Unlocking the Power of the Vagus Nerve: What It Is, Why It Matters, and How to Support It

If you have ever noticed that taking a slow, deep breath genuinely helps you feel calmer, that there is something real happening, not just a placebo, you have experienced your vagus nerve doing its job.

The vagus nerve is the longest and most complex cranial nerve in the human body. It runs from the brainstem all the way down through the neck, chest, and abdomen, branching into the lungs, heart, liver, kidneys, and gut. It carries signals in both directions, from the brain to the body and, significantly, from the body back to the brain. In fact, roughly 80 percent of the fibres in the vagus nerve are afferent, meaning they carry information upward toward the brain rather than downward from it.

(Photo credit: https://www.sheppardchiropractic.com/blog/303818-the-vagus-nerve-and-how-important-is-it-to-my-overall-health)

This makes the vagus nerve one of the most important communication pathways in the body, and one of the most powerful levers for influencing nervous system state, emotional regulation, digestion, immune function, and the capacity for genuine social connection.

At Tailored Developmental Therapies, the vagus nerve is central to how we think about regulation, for children and adults alike. Whether we are working on reflex integration, belly breathing, speech development, or nervous system regulation more broadly, we are always, in some sense, working with the vagus nerve. Understanding it helps families understand why our programs work the way they do, and why the seemingly simple things we ask families to do at home matter more than they might appear.

Is nervous system regulation a challenge for your child or for you? TDT’s programs work at the foundational neurological level, including supporting vagal tone as part of reflex integration and neuroplasticity work. Book your free 30-minute phone consultation — available Mondays 3:30–4:30pm.

What Is the Vagus Nerve and What Does It Actually Do?

The name “vagus” comes from the Latin for wandering, and it is an apt description. Unlike most cranial nerves, which serve a specific, localised function, the vagus nerve wanders through the body connecting the brainstem to a remarkable range of organs and systems.

Its functions include regulating heart rate, respiratory rate, and digestive motility. It controls the gag reflex and the muscles of the throat and voice. It influences the release of neurotransmitters including acetylcholine and serotonin. It plays a central role in the inflammatory response and immune function. And, critically for everything we do at TDT, it is the primary pathway of the parasympathetic nervous system, the branch of the autonomic nervous system responsible for calm, safety, recovery, and social connection.

Stephen Porges’ Polyvagal Theory, developed in the 1990s and now widely influential in trauma-informed and neurodevelopmental practice, describes the vagus nerve as having two distinct branches: the older dorsal vagal branch, associated with shutdown, freeze, and conservation responses; and the newer ventral vagal branch, associated with calm engagement, social connection, and the capacity to be genuinely present with another person.

When the ventral vagal system is active and well-regulated, a person feels safe, connected, and capable of flexible thinking and social engagement. When it is dysregulated, when the nervous system has defaulted to sympathetic activation or dorsal vagal shutdown, the capacity for learning, communication, and relationship is significantly reduced.

This is not an abstract concept. It is what happens every time a child shuts down at a table of homework, or erupts over something that seems minor, or withdraws from social contact they previously enjoyed. The nervous system has shifted state, and the vagus nerve is both a primary reason why, and a primary route back to regulation.

The ventral vagal state is also the state in which communication development occurs most naturally. A child who is in a shutdown or activated state is not available for the genuine social engagement that language development depends on. This is one of the clinical reasons why Fiona’s DIR Floortime sessions, which prioritise relational safety and co-regulation above all else, are so effective for children whose communication difficulties are rooted in nervous system dysregulation.

The Vagus Nerve and Interoception: Your Body’s Internal Compass

Interoception is the sense that allows us to perceive what is happening inside our own bodies, hunger, thirst, heartbeat, temperature, the need to use the bathroom, the physical sensation of emotions, and dozens of other internal signals. It is sometimes described as the eighth sense, and it is one of the most important and least understood aspects of human development.

The vagus nerve is the primary pathway through which interoceptive information travels from the body to the brain. Its upward-travelling fibres carry continuous, moment-to-moment signals about the state of the heart, lungs, gut, and other organs, information the brain uses to generate predictions about the body’s needs and to regulate its responses accordingly.

When vagal tone is healthy, when the vagus nerve is transmitting clearly and the brain is accurately receiving and interpreting those signals, interoception functions well. A person knows when they are hungry before they are ravenous. They sense the early signs of anxiety before it becomes overwhelming. They feel the need to use the bathroom with comfortable advance notice. They experience emotions as bodily sensations they can identify and respond to thoughtfully.

