair if it’s an upscale theater (move), hold our friend’s hand in the scary parts (touch) while we watch the action on the big screen (look) and jump out of our seats (move) with the loud surround sound (listen)! When we realize what we, as adults, do to change how alert we feel, then we are better able to observe and support children.

As adults, we support self-regulation in infants quite naturally. We would comfort a baby who was breathing quickly, maybe crying, tightening her little arms and legs, perhaps flushing. We might offer a bottle (mouth) or rock her (move). We might swaddle her (touch), dim the lights (look), or sing a lullaby (listen). Similarly, if she is slow to rise and needs help to awaken, we might, again, offer a bottle (mouth), gently bounce her arrhythmically (move), swiftly rub her arms and legs (touch), take her outside or into bright light (look), or sing her a silly song (listen).

In this example, obviously, we are not suggesting to use the engine analogy with an infant, “Your engine’s low, hit the gas, wake up!” Children of any age do not need to be able to talk about their engines in order for adults to help provide sensory strategies. If a father suspects his non-verbal child is having difficulty processing sensory information while in a crowded room, he might think to himself, “Looks like my son’s engine is in high.” Then, gently, he might guide his son outside the room and encourage his son to push on a wall with him.

Sensory Overload
Many children on the autism spectrum are experiencing difficulties with self-regulation or sensory overload (engines on very high alert). They can’t take in and make sense of what they see, hear, touch, taste, and smell. Sensation and movement can be so confusing to their nervous systems that their bodies go into fight, flight, or fright. (This is why The Son-Rise Program® has the playroom!)alarmbell

The fight, flight, fright response helps protect our bodies from danger. That’s the response we need if a tiger is coming at us. Sensory overload is a commonly overlooked reason why a child goes into a fight, flight, or fright state. (This can be discerned by observing particular signals from our children, discussed below.) Remember: whether the threat is real or perceived, it can still trigger stress chemistry. For those who do not process sensory information well, the world may feel unsafe and overwhelming. The Alert Program® teaches how to observe, offer strategies, and create environments where sensory information can be processed better. No child should live in a world full of charging tigers.

Whenever possible, we strongly suggest that at least one person on the team be familiar with sensory processing theory and self- regulation. Those trained in using the Alert Program® and sensory processing concepts can be very helpful in this regard, especially when sensory overload is an issue for a child. (To learn more about Alert Program® trainings or books for parents and professionals, visit www.AlertProgram.com and click on “New to the Alert Program.”)

Reading Engine Signals
When adults understand what engine signals the child is giving, powerful changes can occur. The Alert Program® teaches the team how to observe signals of sensory overload such as dilated pupils, changes in breath and skin color, clenching, sweating, or more subtle changes such as eye aversion, finger-flaring, or hiding under the table. Parents and professionals also learn how to observe what a low state and an optimal state of alertness “looks like” specific to a child. For example, for one child “rocking forward and back” may be a cue the child may soon go into a fight, flight, or fright response. yeller-boyFor another child, the same forward and back motion may indicate she is in a optimal state and is using movement to self-regulate. For yet another child, the forward and back motion might be a clue the child is in a low state and needs more intensity of movement (maybe rocking forward and back on an exercise ball or in a rocking chair) to attain an optimal state of alertness (unless preparing to go to bed when a low state is ideal!).

It takes good detectives and observers to read engine signals, but it’s not rocket science. By reading Alert Program® books or taking the online course, parents and professionals easily learn how to support self- regulation. Adults report that using engine strategies doesn’t take more time, but saves time and can decrease behavioral outbursts.

The Alert Program® emphasizes the benefits of setting up the child’s nervous system for success. In one of many research projects, occupational therapists found the Alert Program® to be effective in helping children to “self-regulate, change tasks, organize themselves, cope with sensory challenges, and focus on tasks….” (Barnes, Karin, et al., 2008 – view additional research at www.AlertProgram.com).

If we understand self-regulation and sensory concepts, then we can learn to be “detectives” to decipher the sometimes confusing signals and offer appropriate strategies to support engines running “just right.” (Take Five: Staying Alert at Home and School lists strategies and activities for playrooms and other settings.)

