Mental health has long been thought of as secondary in overall child wellness, and we often hold people more accountable for mental health diagnoses than those with disease of the kidney or heart. However, the brain and the central nervous system are responsible for the function of all bodily systems, so childhood trauma, ADHD, and depression can often present as digestive issues, shaking, changes in pallor, and other tangible manifestations; and physical symptoms can often be an indicator of trauma or a mental health issue. By understanding the function of the vagus nerve and the use of multi-disciplinary and co-regulatory strategies, parents can improve self-regulation, nutrition and overall health in their children.
The vagus nerve is the longest cranial nerve (nerves that connect directly to the brain) and is unique in that it contains both sensory and motor fibers, so it is responsible for sensation and movement. The dorsal branch of the vagus nerve regulates organs below the diaphragm, and when under intense threat can affect the freeze or flight response. The ventral branch regulates body function above the diaphragm and has much to do with social engagement and the fight response under pressure. In his book, Complex PTSD: From Surviving to Thriving, Pete Walker identifies a fourth response, fawn, in which one continually forfeits their own needs to the needs and demands of others, which would also be a ventral branch response.
When children respond to a threat, real or imagined, they will have a fight, flight, freeze or fawn response.
The vagus nerve senses information about pain, temperature and touch, regulates heart rate, and sends information back and forth between the brain and digestive organs. It also controls key aspects of swallowing, speaking and recognition of facial expressions. Knowing that the vagus nerve responds to and helps regulate all these systems makes it easier to see how significant emotions can impact digestion, heart rate and the ability to express oneself.
Polyvagal Theory, developed by Stephen Porges, suggests the two vagal branches work together to regulate the body, but when our defenses are engaged through threat or stress, they can also work together to deregulate the body or even shut it down. Porges stresses that trauma responses are not choices, but reflexive, natural responses that everyone experiences and exhibits. Since responses are instinctive, the body can stay in this defensive stance even after a perceived threat has passed, so that it can protect itself. Once this response is understood to be reflexive, it helps parents and children reduce the shame of big emotions and helps them get to the heart of an issue cooperatively.
Occupational Therapist Christine Catanzariti explains that a co-regulatory approach is important for children who are frequently dysregulated, who can’t identify their emotions, and who need a lot of support. Co-regulation involves meeting children where they are emotionally and working together to calm and soothe so parent and child can begin to communicate on a higher level. “Children need a calm guide in order to myelinate the neurons and begin to self-regulate,” Catanzariti says.
Myelin (a soft white material that forms a thick layer around some neurons) starts to strengthen from the nutrition of a child’s very first meal, and from bonding while breastfeeding. Myelin makes the connections between neurons faster. Since a child’s brain develops most rapidly in the first six months, children who receive minimal skin-to-skin contact and insufficient nutrition may learn/react more slowly, which can lead to global delay.
When children have heightened anxiety or emotions, they can’t be expected to articulate their needs or why they are upset. For children whose disability does not allow them to speak or communicate needs, they may need massage, hugs or weighted blankets, or for a parent to lay next to them quietly. Catanzariti also recommends rhythmic activities, like bouncing on an exercise ball or using the sound of a heartbeat to mimic sounds in the womb.
If children are able to speak, Catanzariti encourages reflective work as they may not be capable of identifying emotions. “Ask the child, ‘How do your hands feel?’ and ‘How does your stomach feel?’” she says. “Once we know how a child’s body feels, we can begin to work on how the brain feels.”
Catanzariti recommends purchasing matching Fitbit “bracelets” for parent/child to monitor breathing and heartbeat, which are elevated when in fight or flight mode. Focus on breathing slowly together and gradually lowering heartrate so children can see their own progress on the Fitbit screen and learn to self-regulate. If you don’t have a Fitbit, a metronome app also works.
There are a variety of strategies for regulation that are dependent upon a child’s presentation. Dr. Rebecca Jackson, Vice President of Programs and Outcomes for Brain Balance and a licensed chiropractor, has a sensory-motor approach to regulation and wellness. Brain Balance is a non-medical program in North County San Diego that focuses on building brain-body connectivity. When a child continually vomits from stress and develops an easy gag reflex, practitioners may work on swallowing exercises or gargling with water, allowing a child to feel liquid move at the back of the throat. Helping children feel and hear how air moves around the palate and nose, humming, and exaggerated facial expressions and speech while touching the face get kids in tune with facial muscles and nerves. Dr. Jackson says the connection between sensory input and motor movement is key.
Brain Balance Director of Nutrition Melissa McDonough focuses on the nutrition angle for stomach upset. She notes that food sensitivities can cause gastrointestinal distress or inflammation, which leads to pain and a lack of absorption of key nutrients, both of which impact mood. Children prone to bowel movement (BM) accidents may not sense the need to go to the bathroom until the last minute. This could be sensory, anxiety or the function of the dietary tract and nutrition. “Dairy can play a big role in overnight bedwetting and [BM] accidents,” McDonough says. Her team works with families on diet and regulatory exercises to improve digestive function.
Many other physical behaviors can signal an emotional need to stimulate or calm the nervous system. Children who move around a lot may be trying to ground themselves. Children who seem disengaged or vacant may need to work on core muscles (exercises that cross the body’s midline) to wake up their brains.
The key to keeping children regulated and healthy is a balance of strengthening the brain and the body. Through an understanding of vagus nerve function, parents can work on bonding, observing and communicating with their children and strengthening their own mental health and physical well-being.
Parenting After Trauma
A parent’s ability to self-regulate has a direct effect on a child’s health. For personal mental health and parenting support, Catanzariti recommends a parent-friendly podcast course by Robyn Gobbel, Parenting After Trauma. Gobbel teaches parents how behaviors are an externalization of what is happening in the brain, body and nervous system, and focuses on responding to children’s behaviors in a way that begins healing, not just achieving a desired behavior. Learn more at www.robyngobbel.com/course/parentingaftertrauma.
Emily Dolton is a resource specialist and mom of two, one with 22Q 11.2 Deletion Syndrome.