Regulation Programs: Hype vs Helpful - A Framework to Choosing the Best Fitting Programs

WEBVTT
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Welcome to OT Figuring It Out.
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A podcast with two occupational therapists that chat about the best, meaningful, and sometimes hilarious parts of life as OT.
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We're learning, growing, and definitely still figuring it out.
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In today's episode, we're talking about how to choose a regulation program for kids and what makes one actually useful in real life.
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What we're going to cover is what regulation means and what it doesn't.
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The common traps of programs.
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One size fits all, too complex, too rigid.
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And a simple way to decide what to try next.
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So Cherry.
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Yeah.
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I think it's important that we start today's conversation with definition.
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English class.
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Definition of regulation.
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Because there's so many words that people use and they use them incorrectly.
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It's kind of a pet hate of mine.
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Oh yes.
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Not a pet peeve, it's pet hate.
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I call it a pet hate.
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I don't know if that's the correct wording on that.
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That's what I say.
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I thought you just leveled up.
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No.
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I thought that's actually what it was.
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So either class is uh Hannah and Cherry and clearly I don't know what I'm talking about.
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No.
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Um all right.
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Well on that note, we'll define regulation correctly.
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Yeah.
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Do we want to start with what it's not almost?
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Yes, actually that might be a good idea.
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Yeah.
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Because as you said, we do hear it a lot used incorrectly.
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Yes.
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And it's a fairly broad term.
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It is.
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And regulation does not equal calm.
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Yes.
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I think the biggest.
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And I think a lot of OTs understand that now.
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I think so.
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In the past it was very much that was always the end goal.
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That was the only outcome we were trying to achieve when we spoke about regulation.
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Yep.
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But I think we've moved away from that, as we should.
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Oh, absolutely.
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Yeah.
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So we're we're talking about an umbrella term when we have regulation at the front of mind.
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Um and has been used interchangeably a lot with emotional regulation, self-regulation, sensory regulation.
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Yes.
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But if you're gonna have different types, there has to be an overarching definition.
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That's right.
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So regulation itself is the ability to notice what your body and brain need, yep, and adjusting that so that you can cope and function in the moment.
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Beautiful.
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It's yeah, it's quite an umbrella term.
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It's not specifically self-regulation, it's not specifically emotional regulation.
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Regulation sits above all of that, it considers all of the different areas of regulation.
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Yes.
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I feel like I'm saying regulation a lot, but yeah.
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Use get use OTs, you get me, you get me.
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No, exactly.
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So that it's a state of you as a human, not just one component of you as a human.
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Yes.
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Yeah.
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And then we move into kind of regulating and to regulate, those are more actions, aren't they?
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They're not a definition word.
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Does that does that make sense?
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Yeah, well, they're a verb.
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Yes.
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Yeah.
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There's an action behind them.
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Absolutely.
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Yes.
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So to regulate is we're changing our state to meet the activity we're doing.
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Yeah.
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We're changing our arousal level to be able to do what we need to do.
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Yes, and that's where we have all started to understand.
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It's not about being calm.
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Yes.
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Because being calm before a race, well, I don't know, maybe some people that works well for them.
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Yeah.
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But I'm thinking that's an adrenaline moment.
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Like, let's go.
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Yes, yeah, and you need that.
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I mean, if you're gonna run a race, you need that.
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Yeah, you need that high energy.
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Absolutely.
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You know, if you're falling asleep, good luck.
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Yeah, exactly.
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You're not regulated.
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And then regulating is the actual process.
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Yep.
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In the moment we are regulating.
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Yes.
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And I think it's important as a therapist to understand those different states, those different uh definitions of the word.
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Yes.
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Because it'll change how you address different areas of regulation.
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Yes, and all of those we haven't even defined emotional regulation, sensory regulation, behavioral, cognitive, social, those are all different areas, different types of regulation.
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Yes.
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We're not probably not gonna deep dive into that today because that's just a whole other can of worms.
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But regulation considers all of those areas, yes, and how they're all working together, impacting one another, all of that.
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So when we're talking about regulation, that is what we're talking about.
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It is complex, it is multi-layered, it is not simple.
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No.
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So then how are we working on regulation as therapists?
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Yeah, that's a good question.
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If I say so, it's a very good question.
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When I think before we go deep dive into a program or a resource, we need to actually ask ourselves, what are we working on?
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Yeah.
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What is it that we are actually doing?
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Absolutely.
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And so with that goal, are we targeting the child's skills?
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Mm-hmm.
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Is it caregiver skills, which is a what we've found is a big missing component.
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Yes, very passionate on caregiver skills and caregiver confidence.
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Yes, yes, and a lot of caregivers aren't confident in supporting their own regulation either.
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Yes, absolutely.
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That needs to be considered very early on.
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And that doesn't include the environment and the social demands and all of that other stuff that impacts regulation.
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So like busy classrooms, if we're only targeting the child, well, they're not going to be able to regulate because the classrooms is what is what's dysregulating.
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You know what I mean?
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Yeah.
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Yeah, you can see how, especially a new grad coming in to work on regulation, if they've missed the definition of regulation, they've missed the goals or the component of those goals.
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This would be an impossible thing to try and focus on.
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Yes.
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Even not for a new grad, for anyone.
