Individuals who present with regulatory difficulties may fluctuate in their energy levels over the course of the day. They may have difficulty getting up in the morning, falling asleep at night, sleep for longer periods of time than average or need to rest in a lying down position for part of their set day. Others do not sit down at all and don’t want to because they state that they feel like they might fall asleep.
It is important to look at the medical histories in collaboration with the medical professionals working with the individual and the families to provide feedback regarding symptoms that may be impacting on an individuals ability to manage their movement skills. Families that you are working with regularly ask questions about a therapists feedback on what is happening as they try to integrate all of the different opinions about what is happening for their child to make decisions about what to do in general or what to do next. It is important to separate out all of the variables interacting with the individuals energy levels, and to monitor their trajectory over a period of time incrementally. Families often struggle with the management of energy levels the most when it interferes with their ability to ‘move’ each other individual in the family through their scheduled activities. The time that it takes to get out of the door: is it attention? is it organisation? is it fatigue? is it avoidance? Looking that the non-verbal and particularly the timing of the verbal feedback that is given is important. Repeat complaints may not seem to have any basis but they may be the starting point of something that isn’t being talked about within general health care.