• Zones of Regulation

  The Zones of Regulation uses four distinct colors to represent different emotional states:

  - Blue Zone: Indicates low states of alertness, such as feeling sad, tired, or bored.
  - Green Zone: Represents a calm state of alertness, optimal for learning and everyday activities.
  - Yellow Zone: Signifies a heightened state of alertness and emotions such as stress, frustration, or excitement.
  - Red Zone: Indicates extremely high levels of alertness and intense emotions such as anger or terror.

  Occupational therapists introduce this concept to help individuals identify their feelings and understand the physiological effects these emotions can have on their bodies. Therapy includes activities that encourage recognizing which zone they are in at any given time and learning strategies to move between zones effectively. These strategies might involve sensory supports, calming techniques, cognitive interventions, or visual supports.

  The Zones framework is highly adaptable and can be used with individuals of all ages, providing them with a visual and concrete way to think about controlling their emotions and impulses. It is particularly effective in educational settings, helping students manage their emotions to improve their engagement and performance in the classroom.

• Occupational Therapy Practice Guidelines For Children and Youth Ages 5–21 Years 2
  research.aota.org

  Author: Cahill and Beisbier - Collaborate with families and caregivers and provide services in the natural context of the desired occupation. The evidence also supports group service models and models that include peer mediation; these models can promote participation across areas of occupation. Skills-based training and therapeutic practice in the context of valued occupations are recommended over isolated sensorimotor approaches. Technology, manualized programs, and sports activities can be effective but should be evaluated and matched to age, diagnosis, and outcomes as guided by the evidence. Activity- and Occupation-Based Interventions to Support Activities of Daily Living, Instrumental Activities of Daily Living, Play and Leisure, and Rest and Sleep -Parent, school, and community involvement should be supported throughout the course of intervention, and pediatric services should be provided in the natural context of the child’s or youth’s routine and environments. -Engagement in daily occupations should remain the central focus of goals and intervention. Practitioners should use manualized programs that have clear activity- and occupation-based strategies as opposed to those that are solely focused on performance skills or client factors. -Practitioners should collaborate with clients and caregivers to establish meaningful occupation-based and achievable goals and use intentional strategies to maintain a collaborative relationship throughout the therapy process. -Consistent caregiver training and instruction should be provided to promote carryover, and the power of the caregiver to effect change and support the child should be emphasized. -Practitioners should follow up with children, parents, and teachers and provide ongoing coaching and feedback on performance. They should provide opportunities for collaborative problem solving and model strategies for ongoing problem solving in the home and community as new challenges arise. -Skills-based interventions should incorporate peer, family member, and practitioner interaction. -Small-group service delivery methods provide an opportunity for increased motivation and modeling. -Practitioners should explore interactive technology interventions, especially with clients with ASD and ADHD. The use of technology can be coupled with skills training and other evidence-based interventions. -The evaluation and occupational profile should include consideration of the quality of rest and sleep. -Rest and sleep should be addressed to enhance health and well-being and increase performance and participation in meaningful occupations. Activity- and Occupation-Based Interventions to Improve Mental Health, Positive Behavior, and Social Participation -Activity- and occupation-based interventions should be implemented to address the mental health, positive behavior, and social participation of children and youth with or at risk for mental health concerns. -Practitioners should use group service delivery models when providing intervention to children and youth with or at risk for mental health concerns. -Sports activities should be used to develop social interaction skills. -Practitioners should incorporate meditation practices and blogging when attempting to foster positive feelings about self in children and youth. -Manualized yoga programs or less structured yoga games and poses should be used when addressing the mental health, positive behavior, and social participation of children and youth with or at risk for mental health concerns. Activity- and Occupation-Based Interventions to Improve Learning, Academic Achievement, and Successful Participation in School -Practitioners should incorporate peer support, such as peer tutoring and peer-mediated interventions, into occupational therapy interventions and provide services in typical school environments to promote social participation and academic performance. -Practitioners should emphasize the use of activity- and occupation-based approaches to improve learning, academic achievement, and successful participation in school. -Therapeutic practice should be favored over sensorimotor approaches for the development and remediation of handwriting and literacy skills and performance. -Weighted vests should be used with caution. Citation: Susan M. Cahill, Stephanie Beisbier; Occupational Therapy Practice Guidelines for Children and Youth Ages 5–21 Years. Am J Occup Ther July/August 2020, Vol. 74(4), 7404397010p1–7404397010p48. doi: https://doi.org/10.5014/ajot.2020.744001
• Intervention Strategies For Anxiety In Children: A Summary of the Evidence 2
  research.aota.org

