Jul 28, 2021

Weighted Blankets for Kids who have Autism: A Positive Tool for Behavioral Modification

Weighted blankets for kids seems like a great idea to curb strong emotions. Don't go and grab the weighted blanket for comfort just yet...

Ah yes, the article has finally arrived pertaining to weighted blankets for kids and autism. As a recap, weighted blankets use deep pressure touch (also known as deep pressure stimulation) which occurs when gentle pressure (such as the pressure from a weighted blanket) is applied to the skin. Weighted Blankets for kids and autism is a slightly controversial topic as some believe that weighted blankets are a cure-all and will aid in the alleviation of behavioral concerns brought on by children with ASD, but what does the science say?

Though this article does not apply to adults due to the participants being comprised of children,  the information is applicable to adults in other situations, so sit back, relax, and get ready to absorb information on the effects of weighted blankets on behavior.

Why Was There A Need For This Study?

To understand the importance of this study, we must first take a tiny step back to discuss how the need came about.

Occupational therapists and Behavioral analysts both work with sensory processing disorders and attempt to reduce anxiety caused by disorders through different means. They implement various interventions in their therapies that mimic deep pressure touch including compression wraps (like those used in medical facilities), mats, pillows, or blankets. Previous research has discussed that deep pressure touch has similar effects on the brain as medication, by increasing serotonin levels (Edelson et al., 1999).

The issue that McGinnis et al. (2013) found and wanted to explore was that deep pressure touch is an enjoyable experience, so using these tactics to calm down a screaming child may help the situation in the moment, but may have the opposite effect in the long run as the child will associate a positive experience (deep pressure touch) with throwing a tantra tantrum.

This concept is basic parenting 101; giving attention or a reward to unwanted behaviors will positively reinforce that behavior because the child will learn that if they act up, they get positive attention, thus engraining those tantra tantrums further. So, although deep pressure touch interventions, such as weighted blankets for kids, may do a good job alleviating the distress that may be causing the child to throw a tantrum, the child may enjoy the weighted blanket and throw a tantrum to receive the intervention in the future.

McGinnis et al. (2013) sought to test whether a child with autism would prefer the deep pressure sensation over other activities.

Can Weighted Blankets for Kids Reinforce Negative Behaviors?

The present study had only three participants: Bennett, Logan, and Carter. All three have a form of autism, although the specifiers and behavioral characteristics associated with their diagnosis are unclear. Also, all three participants responded well to deep pressure touch stimulation.

Participant Profiles

participant profile

**ABA stands for Applied Behavioral Analysis**

Before beginning the study, the researchers sought to determine which form of deep pressure touch each of the participants preferred; they could choose from a gym mat, a pillow, or a blanket. These all mimic the sensations weighted blankets for kids can provide.

Deep Pressure Touch/Stimulation Options

weighted blankets for kids is an option for deep pressure stimulation but other options include gym mats, pillows, and blankets

The participants were allowed to interact with each object for 10 seconds and after all three were interacted with, researchers instructed the children to pick one.

After the child chose their object, the primary researcher (a licensed occupational therapist) utilized the object to apply a sensation similar to that of a weighted blanket. The child was then instructed to choose their second choice and was given 15 seconds to interact with it before the primary researcher used the object to apply deep pressure touch, the process was identical with the third object. This whole process of choosing was done three times so researchers could accurately gauge which object was preferred by each child.

  • Bennett preferred the blanket.
  • Logan & Carter preferred the gym mat.

It’s interesting to note that none of the children chose the pillowcase, but rather objects that would swaddle them. Previous deep pressure research has found that along with pressure, the swaddling ability that weighted blankets for kids offer, aid in the calming effect elicited.  It appears as though this study further supports this claim based on the children’s preferences.

Baseline Procedure (Before the Pressure Variable was Added)

A baseline session is used in studies for the following reasons:

  • This gets participants acclimated to the study’s procedures.
  • A baseline can be used as a comparison point.
  • The baseline can assess whether participants are appropriate for the study’s procedure.

The children were asked to pick or not pick one of these shapes. Upon picking any shape, or not picking at all, they were awarded 15 seconds on free times before needing to select again; 4 sessions included 20 rounds in each round.

triangle and circle
Color and Shape Placemenet Used Within The Study

Reinforcement: Phase 1

To begin, the primary researcher guided participants to choose one of the shapes (circle or triangle) at the start of each session. The shape in which the researcher guided the participant to chose was random at the start of each session. Then Participants could choose whatever they’d like for 20 rounds.

