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If you’re unfamiliar with this dynamic duo of occupational therapists or their fun and effective sensory regulation program, this is the place to be. Read on!

The Alert Program® is a cognitive and experiential sensorimotor approach to teach children how to change and maintain levels of alertness necessary for any given task during their day (i.e., how to self-regulate). Sherry and Mary Sue were the first OTs to marry a child-friendly vocabulary with sensorimotor strategies to help children recognize when their sensory systems are running too slow, too fast or “just right.”

How did you two come to be working together? MS: After working in public schools for many years, we both had the opportunity to work with an outstanding team of therapists at Albuquerque Therapy Services clinic. That’s where I (Mary Sue) came to understand how self-regulation is the foundation of every educational, therapeutic, or parenting goal we have for children. It’s an odd thing, but after I learned the importance of self-regulation, I started observing it in everyone, not just my clients (including a judge while I was on jury duty!).

Sherry’s budding interests in sensorimotor issues arose quite differently. Her younger brother has Down Syndrome. She saw first hand how OTs, along with other early intervention team members, supported her brother’s sensorimotor development and how this affected all other areas of his daily life. That’s when Sherry decided to be an OT – and aren’t we all glad she did!

How did the engine analogy come about? MS: Back in 1987, I was working with an 11-year-old girl with self-regulation difficulties. She would come into the therapy room, sit on a bench to take her shoes off, and I could barely get her up and moving to play on the therapy equipment. But after just a few minutes of movement, a dramatic transformation would occur. While engaging in active play and using sensory integration (SI) techniques, she attained an optional state of alertness which was observed through her muscle tone and postural improvements, eye contact, facial expressions, better organization of thoughts, communication and movement. Yet, each time she came to therapy, we’d have to start the process all over again. I realized I needed a vocabulary to communicate with her about the “transformation” I was observing.

I said to her, “if your body is like a car engine, sometimes it runs on high, sometimes it runs on low, and some times it runs just right.” Then I shared my observations. When she sat on the bench at the beginning of the session, I’d comment, “Gosh, it looks like your engine is really low. I can tell because is seems really hard to get up and get moving to play together.” If in our session her engine went up into high, in a neutral tone of voice I’d say, “Oh, your engine is really up in high gear right now. Seems like you are talking faster and moving more quickly. It’s harder to tell me your ideas.” And then when she got into an optimal state of alertness I’d comment, “Now, it seems like your engine is running just right. It’s easy to talk with me and tell me your ideas of how to play this game.”

Your first book was released in the mid-1990s: How Does Your Engine Run?® A Leader’s Guide to the Alert Program® for Self-Regulation. Has the program changed since then? MS: What has probably changed the most is how to adapt the program for those who are not as verbally expressive as my first client. Over the years we’ve heard many stories of how children have found vocabulary to describe their state of alertness, but not necessarily using the engine analogy… maybe they enjoy dinosaurs (raptors, brontosaurus, or stegosaurus), or colors (red, yellow, and green), or sounds (woooo, ugghh, and humming). Almost anything can be used to convey high, low,and optimal levels of alertness, if it has meaning to the child.

Is the program equally effective for the more challenged, nonverbal child? MS: Yes. Again, it’s how the program is adapted and used that is different. Some children may never be independent in self-regulation and they need us, as the adults, to understand the basics of the Alert Program® so we can use the engine vocabulary, not with the children, but with each other. For example, a paraprofessional and teacher may notice a child with autism in their classroom is not in an optimal state. The teacher may quietly say to the paraprofessional, “Looks like Jerome’s engine is going into high. Would you help him carry this box to the office to regulate his engine? Then he’ll be ready for circle time when you get back.”

What kind of changes have you seen in kids using the program? Sherry: I think the most striking change has to do with setting children up for success. They are more efficient in their work and play, better able to demonstrate their knowledge. Children learn they have options to self-regulate which translates into improvements in self-esteem. Then we see improvements in other areas, since when we can change how alert we feel, we are in an optimal state to learn math, reading, dressing skills, social development, or any other educational or therapeutic goals.

When educational team members, including parents, understand the importance of supporting self-regulation, they become “detectives” to brainstorm and implement engine strategies in homes and schools. I enjoy hearing not only adults but children comment to each other about their need for self-regulation such as, “You might want to get a fidget tool because it looks like your engine’s on high and you could get in trouble!”

With whom can the Alert Program® be used? Sherry: It has been adapted for preschool through adulthood. Even those working with the 0-3 population can incorporate the Alert Program® by using the engine analogy when talking with caregivers. Also, the Alert Program® has been taught and used in homes, schools, therapy clinics, as well as camp settings, group homes, community day programs, mental health facilities, nursing homes, etc.

Can the program be implemented by parents/teachers or only via a trained OT? Sherry: Anyone can be an Alert Program® leader. We suggest that at least one person on the team be familiar with sensory integration theory and can consult with the team to support self-regulation. In fact, our book and CD combo, Test Drive: Introducing the Alert Program Through Song was developed specifically for parents and teachers who want a quick and easy way to teach the Alert Program® to students.

Where would you suggest one start? Sherry: The Leader’s Guide has all the steps and stages explained in detail with 56 pages of reproducible Appendix worksheets and charts to use with students. Therapists mostly use this book to teach the whole program in a school or therapy clinic. Those who don’t want to introduce engine analogy or the program in that much detail may like to begin with the simpler approach in the Take Five! book. Its chock full of lots of practical, low-budget activities to support self-regulation. But as I mentioned, the Test Drive is the easiest and fastest way to teach the Alert Program® concepts. Play a song just once and the children (and adults) will be humming along, perhaps not even knowing they are learning about self-regulation.

How do readers learn more about the Alert Program® and the work you do? Sherry: Our website is and our toll-free number is 877-897-3478. We offer on the website our Introductory Booklet, Leader’s Guide, Take Five!, Test Drive, and our Alert Program® Songs CD, Alert: Go Fish!, Alert Bingo, and Keeping on Track Board Game. And, we continue to provide training through our Alert Program® Online Course.

NOTE: This article first appeared in the September/October 2007 of Autism/Asperger’s Digest Magazine. Reprinted with permission (