  Author: Handojo, Hsu-Nazzal, Kabbani, Swinth, Tomlin, and Brubaker - Treatment of Anxiety in Children. Interventions include cognitive–behavioral strategies, occupation-based and child-centered play interventions, yoga, and music. These may improve functional performance and participation. Social skills and the ability to build high-quality friendships effectively supplement anxiety interventions. Citation: Nina Handojo, Christine Hsu-Nazzal, Nadia Kabbani, Yvonne Swinth, George Tomlin, Kristen Brubaker; Intervention Strategies for Anxiety in Children: A Summary of the Evidence. Am J Occup Ther July 2017, Vol. 71(4_Supplement_1), 7111520273p1. doi: https://doi.org/10.5014/ajot.2017.71S1-PO1052
• Pathological Demand Avoidance: Symptoms but Not a Syndrome 0
  pubmed.ncbi.nlm.nih.gov

  Author: Jonathan Green 1, Michael Absoud 2, Victoria Grahame 3, Osman Malik 4, Emily Simonoff 5, Ann Le Couteur 6, Gillian Baird 4 - In our Viewpoint, we reviewed the current literature and conclude that the evidence does not support the validity of pathological demand avoidance as an independent syndrome. Nevertheless, the use of the term highlights an important known range of co-occurring difficulties for many children with autism spectrum disorder that can substantially affect families. We explore how these difficulties can best be understood through an understanding social, sensory, and cognitive sensitivity in autism spectrum disorder, identification of frequently occurring comorbid conditions, and assessment of how these problems interact within the child's social environment. Pathological demand avoidance (PDA) is a profile that describes those whose main characteristic is to avoid everyday demands and expectations to an extreme extent.
• What Is Behaviour Regulation? And What Does It Have To Do With Language Development? 0
  www.hanen.org

  Author: Lauren Lowry - A child's ability to regulate his own behaviour is closely related to his language development. Studies have shown that preschool children who have better behaviour regulation skills also have better early literacy, vocabulary, and math skills. What are some of the things you can do to promote your child's behaviour regulation and support his language development?
• Leveling Up Regulatory Support Through Community Collaboration 1
  pubs.asha.org

  Author: Amy C. Laurenta and Jacquelyn Fede - While behavioral intervention methodologies and societal expectations for masking remain prevalent, in recent years, there has been a greater emphasis placed on understanding the underlying factors contributing to problematic and challenging behaviors. Furthermore, there has been greater recognition of the need to address those underlying factors as the primary areas to target for effective intervention that can actually help autistic individuals navigate their environments in school and as they transition out of school and into the real world (Prizant et al., 2006a). To provide this type of ethical, efficient, and sustainable support, it is imperative for clinicians to understand emotional or energy regulation as a developmental construct and then to understand its relationship to challenging behaviors.
• Nurturing Care For Early Childhood Development 1
  cdn.who.int

  Author: World Health Organization - Your loving care as a parent is what a child needs to be healthy, wellnourished and safe. • Communicate early and often, starting even before your baby is born. It will help you build a warm and loving relationship. • Make time to play with your child and engage them in your daily chores. You will help your child to learn, be happy and thrive. • Remember that feeding times are periods of learning and love – talk to your child while feeding and make eye to eye contact. • If you feel sad and unable to respond joyfully to your child, seek help from your health care provider.
• Effectiveness of a Mindfulness-Based Social–Emotional Learning Program On Psychosocial Adjustment and Neuropsychological Maturity In Kindergarten Children 2
  www.researchgate.net

  Author: Moreno Gomez, and Cejudo - Our findings suggest that mindfulness programs may be effective in promoting psychosocial adjustment and improving neuropsychological variables in young children. MindKinder program could enhance self-control and consequently decrease maladaptive behaviors like aggression, hyperactivity, anxiety, attention deficit, academic problems, and disruptive behavior. Improvement in social skills could be due to enhanced regulation of the intra- and inter-personal emotions fostered by the program. Improved non-verbal development, visual perception and attention processes. Citation: Moreno Gomez, Alfonso José & Cejudo, Javier. (2019). Effectiveness of a Mindfulness-Based Social–Emotional Learning Program on Psychosocial Adjustment and Neuropsychological Maturity in Kindergarten Children. Mindfulness. 10. 111-121. 10.1007/s12671-018-0956-6.
• Inclusion of Children With Disabilities 2
  www.aota.org

  Author: AOTA - Promoting Inclusion - universal promotion of physical and mental health and wellbeing, targeted prevention, and intensive individualized services. References sources in "Check This Out!" box on universal design, training programs examples, and health promotion intervention examples. Settings: home, school, and community. Citation: AOTA, 2015
• Self-Regulation Archives - The OT Toolbox 0
  www.theottoolbox.com

