Developing an Emotional Regulation Plan for Ben

The childs name in this artefact has been changed to protect his privacy . Tom is 6 years old, with a diagnosis PDD-NOS. He is a much loved and valued member of our new entrant class. All the adults and children in our room show amazing care and empathy for him and none of us want to see him upset. The ideas shared in this artefact will help to move us towards developing an emotional regulation plan for Tom so we can better support him when challenges arise. It will also provide us all with strategies to recognise and control our emotions.

What does Toms behaviour look like when he is dysregulated?

Aggression directed towards adults including biting, spitting, hitting, pushing and pinching Unintentionally hits out at other children Leaves the class Hides under cushions on the sofa, sometimes cries Retreats to the safe place box and cries Throws equipment Knocks over chairs

When, What and Why? Activity Whole Behaviour Observed

Non-compliance

Purpose of Behaviour
Knows that assembly is not

Under-Aroused
Tired: assembly is at the end of the morning

Emotional Regulation In the Zone

Enter hall with TA after rest of school

Hyper- Aroused
Uncomfortable: in the winter the hall is cold.

School Assembly

Physical aggression towards TA Asking repeatedly in loud voice to leave assembly hall Sitting on adults lap

something he enjoys and being in the class 1-1 with the TA is much preferable. Bored and uncomfortable so wants to leave Sitting on an adults lap provides a safe, comfortable, soothing alternative to being squashed on the floor

session. Hungry: lunch is straight after assembly Disinterested: the content is mainly spoken with view visuals. Uncomfortable: in the winter the

settled, or watch from side door. Sit at the end of a row with teacher or TA close by. Only expected to stay for 15 minutes. Use visual schedule to count down time periods left until he leaves. Reward of computer time when he returns to class

The floor is bare wood. Sensory overload: Auditory-assemblies are very noisy as children enter and at other times during the session. There is a lot of clapping. Tactile- children are squashed in by others on all 4 sides Olfactory- especially on hot days. Smell of gas fired heaters on cold days

Non-compliance to come to mat Only remains on mat for short snippets If given a fiddle toy often distracts others by throwing,

Other options in the classroom are more motivating for him

Disinterested May be tired as first thing in the morning

Morning Mat Time

Visual schedule showing each activity which Tom moves across when it has finished Fiddle toys available

Tactile and olfactory sensory stimulation. Children arriving late into class Another child in the class being non-compliant

Does not like the Would rather be on the confusion of computer or looking at others arriving late books or being upset so removes himself to a safe place

Interactive whiteboard is very motivating for Interruptions such as him school announcements

banging, twirling it around Acts The Fool during Brain Gym

over the speaker Peer approval by making them laugh Reaction from peers when distracting them with fiddle toy Opportunity to go with other children to take the role to the office Very motivated if it is his turns to be line leaders, as this involves additional jobs on the IWB Regular tasks to do when we change from one activity to another

Continually attempts to escape from deck area

The playground is far more motivating than an overcrowded, noisy, squashed, cold deck. Does not want to eat food he does not like Confusing when other children are breaking the rules

Not hungry Nothing in his lunch box is motivating him Cold outside Disinterested

Visual breaking down the lunch time routine Accompanied by TA Sits with same children in same place everyday Lunch box contains same types of food everyday

Children sitting in different places and either different friends everyday Children getting up and walking around when they should not be Overload of tactile, auditory, visual, olfactory stimuli Having to wait until the teacher says it is time to go

Lunch Time

Refuses to come to desk Throws pencil and book Physically aggressive towards TA

Waiting to be told to go is wasted time when he could be playing Knows he does not Lack of motivation enjoy what is coming so why get Physical challenge of ready for it motor skills involved Cannot see the point of writing

Provide photos of what he has done at school or at home Link to special interest of diggers and cars Photograph finished work Using an alpha smart or whiteboard Using novelty stationery A quiet place to write TA supervision A worksheet based task Task involving the IWB, laptop or ipad Familiar game played with same peer each

Fear of getting it wrong Chatter from other children a distraction Other children distracting the TA Sensory overload sitting at group table

Writing Time
Hides under desk or under cushions on sofa

Physical aggression can get him removed to the safe place box achieving his goal of avoiding writing

Can get away from Escapes from class this whole ordeal if he sees an outside and play opportunity on the swings instead Refuses to join group with teacher on mat The whole event is too confusing, unpredictable and busy so it is easier to watch from a distance We should have Disinterested Does not want to be with the peers in his group High cognitive demands Distracts others

New equipment Sensory overload from equipment, colour, texture, shapes etc Unpredictability of sessions.

