Photo: Xavier Mouton Photographie

This week, continuing and building on the last podcast on The Foundation for Regulation, speech and language pathologist Amanda Binns joins us to discuss her new publication from the Journal of Communication Disorders, “The speech-language pathologist’s role in supporting the development of self-regulation: A review and tutorial” co-authored with Lynda Hutchinson and Janis Oram Cardy. Amanda is a DIR Expert Training Leader with the Interdisciplinary Council on Development and Learning. She is currently working on her PhD in Communication Disorders at Western University and is a facilitator for Dr. Stuart Shanker’s Self-Reg process.

Amanda Binns has worked with the Developmental, Individual differences, Relationship-based (DIR) model for a number of years now and was one of the speech and language pathologists in the study at York University that gained Floortime so much attention in Canada in 2012. Her latest co-authored publication aims to bring a framework to speech and language pathologists (SLPs) to not only understand self-regulation, but to provide strategies that allow them to incorporate self-regulation into their work. This publication is also very helpful to other professionals and parents as well.

Amanda has seen the DIR model help support all children she’s worked with and during her years of work, the term self-regulation seemed to only be a concept discussed in the developmental community. It has since become more recognized, even appearing as a category on school report cards. However, how self-regulation is defined differs greatly, as pointed out by Jeremy Burman in his co-authored paper with Christopher Green and Stuart Shanker. Amanda wanted to take a look at this, and put SLPs on the same page about how they define self-regulation and use it to support communication.

Self-Regulation

The three authors looked at the goals of self-regulation. It helps children attend to and learn from the social interactions that they’re engaged in, which is so important to the development of communication. Self-regulation helps children work towards achieving academic and personal goals. It also helps to develop empathy and acting in socially responsible and caring ways. They kept all of these ideas in mind in developing the framework. But they also wanted the readers to understand how self-regulation develops, so that the framework makes sense.

Self-regulation develops through co-regulated interactions. This is backed up by a large body of empirical research. In order to self-regulate (recognize, monitor, and manage your internal stress levels, emotions, etc.) you need to have executive functions which develops much later. Children’s pre-frontal cortex doesn’t develop until adolescence so we need to start with co-regulation (how people regulate each other’s behaviour).

When we first start co-regulating children, the adult takes on the bulk of the work. It’s not about what you say. The child picks up on the tone of your voice, the intonation you use, and it doesn’t even matter what you’re saying as much as how you’re saying. When we say “It’s ok“, we are diminishing a child’s reality. We really mean “I want you to be ok.” In order to co-regulate, we want to be attuned to the child’s level of stress. Similar to Self-Reg, the paper sees stress as impacting systems integral to regulation. Eunice Lee discussed with us how we want to be proactive and look for the signs of dysregulation. We want to pick up on the stress before we hit the tipping point.

It’s much easier to co-regulate at that moment rather than waiting until the child is completely alarmed. We also need to check in on our own states so that we remain regulated ourselves. In the publication, Figure 1 outlines the paper’s framework for how to think about supporting a child’s self-regulation as just described. There are a number of other strategies listed in the paper in Table 2. It’s a dance of trial and error to help the child feel safe and regulated, especially when children cannot communicate their stressors to us. As the child becomes more engaged in the co-regulated interactions, co-regulation becomes more balanced towards socially-shared interactions.

Walking Through an Example

Amanda gives an example of visiting a child in a classroom setting. She might have a report from an occupational therapist that says the child has sensory sensitivities. She would start by observing the child in different contexts: at school, one-on-one, and at recess, for example. Next, she’d look at quieting the environment for the child, and think about how staff are supporting the child’s interactions.

The child might be more dysregulated during math, a very cognitively taxing time, for example. So Amanda might suggest using simplified language or visuals to help the child understand the concepts being taught. Before moving on to the next step, she always wants to make sure the child is developmentally ready for the next step, which involves executive functioning and meta-cognitive skills. The end of the publication features a few very helpful case examples of applying the framework.

A Developmental Approach

Amanda’s example highlights the developmental approach. I pointed out that many people might think of an SLP working on articulation and speech production, but she supports the development of communication as a whole. Even when working on speech production, though, Amanda focuses on the child being able to generalize what they learn. The child needs to have the meta-cognitive ability to reflect on what they learn in the speech and language session in order to generalize pronouncing “th“, for example.

For example, does the child recognize what it feels like to put their tongue between their teeth and to notice if they are doing it or not in a given moment? Working on supporting self-regulation at this level is a higher level where the SLP can then scaffold to support foundational skills. At this higher level Amanda would collaborate with the child to co-construct goals, checking in with their learning goals, asking what they want to work on next, when the child would like to work on the goal (at recess, in the classroom, etc.), and reflecting on what worked best and why, which helps them develop self-awareness that will allow them to carry over their skills to other situations. If the child is not there yet, we need to focus on the early social-emotional development as described here and here.

If you have any questions or comments for Amanda, you can reach her via the contact on the publication link. Thank you to Amanda Binns for taking the time to discuss the helpful and informative, reader-friendly publication with us and we hope you enjoyed hearing, watching and/or reading about it, and that you will use the framework and useful tables as a helpful guide yourself. Please share this podcast on Facebook and Twitter and leave us a related comment, question, or experience below.