  Author: Colleen Beck - One of the big executive functioning skills is the ability to self-monitor oneself. Self-monitoring strategies play a part in the ability to notice what is happening in the world around us and what is happening in our own body. The ability to “check” oneself and monitor actions, behaviors, and thoughts as they happen play into our ability to problem solve. Use the tips below to help kids learn how to self-monitor and problem solve. These self-monitoring strategies for kids are applicable in the classroom, home, sports field, or in social situations.
• Scope of Occupational Therapy Services For Individuals With Autism Spectrum Disorder Across the Life Course 1
  research.aota.org

  Author: Copyright © 2015 By the American Occupational Therapy Association, Inc. The American Journal of Occupational Therapy, 2015, Vol. 69(Supplement_3), 6913410054p1–6913410054p12. - Occupational Therapy practitioners work collaboratively with individuals on the autism spectrum, their families, OTHER PROFESSIONALS, organizations, and community members in multiple contexts to advocate for and provide a range of needed resources and services that support individuals' ability to participate fully in life (Case-Smith & Ambersman, 2008; Kuhaneck, Madonna, Novak, & Pearson, 2015; Tanner Hand, O'Toole, & Lane, 2015; Watling & Hauer, 2015a; Weaver, 2015). According to a study conducted by the Interactive Autism Network (2011), occupational therapy ranks second to speech-language pathology as the most frequently provided service for individuals with autism throughout the United States.
• Interventions Supporting Mental Health and Positive Behavior In Children Ages Birth–5 Yr: A Systematic Review 2
  research.aota.org

  Author: Kingsley, Sagester, and Weaver - The evidence indicates that touch-based interventions can improve infant self-regulation (strong), social behavior, and attachment (moderate) and reduce maternal stress, anxiety, and depression (low). Moderate-strength evidence supports PCIT to improve child behavior. The evidence indicates that parent training can improve parent behavior, maternal–infant attachment (strong), and parent mental health (moderate). Teacher training can improve mental health and behavior (moderate). • Practitioners should coach caregivers to use massage to increase infant self-regulation, reduce parental stress, and improve child social behavior. • KC or skin-to-skin contact should be used to address maternal stress, anxiety, and attachment. • PCIT should be considered only to address child behavior. • Practitioners should implement individualized parent or teacher training to promote child mental health and positive behavior. • Occupational therapy educational programs should train practitioners to incorporate parent-mediated intervention to promote infants’ and young children’s positive mental health. Citation: Karrie Kingsley, Grace Sagester, Lindy L. Weaver; Interventions Supporting Mental Health and Positive Behavior in Children Ages Birth–5 Yr: A Systematic Review. Am J Occup Ther March/April 2020, Vol. 74(2), 7402180050p1–7402180050p29. doi: https://doi.org/10.5014/ajot.2020.039768
• Activity- and Occupation-Based Interventions to Support Mental Health, Positive Behavior, and Social Participation For Children and Youth: A Systematic Review 2
  research.aota.org

  Author: Cahill, Egan and Seber - Productive occupations and life skills, sports, and yoga addressed mental health, positive behavior, and social participation for children and youth with and at risk for mental health concerns. Moderate-strength evidence suggests that yoga can be used to address mental health, positive behavior, and social participation of children and youth. Low- to moderate-strength evidence suggests that productive occupations and life skills training can be used to address mental health, positive behavior, and social participation. Moderate-strength evidence supports the use of play and creative arts. Activity- and occupation-based interventions should be implemented to address the mental health, positive behavior, and social participation of children and youth with or at risk for mental health concerns. Practitioners should use group service delivery models when providing intervention to children and youth with or at risk for mental health concerns. Sports activities should be used to develop social interaction skills. Practitioners should incorporate meditation practices and blogging when attempting to foster positive feelings about self in children and youth. Manualized yoga programs or less structured yoga games and poses should be used when addressing the mental health, positive behavior, and social participation of children and youth with or at risk for mental health concerns. Citation: Susan M. Cahill, Brad E. Egan, Joanna Seber; Activity- and Occupation-Based Interventions to Support Mental Health, Positive Behavior, and Social Participation for Children and Youth: A Systematic Review. Am J Occup Ther March/April 2020, Vol. 74(2), 7402180020p1–7402180020p28. doi: https://doi.org/10.5014/ajot.2020.038687
• Pathological Demand Avoidance: Exploring the Behavioral Profile 0
  pubmed.ncbi.nlm.nih.gov