When vagal tone is poor, when the vagus nerve is not transmitting efficiently or when the brain is not accurately interpreting the signals it receives, interoception breaks down. And the consequences of this breakdown are wide-ranging and often surprising.

What Poor Interoception Looks Like in Practice

Poor interoception is a clinical picture we see regularly at TDT, and it underlies a number of presenting concerns that families bring to us. Understanding it helps make sense of behaviours and challenges that can otherwise seem baffling.

Children and adults with poor interoception may: not feel hungry until they are extremely so, then need food urgently; not sense the need to use the bathroom until the urge is overwhelming; not recognise they are tired until they are completely dysregulated; not identify the physical sensation of anxiety until they are already in a full stress response; seem unaware of pain or temperature extremes; have difficulty identifying or naming their own emotions; or experience emotions as overwhelming and unpredictable rather than as signals they can notice and respond to.

These patterns connect directly to several of the presentations TDT works with most frequently, including toileting difficulties, emotional dysregulation and meltdowns, demand avoidance, and difficulties with self-regulation more broadly. When interoception is poor, the nervous system cannot generate accurate predictions about what the body needs, and the result is dysregulation that appears to come from nowhere, because internally, there was no warning.

Supporting vagal tone — and through it, interoceptive development — is therefore central to TDT’s approach, not peripheral to it. It is one of the primary mechanisms through which reflex integration therapy produces its effects: by improving the quality of the signals the nervous system sends and receives, and by reducing the interference that retained primitive reflexes create in those pathways.

The Vagus Nerve and Retained Primitive Reflexes

One of the most important and least commonly discussed connections in developmental therapy is the relationship between retained primitive reflexes and vagal tone.

Primitive reflexes, the automatic movement patterns present from birth that should integrate as the brain matures, are deeply connected to brainstem function. The brainstem is also where the vagus nerve originates. When primitive reflexes remain active beyond their developmental window, they place ongoing demands on brainstem-level processing, demands that compete with the vagus nerve’s capacity to maintain flexible, responsive regulation.

The Moro reflex — the startle reflex — is particularly significant here. When the Moro reflex is retained, the threshold for sympathetic activation is chronically lowered. The nervous system is primed to detect threat in ordinary situations, flooding the body with cortisol and adrenaline in response to sensory events that should not register as dangerous. This is the direct opposite of the ventral vagal state, and it explains why children with retained Moro reflexes so frequently present with anxiety, demand avoidance, and difficulty recovering from even minor upsets.

Reflex integration therapy addresses this at its source, working at the brainstem level to complete the developmental integration that did not happen in early childhood, and gradually reducing the chronic threat-readiness that poor vagal tone and retained reflexes maintain together. As reflexes integrate, vagal tone tends to improve. As vagal tone improves, interoception becomes clearer, regulation becomes more accessible, and the full range of ventral vagal capacities — learning, communication and social connection become more available.

This is the clinical mechanism behind one of the observations families report most consistently: as reflex integration progresses, their child seems to become ‘more settled in themselves.’ They sleep better, their anxiety reduces, mealtimes become easier, transitions become less charged. These are not separate improvements, they are expressions of a nervous system that is moving from a chronic survival state toward a more regulated, connected one. Read more about what this journey looks like in our post on positive changes as therapy progresses.

How to Support the Vagus Nerve: A Practical Guide

The vagus nerve is accessible, which is one of the most important things to understand about it. Because it runs so close to the surface in several locations and because it responds to so many different types of input, there are many practical, low-cost ways to support vagal tone in daily life. These are not replacements for clinical intervention where it is needed, but they are powerful complements to it, and for families managing neurodevelopmental challenges, they can make a meaningful difference to daily regulation.

1. Slow Diaphragmatic Breathing

This is the most reliably effective vagus nerve activation tool available and the one with the strongest research support. Slow, deep breathing, particularly with a longer exhale than inhale, directly stimulates the vagus nerve through the diaphragm’s proximity to the heart and major vessels. The physiological effect is measurable: heart rate slows slightly on each exhale, and over time, consistent belly breathing increases the heart rate variability that is one of the primary measures of vagal tone.

For detailed instructions on how to practise belly breathing with children and adults across different ages, see our dedicated post on the importance of belly breathing. Even two to three minutes of slow nasal belly breathing daily is sufficient to begin building vagal tone over time.

