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Weighted Therapy Review of Research
Summary of Research – Deep Pressure/Weighted Therapy
A literature review was conducted through using a CINAHL database search, using terms such as weighted vests, deep pressure therapy and occupational therapy intervention; and through reviewing cited references from these articles. This review of the literature in no way claims to be complete. The use of weighted wheat packs available through Life Skills 4 Kids is a modified application of the theory underpinning the use of weighted vests.
A sample of the literature findings are presented below.
The knowledge base of using weighted vests as a mode of therapy/ intervention is based on a sensory integration perspective and focuses on improving a sensory modulation disorder. Sensory modulation disorder is a descriptive term that occupational therapists use to describe a person who “over-responds, under responds, or fluctuates in response to sensory input in a manner disproportional to that input” (Koomer & Bundy 1991 p 1991).
The use of deep pressure as a form of tactile sensory stimulation is believed to have a calming effect on adults and children with pervasive developmental disorders (Edelson et al 1999, Grandin 1992, McClure & Holtz-Yotz 1991, cited in Fertel-Daly et al, 2001) and children with ADHD (Joe 1998, Maslow & Olson 1999 cited in VandenBerg 2001).
This use of deep pressure therapy is based on the neurophysiological principles of Rood, as cited below by Huss 1983 p 116 (in McClure & Holtz-Yotz 1991):
- Motor output is dependent upon sensory input. Thus sensory stimuli are utilised to activate and/or inhibit motor responses.
- Since there is interaction within the nervous system between somatic, psychic, and automatic functions, stimuli can be used to influence one or more directly or indirectly.
Weighted vests are one of many methods of applying deep pressure therapy Koomer & Bundy (2002). It is believed that the use of weighted vests assist in:-
- Decreasing purposeless hyperactivity and increase functional attention to purposeful activity (Miller et al 1999 cited in VandenBerg 2001).
- Reducing self-stimulatory behaviours in children with autism (Edelson et al 1999; Joe 1998; McClure & Holtz-Yotz 1991; Zisserman 1992).
- Reducing negative behaviour and increasing positive behaviors (attention, staying on task, following instructions) and
- Markedly increasing balance and stability in children with sensory integrative dysfunction (Olson & Moulton 2004).
How much weight to use?
Research suggests using approximately 5% of a child’s body weight to gain therapeutic results of increased attention, staying on task and following instructions (Honacker and Rossie, 2005b). Of course, weighted vests or other deep pressure/weighted therapy modalities should be used under adult supervision.
If you have any queries about how to use weighted therapy modalities, please contact your local occupational therapist. For optimal results in increasing concentration and attention, weighted therapy should be a part of a balanced “sensory diet”, in conjunction with other behavioural strategies.
References and Further Reading.
Edelson, S. M., Goldeberg, M. , Edelson, D. Kerr, D.C.R., & Grandin, T. (1999). Behavioral and Physiological Effects of Deep Pressure on children with autism: A Pilot study Evaluating the Efficacy of Grandin’s Hug Machine. The American Journal of Occupational Therapy, 53, 2, p. 145-152
Fertel- Daly, D., Bedell, G., & Hinjosa, J. (2001). Effects of a weighted vest on attention to task and self-stimulatory behaviors in preschoolers with pervasive developmental disorders. American Journal of Occupational Therapy. 55 (6), p. 629-640
Grandin T (1992), Calming effects of deep pressure in patients with autistic disorder, college students and animals. Journal of child and adolescent pharmacology. 2 p 63 – 72.
Honaker D. & Rossie LM (2005) Proprioception and participation at school: are weighted vests effective? Appraising the evidence, part 1. Sensory integration special interest section quarterly. Dec; 28 (3) p. 1 – 4
Honaker D. & Rossie LM (2005b) Proprioception and participation at school: are weighted vests effective? Appraising the evidence, part 2. Sensory integration special interest section quarterly. Dec; 28 (4) p. 1 - 4
Huss AJ (1983), Overview of sensorimotor approaches, In HJ Hopkins & HD Smith (Eds.) Willard and Spackman’s occupational therapy (6th ed.) pp 114 – 123. Philadelphia: Lippincott.
Joe, B.E. (1998). Are weighted vests worth their weight? The American Occupational Therapy Association. O.T. Week, p 12-13.
Koomer JA, & Bundy AC, (1991). Tactile processing and sensory defensiveness. In AJ Fisher, EA Murray, & AC Bundy (Eds.) Sensory Integration and practice (pp251-314). Philadelphia: FA Davis.
Koomer JA, & Bundy AC (2002). Creating direct intervention from theory. In AJ Fisher, EA Murray, & AC Bundy (Eds.) Sensory Integration and practice -2nd edn. (pp261 - 302). Philadelphia: FA Davis.
Maslow B, & Olson L (1999) Findings of a nationwide survey about occupational therapy practice with weighted vests. Paper presented at the American Occupational Therapy Association Annual Conference and Exposition, Indianapolis, Indiana.
Miller A, Moncayo Z, Treadwell D & Olsen L (1999), Children with autism sing weighted vests: Two single-subject studies. Paper presented at the American Occupational Therapy Association Annual Conference and Exposition, Indianapolis, Indiana.
McClure MK, & Holtz-Yotz M (1991), Case report – The effects of sensory stimulation treatment on an autistic child. American Occupational Therapy Journal, 45 p 1138 – 1142.
Olson, LJ & Moulton HJ. (2004) 11 (1) 52 – 66. Occupational therapists’ reported experiences using weighted vests with children with specific developmental disorders. Occupational Therapy International.
Olson, LJ & Moulton HJ. (2004b) 24 (3). pp 45 – 60. Use of weighted vests in paediatric Occupational Therapy practice. Physical and Occupational Therapy in Pediatrics.
Walker, D. B. & McCormack, K. (2002). The weighted blanket: an essential nutrient in a sensory diet. Framingham, MA. Therapro.
Watling, R., Deitz, J., Kanny,E. & McLaughlin, J. (1999). Current practice of occupational therapy for children with autism. American Journal of Occupational Therapy. 53 (5), 498-505
Vandenberg, N. L. (2001). The use of a weighted vest to increase on task behavior in children with attention difficulties. The American Journal of Occupational Therapy. 55 (6) p. 621-628
Zisserman L, (1992). Case report- The effects of deep pressure on self-stimulating behaviours in a child with autism and other disabilities. American Occupational Therapy Journal, 46 p 621 - 628.
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