Emotion Regulation through Sensorimotor Tools and Exercises 1

Group Protocol:

Emotion Regulation through Sensorimotor Tools and Exercises

Tayler Stokes and Megan Wilson

University of Utah Department of Occupational and Recreational Therapies

Emotion Regulation through Sensorimotor Tools and Exercises 2

Rationale

One characteristic of autism spectrum disorder (ASD) is sensory processing difficulties.

Ismael, Lawson, and Hartwell (2008) did a systematic review examining the relationship

between sensory processing and occupational performance in individuals with autism spectrum

disorder (Ismael, Lawson, Hartwell 2008). Their results showed that sensory processing can have

a positive and a negative effect on involvement in everyday activities (Ismael, Lawson, Hartwell

2008). Meaningful occupations adolescents engage in include school, leisure activities, social

participation, and more. A child's inability to understand and process their sensory input

appropriately can make performing in these occupations difficult. We have created a group

protocol to help adolescents with autism learn essential skills that will help them regulate their

sensory input so they may participate fully in their daily occupations.

Our protocol includes sensory-based interventions, which are therapist directed

interventions that focus on a child's ability to self-regulate when their "arousal levels do not

match the requirements of the situation" (Brown, Steffen-Sanchez, Nicholson 2019). We believe

these interventions will best meet the population's sensory needs to ensure their success in

occupational participation, as evidenced by research in the occupational therapy literature. One

being a systematic review completed by May-Benson and Koomar (2010) that studied the effects

of sensory integration interventions for children. Their review included 27 different studies to

determine the efficacy of these programs (May-Benson and Koomar 2010). The results showed

that there may be a "positive" outcome on an individual's sensorimotor skills, behavior

regulation, and improvement of other skills necessary for engaging in meaningful activities

(May-Benson and Koomar 2010).

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Population

The population that this class is designed for are adolescents with moderate functioning

autism that have difficulty with processing sensory input and regulating emotions. To be able to

participate optimally, participants need to have intact communication skills in some form in

order to identify various emotions. Participants should also be able to tolerate sitting next to and

communicating with others in a group while maintaining appropriate behavior, for example, no

physical or behavioral outbursts.

Format

The group will be a closed group. As facilitators, we believe that each individual group

session has important skills that are needed to reach the goals for the group as a whole. The

beginning sessions teach base knowledge to help the other sessions be more effective. If an

individual comes halfway through, they miss out on foundational information. Although an

individual session would still be beneficial in regulating emotions, we feel that to be successful,

attending all sessions from the beginning would be best. Due to the population and activities

chosen, the group will work best with ten members and two facilitators.

Leadership

The leadership style that will be implemented for this group is facilitative leadership

style. A facilitative style is a client-centered approach that requires individuals to put forth effort

towards making decisions and reaching their goal but has help and guidance from the facilitator

when needed (Cole, 2018). These participants need to be able to come up with a large amount of

the information themselves. They will practice skills regarding individual application, running

activities, leading discussions, and answering questions. This leadership style will encourage the
Emotion Regulation through Sensorimotor Tools and Exercises 4

participants to put forth energy and effort while also having the proper amount of guidance and

direction.

Methods

Our group will include discussions, interactive activities, role-playing, games, and worksheets.

These activities will utilize concepts from Dunn’s Sensory Processing Model (Dunn, 2007),

Zones of Regulation (Kuypers, n.d.), and the Sensory Connections Program (Moore 2005).

Goals and Evaluation

By the end of ten weeks, participants will be able to:

1. Recognize when they are feeling over or under-stimulated.

2. Identify specific coping tools and mechanisms.

3. Successfully regulate their emotions when feeling over or under-stimulated.

They will demonstrate this by successfully role-playing situations and completing a pre-

and post-survey. In the last session, the participants will create a situation they may find

themselves in that will require them to use the self-regulation skills they have learned to manage

their sensory input. They will then play this situation out with the facilitators and other group

members. This will demonstrate their progress and knowledge in sensory regulation. The pre and

post-survey will be given at the beginning of session one and at the end of session ten. The

questions will ask the participants to circle how they feel (sad face, neutral face, happy face),

about their knowledge of emotions. It will also ask questions about how to deal with a difficult

situation requiring regulation of sensory input and emotions. Lastly, the survey will ask about

identifying and using a tool to help them regulate.

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Session Outline

The group will be ten sessions total, once a week for forty-five minutes, lasting ten weeks.

Session 1 Exploring the Seven Senses.