2. Humming, Singing, and Chanting

The vagus nerve innervates the muscles of the larynx and pharynx, the throat. Vibration in these muscles directly stimulates vagal fibres, producing a measurable parasympathetic response. This is why humming, singing, gargling, and even chanting have been used as calming and regulatory practices across cultures for thousands of years, not as spiritual practices with placebo effects, but as physiologically effective vagal stimulation techniques.

For children, singing is often one of the most accessible and enjoyable regulation tools available. A familiar lullaby, a silly made-up song, or singing along to a favourite track all stimulate the vagus nerve through the throat while simultaneously creating connection and safety through the relational experience of music. This is one of the reasons Fiona incorporates vocal play into speech therapy sessions, it is regulation and communication development happening simultaneously.

💡  Gargling with water for 30 to 60 seconds is a simple, evidence-based vagal stimulation technique for older children and adults. It stimulates the muscles at the back of the throat where vagal branches run particularly close to the surface. Start with plain water and do it morning and evening as part of the routine.

3. Cold Water Exposure to the Face

Cold water applied to the face, particularly around the eyes and forehead, activates the diving reflex, a powerful autonomic response that immediately reduces heart rate and shifts the nervous system toward the parasympathetic state. It does this through the trigeminal nerve’s interaction with the vagus nerve, and the effect is rapid and reliable.

For children who tolerate it, splashing cool water on the face, holding a cool damp cloth against the forehead and cheeks, or submerging the face briefly in a bowl of cool water can produce a noticeable calming effect within seconds. This is also relevant for children who struggle with swimming, the face-in-water aversion some children experience is not simply anxiety about swimming; it may involve a dysregulated diving reflex response worth understanding at a neurological level.

💡  For young children or those who are water-sensitive, start very gently — a cool, damp face cloth on the forehead can be enough to begin building comfort and producing a mild vagal response without overwhelming the system.

4. Mindfulness and Body Awareness Practices

Mindfulness practices, when they are accessible and appropriate for the individual support vagal tone by training attention on the present-moment experience of the body. This is interoception in practice: noticing the breath, the heartbeat, physical sensations, emotional states as they arise in the body rather than as abstract experiences. Over time, this practice strengthens the brain’s capacity to accurately interpret vagal signals, improving both interoceptive awareness and the nervous system’s capacity for flexible regulation.

For children, formal mindfulness is rarely appropriate. The equivalent, following the child’s lead in slow, embodied play, narrating what they are experiencing physically and emotionally, creating space for them to notice their own internal states, is built into the approach Fiona uses in her speech therapy sessions and that Emily builds into neuroplasticity programs.

5. Gentle Movement and Yoga

Slow, rhythmic movement, walking, gentle stretching and yoga supports vagal tone through several mechanisms simultaneously: the proprioceptive input of movement, the rhythmic breathing patterns that movement encourages, the postural changes that affect thoracic pressure, and the social and emotional safety of movement done in a connected, unhurried way.

For children, this does not need to look like yoga. Slow walks, gentle swinging, rhythmic rocking, and heavy work activities all provide similar regulatory input through overlapping pathways. The key quality is slowness and rhythm, fast, unpredictable, or competitive movement tends to increase sympathetic activation rather than support vagal tone.

6. Gut Health and Diet

The gut-brain axis, the bidirectional communication pathway between the gut and the brain, runs primarily through the vagus nerve. A significant proportion of the body’s serotonin is produced in the gut, and the gut microbiome directly influences vagal signalling in ways that affect mood, anxiety, and nervous system state.

Dietary approaches that support the gut microbiome, probiotic-rich foods such as yoghurt and kefir, prebiotic foods such as legumes and vegetables, omega-3 fatty acids from oily fish and flaxseed, and a diet low in ultra-processed foods and refined sugars, also support vagal tone through the gut-brain axis. This is particularly relevant for children and adults with toileting difficulties, digestive discomfort, or mood and regulation challenges that appear to worsen with certain dietary patterns.

💡  For families managing complex neurodevelopmental presentations, gut health is often worth discussing with a general practitioner or naturopath alongside therapeutic programs. The gut-brain connection is real and bidirectional, supporting one supports the other.

7. Warmth, Connection, and Safe Relationships

Perhaps the most powerful vagus nerve activation tool of all is something that cannot be prescribed as an exercise: the experience of genuine safety within a trusted relationship. Stephen Porges’ Polyvagal Theory identifies social engagement, eye contact, prosodic voice, facial expression, physical touch from a safe person and as the most powerful activator of the ventral vagal system.