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Well, because it's so complex and multi-layered, and also like we have to also think about well, what's within our scope as OTs and what at what point does it become actually this needs to be targeted by a mental health clinician?
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Yes.
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Does it need to psych a plate therapist or a mental health OT?
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It's it's really hard sometimes to make that call too with families.
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Yes.
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Because they think as OTs we can do it all.
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I think sometimes OTs think they can do it all too.
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And I think we'd like to because we want to help people, but we need to remind ourselves, hang on, this is actually probably not for me to do.
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Yeah.
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And this is why we need our OT frameworks, right?
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We love a good framework.
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You know, we need to break it down.
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If our goal is regulation after school, we need to break it down.
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Like if we're using the POP, all right.
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Well, what are the person things?
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What's their sensory needs doing?
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What skills do they currently have that can be used?
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What are their interests that can be used to help regulate what's happening in the environment?
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What are they actually being stopped from being able to do in terms of being occupation focused?
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Yes.
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And what are they expected to be able to do?
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Yes.
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In that after-school routine.
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Yes, exactly.
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Because saying being better regulated is too vague.
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What what is that?
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Yeah, what is that?
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What does that actually look like?
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What does better regulated look like for that child, for the family, in what context?
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Yeah.
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Where, who, when, how?
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Like, these are the questions we need to be asking ourselves.
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And the family?
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Yes.
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Yep.
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Because I I think it's too broad when we're if we just say, okay, they're going to build their self-regulation skills.
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Are they going to be able to express how they feel?
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For what purpose?
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Yes.
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Why?
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Yeah.
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Do they need to communicate how they feel?
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When what is that really achieving?
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Yes.
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And you know, if we're like, oh, when they're having a meltdown.
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Well, no.
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I'm not doing that.
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We we can't communicate and problem solve and access those higher functioning parts of our brain if we're having a meltdown.
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So something like that type of goal.
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We need to rethink that.
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Yeah.
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And I think this is something I talk about with my mentees a lot.
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But parents will come to us and say, I want my child to um be better able to do handwriting or use cutlery.
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But they don't with regulation.
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They just want them to be calmer or um have less meltdowns.
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You know, they don't bring that goal in the same way they bring motor goals, for example.
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Yes.
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So we as therapists need to do more work to get to the occupation of that.
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Absolutely.
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Than we do with those other goals.
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Absolutely.
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And I often ask, well, at the moment when we're thinking of emotions and meltdowns, at what point in the day or the week is the hardest right now?
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Yes, I like that.
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So that's one way to kind of bring in that occupation and function focused element to then start to really deep dive and break down what's happening.
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Yes.
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I'm gonna use that.
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Yeah.
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I like it.
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Yes.
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Focus on one moment at a time.
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Not an entire day, not an entire week.
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Because that is way too much.
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Yes.
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So today we're going to focus specifically on programs to support regulation, aren't we?
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Yeah.
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And what makes a program good or good enough?
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Because if you've ever bought a beautiful regulation resource, and there are many beautiful resources, and then you've never used it, you are not alone.
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Yeah, it's we've we've all done that.
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We've all done that, and I'm sure a lot of clinics and a lot of therapists have an abundance of resources that they go through and then or create themselves.
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Yes.
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And then forget about them.
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Oh yeah.
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Because they didn't do what we hoped they would meant to do.
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That's me.
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Yeah.
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So let's talk about what makes a regulation program good.
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Yes.
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So we need to consider if the resource of the program is a good fit and not just that it's something that is hyped about.
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So just because a lot of people are saying a certain program or resource is really good and it's working, we still need to consider, well, is it the right fit for this family and for this child?
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If it's a program that doesn't target what we need it to target, then what's the point of doing it?
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So there's programs out there that are very emotional regulation focused or very sensory focused.
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But if you're not actually targeting that specific area, then why are you doing it?
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Yeah.
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And they might be good programs, but we need to consider who it who are we trying to work with.
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Yes.
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Who's sitting in front of us?
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Yes.
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And we need to consider does it support the child's sensory needs and sensory preferences in one way?
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Yes.
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Yep.
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Huge.
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And their communication style.
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Yes.
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As part of that too.
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And being able to adapt that as well.
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Like if is the program or resource flexible enough that it can be delivered in a number of ways to support that child's communication and learning style.
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Yes.
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We're very passionate on capacity and presentation changing.
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Yeah.
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So do our programs.
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Yes.
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Because, you know, a worksheet.
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Having a four or five year old sitting down doing a worksheet.
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Mmm, probably not.
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Not most of them.
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No.
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A huge thing that we've noticed that's quite lacking in a lot of resources and programs that have been around for quite a while is that there's no co-regulation being addressed.
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Yeah, at least not explicitly enough to to meet the needs of the parents that we're working with.
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Yes.
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And it's a huge factor that's missing because if we're thinking of family-centered practice, yes, we shouldn't just be isolating the child and their skills.
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We need to consider the parents and the whole family as well.
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Absolutely.
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So, you know, is there different sibling needs when it comes to regulation?
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Yeah.
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Well, I love um the term that regulation is relational and contextual.
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You might have all of the amazing strategies, but if you've missed the relationships and the context, those strategies can only go so far.
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Yes.
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But another thing is, well, does the family actually have capacity right now to be doing this?
