Today Dr. Stuart Shanker speaks with us about how Self-Reg came about. Self-regulation is the first functional emotional developmental capacity in DIR/Floortime, and Dr. Shanker was the lead researcher on the DIR/Floortime brain research study. Dr. Shanker is the founder and Chief Executive Officer of the MEHRIT Centre. He is a Distinguished Research Professor Emeritus of Philosophy and Psychology at York University. He is also the Founder and Science Director of the Self Regulation Institute at Trent University in Peterborough, Ontario.

Self-Reg and DIR with Dr. Stuart Shanker

by Affect Autism

I first heard about Dr. Shanker a few months after our release from the hospital and just before our son’s imminent autism diagnosis. I was watching the national news in Canada and they were covering the DIR/Floortime brain research study done at York University. I contacted Dr. Shanker and he connected me with his team. From there, I was hooked on DIR/Floortime and went on to take the certificate courses at ICDL and eventually become ICDL’s Parent Advocate. So, Dr. Shanker is really the reason exists.

Meeting Dr. Stanley Greenspan

In 1997, Dr. Shanker read The Growth of the Mind by Dr. Stanley Greenspan then sent Dr. Greenspan a message about how it helped his team. They finally met in 1998 when Dr. Greenspan invited Dr. Shanker to a training class he was holding in Toronto. After the event, Dr. Shanker recalls that Dr. Greenspan grilled him in a way he hadn’t been since graduate school! A few days later, Dr. Greenspan called and asked if Dr. Shanker would like to be trained by him in child psychiatry. Dr. Shanker didn’t hesitate to accept the offer.

And so, Dr. Greenspan trained Dr. Shanker in the same way that Erik Erikson had trained him. They trained 7 days per week for one to four hours each day for almost five years, which involved many readings and clinical work. A few years in, since both Dr. Greenspan and Dr. Shanker had been interested in a universal program for children, they launched a project they called Building Healthy Minds. They trained physicians in Bethesda, MD in what today is essentially self-reg, but it wasn’t going well because the pediatricians were too busy and didn’t see their patients frequently enough to have the desired impact.

Dr. Shanker was then approached by Canadian philanthropist Milt Harris who was familiar with Dr. Shanker’s work and whose friend’s son had been “saved by Stanley“. This lead to him funding the randomized, controlled trial study of DIR/Floortime that eventually began in 2005 and went until 2012. It was a big project as they had to work with therapists who were not trained in DIR/Floortime to show it was the Developmental, Individual differences, Relationship-based (DIR) approach and not their experience that was the contributing factor to favourable results.

The goal of the MEHRI (Milt and Ethel Harris Research Initiative) study was to work with children, all diagnosed on the autism spectrum, who appeared to have considerable difficulty engaging with their caregivers. By identifying and reducing their stress and building in restorative practices, they wanted to see if they could get the children to be able to engage with, and enjoy interacting with their caregivers.

The History of Self-Reg
Some years ago, Dr. Shanker was working on an early childhood development council across Canada with Dr. Fraser Mustard. They were alarmed by the explosion of problems they were seeing in children, namely a dramatic increase in anxiety. Educators didn’t realize the symptoms of anxiety and were exacerbating the problem. So Dr. Shanker went back to the aforementioned original universal idea and this time, instead of working with physicians, he decided to work with teachers in a school-based initiative.

The first two stages in the DIR model are the heart of Self-Reg: regulation and engagement. But there are also big differences between Self-Reg and DIR. The Developmental, Individual differences, Relationship-based (DIR) model was explicitly developed for children who struggle with back-and-forth interactions, and reflective and logical thinking, but that’s not the group of kids Dr. Shanker was looking at in the school system. These were kids who were able to hold conversations and distinguish between reality and fantasy, but who were having serious problems with attention, behaviour, and mood. Dr. Shanker wanted to expand the platform for all children.

With the new initiative, Dr. Shanker was worried about regulation and the kinds of things they were seeing happening in school. In Self-Reg, they talk about reframing. Very antiquated biases can affect how you see a child and how you respond to a child. They are self-conscious and they leak out in tone of voice, facial expressions, etc. Dr. Shanker gives an example of his own experience with his son who is on the spectrum. He found himself snapping at him even though he knew his son was not misbehaving. Despite making a very conscious attempt not to snap, if his son did something Dr. Shanker found irritating, it would leak out.

When a child or a teen is in flight or flight, what they hear is limbic cues (i.e., what look is in your eyes or other non-verbal language). They don’t process what you’re saying, just what they’re seeing. In those moments, you can’t change what you feel through will power. It’s when you understand and see what’s happening with the child that your own anxiety and tension disappears and only then are you calm. Then, the child can hear and feel that calmness. So it’s every bit as critical what the adult feels/understands/experiences as what the child does.

