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

In today's episode, Hannah and Cheri share their framework to guide therapists through analysing and selecting the best regulation program or resource to support their clients through their regulation learning and journey. Cheri and Hannah also share the importance and tips for collecting the correct information to set up regulation goals for success.

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This podcast is brought to you by Charge Your Mind Program, WonderGlowOT and Joyful Journey OT.

We acknowledge the Wathaurong people as the traditional ownders of the land on which we work and live here in Geelong, Victoria. We acknowledge the Traditional Owners of Country throughout Australia and recognise their continuing connection to land, waters and culture. We pay our respects to their Elders past and present.

Produced by Hannah Lees

Transcript

Cheri 0:00

Welcome to OT Figuring It Out. A podcast with two occupational therapists that chat about the best, meaningful, and sometimes hilarious parts of life as OT.

SPEAKER_01 0:10

We're learning, growing, and definitely still figuring it out. 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.

Cheri 0:33

What we're going to cover is what regulation means and what it doesn't.

SPEAKER_01 0:38

The common traps of programs. One size fits all, too complex, too rigid. And a simple way to decide what to try next. So Cherry. Yeah. I think it's important that we start today's conversation with definition. English class.

Cheri 0:58

Definition of regulation. Because there's so many words that people use and they use them incorrectly. It's kind of a pet hate of mine. Oh yes. Not a pet peeve, it's pet hate. I call it a pet hate.

SPEAKER_01 1:15

I don't know if that's the correct wording on that. That's what I say. I thought you just leveled up.

Cheri 1:19

No.

SPEAKER_01 1:20

I thought that's actually what it was. So either class is uh Hannah and Cherry and clearly I don't know what I'm talking about. No.

Definitions

SPEAKER_01 1:34

Um all right. Well on that note, we'll define regulation correctly. Yeah. Do we want to start with what it's not almost?

Cheri 1:44

Yes, actually that might be a good idea.

SPEAKER_01 1:46

Yeah. Because as you said, we do hear it a lot used incorrectly. Yes. And it's a fairly broad term.

Cheri 1:53

It is. And regulation does not equal calm. Yes. I think the biggest. And I think a lot of OTs understand that now. I think so. In the past it was very much that was always the end goal. That was the only outcome we were trying to achieve when we spoke about regulation. Yep. But I think we've moved away from that, as we should.

SPEAKER_01 2:19

Oh, absolutely. Yeah. So we're we're talking about an umbrella term when we have regulation at the front of mind. Um and has been used interchangeably a lot with emotional regulation, self-regulation, sensory regulation. Yes. But if you're gonna have different types, there has to be an overarching definition.

Cheri 2:42

That's right. 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. Beautiful. It's yeah, it's quite an umbrella term. It's not specifically self-regulation, it's not specifically emotional regulation. Regulation sits above all of that, it considers all of the different areas of regulation.

SPEAKER_00 3:15

Yes.

Cheri 3:16

I feel like I'm saying regulation a lot, but yeah. Use get use OTs, you get me, you get me.

SPEAKER_01 3:22

No, exactly. So that it's a state of you as a human, not just one component of you as a human.

Cheri 3:31

Yes. Yeah. And then we move into kind of regulating and to regulate, those are more actions, aren't they? They're not a definition word. Does that does that make sense?

SPEAKER_01 3:44

Yeah, well, they're a verb. Yes. Yeah. There's an action behind them.

Cheri 3:49

Absolutely. Yes. So to regulate is we're changing our state to meet the activity we're doing. Yeah. We're changing our arousal level to be able to do what we need to do.

SPEAKER_01 4:03

Yes, and that's where we have all started to understand. It's not about being calm.

unknown 4:08

Yes.

SPEAKER_01 4:08

Because being calm before a race, well, I don't know, maybe some people that works well for them. Yeah. But I'm thinking that's an adrenaline moment. Like, let's go.

Cheri 4:18

Yes, yeah, and you need that. I mean, if you're gonna run a race, you need that. Yeah, you need that high energy.

SPEAKER_01 4:24

Absolutely. You know, if you're falling asleep, good luck.

Cheri 4:28

Yeah, exactly.