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Because doing one-on-one sessions with a child for regulation is only going to take you so far there needs to be an element of caregivers involved, and they should be doing stuff at home because co-regulation is the foundation of all regulation.
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Yeah, being able to regulate in a one-hour session once a fortnight is not the same as building regulation skills for life.
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And actually, on that, yes, you're building regulation skills in the session, but you're probably co-regulating with the child.
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Yes.
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So prime example of oh yeah, they they regulated really well in the session because I had different supports for them.
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I set up the session in a way that supports their different energy levels, their different skills and capacity they have.
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That's you co-regulating.
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So it's a prime example to be showing parents, hey, we did XYZ, I was helping them co-regulate.
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This is something you can do at home.
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Yes.
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And I think it's something as therapists that a lot of us are very good at, but we don't realize it because we don't explicitly plan it out.
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So you need to be very aware of what you're doing to be able to educate parents.
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Yes, absolutely.
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And because there's so many things that we consider, even if maybe you're not explicitly thinking of it in your sessions, but you are targeting sensory, emotional, cognitive, and behavioral regulation.
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You're targeting all of them in your session because they're always at play, always present, always we're always trying to stay within a reasonable level of arousal for all of them.
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Yes.
00:16:29.679 --> 00:16:32.720
Even if you don't know it, you are doing that in your therapy.
00:16:32.960 --> 00:16:37.679
But then being able to educate and communicate that to families is a whole nother step.
00:16:37.840 --> 00:16:38.879
Yes, yeah.
00:16:39.120 --> 00:16:43.679
And so does the program you're working with help you with that too.
00:16:43.840 --> 00:16:44.399
Exactly.
00:16:44.559 --> 00:16:47.440
Does it really break it down for you?
00:16:47.679 --> 00:16:50.720
What like what and what do you need as a therapist?
00:16:50.879 --> 00:16:53.679
How much structure do you need?
00:16:53.919 --> 00:16:56.879
How much support do you need?
00:16:57.120 --> 00:16:59.759
That's something that we need to consider as well as therapists.
00:17:00.000 --> 00:17:04.000
For me, I love I love structure, love visual systems.
00:17:04.480 --> 00:17:05.759
It's my jam.
00:17:06.000 --> 00:17:14.559
So I like to be able to have a a process to follow, but also I need it to be flexible.
00:17:14.720 --> 00:17:15.359
Yeah.
00:17:15.920 --> 00:17:21.359
Because like I don't know if it's like a bit of PDA or what, but I'm like, no, I don't want to do it that way.
00:17:21.599 --> 00:17:25.279
Yeah, well, also you're trying to match it to who you're working with.
00:17:25.680 --> 00:17:27.200
So that's that's fair.
00:17:27.519 --> 00:17:39.039
I think another thing too is yes, we want the program to be flexible, but is it flexible enough that what happens if things go off plan?
00:17:39.200 --> 00:17:49.039
Off plan for the family, you know, if they can't follow certain aspects of the program, but also for us as therapists if we can't follow certain aspects or do certain aspects.
00:17:49.359 --> 00:17:54.400
Is it flexible enough that we can kind of go off plan a bit?
00:17:54.720 --> 00:17:55.200
Yes.
00:17:55.519 --> 00:18:01.279
But still be working towards that goal and providing meaningful intervention.
00:18:01.599 --> 00:18:02.880
Yeah, you can't be too rigid.
00:18:03.119 --> 00:18:04.079
No one's going to do that.
00:18:04.400 --> 00:18:04.559
Yes.
00:18:04.880 --> 00:18:06.000
Not long term anyway.
00:18:06.559 --> 00:18:07.839
Yes, absolutely.
00:18:08.400 --> 00:18:08.640
Yeah.
00:18:09.599 --> 00:18:18.160
So we have chatted about the different aspects we need to consider when using or choosing resources and programs.
00:18:18.400 --> 00:18:18.640
Yeah.
00:18:20.079 --> 00:18:24.960
But we want to provide you with a bit more of a framework to make that decision.
00:18:25.440 --> 00:18:27.039
We did say we love a framework.
00:18:27.359 --> 00:18:27.680
Yes.
00:18:28.079 --> 00:18:30.319
Love frameworks system process.
00:18:30.559 --> 00:18:31.200
Yes.
00:18:32.160 --> 00:18:39.680
So, and these might include some points that we've kind of already touched on, but I'm gonna set it, we're gonna set it out really clearly.
00:18:40.000 --> 00:18:40.400
Yes.
00:18:40.640 --> 00:18:41.200
Step one.
00:18:41.759 --> 00:18:42.079
Yep.
00:18:42.240 --> 00:18:43.519
Step one, step two.
00:18:44.160 --> 00:18:52.480
So, step one, we need to get really clear on the goal and the purpose for addressing regulation.
00:18:52.799 --> 00:18:53.359
Yes.
00:18:53.599 --> 00:19:01.440
And for therapists who are listening, I think it's important to remember this doesn't have to happen in one session or in the initial.
00:19:01.599 --> 00:19:09.680
Like this, if you can dedicate proper time to doing this well, it will set you up so much better than rushing through it.
00:19:10.000 --> 00:19:10.720
Absolutely.
00:19:10.880 --> 00:19:17.200
Often what I do is I actually dedicate an entire session breaking down a regulation goal.