A lot of the families whom Dr. Shanker’s team met with had children who were being diagnosed or treated as if they had an attachment disorder where the child is very avoidant or resistant because the caregiver didn’t love the child. The hidden assumption was back to the ‘refridgerator Mom’ days. Dr. Shanker’s group pays attention to the interbrain–the wireless connection between child and adult. The interbrain is a brain-to-brain hook up. These were children whose caregivers were actually great at helping their children, and the children were securely attached with them. So what was going on?

Dr. Shanker called this fragile secure attachment. They were children who became very disorganized when they went to preschool or school because of the huge jump in stress. Maybe there were things taxing that child’s sensory system, or you could have a caregiver in the school environment who had not learned to tailor their interactions with that child. It’s up to the caregiver to read the child’s cues and adjust the stimulation to the child, but if the early educator wasn’t able to do that or didn’t have the resources to devote to that, Dr. Shanker’s team saw that the child would become disorganized. They also saw children who looked like they were on the spectrum simply because they were overly stressed.

Dr. Shanker says that we are raising a generation of kids who are overstressed. Much of this is made up of hidden stressors. A child will be spending two thirds of their time in school. The child develops defensive mechanisms at school to deal with these stressors, which changes their interactions with their parents and causes them to no longer feel safe at home either. This is why Dr. Shanker’s team wanted it to be a school-based initiative. Education has to nurture, not stress out a child.
What happens in school doesn’t stay in school.
Dr. Stuart Shanker

Stress behaviour versus misbehaviour

The Self-Reg concept of the interbrain reminded me of co-regulation in DIR/Floortime. But before we even begin to co-regulate, it’s about what we see: stress behaviour or misbehaviour?

I gave an example of how my son has been sticking his tongue out and spitting lately when he doesn’t want to do something. I pointed out that in Floortime we always want to think about the environment and what happened just before the child behaved in an unpleasant way, in this case referring to my son’s spitting.

If I think about what happens before our son spits, it is usually following something he doesn’t want to do, such as us saying it’s bedtime, that it’s time to brush his teeth, or that we have to leave a place he wants to stay at. With a son who is quite verbal, parents might wonder why he can’t just use his words instead of spitting, so I asked Dr. Shanker, “Why can’t he tell us, Dr. Shanker?” Dr. Shanker explained that at this moment he’s so hyperaroused and is in ‘red brain’.
The ‘blue brain’ provides the abilities to think, speak, and formulate ideas, but these abilities are suppressed by acute stress. So Dr. Shanker says that parents and teachers need to learn to speak ‘limbic’. My son is speaking in limbic communication which is incredibly meaningful in the moment where he’s spitting, or hitting at us.
It’s so serious because if you confuse stress behaviour for misbehaviour, you can do genuine harm and ruin a life. We have to work on getting educators to understand how to get this distinction, but also how to pick up the cues in advance. Sometimes kids tell you with their pupils. In red brain, their pupils go dilated. Dr. Greenspan used to say, “Listen with your eyes too” (not just your ears).
Dr. Shanker gave us an example of being called in to a school where a student whose family he knew was in a lot of trouble for continuing to say “I don’t care” to all of the adults in response to their attempts at controlling his behaviour. By the time Dr. Shanker arrived, the student was about to be expelled because he just kept repeating “I don’t care” and Dr. Shanker says that at this point, the teen’s ability to know what’s he was feeling had been incredibly compromised.

The ‘red brain’ was on. You know that because the tone of voice changes: he was actually communicating that he was scared, and that he really didn’t know what he’d done. He wasn’t at all communicating that he didn’t care, Dr. Shanker says. The vice principal couldn’t distinguish between misbehaviour and stress behaviour. The teen was in freeze. So Dr. Shanker turned off the lights, relaxed and just sat with the teenager. Even speech in that state is really stressful, so they just sat and ‘were‘ together.

Dr. Shanker just wanted to let the teen know and feel that he was safe with him, as they did know each other. As the teen’s alarm system gets turned off, the blue brain comes back on. After a few minutes of just sitting there, the boy asked Dr. Shanker if he liked bugatti racers. This indicated to Dr. Shanker that he was reaching out for social engagement.

Critics say that Self-Reg is advocating permissive teaching. No, we’re advocating keeping children safe. When the child is in a state to learn what they did wrong, we will address it. If you see the child’s behaviour as stress, you relax, your tension comes down, and you can transmit the affect cues that tell the child that (s)he is safe.

