Focus on Autism and Other Developmental Disabilities has published a research article on the effects of weighted vests on the engagement of children with developmental delays and autism. Three participants (who had previously worn weighted vests) were observed in three different conditions - no vest, vest with no weight and vest with 5% of body weight. Data was collected using videotapes of the different conditions and the effects on engagement and behaviors. The results indicated that the weighted vest did not change engagement or behaviors.
The authors state that the limited number of participants was a significant limitation of this study. The researchers recommend further research to determine the proper amount of weight to be added to a weighted vest for there are no standard guidelines.
What percentage of body weight do you recommend for weighted vests? Do you collect data on whether the weighted vest is benefiting the child? Scary to me that the use of weighted vests are common practice and there is very limited research to back it all up.
Reference: Brian Reichow, Erin E. Barton, Joanna Neely Sewell, Leslie Good, and Mark Wolery Effects of Weighted Vests on the Engagement of Children With Developmental Delays and Autism Focus on Autism and Other Developmental Disabilities 2010 25: 3-11
5 comments:
I hae been on the fence about weighted vests for my son... at this point he only has SPD-- (he's 7) and I don't know that introducing a new tool would help... or hurt. (since transistions are not his...thing..)
I do however need to step up my work with no crashing in the house-- and listening the first time.
It might be time to go back to Therapy Solutions for kids... and get some more OT ...
Funny that you should mention hurt... For one child in the study the weighted vest actually increased negative behaviors. Sounds like a great idea to meet with your OT to discuss this with him or her (probably a her).
An excellent issue to post for discussion, Margaret. I don't want to emphasize the lack of research for treatment techniques like weighted vests (here, now). My professional response to the current lack of evidence for effectiveness is to support the concept of a sensory diet - individual trial-and-error for benefit - with the parent/teacher/therapist deciding on the diet.
Your concern is not unfounded, however. SOME therapists purport a technique for ALL children of a certain category/diagnosis - without evidence that the technique is effective for even most children. (See my post titled: Shotgun Therapy.)
So what percentage weight? - trial and error is my answer. Also, I think both of you, Stacey and Margaret, would find JoyMama's current post interesting. Barbara
I attended a course on SPD by Delana Honaker and she cited some research on weighted vest use. All of the following are available to AOTA members and accessible on the website, except for the last item.
Effects of a Weighted Vest on Attention to Task and Self-Stimulatory Behaviors in Preschoolers With Pervasive Developmental Disorders
Doreen Fertel-Daly-MA, OT, BCP; Gary Bedell-PhD, OT; Jim Hinojosa-PhD, OT, FAOTA
November/December 2001
The Use of a Weighted Vest To Increase On-Task Behavior in Children With Attention Difficulties
Nancy L. VandenBerg-MS, OTR
November/December 2001
Proprioception and Participation at School: Are Weighted Vests Effective? Appraising the Evidence, Part 1
Author: DeLana Honaker, PhD, OTR/L, BCP, and Lisa M. Rossi, MOTS
Published: 9/2005
Sensory Integration SIS Archive - 2005
Proprioception and Participation at School: Are Weighted Vests Effective? Appraising the Evidence, Part 2
Author: DeLana Honaker, PhD, OTR/L, BCP, and Lisa M. Rossi, MOTS
Published: 12/2005
Davis, L. (2001). Effects of deep pressure on physiological responses to light touch. Unpublished master's thesis, Temple University, Philadelphia.
The consensus from these studies and some expert opinions in survey and article form was that a weighted vest should have 5% of the child's body weight and be worn 10-15 minutes at a time, however there isn't an official published protocol. Dr. Honaker did outline how school based clinicians could conduct research in a convenient fashion. So now, as with many therapy interventions, we just need larger higher level research studies to prove effectiveness.
Upon reviewing some of the studies that you cited, there was only vest or no vest conditions. This makes it very hard for the evaluators of resulting behaviors to be objective. In addition, in the first two studies, both were done with very small sample sizes (4 and 5 children).
Barbara - I agree that trial and error in the use of weighted vests is a must for informed OT's. The 5% and 15 minute schedule does not seemed to be based on strong research.
Cheryl - That is great that Dr. Honaker has outlined how we can conduct research. The tricky part is getting any school based therapists to find the time to actually do it. Thank you for your very informative comment. This will be a great resource for therapists looking to research the use of weighted viests.
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