Maths Time

Messes around with equipment

Leaves the room Lays on the sofa

milk before maths and we have not had it yet so we cannot start maths. More interesting to play around with the equipment than to use it for a specific task Gains peer attention by messing around removes focus from fact he is unsure what to do and could be compensating for lack of social interaction skills

This is usually an afternoon slot so he may be tired

time Practice new task with TA in morning session Developmentally appropriate task

Classroom very noisy with independent groups Disruption of daily routine Not knowing what to do on a new task Anticipating end of school day High level of social interaction

The green In the Zone column of the table above describes things that we c ould do or already do to avoid Tom getting hyper or hypo aroused. These include: Predictability, structure, visuals Working at his own pace, practicing tasks on more than one occasion Clear beginnings, middle and ends to tasks

Appropriate developmental level of task Use of strong motivators Safe environments to work in Listening to what Tom is telling us

How can we help him help himself?

This section looks at ways of increasing self-regulation that may help Tom, but are also applicable to the whole class, children and adults. The Incredible 5 Point Scale This was developed by Buron and Curtis in 2003 and uses the following 5 point system: 1. I am happy and calm 2. I am a little upset 3. I am definitely upset 4. I am about to lose control 5. I cannot control my behaviour Artefact 3 for this goal is a video outlining a lesson introducing the 5 Point Scale to the whole class. This is for slightly older children but could easily be adapted for a new entrant class. There is also a free iPad app for this intervention, which for Tom would be incredibly motivating. Emotional Tool Box The Emotional Tool Box is an idea developed by Tony Attwood in 2004 and contains a repertoire of tools aimed at increasing self-regulation.

Physical tools These release emotional energy e.g. walk, run, bounce on a trampoline or gym ball, swing, do a sport, dance, bike, swim, play an instrument, take a break. Relaxation Tools These have a calming effect e.g. draw, read, listen to music, a quiet place, repetitive movements, massage, stress ball, delivering a message, doing a job in class. Social Tools Spending time with a staff member or peer mediator outside of the classroom, teaching a new skill that he is good at to a peer, working with a favourite peer. Thinking Tools These use the childs intellectual strengths to control emotions e.g. self-talk, reality check, working on tasks they are good at, having a secret calming symbol or object to refer to when anxious.

Tension Release and Breathing This approach includes: Squeezing a ball for 5 seconds and releasing, repeating this 5 times Breathing slowly in through the nose and out through the mouth

Conclusion
All these approaches can be taught to the class through modelling, drama and social stories. We have used aspects of some of these approaches through work based on the Sue Larkeys book Panicosaurus. All the children have enjoyed using these methods but

Tom remains reluctant to partake shouting out that he does not like Panicosaurus. However the calm created in the classroom by everyone else doing squeezing or breathing exercises has a calming effect on Tom anyway. We have already leant the Panicosaurus book to a number of families from our current class and from previous classes. Our next step is to continue to examine how we can avoid situations that lead to hyper-arousal for Tom, and to learn to read the signs of his hyper-arousal so we can use calming strategies before he goes beyond this point. No one intervention is going to work for Tom every time or for every situation which is why we need to have a class Feelings Tool Box of i nterventions that can be trailed, assessed using structured data collection and monitored. The strength of this type of intervention is that it is inclusive of everyone in the class and can be generalised to home and community settings, potentially informing a School Wide Discipline and Individual Support strategy (Gould, K., & Pratt, C.,2008, May/June).

References
Al-Ghani, K. (2012). The Panicosaurus: Managing Anxiety in Children Including Those with Aspergers Syndrome. Jessica Kingsley. Gould, K., & Pratt, C. (2008, May/June). Schoolwide discipline and individual supports for studets with autism spectrum disorder. Prinicpal, 38-41. Harpold, C. (2012). Autism 5 Point Scale EP App. Retrieved from OT's with Apps: http://otswithapps.com/2012/05/30/autism-5-point-scale-ep-app/ Moret, P., & Moret W. (n.d.). Emotional Regulation in the Classroom Part 1. Retrieved October 2013, from Popard: Autism 5 Point Scale EP App South Carolina, U. (2010). Project STAGES: Supporting Students with Autism in General Education Settings, 4-3 Regulating Emotions. (University of South Carolina) Retrieved from Center for Disability Resources: http://uscm.med.sc.edu/autism_project/