Description This session will teach the participants about what the seven senses are, why they

are important, and how they affect their lives. There will be seven activities, each exploring one

of the senses.

Objective By the end of the session, participants will be able to identify the seven senses and

how they relate to their emotions, using no more than two verbal prompts from the facilitator.

This session works towards long term goals number one and three.

Session 2 Types of Sensory Input,

Description This session will explore which of the four sensory categories the participants are,

using Dunn's sensory processing model (Dunn, 2007), adjusting the questions where needed.

Facilitators will discuss how the environment can be changed to help regulate sensory input and

emotions.

Objective By the end of the session, participants will demonstrate an understanding of their own

sensory needs by explaining what sensory category they are in and generalizing it to their life

with no more than two verbal prompts from facilitators. They will also demonstrate an

understanding of how the environment can play a role and what they can do to help. This session

works towards long term goals number one and three.

Session 3 What are Emotions?

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Description This session will be about teaching participants what emotions are using the zones

of regulation. Participants will learn about the zones and the emotions in each. They will then

play an emotions bingo game and discuss each emotion. Afterward, using a cootie catcher,

facilitators will tell stories of different situations the participants may find themselves in, and

they will describe the emotions felt by the characters.

Objective By the end of the session, participants will be able to recognize at least three emotions

and explain when they are appropriate using no more than two verbal prompts from facilitators.

This session works towards long term goals number one and three.

Session 4 Create a Sensory Toolbox

Description In this session the group will discuss what sensory tools are and how they can help

the individuals. Participants will decorate and personalize a "toolbox" to put sensory tools that

are created in subsequent group classes or ones they have at home.

Objective By the end of the session, participants will demonstrate an understanding of sensory

tools by naming at least two tools and what they can be used for using no more than two verbal

prompts from facilitators. This session works towards long term goals number two and three.

Session 5 Triggers, Warnings, Helps

Description This session will be about identifying stressful triggers, warning signs, and things

that personally help the individuals during difficult sensory situations. The participants will make

a list of each using worksheets from the sensory connections program. They will also create a

stress ball, or another tool of choice, to add to the toolbox.

Emotion Regulation through Sensorimotor Tools and Exercises 7

Objective By the end of the session, participants will be able to identify a trigger, a warning

sign, and one thing participants can do to regulate during times of stress using no more than two

verbal prompts from facilitators. This session works towards long term goals one, two and three.

Session 6 Calm versus Alert

Description This session will teach the participants what calmness and alertness are, what it feels

like, and when it is appropriate to feel either emotion. The participants will be able to practice

and continue to learn by playing the "in tune game" from the sensory connections program. Once

the participants are familiar with calm and alert, they will identify sensory tools that allow them

to feel calm and alert. They will then create both a calming and alerting sensory tool to add to

their sensory toolbox.

Objective By the end of the session, participants will demonstrate an understanding of what calm

and alert is by describing an appropriate time for each emotion along with identifying a self-

regulation sensory tool from their toolbox to facilitate that emotion using no more than two

verbal prompts from facilitators. This session works towards long term goals number one, two

and three.

Session 7 Creation Day

Description This session will give the opportunities time to explore different sensory tool ideas

and create them to add to their toolbox. Participants will be directed to discuss amongst each

other what tools help and don't help them to feel different emotions and why.

Objective By the end of the session, participants will have expanded their sensory toolbox and

explored others' feelings and sensory input preferences, along with differences in how they
Emotion Regulation through Sensorimotor Tools and Exercises 8

handle situations compared to themselves. This session works towards long term goals number

one, two and three.

Session 8 Non-tool Sensory Activities

Description This session will teach participants other tools they can use for self-regulation when

a physical, sensory tool isn't available or appropriate. They will do this by playing the "non-tool

game" from the sensory connections program.

Objective By the end of the session, participants will be able to identify when sensory tools and

non-sensory tools are appropriate for use and give an example for each using no more than two

verbal prompts from facilitators. They will also come up with three individualized non-tools that

can be used for self-regulation. This session works towards long term goals number two and

three.

Session 9 Who Could You Go To?

Description This session will teach the participants the importance of connecting with others and

how other people can help one to self-regulate. They will do this by playing the "Who could you

go to game" from the sensory connections program.

Objective By the end of the session, participants will understand the importance of utilizing

others along with identifying three people in the participants' lives they can go to for help

regarding self-regulation. This session works towards long term goals number two and three.

