Podcast

There are many activities parents can incorporate into their child’s daily routine to support their sensory processing abilities and help them learn to effectively regulate their emotions.

Joining me this week is Laura Petix, also known as The OT Butterfly, to discuss what exactly occupational therapy is, why it can be so beneficial for children, the role our 8 senses (that’s right, I said 8) play in our ability to remain calm and in control, and the best way to set our children up for success whether they are neurotypical or neurodivergent. 

Laura (00:00):

When I coach parents about handling meltdowns, I break it down in four phases. I talk about before the meltdown during, after, and between meltdowns. And so that between meltdowns is where like all the work happens,

Dr. Sarah (00:19):

Children aren’t born instinctively knowing how to calm themselves down when they’re triggered or upset. That is why we as parents must co-regulate using our own calm to help them regulate their brain and body and strengthen their own ability to calm their bodies down themselves over time. Regulation is one of the things that occupational therapists work with patients to build. And this is why I’m so excited to have Laura Petix, who you may know as The OT Butterfly from her popular Instagram account and podcast, on the show this week. Laura is a pediatric occupational therapist and a mom to a neurodivergent four year-old with sensory processing disorder and anxiety. We’ll discuss the tools that OTs use and how parents can use these techniques with their own children, no matter where they fall developmentally.

Dr. Sarah (01:13):

Do you wish you knew exactly what to do before, during, and after your child’s tantrums? Not just to get them to stop, but to stop in a way that it actually benefits their development, their mental health and their relationship to you. That is exactly why I made The Science of Tantrums, a highly targeted framework created by me, a clinical psychologist and mom of two toddlers to help you understand what exactly is happening in your child’s brain and their body when they have a tantrum. And I’ll teach you the most effective tools to reduce the frequency, duration, and intensity of dysregulation over time. And because it’s a framework, not a one size fits all script, it allows you to meet your own child exactly where they are at any given moment, no matter how big their dysregulation gets. Over my 12 years of clinical experience, I have honed strategies that I have seen work with everyone from developmentally typical children, to those with some of the most severe cases of behavioral and emotional disorders. I know this works because I’ve seen it work time and time again. To learn more and to sign up for The Science of Tantrums, go to drsarahbren.Com/tantrums. That’s drsarahbren.com/tantrums.

Dr. Sarah (02:34):

Hi, I’m Dr. Sarah Bren, a clinical psychologist and mom of two. In this podcast, I’ve taken all of my clinical experience, current research on brain science and child psychology and the insights I’ve gained on my own parenting journey and distilled everything down into easy to understand and actionable parenting insights. So you can tune out the noise and tune into your own authentic parenting voice with confidence and calm. This is Securely Attached.

Dr. Sarah (03:08):

Hi, I’m so excited to have Laura Petix on the podcast today. Laura is a pediatric OT. She’s a mom. She has an amazing Instagram account called @theOTbutterfly. Thank you so much for being here.

Laura (03:22):

I am happy to be here. Thanks for inviting me, Sarah.

Dr. Sarah (03:25):

Yeah. I’ve been following your work for a while. Actually. I think I found out about you maybe a year ago, even. And like, I love, I love the way you talk about regulation, physical and affective regulation in kids. It’s very aligned with the way I think about this stuff.

Laura (03:46):

It’s so important in this day and age to speak, not only on simplistic terms, but also I find the parents get a lot of value out of when I can bring some very, very concrete examples and also blend it with the permission that it sometimes doesn’t work out. I’m here to give you all the tips and teach you everything. But Hey, I am the first one to admit that I don’t always do everything perfectly. And so I’m letting everyone learn through my mistakes as well and learn alongside me. I’m happy to be this like guru to lead you. But I’m also one of you too, because I also have a child who is neurodivergent. So we have a lot of dysregulation in this house. So I’m happy to be there for everybody.

Dr. Sarah (04:36):

Oh, amen. Like, I, and this is just from professional to professional, who does this sort of like, puts the content out there for people. And we have to understand, we put this information out there and then we don’t get to fill in the context all the time. Like people read it and they have to kind of figure it out on their own. And I think there’s a huge issue that exists in that world of people read something and then there isn’t this opportunity to say, but by the way, this isn’t how you have to do it every single time. And like, this is maybe an ideal that you strive for some of the time when you can and know that it’s not always gonna work. Like I am a mom of two toddlers. I definitely, we have massive meltdown in my house. We have moments where I’m the one melting down. Like, there’s never, there’s no family out there that doesn’t deal with this. I don’t care if you study this and teach this every single day of your life, or you’ve never heard of any of this before. Like it, this is part of being human.

Laura (05:38):

Exactly that. And I feel at first, when I would share a lot of my story, I remember worrying like, oh no, am I not gonna have enough credibility to coach parents through this? If they’re seeing me say like, oh my gosh, we had a horrible meltdown this morning and I couldn’t handle it. And I’m at my wits end. And I was like, I feel like a fraud. Like, I’m coaching them on this. Like, I will literally just like walk away from the hardest meltdown and then like open my computer and coach parents on like how to keep calm during a meltdown. And I’m like, this is a little, this feels very ironic. And I felt like imposter syndrome, but then I kept getting so many messages of parents, like actually feeling more hopeful after seeing me struggle, because they’re like, if the professional is struggling, then I know I’m not failing too hard. Or that I’m not doing anything wrong. I’m like a hundred percent. I did everything right in the book. When she was an infant development, I’m gonna hit every milestone. I’m gonna do every sensory play. I’m gonna do this, that and that. And I’m gonna have the perfectly developmentally typical child and…

Dr. Sarah (06:52):

Right, wouldn’t that be amazing if you could just do that.