00:19:17.359 --> 00:19:18.480
I think that's amazing.
00:19:18.720 --> 00:19:31.599
Because there's way too many things to cover and deep dive into that saving only 10 or 15 minutes, you're not gonna get the information you need.
00:19:31.839 --> 00:19:41.359
Yes, to be able to make a good decision on what the plan forward is in addressing the goal.
00:19:41.599 --> 00:19:42.000
Yeah.
00:19:42.240 --> 00:19:49.200
And a hot tip maybe on the back of that, at least in my mind, is setting expectations around that early.
00:19:49.359 --> 00:20:09.279
You know, if parents are coming in expecting you to work one-on-one with their child from session two, and then you want to do all of this beautiful work to set amazing goals, which I 100% support, it's important to communicate that with families and get on the same page.
00:20:09.599 --> 00:20:15.839
Yes, because I think there are some misconceptions around what therapy actually looks like in pediatrics.
00:20:16.160 --> 00:20:19.839
So, like what you're saying, families think that you're just working one-on-one with a child.
00:20:20.079 --> 00:20:27.279
Well, no, your parents are supporting children, they need you to be providing them with support as well.
00:20:27.519 --> 00:20:28.720
Absolutely.
00:20:29.359 --> 00:20:31.440
So, getting clear on the goal and purpose.
00:20:31.680 --> 00:20:43.119
So, what is the family actually hoping to address or change and linking that to an occupation or a part of the child's day?
00:20:43.440 --> 00:20:44.799
Beautiful, yes.
00:20:45.039 --> 00:20:49.519
Because remember, we're we're occupational therapists, we need to be occupation focused.
00:20:49.759 --> 00:20:55.119
And then consider what are we actually working on or changing to achieve that goal?
00:20:55.359 --> 00:20:55.680
Yes.
00:20:55.920 --> 00:21:06.000
Are we like we've spoken about, are we looking at the child's skills, the caregivers' skills, their confidence, the environment, those routines, the relationship?
00:21:06.640 --> 00:21:12.799
And that's where that groundwork really matters to know what we're trying to address or change.
00:21:13.039 --> 00:21:22.240
Yes, what's the underlying area or skill that we're needing to address to move forward with the goal?
00:21:22.480 --> 00:21:31.920
Yes, because if it's always the child's skill that you're working on, chances are you're missing some really useful nuggets.
00:21:32.319 --> 00:21:32.880
Yes.
00:21:33.119 --> 00:21:40.880
And you know, the part of the brain that is responsible for regulation, it doesn't finish developing until our mid 20s.
00:21:41.039 --> 00:21:48.880
So expecting a child to be able to self regulate, regulate on their own, biologically, that is impossible.
00:21:49.519 --> 00:21:52.400
Before you add in any other challenges or barriers.
00:21:52.799 --> 00:21:53.519
Exactly.
00:21:54.160 --> 00:21:59.519
And that's always a point I make to parents and families because I think sometimes their expectations are way.
00:22:00.160 --> 00:22:04.000
Too high for children, let alone children who are neurodivergent.
00:22:04.240 --> 00:22:05.279
Yeah, agreed.
00:22:05.440 --> 00:22:08.720
So, step one, get really clear on the goal and the purpose.
00:22:08.880 --> 00:22:09.279
Yes.
00:22:09.519 --> 00:22:15.039
Step two, we're checking fit, not just best practice in theory.
00:22:15.200 --> 00:22:22.559
We love best practice, we're not throwing that out, but how are we fitting that to this family and this child?
00:22:23.039 --> 00:22:23.680
Yes.
00:22:24.000 --> 00:22:36.720
How is it going to support or factor in the child's sensory needs, their communication style, their developmental level is another good one?
00:22:37.119 --> 00:22:37.359
Yeah.
00:22:37.519 --> 00:22:39.680
Going back to is it Eric Ericsson?
00:22:40.240 --> 00:22:41.200
Yes, I think so.
00:22:41.599 --> 00:22:42.079
Love that name.
00:22:42.720 --> 00:22:43.759
Eric Ericsson.
00:22:44.640 --> 00:22:45.279
Yeah.
00:22:45.599 --> 00:22:46.880
And the caregiver too.
00:22:46.960 --> 00:22:48.720
What about their capacity right now?
00:22:48.960 --> 00:22:49.759
Their confidence?
00:22:49.839 --> 00:22:51.440
What about their own regulation?
00:22:51.599 --> 00:22:51.759
Yeah.
00:22:52.000 --> 00:22:55.839
Because co-regulation starts with self-regulation for the parent.
00:22:56.079 --> 00:22:56.400
Yes.
00:22:56.559 --> 00:22:58.400
Or the co-regulator, whoever that is.
00:22:58.640 --> 00:23:04.160
Yes, they need to have their own supports and systems in place.
00:23:04.400 --> 00:23:04.960
Yes.
00:23:05.279 --> 00:23:08.319
Because they are the role model for regulation.
00:23:08.559 --> 00:23:10.000
They are the nervous system.
00:23:10.160 --> 00:23:10.559
Yes.
00:23:10.720 --> 00:23:11.200
Mm-hmm.
00:23:12.079 --> 00:23:14.480
And then we can get really specific.
