Is laying in a hammock with a child passed out on me considered skilled occupational therapy services? I’m asking to challenge you. Child arrives at OT hysterically crying and in a state of dysregulation. Unskilled would be NOT recognizing that this child’s nervous system was in a state of disarray. Unskilled would be pushing that child to participate in the planned treatment activities for that day. Unskilled would be canceling the session and sending the family away, with still a dysregulated child. Unskilled would be rationalizing and attempting to talk the child through her state of dysregulation. Let’s talk skilled... Skilled services recognizes that this child’s nervous system needs calming and organizing input. Skilled services also recognizes that this child currently does not have the independent skills to bring regulation for her nervous system. Skilled services recognizes that this child can benefit from slow, rhythmic movement to calm and organize (not fast and jerky), so I swing slow and rhythmically in the hammock. Skilled services recognizes that this child could benefit from deep proprioceptive input, so I provide long sustained bear hugs while swinging rhythmically. Skilled services recognizes that decreasing auditory input for this child will bring about regulation sooner, so we swing and hug in silence. Skilled services, recognizes that within 10 minutes when I feel her body start to relax, I allow her to go into a sleep state. Her nervous system needed to shut down for a restart, so I continue to swing and rock in silence while I allow her to sleep. Skilled services recognizes that when mom arrives, you can be flexible with the plan and do a parent meeting. Skilled services recognizes that when this child awakens after 20 minutes, she is in a new state of regulation. Skilled services, recognizes that what may have appeared to be taking a nap in a swing has now provided an opportunity for 15 minutes of participation in planned treatment activities. YOUR TREATMENT PLANNING AND PARENTING HAVE TO START WITH REGULATION OF THE NERVOUS SYSTEM. Function is dependent on it. #sensoryprocessingdisorder #nervoussystemregulation