Laura (06:53):

That would be amazing. If they were just like robots and you could like plug in, like, I know all the cheat code for this. It doesn’t work that way. She has a uniquely beautiful neurodivergent brain. And I’m an OT. And I don’t do OT things with her, like all the time that surprises people. They’re like, you must do OT stuff with her all day. I’m like, I don’t, I really don’t. I try but.

Dr. Sarah (07:11):

No, cause you’re her mom, you know, you’re not her occupational therapist.

Laura (07:16):

Exactly.

Dr. Sarah (07:16):

You’re her mom. Sometimes you just have to have a real relationship where you’re not working. Like I’m not my children’s therapist. Never. Like I sometimes try to be my own therapist. And even that doesn’t really work very well for me.

Laura (07:31):

I know I try to DIY way too much in my life, but I’m like, I can’t, I gotta start delegating or like.

Dr. Sarah (07:38):

I know, everybody needs support. But it’s yes. I mean, I literally had, I had a session earlier today with a family and one of the first things they said, and it was so incredible to hear them say this was like, things are going really well because we have like shifted our sense of urgency to have the right response in the moment. And that’s let everybody relax. And so our kid is having an easier time. I’m like, there we go. That’s the secret sauce, right? It’s not how do I get my kid to never have meltdowns and be regulated all the time. It’s how do I have a relationship in the family around emotion, dysregulation, where it’s comfortable for us. It’s more comfortable for us to tolerate this because we recognize it’s actually a healthy and appropriate and normal part of life.

Laura (08:20):

Absolutely. Yep. Those mindset shifts are gold in like making those first steps towards progress and sometimes are the best progress makers from like all of the sessions that you have is just like once. And, and it’s one of those things where you can like tell them to have this mindset shift. Like you should think of it this way, but it’s another, when it happens for them or they think about it often, they’re like, no, you know what? I am starting to shift the way. I think not just like, take your words and be like, oh, well, my therapist said to think of it this way. But like, you actually start changing the way you think and frame things and see things will definitely change the way that you respond and how your child responds to you. It’s amazing.

Dr. Sarah (08:58):

And then it’s funny, cuz it’s like, it’s ironic. Right. As soon as we kind of stop trying to make the dysregulation go away because we are coming into it more calmly and more regulated ourselves, guess what happens?

Laura (09:13):

I know it’s like it unlocks everything. Oh, I was the problem the entire time?

Dr. Sarah (09:20):

Yeah. And not like, and I say, you know, not even the problem, just I was part of it. Like I was true. We were all responding to one another and we were all increasingly becoming more dysregulated and all of a sudden, as soon as I stopped doing that dance. And I start kind of focusing on my own regulation, my kids dysregulation matched up, like synced up with my regulation. So it’s, it’s a different way of thinking about it. And it’s actually why I love working with occupational therapists. I refer a ton of my patients, cause I typically work with parents and then I work with parents of young kids. And sometimes, sometimes it makes sense for those kids to be seen by a therapist and do play therapy, trauma narratives, all kinds of really important work, you know, processing emotions, all that stuff. Like there’s a lot of room for therapy for young kids. We do that in my group practice all the time. But a lot of times I actually say we’re not the right treatment modality here. I actually think that this young child would be better served with occupational therapy. So I was actually, maybe it would be helpful for you to share a little bit with this audience. Like what is occupational therapy? The name is kind of unclear and misleading. You’re not like teaching them how to have an occupation.

Laura (10:38):

Oh my gosh, yes.

Dr. Sarah (10:38):

You know, what does an occupational therapist do? What are some of like the pillars of that type of treatment? Why would someone send their kid to see an OT?

Laura (10:48):

Yeah. Perfect. And this is actually great cuz it is occupational therapy month. I don’t know when you’ll be listening this, but as we talk in April, it is occupational therapy month. So occupational therapy. Yes. The name is so misleading, but when they created this field, they meant the word occupation to to mean things that occupy your time. And it started its roots started in with soldiers coming back from the war and these nurses, these occupational nurses would help rehabilitate them back into like civilization, by doing arts and crafts and a lot of like hands on vocational type skills to help get their range of motion back in their limbs and their and their cognitive skills back. If they had, you know, a stroke or some head injury and they would work all of those things within the context of things that like occupy that are meaningful for that person. So, hands on crafts, hands on like cooking and like all of those things were root part of occupational therapy. So it’s using something meaningful and purposeful to gain new skills or rehabilitate skills that have been lost. So it’s it started there, but now OTs work across the lifespan from newborns all the way until the end of life. So I’m a pediatric OT. So I specialize in children’s, in children ages like two to like I think my oldest client right now, my caseload is 12, but I say I’m, I’m most comfortable with kids between like two and like 10 around that age. And so whatever skills that that child is needing support with, whether it is fine, motor skills for handwriting or gross motor skills relating to balance, being able to climb the playground appropriately or cognitive skills related to doing multi-step activities at home or listening to instructions in the classroom or focusing in the classroom, things that are meaningful and purposeful in kids daily lives that they have to do just being a kid, which includes play by the way, a huge piece of it. But also eating at home, putting clothes on. Like I said, going to the bathroom or going on the playground, all of those things. Those things are meaningful and purposeful to kids, but they may have some underlying skills that need further support. Maybe they have not fully developed all the way or maybe they had an injury that may have taken a skill away. So I focus on sensory processing skills and sensory processing, which we’ll probably talk about in a second, that is it’s foundation to building these higher level skills. So a lot of times what you’ll see when you look in an OT gym or OT clinic, it looks like a Gymboree or like an indoor play, like bounce house area. Lots of obstacle course foam wedge pieces. It kind of looks like a gymnastics area. There’s trapezes, probably climbing ladders, slides, lots of pillows to crash on it is a play space. But OTs use those, that environment to activate certain sensory responses in your child to hopefully get your child in a space where they can feel more regulated and calm. And then once your child is regulated and calm, we can build so many more skills on top of that. So OT always looks like play, but there’s always a clinical reasoning behind one of the activities that they’re doing.

