OTA 2320 OT Modalities III Lecture

Group Process Reflection: Teaching Zones of Regulation at Neighborhood House

Mercedes and I did our group process assignment at Neighborhood House in Salt Lake City. The clients we worked with were kindergarten students, ages 5 and 6, at the child care center. The class we taught was part of an after-school program that included children from various racial and ethnic backgrounds, family situations, and developmental needs. At Neighborhood House, most of the children come from low-socioeconomic backgrounds and have developmental delays or learning disabilities. We were given very little information on the specific struggles of these families. However, it is common for children of low-socioeconomic families to struggle with multiple physical and psychosocial stressors due to lower parent education, lower health literacy, financial insecurity, and discrimination. Because many of the children also have developmental delays, they struggle with emotional regulation, attention, and disruptive behaviors, especially in the classroom. We worked with five children who were there the whole time, and we focused our documentation on them. However, due to the nature of the program, children were coming and going as they started class or were picked up from class.

With the guidance of the program teachers, we decided to focus on emotional regulation for this group. The goal for our group was “Clients will be able to identify emotions when they experience them and identify at least 1 way to cope with emotions.” Our treatment plan focused on teaching performance skills (identifying emotions, emotional regulation, and coping strategies) and sensorimotor processing skills that are impacted by developmental delays and age. We utilized the Zones of Regulation curriculum to educate the students and for handouts. We chose to use the sensorimotor model for this treatment, specifically the Ayres Sensory Integration (ASI) framework. The ASI frames disruptive behavior as dysregulation and the child seeking equilibrium: either relief from overwhelming sensation or stimulation from increased sensation. When you teach children the skills to recognize and to find appropriate outlets for sensory needs, behavior and learning improve. Using this framework, we focused on body sensations and their association with different emotional states, as well as how they affect occupations.

This group experience was both really fun and really challenging. Miscommunication due to staffing issues led to us being in a completely different space than we had expected, with children going in and out of the classroom as they were either dropped off or picked up. However, Mercedes and I did our best to manage the chaos and adapt. To begin, we discussed our favorite colors and what the children were feeling in the moment. We explained why we were there: to talk about emotions and the Zones of Regulation. The children were very restless and struggled to pay attention, especially with students coming in and out of the classroom. But they were smiling and following directions as Mercedes led them through Red Light, Green Light to warm up. Mercedes then explained what each Zone of Regulation was, and we talked about what the students felt in their bodies with each one. We played Red Light, Green Light, prompting the children to move how they feel in each Zone. We also talked about coping skills for when they feel overwhelmed in any of the Zones. They required redirection every few minutes, but they were able to teach back to us what Red and Blue Zones feel like and participated in short breathing exercises to calm down a bit. Mercedes and I rushed a bit through sharing, generalizing, application, and summary as the students were obviously at the limit of self-regulation. However, they shared at the end that they had a lot of fun. The five students who had been there the whole time were able to briefly teach students who came in at the end what each Zone felt like and one skill for coping in the Red Zone. The teacher, Mrs. Nancy, thanked us for coming and shared that she was going to start using the Zones of Regulation curriculum to practice the skills with the students.

Mercedes and I worked well together and had a good back and forth during the group. However, we really struggled to manage the students’ restlessness, in part because we hadn’t anticipated just how wound up they would be. I think we also lost the structure of the seven steps in the chaos, but we were able to stay relatively calm and regulated. The greatest progress I felt I made was in understanding realistic expectations for 5- and 6-year-olds. I have had very little experience with children, even less in groups, so I didn’t really know what to expect, and my expectations were way beyond what they were capable of. I learned how important it is to have a solid understanding of the population or specific group that I am working with as a COTA. This will help me create realistic expectations for the group goals and process and prepare better. I will also study Cole’s 7 Steps because I still don’t totally understand Steps 3-7, but I recognize that they offer a valuable structure for creating and leading an effective group. This was a great learning experience.