Occupational Therapy Sensory Integration Interventions Part 2

1. Occupational Therapy Sensory Integration Interventions Part 2 Stephanie M. L. Potts, MOTR/L

2. Weighted Vest • Weighted vests can provide deep, sustained pressure. Research has shown that the application of deep pressure can be calming for a child, decreasing purposeless hyperactivity, and increase functional attention to purposeful activities (VandenBerg, 2001, p 622).

3. Process of getting a weighted vest • If it is determined that a student can benefit from a weighted vest by the occupational therapist the following steps are taken: • 1. The child is measured for the appropriate size vest. • 2. The student is weighted to determine the appropriate amount of weighted needed in vest. • 3. A consent form is sent home to the parent explaining that a weighted vest is suggested, the weight amount that the student will be wearing, and evidence based literature that supports the use of weighted vests. • 4. The vest is weighted based on 4-7% of the child’s overall weight. • 5. A weighted vest is never applied until parent consent is received back.

4. Weighted Vest Research • A study conducted by VandenBerg (2001) concluded that on-task behavior increased by “18%- 25% when wearing a weighted vest” (p 625). • Occupational therapists who were interviewed during a study regarding perceived affects of weighted vests concluded that they were effective for “increasing the following behaviors: staying on task, staying in seat, and attention span” (Olson & Moulton, 2004a, p 59).

5. Implementation • Weighted vests should be work 2-3 times throughout the day for no more then 30 minutes at a time. • Never have a student wear a weighted vest during recess or gym. • Weighted vests are most beneficial when being worn during table top writing activities where students are expected to maintain sitting for an extended period of time.

6. Wilbarger brushing protocol • The Wilbarger brushing protocol consists of brushing and compression program in conjunction with a sensory diet for optimal results. • Brushing and joint compressions helps the calm and regulate the students body. • Protocol should be done every 90 minutes for optimal results.

7. Who Benefits • Research shows that the Wilbarger brushing protocol can be affective for children with sensory defensiveness. • A research study done by Pfeiffer, Kinnealey, Reed, and Herzberg (2005) declared, “individuals with sensory defensiveness, social interactions, and environments over which they have no control may make the person feel uncomfortable or distressed and lead to avoidant behaviors” (p 342).

8. Implementation of Wilbarger Brushing Protocol • Wilbarger brushing protocol can implemented within the classroom by a teacher, it should also be taken into consideration that the Wilbarger brushing protocol is not utilized by itself but rather, “it should be used in conjunction with other interventions such as a sensory diet” (Davich, 2009, p 16.

9. Sensory diet • Sensory diet is described as, “several strategies that are put together in order to modulate arousal, attention, affect and action for an individual” (Bongatt & Hall, 2010, p 295). • Improvements in students distractibility by an external stimuli and initiation to carry out tasks independently have been noted in research studies with the implementation of a sensory diet.

10. Sensory Diet Activities • Activities can include: • 1. Erasing chalk board, carrying snack bag, pushing weighted cart • 2. Scooter activities • 3. Shaving cream activities used for handwriting preparation • 4. Weighted vests and blankets • 5. Activities on a therapy ball • 6. Jumping, “crashing” into pillows in crash room, hopping • 7. Movement break activities- wall pushups, hand pushes, and chair pulls/push. • 8. Take 10 movement breaks

11. Remember… • Implementation of Sensory Integrative Interventions in the classroom by the teacher, as directed by the occupational therapist can significantly help students within the classroom to maintain attention and focus on academic related work.

12. References • Ayres, J. (1979). Sensory integration and the child. Los Angeles: Western Psychological services. • Autism Research Institute. (2012, March). Sensory Integration. Retrieved from: http://www.autism.com/fam_page.asp?PID=372 • Bonggat, P., & Hall, L. (2010). Evaluation of the effects of sensory integration-based intervention by a preschool special education teacher. Education and Training in Autism and Developmental Disabilities, 45(2), 294-302. • Futrell, M. (2006, October). Neuromuscular Control, Proprioception and Balance. Retrieved from http://www.cofc.edu/~futrellm/nmcontrol.html • Mullen, B., Champagne, T., Krishnamurty, S., Dickson, D., & Goa, R. (2008). Exploring the safety and therapeutic effects of deep pressure stimulation using a weighted blanket. Occupational Therapy in Mental Health, 24(1), 65-89. • National Institute of Health. (2012, February). Balance Disorders. Retrieved from http://www.meei.harvard.edu/patient/balancedisorders.php • Olson, L. & Moulton, H. (2004a). Use of weighted vests in pediatric occupational therapy practice. Physical & Occupational Therapy in Pediatrics, 24(3), 45-60. • Schilling, D., Washington, F., & Deitz, J. (2003). Classroom seating for children with attention deficit hyperactivity disorder: Therapy balls versus chairs. American Journal of Occupational Therapy, 57, 534-541. • Stephenson, J., & Carter, M. (2011). Use of multisensory environments in schools for students with severe disabilities: Perceptions from schools. Education and Training in Autism and Developmental Disabilities, 46 (2), 276-290. • VandenBerg, N.L. (2001). The use of a weighted vest to increase on-task behavior in children with attention difficulties. American Journal of Occupational Therapy, 55, 621-628.