Dr. Sarah (14:26):

That’s such a helpful explanation, even for me, because like I often will have like parents be like, well, why would I send my kid to OT? And I’m like, I can’t explain it as well as an occupational therapist, but I know you should.

Laura (14:38):

That’s what I say about play therapy. That’s exactly what I say, play therapy, cuz I, my daughters was in play therapy and someone was like, would you recommend this or this? I’m like, I might look into play therapy. They’re like, why my daughter knows how to play. I’m like, it’s not that they’re like, well, what is it? I’m like, I can’t explain it, but I think your daughter would do it. So just go to play therapist. So that’s the same way.

Dr. Sarah (14:58):

Yes. And play therapy for anyone. Who’s curious, like the idea is the play is the vehicle through which we can kind of integrate and offer typical therapeutic interventions that we would maybe do in talk therapy. But you’re not gonna just sit a kid down on a couch and be like, so tell me about about your relationship with your mother.

Laura (15:20):

Exactly.

Dr. Sarah (15:22):

You know, we, we use play to act out interpersonal interactions with toys or get a child’s to just kind of get in a flow state so that they can then tolerate more complicated and emotionally activating conversations about things and work out things. So it’s, yes, there’s lots of amazing. And I should do an episode on play therapy with one of my play therapists in our group practice. Because it’s an amazing modality, but I think, and the reason why I often refer some patients out to occupational therapy and the ones that I tend to do so with is because I love the sensory integration work of occupational therapy. I think that is super in line with a lot of the work that I do with parents in helping teach parents about emotion regulation, about how to help children when they’re having tantrums, how to help children who get dysregulated easily and have a hard time coming back to baseline. And those kids, those sensitive, nervous system kids, whether they have a sensory processing disorder or not they may just be completely developmentally, you know, neurotypical, but they still just get hot, fast and come down slow. And that nervous system integration work that you guys do is when I’m like, I think that would be so helpful for this kid. They need to move their body. They need to figure out where their body ends and another body begins. They need to learn ways to calm their body down and get still and quiet, that’s OT work in my mind. So like, I don’t think that play therapy is as effective at treating that particular stuff as OT for young kids, especially.

Laura (17:07):

Yeah. I look at it a lot, like a top down versus bottom up approach. Right? So OTs can do both approaches. So a bottom up approach is the way that I describe it are, like a very simplistic way, is like a bottom up approach is like marinating the steak for like days where like soaks up all the juices and you’re making it flavorful from like within. And top down approaches is like adding like salt and pepper, like on to like the surface level. Right? Both of them are gonna achieve like a flavor that you want. One is probably faster, which is more like top down approach, adding little sprinkles of seasoning on top. One of it takes a little bit longer to marinate, right? So bottom up approaches in OT are a lot of body-based movement work. But what, what that part is sometimes hard for parents to understand or see, because it’s not always a direct link. It’s not always like, oh, you did this activity. So now my child is washing their hair better. Like today it doesn’t take that long. It takes a lot longer, right? It takes a lot of consistency. It takes a lot of new pathways in the brain to be created towards regulation. But you are setting their nervous system up for success in a way that it’s going to feel, have more moments of regulation, maybe your child right now experiences a higher proportion of dysregulation throughout their day. So OT can work on it that way. But also you can do top down approaches, like talking to them about reframing their fears of the bathtub. If we’re talking about washing hair, right? That’s more top down approach talking about it, bringing it up to their higher level brain. But a lot of the top down approaches require a certain age and developmental stage and language abilities for a lot of top down approaches, especially for emotional regulation and sensory regulation. When we talk about, when we teach them like the zones or like how their body moves and what sensory tools they need, they really do need some level of receptive and expressive language for that. So it’s always, it’s not always appropriate for all kids of all stages and ages.

Dr. Sarah (19:08):

Right. And even like in a very like, sort of concrete way in the moment that you’re teaching it, they have to be regulated. They have to have access to their frontal lobes. So it’s like, exactly, you can’t teach this in the hot moments. You have to teach it in the cool moments. Um and you develop that through this like trusting relationship with, and this fun association with this play-filled space. But really it’s like, a metaphor I often use is it’s like, it’s like planting a seed and then you water it. And you water it and you water it and you water it and you watering it in watering it for a long, long, long time before you’ve got a nice, big blooming flower there. Like it’s not it. You have to kind of nurture this. And it’s very small at first and it, but it, it does grow. And every time you do something where you’re helping your child regulate their nervous system, whether it’s rough and tumble play or, you know, heavy work, which we’re gonna talk about, or maybe it’s coregulation, I talk about a lot on the podcast. You, that’s just a drop of water you’re putting in, in your, in, you know, in the pot with this seed. You’re not gonna see a plant the next day, but that water is doing something, it’s just, you don’t see the effects of it immediately.

Laura (20:31):

Exactly. And that’s definitely, it’s definitely a trust the process kind of thing that I have to continually tell parents, trust the process, trust the process. I promise we’re going to get, cuz a lot of parents, you know, when you start working with OT, you come in with these very higher level behaviors that you’re seeing, they’re hitting, they’re screaming. They’re not listening to instructions. They keep throwing food. Every time I put it on their plate, that’s the behavior that they’re wanting to change or fix or address or support. And I promise like we are working on that even though you see us like rolling around on the ground at OT, this is going to contribute to that. Trust the process. But on day one, I’m not going to say, we’re not gonna have this sit down lecture, lesson type thing. It is very bottom up through your body until you’re in a regulated space so that we can teach them those top down approaches or they will just have those more regulated interactions in general and will not have that need to have a fight or flight or to throw something or to hit or scream. And instead they might have the ability to access the language. That’s like actually I am kind of mad right now and I’m mad instead of like yelling it, but it takes time.