00:23:14.640 --> 00:23:19.039
Okay, at what time of the day or week are we looking at?
00:23:19.200 --> 00:23:21.440
Is it to do with a particular routine?
00:23:21.599 --> 00:23:27.759
Do we have to consider other siblings or other people involved in that scenario?
00:23:28.319 --> 00:23:32.319
Are there cultural considerations that we need to include?
00:23:32.480 --> 00:23:35.039
What are the expectations in that moment?
00:23:36.319 --> 00:23:42.079
We need to consider all of those, I guess they're more environmental factors.
00:23:42.400 --> 00:23:44.079
Yeah, external factors anyway.
00:23:44.480 --> 00:23:44.720
Yeah.
00:23:44.960 --> 00:23:46.640
Checking that flexibility.
00:23:47.440 --> 00:23:48.000
Yes.
00:23:48.640 --> 00:23:51.440
How and then coming back to how flexible is the program.
00:23:51.839 --> 00:23:53.200
Absolutely.
00:23:53.519 --> 00:24:05.440
And then step three, we need to understand the load or the involvement that is needed for us to do the program or resource.
00:24:05.680 --> 00:24:09.039
Yeah, as therapists, and what are we asking the parents?
00:24:09.119 --> 00:24:09.359
Yes.
00:24:09.599 --> 00:24:10.480
Both of those.
00:24:10.720 --> 00:24:11.119
Yes.
00:24:11.599 --> 00:24:16.079
Because I've certainly had programs where I felt like there was no end in sight.
00:24:16.400 --> 00:24:18.480
And I felt like that as the therapist.
00:24:18.640 --> 00:24:21.279
I don't know what how the child would feel then.
00:24:21.440 --> 00:24:21.680
Yeah.
00:24:21.839 --> 00:24:23.440
Who is learning all this?
00:24:23.680 --> 00:24:29.839
If I feel like there's no end in sight, they probably feel really disheartened and like, oh, why are we still doing this?
00:24:30.079 --> 00:24:30.799
Yeah, yeah.
00:24:30.960 --> 00:24:33.119
Haven't we done this 50 times already?
00:24:33.359 --> 00:24:33.839
Yes.
00:24:34.160 --> 00:24:42.640
So looking at how many steps or parts are involved in the program?
00:24:43.119 --> 00:24:43.599
Yeah.
00:24:43.839 --> 00:24:46.960
And how much setup is there for each of those steps?
00:24:47.200 --> 00:24:47.440
Yes.
00:24:47.680 --> 00:24:50.559
If it's a never-ending program, it's never-ending setup.
00:24:50.799 --> 00:24:51.039
Yes.
00:24:51.200 --> 00:24:52.240
And how can you?
00:24:52.480 --> 00:24:53.599
I love tracking.
00:24:53.759 --> 00:24:55.920
I love good tracking of things.
00:24:56.000 --> 00:24:57.519
I track everything in my life.
00:24:57.920 --> 00:25:06.799
So does the program have a way for you to be able to track where you're up to, what's working, what's not working, and track progress as well, I think is really important.
00:25:07.119 --> 00:25:07.519
Yeah.
00:25:07.759 --> 00:25:11.359
I think a lot of us are visual, so being able to see that progress.
00:25:11.680 --> 00:25:12.079
Yes.
00:25:12.640 --> 00:25:13.359
Very nice.
00:25:13.599 --> 00:25:14.079
Yes.
00:25:14.400 --> 00:25:20.559
And how hard is it to implement things from the program on a hard day?
00:25:20.720 --> 00:25:22.240
Yes, especially for those parents.
00:25:22.400 --> 00:25:22.640
Yes.
00:25:22.799 --> 00:25:24.640
They're trying to do the work.
00:25:25.200 --> 00:25:25.680
Yeah.
00:25:26.319 --> 00:25:26.799
Yeah.
00:25:27.039 --> 00:25:30.000
And then going back to how flexible is the program?
00:25:30.640 --> 00:25:32.559
We're gonna keep saying that.
00:25:33.039 --> 00:25:44.000
What is the bare minimum that the program needs you to do in order to maybe see change or at least explore the goal?
00:25:44.160 --> 00:25:44.400
Yeah.
00:25:44.559 --> 00:25:47.279
So what is the bare minimum requirement?
00:25:48.160 --> 00:26:04.240
Because if the program doesn't work, if it's too rigid, so like if it's like you have to do lesson one, two, three, four, or five in that order up to lesson twenty, well, that's really hard for us to achieve.
00:26:04.319 --> 00:26:10.880
Like if we are doing fortnightly sessions and there are 20 lessons, that's 40 weeks, that's nearly a year.
00:26:11.119 --> 00:26:18.160
Yeah, that's not including us going on leave, people are sick, yeah, needing to focus on something else for a week.
00:26:18.240 --> 00:26:26.160
Yeah, yes, that's you're asking probably 18 months for 20 fortnightly sessions that are followed rigidly.
00:26:26.400 --> 00:26:39.920
Yes, which is why I'm gonna go on a bit of a promo here for our program, which is why we wanted our program to be able to be also implemented at home without the therapist.
00:26:40.079 --> 00:26:55.440
So if you did miss a session, the family can still do something to be supporting regulation and regulation development, even if the therapist is on leave, even if maybe they missed their session because they were sick on that day.
