A Review of Research on the Use of Weighted Vests with Children on the Autism Spectrum

INTRODUCTION Autism spectrum disorder is a neurobiological disorder that is characterized by qualitative impairments in language, qualitative impairments in social skills, and stereotyped or restricted patterns of interest, behavior, or activities (DSM IV-TR, 2000). It has recently been estimated that . 6% of the population has a diagnosis of autism spectrum disorder (Fombonne, E., 2005). Occupational therapists working in the school system have been and will continue to assess and treat students with autism spectrum disorder. However, empirical research studies on occupational therapy services with children with autism are rare (Watling, R., Deitz, J., Kanny, E.M., McLaughlin, J.E, 1999). Conversely, healthcare and education are increasingly pushing for evidenced based practice (Honaker, C., & Rossi, L.M., 2005). Accountability is, and should be, demanded by reimbursement sources, parents, teachers, and other healthcare professionals. An example of an occupational therapy technique used with students with autism spectrum disorder is a weighted vest. The use of a weighted vest is based on the sensory integrative frame of reference. It is argued that the weight in the vest provides proprioception (deep pressure), which provides calming input to the central nervous system by promoting the production of neurotransmitters such as serotonin and dopamine (Vandenburg, N.L., 2001, Honaker, D., & Rossi, L.M., 2005). A survey of school-based occupational therapists reports that 82% report using weighted vests with students. These therapists report seeing benefits of calming, increased attention to task, and decrease in self-stimulatory behaviors (Olsen, L.J. &Moulton, H.J., 2004). Many occupational therapists report using the sensory integrative framework when treating children with autism. They also report using proprioceptive input as a part of the intervention (Watling et al, 1999). Despite this and other qualitative reports of the benefits of weighted vests, there is little organized assessment regarding the effectiveness of their use (Honaker, D. & Rossi, L.M., 2005). The purpose of this paper is to gather and review the literature on the use of weighted vests with students who have an autism spectrum disorder, as well as specific protocols for use. Sound, research-based evidence for the use of weighted vests with this population will assist therapists in making informed decisions on appropriate use. It is also imperative that occupational therapists understand specific treatment techniques to be valuable members of the Individualized Education Plan (IEP) team. LITERATURE SEARCH The following journals were manually searched: American Journal of Occupational Therapy (1999-2005), AOTA's Sensor), Integration Special Interest Section (1998-2005), OT Practice (1999-2005), Canadian Journal of Occupational Therapy (1997-2005), and Occupational Therapy in Health Care (1984-2006). The following databases were electronically searched: Medline (1980-present), Cumulative Index to Nursing and Allied Health Literature (1980-present), Psychinfo (1980-present), Academic Search Premier (1980-present), Educational Resource Information Center (1980-present), Professional Development Collection (1980-present), and Health Source: Nursing/Academic Edition (1980-present). The search terms used were weighted vest, autism AND deep pressure, autism AND proprioception. The reference section and in-text citations were examined for other works, and this process was repeated until no new studies were found. INCLUSION-EXCLUSION CRITERIA FOR STUDIES The studies used in this review had to be published in English. Studies had to be published between 1980 and 2006. Knowledge of autism has grown and changed rapidly in the last 25 years, and the use of a weighted vest in school system practice is a fairly new treatment technique. Articles chosen were those that studied the use of the weighted vest for children with autism spectrum disorder. …