Dr. Sarah (21:46):

Yeah, it does. And it’s, you know, I feel like this is a nice segue into talking about, okay, so you can send your kid to an occupational therapist and they can do all this stuff. But some of the things that I wanted to talk to you about today in this episode is about like things that we can do at home with our kids that pull upon some of the same, you know, constructs as occupational therapy and this nervous system, you know, sensory integration kind of stuff. And like you might call it rough and tumble play. You might call it heavy work. You might call it just goofing around at home. But there are things that like we, we already naturally probably do with our kids, some of these things, but we can actually, if we understand these concepts, be really intentional and targeted and have kind of like a little hidden agenda in the back of our minds, as we are goofing around with our kids to try to actually tap into some of these, you know, regulation systems. And maybe, maybe it would start with talking about like the hidden senses, the secret senses that I bet most people have never heard about. Cuz we don’t have just five senses. We have more.

Laura (22:50):

That’s right. Surprise bonus. We have eight senses. There are three hidden senses that is not talked about unless you speak to an OT. And actually PTs know a lot about all of the sensory systems as well. So, yeah, so let’s just talk about the three hidden senses. So aside from sight smell, sound, touch and taste. We have the vestibular system and the vestibular system is the system that’s gets activated every time your head is moving. So when I say head moving, like moving through space, meaning you like running or swinging. Or even if we’re just sitting here and we tilt our heads back and forth, do a big circle every time our head is upside down that is activating your vestibular system. In fact, if you close your eyes and your head is tilted one way and you thought about it, like, you know, your head is directly in this position because your vestibular system is telling your brain, this is the position of your head right now, it gets activated. This sense contributes to your sense of balance, your posture. This contributes to developing bilateral coordination and a lot of gross motor skills. This is how kids feel secure enough to ride a bike or to climb a tower actually, because you need a lot of postural control. So that is one sense. The vestibular sense. And this is also gets activated when you feel dizzy when you, after you spin all of that. So the other hidden sense is the proprioceptive system. And if you have talked to OTs before, or you might have heard other people who are familiar with sensory, they might have called this heavy work. So heavy work is a way to provide your body with proprioceptive input. And those receptors. So the vestibular receptor are in your inner ear. Your proprioceptive receptors are all over your body, in your joints and muscles and tendons. So anytime you have active resistance to those muscles and tendons and joints, your proprioceptive receptors are activated. So right now, if everyone listening is like, if you push your hands together, or if you push against a wall that is proprioceptive input, that is direct input to your muscles and tendons and joints, you have a lot of proprioceptive receptors in your jaw, which is why chewing and sucking is highly regulating for kids. Sometimes you’ll see kids chewing on everything. Like not even just food they’ll chew on their sleeves, chew on the top of their pencils. That is proprioceptive input. The very cool thing about proprioceptive input. So again, it’s like lifting, carrying, pushing, jumping, chewing. The cool thing about proprioceptive input. It is an inherently regulating input to all sensory profiles, to all nervous systems, which is rare because you’ll hear me talk about the other senses and you can typically be like hypersensitive to it or you could seek more of it. Proprioceptive input is rare. And I talk about this. I have, haven’t seen it documented of a child who is hypersensitive to isolated proprioceptive input because the proprioception system is, is really integrated with vestibular and the touch system. Cuz you kind of mix both, but I have never worked with a kid who couldn’t joint compressions, that they were doing themselves. Right. If it was, they didn’t like joint compressions, it was like, they didn’t like the other person touching them, which was their tactile system. But proprioceptive heavy work is universally regulating.

Dr. Sarah (26:43):

Yeah. It makes me think of, did you ever see the documentary about Temple Grandin or the movie about Temple Grandin?

Laura (26:50):

Oh, like in grad school, but it’s very fuzzy to me.

Dr. Sarah (26:52):

She created. So if you’ve never heard of this, Claire Danes played her in a HBO remake, a movie about her. It was amazing movie. I love it. This is a woman, a real woman. Temple Grandin is a real woman. She has autism. And when she was in college, she created, she called it the hug machine. Like, because she didn’t like to be touched, but she liked that proprioceptive input. And so she created a, she’s an engineer. Like this is what she does. She has like this, you know, svante capacity to engineer things. And she would, she created this machine that would like squeeze her to help her regulate. So she needed it whenever she would get agitated, which was often, she was very easily dysregulated and she would get in her hug machine and it would squeeze her and she like calmed down. And so I dunno, that just played in my head right now.

Laura (27:43):

That is exactly proprioceptive input. And it’s universally regulating. So we’ll talk about some ways and that definitely contributes to what we’re gonna talk about and preparing the nervous system to wind down for bed. And then the last sense is the interception sense, which I’m sure you are probably the most familiar with. If you’re looking at this from a clinical psychology perspective, because it connects a lot with the emotions and this is your internal, your internal sensations. So this is what you become aware of when your heart is racing really, really fast or your internal body temperature or those butterflies in your tummy or when you have to go to the bathroom or if you’re full or if you’re hungry. All of those internal states of sensation is, is a part of interception. And so when we use like mindfulness techniques and meditation techniques, you are targeting the interception sense and learning how to regulate the interception sense.

Dr. Sarah (28:43):

That is a really helpful breakdown of all these. And I would be very curious if people have heard of these before, like, you know, this is, I, I say, I joke that they’re hidden, but I think, you know, a lot of people don’t, I didn’t even know about all of this. They didn’t teach to me in graduate school.

Laura (28:59):

Oh no. Yeah. They’re hidden. But they play such an integral role in like everything in development for sure. Like everything.

