The 5-Point Scale and Emotional Regulation

By Kari Dunn Buron

Emotional regulation can be defined as the ability to separate your emotional responses to a problem from the thinking you must perform to resolve the problem. The 5-point scale is a visual system that can help to organize a person’s thinking when working through difficult moments, particularly those that require social understanding.

Autism impacts a person’s ability to understand social information. This can involve understanding other people’s intentions, knowing how to manipulate social situations, and repairing social interactions that have gone poorly. Difficulty in social thinking can affect a person’s ability to be comfortable in social situations and cause social confusion and anxiety. Social anxiety makes it even more difficult for a person with ASD to work through big emotions. Creating a visual system for working through challenging situations can be considered a strength based approach since most individuals with autism tend learn most effectively through concrete, predictable systems (Baron-Cohen).

The first step in using the scale to support emotional regulation is to identify problem areas for this person. For example, problems involving changes in routine, playing with peers, or following rules at work. The next step is to break the problem area into 5 parts clearly illustrating the degrees of the situation and putting this information onto a visual scale. A common issue when discussing emotional regulation is that of stress and anxiety. This is a good place to start, creating a scale that breaks down stress into the following 5 parts:

5 = This could make me lose control.
4 = This can really upset me.
3 = This can make me nervous.
2 = This sometimes bothers me.
1 = This never bothers me. *

It is important to get input from the person as much as possible and one way to do this is to create a pocket activity. The pocket activity can be purchased (www.autismawarenesscentre.org) or made using a file folder and library pockets. The caregiver then generates a list of environments and social situations that the person is exposed to everyday and that might cause stress. Next you make cards that can fit into the pockets with the situations and environments written on each card (commercial product also has picture/word cards for common situations). You then introduce the described scale to your child or student by using the activity to visually illustrate and clarify.

Hand the person one card and either have him read it or you read it allowed. Direct the person to then put the card into the number pocket that best describes how that situation makes him feel (as defined above). Keep some blank cards available to add situations that come up that you might not have anticipated. Once the person has rated a number of key situations, create a scale that clearly illustrates the results. This scale provides the foundation of an emotional regulation program. The scale in figure one is an example of a scale that was developed in this way.

A young girl named Petal was in a self contained secondary vocational class of all boys. Each student had his or her own workspace and typically Petal would remain in her own space during work time. Every now and then Petal would get up from her work and quickly walk over and scream at the boys. The educational team determined that this would happen when the boys were talking or laughing loudly. The first intervention tried was to offer Petal a “break card” which she was instructed to take to her teacher if she started to feel frustrated with the boys. She was then able to take a break in another room, away from the boys. After several weeks, the data showed that although Petal was using her break card, she continuously did so after she screamed at the boys. She had learned to give her teacher the card but had missed the point of using it to preempt the loss of control. Working through the pocket and card activity mentioned above, Petal and her teacher were able to systematically determine what things made Petal feel frustrated (#3), what things made her start to feel angry (#4), and what made her lose control (#5). Petal’s teacher wrote her a story about being in class with other students and how those other students often liked to talk and laugh but how that sound was irritating to Petal. The story listed things that Petal could do when she began to feel different ways. The goal of the scale and the memo were to clearly and systematically teach Petal to listen to her own body and to respond to frustration in more adaptive ways. Because she had previously learned to take a break card to her teacher, the team incorporated a “help” card into the new plan (figure two).

In the beginning, it was important for the classroom staff to be aware of the noise level themselves so that they could pre-empt Petal’s loss of control. Teaching Petal to use the card involved prompting her to give the card to an adult when the boys started to get noisy or when she started saying “shut up” to herself. The staff person would then praise Petal and prompt the boys to keep their voices down to a #2 (quiet talking on their volume scales).

The program succeeded in helping Petal to recognize that when she started to think too much about the boys she started to talk to herself. When she started talking to herself out loud, it was time to ask for help.