Practical Sensory Based Strategies for Trauma- Responsive Co-Regulation
Photo by Kelly Sikkema on Unsplash
In last week’s post, we explored what regulation means and the importance of co-regulation. It’s a great foundational resource, if you missed it, check it out HERE!
Today is all about practical strategies. Co-regulation with children who have experienced trauma can be confusing, difficult, and counterintuitive. Often, the process looks really different than it does with children who have more “typically developing” stress response systems and relational templates. When a child has experienced something like a lack of attuned, attentive, safe caregiving or gone through a life threatening or near life-threatening experience, their regulation system can be impacted.
Instead of learning the smooth process of assessing their current state, deciding what state they need to be in and then taking action to get there, they may have difficulty with each of these steps.
Before a child can regulate themselves, they need to experience countless repetitions of a caregiver supporting them from dysregulation to regulation. In infancy, hopefully, this happens naturally and very frequently. A baby becomes uncomfortable when they are wet, they become dysregulated and cry out, a caregiver notices this discomfort and lovingly and safely cleans and changes them. They may also look at them, talk to them in a soothing voice, hold them securely. When the changing process is over, the baby feels better and a connection is made- when I’m in distress, someone can come help me and I feel better. After this and moments like it happen thousands of times through infancy, toddlerhood and beyond, children build the capacity to take steps to regulate themselves more independently.
When working with young children, following Bruce Perry’s “sequence of engagement” is one way I have found that’s as close to fool-proof as things get in the unpredictable and nuanced world of child mental health. Beginning by supporting and allowing the child’s body to reach a regulated state is the first step in supporting a child in getting re-connected and ready for learning and playing.
Begin with Regulating the Body through Sensory Strategies
Focusing on helping the body be regulated is the first step. I recommend doing strategies like these with minimal, if any talking at all. The goal is to limit the demand on the child so they can focus on getting their nervous system back to baseline.
Breathing Strategies- you can model and support the child in joining you as they’re ready
Breathe using a visual, trace your finger along the “in” and “out” sections
Breathe in to smell a calming essential oil and then blow a small pinwheel
Laying on your back, place a small stuffed animal on your belly, breathe in and watch it rise up, breath out and watch it sink down
Standing, hold a balloon on a string against your belly- breathe in and watch it move out, breath out and watch it move back in
Blow bubbles- the child can blow them or you can blow them and the child can use their breath to move them around in the air
Movement Strategies
Sway or rock with the child in a rhythmic, repetitive pattern
Pace back and forth or in a large circle around the space with the child. You can walk together, hold the child while you walk, or pull/push them in a wagon or stroller
Swing back and forth or side to side on a swing set or indoor swing
Rock in a rocking chair. You can gently push the child in a rhythmic soothing rocking motion.
Jump on a trampoline
The child may jump on their own
You may hold their hands while they jump and you stand next to the mini trampoline
Deep Pressure & Heavy Work Strategies
Offer a weighted lap pad, blanket or stuffed toy to the child
Note: blankets should not exceed 10% of the child’s body weight plus 1-2 pounds depending on the child’s preference. The child MUST have the strength & coordination to remove the weighted object themselves
Offer weighted stuffed toys to hold or carry while walking or swinging
Animal walks- walk on hands and feet, crawl or roll on the floor
Steam roll- use an exercise ball to roll over the child while they lay on the floor or on a mat being careful to use pressure that’s appropriate for their size
Auditory Strategies
Use a rhythmic and soothing voice when talking to the child
Play familiar music
Low frequency
60-80 beats per minute (you can search “60-80bpm” on your favorite music platform for playlists and albums that are regulating)
Visual Strategies
Offer visual tools to look at
Bubble tubes
Hour glass/sand timers
Timer apps with a visual countdown
Blow bubbles or use a bubble machine to watch them fall
Regulating Snacks & Drinks
Offer warm or lukewarm water or other drinks
Offer thick liquids like smoothies, apple sauce or yogurt through an extra wide straw to engage sucking
If safe to do so, offer something to suck on such as a juice popsicle or mint
Offer chewy deep-pressure snacks such as dried mango, fruit leather, jerky, crunchy hard pretzels, chewy bagels
Positioning Strategies
Sit at a 90 degree angle or next to the child instead of face to face
Allow the child to be positioned between you and the door, if safe to do so, to prevent them from feeling trapped
Be at or below the child’s eye level and avoid looming over them
When approaching the child, do so from the front instead of from behind or outside their visual field
Leave your hands in places the child can see and do your best to move slowly and intentionally to limit startling the child
Be intentional in your physical contact with the child- that may mean intentionally avoiding physical contact, it may mean strategically using safe touch in accordance with the child’s needs, the family’s comfort and the rules of your place of work
Tips for Your Practice
Regulation takes time! Plan for a minimum of 20 minutes of using regulating strategies to allow the child’s nervous system enough time to relax and re-set. Some children will require less time but some will require more. Read their cues to know when they are returning to baseline, don’t rely on a timer!
