Transcript for
Supporting children through understanding regulation – part 1

Runtime 00:25:16
Released 7/11/20

Narrator [00:00:02] Welcome to the Emerging Minds’ podcast.

 

Sophie Guy [00:00:07] You’re with Sophie Guy, and today I’m joined by my colleague Ben Rogers to discuss regulation, the nervous system and children’s wellbeing and development. Ben is the manager of community trauma at Emerging Minds, a role that includes working with Be You’s Bushfire Response Program to support learning communities following the 2019/2020 bushfires in Australia. An occupational therapist by training, Ben has held positions in a variety of mental health and child and family services across Australia and the United Kingdom. He joins me to discuss what is meant by the term regulation, its role in supporting children’s social and emotional wellbeing, and how practitioners can start to integrate the principles and practices of regulation into their work. As this was a longer conversation than usual, we have broken the interview into two parts. Stay tuned to catch part two in a fortnight.

 

Sophie Guy [00:01:01] Hi, Ben, welcome and thank you for joining me on the Emerging Minds’ podcast.

 

Ben Rogers [00:01:05] Thanks for having me.

 

Sophie Guy [00:01:07] So we’re here today to talk about the process of regulation and how it relates to children’s social and emotional wellbeing. In recent times, it’s become really clear to me how key healthy regulation is for children’s mental health and wellbeing. And so I think this is a really important topic to cover. And I’ve also sort of noticed that as I’ve become more immersed in the field of child development and mental health, that it’s a process that seems to be particularly well understood and worked with among occupational therapists. But I’m not sure how widely understood it is outside of OT or sort of developmentally focussed services. So I think having this conversation about regulation and children’s social and emotional wellbeing today will be really valuable to our audience. So to start off with, Ben, could you tell us a little bit about your background and your role at Emerging Minds?

 

Ben Rogers [00:02:02] Yeah, thanks, Sophie. Well, I’m an occupational therapist, and my experience has seen me working in the UK and in Australia in a variety of different settings. So in education settings, in clinical settings, in developmental assessment services. I also have experience working in telehealth and working at Emerging Minds, I’ve worked in the workforce development team here for a while and I’ve just transitioned into a role where I’m focussed on managing the community trauma space.

 

Sophie Guy [00:02:31] So what is regulation and how does it relate to children’s social and emotional well-being?

 

Ben Rogers [00:02:37] Well, when you think about social and emotional wellbeing you, I guess you think about the building blocks of what that looks like. So we’re thinking about development, we’re thinking about relationships, we’re thinking about emotions and behaviours and communication. And regulation really sets as a foundation to a lot of those things. And obviously, those things are influenced by each other quite a lot. And a definition of regulation is the body’s ability to attain and maintain a level of arousal which can meet the demands of the task that we’re engaging in. A good example of that is, is right now as me as an adult, I’ve got, you know, bright light shining down and I’ve got a big set of headphones on and, you know, I’ve got a toddler at home so I haven’t slept loads this week with him waking up through the night. As well as the kind of just slightened stress response of trying to answer questions in a, in a podcast. And I think, all those things are happening and integrated in my system, my body, for me to be able to be regulated and respond and access all the cognitive resources I need to to function to the best of my abilities. And that’s a good example of, I guess, this complex neurobiological system that sits within us that helps us to do all these things.

 

Ben Rogers [00:03:48] So even with all the thoughts and sensory stimuli and emotions that are naturally happening inside me right now, my body’s able to process those things and keep my arousal state calm yet balanced and to be able to respond to these questions, to be able to access my thinking skills and function in this moment. And so for children, we often refer to this zone as being the green zone, an optimal state of arousal where they can engage, they can learn, they can socialise, they can reflect and reason and participate meaningfully in their role as a student or in the community or at home. And this really, as I see it, is the foundation for positive mental health and social emotional wellbeing. And so on the flip side of this is when a child becomes dysregulated, becomes outside of what we like to think of this green zone. And I think this is useful kind of conceptual way of bringing together regulation, and I know there’s a lot of different ways that it’s described. And one of the most familiar ways that, and I’ve found helpful talking to parents, is thinking about the nervous system having three distinct zones. So, and I’ll try and describe this in a way that’s meaningful by using my own examples.

