Building the Foundation for Communication🔗

A great therapy session is a regulated therapy session. Clients cannot attend, learn, nor communicate if they are not regulated. Dysregulation can be caused by many factors, some including sensory overload (noises, touch, sounds), overwhelming demands, increasing cognitive load, changes in routine or difficulty in social situations.

Using a total communication approach is especially important when working with individuals who have increased sensitivities and are prone to dysregulation. This approach incorporates multiple forms of communication including verbal language, gestures, facial expressions, visual supports, and alternative communication methods. When communication is accessible, frustration often decreases, which can reduce the likelihood of dysregulation.

What does Dysregulation look like?🔗

• Intense emotional highs/low
• Increase behaviors which can include self-harm, physical harm, object destruction
• Stimming (vocal, visual, physical)
• Eloping

In these moments where a client is either dysregulated, or showing cues they are nearing a dysregulated state, modeling communication without expectation is important. For example, if you notice your client starting to become dysregulated, add language when possible. Being able to model this language can help in the future… ideally before dysregulation occurs. For instance, if you notice the client pulling away, becoming fidgety, or beginning to stim, you might model:

• “I don’t like this.”
• “Let’s do something else.”
• “I feel frustrated/sad/mad.”
• “Let’s play with preferred item.”

Our goal as speech therapists is to create space for meaningful communication opportunities. We can do that by honoring total communication and following our clients’ interests while ensuring a comfortable, regulating environment.

What Are Some Good, Basic Sensory Supplies to increase regulation? How can I model communication during these tasks?🔗

Handheld Massager🔗

• “I would like to stop.”
• “I would like more.”
• “More/stop.”
• “Up/down on arm/legs/head/back.”
• “Turn on/off.”
• “Help me.”

Tactile Squares🔗

• “The green square feels rough/soft.”
• “Feel it on your arm/leg/hand/face.”
• “More/stop on arm.”
• “I don’t like how this feels”

Music Toys🔗

• “Let’s listen.”
• “Let’s play.”
• “The music is too loud/quiet.”
• “I want a turn.”
• “Your turn.”
• “Go/stop.”

It is important to remember that modeling language without expectation both during times of regulation and during moments of dysregulation, can help provide clients with the words they may be searching for. When we consistently model calm, supportive language, we demonstrate how to express emotions, needs, and boundaries in an effective way. During regulated moments, this modeling builds skills and expands emotional vocabulary. During dysregulation, it offers clients accessible language when their own words may feel out of reach.

Written by Katie Fisher MS.,CCC-SLP