All sensory strategies should be offered with the option for the child to decline verbally or non-verbally. Sensory strategies should NEVER be used through force, coercion or tied to a reward system of any kind.
Regulating strategies should be simple & easy for the child to understand. Activities that are too complex may be less likely to lead to regulation if they haven’t been practiced
You may want to track which strategies you use and how long you use them for but avoid placing a timer or time expectation on the child
How does this look for me?
Lists of strategies can be really helpful when you’re in a pinch and need a few new ideas. If you’re wanting a little more, keep reading. This is an example of how I use strategies like this in my work.
When working at a special education school for children with emotional and behavioral “challenges” stemming from trauma, I had a lot of interaction with students who were chronically dysregulated, fearful, and had difficulty controlling their behaviors. Here’s a little snap shot of an interaction I had with a young elementary student in a therapy room at school because they were not ready to be in class.
I sat on the floor against a wall in a non-threatening place in the room and started doing deep breathing with a pinwheel toy and offered him one as well. At first, I think he thought I was a little weird but watched curiously for a few minutes as I calmly used the pinwheel to see my breath. He joined in and started to blow his pinwheel as well. Soon he started to try to blow it faster and faster and I knew this was becoming a more up-regulating activity than down regulating so I put mine away quietly and calmly and said out loud to myself, “Sometimes pinwheels are so exciting and make us want to go faster and faster. I’m going to put mine away and find a better tool for making my body and brain more calm instead of more excited.”
I moved slowly to get out two exercise balls and lay on my stomach over one and used my legs to rock back and forth while I watched a bubble timer. When I noticed the child show some interest in the bubble timer, I invited them to the exercise ball next to me. We both watched the timer for two or three minutes and the child started to talk more- about the bubbles, about his day and classmates. This helped me realized that the child was becoming more organized and regulated. I said “it’s going to be nice to get back to class soon. I wonder if you’d like a snack so you’re ready to join your class when you get back.”
Once the child said yes, we moved to the table, sitting at 90 degrees from each other instead of directly across, and I offered a weighted lap pad and apple sauce (that’s what was available that day) with a straw. I got one for myself as well and modeled using a straw to drink the apple sauce like a smoothie. The child copied me and we both enjoyed our snack together. Once we were finished, I said, “I’m going to throw my container away since I’m all done” and modeled cleaning up my area. Then I noted, “your body is moving nice and slowly and you’re telling such interesting stories now. It seems to me that you’re body and brain are ready to go back to class and start learning with your friends.” I could tell this was correct because the child stood up, threw their container away and went to the door. While walking back, I offered a small game, “let’s point to each letter E (the first letter of the child’s name) we see in the hall on the way back to class” and together we walked slowly and used our fingers to physically point at letters we saw. This helped transition back to a more academic/learning mind set while also focusing on slow intentional movement in parallel.
I hope this little story helps give a sense of what it might look like to use several strategies without just offering them in a list form to a child. Of course many of my interactions with children are MUCH messier than this, I promise you’ll hear about those too!
Resources & References
Bruce Perry’s Sequence of Engagement: Video