 

Ben Rogers [00:05:01] So when I wake up in the morning, I naturally sit in what we call the blue zone. So I’m a bit of a sleep zombie. In the mornings, I roll out of bed. I have an under responsive nervous system. It’s like an old tractor that’s trying to start up. And this blue zone, this low level of arousal is really functional when we’re trying to sleep, but not so functional when I’m trying to get going in the mornings. So I bump into the walls and I’ll move into the the bathroom and have a shower. And for me, that’s that’s a key tool, a key resource I’ve used to regulate my nervous system. So I’ll move into more of an optimal state of arousal, so the green zone as we like to call it in OT talk. And in that state, we can access our motor skills, our thinking. And then I guess an example of this is when we become more heightened and have a stress response. And a good example of that is recently when I was riding my bike into work, and I have a beautiful ride in the morning. So for me, movement and the proprioceptive system, when I use it, is really regulating and naturally gets me into a calm and balanced state. So I was riding my bike along the river. It’s a beautiful visual kind of stimulus as well. And I came out onto one of the main roads. So still sitting in that green zone, calm, balanced, my motor skills, everything’s going really well. And as I was coming over a slight rise in the hill, a car swung in front of me and nearly clipped the front of my bike.

 

Ben Rogers [00:06:22] And so in that moment, without thinking, without conscious awareness, I slammed on the brakes and the car kind of swung past me and kept going. But I just want to draw attention to what happened in that moment is I had a stress response. And that’s really important for me in that moment. Really important from a functional perspective that I did that to keep me alive. Likely would have just been badly injured in that moment. But I didn’t think about it. I just stopped. And those kind of flight or fight mechanisms that kick in when we move from, you know, what we call the green zone into a heightened state of arousal, the red zone or sympathetic arousal in the, if we’re talking about the autonomic nervous system. So in that state, it’s built for mobilisation. It’s built to fight or flee and keep us alive. And so I think those zones, naturally we move in and out of these as children and adults throughout the day, and each has its own kind of functional importance for us. But where we focus and think about social emotional development a lot is, is that green kind of balance state where we’re able to access the parts of our brain that allow us to learn, to think, to socialise and engage with others. And I think that’s a conceptual view of of what is regulation.

 

Sophie Guy [00:07:32] OK, thank you. That’s a great overview. And I wanted to ask you if you could perhaps just talk a little bit about, you mentioned the proprioceptive system. Can you just talk a little bit about what that is?

 

Ben Rogers [00:07:43] Yes. So there’s many ways in which we can regulate our nervous system. So you think about the body, you know, foundations of regulation is thinking about sleep, thinking about nutrition. But there’s also ways that we can use body-based approaches to support our regulation. You know, even as I’m talking to you now, I curl my toes up in my shoes and that’s kind of a, a functional way that I can regulate my nervous system to, to think and talk. And you notice people that might kind of fidget with their hands and kind of move in their chairs. So our body is naturally trying to find ways to, to regulate throughout the day. And for kids this isn’t as hidden, I guess, in many ways. Children are very overt in terms of their need to move and wriggle and kind of seek movement. But proprioception is something that OTs talk a lot about. And we use the term ‘heavy work’ for, you know, when we talk to educators and parents, which essentially means that when we can activate the muscles and the joints in the body, the proprioceptive system, it naturally calms and regulates the nervous system. And it’s the type of system as well that if we’re feeling underresponsive in that blue zone, it can actually bring us up into an optimal state or if we’re feeling neightened it can actually bring us down as well. So having regular movement breaks or regular opportunity for heavy work can can be really important for our regulation.

 

Sophie Guy [00:09:00] Okay. So it’s to do with movement and the body’s need to move as a way of, part of this sort of regulation process?

 

Ben Rogers [00:09:08] Yeah. So when when working closely with parents, a parent might say to me as an OT, you know, what kind of inputs can I give a child or how do I support them with their regulation? And I’ll often say, well, let’s just, let’s just observe them in their natural environment of play and notice what they’re doing. And if you watch a child, you’ll often see what they’re seeking out or avoiding in their environments. So a child that’s seeking a lot of movement or proprioception, as we mentioned, you want to try and feed that need throughout the day to allow them to move into an optimal state of arousal when they need it.

