Manipulating things with our hands is common to everyone and therefore is typically a part of each individual's sensory diet. Do you ever play with your hair, use a rubbing stone, fiddle with your keys in your pocket, or use a stress ball? These are some of the ways we distract ourselves, help to stay alert or try to soothe ourselves. Having a variety of tactile manipulative's available for use has been helpful for both consumers and staff! This picture shows some examples of just a few of the many tactile objects offered on the unit at Cooley-Dickinson Hospital. Putty, tactile books, lotions, powders, clay, assorted art materials, cooking and baking activities are other examples.

It is helpful to keep occupational therapy supplies, equipment and any surplus of supplies in a locked cabinet. This way items can be stored, rationed out as needed and more easily accounted for. Items considered unsafe in certain settings may also be locked safely away into a cabinet, such as thera-band. It also may serve as a place to keep OT modalities such as sound therapy equipment, vibrating and brushing tools. Having a magnetic dry erase board on the outside of the locked cabinet affords the ability to sign out items and keep track of them.

Rhymes with Orange
Nationally syndicated comic strip published: January 29, 2006
Re-printed with permission of the artist

The Therapeutic Use of Weighted Blankets

There are a variety of ways to incorporate the use of weight into daily activities and treatment sessions. One example of the therapeutic application of weight is the use of a weighted blanket. It has been used in acute psychiatry among a variety of age groups and populations and is currently perceived by both consumers and staff as one of the most helpful of the sensory tools used by people during crisis states.


Modified version of the 2007 AOTA presentation by Champagne, Mullen & Dickson: Exploring the Safety & Effectiveness of the Use of Weighted Blankets with Adult Populations

Weighted Blanket Presentation References

Note: all research data contained in this power point presentation has been accepted for publication or is going through the acceptance process. Use of this data for any purposes other than personal review requires written authorization by Tina Champagne. M.Ed, OTR/L.


Hospital Trying Blanket Therapy
Article printed in the Republican Newspaper's Health & Science Section
Friday April 28th, 2006
Re-printed with permission from the Republican

New vest offers wearer a portable hug
The Boston Globe

Ways to utilize a weighted blanket:

Lying under a weighted blanket		Wrapping in a weighted blanket while rocking in a glider
Photo taken in: Cooley-Dickinson Hospital 's Adult Acute Inpatient Psychiatric Unit's Sensory Room Northampton, MA USA		Photo taken in: Cooley-Dickinson Hospital 's Adult Acute Inpatient Psychiatric Unit's Sensory Room Northampton, MA USA

People experiencing symptoms of depression, mania, anxiety, psychosis, paranoia, trauma or detoxification have reported relief from the use of weighted blankets in particular. People with mood disorders, trauma histories, substance abuse histories and those who tend to engage in self-injurious behaviors often report positive effects when using weighted items when feeling stressed, disorganized or when cravings occur. Some use weighted items only when in crisis states, others only when not in crisis states and yet there are others who report it is beneficial at both times. Those who report having a positive effect from the use of weight typically describe it as having a "grounding" effect. However, it is important to stress that for some it may be very alerting to the system. Furthermore, as with any type of stimulation, there are people who report having a noxious or undesirable response to the use of weighted items.

Weighted blankets, vests, lap pads, wrist and ankle weights are examples of weighted items. It is helpful to offer these items in a variety of fabrics and with the option to be able to vary the amount of weight used at any given time. For example, a fleece material may be much preferred over velour.

Examples of weighted items:

The Weighted Cozy Comforter can be used by all age groups		The Weighted Vest is also used by all ages and is made in casual styles
Pictures provided by www.weightedwearables.com

Although there have been guidelines established for how much weight to use, how long, and how often, it is a very individual process. Human beings are very dynamic and what works for one person may or may not necessarily work for another. It is important to work with each person and help them determine what helps and how much intensity is most beneficial during different states over time.

