Jul 28, 2021

The use of Weighted Vests in Pediatric Occupational Therapy Practice: Where Did the 10% of Body Weight Rule Come From for Weighted Blankets?

The use of weighted vests in pediatric occupational therapy practice inform how we can use weighted blankets therapeutically

The use of weighted vests in pediatric occupational therapy practice has been going on for decades with success, thus why we continue to talk about them! Occupational therapists are the best source of information to understand the use of weighted devices due to their years of culminated experiences.  Understanding others’ experiences is invaluable because the data gives us an additional element of information as to how to use weighted vests and weighted blankets. Data showcasing the effectiveness/ benefits of deep pressure stimulation through physiological measurements are essential for understanding potential therapeutic benefits, but so are insights from experts who work with weighted interventions daily with a variety of clients.

Weighted vests and weighted blankets have many similarities in that they both provide deep touch pressure to the person who uses them. People who wear a weighted vest have the advantage of a hands-free experience, but weighted blankets can yield similar benefits when wrapped around a user as they engage in tasks. With this connection, it’s likely that the information provided below relates to weighted blankets, which may have similar applicable benefits. Also, the information allows users to form an opinion on how they may wish to use weighted blankets in their lives. 

Occupational Therapy Weighted Vest Protocol

The use of weighted vests in pediatric occupational therapy practice was researched to determine if there is an unwritten occupational therapy weighted vest protocol. Researchers mailed out surveys to 514 pediatric occupational therapists throughout the United States. The questionnaire included 43 questions to gauge therapists’ opinions, observations knowledge, with the use of weighted vests in their practice. A total of 341 therapists responded to the survey, and out of those respondents, 193 reported using weighted vests in practice for an average of 5.3 years.

How Heavy Should a Weighted Vest Be &  How Frequently Should a Weighted Vest be Worn?

how heavy should a weighted vest be

(Olson & Moulton, 2004a)

This chart tells us that most occupational therapists use two-pound weighted vests twice a day for less than one hour during desktop activities. However, the amount of weight of frequency varies and may be linked to preference or weight positioning.

Behavior Changes Observed when Wearing a Weighted Vest

The use of weighted vests in pediatric occupational therapy practice and how they help
(Olson & Moulton, 2004a)


The asterisks denote significance, meaning there were major changes observed in these categories.

Who Uses Weighted Vests the Most?

who typically uses weighted vestsAge Range of Weighted Vest Users(Olson & Moulton, 2004a)

What are Common Diagnoses of Weighted Vest Users?

what problems do weighted vests help with

Amount of Children Who Use Weighted Vests Per Diagnosis(Olson & Moulton, 2004a)

The Use of Weighted Vests in Pediatric Occupational Therapy Practice Data

Upon completion of the study, the researchers reached out to 51 additional pediatric occupational therapists to gather even more information regarding the use of weighted vests in pediatric occupational therapy practice — specifically, changes observed based on the diagnosis. To gather information this time around, researchers conducted 21 question phone surveys.

Percentage Of Clients With Each Diagnosis

percentage of clients with a diagnosis(Olson & Moulton, 2004b)

Changes in Behavior when Wearing a Weighted Vest and Autism

how a weighted vest helps(Olson & Moulton, 2004b)

Changes in Behavior when Wearing a Weighted Vests and ADHD

changes when a weighted vest is used(Olson & Moulton, 2004b)

Changes in Behavior with Wearing a Weighted Vests and Sensory Processing Disorders

changes in behaviours when a weighted vest is used(Olson & Moulton, 2004b)


How Quickly Do These Behavioral Changes Occur when Wearing a Weighted Vest?

Some therapists reported that there were shifts in behavior almost immediately. Here are quotes that were taken from the study:

-“Changes occur almost immediately once the vest is put on. His teachers report marked decreases in flapping, tantrums, and rocking, and increased attention and staying on task.”

-“When the vest is taken off, the child reverts back to all behaviors.”

-“I see rapid changes after using weighted vests with children who have sensory integration dysfunction, especially if the vest fits the child snugly. They physically relax; I see their shoulders drop. They remain calm and organized for 15 – 20 minutes after the vest is removed.”

Other therapists reported that the changes they observed in children were a culmination of treatment approaches, and not limited to just the weighted vest. Finally, some therapists reported there were no changes, but they attributed this to not using the vest frequently enough or the child not being a correct candidate for the vest.

How Heavy Should a Weighted Blanket be based on Weighted Vest Research

How Weight Amount Was Determined :

-“I start with 2% of the child’s body weight and then move up to 5%. I have gone up as high as 10%.”

-“I follow the American Academy of Pediatrics Guidelines for backpacks which is 10% of the child’s body weight”
**This is how the 10%-12% of body weight rule for weighted blankets was developed**

-“It depends on the child and his needs. I start at .5 lb and go up by .5 lb depending on the child and his tolerance.”

Wearing a Weighted Vest Duration Recommendations

The length of weighted device use varies and is based on multiple factors. Habituation is one of those factors that has not been proven but theorized. It has been proposed if the children were to keep the vest on continuously, they would become accustomed to the physical sensations and their body would make adjustments to accommodate the weight, thus not providing therapeutic benefits. Though this was theorized, there were no reported signs of habituation.

Limitations from the Occupational Therapy Weighted Vest Protocol

The surveys that were mailed could have been completed by someone who was not intended to complete the survey. This information cannot be verified and we do not know the specifics of the weighted devices used by these therapists such as weight positioning.

What can we Generalize about These Data?

-Occupational Therapists tend to use two-pound weighted vests, twice a day, for less than one, house, while their client is participating in tabletop activities. 

-Weighted vests are used primarily with preschoolers who present with autism or ADHD. 

-Rocking, tantrums, and wandering are the behaviors that are reduced the most due to weighted vest use. 

-Attention and staying on task are behaviors that are increased the most due to weighted vest use.

-With relation to adults, there is no evidence to suggest that these outcomes could not occur in adults with similar issues. Adjustments in weight and frequency may need to be made in order for similar benefits to apply to adults, but the information gathered by these occupational therapists could undoubtedly apply. 


Olson, L., & Moulton, H. (2004a). Occupational therapists’ reported experiences using weighted vests with children with specific developmental disorders. Occupational Therapy International, 11 (1), 52-66.

Olson, L., & Moulton, H. (2004b). Use of weighted vests in pediatric occupational therapy practice. Physical & Occupational Therapy in Pediatrics, 24 (3), 45-60.



Veronica is a mental health professional who is pursuing a doctorate in Clinical Psychology. She has earned her master’s degree in Clinical Mental Health Counseling and now provides therapy to children and youth in the community agency setting. She has been a part of several studies withiфn the field of psychology, including cognitive psychology, sports psychology, and health psychology. Her current research interests revolve around utilizing mindfulness meditation techniques and how they can impact the health of individuals in various socio-economic settings. She also has research interests revolving around developing and implementing interventions to aid in recovery from substance abuse within the primary care setting.

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