Applying deep pressure as opposed to light touch can have a calming and regulating effect for some people with autism; however, it is not a one-size-fits-all approach to treatment and may not work on all individuals. Before you begin using this type of therapy, it's helpful to understand how well it works and the science behind it.
Theory Behind Deep Pressure
Noted autism advocate Temple Grandin proposed the idea of deep pressure treatment in a 1992 journal article. In the article, Grandin, who is herself on the autism spectrum, described the calming effects of steady, firm pressure as opposed to lighter touch. Deep pressure does not come from simple hugs. Instead, it's a steady weight, such as a stack of quilts or a weighted garment.
It is part of the Applied Behavior Analysis approach to autism treatment, but other therapy approaches uses it too. The theory is that the deep pressure allows the body to switch out of the "fight or flight" response and give the individual a chance to feel calmer.
Conflicting Research About Deep Pressure
Research about whether deep pressure is effective has been inconclusive for decades, and even recent studies have not determined whether this is an effective treatment:
- A 2017 study in the journal Occupational Therapy International found that the therapy helped six out of eight individuals with severe ASD. However, the study recommended that the individual's response should be very carefully monitored to determine whether the therapy was helpful.
- Another 2017 study published in the journal Behavioral Disorders found that deep pressure was of no benefit in reducing stereotypical behaviors like hand flapping or repeating words and phrases. Instead, exercise on a stationary bicycle was more effective.
Despite the mixed research results, many individuals, parents, and teachers report that deep pressure has helped with functioning and anxiety. Occupational therapists sometimes use a practice called "joint compression" that involves gently squeezing the joints of the arms and legs, as well as sensory products to provide pressure. Many schools have weighted vests or blankets for students.
Safety and Financial Concerns
Many speciality retailers sell weighted vests, blankets, lap pads, and other items. There are also products that provide full-body squeezes, such as crawl-through floor gym items or hanging swings. Retailers are quick to point out the benefits of these items, but there may be some ethical issues with the research they conduct or choose to share.
Deaths and Health Issues
In 2008, a Canadian boy died as a result of using a weighted blanket as part of his autism therapy. Because of this, health professionals recommend that parents and caregivers only implement weighted items with assistance from a professional. The weight must be in proportion to the persons's body weight, and it's essential that the individual is supervised when using the deep pressure device.
There is also concern that too much pressure for too long can cause long-term back problems or injuries. Most health professionals recommend that if these devices are used, they should be used for short periods of time.
Cost of Deep Pressure Products
Some types of deep pressure therapy, such as the joint compressions an occupational therapist may recommend, are free, and trying them doesn't put undue financial strain on families.
However, there are many products marketed for this purpose that can costs hundreds of dollars. The Big Hug, for instance, is a deep pressure positioning device with adjustable straps and headrest that retails for about $750. Many other products, such as the crawl-through Double Squeezer, sell for around $700 as well. These expensive devices may or may not benefit the individual and can be financially harmful to families who are already under stress from the cost of therapy, schools, medications, and other autism-related health items.
Work With an Occupational Therapist
In general, it's a good idea to try anything that might improve the life of someone with ASD. However, in the case of deep pressure therapy, it's very important to work with a trained occupational therapist to ensure the treatment is safe and effective. Additionally, a therapist will have specific product recommendations that may be a good investment if you would like to try this type of therapy.