SPEAKER_01 4:29

You're not regulated.

Cheri 4:31

And then regulating is the actual process. Yep. In the moment we are regulating.

SPEAKER_01 4:40

Yes. And I think it's important as a therapist to understand those different states, those different uh definitions of the word.

unknown 4:47

Yes.

SPEAKER_01 4:48

Because it'll change how you address different areas of regulation.

Cheri 4:54

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. Yes. We're not probably not gonna deep dive into that today because that's just a whole other can of worms. But regulation considers all of those areas, yes, and how they're all working together, impacting one another, all of that. So when we're talking about regulation, that is what we're talking about. It is complex, it is multi-layered, it is not simple.

SPEAKER_01 5:36

No.

Information Gathering

SPEAKER_01 5:37

So then how are we working on regulation as therapists? Yeah, that's a good question.

Cheri 5:43

If I say so, it's a very good question. 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? Yeah. What is it that we are actually doing? Absolutely. And so with that goal, are we targeting the child's skills?

SPEAKER_00 6:10

Mm-hmm.

SPEAKER_01 6:11

Is it caregiver skills, which is a what we've found is a big missing component. Yes, very passionate on caregiver skills and caregiver confidence.

Cheri 6:21

Yes, yes, and a lot of caregivers aren't confident in supporting their own regulation either.

SPEAKER_01 6:28

Yes, absolutely. That needs to be considered very early on.

Cheri 6:34

And that doesn't include the environment and the social demands and all of that other stuff that impacts regulation. 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. You know what I mean?

SPEAKER_01 6:55

Yeah. 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. This would be an impossible thing to try and focus on. Yes. Even not for a new grad, for anyone.

Cheri 7:14

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? Yes. Does it need to psych a plate therapist or a mental health OT? It's it's really hard sometimes to make that call too with families. Yes. Because they think as OTs we can do it all. I think sometimes OTs think they can do it all too. 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. Yeah. And this is why we need our OT frameworks, right? We love a good framework. You know, we need to break it down. If our goal is regulation after school, we need to break it down. Like if we're using the POP, all right. Well, what are the person things? What's their sensory needs doing? What skills do they currently have that can be used? What are their interests that can be used to help regulate what's happening in the environment? What are they actually being stopped from being able to do in terms of being occupation focused?

SPEAKER_01 8:32

Yes. And what are they expected to be able to do? Yes. In that after-school routine.

Cheri 8:37

Yes, exactly. Because saying being better regulated is too vague. What what is that? Yeah, what is that? What does that actually look like? What does better regulated look like for that child, for the family, in what context? Yeah. Where, who, when, how? Like, these are the questions we need to be asking ourselves. And the family?

unknown 9:06

Yes.

Cheri 9:06

Yep. 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. Are they going to be able to express how they feel? For what purpose? Yes. Why? Yeah. Do they need to communicate how they feel?

SPEAKER_01 9:28

When what is that really achieving?

Cheri 9:31

Yes. And you know, if we're like, oh, when they're having a meltdown. Well, no.

SPEAKER_01 9:37

I'm not doing that.

Cheri 9:38

We we can't communicate and problem solve and access those higher functioning parts of our brain if we're having a meltdown. So something like that type of goal. We need to rethink that.

SPEAKER_01 9:53

Yeah. And I think this is something I talk about with my mentees a lot. But parents will come to us and say, I want my child to um be better able to do handwriting or use cutlery. But they don't with regulation. They just want them to be calmer or um have less meltdowns. You know, they don't bring that goal in the same way they bring motor goals, for example.

Cheri 10:21

Yes.

SPEAKER_01 10:21

So we as therapists need to do more work to get to the occupation of that.

Cheri 10:26

Absolutely.

SPEAKER_01 10:27

Than we do with those other goals.

Cheri 10:29

Absolutely. 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? Yes, I like that. 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. Yes. I'm gonna use that.

SPEAKER_00 10:55

Yeah.

Cheri 10:55

I like it. Yes. Focus on one moment at a time. Not an entire day, not an entire week. Because that is way too much.

SPEAKER_01 11:05

Yes.

