Focus on Autism and Other Developmental Disabilities XX(X) 1–9 © 2010 Hammill Institute on Disabilities Reprints and permission: http://www. sagepub.com/journalsPermissions.nav DOI: 10.1177/1088357609353751 http://focus.sagepub.com Effects of Weighted Vests on the Engagement of Children With Developmental Delays and Autism Brian Reichow, 1 Erin E. Barton, 2 Joanna Neely Sewell, 3 Leslie Good, 4 and Mark Wolery 5 Abstract The use of weighted vests for children with autism spectrum disorders and developmental disabilities is a common practice as part of sensory integration therapy programs.The purpose of the current investigation was to extend the research on the use of weighted vests for children with autism and developmental delays in a methodologically rigorous study. The study was conducted using an alternating treatment design.This allowed the comparison of three different conditions: weighted vest, vest with no weight (which served as a placebo), and no vest (which served as a baseline).The results showed no differentiation in engagement between conditions for any of the participants. Implications for practice and future research are provided. Keywords autism spectrum disorders, sensory integration, weighted vests, engagement Sensory abnormalities are frequently reported by individu- als with autism spectrum disorders (ASD) and parents of individuals with ASD (Rogers, Hepburn, & Wehner, 2003). Although sensory abnormalities are not a diagnostic marker for ASD, these abnormalities may be one of the first signs of the disorders (Lord & McGee, 2001). Reports of sensory abnormalities suggest that individuals with ASD display atypical sensory responses due to poor sensory integration (SI) or arousal modulation (Baranek, 2002). Although reports of sensory abnormalities in ASD are numerous, no empiri- cal evidence exists that explains the underlying neurological processes responsible for such abnormalities (Rogers & Ozonoff, 2005). In fact, recent data have been interpreted to suggest that the pattern of sensory abnormalities might differ across diagnostic categories of ASD (Myles et al., 2004). Hence, much remains to be discovered concerning how indi- viduals with ASD process sensory information. The hypothesized differences in processing sensory infor- mation for individuals with ASD have led to the creation of several treatments and practices based on the theories under- lying SI therapy (Ayres, 1972; Iarocci & McDonald, 2006; Schaaf & Miller, 2005; Smith, Mruzek, & Mozingo, 2005). The use of a weighted vest has been hypothesized to decrease behavioral difficulties by helping children regulate and orga- nize sensory input (Olson & Moulton, 2004) and has become a common treatment for children with ASD (Green et al., 2006). Although weighted vests frequently are used with children with ASD, there are no protocols or guidelines for practice (Fertel-Daly, Bedell, & Hinojosa, 2001; VandenBerg, 2001). Olson and Moulton (2004) surveyed occupational therapists (OTs) and found that they reported having insuf- ficient knowledge and information about how to use weighted vests. OTs must make difficult decisions regarding the weight of the vest as well as when, how long, and how often a child should wear the vest (Farber, 1982). The lack of a protocol and guidelines for practice with weighted vests might increase the possibility of improper or unnecessary use. Further- more, wearing weighted vests may have an aversive rather than a therapeutic effect (e.g., Kane, Luiselli, Dearborn, & Young, 2004/2005). In a database search of PsycINFO and Medline, four arti- cles examining the use of weighted vests were identified: three with children with ASD (Case-Smith & Bryan, 1999; Fertel-Daly et al., 2001; Kane et al., 2004/2005) and one with children with attention difficulties (VandenBerg, 2001). Case-Smith and Bryan (1999) examined the use of direct 1 Yale Child Study Center, New Haven, CT, USA 2 University of Oregon, Eugene, OR, USA 3 Fairforest Elementary School, Spartanburg, SC, USA 4 Vancouver Early Childhood Center,Vancouver, WA, USA 5 Vanderbilt University, Nashville, TN, USA Corresponding Author: Brian Reichow,Yale Child Study Center, 40 Temple Street, Suite 7-I, New Haven, CT 06510, USA Email: brian.reichow@yale.edu Focus Autism Other Dev Disabl OnlineFirst, published on December 23, 2009 as doi:10.1177/1088357609353751