Dr. Stuart Shanker

Self-Reg starts with us

I asked Dr. Shanker what process really gets the parents and teachers to practice this new outlook. Certainly it’s necessary for the those who are firm in their behavioural stance that this approach is too lenient or not ‘teaching kids lessons’ when they misbehave. But I pointed out that in DIR, we also look at behaviour as a why and as communication. Yet, even knowing this approach cognitively, it can all go out the window when you are in the moment and can’t control how you react!

Dr. Shanker said it’s really just about making the shift from “I have to teach/educate this child how to behave” to lowering the child’s stress and then the misbehaviour disappears. Canadian developmental psychologist, Dr. Gordon Neufeld also says that when you look through the new lens, you see a different child. He also says having the strategies and tools of how to respond will help you in those tough moments. Dr. Shanker described the breakthrough that lead to his team figuring out how to inspire change in the adults they worked with to looking through this new lens.

At the MEHRIT centre when it wasn’t going very well, researcher Devin Casenhiser realized they needed a mental health expert to explore where the parents were at. Eunice Lee was hired and they only worked on the parents’ regulation. They started by asking the parents, “How much stress are you under? It’s very stressful to have a child on the spectrum.” Dr. Shanker says that was the turning point to seeing the parents being able to apply the DIR model.

Dr. Shanker says in Self-Reg, they made the same mistake when they started with teachers. They gave them all the information, but the teachers were coming to them with a behavioural management mindset of “Will self-reg give me a quiet classroom?

So Dr. Shanker’s team switched it entirely and started doing a ‘Self-Reg for you‘ approach. They would ask educators, “What are your stresses and what do you do about them?” He acknowledged that the stress load on educators is ridiculous.
Force instills only fear, not empathy. Empathy grows through the interbrain.
Dr. Stuart Shanker

Once educators learn how to take care of their own regulation, things begin to improve because it won’t work unless this is internalized and personally meaningful. Dr. Shanker gave the example of an administrator who found Self-Reg so helpful not just for stress at work, but as the cause of her struggles with her weight. Dr. George Chrousos has done a lot of research on stress and obesity, Dr. Shanker offered.
Look for the signs and pause
The Self-Reg team can then show educators that there are lots of signs of stress before we see this stress behaviour in children. In fact, we often do see the signs, but tend to ignore them and hope for the best. Dr. Shanker wants educators and parents to be able to identify the signs well before the stress behaviour in order to have a calming and regulating effect on the child. Otherwise, once you’re in the moment, all you can do is take a deep breath, then take another. It’s those steps leading up to it that are like a pressure cooker.

Dr. Shanker’s team uses the Thayer matrix to show low energy, high energy, low tension and high tension states. They want everyone to ask “Why?” and “Why now?” about stress behaviour. When we go red brain, we go into automatic mode. It doesn’t matter why or if you can figure out why, but you’re more interested in the pause. We don’t want the clash of fight or flight. It’s the pause between stimulus and response, Dr. Greenspan would say.

You can also teach kids to do ‘the pause’. Dr. Shanker’s son would get up at school and walk around when things were too much. He was self-regulating. The first time it happened everybody freaked out and it could have been treated like misbehaviour. But Dr. Shanker spoke with the principal and they were able to work it out. If you can show the child how to recognize the signs and then give them a solution, they can self-regulate. So Dr. Shanker told his son that whenever he got “that itchy feeling in his arms“, he could put his hand up in class and the teacher would give him permission to walk in the hallway until he was ready to return.

I asked Dr. Shanker what works for young children or even non-speaking children. He said that indeed you can describe things in a way like he did with his son (‘itchy arms’) and he has seen it work. In DIR, we want to help the child who is unable to self-regulate by co-regulating with them, with the hope they can do it themselves in time. Dr. Shanker points out that children and teens can often regress back in times of stress and require that co-regulating adult to help them get back into homeostasis and a calm state.

When you see a child through this new lens, you see a new child: a wonderful child. They all are. When you can start to release the alarm, I am always amazed at the child who comes out.
Dr. Stuart Shanker

It was a great joy to bring you some of the history of the Canadian DIR/Floortime study and Dr. Shanker’s relationship with Dr. Stanley Greenspan. More so, I enjoyed learning more about Self-Reg. If you enjoyed the podcast, please consider sharing it on Facebook or Twitter. If you have any comments or shared experiences, I hope you will share them in the Comments section below. Stay tuned for a follow-up podcast with social worker and Expert DIR Training Leader, Eunice Lee, on what Dr. Shanker said was the breakthrough in the DIR/Floortime study: turning their focus on the stress of the parents.

Until next time… here’s to affecting autism through playful interactions!

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