Choosing The Right Program

SPEAKER_01 11:06

So today we're going to focus specifically on programs to support regulation, aren't we?

unknown 11:12

Yeah.

SPEAKER_01 11:12

And what makes a program good or good enough? 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. Yeah, it's we've we've all done that.

Cheri 11:30

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. Yes. And then forget about them. Oh yeah.

SPEAKER_01 11:44

Because they didn't do what we hoped they would meant to do. That's me.

unknown 11:50

Yeah.

SPEAKER_01 11:51

So let's talk about what makes a regulation program good. Yes.

Cheri 11:55

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. 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? If it's a program that doesn't target what we need it to target, then what's the point of doing it? So there's programs out there that are very emotional regulation focused or very sensory focused. But if you're not actually targeting that specific area, then why are you doing it?

SPEAKER_01 12:41

Yeah. And they might be good programs, but we need to consider who it who are we trying to work with. Yes. Who's sitting in front of us?

Cheri 12:49

Yes. And we need to consider does it support the child's sensory needs and sensory preferences in one way? Yes.

SPEAKER_01 13:00

Yep. Huge. And their communication style. Yes. As part of that too.

Cheri 13:04

And being able to adapt that as well. 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.

SPEAKER_01 13:16

Yes. We're very passionate on capacity and presentation changing.

unknown 13:21

Yeah.

SPEAKER_01 13:21

So do our programs. Yes. Because, you know, a worksheet.

Cheri 13:27

Having a four or five year old sitting down doing a worksheet. Mmm, probably not. Not most of them. No. 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.

SPEAKER_01 13:49

Yeah, at least not explicitly enough to to meet the needs of the parents that we're working with. Yes.

Cheri 13:57

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. We need to consider the parents and the whole family as well. Absolutely. So, you know, is there different sibling needs when it comes to regulation?

SPEAKER_01 14:19

Yeah. Well, I love um the term that regulation is relational and contextual. 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.

Cheri 14:34

Yes. But another thing is, well, does the family actually have capacity right now to be doing this? 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.

SPEAKER_01 14:59

Yeah, being able to regulate in a one-hour session once a fortnight is not the same as building regulation skills for life.

Cheri 15:07

And actually, on that, yes, you're building regulation skills in the session, but you're probably co-regulating with the child. Yes. So prime example of oh yeah, they they regulated really well in the session because I had different supports for them. I set up the session in a way that supports their different energy levels, their different skills and capacity they have. That's you co-regulating. So it's a prime example to be showing parents, hey, we did XYZ, I was helping them co-regulate. This is something you can do at home.

SPEAKER_01 15:45

Yes. 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. So you need to be very aware of what you're doing to be able to educate parents.

Cheri 15:59

Yes, absolutely. 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. 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. Yes. Even if you don't know it, you are doing that in your therapy. But then being able to educate and communicate that to families is a whole nother step.

SPEAKER_01 16:37

Yes, yeah. And so does the program you're working with help you with that too. Exactly.

Cheri 16:44

Does it really break it down for you? What like what and what do you need as a therapist? How much structure do you need? How much support do you need? That's something that we need to consider as well as therapists. For me, I love I love structure, love visual systems. It's my jam. So I like to be able to have a a process to follow, but also I need it to be flexible.

unknown 17:14

Yeah.

Cheri 17:15

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.

SPEAKER_01 17:21

Yeah, well, also you're trying to match it to who you're working with. So that's that's fair.

Cheri 17:27

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? 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. Is it flexible enough that we can kind of go off plan a bit? Yes. But still be working towards that goal and providing meaningful intervention. Yeah, you can't be too rigid. No one's going to do that. Yes. Not long term anyway. Yes, absolutely. Yeah. So we have chatted about the different aspects we need to consider when using or choosing resources and programs. Yeah. But we want to provide you with a bit more of a framework to make that decision. We did say we love a framework. Yes. Love frameworks system process. Yes. 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. Yes. Step one. Yep. Step one, step two.

The Framework

Cheri 18:44

So, step one, we need to get really clear on the goal and the purpose for addressing regulation.