Dr. Sarah (29:08):

Right? And that’s why I think that like the work that I do with families and the work that a lot of occupational therapists do are so complimentary because they actually really talk about this integrated. Like they integrate these sensory things. And like parents who come to me to be like, I, my kid keeps melting down and then I’m losing it. And I don’t how to, like the things that if you are a parent who wants to understand how to reduce your child’s tantrums or help not have them yourself when your kid is melting, like how to not lose it with your kid, cuz we do it’s proprioceptive and interceptive work. It’s like, how do I calm my nervous system down or support my child and calming their nervous system down. Some of it is what do we do beforehand? Like a lot of this is like preemptive work, which is why I think things like rough and tumble play or heavy work or like dance parties with our kids. You know, I like, I always say like, I often joke how like, okay, we build in all these times for feeding our kids food and snacks because we like wanna stay ahead of the hangar. And it’s like, we need to kind of prophylactically or preventatively regulate our kids nervous system, like every couple hours.To get ahead of the dysregulation. Like you don’t have to wait for that meltdown to regulate.

Laura (30:37):

Exactly. I say that all the time, especially for sensory seekers, I will tell it’s better to proactively feed their nervous system so that they’re not hangry. Like when you’re hangry and you eat like the most unhealthy thing because you’re starving and instead, and rather than eating, like every, like through intermittently throughout the day, you might make a more healthy, balanced choice for yourself rather than waiting until you’re very, very hangry. Same thing with sensory seek you wait till the end of the day. And they tend to be more rambunctious, more hyperactive and in a way where you can’t even get through to them to redirect that energy to something more regulated it’s too, they’re too far gone at that point. So you need to proactively feed them. And what I also, like what you said is talking about when we’re talking about meltdowns and support them with heavy work. A lot of it does come before when I coach parents about handling meltdowns, I break it down in four phases. I talk about before the meltdown during, after, and between meltdowns. And so that between meltdowns is where like all the work happens, but I consider it when you have a child who like has meltdowns often, like I say, I live life between meltdowns. Like I’m just, there’s another one coming tomorrow or maybe later tonight. And so the work that I do now will like later Laura will like thank me. Or like later Laura will be really mad at me if I don’t do this like right now. So it’s, those are the four phases that I talk about for meltdowns. It’s really helpful to think about it that way.

Dr. Sarah (32:04):

Yes it is. And I teach a very similar thing. I talk about like, you know, in the middle of it, we got a couple options. Really. We could, co-regulation is our best bet discipline and teaching and all that stuff. I always put that in the, in the after or the, in between. And I call it like the debrief, like there’s time, you do that stuff, but you don’t do it, you don’t do it in the heat of the moment. You don’t even do it immediately after, unless it was a quickie and they calm down pretty fast and they’re back to regulation fast. Then maybe you can do it cuz there’s, you know, there’s small dysregulation moments. And then there are massive meltdown dysregulation moments. And so like the bigger, the meltdown, the longer the space in between the debrief and the actual event.

Laura (32:54):

Yep. Agree.

Dr. Sarah (32:56):

So, okay. If we are thinking about all this proprioceptive and interceptive work, vestibular work, and we’re thinking about wanting to in the, in between space help kind of preemptively regulate our kids’ nervous system. What are some things that we can do? What are some things that you might be able to do in your home with your kids? That’s playful and fun, but will actually serve dual purposes.

Laura (33:24):

Yes. So I will share some of my favorite strategies to provide this, this input, but I want to preface it by saying every child’s nervous system is different. So what might be regulating to child a might only like not be regulating to child B, but might be like dysregulating to child B. So you have to truly know your child’s sensory patterns and how they respond with or without an actual sensory disorder. Everybody has sensory quirks and every child will be regulated or dysregulated by something different. So you don’t have to think like, well, my child doesn’t have a SPD no, all children will respond differently to, to these types of sensory input. So definitely just keep that in mind. Some of this might not work, so I will share, first, I guess I just want to reiterate what it means to be regulated and what you should look for. So then you can kind of like monitor those things. Right. So when we talk about being regulated and when we talk about your nervous system, I realized lately I say nervous system a lot, and I never fully, like just told people like that just means brain. Your nervous system is your brain. Right. And so when your brain is regulated, then you are able to have more calm like grounded behavior on the outside. So this looks like having a regular breath rate, having a normal or regular tone and volume of voice being able, like follow a conversation or follow instruction within age limits, or, you know, developmental norms for your child and be able to have like a body that’s like in control. So they are in control of their actions. And when we’re talking about getting ready for bed, you definitely want a nervous system, a brain that is in this regulated state. So they can eventually relax and go to sleep turn off everything. Right. If you are dysregulated, some common signs that you could see is like dilated pupils. So this happens a lot when, for my daughter’s meltdowns, I can instantly tell it is she’s like a different person. When you look in her eyes, dilated pupils, faster, heart rate, faster breathing, usually louder voice. It doesn’t have to be screaming. It could be like uncontrollable laughter, which is another sign of dysregulation. Sometimes we see kids spinning on swings and they’re laughing, laughing, laughing, laughing, and we think it’s so fun. And they like it and we keep spinning them. And then sometimes they will like vomit or have a headache cuz they didn’t know it was enough. And their laughter was really dysregulation. So high pitched loud volume of voice typically can be dysregulation that really like hyperactivity to the point where they’re like uncontrollable. And like they’re not listening to your instruction, like stop spinning. And they’re just not listening. They might like speaking gibberish or just like not making sense and not even like fully processing what you’re telling them. If you’re giving them an instruction. Those are all signs of dysregulation and body moving really fast and really out of control. Again, whether that’s an angry body movement, whether that’s a hyperactive, silly, there’s a lot of different emotions that can be associated with dysregulation. But the point is that you are not really in control of your body when you’re dysregulated. Um so when we’re thinking of these activities to do we wanna try to get them, move them towards regulation. That calm regulated breath rate, regulated heart rate indoor, I say indoor voices, but just like regular volume of voice, not something too loud, not something too like past like high threshold type, like movements and motions and things like that.