00:26:55.759 --> 00:27:01.920
So that flexibility of when and who can implement it was something we considered.
00:27:02.160 --> 00:27:02.720
Yes.
00:27:03.039 --> 00:27:09.119
I think we yeah, focused a lot on that flexibility and the capacity of the parents.
00:27:09.279 --> 00:27:09.519
Yes.
00:27:09.759 --> 00:27:13.039
Both in the they have no capacity, so what's the bare minimum?
00:27:13.200 --> 00:27:16.960
And those parents that are really motivated, they're ready to learn.
00:27:17.599 --> 00:27:21.039
They could do three lessons a week if they really wanted to.
00:27:21.279 --> 00:27:22.640
Yes, yes.
00:27:22.960 --> 00:27:27.920
So that was step three, checking the load and the involvement to do the program.
00:27:28.240 --> 00:27:28.880
Yes.
00:27:30.079 --> 00:27:31.359
Step four.
00:27:32.319 --> 00:27:37.440
Checking to see what supports it includes for the adults, the co-regulators.
00:27:37.599 --> 00:27:48.480
Yeah, yeah, we've checked the load, and so then what are the supports in place to support that for these often very busy and overwhelmed, rightly so, parents and caregivers.
00:27:49.920 --> 00:28:03.119
Because we need it to include co-regulation, we need it to be supporting the family, yes, not just targeting the child, not just isolating them from the whole regulation scenario.
00:28:03.359 --> 00:28:04.880
Absolutely, yep.
00:28:05.200 --> 00:28:10.079
And speaking of scenarios, we want it to be real life scenarios.
00:28:10.319 --> 00:28:16.319
Yes you know, we we're not again, we love best practice, but we're not just working in theory.
00:28:16.640 --> 00:28:20.319
We need it to be real, yes, and doable for families.
00:28:20.400 --> 00:28:28.640
It needs to be on the ground, doable, real life, relatable.
00:28:28.960 --> 00:28:29.440
Cool.
00:28:29.920 --> 00:28:30.640
Look at it.
00:28:30.799 --> 00:28:33.920
Yeah, that list yeah.
00:28:34.240 --> 00:28:40.559
And considering as well their their learning styles, their preferences, their wow, capacity.
00:28:41.119 --> 00:28:42.319
Speak of that word, yeah.
00:28:42.799 --> 00:28:43.440
Yes.
00:28:43.839 --> 00:28:44.240
Yeah.
00:28:44.480 --> 00:28:56.799
And having an option for adults and those caregivers for when things go off track at home as well.
00:28:57.119 --> 00:28:57.440
Yeah.
00:28:57.759 --> 00:28:58.880
Grace built in.
00:28:59.119 --> 00:28:59.440
Yes.
00:28:59.680 --> 00:29:01.119
We're not expecting perfection.
00:29:01.440 --> 00:29:01.920
Yes.
00:29:02.079 --> 00:29:02.400
Yes.
00:29:02.640 --> 00:29:09.920
There's not oh, you should be practicing this strategy four times a week, and if you don't then you're not gonna get anywhere.
00:29:10.000 --> 00:29:11.359
So my goodness.
00:29:12.000 --> 00:29:12.480
Yeah.
00:29:13.759 --> 00:29:23.279
I've never done that, but I'm sure there's people that might practice that way, but that's not being family centered, that's not being considered of the hot bigger picture.
00:29:23.519 --> 00:29:23.920
Yeah.
00:29:24.799 --> 00:29:27.119
Alright, so we've considered the backgrounds.
00:29:27.279 --> 00:29:28.960
Now what about the application?
00:29:29.680 --> 00:29:30.720
Step five.
00:29:31.200 --> 00:29:32.000
Step five.
00:29:32.240 --> 00:29:35.839
We're choosing one small thing to work on.
00:29:36.000 --> 00:29:36.160
Yeah.
00:29:36.880 --> 00:29:38.400
And picking trialing it.
00:29:38.880 --> 00:29:42.240
Yeah, giving it a real hot go too, a red hot go.
00:29:42.880 --> 00:29:43.279
Yes.
00:29:43.519 --> 00:29:53.759
Um, yeah, working on a a strategy once or twice and it not working is not trialing a strategy to its fullest potential.
00:29:53.920 --> 00:29:54.559
Yes.
00:29:55.119 --> 00:30:02.720
And that tool or strategy has to target a specific if we're thinking of like our OT frameworks.
00:30:03.039 --> 00:30:06.000
So we've got the person, the environment, the occupation.
00:30:06.960 --> 00:30:11.440
Which part of that framework is that tool or strategy supporting?
00:30:11.680 --> 00:30:12.160
Yes.
00:30:12.319 --> 00:30:14.079
Yeah, getting specific.
00:30:14.319 --> 00:30:14.720
Yes.
00:30:14.960 --> 00:30:21.359
So is it okay it's targeting the child's sensory regulation?
00:30:21.599 --> 00:30:21.920
Yep.
00:30:22.079 --> 00:30:29.359
So we're implementing a sensory activity, for example, for regulation.
00:30:29.599 --> 00:30:32.799
So we're targeting the child in that specific moment.
00:30:33.039 --> 00:30:39.279
Obviously, you get more specific than that, but that's like you know, the P and the PO model.
