Self-regulation is the ability to maintain a level of alertness appropriate to a given activity. Adequate self-regulation is essential to the development of attention, regulation of sleep/wake cycles, and control of emotions, as well as the daily transitions that make up a child's routine. For example, a school-aged child may demonstrate an elevated level of alertness when playing a fast-paced game of chase on the school playground. Moments later, when that same child lines up to go back into the classroom, his/her body will move more slowly and deliberately, yet will still be alert and attentive—to the instructions of the recess monitor. This smooth transition between arousal states demonstrates adequate self-regulation.

From birth a child builds self-regulation skills through sensory experiences—rocking in his mother's arms, sucking on a pacifier, and so on. Initially, his/her strategies are limited to sensory/bodily inputs—a deep pressure from swaddling, rocking input, soft coos of his caregiver, or the rhythmic nature of his lullaby—but as a child develops, his/her strategies become more varied: "checking in" with his/her mother from across the room for reassurance, or hearing her voice telling him everything is all right. This represents an important jump in the developmental process: the child can use language rather than sensory or "body-on-body" input alone to self-regulate.

Children with sensory processing difficulties often have a difficult time making this transition away from bodily input as their main strategy for regulation. This could take the form of increased activity levels ("crashing" their bodies), increased oral-motor seeking (e.g. chewing clothing, writing utensils, etc), or increased aggressive behaviors. Underlying difficulties with sensory processing often also have a direct impact on a child's ability to self-regulate. Sensitivities to sound, movement, or other sensory input make it very difficult to attain and maintain the right level of regulation: the nervous system often reverts to "high alert" or "shutdown mode" in such situations.

An occupational therapist can promote self-regulation strategies by helping a child adapt to his/her various environments (e.g., home, school) and by providing sensory diet recommendations that enable a child's sensory system to better handle regulatory demands. Treatment of the underlying processing difficulties promotes better regulation skills overall.

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