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By Nancy VandenBerg, MS, OTR
The OTvest™ is a stylish denim vest ("Levi" type) that looks like an everyday garment and is undetectable as anything "therapeutic"--providing an alternative or adjunct to medication. The weights are invisible from the outside of the vest. Similar to someone pressing gently down upon the shoulders and upper back, the weights lie directly upon the muscles of the shoulder-girdle to apply MILD, yet calming, deep pressure. Most children comment "It feels good" when they put the OTvest on. This is similar to the calming effect that sleeping under a heavy blanket provides. The central nervous system's sensory areas respond to deep pressure by producing a settling effect--which may be produced by increasing the brain chemicals (neurotransmitters) in some of the ways that medications work (see VandenBerg, N.L. (2001) *. Individuals who are good candidates for use are those who appear hyperactive, show disorganized behavior (messy work area, lack of attention-to-task, excessive movement in their seat that inhibits productivity), children with tactile defensive behaviors (overreaction to touch, or always needing to touch everything), are easily distracted, show poor body awareness, those with sensory processing/modulation difficulties, and autism. Young children are particularly highly responsive to deep pressure, as their nervous systems are more plastic--however, even adults have demonstrated benefits from the use of deep pressure from the OTvest. VandenBerg's research study, published initially in The American Journal of Occupational Therapy (see VandenBerg, N.L. (2001)* and more recently as Chapter 26 in Pediatric Issues in Occupational Therapy: A Compendium of Leading Scholarship (C. Royeen, 2004), used 5% of each child's body weight as the amount of vest weight. This research prompted VandenBerg's improvement upon the vest design--resulting in the OTvest ™ which has a PATENTED design--where the weights press gently down directly upon the muscles of the shoulder-girdle to apply MILD, yet calming, deep pressure. Most children comment "It feels good" when they put the OTvest on. This is similar to the calming effect that sleeping under a heavy blanket provides. The central nervous system's sensory areas respond to deep pressure by producing a settling effect--which may be produced by increasing the brain chemicals (neurotransmitters) in some of the ways that medications work (see VandenBerg, N.L. (2001) *. Having the individual wear the vest during an enjoyable activity is an excellent way to introduce vest use. Some children may need to wear the OTvest for greater periods of time initially to become more accepting of its use. A general guideline is to have the individual wear the vest for 20-40 minutes, remove it for the same amount of time, (so that the nervous system does not adapt to this new sensation of increased weight), and then wear it again. Do not remove the vest in the middle of an activity, however, but wait until its completion. MANY children put the vests on themselves when they feel they need it! For others, a schedule if often helpful so that the vest if worn during the times most needed, such as when first starting the day, after recess, during specials classes, for written work , reading, homework, prior to bedtime--or during stressful activities (haircuts, shopping, dining out). Some children may tolerate only 10-15 minutes before they want to remove it. They may be urged to keep it on a bit longer to try and build them up to a longer period of time, but should be allowed to remove it if they persist. Each child is individual and needs to have the judgment of the supervising adult utilized with some experimentation. It is best to consult with an occupational therapist concerning a wearing schedule and the OTvest used under the direction of a licensed therapist or healthcare professional and worn while under adult supervision.
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, 621-628.
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