Breathing, Disabilities, and Whole-Body Regulation: Why We Need to Look Beyond the Breath

What if the child who struggles to take a deep breath isn’t refusing to participate—but is showing us something important about how their body functions?

We often hear adults tell children:

“Take a deep breath.”

“Slow your breathing.”

“Just breathe.”

But what happens when a child’s body cannot easily do what we’re asking?

For children with disabilities, developmental differences, sensory processing challenges, or neurological conditions, breathing may be more complex than we realize.

Breathing is not just about the lungs. It’s connected to the brain, nervous system, muscles, posture, sensory processing, and movement.

And when we begin to understand those connections, we can change how we support children.

Breathing Is a Whole-Body Experience

Breathing begins with automatic processes in the brainstem, but it involves much more than simply moving air in and out of the lungs.

The diaphragm, rib cage, abdominal muscles, spine, and nervous system all work together to support respiration.

Our breathing also changes in response to movement, emotions, physical demands, and our environment.

Think about a child who struggles to sit upright.

A child with low muscle tone may be working incredibly hard just to stabilize their head and trunk.

A child with cerebral palsy may experience differences in muscle coordination that affect both posture and breathing.

A child with autism may experience certain breathing sensations as uncomfortable or overwhelming.

A child with ADHD may find it difficult to sit still and follow a structured breathing exercise.

And a child with significant developmental delays may not understand the verbal instruction to “take a deep breath.”

These children aren’t necessarily refusing to cooperate. Their bodies may need a different approach.

The Connection Between Breathing and the Nervous System

Our autonomic nervous system helps regulate many processes we don’t consciously control, including heart rate, digestion, and aspects of breathing.

When we experience stress, excitement, fear, or uncertainty, our breathing patterns may change.

We might breathe faster, hold our breath briefly, or experience tension in the muscles surrounding the chest and abdomen.

Children experience these changes, too.

But here’s something important:

Not every breathing difficulty is caused by nervous system dysregulation.

Some children have physical, structural, neurological, or medical conditions that affect breathing.

For example, children with certain disabilities may experience respiratory muscle weakness, airway differences, swallowing difficulties, or sleep-disordered breathing.

These concerns require appropriate medical assessment and care.

Nervous system regulation strategies can complement that care, but they cannot replace it.

What About Sensory Processing and Body Awareness?

One area I find especially important is the relationship between breathing and interoception.

Interoception is our ability to notice and interpret sensations happening inside our bodies.

These include hunger, thirst, heartbeat, temperature, and breathing sensations.

Some children with disabilities experience differences in interoceptive awareness.

They may have difficulty noticing changes in their breathing or identifying what their bodies need.

Other children may be highly sensitive to internal sensations.

Imagine asking a child to close their eyes, sit still, and focus on their breathing when those sensations feel unfamiliar or uncomfortable.

What we intended as a calming exercise could actually increase their distress.

This is why regulation cannot be a one-size-fits-all approach.

We need to understand the child before choosing the strategy.

Movement May Be the Missing Connection

In my work through Move Into Calm™, I emphasize the relationship between movement, breath, nervous system awareness, and connection.

Sometimes, rather than beginning with breathing instructions, we can begin with movement.

A child might explore:

• Pushing their hands against a wall.
• Gently rocking or swaying.
• Reaching their arms overhead.
• Feeling their feet press into the floor.
• Watching a Hoberman sphere expand and contract.
• Listening to humming or participating in gentle vocal play.
• Moving rhythmically alongside a trusted adult.

These experiences may support body awareness, postural organization, and opportunities for co-regulation.

They also allow children to participate without needing to perform a particular breathing pattern.

Of course, activities must be adapted to each child’s physical abilities, sensory preferences, and medical needs.

Movement is not a substitute for respiratory treatment, but it can be an important part of supporting participation, comfort, and whole-body awareness.

Adults Go First

Here’s where parents, caregivers, and educators play an essential role.

Children learn through relationships and shared experiences.

Our facial expressions, tone of voice, pace, movement, and responsiveness all influence how we connect with them.

When a child is overwhelmed, our first response doesn’t always need to be another instruction.

Sometimes, it begins with noticing.

Is the child physically comfortable?

Are they working hard to maintain their posture?

Is the environment overwhelming?

Are we asking them to perform something that is developmentally or physically difficult?

Do they need movement, support, space, or connection?

And most importantly:

Are we responding to the child’s needs—or expecting the child to adapt to our strategy?

Co-regulation is not about making a child appear calm.

It’s about creating supportive conditions in which the child feels understood, respected, and connected.

Regulation Begins in the Body, Not in Behavior

This is one of the foundational messages behind Move Into Calm™.

When we focus only on behavior, we may miss what is happening underneath.

A child who cannot sit still may need movement.

A child who resists a breathing exercise may be experiencing sensory discomfort.

A child who appears distracted may be working hard to maintain their posture.

A child who struggles with transitions may need additional predictability, communication support, or time.

And sometimes, a child who appears dysregulated may actually be experiencing physical discomfort or a medical concern.

Behavior gives us information. But it doesn’t always tell us the whole story.

We need to look deeper.

