“Take a deep breath.”
“Use your calming strategies.”
“Think about what you could do instead.”
These are phrases many children hear when they’re upset or overwhelmed. While they are well intentioned, they often don’t have the desired effect, particularly for autistic children.
As occupational therapists, we frequently work with children who know what they “should” do when they are feeling overwhelmed, but in the moment, they simply cannot access those strategies. This is not because they are being difficult or choosing not to regulate. It is because their nervous system is overwhelmed.
For many autistic children, regulation is not something they learn by talking about it. It is something they learn by experiencing it.
From Talking to Doing
Recently, I worked with a young autistic client who found discussions about emotional regulation difficult. We had talked about breathing techniques before, but they never seemed particularly meaningful to her. Instead, we made a simple breathing tool together using a pipe cleaner bent into a square with colourful beads threaded onto it. As she slowly moved one bead along each side of the square, she matched her breathing to the movement. Her response was immediate.
“This will actually help.”
What made the difference was not the breathing exercise itself. It was that the strategy became tactile, visual and interactive. She had something to hold, something to move and something she had created herself.
This experience highlights an important principle in occupational therapy: children are often far more engaged with strategies they have helped create than those they are simply told to use.
Understanding the Nervous System
Many autistic children experience differences in sensory processing and interoception, which is our ability to notice and interpret what is happening inside our bodies. They may not recognise the early signs that they are becoming overwhelmed until their nervous system is already working very hard.
When this happens, asking questions such as:
- “How are you feeling?”
- “What strategy could you use?”
- “Why are you upset?”
May actually increase the cognitive demands on a child whose brain is already overloaded. Instead, it can be more helpful to focus on what their body is experiencing.
Questions such as:
- “What is your body telling you?”
- “Does your body need movement, pressure or quiet?”
- “Is your engine running fast or slow?”
- “What would help your body feel just right?”
Can feel much more accessible.
Why Hands-On Strategies Work
Many children regulate more effectively when they are actively doing something. Hands-on activities provide sensory input while also giving children a clear focus, making it easier to slow their breathing, organise their thoughts and reconnect with their bodies.
Here are some ideas that combine sensory regulation with practical activities:
Create a Calm Bracelet
Thread different coloured beads onto an elastic bracelet, with each colour representing a calming action.
For example:
- Blue = take a slow breath
- Green = relax your shoulders
- Yellow = squeeze your hands
- Purple = breathe out slowly
As the child touches each bead, they complete the matching action.
Finger Breathing Paths
Create raised pathways using pipe cleaners, string or puffy paint on card. Children slowly trace the path with their finger while matching their breathing to the movement.
Different shapes can include:
- Squares
- Spirals
- Rainbows
- Hearts
- Infinity symbols
Better still, let your child design their own.
Pop-It Breathing
Rather than using a Pop-It as a fidget, turn it into a breathing activity.
For example:
- Pop four bubbles.
- Take one slow breath.
- Pop another four.
- Repeat until finished.
The repetitive rhythm can be wonderfully calming.
Therapy Putty Breathing
Roll therapy putty into a ball.
Press your thumb into the putty.
Take one slow breath.
Move around the edge until you have created a flower.
The resistance provides calming proprioceptive input while encouraging slow breathing.
Build While You Breathe
If your child enjoys LEGO® or magnetic tiles, encourage them to add one piece after each slow breath. Breathing suddenly has a purpose and a visible outcome, which can be far more motivating than simply being told to breathe.
Movement Cards
Create a set of simple movement cards featuring activities such as:
- Bear walk
- Butterfly stretch
- Wall pushes
- Tree pose
- Starfish breathing
- Cat stretch
Allow your child to choose three cards to complete. Having choice increases motivation and gives children a sense of control.
A Calm Keyring
Make a small, laminated keyring containing simple strategy cards.
Ideas include:
- Bubble breaths
- Wall pushes
- Heavy hugs
- Drink some water
- Stretch
- Find five blue things
- Push your palms together
Children can flip through the cards until they find one that feels right.
Build a Regulation Toolkit Together
One of the most successful approaches is to gradually build a personalised regulation toolkit over several therapy sessions or at home. Rather than expecting children to remember a list of strategies, they create their own collection of tools.
This might include:
- A breathing square
- A calm bracelet
- Stretch cards
- A feelings thermometer
- A sensory keyring
- A small “first aid kit for my nervous system”
When children help design these tools, they are much more likely to use them when they need them.
Remember: Every Child is Different
There is no single calming strategy that works for every child. Some children need movement before they can become calm. Others need deep pressure, quiet spaces or tactile activities.
The key is curiosity rather than correction. Observe what helps your child’s body feel safe, organised and ready to engage, rather than focusing solely on stopping unwanted behaviours. When we understand that behaviour is communication and regulation begins with the nervous system, we can move away from asking children to simply “calm down” and instead give them practical tools that genuinely help them do so.
As occupational therapists, our goal is not just to teach calming strategies. It is to help children discover which strategies work for their unique nervous system, empowering them to become confident and independent in managing everyday challenges.
References
Ashburner, J., Bennett, L., Rodger, S., & Ziviani, J. (2014). Understanding the sensory experiences of young people with autism spectrum disorder. Australian Occupational Therapy Journal, 61(3), 171 to 180.
Dunn, W. (2014). Sensory Profile 2. Pearson.
Schaaf, R. C., & Mailloux, Z. (2015). Clinician’s Guide for Implementing Ayres Sensory Integration®. In Ayres Sensory Integration® and Occupational Therapy.
Williams, M. S., & Shellenberger, S. How Does Your Engine Run?® The Alert Program® for Self-Regulation. Alert Program Foundation.
Ayres, A. J. (2005). Sensory Integration and the Child (25th Anniversary Edition). Western Psychological Services.
by Nicola Van Zyl