Guidance for getting started with weighted products
The first question is always, how much weight should be in the weighted blanket or product? There is a general rule that weighted products should weigh no more than 10% of the individual’s body weight for blankets. And, yes, it is possible for a weighted blanket to be too heavy. This is why blankets should not be shared unless children are similar weights themselves. For toys or lap pads 5% is sometimes recommended.
There is also some literature saying that after 20-30 minutes the effects of the product have worn off; however there is no solid research to support this claim. It is important to monitor the individuals’ response. If it is still helping and your lesson is 40 minutes long, then the extra ten minutes might just help them to attend. Equally some individuals may only tolerate the weight for 10 minutes.
How to use weighted blankets
Weighted blankets are typically available in single and double bed sizes. As mentioned above they can be used to provide touch pressure sensory input at times when the individual needs to calm down. Usually the individual will lie or sit under the blanket. Some individuals like to have the blanket wrapped around their shoulders. Weighted blankets can be a great addition to sensory play as you can put things under them to go and collect, or you can have the child crawl from one side to the other.
It is important these are supervised closely. Ensure that the individuals’ head is visible and the adult is monitoring breathing. If the individual does go completely under the blanket, ensure that they can independently get themselves back out and that they can verbally respond so adults can double check they are safe. Children should not be left unsupervised and unless they are able to independently get out they should never be rolled or completely wrapped up. In school it is helpful to have a clear policy for use and ensure that all staff are aware of the risks.
What about bed time?
There are anecdotal reports that weighted blankets can be helpful for sleep. However, the reports of success vary hugely. There are also a number of different Lycra sleep socks on the market. These products wrap around the mattress and in theory provide extra deep touch pressure whilst the individual sleeps. You will find advocates for all products.
Typically it is not recommended that children sleep under weighted blankets. This is due to the risk of suffocation. Risks would be higher for children who have asthma, allergies or any condition that affects their breathing. They are definitely not recommended for individuals who cannot move out from under them independently.
Use them before bedtime
Weighted blankets could be used before bed time to help with lowering arousal. They are great for story time before bed. It may be that you leave them on the lower half of the child’s body (i.e. their hips and legs) for an extra 10-15 minutes as they start to drift off to sleep. However, it is best to not leave all night for young children. Sometimes you can achieve a similar effect with a heavier duvet, an extra blanket or tucking the sheets quite firmly.
It’s tricky to give a specific age for when blankets can be used at night as all children are different sizes and have different levels of mobility. When considering using a blanket through the night you must ensure the individual can independently pull it on and off. It is important they do not put their head under the blanket whilst sleeping. And, they are not recommended for any individuals with breathing conditions (e.g. asthma).
My experience is that very few individuals like the blankets for sleep. Many complain that they are too hot under them. Others don’t like the feeling of having them on. Some move about so much that they never really stay under them for very long. If using there is a general recommendation of maximum blanket weight of ten percent of the individual’s body weight. The blanket should lay on top of the bed, rather than drape over the sides (again to avoid trapping and restriction).
How to use weighted lap pads, shoulder pads and animals
Weighted lap pads and animals are designed to sit on top of a child’s lap. These can be great for children who have poor proprioceptive awareness, as it gives them extra feedback about where they are. This can decrease their fidgeting and also help them to stay in their space, especially on the floor. They can also be used with small children instead of a blanket when lying down. Some children like the feel of animal ones as well, and this helps them to regulate. They are a good addition to most classrooms.
Weighted shoulder pads are designed to sit on the child’s shoulders. If I am honest I have personally never had much luck with these. It’s hard to get them to fit well on the shoulders. Some children don’t like the feel of the pad on their neck. The snake shaped animals can work better as they conform around the neck and shoulders. A larger lap pad can also be folded in half long ways and drape them over the shoulders for mostly the same effect.
What about weighted vests?
Weighted vests are designed to be worn over the top of clothing. These can work better than shoulder pads, as they don’t fall off. Again, they can be helpful for some children but not others. You must ensure the vest is the right size and weight for the child. Some children also prefer the squeeze vests / bear hugs rather than weighted vests. If there is a likelihood the vest will be thrown, then the weight free ones are also a better option.
It is also important to consider the child’s overall mobility and joint stability when using these. If a child has very low tone, i.e. they are quite floppy; a weighted vest may not be the best solution for them. The squeeze vests are likely a better option. You should seek guidance from your occupational therapist.
Weighted products can be a useful sensory strategy, for some individuals. It’s important to make sure they are used safely and monitored well. If you are every unsure you should check with your occupational therapist for further guidance. If you want to learn more about using sensory strategies, these are discussed in Level 2&3 of the GriffinOT online sensory training.
Finally, you must always remember that they won’t be a magic bullet for everyone. At the end of the day the best thing to do is to test before you buy and to see what works for our own child or the individual you’re supporting.
This guidance document, which Kim contributed to, published by the Royal College of Occupational therapists gives a quick summary of the current evidence and recommendations.