Recently I was at an autism training day and the presenter asked, ‘Have you heard of heavy work?’ There were about 200 people in the audience and most of them put their hand up. The presenter then asked, ‘Does anyone know what heavy work is, could you show me?’ After this question, not one hand went into the air. When the presenter started to demonstrate some squashes and compressions the audience appeared quite amazed. It was as if they had never seen heavy work in action before.
As an occupational therapist this surprised me. Whilst most of the attendees in the audience said they had heard of the term heavy work, many of them didn’t seem to know what it really was. The term ‘heavy work,’ is frequently mentioned in books and advice for children with sensory processing difficulties and/or autism. It is commonly recommended to help support their sensory issues, yet, to those in the audience, what it actually was seemed to be a mystery. In this post, I hope is to solve the mystery of heavy work.
Heavy work = Proprioception
When occupational therapists use the term heavy work they are usually referring to an activity that activates our proprioceptors. Our proprioceptors are parts of our joints and muscles that receive feedback when we move. They tell us the position our limbs are in. They let us know how much or how little force we are using. We discuss proprioception in much more depth in our post ‘What is Proprioception?’ If you haven’t read this post, or aren’t familiar with the term proprioception we recommend you read it first before you continue.
Heavy work will include any activity that provides resistance. When you push something you create resistance. When you pull something you create resistance. If you carry something there is resistance. Moving your body also activates the proprioceptors but when therapists refer to heavy work they typically mean moving with or against some resistance.
When should we use heavy work?
Sensory integration theory indicates that proprioceptive input helps to calm and organise the brain. This input is usually suggested to help children calm their bodies down. It can be a good strategy for a child that experiences sensory overload, both before and after activity they find overloading. Therapists recommend it for a child or adult who has sensory sensitivities, especially if this is with their touch sense. It is also a good sensory strategy for sensory seekers as it can also help them organise.
If you’re not familiar with the different sensory processing challenges children and adults may have you can learn more about them here.
What heavy work activities could we do?
Digging & pouring
Rolling and cutting out play dough
Resistance band exercises
Pushing a trolley, cart, wheelbarrow or box – encourage the child to be creative in the play space
Carrying a bag with some weight, this needs to be adapted for each child and we would recommend starting with no more than 5% of their body weight in a backpack, bag or container. Carrying their water bottle and snack might be just the right amount for a young child.
Tug of War
Yoga – Cosmic Kids Yoga is great, as are the Yoga Pretzels Cards
Cycling and scooters
Teenagers and adults may find weight training a good option. It is recommended professional advice is sought initially to ensure they are using these items safely
Rowing, including rowing machine
What about squashing and brushing?
Squashing and brushing are often included under the heading heavy work. I think this is because occupational therapists often use these strategies to help children to calm down. They may use them in the same session and alongside heavy work. Technically speaking they are not the same as heavy work. This is because they target the touch sense not the proprioceptive sense. They trigger the touch pressure receptors in the skin rather than the proprioceptors in the joints and muscles. Whilst they are helpful strategies to help to regulate some children with sensory sensitivity I think it is important to understand exactly which sense they target. This is because it helps to ensure the right strategy is being used correctly with the right child.
What about weighted products?
There are also numerous weighted products available, such as weighted blankets and vests. These by themselves are not heavy work. Like squashing they tap into the touch sense, primarily deep touch pressure. However, when a child moves under or wears a weighted product, there is additional resistance to their movement. This will active their proprioceptors and, if you remember back to the beginning of this post, we said heavy work = proprioception.
An occupational therapy assessment is the best way to find out which strategies are most appropriate for each child. You need to make sure the therapist you see has completed additional training in sensory integration or sensory processing. We also cover this in more detail in our introductory course – Sensory Processing: What’s the Fuss.
- Ayres, A.J. (1972). Sensory Integration and Learning Disorders.
- Lane, S. (2002). Chapter 4 Sensory Modulation in Sensory Integration Theory and Practice 2nd Edition by Bundy, Murry & Lane.
- Miller, L.J. (2014) Sensational Kids Hope and Help for Children with SPD–Revised
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