 

Sophie Guy [00:09:42] You’ve described really well what regulation is, and you’re giving these nice examples of how from your life that, what it looks like and how it works. Why might practitioners who are not really familiar with talking about regulation in this way and what’s happening in our bodies and the nervous system, why might they want to know about it?

 

Ben Rogers [00:10:00] I think we’re all curious about it, to be honest. We’re all have a nervous system and we all interact in this world. And we’ve all experienced various states of arousal, depending on what stressors we’ve been exposed to. So I think just first and foremost, understanding that regulation impacts us as well as a practitioner is really important. And also this idea of regulation, in the fact that the way we naturally feel is resonated by the children and families that we work with just due to the facial expressions and reciprocity that we share. So there’s a resonance between people, between relationships that naturally make our nervous system feel a certain way. And I think that’s where coregulation is really important and, you know, the flip side of this is when we’re feeling heightened or stressed, there’s a dyscoregulation that can happen in session. So being aware of that mechanism is really important and supportive for practitioners.

 

Ben Rogers [00:10:54] I think what regulation does is it opens up a broader understanding of behaviour as well. So a practitioner can look at a certain behaviour and potentially understand what’s happening at a foundational level for that child. So whether they’re fleeing or having a reactive response, they can be curious about that and what’s happening. And so a practitioner can start to understand what might be causing that for the child, but also open up to a broader understanding of what might help that child and support their social emotional wellbeing. So when we start to think about what might be causing a child to become dysregulated, we begin to open up a broader understanding of what, what might support this child in the moment. So that might be an environmental strategy. So thinking about the noise, the movement in the room by others, thinking about other factors of relational strategies, a therapeutic use of self or how we interact. You know, even standing above a child as they’re playing can kind of increase their cortisol levels. So getting on the floor self can have some neurological and regulatory changes for the child.

 

Ben Rogers [00:11:59] And also, as I mentioned, body-based approaches. And so a child that’s had a transition with their parents to get to the session, or if you’re supporting a child in a school, there’s been a lot of interactions and stimulus that have happened just before they get into that room. So using body-based approaches to start the session can really allow that child to be regulated and then transition into what the aim for that session is. You know, these body based approaches don’t have to be complicated. One of the strategies that I love to recommend to educators is chair push ups. I won’t get us to do it today, Sophie, but you’re basically just putting your hands underneath your thighs and your chair and you’re pushing your bottom up and down off the seat. And as a child engages in that, we get them to count. So that gets their breath going as well. And it’s a really easy, practical task that an educator can use to support a child’s regulation without having to leave their chair. So there’s lots of different examples like that that are really helpful.

 

Ben Rogers [00:12:53] I always like to draw on body-based approaches that incorporate some level of relational factors as well. So getting a child to stand up with their peer and push their hands against each other and count to ten. We often find, as I mentioned before, that a child, when they engage in heavy work, proprioceptive activities, might hold their breath. So they might kind of take a big breath and then do the task because they want to kind of get as many as they can out, and that can have a bit of an opposing effect. So something that involves counting can be really helpful. So just pushing against each other’s hands and counting together to ten is, is an example of using proprioception. But kids are so creative and innovative in this space. So once you know, it’s simply movement with activation of your muscles and joints, you can do all sorts of things. Obstacle courses in the room or just access to the playground. Children are naturally seeking out this movement and input through the day. And as I mentioned earlier, for me in this situation, curling my toes up is something that I do and when I do public speaking as well. And that’s something that’s very functional. And for kids who are sitting in chair for long periods a day, we can find other ways of giving that feedback. OTs use like therabands under the chairs or various kind of wobble cushions and things that support feedback through the vestibular system as well. So, yeah, there’s a lot of creative approaches and I often come back to what the child’s seeking and and looking for in their environment.

 

Sophie Guy [00:14:17] Uh huh. And so it sounds like, if I’m understanding it correctly, a simple way of drawing out what you’re saying here is that when a child is in the upper limits of their green zone or tipping over. You know, there’s a lot going on, like you say, they’ve just been picked up from school and they’ve come to a strange environment and their nervous system is possibly feeling a bit activated. Maybe that going into fight or flight, that there’s something useful around sort of proprioception and what you’re calling heavy work to tense and sort of use the muscles in a way to to get some energy out through tensing and using some muscle strength, and that is regulating. Am I understanding that?