Why Heavy Work Activities?
The Alert Program® frequently recommends heavy work activitiestug-of-war because heavy work “works” when engines are in high or in low states of alertness. Activities that involve pushing, pulling, tugging, towing, and carrying heavy objects help engines to rev up or cool down to return to a “just right” state where it’s easier to interact, learn, and play.

Through the Alert Program® games and songs, we can help our children to self-regulate and attain a “just right” state. The snappy rhythms of the Just Right Song and Five Ways Song make identifying engine states and choosing engine strategies fun. Our Alert: Go Fish!, Alert Bingo, and Keeping on Track board games reinforce the self- regulation concepts through visually appealing themes like cars racing, monkeys on a playground, ducks at school, and dogs playing poker.

dog-pokerEngine Vocabulary
Using engine vocabulary bridges the gap of our jargon on teams so we can focus on what is best for the child. When adults talk about a child’s engine (whether or not the child is participating in labeling engine levels for themselves), they create better communication and solutions. For example, a Son-Rise Program parent of a child with autism who is non-verbal may have a spiral notebook in which they, as well their volunteers, take notes. After the team is familiar with the Alert Program®, the mom may write in the morning, “Jane‘s engine is in high this morning. Our alarm clock didn’t go off so all of our engines are in high gear this morning.”

Reading this in the child’s notebook, the first person to go in the playroom would then have a much better idea of how to start the day. The parent or volunteer might begin by looking for an opportunity to engage in heavy work with the child such as moving the playroom furniture. female-voiceEngaging in heavy work would help the child’s engine return to a “just right” level. The parents and volunteers might provide other “engine strategies” such as chewing on a straw (mouth), pushing on a wall (move), sitting on an exercise ball (move and touch), dimming the lights (look), or listening to music (listen).

Throughout the day, each person might write engine level observations in the notebook, such as “Jane’s engine was in high gear at the beginning of my session, so we played a game where we rolled the giant ball over one another, and she was calm, alert, and interactive at the end of the session.”

But the team does not need to use only the engine analogy. We initially introduce the engine vocabulary because it is a common analogy that many children enjoy. Use any descriptors that have meaning for the child (sounds, colors, animals, etc.).

Choose words that are most useful to children to describe their inner experience of self-regulation. For example, if a child loves dinosaurs then you might use raptors for a high state of alertness, brontosaurus (apatosaurus) for low, and stegosaurus for just right.
For some with autism, for those who have significant developmental delays or for whom language is challenging, the concept of an engine may be too abstract. Rather than talking about their engines, they could point to photos taken when they were in high, low, and just right. Or adults might only offer engine strategies, without labeling engines. An adult might say, “Today, in the car, do you want to take your Silly Putty?” Remember the goal is not to be excellent at labeling levels of alertness, the goal is to help children self-regulate.

In Summary…
If your engine has been idling nicely and you were attending easily as you read this, then you already know about self-regulation. We hope the Alert Program® renews, refreshes, and refuels your ways of supporting children, so their engines can run “just right.”

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About the Authors:
Mary Sue and Sherry, occupational therapists, have over 35 years of experience working with and learning from a variety of children, parents, and teachers in urban and rural school districts as well as clinic, home, and camp settings. They have focused on developing practical ways to teach people of all ages how to incorporate sensory integration theory into every day living. For the past two decades, they have developed, refined, and kid-tested the Alert Program®. As co-owners of TherapyWorks, Inc., Mary Sue and Sherry have published numerous books, games, and songs relating to self-regulation. Since 1991, thousands of parents, teachers, and other professionals have attended Alert Program® trainings (“live” and online courses) with enthusiastic reviews. In 1996, the authors decided to lecture full-time to spread the word about using the engine analogy and how understanding self-regulation can enrich the lives of children. Since children are their finest teachers, Sherry and Mary Sue now enjoy volunteering time in the Albuquerque community where they look forward to learning more from their excellent student “instructors.”

To learn more about Alert Program® books, songs, and games visit:
www.AlertProgram.com

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NOTE: Parents, teachers, and therapists can print this to share with others on their team who are supporting autism.
Those using the Son-Rise Program® will find it especially useful.

© 2010 TherapyWorks, Inc. Reprinted with permission for educational purposes.