SPEAKER_01 18:52

Yes. 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. Like this, if you can dedicate proper time to doing this well, it will set you up so much better than rushing through it.

Cheri 19:10

Absolutely. Often what I do is I actually dedicate an entire session breaking down a regulation goal. I think that's amazing. 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. Yes, to be able to make a good decision on what the plan forward is in addressing the goal.

SPEAKER_01 19:41

Yeah. And a hot tip maybe on the back of that, at least in my mind, is setting expectations around that early. 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.

Cheri 20:09

Yes, because I think there are some misconceptions around what therapy actually looks like in pediatrics. So, like what you're saying, families think that you're just working one-on-one with a child. Well, no, your parents are supporting children, they need you to be providing them with support as well. Absolutely. So, getting clear on the goal and purpose. 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? Beautiful, yes.

SPEAKER_01 20:45

Because remember, we're we're occupational therapists, we need to be occupation focused. And then consider what are we actually working on or changing to achieve that goal?

SPEAKER_00 20:55

Yes.

SPEAKER_01 20:55

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? And that's where that groundwork really matters to know what we're trying to address or change.

Cheri 21:13

Yes, what's the underlying area or skill that we're needing to address to move forward with the goal?

SPEAKER_01 21:22

Yes, because if it's always the child's skill that you're working on, chances are you're missing some really useful nuggets. Yes.

Cheri 21:33

And you know, the part of the brain that is responsible for regulation, it doesn't finish developing until our mid 20s. So expecting a child to be able to self regulate, regulate on their own, biologically, that is impossible.

SPEAKER_01 21:49

Before you add in any other challenges or barriers.

Cheri 21:52

Exactly. And that's always a point I make to parents and families because I think sometimes their expectations are way. Too high for children, let alone children who are neurodivergent.

SPEAKER_01 22:04

Yeah, agreed. So, step one, get really clear on the goal and the purpose.

Cheri 22:08

Yes.

SPEAKER_01 22:09

Step two, we're checking fit, not just best practice in theory. We love best practice, we're not throwing that out, but how are we fitting that to this family and this child?

Cheri 22:23

Yes. How is it going to support or factor in the child's sensory needs, their communication style, their developmental level is another good one?

SPEAKER_01 22:37

Yeah. Going back to is it Eric Ericsson? Yes, I think so. Love that name. Eric Ericsson. Yeah. And the caregiver too. What about their capacity right now? Their confidence? What about their own regulation?

unknown 22:51

Yeah.

SPEAKER_01 22:52

Because co-regulation starts with self-regulation for the parent. Yes. Or the co-regulator, whoever that is.

Cheri 22:58

Yes, they need to have their own supports and systems in place. Yes. Because they are the role model for regulation. They are the nervous system.

unknown 23:10

Yes.

Cheri 23:10

Mm-hmm. And then we can get really specific. Okay, at what time of the day or week are we looking at? Is it to do with a particular routine? Do we have to consider other siblings or other people involved in that scenario? Are there cultural considerations that we need to include? What are the expectations in that moment? We need to consider all of those, I guess they're more environmental factors. Yeah, external factors anyway. Yeah. Checking that flexibility. Yes. How and then coming back to how flexible is the program. Absolutely. And then step three, we need to understand the load or the involvement that is needed for us to do the program or resource.

SPEAKER_01 24:05

Yeah, as therapists, and what are we asking the parents?

Cheri 24:09

Yes. Both of those.

unknown 24:10

Yes.

Cheri 24:11

Because I've certainly had programs where I felt like there was no end in sight. And I felt like that as the therapist. I don't know what how the child would feel then. Yeah. Who is learning all this? If I feel like there's no end in sight, they probably feel really disheartened and like, oh, why are we still doing this?

SPEAKER_01 24:30

Yeah, yeah. Haven't we done this 50 times already?

unknown 24:33

Yes.

Cheri 24:34

So looking at how many steps or parts are involved in the program?

SPEAKER_01 24:43

Yeah. And how much setup is there for each of those steps?

unknown 24:47

Yes.

SPEAKER_01 24:47

If it's a never-ending program, it's never-ending setup.

Cheri 24:50

Yes. And how can you? I love tracking. I love good tracking of things. I track everything in my life. 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.