 

Ben Rogers [00:14:55] Yeah, definitely. And I guess it can sound complicated, but if we really pull it back, heavy work is anything that involves the muscles and joints against resistance. So you can do something like progressive muscle relaxation for adults. But for kids, it’s it’s often just embedded within that play or something that’s fun that gets them moving. And I think if we come back to movement being regulating, that’s a really key thing that for anyone listening today you can engage in with children. The other aspect that you mentioned, which is really important is that we might often think of these body-based approaches to use them when a child is already heightened. But we find that using these, these strategies proactively really supports children to remain in that green zone that we referenced earlier. And to come back to the idea of what that means, because if we can have regular movement breaks throughout the day, a child can stay in that optimal state of arousal for the task of learning if we take the learning or learning community context into mind. And so the longer they’re in that state of arousal, that green zone, the more they’re able to access their thinking skills, their social skills, and they’re able to learn to the best of their ability throughout the day. And so that’s where these proactive regular movement breaks to have, you know, patterned, repetitive experiences throughout the day of feeling calm has a really embedded approach to helping children to learn as well.

 

Ben Rogers [00:16:18] In terms of why practitioners might want to know about it. We’ve talked about coregulation. We talked about understanding behaviour. But as an OT, I’ve found that helping children to understand their own regulation is a really big impact on them. And, you know, a task like body mapping has been really effective when I’ve worked with kids, not just body mapping, but any kind of activity where they’re able to draw or represent what’s going on for them when they’re outside of that green zone or when they’re in it as well.

 

Sophie Guy [00:16:44] So what’s body mapping?

 

Ben Rogers [00:16:45] So body mapping is when a child will draw a map of their body on the piece of paper, and then we would explore a situation where they might have been in, you know, that blue zone or red or potentially green. And they use different colours, different pencils, pens, whatever is available, craft, to represent how they were feeling in those moments. And you don’t have to really say that much often. You might just say, well, tell me about what happened when you got upset at school last week and and then they’ll grab the red pencil and scribble onto the head or scribble onto their belly or their hands. And then this opens up a conversation with them to explore what happened in those moments, you know, what were the triggers, what help them and also just allow them to make some meaning about that experience. And I find that that’s really helpful to open up discussions around self-regulation, which, you know, is down the track for many kids. And so kids will start giving, you know, these experiences there own names. They won’t even call it the green, the red, the blue. They might call it, I had a child that talked about the red mist that came through when he was feeling heightened. There was another boy that talked about fire hands when he was really upset. And when you think about sympathetic arousal, the blood flows to the extremities in the arms when we’re in a mobilised state. So the fact he could, he could feel that and give it a name was really powerful for him. And, you know, there were other, you know, the storm’s been mentioned. So I think this gives children awareness of when they’re feeling these ways. They might be able to find the name, oh the red fogs coming, or whatever it is. And that opens up a bridge to supporting them to understand potential strategies that might support them.

 

Sophie Guy [00:18:19] Mm hmm. Yeah. And you touched on before in relation to why practitioners might want to know about this, and this idea of the therapeutic use of self. Could you talk a little bit more about that and how that relates to regulation, supporting children yeah with coregulation?

 

Ben Rogers [00:18:36] Definitely. The ‘therapeutic use of self’ is a term that OTs use, and it might be used in other professions as well, which looks at how we use our selves and our interactions with others in a therapeutic way with others. And I think for me, the work of Stephen Porges really opened up my level of understanding of this work. He developed the polyvagal theory, which was this idea that under the surface our nervous system is always looking for danger. And so you called it ‘neuroception’. So it’s, you know, subconscious, unconscious kind of view that it’s always looking for something that’s new and unfamiliar and dangerous. And that system, as I mentioned earlier when I was riding my bike and hit the brakes, will override any kind of social engagement system. You know, without, without thinking if there’s any potential risk it will override what’s happening for us. And but we can also hack that system in many ways, because if we can give out safety cues. If we can use our expression, our reciprocity, our prosody, our tone of voice, we can talk to the nervous system in a way that makes it feel safe. That we’re a safe person and that activates, you know, he talks about the vagus nerve activating this social engagement systems of the body to bring on things around curiosity and play and regulation as a whole. So I think it’s a fascinating approach where we can just use ourselves, our body posture, as I mentioned, tone of voice and expression to regulate someone else.

