5 Reasons Why Regulation Comes First in Therapy (and in General)
All pediatric therapists, including us at OutGrow, have felt pressure to “manage behaviors.” When a child is bouncing around the room, touching everything, or refusing to participate, it’s easy to slip into problem-solving mode, tightening structure and trying to regain control.
But when we shift our lens, those moments look different. Challenging behaviors aren’t defiance, they’re communication. More often than not, they’re a sign of sensory or emotional dysregulation.
Here’s the truth: kids can’t access higher-level thinking when they’re dysregulated.
That means no real progress in areas like attention, memory, problem-solving, or executive functioning until regulation comes first. This is why understanding and supporting regulation is one of the most powerful skills we can bring into a therapy session.
1. Dysregulation Blocks Learning
Imagine being on a road trip, chatting and following directions, until you suddenly really need to pee. At that moment, can you focus on the map, the conversation, or even the music? Definitely not. That’s how dysregulation feels to a child.
They may be distracted by the buzz of fluorescent lights, discomfort from sitting too long, or fatigue from back-to-back demands. When a child’s nervous system is overwhelmed, their body is focused on one thing: finding regulation.
This is when we often see “behaviors” like running, rolling, or bouncing. Those behaviors aren’t the problem; they’re the body’s signal that something is off. Once regulation is restored, kids no longer need to seek sensory input in disruptive ways and can return to learning, listening, and engaging.
Key takeaway: When the nervous system is dysregulated, the brain can’t focus, attend, or remember. Regulation must come before any therapeutic learning.
2. Behaviors Are Clues, Not Problems
When children are dysregulated, their behavior is the body’s best attempt to cope. Running out of the room, collapsing on the floor, or acting silly when faced with a challenge are all communication signals.
Pediatric therapists often feel the urge to stop the behavior immediately. But when we pause and ask why it’s happening, we uncover valuable insight. Viewing behaviors as clues helps us see what the child is really saying: “I need help.”
Responding with regulation strategies, such as co-regulation or sensory input, meets that need at its core. Rather than suppressing the signal, we’re decoding it and giving the child what their nervous system truly needs.
3. Regulation Unlocks Participation
Once regulation is restored, everything shifts. Just as you can refocus after finding a bathroom on that road trip, kids can re-engage once their bodies feel organized. Suddenly, they can listen, follow directions, and practice new skills.
The child who was bouncing can now focus. The one who was quiet or withdrawn is ready to participate. When regulation is missing, participation feels impossible. When it’s supported, kids can connect and grow.
Research backs this up. A 2021 study by Allan, Hume, Allan, Farrington, and Lonigan* found that self-regulation predicts both academic readiness and social-emotional growth. Supporting regulation isn’t about helping kids “calm down”, it’s about giving them access to executive functions like working memory, sustained attention, and flexibility.
Take our FREE quiz! Find out what a child’s behavior is telling you in under two minutes.
4. Regulation Builds Trust in the Therapeutic Relationship
When we prioritize regulation, we send a powerful message: this is a safe space. Children who learn that their signals are respected begin to trust the process, their own bodies, and their therapist.
That trust reduces resistance and power struggles. Instead of escalating, children feel safe enough to try, fail, and try again. When kids feel regulated, they feel safe, and that safety is what allows true behavior change and therapeutic growth to occur.
5. Regulation Creates Progress That Lasts
Therapy goals don’t exist in isolation. Skills like attention, memory, problem-solving, and emotional control all rely on one essential foundation: a regulated nervous system.
When a child is regulated, they can take what they’ve learned in therapy and apply it in classrooms, at home, and in the community. This is the type of progress that sticks.
When we focus on regulation first, behaviors shift not because we demand compliance, but because the child’s brain and body are finally ready to learn. Children who understand how to find their own regulation are developing a lifelong skill that supports learning, relationships, and resilience.
Why This Matters for Pediatric Therapists
It’s easy to feel pressure to “get through” your therapy plan. But sometimes the most meaningful progress happens when we pause, notice the signs of dysregulation, and support regulation before moving forward.
Supporting regulation doesn’t mean letting a child “run the show,” and it doesn’t mean applying more control. It means listening to what the body and brain are communicating and offering the support needed to feel steady and safe.
When we lead with a whole-child approach and put regulation first, behavior starts to make sense. The real work of learning and growth can finally begin. Regulation is not a warm-up; it’s the foundation for every meaningful therapeutic outcome.
Take This Into Practice
If this resonates with you and you’d like to dig deeper into how sensory regulation drives therapeutic progress, we’d love for you to join us inside Making Sense of Sensory: Therapist Edition.
It’s a self-paced course built by therapists, for therapists, filled with practical strategies to help you weave regulation into every session.
Hope to see you inside! Email admin@outgrowtherapeutics.com for questions or group/clinic discounts.
🌿 OutGrow Therapeutics: helping kids (and their therapists!) OutGrow What They Know.
*References:
Allan, N. P., Hume, A. L., Allan, D. M., Farrington, A. L., & Lonigan, C. J. (2021). Self-regulation in preschool: Examining its factor structure and associations with pre-academic and social-emotional skills. Frontiers in Psychology, 12, 717317. https://doi.org/10.3389/fpsyg.2021.717317