SPEAKER_01 25:07

Yeah. I think a lot of us are visual, so being able to see that progress.

Cheri 25:11

Yes.

SPEAKER_01 25:12

Very nice.

Cheri 25:13

Yes. And how hard is it to implement things from the program on a hard day?

SPEAKER_01 25:20

Yes, especially for those parents. Yes. They're trying to do the work.

unknown 25:25

Yeah.

Cheri 25:26

Yeah. And then going back to how flexible is the program? We're gonna keep saying that. What is the bare minimum that the program needs you to do in order to maybe see change or at least explore the goal? Yeah. So what is the bare minimum requirement? 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. Like if we are doing fortnightly sessions and there are 20 lessons, that's 40 weeks, that's nearly a year.

SPEAKER_01 26:11

Yeah, that's not including us going on leave, people are sick, yeah, needing to focus on something else for a week. Yeah, yes, that's you're asking probably 18 months for 20 fortnightly sessions that are followed rigidly.

Cheri 26:26

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. 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. So that flexibility of when and who can implement it was something we considered.

SPEAKER_01 27:02

Yes. I think we yeah, focused a lot on that flexibility and the capacity of the parents. Yes. Both in the they have no capacity, so what's the bare minimum? And those parents that are really motivated, they're ready to learn. They could do three lessons a week if they really wanted to.

Cheri 27:21

Yes, yes. So that was step three, checking the load and the involvement to do the program.

SPEAKER_01 27:28

Yes.

Cheri 27:30

Step four. Checking to see what supports it includes for the adults, the co-regulators.

SPEAKER_01 27:37

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.

Cheri 27:49

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.

SPEAKER_01 28:03

Absolutely, yep. And speaking of scenarios, we want it to be real life scenarios. Yes you know, we we're not again, we love best practice, but we're not just working in theory. We need it to be real, yes, and doable for families.

Cheri 28:20

It needs to be on the ground, doable, real life, relatable.

SPEAKER_01 28:28

Cool. Look at it. Yeah, that list yeah. And considering as well their their learning styles, their preferences, their wow, capacity. Speak of that word, yeah.

Cheri 28:42

Yes. Yeah. And having an option for adults and those caregivers for when things go off track at home as well. Yeah. Grace built in. Yes. We're not expecting perfection. Yes. Yes. 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. So my goodness. Yeah. 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.

SPEAKER_01 29:23

Yeah. Alright, so we've considered the backgrounds. Now what about the application? Step five.

SPEAKER_00 29:31

Step five.

SPEAKER_01 29:32

We're choosing one small thing to work on.

unknown 29:36

Yeah.

Cheri 29:36

And picking trialing it.

SPEAKER_01 29:38

Yeah, giving it a real hot go too, a red hot go.

unknown 29:42

Yes.

SPEAKER_01 29:43

Um, yeah, working on a a strategy once or twice and it not working is not trialing a strategy to its fullest potential. Yes.

Cheri 29:55

And that tool or strategy has to target a specific if we're thinking of like our OT frameworks. So we've got the person, the environment, the occupation. Which part of that framework is that tool or strategy supporting?

SPEAKER_01 30:11

Yes. Yeah, getting specific.

Cheri 30:14

Yes. So is it okay it's targeting the child's sensory regulation? Yep. So we're implementing a sensory activity, for example, for regulation. So we're targeting the child in that specific moment. Obviously, you get more specific than that, but that's like you know, the P and the PO model. Or is it environmental? Is it oh they don't like uh the sound of the vacuum cleaner that's impacting their regulation? They have a meltdown. So kind of getting really specific, what actual area are you targeting for that tool or strategy before going on to another area? So if we're still thinking of, you know, the when mum has to clean the house and they get the vacuum cleaner out. Okay, we've considered the environment factor. What about the occupation? What is it stopping them from being able to do?

SPEAKER_00 31:16

Yeah.

Cheri 31:16

Implementing a strategy for that. So is it it's in the morning, they're trying to get ready for school. Okay, well then how can we make their school routine a bit easier when mum's also trying to clean?

SPEAKER_01 31:26

Yeah, absolutely.