00:30:39.920 --> 00:30:41.359
Or is it environmental?
00:30:41.519 --> 00:30:49.119
Is it oh they don't like uh the sound of the vacuum cleaner that's impacting their regulation?
00:30:49.279 --> 00:30:50.640
They have a meltdown.
00:30:51.039 --> 00:30:59.920
So kind of getting really specific, what actual area are you targeting for that tool or strategy before going on to another area?
00:31:00.559 --> 00:31:06.960
So if we're still thinking of, you know, the when mum has to clean the house and they get the vacuum cleaner out.
00:31:07.200 --> 00:31:10.000
Okay, we've considered the environment factor.
00:31:10.880 --> 00:31:14.400
What about the occupation?
00:31:14.480 --> 00:31:16.160
What is it stopping them from being able to do?
00:31:16.319 --> 00:31:16.640
Yeah.
00:31:16.880 --> 00:31:18.240
Implementing a strategy for that.
00:31:18.319 --> 00:31:21.440
So is it it's in the morning, they're trying to get ready for school.
00:31:21.839 --> 00:31:26.319
Okay, well then how can we make their school routine a bit easier when mum's also trying to clean?
00:31:26.559 --> 00:31:27.920
Yeah, absolutely.
00:31:28.640 --> 00:31:34.160
So really breaking it down and just having one little part of that moment at a time.
00:31:34.480 --> 00:31:34.720
Yeah.
00:31:34.960 --> 00:31:38.319
If you try and change too many things at once, A, they might all fail.
00:31:38.559 --> 00:31:41.279
And B, you don't know which one worked or didn't.
00:31:41.680 --> 00:31:42.000
Yes.
00:31:42.240 --> 00:31:43.359
So then what are you gonna do?
00:31:43.599 --> 00:31:43.680
Yeah.
00:31:44.640 --> 00:31:45.759
Or if it stops working.
00:31:46.400 --> 00:31:47.759
Yes, exactly.
00:31:48.079 --> 00:31:59.920
And what does the intervention actually look like in terms of what's the minimum requirement we're asking the families to be implementing to know if it's working or not?
00:32:00.160 --> 00:32:06.640
So is it every single time mum's vacuuming they need to be doing this strategy?
00:32:07.119 --> 00:32:09.359
Is it just three days a week?
00:32:09.680 --> 00:32:15.039
What's the minimum that we're expecting to be happening to be able to decide?
00:32:15.279 --> 00:32:18.799
Yes, that strategy's working, we need or we need to adjust it.
00:32:19.279 --> 00:32:19.920
Yeah.
00:32:20.240 --> 00:32:23.119
And what does working mean too?
00:32:23.440 --> 00:32:25.440
Yes, that's really important.
00:32:25.759 --> 00:32:28.319
Yes, are we expecting perfection?
00:32:28.559 --> 00:32:30.640
This strategy removes all meltdowns.
00:32:31.039 --> 00:32:31.279
Yeah.
00:32:31.440 --> 00:32:33.920
If you've got that strategy, let me know what it is.
00:32:34.400 --> 00:32:35.759
Because I haven't found it.
00:32:36.000 --> 00:32:36.480
Nope.
00:32:36.720 --> 00:32:38.160
That magical unicorn.
00:32:38.400 --> 00:32:38.720
Yes.
00:32:39.279 --> 00:32:40.319
Ah, one day.
00:32:40.799 --> 00:32:41.680
So yeah, what is it?
00:32:41.839 --> 00:32:43.279
Is it is it quicker recovery?
00:32:43.440 --> 00:32:45.039
Is it that there's less conflict?
00:32:45.119 --> 00:32:46.799
Is it easier transitions?
00:32:47.039 --> 00:32:48.720
What tells you that it's working?
00:32:48.960 --> 00:32:49.599
Yeah.
00:32:49.920 --> 00:32:51.519
And how are we measuring that?
00:32:51.680 --> 00:32:54.880
We're not measuring for the sake of just ticking a box.
00:32:55.119 --> 00:33:01.119
So we might not be as specific as you know, um timing a meltdown.
00:33:01.359 --> 00:33:03.920
But also, how do you know if it's less?
00:33:04.160 --> 00:33:12.559
And it may not be I hate these ones, but three out of five moments they were able to use the strategy.
00:33:13.119 --> 00:33:13.680
Yeah.
00:33:14.000 --> 00:33:23.039
Those types of things, I I hate those goals, they're not meaningful at all.
00:33:23.759 --> 00:33:26.000
They might be able to use it, but is it working?
00:33:26.319 --> 00:33:27.039
You get what I mean?
00:33:27.200 --> 00:33:30.559
Yeah, or they're gonna use deep breathing three out of five times.
00:33:30.880 --> 00:33:35.839
Great, sure, they're using it three out of five times, but is it actually helping?
00:33:36.000 --> 00:33:38.079
Is it what they need in that moment?
00:33:38.319 --> 00:34:06.480
Yeah, and then step seven review, review, bring it on back, yes, having that parent input, continuing these parent conversations and adjusting one thing or moving on to the next little part of that goal, yes, and please put in the work too to analyze what did or didn't work with a previous strategy, yes.
00:34:06.720 --> 00:34:10.079
You know, often it's not black and white or all or nothing.