Laura (37:19):

One of my favorite ways to integrate, I like to whatever heavy work that we talk about in the evening routine or really within any daily routine, but particularly around bedtime is integrating these heavy work activities throughout your bedtime routine. And one of the best ways to do that is through like what I call like animal walks, right? So like anytime you are bearing weight through your hands, like crawling or like feet by jumping you are providing proprioceptive inputs. So animal walks are a great way to do this. So crawling like a bear, crab walking stomping, like a dinosaur, all of those things. If you can have like a different animal walk through each room of the house. So after dinner, push your chair and then hop like a frog to the bathroom to take a bath after the bath. Now you’re gonna stomp like a dinosaur to your room. After you put your clothes on, then we’re gonna crab walk to the bed. So all of those little bits of motions and different ways to transition not only will help your overall evening routine be much smoother because it’s gonna be more fun. Especially for kids who avoid bedtime, but you’re going to be feeding their nervous system with regulating heavy work input. You can also add in some, like one of my favorite ways is like cleaning up. The cleaning up is usually having to ha you usually have to clean up right before bedtime or leading into bathtime. If there’s toys around, this is a great way to add in heavy work. They can, you can have them pick up all of the blue blocks first and then hop like a bunny to throw it in the basket. You can have them grab puzzle pieces to clean up and log roll across the floor. When I say log roll, think of your body, like a log straight line on the floor. And you are just making your whole body roll in one direction to go put it in a basket, roll back the other way and grab it. That is providing you full body touch input, or we call tactile. It’s providing you vestibular input through spinning and it’s providing you proprioceptive input. So that’s like a full integrative thing. Again, making sure your child doesn’t get dysregulated from a lot of the spinning. You can also have just some more like calming heavy work input, like right before bed. When you’re reading them a book or after the book, just like even gentle body squeezes is what we call it. And if you take your hands, your, the your hands and you are kind of just like giving their body like squeezes on their shoulders, squeeze their arms, squeeze their wrists.

Laura (39:53):

You could squeeze their legs. Their knees, their feet, their toes. If they like that, those just like squeezes throughout their body is direct input to their muscles and tendons and joints without having your child have to do like big motions. Right? So that’s a great one to do, like right when they’re already in bed and that physical touch, that close touch. If they like it, if they like cuddling, is a great way to connect in providing them that heavy work input, some kids will like jumping. Jumping is one of the ones where I stress some kids. Because this can also be a time where it might be dysregulating for your child depending on their sensory profile. So you talked about dance parties. If you’re like dancing and jumping, that’s a great way to be silly, to connect with them, to have a familiar song and rhythm to dance to which can be regulating. Um so that’s a great way to do it, but what I would recommend for parents who know their children like to jump, but you don’t want them to get dysregulated. My best tip is to adapt the environment. So try to do it with lights off or like dim lights, not quite like the brightest light in that room. So if you have a nightlight, maybe do dance party with like the lights off, which is a cool thing.

Dr. Sarah (41:10):

Yeah. Like a disco.

Laura (41:11):

A disco. The other part is incorporating a start and stop component. So like almost a freeze dance. What that does is then that’s starting to pull in a little bit of that frontal lobe to inhibit some of your motion, your like actions to start and stop. When you hear the music, it’s getting their body to stop and process the vestibular input and all that their body is already getting so that it doesn’t get too far past. Cuz a lot of times what happens is when we do these high intensity or like non-start and stop activities where it’s just like keeps going. Some kids, even if they seek a lot of this input and they really like, it will easily get even more dysregulated cuz they don’t have enough time to like realize, oh I’ve had my fill of sensory. It’s like when you stuff yourself too much. And you’re like, I should not have had like those last three bites now I’m like paying for it. It’s the exact same thing. So when you facilitate a start and stop by, you know, turning off the music or if you do like, they jump and crash into pillows, but like you jump and crash to find like every time you find three blue things in the room, then you can jump again, some start and stop structure.

Dr. Sarah (42:24):

Right. So you’re kinda activating their frontal lobes, making them solve problems, making them do something interrupts, like bookends, the physical activity.

Laura (42:35):

Yeah. Gives them something focused and structured. So it really like slows them down while they’re still getting the input so that we can mitigate the chance that they might get like way too far gone. So it slows it down, but they’re still getting the input at the same time. Cuz remember we do wanna still make sure that they’re not like so much like aerobic activity with like your heart is pounding. Like and then like, okay, go to sleep. So these are, but like you said, some kids really do like that jumping input. So I would try to add it in a way where, anytime you can sort something in the environment, you can count things. You can point things out, start and stop with music, start and stop with like red light green light instructions. You could be like red light means lay on the floor. Yellow light means hop like a bunny,y green light means stomp in place. And so you’re just like green light, red light. They’re having to switch and listen to the instructions and the rules still getting the movement, but it’s a little bit more regulated and structured and they’re in a much better place to be like, all right. Red light means done. Like we’re all stopped, like time to go. Like let’s switch to the next activity they’re already kind of in that mode of stillness.

Dr. Sarah (43:47):

Yes. I think that’s helpful for transitioning out of. And so like, it’s funny cuz like, so I have talked about rough and tumble play, which is different than heavy work. But it’s similar in that it’s very physical. There’s a lot of, there is a lot of proprioceptive input and vestibular input in rough and tumble play. But I get like, I remember talking about rough and tumble play as something that parents are actually maybe could do around bedtime to help children release some of that pent up energy that’s been building up in their bodies throughout the day. Again, obviously you’ve gotta know your kid. You have to know like if you’ve got a kid who, you know, gets amped up very easily and takes a long time to return to baseline, then doing this right before, bed’s probably not the best timing. Can you move it up, maybe do a dance party before dinner or rough and tumble play before dinner. But this idea that in the evening time having some dedicated space for like exerting and releasing and being very big and active in our movements. And it’s funny cuz I had talked about that and I got so many dads being like, see, I told you I’m allowed to rough and tumble play with my kids before bed because, and cuz notoriously, I think as a society and this is completely an overgeneralization, but I think we have this idea of like the dads wanna wrestle at night and the moms are like, you can’t wrestle, you’re riling them up. Like, we need to be quiet and peaceful and come. And I think, you know, yes, we wanna be intentional, intentional with the function of our, you know, big actions and movement and play at bedtime or in the evening hours.

