Emma
Processing supported by safe/comfort item and self-regulating while interacting with us.
Emma is a young woman, who seems interested in connecting with others, but has several sensory impairments (visual impairment and has cochlear implants) and other complex needs which seem to make it more challenging for her.
We got to know Emma this year and structure our sessions in ways that prioritize her feeling comfortable, rather than building on surprises and changes for a sense of adventure. This would follow once settled trust is formed and established. We saw her in her home, where she seems to feel most relaxed and comfortable, and her whole surroundings and environment are adapted to her. She has people around that know her well and are happy to answer questions or provide additional information.
While she doesn’t use speech nor singular words, she does use her voice, her body posture and gestures to clearly communicate yes and no, like/dislike and overwhelm/contentment.
She seems to consistently need additional time and pauses to process sensory information of any type that she hasn’t chosen herself for self-regulation.
She seems to self-regulate by sensory seeking, using her fingertips and palms of her hands to explore textures and surfaces with an apparent preference for rougher textures.
The first week I met Emma, I noticed her fluttering her eye lids and sometimes closing her eyes. I observed that our actions and verbal input were probably too fast paced for her and therefore overwhelming. I communicated my thoughts to my IP partner, and we slowed down to about 20 percent of the pace and allowed more time without much speech to enable Emma to process, the visual and tactile input a little faster/better. She seemed more engaged from then on and stayed alert and was able to participate for the full hour.
When we introduced a big extendable red tube with ridges along it to feel with her fingers, she showed an interest, and we left it with her for her own exploration. We joined in, by asking if we could feel it too and reaching through with our hands to offer our fingers, tapping her resting fingertips lightly. She kept her fingertips where they were, apparently thinking about this. This step-by-step approach created predictability and safety and allowed room for processing. The key point is that sociability/touch or close proximity was introduced after appropriate time was given.
Slowing down to the point where it is a conscious effort for us to keep that slow pace is such a simple but powerful way to facilitate the other person to be able to lead. It also gives us a chance to observe body language and details closely and build/plan our next approach upon those.
Safe/comfort items, how to spot them, how to respect and incorporate them
Emma owns a woven cotton matt with a spiral pattern, which she apparently likes a lot and uses to self-regulate by moving her hands over it. We didn’t know this when we started, so when we noticed that she was so focused on the mat and that there wasn’t much space to focus on us, we tried to take it away and exchange it. However, she shook her head, vocalised in a frustrated tone and used wide searching motions with her hands signalling she wanted it back. We respected her choice, put it back and gave her a bit of time to settle before using a different approach. A big emotional response like this can be a sign that the person is emotionally attached to the piece of equipment and/or relies on it to self-regulate and possibly manage overwhelming situations. The item can help them to process other sensory input that is coming in at the same time better and quicker, as the nervous system is more regulated.
If we notice someone having a safe/comfort item, we can incorporate it in our approach to connect, by seeing if they are open to sharing it or use it in a variety of ways that they might not have explored before. If enacted in a step-by-step way, acknowledging they are attached to it and it is important they know it is safe/won’t be taken away from them, sharing often naturally occurs, especially if enacted playfully.
Once we had shared the mat all together by taken turns and Emma seemed comfortable, we lifted the mat high up in the air but still in her reach and she reached out for it from underneath, explored the edges and sides and bottom side of the mat and seemed interested, focused and engaged, and started using more explorative than repetitive motions.
After we lowered the mat down again Rebecca started to slowly move one of her hands between Emmas moving ones and Emma slowed down her own movements to wait for her, lightly let their hands meet every time.
Another time when one of the practitioners joined Emma’s hand on the mat, she playfully tapped/slapped it as if to say, “Hey that’s my mat”, and the practitioner responded by playfully covering hers in response, saying “one potato” (as in the children’s rhyme). I joined in, but it became apparent that Emma didn’t seem to like her hand being covered by ours, even just momentarily, as she quickly took hers away and her body language seemed a bit unsettled. We verbalised, that we noticed this (for her and her carers around) and I changed it to just fingertips touching and saying they are “new baby potatoes” instead. Emma smiled, perhaps at the concept, and playfully engaged with our fingertips slightly overlapping for short times.
Interestingly another outing of the one potato rhyme met with a different response, with Emma happily engaging with the hands on hers and even placing one of hers on the top of the pile. An illustration that it is impossible to predict how anyone will respond in any newish circumstance.
This is an example where we quickly, in the moment, adapted to the person we are seeing. We didn’t stop the interaction but changed it in a way that we thought might be more comfortable for her and could therefor hold the playful element and flow, even though she was momentarily unsettled. The fact that on some occasions the sensory input was manageable for her highlights the idea that “no” may not mean “never”.
Luca Grys October 2025
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