Cheri 31:28

So really breaking it down and just having one little part of that moment at a time.

SPEAKER_01 31:34

Yeah. If you try and change too many things at once, A, they might all fail. And B, you don't know which one worked or didn't. Yes. So then what are you gonna do?

unknown 31:43

Yeah.

SPEAKER_01 31:44

Or if it stops working.

Cheri 31:46

Yes, exactly. 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? So is it every single time mum's vacuuming they need to be doing this strategy? Is it just three days a week? What's the minimum that we're expecting to be happening to be able to decide? Yes, that strategy's working, we need or we need to adjust it.

SPEAKER_01 32:19

Yeah. And what does working mean too? Yes, that's really important. Yes, are we expecting perfection? This strategy removes all meltdowns.

unknown 32:31

Yeah.

SPEAKER_01 32:31

If you've got that strategy, let me know what it is. Because I haven't found it. Nope. That magical unicorn. Yes. Ah, one day.

Cheri 32:40

So yeah, what is it? Is it is it quicker recovery? Is it that there's less conflict? Is it easier transitions?

SPEAKER_01 32:47

What tells you that it's working? Yeah. And how are we measuring that? We're not measuring for the sake of just ticking a box. So we might not be as specific as you know, um timing a meltdown. But also, how do you know if it's less?

Cheri 33:04

And it may not be I hate these ones, but three out of five moments they were able to use the strategy. Yeah. Those types of things, I I hate those goals, they're not meaningful at all. They might be able to use it, but is it working? You get what I mean? Yeah, or they're gonna use deep breathing three out of five times. Great, sure, they're using it three out of five times, but is it actually helping? Is it what they need in that moment? 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.

SPEAKER_01 34:06

You know, often it's not black and white or all or nothing. So, what did work or if it didn't work, why? What were the barriers? Yes, we're not just throwing strategies out, yeah.

Cheri 34:18

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?

SPEAKER_01 34:31

Yeah, or why did it work with mum but not dad? And so then we're not getting rid of that strategy either. No, we're either adapting it to work in more environments or we just need a strategy for those situations.

Cheri 34:43

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. 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.

SPEAKER_01 35:24

Yes, or it's a lot of work on you to try and meld them all into one.

Cheri 35:29

Because then how are you tracking what you have done, what you haven't done? Yes. Oh, I did uh, you know, a couple of these lessons from the introsceptive curriculum, and then this lesson from zones of regulation. 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? A lot of these programs have been made to okay, these are the core concepts.

SPEAKER_00 35:52

Yep.

Cheri 35:53

And then you start working on the program, but if we're just pulling bits and pieces, sometimes we're missing. Oh, actually, I haven't explained with the alert program that there's different energy levels, you know, the different um engine speeds. 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. So then we're changing it, adapting it, pulling different bits from different places. It's a lot of work for us. Especially if it doesn't work.

SPEAKER_01 36:26

Yeah, being able to put that back into the home as well. 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. Yeah, relationships and environments do.

unknown 36:42

Yeah.

SPEAKER_01 36:42

So that's what we want to focus on.

Cheri 36:44

Yeah, specific that that family-centered and including the caregivers. Yes, please. So we would love to know what's one area of regulation with your caseload that feels hard right now. Have a think.

SPEAKER_01 37:00

Bit of reflection minute. Yes. What's hard in regulation for you?

unknown 37:04

A bit of reflective practice.

SPEAKER_01 37:06

And then on the back of that, what are you gonna do with that? What's one small change or the smallest change that you could trial this week?

Cheri 37:14

Yeah, what something you might do a little bit differently.

SPEAKER_01 37:18

Yeah.

Outro

Cheri 37:20

This was probably a little bit of a longer episode. Yeah. 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.

SPEAKER_01 37:35

And so a good program reduces load and supports co-regulation.

Cheri 37:41

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.

SPEAKER_01 37:56

That's where success lies. If you enjoyed this episode, leave us a review and share it with a colleague.

Cheri 38:02

Yes, and make sure to follow us on our socials to stay updated on OT's Figure It Out and future episodes. Thanks for listening. Thank you.