Session 10 Role Playing

Emotion Regulation through Sensorimotor Tools and Exercises 9

Description This session will place participants into various situations where they will be

required to role-play how they would respond to the situation and identify what appropriate tools

from their toolbox they could use.

Objective By the end of the session participants will respond appropriately to a given situation

and choose an appropriate self-regulation sensory tool from their sensory toolbox, using no more

than two verbal prompts from facilitators. This session works towards long term goals number

one, two and three.

Session Plan

We are choosing to facilitate the third session, "What are Emotions?". Using the zones of

regulation, facilitators will teach participants what emotions are through an introduction game,

discussion, a bingo game using faces showing different emotions, along with scenarios to

evaluate their knowledge.

Objective: By the end of the session, participants will be able to recognize at least three emotions

and explain when they are appropriate, using no more than two verbal prompts from facilitators.

Works towards long term goal number one.

Materials To facilitate the session, the following materials will be needed: a bingo card with

different faces expressing emotions, white paper, and four markers – red, blue, yellow, and

green. Other materials include stories/scenarios regarding example situations using different

emotions, a cootie catcher, and a book about emotions to us as an alternate activity if needed.

Session Outline
Emotion Regulation through Sensorimotor Tools and Exercises 10

1. The introduction game will act as an ice breaker to start the session. Each participant will

take turns telling the group their name, saying one thing that makes them feel happy, and

one thing that makes them feel sad.

2. After, the facilitators will go over each zone of regulation and give examples of emotions

that belong within each zone.

3. Once the participants have a better understanding of emotions, they will engage in a

bingo game where each space includes a face expressing a particular emotion or a written

emotion. The facilitators will hold up either a picture of a face or a written emotion.

Participants will match the face with the emotion or the emotion with the face. They then

will be asked why they made that choice, what signs they are showing to convey that

emotion along with when individuals feel that emotion.

4. After the bingo game, the facilitators will present the participants with different

scenarios. They will be told a story and then asked to identify three emotions of

characters within the story, using no more than two verbal prompts from facilitators to

evaluate their knowledge.

Alternate Activities Activities for the session include role-playing, reading a book about

emotions, and making a cootie catcher.

Evidence

The Zones of Regulation is an evidenced-based program created by Leah Kuypers, an

occupational therapist. She wrote her dissertation on how to create a curriculum specifically

geared toward students with certain disorders to help with self-regulation skills (Kuypers, 2008).

She conducted a literature review to help answer her research question. She explored literature
Emotion Regulation through Sensorimotor Tools and Exercises 11

related to self-regulation, neurological disorders, how they learn best, and the most effective way

to teach them (Kuypers 2008). This is how she came to create the Zones of Regulation. "The

Zones of Regulation curriculum provides learning activities and assessments to help students

make learning meaningful and generalize self-regulation skills." This program is beneficial for

multiple different neurobiological disorders, including Autism and Attention deficit hyperactivity

disorder (Kuypers 2008).

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References

Brown, C., Steffen-Sanchez, P., Nicholson, R. (2019). Sensory Processing. In C. Brown, V.C.

Stoffel, J.P., Munoz (Eds.). Occupational therapy in mental health: a vision for

participation (2nd ed., pp.323-341). Philadelphia, PA: Davis Company

Cole, M. B. (2018). Group Dynamics in Occupational Therapy: The Theoretical Basis and

Practice Application of Group Intervention (5th ed., p. 14). Thorofare: Slack.

Dunn, W. (2007). Supporting children to participate successfully in everyday life by using

sensory processing knowledge. Infant and Young Children, 20, 84-101.

May-Benson, T. A., & Koomar, J. A. (2010). Systematic review of the research evidence

examining the effectiveness of interventions using a sensory integrative approach for

children. American Journal of Occupational Therapy, 64, 403–414.

Moore, K. M. (2005). The Sensory Connection Program: activities for mental health treatment

(1st ed.). Framingham, MA: Therapro, Inc.

Ismael, N., Lawson, L. M., & Hartwell, J. (2018). Relationship Between Sensory Processing and

Participation in Daily Occupations for Children With Autism Spectrum Disorder: A

Systematic Review of Studies That Used Dunn's Sensory Processing Framework.

Retrieved from https://ajot.aota.org/article.aspx?articleid=2676929&resultclick=3#Top

Kuypers, Leah M., "A curriculum designed to foster self-regulation in students with

neurobiological impairments" (2008). School of Education Student Capstone Theses and

Dissertations. 2124.
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Kuypers, Leah M. n.d. Zones of Regulation. Retrieved from

http://www.zonesofregulation.com/index.html