A Different Approach to Breathing

Rather than asking every child to take a deep breath, what if we began asking different questions?

What does this child’s body need to breathe comfortably?

How does their posture influence their movement?

What sensory experiences help them feel supported?

Can we introduce breath awareness through play rather than instruction?

How can we adapt our approach to honor the child’s abilities?

And how can we help adults become more aware of their own breathing, movement, and nervous system responses?

This is where the science of development, movement, and nervous system regulation begins to come together.

Every Child Deserves an Individualized Approach

Children with autism, ADHD, cerebral palsy, Down syndrome, intellectual disabilities, sensory processing differences, and other developmental or physical conditions do not all experience breathing in the same way.

Even two children with the same diagnosis may have very different needs.

We cannot assume that one breathing exercise, movement strategy, or sensory activity will work for everyone.

But we can become more observant.

More curious.

More responsive.

And more willing to adapt.

Because the goal isn’t to teach every child to breathe the same way.

The goal is to understand the whole child.

Bringing It All Together Through Move Into Calm™

For more than 40 years, my work with children, families, and educators has reinforced an important lesson:

We cannot separate the brain from the body.

We cannot separate breathing from movement.

And we cannot separate nervous system regulation from the relationships and environments in which children develop.

Through Move Into Calm™, I help parents, educators, and caregivers explore the connections between movement, breath, nervous system awareness, and co-regulation.

My approach is grounded in developmental understanding, movement education, and the belief that every child deserves support that respects their individual needs.

Because regulation isn’t about making children fit our expectations. It’s about understanding what their bodies need to participate, connect, and thrive.

Let’s Look Beyond the Behavior. Let’s Understand the Body.

Are you a parent, caregiver, or educator supporting a child with disabilities, developmental differences, or sensory challenges?

Are traditional calming strategies simply not working?

Move Into Calm™ offers individualized, movement-based education and coaching to help adults better understand and support children’s whole-body regulation.

Schedule a free Calm Chat to explore how Move Into Calm™ can support your family, classroom, or organization.

www.moveintocalm.com

Move Into Calm™ — Movement • Breath • Nervous System Awareness • Connection

Educational note: This article is intended for education and awareness. Breathing difficulties, including noisy breathing, persistent mouth breathing, breathing pauses during sleep, or increased work of breathing, warrant medical evaluation. Movement and regulation activities do not replace medical, respiratory, occupational, physical, or speech-language therapy when indicated.

Research and Additional Resources

Understanding the relationship between breathing, disabilities, movement, sensory processing, and nervous system regulation requires looking at the whole child.

The following resources offer additional information about respiratory health, developmental differences, motor development, and individualized support for children with disabilities.

1. American Academy of Pediatrics (AAP)

Health Supervision for Children and Adolescents With Down Syndrome

Bull, M. J., et al. (2022). Pediatrics, 149(5), e2022057010.

This clinical report explores developmental and medical considerations, including muscle tone, airway differences, and sleep-disordered breathing.

Although specific to Down syndrome, it illustrates why breathing concerns should be evaluated in the context of a child’s overall health and development.

https://doi.org/10.1542/peds.2022-057010

2. American Speech-Language-Hearing Association (ASHA)

Pediatric Feeding and Swallowing — Practice Portal

This professional resource explains the complex coordination of breathing, swallowing, feeding, posture, and oral-motor function.

It is particularly relevant for children with neurological conditions, developmental disabilities, and complex medical needs.

https://www.asha.org/practice-portal/clinical-topics/pediatric-feeding-and-swallowing/

3. CanChild Centre for Childhood Disability Research

The F-Words for Child Development

CanChild’s framework encourages families and professionals to focus on six important areas:

• Functioning
• Family
• Fitness
• Fun
• Friends
• Future

This strengths-based approach emphasizes participation, relationships, and meaningful experiences rather than defining children solely by their diagnoses.

https://canchild.ca/research-in-practice/f-words-in-childhood-disability/

4. American Academy for Cerebral Palsy and Developmental Medicine (AACPDM)

Care Pathways and Evidence-Informed Resources

AACPDM provides clinical resources addressing developmental disabilities, motor function, hypotonia, and associated health considerations.

Its care pathways can help professionals understand why posture, mobility, muscle function, and respiratory health sometimes need to be considered together.

https://www.aacpdm.org/publications/care-pathways

5. American Occupational Therapy Association (AOTA)

Occupational Therapy Practice Resources

Occupational therapy addresses participation in daily activities, including the sensory, motor, and environmental factors that influence children’s experiences.

These resources can help parents and educators understand the importance of individualized sensory and movement supports.

https://www.aota.org/

A Final Thought

Breathing exercises are often presented as simple solutions for helping children become calm.

But for children with disabilities, the relationship between breathing, body awareness, movement, and nervous system regulation may be much more complex.

Research supports individualized assessment and interventions that reflect each child’s abilities and medical needs. Evidence for specific breath-based regulation activities varies across disability groups, and more research is needed.

At Move Into Calm™, we begin with curiosity, connection, and an understanding of the whole child.

Because every child deserves to be supported—not simply instructed.

Move Into Calm™

Movement • Breath • Nervous System Awareness • Connection

www.moveintocalm.com