Are We Measuring Regulation, or Compliance?

As therapists, we frequently document regulation goals.

- Remained seated.
- Followed instructions.
- Completed the activity.
- Required fewer prompts.

But I think we need to ask ourselves an uncomfortable question:

Are we measuring regulation, or are we sometimes measuring compliance?

A quiet, compliant child isn't necessarily a regulated child. Likewise, movement, excitement, frustration or asking for a break doesn't necessarily indicate dysregulation. If regulation is about supporting occupational participation, perhaps our measures need to go deeper.

Regulation should enable participation

Occupational therapy gives us an important lens here.

Ismael, Lawson and Hartwell's (2018) systematic review examining sensory processing and participation in autistic children highlights the relationship between children's sensory characteristics and participation in everyday occupations.

That matters.

Our goal isn't simply to change the child's observable state. It is to support their capacity to participate meaningfully.

Perhaps we should be asking:

- Can the child engage?

- Can they communicate what they need?

- Can they tolerate manageable challenge?

- Can they recover and return?

- Can they increasingly recognise when support is needed?

These observations may tell us considerably more about regulation capacity than minutes seated or the number of prompts required.

Recovery is progress too

We also need to be careful not to define successful regulation as the absence of dysregulation. Children will encounter demands that exceed their capacity. What happens next can provide valuable clinical information.

Can the child accept co-regulation? Can they reconnect? Can they return to the occupation? Does the amount of adult support required change over time?

Co-regulation literature describes adult support as developmentally responsive and as contributing to emerging self-regulatory capacity (Rosanbalm & Murray, 2017).

Progress might therefore look like: “Recovered with adult support and returned to participation.”

Later: “Recognised increasing overwhelm and requested support.”

And eventually: “Selected an effective strategy with less external support.”

That's a very different way of thinking about progress.

I encourage you to think about Capacity, before behaviour

This is what I mean within The Regulation Hourglass™ when I say:

Capacity, before behaviour.

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Behaviour remains important information, but it isn't necessarily the outcome. We need to consider what behaviour tells us about the child's available capacity for participation in their occupational roles.

That distinction also protects us from inadvertently making calmness the therapeutic goal.

A question for supervision

Take one regulation goal from your current caseload and ask:

If this child achieved this goal tomorrow, would they actually be participating more successfully, or would they simply be easier for adults to manage?

Then ask:

What would meaningful regulation progress look like if participation, agency and recovery were the outcomes?

These are exactly the kinds of questions worth unpacking in clinical supervision, because our assumptions about regulation can quietly shape the goals we write, the interventions we choose and the progress we measure.

Regulation isn't about creating quieter children.

It's about supporting greater capacity to engage, participate, recover and increasingly navigate everyday life.

Capacity, before behaviour. Think about it!