Outcomes-based on Phase 1

phase one
Carer phase one

Reinforcement: Phase 2

Outcomes based on Phase 2

Carter phase two
Bennett and Logan phase two

Reinforcement: Phase 3

Outcomes Based on Phase 3

Carter phase three
Bennett and Logan phase three

Are Weighted Blankets for Kids Helpful or Harmful to Children with Autism?

Both.

The researchers took all the data and gave it to an outside Board Certified Assistant Behavioral Analyst for review, which helped prevent bias. They were looking to see how many times the children selected the shape associated with deep pressure touch in under 5 seconds.

Essentially, what they found was that the children picked up on the changes quickly and would adjust their choice to get the deep pressure touch stimulation as the reward over free time.

The children enjoyed the deep pressure touch stimulation from either the gym mat or blanket more than free time, and because of this, they wanted to choose the shape associated with deep pressure touch.

Therefore, although deep pressure touch, such as weighted blankets for kids, can calm the nervous system, they can also reinforce negative behavior if used every time a child has a tantrum.

How Does This Concept Apply To Everyone?

Although this study utilized participants with an autism diagnosis, the results apply to everyone. Anyone can change their own behavior. We do things each and every day out of habit and for pleasure. For example, if you reward yourself with a fruit smoothie every time you work out, you’re going to want to work out and build motivation.

Here’s another scenario of behavioral modification that I use with my clients on a daily basis! Say you have two people sitting in front of you. One of those people are sitting quietly and the other is screaming and crying. Which one are you going to pay attention to? If you’re like most people, you will attend to the screaming and crying person in hopes of making them stop, but by doing this you’re showing them that if they scream and cry they’ll get positive attention, thus reinforcing that behavior. I’m not saying you shouldn’t comfort your friends, I’m simply explaining reinforcement theory.

What Does This Have To Do With Weighted Blankets for Kids?

Because deep pressure touch has the same effects regardless of what method is preferred, the results found in this study can be applied to weighted blankets.

I. Using a weighted blanket when happy over a period of time may help your brain associate the blanket with good feelings, thus allowing you to use the blanket as a coping mechanism when feeling upset. (Note, if you use it while upset too much the opposite will occur). Read more about this theory here!

II. Using a weighted blanket to calm down a child may work in the moment, but will reinforce the problematic behavior, thus more tantrums.

III. There is evidence that using a weighted blanket may allow for better sleep, but you may struggle to sleep even more when you stop using the blanket.

IV. Weighted Blankets can benefit Autism symptoms, but can also reinforce negative behaviors.

Something To Consider

We’ve written previously about the autonomic nervous system, and how weighted blankets essentially trick the brain into thinking there’s no danger in the environment, thus preventing bodily stress responses to occur. However, a person can still have stressful thoughts and emotionally feel anxious with the blanket.

Here’s where things get tricky and a bit paradoxical. Yes, the weighted blanket can trick the brain into thinking it’s in a safe environment, thus preventing bodily stress responses and discomfort. BUT, conditioning theories say if you use the weighted blanket primarily when you feel stressed, you will probably start to emotionally feel stress every time you use the blanket regardless of how you felt before using the blanket.

Again, this is anecdotal evidence and I’m drawing conclusions by mixing two studies/theories, but it’s food for thought! Luckily preventing conditioning is fairly simple: use your blanket all the time so your brain won’t associate it with a certain emotion. Easy fix, as there are other potential benefits the blanket can bring you than just anxiety reduction.

References

Edelson, S., Edelson, M., Kerr, D., & Grandin, T. (1999). Behavioral and physiological effects of deep pressure on children with autism: A pilot study evaluating the efficacy of Grandin’s hug machine. American Journal of Occupational Therapy, 53, 145-152.

Harron, W. (2014). Occupational Therapy retrieved from https://kidshealth.org/en/parents/occupational-therapy.html

McGinnis, A., Blakely, A.H., Hodges, A., & Rickards, J. (2013). The behavioral effects of a procedure used by pediatric occupational therapists. Behavioral Interventions, 28, 48-57.

Rudy, L. (2018). What is ABA therapy for autism retrieved from https://www.verywellhealth.com/aba-applied-behavioral-analysis-therapy-autism-259913

Veronica

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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