00:34:10.320 --> 00:34:14.000
So, what did work or if it didn't work, why?
00:34:14.159 --> 00:34:15.440
What were the barriers?
00:34:15.599 --> 00:34:18.480
Yes, we're not just throwing strategies out, yeah.
00:34:18.559 --> 00:34:31.360
And it might be the case of well, it worked in these circumstances but not in these circumstances, and that can give you really valuable information about well, why did it work at home but not at school?
00:34:31.440 --> 00:34:33.840
Yeah, or why did it work with mum but not dad?
00:34:34.000 --> 00:34:36.239
And so then we're not getting rid of that strategy either.
00:34:36.400 --> 00:34:42.960
No, we're either adapting it to work in more environments or we just need a strategy for those situations.
00:34:43.440 --> 00:35:06.320
Yes, there's a lot of programs that I think are great, but I probably just use bits and pieces from everything to be able to meet the needs of that child and family, which I think well, if I've got four different programs I'm pulling from, that's a lot of different resources I'm trying to use.
00:35:06.639 --> 00:35:24.239
Yeah, and they use different language, they use different visuals, there's no consistency there, which can be a little bit hard for families and kids to be able to learn when we're still speaking about the one, we're still sticking out regulation, but we're using all different bits and pieces.
00:35:24.480 --> 00:35:29.280
Yes, or it's a lot of work on you to try and meld them all into one.
00:35:29.599 --> 00:35:32.559
Because then how are you tracking what you have done, what you haven't done?
00:35:32.719 --> 00:35:32.960
Yes.
00:35:33.199 --> 00:35:40.320
Oh, I did uh, you know, a couple of these lessons from the introsceptive curriculum, and then this lesson from zones of regulation.
00:35:40.559 --> 00:35:48.400
Oh, I guess we did a little bit of like the alert program with the sensory motor activities, and it's like, well, how much of it have you done?
00:35:48.639 --> 00:35:52.639
A lot of these programs have been made to okay, these are the core concepts.
00:35:52.800 --> 00:35:53.280
Yep.
00:35:53.599 --> 00:35:59.199
And then you start working on the program, but if we're just pulling bits and pieces, sometimes we're missing.
00:35:59.280 --> 00:36:06.800
Oh, actually, I haven't explained with the alert program that there's different energy levels, you know, the different um engine speeds.
00:36:06.960 --> 00:36:17.519
So if you're doing the sensory motor exploration aspect, some of those lessons really rely heavily on them being able to communicate how it impacts their engine speed.
00:36:17.599 --> 00:36:22.159
So then we're changing it, adapting it, pulling different bits from different places.
00:36:22.320 --> 00:36:23.840
It's a lot of work for us.
00:36:24.079 --> 00:36:25.840
Especially if it doesn't work.
00:36:26.079 --> 00:36:30.079
Yeah, being able to put that back into the home as well.
00:36:30.320 --> 00:36:39.039
But I think this is all summed up very beautifully by saying programs don't regulate kids, no matter how many programs you use, they don't regulate kids.
00:36:39.119 --> 00:36:41.840
Yeah, relationships and environments do.
00:36:42.000 --> 00:36:42.320
Yeah.
00:36:42.559 --> 00:36:44.320
So that's what we want to focus on.
00:36:44.559 --> 00:36:48.880
Yeah, specific that that family-centered and including the caregivers.
00:36:49.360 --> 00:36:50.480
Yes, please.
00:36:51.280 --> 00:36:59.039
So we would love to know what's one area of regulation with your caseload that feels hard right now.
00:36:59.280 --> 00:36:59.920
Have a think.
00:37:00.400 --> 00:37:01.599
Bit of reflection minute.
00:37:01.679 --> 00:37:01.920
Yes.
00:37:02.159 --> 00:37:04.000
What's hard in regulation for you?
00:37:04.239 --> 00:37:05.840
A bit of reflective practice.
00:37:06.079 --> 00:37:08.960
And then on the back of that, what are you gonna do with that?
00:37:09.199 --> 00:37:14.639
What's one small change or the smallest change that you could trial this week?
00:37:14.960 --> 00:37:18.000
Yeah, what something you might do a little bit differently.
00:37:18.239 --> 00:37:18.880
Yeah.
00:37:20.880 --> 00:37:23.840
This was probably a little bit of a longer episode.
00:37:24.079 --> 00:37:24.719
Yeah.
00:37:25.039 --> 00:37:35.599
But just to recap, regulation programs need to fit our clients, the family, and the season of life that they're in at the moment.
00:37:35.840 --> 00:37:41.360
And so a good program reduces load and supports co-regulation.
00:37:41.679 --> 00:37:55.840
And picking one specific moment for that child and the family and testing the smallest next step is going to be the most helpful for targeting your regulation goal.
00:37:56.000 --> 00:37:57.360
That's where success lies.
00:37:57.599 --> 00:38:01.840
If you enjoyed this episode, leave us a review and share it with a colleague.
00:38:02.000 --> 00:38:10.960
Yes, and make sure to follow us on our socials to stay updated on OT's Figure It Out and future episodes.
00:38:11.280 --> 00:38:12.320
Thanks for listening.
00:38:12.480 --> 00:38:13.280
Thank you.