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Regulatory disorders

Author: Anita Madács, special education teacher of the visually impaired, somatic movement educator, MA in Public Education, TSMT therapist and mentor.

Instructor at TSMT-HRG College, lecturer at Pázmány Péter Catholic University, Department of Developmental and Clinical Paediatric Psychology, Institute of Psychology.

To view the mechanism of action of TSMT and HRG therapies on regulatory disorders, click here!

A few words about regulatory disorders:

The development of children can be influenced by a number of factors. At birth, infants have to adapt to a changed environment as compared to the foetal one. In addition to the child’s own biological process, physical maturation, environmental factors, his relationship with the caregiver, events that happened during pregnancy and around birth, jointly influence this process of adaptation. During the first two years of life, extremely intensive development takes place in children, which in itself may be accompanied by differences in regulation of behaviour. “Regulation means regulating the physiological and emotional processes of the infant, namely regulating the processes of feeding and digestion, of the circadian rhythm (sleep-wake cycle), of crying and calming, and of breathing." (Guardians, p. 563.)

In cases where infants or young children have trouble with self-regulation, i.e. difficulties with regulating their mood, behaviour and physiological processes during the first three years of life, the issue of regulatory disorders may arise. The children’s behavioural disorders are manifested in their perception, attentional skills, movements, or emotional self-regulation.

These can be:

  • chronic restlessness: the duration, extent and frequency of the phenomenon differs from the average; there is a difficulty/inability to calm down. They respond with violent reaction even to simple stimuli, it takes extremely long time to calm them down, they are almost constantly over-stimulated, yet they still seek more new stimuli. (These babies are often called “colicky babies”, although belly ache is just one possible cause of the problem.)
  • excessive (heavy) crying means, when the baby is being fussy or whiny at least three days a week for the duration of at least three weeks in the first three months after birth, or in other form may also mean a prolonged crying mainly at night that persists beyond the third month. (persistent crying).
  • sleep disorders: if your baby has serious problems falling asleep or sleeping through the night at least five times a week from the age of 6 months. This includes low sleep need, restlessness during sleep, frequent night waking or even being awake through the night.
  • feeding disorders: feeding disorders in the child/infant (also termed avoidant/restrictive food intake disorders), which may occur due to a traumatic experience (painful stimulation of the face, mouth, throat, e.g. violent feeding, probing); in severe cases associated with total refusal of eating, and these may also be manifested by refusal of certain foods (due to their substance, odour, temperature or texture).

What factors may affect the development of regulatory disorders?

Factors determining the development of regulatory disorders may include the child’s biological risk factors, underdevelopment of sensory integration and traumatic events before or during birth, besides, the environmental impacts are not negligible either. (mental state of parents/caregivers, other events such as abuse, quarrels, divorce). Each disorder can manifest in itself, or in several areas at the same time. Children with abnormal regulatory processes may be oversensitive or undersensitive, and they may also manifest stimulus-seeking behaviour, which will affect their daily lives.

The possible underlying medical reasons should first be ruled out or treated, if necessary, while the environmental factors should be carefully examined.

It should be noted that regulatory disorders occurring in the early stages of development are not typical of modern society, they have been known previously (they have been researched from the middle of the 20th century). It has been described that development can be accompanied by so-called typical crises, when the parent/caregiver may experience a change in the child’s behaviour. (e.g. he becomes fussier or more difficult to calm down, his motor development is stagnating for a while, etc.). If these represent a transitional period only and the previous behaviour pattern later returns to its normal pattern, the process can be assessed as a natural phenomenon. However, if any questions arise due to the child’s current condition or the said period is prolonged, it is recommended to consult a specialist.

Why are regulatory disorders a problem?

If the child finds it difficult to adapt to his environment through his self-regulatory system, he will be unable to create his own well-being, which will have negative impacts on many aspects of his development. E.g., if the infant is irritated because the perceived stimuli are excessive and overstimulating for him, he will not be able to adequately interpret them and will rather block them. As a result, he will fail to go through the learning process required for his intellectual, motor or social maturation. The inadequate amount and quality of rest time also affects the everyday well-being, the reaction to the stimuli of the environment, the controllability and durability of the child’s attention. Eating difficulties can fundamentally affect physical development through the quality and quantity of nutrients ingested, and in extreme cases can be interpreted as a rejection of life.

How can TSMT and HRG help?

The symptoms perceived may raise questions and anxieties in the child's environment, which will affect the relationship of the child with the parent/caregiver, as well as their everyday life as a whole. Therefore it is essential to recognize the problem as soon as possible and get professional help. If there are underlying neurological immaturity factors behind the disorder, there are several methods within the scope of sensory integration therapies that can be used as effective help: these are TSMT (Targeted Sensorymotor Trainings), which take place in the gym; the HRG-method (Hydrotherapeutic Rehabilitation Gymnastics), taking place in the pool, as well as Dynamic Sensory Integration Therapy. Used with proper stimulation, they improve the processing of environmental stimuli and the development of appropriate responses.

The study protocol prior to the TSMT and HRG therapies is suitable for mapping the developmental disorders associated with maturation, which help the treatment be as effective as possible. The therapy guides the child through the stages of motor development, helping establish the normal functioning of their own regulatory system through making them experience the targeted stimuli. This will create a suitable basis for perceiving and experiencing the world, which supports the proper learning process. The TSMT therapy can be used from three months of age. It helps the development of the age-appropriate motor, intellectual and social skills, through practicing certain sets of exercises compiled and trained according to the appropriate rules, and given to the parents for practicing with their kids at home.

The most effective case is when the child’s environment (parent/caregiver, nurse, home paediatrician) discovers the child’s delays in time and he will receive the needed help, which can be medical, psychological or educational, depending on the characteristics of his problems. Exploring the causes and dealing with the situation is also extremely important, since a long-term problem may deepen later and become a source of mental illness, but it is important for the parent-child relationship and family well-being as well.


  • Danis I., Németh T., Prónay B., Góczán-Szabó I., Hédervári-Heller É.: Theory and practice of early childhood mental health support. Semmelweis University, Institute of Mental Hygiene, Faculty of Public Health. Budapest, 2020.
  • The Guardians – A practice-oriented handbook for primary care providers. Office of the Chief Medical Officer Budapest, 2014.
  • Areas of application of sensory integration therapies. In: A. Vikár, Gy. Vikár, E. Székács: Dynamic child psychiatry. Publishing house medicina Zrt. Budapest, 2014.