Association for Behavior Analysis International

Teaching emotional self-regulation is challenging for care providers. The Zones of Regulation is a curriculum used widely by occupational therapists to teach emotional regulation. There is no evidence yet to support its efficacy. While the Zones curriculum provides guidance on progression of teaching skills and a plethora of teaching materials, there is no standard method of teaching within the curriculum. For instance, there is no guidance correcting errors, prompting hierarchy, or standardized instructions. Additionally, challenges in teaching emotional regulation are more pronounced given significant communication barriers. Many individuals with developmental disabilities have comorbid medical issues, including neurological and gastrointestinal complications such as epilepsy and fecal impaction, which can be painful and lead to negative emotional responding. Difficulty communicating pain has been reported to lead to lack of medical care, attributions of symptoms to behavioral issues, unnecessary or incorrect medical care, and invasive medical procedures. This paper explores a way to apply the curriculum with an applied behavior analytic framework, and examines if using stimulus equivalence and automaticity of reinforcement by pairing overt indicators of pain (e.g., precursors to problem behaviors, overt symptoms of illness) with colors that correspond to the Zones might increase the ability to identify and communicate distressing emotions in order to receive appropriate interventions from caregivers.