  Author: Elizabeth O'Nions 1, Essi Viding 2, Corina U Greven 3, Angelica Ronald 4, Francesca Happé 5 - This study is the first to use standardized measures to explore the behavioral profile of children receiving the increasingly used label PDA. It represents the first clear evidence that children fitting the PDA description display severe impairments across multiple domains. Comparisons between behavior in PDA and two putatively overlapping groups, ASD and CP/CU, revealed levels of peer problems and autistic-like traits in PDA comparable to ASD.
• Self Regulation 0
  childdevelopment.com.au

  Author: Kid Sense Child Development - Occupational Therapists assist with self-regulation, which is a person's ability to adjust and control their own energy level, emotions, behaviours and attention.
• Effectiveness of Cognitive and Occupation-Based Interventions For Children With Challenges In Sensory Processing and Integration: A Systematic Review. 2
  research.aota.org

  Author: Pfeiffer, Clark, and Arbesman - Moderate support for specific types of cognitive and occupation-based interventions that support self-regulation including Alert Program and Social Stories. Occupation-based interventions involved leisure activities, which often occur in community settings. The provision of cognitive and occupation-based interventions that transcend clinical and school settings may result in successful outcomes in the natural home and community settings typical for children and adolescents. This therapeutic consideration is important in treatment planning and determining appropriate service delivery models for occupational therapy services. The cognitive and occupation-based interventions included in this systematic review were provided by interdisciplinary teams of professionals, and all included outcomes within the scope of occupational therapy. The interventions involved collaborations with families, educational staff, and other professionals to promote participation in daily life skills. These collaborations should be a priority when implementing these types of interventions. Citation: Beth Pfeiffer, Gloria Frolek Clark, Marian Arbesman; Effectiveness of Cognitive and Occupation-Based Interventions for Children With Challenges in Sensory Processing and Integration: A Systematic Review. Am J Occup Ther January/February 2018, Vol. 72(1), 7201190020p1–7201190020p9. doi: https://doi.org/10.5014/ajot.2018.028233

• Size of the Problem - Zones of Regulation 1
• Size of the Problem Scenarios - Zones of Regulation 0
• Body listening strategies 2
• Zones of Regulation 1
• Get Attention and Body Listening 1
• Zones of Regulation - Zones 0

• 

  Play Ball 0

• 

  Art 0

• 

  Music 0

• Autism Spectrum Disorder - Autism Spectrum Disorder (ASD) is a complex developmental condition that involves persistent challenges in social interaction, speech and nonverbal communication, and restricted/repetitive behaviors. The effects of ASD and the severity of symptoms are different in each person.
• Post-traumatic stress disorder - Post-traumatic stress disorder (PTSD) is a psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, or rape or who have been threatened with death, sexual violence or serious injury.
• Neurological Conditions - Types of neurological conditions may include: Alzheimer’s Disease, Dementias, Brain Cancer, Epilepsy and Other Seizure Disorders, Mental Disorders, Parkinson’s and Other Movement Disorders, and Stroke and Transient Ischemic Attack (TIA).

• 

  Adolescent/Adult Sensory Profile Self Questionnaire

  Helps measure sensory processing patterns and effects on functional performance.

• 

  Developmental Indicators for the Assessment of Learning - Fourth Edition 0

  DIAL-4

  A global screener for assessing large groups of children quickly and efficiently.

• In order to improve focus and attention for educational activities, Peter's teacher will implement 1 movement break lasting 2 minutes before each circle time by May 5, 2023 . 0
• When Peter is dysregulated, Peter will self-advocate by asking permission to take a 5 minute break in 2 out 3 instances by May 5, 2023 . 0
• Kurtis will improve sensory processing and self regulation, independently, in 3 out of 3 attempts for increased body awareness, coordination, safety and direction following within a 3 month therapy period. 5
• Candelaria will demonstrate increased self-regulation and attention as evidenced by attending to an adult directed activity for 3/5 minutes with minimal cuing as seen in 4 different therapy sessions and demonstrate at least 30% decrease in meltdowns across 6 weeks per Mom's report with in 2 therapy months over a 6 week therapy period. 4
• Peter will use a coping mechanism of their choice on 9 /10 occasions as reported by the caregiver for enhanced emotional regulation by May 5, 2023 . 0
• In order to enhance social participation and student role, Peter will meet participation expectations in a small group activity with peers at school with 2 verbal prompts 3 out of 5 days by May 5, 2023 . 1
• In order to improve concentration during school, Peter will remain focused on the task (seated if possible) 80% of the duration of math class by May 5, 2023 . 0
• Peter will transition between activities with a regulated emotional status using a visual routine or schedule to promote predictability and consistency for 95% of transitions during the school day by May 5, 2023 . 1

Therapists who selected this major focus area as their top area of expertise.

• 

  Maria Roberts

  Full-time Therapist OTR/L

  My name is Maria Roberts, and I have been practicing occupational therapy for 4.5 years. I starte...