This is why consistent, relationship-based support produces better outcomes than transactional support. Why Fiona’s sessions are child-led and relationally grounded. Why Emily’s mentoring of support workers focuses on genuine connection rather than compliance. The nervous system regulates most effectively in the context of safe relationships, and building those relationships is one of the most important things TDT does.

The Vagus Nerve Across TDT’s Programs

Understanding the vagus nerve helps make sense of why TDT’s approach looks the way it does, why seemingly simple activities carry significant therapeutic weight, and why the integration of different program elements produces effects that none of them produces alone.

Emily’s reflex integration and neuroplasticity programs work at the brainstem level, the origin of the vagus nerve, to complete the developmental organisation that underpins flexible, responsive vagal regulation. As retained reflexes integrate, the brainstem’s functional load reduces, and the vagus nerve’s capacity for clear, efficient signalling improves.

Fiona’s speech therapy sessions create consistent ventral vagal activation through relational safety, child-led engagement, and vocal play, building the foundation of co-regulation that communication development depends on. Read more in our posts on speech and communication development and why children need foundation skills before words.

Our mentored support workers reinforce vagal regulation strategies — belly breathing, heavy work, rhythmic movement, consistent warm relationships — across the everyday environments where the nervous system does most of its learning. Read about this in our post on what mentored support actually means.

And the home strategies TDT families are given, breathing exercises, heavy work circuits, singing, warm predictable routines, are not arbitrary activities. Each one is a vagal stimulation tool, chosen because it is accessible, sustainable, and clinically relevant to the individual’s presenting needs.

Frequently Asked Questions

What is vagal tone and how do I know if mine or my child’s is poor?

Vagal tone refers to the resting activity level of the vagus nerve and the nervous system’s capacity for flexible, responsive regulation. High vagal tone is associated with good emotional regulation, social engagement, digestive health, and resilience. Poor vagal tone is associated with heightened anxiety, poor emotional regulation, digestive difficulties, chronic stress reactivity, and difficulty recovering from activation.

Signs of poor vagal tone in children include frequent meltdowns with slow recovery times, persistent anxiety or hypervigilance, poor interoception, demand avoidance, sensory sensitivities, digestive difficulties, and frequent illness. In adults, similar patterns apply alongside fatigue, brain fog, poor stress resilience, and difficulty relaxing fully even in safe environments. If several of these resonate, it is worth discussing with TDT during a phone consultation.

How long does it take to improve vagal tone?

Research suggests that consistent daily practice of vagal stimulation techniques, particularly slow diaphragmatic breathing, begins producing measurable improvements in heart rate variability (a key measure of vagal tone) within four to six weeks. More substantial and sustained improvements in regulation, interoception, and resilience typically take three to six months of consistent practice. When vagal support is combined with reflex integration therapy, which addresses the brainstem-level foundations of vagal regulation, families often report faster and more comprehensive progress than with either approach alone.

Can vagus nerve stimulation help with my child’s anxiety?

Yes, and this is one of the most well-supported applications of vagal stimulation in the clinical literature. Anxiety is fundamentally a nervous system state: an overactive sympathetic response combined with reduced parasympathetic capacity to bring the system back to regulation. Vagal stimulation techniques directly support the parasympathetic capacity that anxiety reduces. Combined with reflex integration work addressing the retained reflexes that maintain chronic sympathetic activation, the combined effect on anxiety can be significant.

Is the vagus nerve relevant to children as well as adults?

Absolutely, and we would argue it is even more important in children, because the developmental period of childhood is when the vagal regulation system is being established for life. The patterns of vagal tone and autonomic regulation that develop in childhood tend to persist. Supporting healthy vagal development in children, through safe relationships, rhythmic movement, belly breathing, and addressing retained reflexes that interfere with brainstem regulation, is one of the most important contributions a therapeutic program can make to long-term health and wellbeing.

Can this be funded through NDIS?

Yes. TDT’s therapeutic programs, including the reflex integration and neuroplasticity work that directly supports vagal regulation, may be accessible under relevant NDIS support categories for plan-managed and self-managed participants. We are happy to discuss funding options during your complimentary phone consultation.

How does the vagus nerve connect to interoception and toileting?

The vagus nerve is the primary interoceptive pathway, the route through which the brain receives signals about internal body states. This includes the signals from the bladder and bowel that regulate the urge to use the bathroom. When vagal tone is poor and interoception is disrupted, these signals may not be perceived clearly or with adequate advance notice, contributing to toileting accidents, urinary urgency, bowel irregularity, or the patterns described in our post on how TDT supports toileting difficulties. Supporting vagal tone is therefore often part of the therapeutic picture for clients with toileting challenges.