Translation to the Clinical Setting

Alleviation of Distress

  • It takes attunement to the child’s emotional state and developmental level to provide co-regulation and alleviation of distress. When observed, it is an indication of a healthy parent-child relationship.
  • Notice when parents help their child warm up to the visit by providing proximity, going at their child’s pace, or trying to engage their child by exploring the room (i.e., looking out the window together, reading a book, etc.)
  • Notice when the child responds to the parent’s attempts to make them feel safe.
  • Notice and describe the child’s visual exploration of the room or engagement with you from the comfort and safety of the parent’s arms. Also notice when the toddler ventures out to explore the exam room when they feel safe but then returns to the parent to check in.
  • As a provider, you can provide co-regulation in the visit by following the child’s and parent’s cues. Interact with the parent first and slowly engage with the child so the child feels “felt” and understood by you.
  • Offer positive feedback about how the parents helped their child manage the stress of adjusting to the visit:
    • Your son really got adjusted easily to this new room with the way you helped him warm up to a new place.”
    • “That was so nice how you showed your son how soft the couch was and encouraged him to feel safe to explore this new room. Your comforting and calm presence really helped him manage his worried feelings about a new place.”
  • The need for these moments of connection and alleviation of distress never goes away. It may not seem like it at times, but adolescents especially need these moments of shared attention and co-regulation from their parents.
  • The need for co-regulation is universal for all of us, providers, parents, and children.
  • It is NOT spoiling to help a child break tasks into achievable pieces, by offering the “right task at the right time” in the child’s “zone of proximal development” and to help them with their frustration while they are learning new things.
  • All of us can only take in so much new information and learning at a time. When we are in the role of the “more knowledgeable other”, it takes attunement and sensitivity to be most effective within the other’s zone of proximal development.
  • Disengagement cues can be a sign that we’ve moved out of the other person’s zone of proximal development.
  • Parents and providers need ongoing support to be in this role of “more knowledgeable other” Holding another’s mind in your mind requires a lot of social cognition and is a skill.

“It seems to me that one of life’s greatest privileges is just that – the experience of being held in someone’s mind. Possibly, though, there is one exception – and that is the privilege of holding another in one’s own.” ~ Jeree Pawl