Does this sound familiar: A young client walks into your therapy room and immediately tips out a box of toys, scattering the contents across the floor. As you bend down to tidy up, they grab the markers and sweep them off the table. You turn to collect your visual schedule and when you look back, they’re climbing onto the table.
Or perhaps it looks very different: A client comes in, drops heavily into the chair and slumps forward. You explain the plan for the session and their head sinks into their hands. You introduce an engaging new activity… and they stare past you, disconnected and distant.
Two very different presentations. The same underlying question: What state is this child’s nervous system in right now? Both scenarios are evidence of a dysregulated child and when a child is dysregulated, communication and learning is impacted. A dysregulated nervous system affects attention, processing, motor planning, emotional availability and social engagement. You cannot expect language from a nervous system that is in fight, flight, freeze or shutdown.
When we, as therapists, shift from “How do I get this child to comply?” to “What state is this child’s nervous system in right now?” everything changes.
Rather than pushing through dysregulation and interpreting behaviour as defiance, we can view communication through a neurodevelopmental lens. From an interpersonal neurobiology perspective – as described by Dan Siegel – integration and regulation are foundational for higher-level functioning. Communication sits on top of that foundation. Regulation is not separate from communication. It is the gateway to communication.
When we:
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- Build in movement breaks
- Adjust seating or posture
- Offer deep pressure input
- Reduce visual clutter
- Support co-regulation
We are not “adding something extra.” We are creating the conditions that allow communication and learning to happen.
However sometimes speech pathologists are hesitant to include sensory strategies into their sessions. Whether it’s bouncing on a gym ball, doing animal walks or providing deep squeezes, they may think: “I’m not an OT… is this really my role?”
Scope of practice matters, and this is an important distinction:
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- We are not diagnosing sensory processing disorder.
- We are not replacing occupational therapy.
- We are not stepping into someone else’s professional lane.
- We are supporting regulation as it relates to communication and learning.
If a child cannot attend, stay engaged, or remain in a regulated state long enough to process language or attempt speech our therapy goals are directly affected. Supporting regulation so a child can access learning? That is absolutely within our scope.
Another concern is about not having the right equipment. The fact is that you don’t need fancy equipment. You don’t need suspended swings, trampolines or crash mats. These are simply tools; they are not the intervention. The intervention is your understanding of regulation and how it connects to communication. Sensory-informed strategies can be embedded into whatever setting you’re already in, including clinic rooms, schools, home visits, group therapy and telehealth.
This might look like:
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- Starting sessions with purposeful heavy work (carrying books, wall pushes, chair stacking)
- Using rhythmic movement while practicing speech targets
- Offering alternative seating (kneeling, standing, wobble cushions)
- Embedding speech or language goals into movement-based games (e.g. saying ‘ready, set …go’ before spinning on a chair)
- Prioritising co-regulation before expecting expressive output
None of these require a sensory gym. They require clinical reasoning.
Through collaboration with occupational therapists and application of clinical reasoning, speech pathologists can understand sensory processing and regulation at a functional level, so we can:
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- Better interpret what we’re seeing in sessions
- Make appropriate referrals when needed
- Reinforce strategies recommended by OT
- Integrate regulation supports directly into communication tasks
If communication is your goal, regulation matters. You don’t need to diagnose sensory disorders, become an OT, or have a fully equipped sensory gym.
You do need to understand how nervous system state impacts communication and adjust your therapy accordingly. If you’re wanting to learn more about this and how to incorporate sensory strategies in your speech sessions, I recommend looking at the Sensory Certificate Course for SLPs by Jessie Ginsburg.
