Deep Touch Pressure Helps Kids Concentrate and be Calm
Every working day I meet children who struggle at home and at school to be able to meet the expectations of their teachers and parents to “behave” in an acceptable way and to do the things the way that adults seem to need them to be done. These children have good parents, who are doing all they know to help their children become the best they can be. By the time I see them, they often are almost at their wits end and don’t know where else to go, and often they are being pressured to look at medication as an option to help their child. (A note on this: I am not against medication, and know that this does help many children to cope better in life. However, often I give parents another option to try, or to use in tandem with medication).
So, how does deep touch pressure help children (and adults) to calm their bodies (through their nervous systems) and assist in concentration and learning?
The knowledge base of using deep touch pressure as a mode of therapy/ intervention is based on a sensory processing perspective and focuses on improving a sensory modulation. Sensory modulation is a descriptive term that is used 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).
OK, so what does this mean? Some children struggle to sit still, focus on the task at hand, are always on the move, cannot stay sitting on their chair, or cannot stay in the same place for story time. These children may be over responding to the different stimuli in the room (noises in and outside the room, visual input – kids moving around the room, the feel of the carpet or chair). You get the idea, they can be distracted by almost anything. This child may be moving or fluctuating in reaction to the different sensations in their environment. Their nervous system is over active, and they need to move to be able to listen and take in information.
Another child in the same class, may be struggling with similar behaviours, but may be doing so because her body and nervous system is under-responding, and she is moving and wiggling in an effort to “stay awake” and “stay on task”. So, even though similar behaviours are being observed, there may be different or even opposing reasons why they are “behaving” like this.
For this reason, a full sensory processing assessment by an Occupational Therapist who is experienced in sensory processing is highly recommended.
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) and children with autism.
This use of deep touch 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.
So, basically, how our body feels is impacted directly by what our senses pick up from the environment, and deep pressure input is the most calming of sensory inputs, which can last in the nervous system for up to a couple of hours, or even longer, dependent on the intensity. What about the teacher standing behind a child and putting some gentle weight through the shoulders of a child who struggles to focus? Or, think of the last time you had a massage. A massage is an intense session of deep touch pressure. Did you feel calmer and relaxed afterwards? I know that I feel so relaxed I don’t feel like moving after a good massage. The same principle works for helping kids calm down when they need to do tasks where they need to sit still, or at times when they become worked up, or have meltdowns.
Deep touch pressure is very calming, and there are a number of resources available for children and adults which help by applying deep pressure to the body (nervous system) to result in calming of the nervous system. These may include using
- weighted lap pads (plain or in animal shapes) used on the lap either at the desk or on their lap on the floor, say in story time;
- pressure vests which can be worn all day, as the body doesn’t accommodate or get used to the pressure,
- weighted blankets,
- weighted vests,
- pea pods
- Rollease rolling pin. This is one of my favourites. It’s an over sized foam covered rolling pin where you can apply deep touch pressure to a child’s (adults love it too!) back for a great massage feeling. Do not use on front of body.
There are many resources being created all the time which use the principles of deep touch pressure.
Most of the research on deep touch pressure comes from the use of wearing weighted vests to help calm children and keep their focus (Koomer & Bundy, 2002). It is believed that the use deep touch pressure in the form 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 to create deep touch pressure?
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 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. This information in this article should be used with a dose of common sense, and if you have any concerns, please contact your local Occupational Therapist.
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.