 

Sophie Guy [00:19:59] Mm hmm. Mm hmm. Yeah. So I’m getting a good sense of what regulation is and how practitioners might start to notice it and see the value of working with it in a session with children. Now I want to ask you, how does healthy regulation develop? What do children need to develop healthy regulation?

 

Ben Rogers [00:20:22] It’s such a great question, Sophie, because we often, and I’m caught in this sometimes as a parent, we often think that children should just be able to self regulate. You know, my son was having a meltdown the other day and I’m like, you know, just can you calm down. And it’s really common for us to jump to that space. But the reality is that they learn to regulate through coregulation, through their interactions with us. You know, I even think when my little boy was born and, you know, he came out and there was a big bright room and there was these unfamiliar faces and voices and he was crying and hysterical. And then as soon as he went onto my wife’s chest, you know, that thermoregulation, the sound of her voice, the way she held him, naturally calmed him down. And so in that moment, she she taught him what it felt like to be calm and regulated. So at that point, as we begin to experience life and life stressors, we need someone close to us. So someone in a trusted, attuned relationship to help us make sense of this crazy world, you know, of new experiences, of new people, a lot, a lot of stress for a lot of people. And that’s where relationships really are so important.

 

Ben Rogers [00:21:35] One of my former colleagues describe this so well. She talked about relationships in the context of when you’re asleep, it’s midnight and you’ve just gone to sleep and you’re in your house and picture yourself completely alone in your house in that moment. And you hear the front gate open or the front door, someone knock on it. And think about how you process that sound of that knocking or that gate. And then let’s take an example, if you put everyone you loved in that room with you. All your friends and family, it’s a big sleepover. And the same stimulus happened. How you would process that sound is completely different. And I think this is a really nice way of understanding relationships and how they help us to feel safe and explore the world around us. Another part of that is often, and I’m guilty of this as a parent, we expect children to just understand their own emotions, but I often think that if we can give words to those emotions or attune to those emotions in a way that allows them to feel safe to have those emotions, next time they feel that, if we’re not around, they’re, they’re familiar with that kind of internal sense of regulating with that emotion. And it can really have a big impact on them throughout their life. And you think about the interactions that we’re having with each other, you know, there’s millions of interactions in a day with other people. And so each interaction, I think, as a parent or a carer is an opportunity to, to practice that attunement and coregulation. And we get it wrong. I get it wrong all the time. But I think it’s that kind of hitting of the tennis ball over the net and trying to attune in the right way and be responsive. That can really impact healthy regulation.

 

Ben Rogers [00:23:11] And we can’t discount the other body-based factors as well around physiology. So sleep, for example, and as I mentioned earlier, I’ve got a toddler at home who’s waking through the night. And I can experience that firsthand what it’s like when you haven’t slept and your, your window of tolerance has really shrunk right down. And nutrition is another factor. And I think that’s why body-based approaches are so helpful as well, because when we have access to things like movement, as I mentioned, we’re able to move into that regulated state and that green zone, as we’ve referenced. And, you know, have a felt sense of what that’s like. I think that’s where things like mindfulness and yoga are really helpful because, well, mindfulness in particular, being aware of your own emotions to then kind of identify and come back to an anchor point and be present in the moment. And yoga is a really good example, i know the evidence is so strong with yoga because of the fact it’s the mind and body kind of yoking together in a way that’s really regulating. So there’s lots of different ways, we could dive in many paths with this. But I think coregulation, understanding the body, sleep, nutrition, as well as body-based approaches. And probably the final part of this is the environment. If we can limit prolonged exposure to stress and adversity, it really does set us up for having a broader window of tolerance for what is the world’s stressors.

 

Sophie Guy [00:24:34] Thank you for tuning in to part one of this conversation about the role that regulation plays in children’s social and emotional wellbeing. Stay tuned for part two to be released in a fortnight.

 

Narrator [00:24:47] Visit our website at www.emergingminds.com.au to access a range of resources to assist your practice. Brought to you by the National Workforce Centre for Child Mental Health led by Emerging Minds. The National Workforce Centre for Child Mental Health is funded by the Australian Government Department of Health under the National Support for Child and Youth Mental Health Program.