Weighted Blankets and Deep Touch Therapy for Autism

Research suggests that deep pressure touch, such as that provided by weighted blankets and vests, can help relieve anxiety in both children and adults with sensory processing disorder. As sensory processing challenges are an issue for most people on the autism spectrum, deep pressure touch is often recommended as a tool to reduce anxiety and induce calm. Researchers have discovered that this technique can help people with autism reduce anxiety when it arises and maintain calm in potentially stressful situations.

Sensory Processing Disorder

According to the STAR Institute for Sensory Processing Disorder, "Pioneering occupational therapist and psychologist A. Jean Ayres, Ph.D., likened SPD to a neurological “traffic jam” that prevents certain parts of the brain from receiving the information needed to interpret sensory information correctly." The outcomes of this traffic jam include a range of difficulties including (but not limited to):

• Discomfort with clothing
• Difficulty falling or staying asleep
• Slow speech development
• Clumsiness (often bumps into things)
• Physical restlessness
• Unawareness of pain (hurts self but doesn't notice the pain)
• Discomfort with being hugged or cuddled

While SPD is often described and treated in children, it is by no means limited to children. Many teens and adults have SPD symptoms that may be diagnosed (or part of) another disorder such as autism or ADHD.

SPD in Autism

People with autism often have sensory processing challenges; in fact, one of the official criteria for autism spectrum disorder is "Hyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement)."

While not experienced by every individual on the spectrum, SPD can have a significant impact on autistic individuals' ability to function comfortably in day to day life. For example, people with autism and SPD may have increased difficulty with:

• Sitting in a classroom with bright lights or moving objects
• Wearing appropriate clothes such as coats with long sleeves
• Coping with the noise and confusion of school hallways or lunchrooms
• Responding appropriately to touch or pain

Naturally, these issues interfere significantly with the ability to learn in a typical classroom, play games, or socialize with classmates during recess or lunchtime. Teens and adults who have grown up with untreated autism-related SPD may have learned to (or been steered away from) social interaction, physical activity, or typical learning situations because they are uncomfortable or even traumatic.

While avoidance is one coping mechanism, it is not ideal. Small, quiet, carefully modified situations may make it easier for a person on the spectrum to function effectively, but it is extremely difficult to maintain such a setting outside of an institution such as school. The ideal is to provide treatment so that the child with autism can interact successfully in a typical (or semi-typical) setting.

SPD and Proprioception

Proprioception is one of the eight sensory areas that can be impacted by SPD. Proprioception is our ability to sense where we are and how the movement of our muscles will change our position. For example, we use proprioception when we position ourselves to sit down, or when we prepare to catch or throw a ball. A person with proprioceptive processing challenges may:

• Need physical contact (enjoy crashing, squeezing, hugging, or other forms of pressure)
• Have difficulty sleeping or keeping their eyes closed
• Be physically restless
• Be clumsy or have difficulty orienting themselves correctly for team sports or other physical challenges

Often, treatment for proprioceptive challenges can have a calming impact. Deep touch therapy, in particular, can help reduce anxiety and improve an individual's sense of body awareness.

Deep Touch Therapy

In 1992, Dr. Temple Grandin (an adult with high functioning autism) wrote a paper about her "squeeze machine." This simple device, built to provide deep pressure touch, helped her manage anxiety through her teenage years; a patented version provided relief to many people on the autism spectrum. According to Grandin, "Using the machine for 15 minutes would reduce my anxiety for up to 45-60 minutes." The "squeeze machine" was one of the first scientifically evaluated techniques for providing deep touch therapy as a way to calm individuals with autism.

Today, proprioceptive SPD is usually treated by an occupational therapist—but treatment still employs some of Grandin's theories and techniques. Depending on the type and severity of symptoms, therapists use a range of therapeutic tools such as swings, brushes, blankets, trampolines, or balls. When working with clients, therapists (for example):

• Use swings to help children develop a better sense of their body in space
• Have children bounce on trampolines or balls to provide sufficient tactile input to feel grounded and calm
• Use brushes and joint compression as a "sensory diet" to reduce anxiety and improve proprioception
• Roll children in blankets to provide a "squeezing" sensation
• Provide weighted blankets and/or vests to use in school or at bedtime to help promote relaxation and reduce anxiety

Research Findings

Research into the efficacy of deep touch therapy has had mixed results. Some smaller studies suggest that the approach is extremely helpful, while a metastudy conducted in 2016 finds that "DTP interventions are of generally poor quality and demonstrate effects that do not validate their current use for students with disabilities."

On the other hand, a group that replicated something similar to Grandin's squeeze machine conducted a small study and found "a satisfactory therapeutic capability." In addition, a 2001 study using weighted vests found that "On-task behavior increased by 18% to 25% in all four students while wearing the weighted vest. Additionally, three of the four students frequently asked to wear the vest other than during the observation times." A 2008 study using weighted blankets found that "63% reported lower anxiety after use, and 78% preferred the weighted blanket as a calming modality."

Trying Deep Touch Therapy for Autism

While research findings aren't universally positive for deep touch therapy, DTP carries almost no risk, is not expensive, and could potentially provide benefits for some people with autism or related sensory issues.

To get started, you'll ideally want to seek out an occupational therapist with sensory integration training and experience who will evaluate and treat your child. This is, of course, the best choice; it may, however, not be feasible. While occupational therapy is often provided through schools (free of charge to parents), few school OTs are specifically trained in sensory integration or deep touch therapy; they are more likely to work with your child on school-related skills such as handwriting, cutting with scissors, etc.

If you must find a sensory integration specialist in the community there is a good chance that their services will not be paid for by insurance: sensory integration is considered, by some insurers, to be an alternative form of therapy.

If you are unable to find or afford a therapist who can work with your child effectively, you can integrate some DIY deep touch pressure into your child's routine. Here are a few options:

• Purchase a weighted blanked and have your child try it out at bedtime or at times when she seems particularly anxious. You can buy weighted blankets through most online shops and big-box stores; there is no need to buy a product labeled "therapeutic."
• Try out a weighted vest during times when your child should be sitting still and attending to homework or a meal.
• Roll your child firmly in a blanket to make a “burrito” (ensuring that he is comfortable rather than claustrophobic and can breathe properly)
• Press your child between two soft pillows to make a "sandwich"

While any of these techniques may be helpful, there is no guarantee that they will have a calming impact. To determine whether they are really making a difference, you will have to observe your child in similar situations with or without the DTP, and carefully note how your child responds to DTP.

For example, if your child is typically restless at bedtime, note how long it generally takes her to get to sleep; how often she gets out of bed; whether she stays asleep and for how long. Then provide a weighted blanket and make similar observations. Compare your findings to determine whether the blanket is helpful, neutral, or problematic.

A Word From Verywell

Many therapies for autism are under-researched, and many work well for some people on the spectrum but not for others. It's important, before trying out any therapy, to carefully evaluate potential risks and negative outcomes as well as possible benefits. If the potential benefits far outweigh any possible risks, it's also important to accurately measure symptoms before and after using the therapeutic intervention. Accurate measurements can help avoid the possibility of a false positive (or negative) outcome.