Laura (45:34):

Yes.

Dr. Sarah (45:34):

But I also think parents maybe, you know, depending of course on your kid, like it’s allowed, it’s okay. Like, you know, we can, we can mess around and play around and get goofy with our kids. We don’t have to have like Zen and kumbaya the whole evening. And like we have to whisper and dim the lights, like that might for some kids you might actually have to do that. But I think there’s a lot of research that has shown that rough and tumble play, especially with fathers is associated with a ton of emotional learning. And there’s a lot of like impulse inhibition that they learn there’s social cues and actually emotion regulation, like especially around aggression cues that they learn. And so it’s, it’s good. It’s helpful. I mean again, like you need to know how much can I give, how much can I do with my child before I give them the runway, they need to come back down so that we can have a transition to bed where they’re not like still bouncing off the walls.

Laura (46:49):

Yeah. And that’s, yeah, that makes so much sense. And I, it happens in my house too, where my daughter and my husband love to rough and tumble play. And it’s, it’s not, I don’t think that it riles her up, like it’s fine for her. She can tolerate it. It’s just not a way that I like to play. And it’s almost a thing where I see it and I just like, it almost like triggers me seeing too much movement at that late at night. I’m like, you guys do what you do. I know that’s how they connect. I think that’s also important to have different ways of playing and for your child to know when they need that or they want that. Then they can seek that from that parent. And that is a form of self-regulation if you know the rough and tumble play with dad or whoever, whichever caregiver does that rough and tumble play with you, if you know, that makes you feel good inside and you like it. And then one Saturday you’re feeling some type of way. And you’re just like, I really need that again. Oh yeah. I remember that caregiver does this. So I’m gonna ask them for that. And that could be a sensory strategy that they can pull out from their toolbox and say like I needed that. That makes my body feel something that I need right now. So that is a form of self-regulation if they can identify it. And I think that, like you said, it matters, it’s gonna depend on each household. If it’s, if every time your husband or your partner or whoever does a rough and tumble play in your house, if after every time there’s an issue with going to bed, then yeah. It’s probably not a good thing to do right before bed. Even though your child is asking for it, even though that caregiver, that’s their one time to do this with them because they just got home and they really want to. I would say, look, our track record is showing us that this is not a great thing to do right before bed. It needs to change or we need to do it at the different time. Only on the weekends. Maybe not on a school night. But if there is no, if you’re not having a bedtime issue with your child going to bed then a hundred percent keep that in your bedtime routine, it’s working for you. And there’s nothing wrong with that.

Dr. Sarah (48:44):

Yeah. And I always say like, you know, bedtime routines and at least in my house take a long time. They like, they really start like as soon as dinner’s over in my head, that’s like the wind down to bed and in our family does include a dance party. That’s like the one way I get my kids to even come upstairs to get ready for bed is like, all right, we’re gonna do a dance party.

Laura (49:05):

Do you do like three songs?

Dr. Sarah (49:08):

Yeah, like three or four songs. I love the, we actually definitely do. I didn’t even think about this, that the, but we do freeze dance a lot and that’s been helpful. I didn’t realize it was, it makes so much sense now that I think about it.

Laura (49:19):

I also think that finding the rhythm and clapping to it has a regulating component. Right. Unless, I mean, and again, this isn’t even addressing the fact that there are some kids who are auditory sensitive of which definitely like the extra sound before bed.

Dr. Sarah (49:33):

Yeah. Doesn’t work for that.

Laura (49:34):

But I was also thinking if someone wants to try this and your child loves it, then you might even pick four songs. But like maybe the last two are slower in tempo, right? So it can come closer. Like you’re slowing your body. You’re still like clapping to the beat, but maybe it’s more of like a ballad or something that it you’re just all singing to. Like sitting and singing with like a pretend microphone. Like there’s so many cute ways to do it. But I think that if you want to keep in mind to the regulation piece and you wanna try this and you could definitely like transition to like slower pace songs towards the end which would be really cool.

Dr. Sarah (50:06):

And then we also have a closing ritual. So that also helps them like kind of transition. We roll them and it’s, I pulled it straight from an OT playbook, but it’s like, I do, we do burrito rollups. So we roll them up in. So they like to, they have this cute little thing. They both have these blankets and they bring them into our bedroom and they lay them out on the floor, like a dance floor. So they each have their blanket that they like to dance on. And then after we’re done, we roll them up in their blankets, like a burrito. And we push on them with all the toppings and we sprinkle hot sauce on them. And then we joke that we’re eating them, but we’re doing that to like release a little bit, like to give that proprioceptive input. Right. A lot of times during the dancing I’ll pick them and dip them. Um I will swing them and like toss them onto the bed. Like I’m doing things intentionally to kind of get that different types of sensory input. And then we sort of have this ritual where we kind of close the dance party in the same way every time. So it’s like a cue then. And like, again, like you talked at the beginning, like a lot of this work is about slowly and repeatedly creating these neural pathways. Right. These associations, this mind and body associations. And so when we have these, like the dance party ends with the burrito roll up, there’s like this neural cue. And now we’re transitioning out of it.

Laura (51:26):

It’s a context. Yeah. And they’re, it helps them before bed. So what I like to, well, I’m curious, did you, did you start that routine as a solution to like bedtime battles? Like, did you do that or have you just like, did you just like always want this kind of like routine before bed?

