Sensory integration therapy has been used for people with autism and other neurological disorders to try and tackle the underlying neurological processing and integration of sensory information in order to have a positive effect on emotion, learning, and behavior. Using a weighted vest for autism is an example of sensory integration therapy that is advertised as having a positive effect. But is it actually helpful?
With the increasing amount of autism awareness and education, there is a growing need for evidence-based therapies. In other words, these are therapies and treatments that have been proven through the collection of evidence to be effective. As creativity and scientific knowledge come together to develop new and potentially revolutionary treatments, it is critical that these new discoveries be evaluated for effectiveness.
What is a weighted vest?
A weighted vest is an article of clothing that adds and distributes 10% of the individual’s body weight to the rest of their body. Frequently, occupational therapists will advise people with autism to wear these vests only during specific activities or at certain times of the day. The thought is that the pressure increases calming effects by releasing dopamine and serotonin. The vest is also supposed to reduce movements that can add to distractions and difficulties for people with ASD. Companies that make the vests advertise that people with ASD and ADHD experience anxiety relief by wearing the vests. They say that the vest helps the individual stay calm and focused by stimulating their muscles and joints through deep pressure.
One company states that, “Many children and adults with sensory processing disorders, autism, or ADHD show dramatic improvement in their ability to sit still and concentrate on tasks when wearing a weighted vest, especially our weighted vest.” Additionally, they claim that, “If you have an autistic child or adult with special needs and want to travel, a weighted vest is very effective in giving a feeling of security.” These claims need to be supported by research. The link to this particular vest company is posted on the Autism Speaks website, so there are likely many people looking at it and hoping that it will help their children.
There are numerous reasons why a person may recommend that a child with autism wear a weighted vest. Some of the reasons involve helping the child focus on academic work in the classroom, while others may recommend them just to keep the child calmer.
The calming theory of weighted vests suggests that the pressure impacts the limbic system of the brain (the part that regulates emotions and is responsible for the fight-or-flight reflex). There is little research to support this, but teachers and occupational therapists still use the vests to calm down students so that there is less distraction in the classroom.
This potential to calm down students also has professionals hoping that weighted vests can decrease the amount of stereotypical ASD behaviors. There can be distracting to other children in the classroom and could lead a child with autism to be a target for teasing. Other weighted items such as blankets and belts are sometimes recommended by occupational therapists, but there is even less research on these items.
What does the evidence say?
According to one systematic review, using weighted vests for children with ASD is not an evidence-based practice. Just because the use of such vests is popular among occupational therapists and educators, that does not mean that it is supported by evidence. This review emphasizes that future research for the use of weighted vests should look at exactly how they are implemented. A lack of consistency in the way in which the vests are used could impact the effect that it has on the child and could impact the results of future studies.
This review discussed how educators and other professionals have an ethical responsibility to use interventions that are based in sound evidence. As they say, popularity and effectiveness are not synonymous. It is important that therapies are evaluated for effectiveness. If ineffective therapies continue to be used frequently, there could be less motivation to develop other types of therapies. This would negatively impact children with ASD who do not benefit from weighted vests, and do not have new potential therapies on the horizon. Additionally, families could be spending time and money using therapies that have no benefit on their children’s lives.
Recent research, though small, is promising
A recent article states that research indicates that children with ASD could benefit from weighted vest usage. They cite a study that found that children who used weighted vests had an increase in on-task behavior by 18% to 25%. While these are great statistics, the study only included four students. This is hardly a large enough sample to accurately represent the entire ASD population. The next study that was cited only included 5 children in the study population. Again, this is too small of a number to be representative of the entire ASD population and more research with a larger study population is necessary to draw definitive conclusions.
Another study included 110 children in the study population. The study looked at the effect that weighted vests had on “improving attention, impulse control, and on-task behavior in children with attention deficit hyperactivity disorder (ADHD).” The results showed that the children had significant improvement in the following areas: “speed of processing and responding; consistency of executive management; and three of four on-task behaviors, including off task, out of seat, and fidgets.” While the study population looked at children with ADHD and not ASD, it is possible that the vests could have a similar effect on children with ASD. Ultimately, more research is needed.
While there may be some benefits for some children who use a weighted vest, the available research is either inconclusive, or there simply is not enough of it. Larger studies are needed to produce definitive results. In the meantime, parents of children with ASD should try to get information on weighted vests from a number of healthcare professionals. Making collaborative decisions with professionals from different specialties can help ensure that parents are making the best decision for their individual children. What works for one child might not work for another. It is important that each child be looked at and treated like the individual that he/she is.
Parents should also remember that they know their children better than anyone. This in and of itself is expertise. Parents should feel empowered to trust their intuition when making decisions regarding the health of their children, and they should discuss this with their healthcare team.