Implementation of Weighted/Compression Vest Protocol in the School Setting to Maximize Self-Regulation. Rachel DeCarie, MOT, OTR/L; Dr. Sonia Kay, Ph.D. OTR/L; Rachel Khalifa, M.S. OTR/L; Nicole Wilson, M.S. OTR/L;

Nova Southeastern University, Fort Lauderdale, FL

Abstract

The use of Weighted/Compression Vests is an

intervention strategy that is used by the

occupational therapist (OT) to facilitate

increased attention and emotional regulation.

The vest provides the individual with

continuous proprioceptive input.

Previous findings on weighted vests have

shown weighted vests to be ineffective in

decreasing stereotypical behaviors (Hodgetts,

Magill-Evans, & Misiaszek, 2011) and off task

behaviors (Collins & Dworkin, 2011). A review

of research articles from 2001-2011, revealed

a number of methodological weaknesses. The

purpose of the current investigation was to

extend the research on the use of weighted

vests in order to implement a protocol on the

use of the weighted/compression vest in the

classroom setting.

Objectives

The objectives of the study are as follows:

1. Examine the limitations of current literature

2. Develop a criteria to determine which

children would benefit from the use of a

weighted/compression vest.

3. Establish a weighted/compression vest

protocol that can be used consistently to

provide effective results.

4. Establish appropriate goals for the use of the

weighted compression vest.

Limitations of Previous Research Method/Protocol Conclusion

References

Ferrel Daly, D., Bedell, G., & Hinojosa, 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, 629-640

Hodgetts, S. Magill-Evans, J & Misiaszek, J. (2011) Weighted vests,

Stereotyped Behaviors and Arousal in Children with Autism. Journal of

Autism and Developmental disorders. 41:805-814.

Leew, S. V., Stein, N. G. & Gibbard, W. B. (2010). Weighted vests’

effect on social attention for toddlers with Autism Spectrum Disorders.

Canadian Journal of Occupational Therapy, 77 (2), 113–124.

Collins, A. & Dworkin R.J. (2011). Pilot study of effectiveness of

weighted vests. American Journal of Occupational Therapy, 65, 688-

694.

Lack of controlled experimental

manipulation:

1. Studies used an A-B or randomized design.

2. Small sample size.

3. No qualifying criteria for wearing the vest.

4. The duration of all research studies was

fairly short. Studies conducted varied from

3-9 weeks.

5. Studies examined only most common

stereotyped behaviors for children with

autism or pervasive developmental

disorder.

Threats to internal validity:

Changes in behavior were isolated to effects of

the weighted vest and not an unknown variable

for all participants

External validity:

Weak descriptions of independent variables.

Expectations of Vest Usage

1. At the completion of the 9th week of vest

usage, the classroom teacher will collect

one week of data on the targeted behavior

and then share the original and follow-up

data with the OT.

2. The OT and the teacher will determine if

continued use of the vest will be

recommended.

Discussion

The implementation of the weighted

compression vest using a structured protocol

has led to increased consistency and

appropriate use of the weighted/ compression

vest in the school setting. The challenges have

been identifying measurable target behaviors

and consistent implementation of the protocol

across all classrooms. This research is

ongoing and the results of this study are

pending.

Student Identification

1. The Sensory Profile School Companion was

given to newly enrolled Baudhuin students.

2. Distribution and use of the

weighted/compression vests was

determined based on the results of the

Sensory Profile School Companion.

3. Collaboration between teacher and OT

occurred to identify one target behavior for

improvement.

4. One week of baseline date was collected on

this behavior.

Implementation of the Vest

1. Five percent of the child’s body weight was

used and was equally distributed to all parts

of the vest.

2. Initially, the student was acclimated to the

vest by wearing it during a highly preferred

and enjoyable activity, for a 10 minute time

period several times a day.

3. The vest was placed on the student 10

minutes before the targeted activity and 20

minutes during the activity, for a total of 30

minutes.

4. The student wore the vest for a maximum of

20-40 minutes; and then removed it for the

same amount of time.

Administer Sensory Profile

Determine Eligibility

Identify Target Behavior to be

Remediated

Collect One Week of Baseline Data

Implement Vest

Limitations

Small Sample

Short Timeframe

No Vest Usage Criteria

Weak independent

Variables

Only Common Behaviors Explored

Research Design

Internal Validity Threats