Grounding Exercises: Supporting Emotional Regulation for Adults with Intellectual and/or Developmental Disabilities
For adults with intellectual and/or developmental disabilities (ID/DD), managing stress, anxiety, and overwhelming emotions can be particularly challenging. Grounding exercises—simple practices that help bring attention back to the present moment—are effective tools to promote calm, focus, and a sense of safety.
What Are Grounding Exercises?
Grounding exercises are techniques that use the five senses or mental focus to redirect attention away from distressing thoughts and toward the here and now. Examples include:
5-4-3-2-1 sensory exercise: Naming five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste.
Breathing with focus: Taking slow, intentional breaths while counting or following a rhythm.
Movement-based grounding: Engaging in simple physical activities, like stretching, walking, or tapping the feet against the floor.
These practices can be adapted to different ability levels, making them accessible for many adults with ID/DD.
Why Grounding Matters for Adults with ID/DD
Many individuals with ID/DD experience higher rates of co-occurring mental health conditions than the general population. For example, a recent review notes that people with intellectual and developmental disabilities often have greater behavioral and mental health support needs. (PMC) Additionally, individuals with ID/DD are recognized as being at high risk for co-occurring mental health disorders. (Psychiatry Online)
Because some individuals with ID/DD may have difficulty expressing emotions verbally or may be more prone to sensory overload, grounding exercises provide concrete, nonverbal tools for managing distress.
Benefits Include:
Reducing anxiety and emotional overwhelm by offering predictable, repeatable coping strategies.
Improving focus and attention, especially in overwhelming settings or moments of high stress.
Fostering independence by equipping individuals with tools they can use without relying solely on caregivers or verbal prompts.
Enhancing participation in daily life—from social interactions to work tasks—by supporting better self-regulation.
Self-regulation and co-regulation are areas of particular importance for people with intellectual disabilities. A review found that support in co-regulation (i.e. external scaffolding by caregivers) is often crucial in helping individuals develop self-regulation skills. (ResearchGate)
Practical Tips for Caregivers, Support Staff, and Advocates
Model the exercises: Demonstrate grounding in real time so that adults with ID/DD can see and mimic.
Use visual aids and prompts: Picture cards, step-by-step visuals, or simple cue cards can make the process more concrete.
Embed in routines: Introduce grounding as a regular practice (e.g. before transitions, at breaks, or during check-ins), not only in crisis moments.
Personalize strategies: Some individuals may respond better to tactile grounding (e.g. holding a textured object), while others prefer breathing, movement, or auditory focus.
Provide consistent encouragement: Reinforce attempts, even small ones, and gradually fade scaffolding as competence improves.
A Step Toward Emotional Well-Being
Grounding exercises are not a cure-all—but they offer a low-cost, low-risk, and adaptable strategy that can empower adults with intellectual and/or developmental disabilities to manage distress, reduce anxiety, and engage more fully in life. When integrated thoughtfully into support systems, these practices help promote safer, calmer, and more supportive environments.
References & Links
Lineberry, S., & colleagues. Co-Occurring Mental Illness and Behavioral Support Needs in People with IDD. [PMC article] (PMC)
Pinals, D. A., et al. Persons With Intellectual and Developmental Disabilities in Psychiatry. [Full text via Psychiatry Online] (Psychiatry Online)
National Association for the Dually Diagnosed (NADD). IDD/MI Diagnosis (overview) (The NADD)
Georgia Department of Behavioral Health & Developmental Disabilities. Understanding Dual Diagnosis (IDD + Mental Health) (Georgia DBHDD)
Andrikos, G. P., Smith, C. A., & Ciccarelli, M. Supporting Co-Regulation and Development of Self-Regulation Skills in Students With Intellectual Disabilities: A Scoping Review. (ResearchGate)