Dr. Sarah (51:44):

It was less of a bedtime battle and more of a get upstairs incentive cuz it was like, we couldn’t end, we had a hard time kind of ending dinner and transitioning up to get, to start the bedtime routine. So this was, it started off as like, okay guys, if we go upstairs and brush our teeth and get our jammies on quickly we could have a dance party. And then that turned into this like, oh wait, if we’re doing this dance party, like what are some ways I can sneak in little regulatory moments with them.

Laura (52:19):

Right. Yeah. I love that because it’s so funny cuz I hear a lot of like, I will suggest something similar, not always a dance party, but some sort of like exciting activity to get the child primed and ready to like transition to the bathroom, to do the whole like bedtime routine. And then I almost always, especially when parents are like new in their journey, I almost always will get a parent that is like, well, I don’t really wanna do all that. I just want them to like, why can’t they just like do it? Like why can’t they just listen? I don’t want to put on a puppet show. I don’t wanna do a silly dance. Like they should just do it. I’m like, I know they should, but, but you’re here sitting in front of me right now because it’s not working. So your child is not there yet. And they are needing a little bit extra energy. And I will say like, how long are you spending, battling your child before bed or trying to negotiate them? They’re like probably like 20, 30 minutes. And I’m like, it will probably take you like five minutes to add an extra story or to do a dance party or to wheelbarrow walk to the bathroom. I’m like, I know you don’t feel in the mood cuz I 110% get that. I’m like that as well. But if you’re looking at which way, you’d rather spend your energy right now, it’s not an option to just have a robot kid who you tell to get in the bathroom, they’re gonna get in the bath right now. Your child is having a hard time making that transition. So you can go through these power struggles, 20, 30 minutes, or you could spend five, 10, 15 minutes doing something else that, yes, takes like a lot of energy. It’s not easy. But maybe build more connections, more pathways to better associations and will help you long term down the road. So that’s the way I like to reframe it.

Dr. Sarah (53:57):

Yes. And I think a key piece here too is like the, you know, one of the reasons why our dance parties are successful, I do believe is for the sort of sensory input and the regulation component that come with it and just the release of the pent up energy from the day. But the other piece that you bring up is the connection. Like it’s because we are there, we’re bonding, we’re paying attention to them. You know, often, some, most of the time, our phones are not in the room. You know, sometimes I get on my phone during the dance party. Like I won’t lie, I’m like good they’re dancing. I’m gonna just check my email real quick.

Laura (54:30):

Same, same.

Dr. Sarah (54:31):

But, they’re quick to be like, mommy, put your phone down, dance with us. So like, but that’s the goal too, is like the connection. And then that fill up, that connected fill up time, right before bed helps with the separation.

Laura (54:44):

The separation. Exactly.

Dr. Sarah (54:46):

So that taps into a very different issue, which isn’t really about nervous system regulation. But that separation.

Laura (54:52):

It’s a big piece for some parents, for some kids.

Dr. Sarah (54:54):

Yeah. Going to bed is a big goodbye for kids. It’s very hard. And so when your kids struggle with separation, I also think that this is a healthy strategy because yes, it’s regulating. So it’s gonna help them just feel less anxious in their bodies. But also when they do feel, like when, when they feel filled up by you, it’s, it’s a little bit easier for them to tolerate this, the goodbye.

Laura (55:22):

Yeah. Yeah. That’s a great point.

Dr. Sarah (55:26):

So I mean, this was incredibly informative for me too. Like, I really love talking to you about the like intricacies of occupational therapy. I think this is really helpful for people who maybe aren’t, you know, this is a new idea for them as a resource. And so thank you so much for coming on and sharing all this with us.

Laura (55:46):

I am happy to do it. I could talk for hours and hours and hours. I always try to stop myself, like too much info, Laura, too much info, but like, it’s so good. And I want parents to hear it. So thank you for offering this space.

Dr. Sarah (55:57):

It’s so good. Yes. If people wanna like connect with you or learn more about the work that you do or get in touch with occupational therapists, like what can they, what, where should they go?

Laura (56:09):

Yes. So I am hanging out on Instagram all the time @theotbutterfly and I’m pretty, I post content on there a lot. I share a lot of my behind the scenes, my most vulnerable moments. I am not shy to share because I feel like I connect with so many parents on the internet versus like in real life friends in a weird way. So I share a lot of that there on Instagram. I have my own podcast, which is called Sensory W.I.S.E. Solutions Podcast for Parents. You can search that or you can just go to TheOTbutterfly.com/podcast. And you can just check out my website while you’re there too at theotbutterfly.com. And you can find all of my services I offer. I have some courses, I have some guides. I have a lot of free downloads for parents. So it’s all there for you.

Dr. Sarah (56:56):

Amazing. Well, thank you so much, Laura, and let’s definitely talk again soon.

Laura (57:01):

Yes. I’m happy to talk any time you want.

Dr. Sarah (57:09):If tantrums are a frequent occurrence in your house, or if you just wanna learn the best ways to approach your child’s dysregulation in a way that also supports their development, mental health and their relationship with you, check out The Science of Tantrums. It’s a two and a half hour video crash course in all things tantrums, strategically split into six short sections, so you can break it up however, is most convenient for you. Plus a companion workbook will help you adapt these strategies to fit your unique child and apply them into your own life right away. This is a framework that not only to teaches you how to stop tantrums, but it teaches you the brain science of exactly what is happening inside your child’s brain and body when they’re melting down. So you not only have the tools, but you know exactly how to adapt them to your own child in any situation you find yourself in. If you want to learn to reduce the frequency, duration and intensity of tantrum, go to drsarahbren.com/tantrums, or if you’re scrolling through Instagram as you listen to this, just click the link in my bio to sign up and learn more. Thanks for listening this week. And don’t be a stranger.

49. Supporting our children’s emotional regulation and sensory processing experiences: With occupational therapist Laura Petix

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