Weighted Stuffed Animals & Dolls

Weighted stuffed animals and dolls are other weighted modality options.  The pictures above demonstrate examples that have been provided by: Salt of the Earth Weighted Gear.  Each of these weighted items weighs up to 4 pounds and is each 13 inches long. 

Stuffed animals and dolls are sometimes carried around and therefore, must not be weighted any heavier than can easily be carried by the person using it.  It is also possible to add weight to any favorite stuffed toy.  Plastic pellets, used to weight craft dolls and to fill beanbags, are available at most craft supply stores and are one of the most hygienic materials to use when adding weight to any object.  Poly-Pellets can be used alone or with cotton batting or fiberfill when making or adapting a weighted item.  Pellet quality will influence the appearance of your finished project.  For a top-quality poly-pellet product go online to Poly-fil.

Infection Control Considerations

It is important to note that when using weighted modalities in hospital settings is it necessary to be able to wash each of the items between use by different people.  Therefore, use caution in the kinds of equipment purchased, being sure that they are machine and/or hand washable and that they will withstand ongoing washings.  When a weighted item is created or purchased specifically for one individual, infection control issues differ because it is not for general use.   However, when used by more than one person this becomes an infection control issue within most healthcare organizations.

A Big Investment

Weighted modalities can be very costly. Therefore, it is essential to shop around, find a vendor that you can contact directly, and one that can help you to customize your order to best fit your needs.

Making your Own Weighted Modalities

For many people, purchasing a weighted modality is beyond their means financially. Therefore, the following downloads are provided to demonstrate ways to make some of the different weighted modalities (weighted blankets, vests, and stuffed animals).

 Make Your Own Weighted Blanket

Make Your Own Weighted Vest (PDF)(to be posted soon)

 Make Your Own Weighted Stuffed Animal, Pillow or Baby Doll

The Weighted Blanket is a book by Diane Walker, MS, OTR/L and Kathleen McCormack, which includes information about the use of weighted blankets and instructions on how to make weighted blankets for the more skilled seamstress.

Enter to Win a Weighted Modality

For those in need, the following opportunities are available to apply to win a weighted modality. Important note: these listings are not ranked in any particular order. Please email this author to inform of any other potential opportunities for those in need @: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Option A: Go to this web address to apply:

http://www.quietquilt.com/contest.html

Option B.: Scroll to the bottom of this page for more information:

http://www.saltoftheearthweightedgear.com/THANK-YOU.html

Option C: Give & take program and the blanket exchange program

http://members.aol.com/mtcustomblankets/GIVE.html

News Flash: Cozy Calm works to help clients get weighted blankets covered by insurance companies!

What is a Sensory Kit?

Referred to by a variety of names (safety kit, tool kit, motivation kit, sobriety kit, relaxation kit, serenity kit, spirituality kit, self-soothe kit, comfort box, etc.) a sensory kit is a personalized kit created by the individual who intends to use it. Therefore, the theme of each kit must be chosen by the individual and should be related to what he or she wants and needs it for.

A sensory kit is a self-created box, bag, or bin, that is a special and designated place to keep meaningful items that each person finds specifically important and helpful – both for preventative purposes and during times of crisis. It is a place to keep things that help the individual self-organize. It is important to help each person think about what things to keep in their kits, where the kits will be kept, how they will use them, and what to do in situations where they may not have access to the kit.

Creativity A Must!

Allow for and support creativity! This is a great opportunity for people to express themselves. Creating meaningful and purposeful projects is not only fun but also facilitates self-expression and enhances self-awareness. Some ideas of what people have used to begin creating a sensory kit:

• Card board boxes

• A back pack or a small bag that fastens around the waist

• A small wooden chest

• A plastic bin

Provide a variety of art media for kit decorating each kit (markers, paints, assorted colors of tissue paper, glitter, collage’ materials, nature items, etc.).

Sensory Kit Theme & Contents:

It is important to initially help each person brainstorm about the type of kit that would be the most meaningful and helpful. People should be allowed plenty of time to decorate the kit using the chosen theme as a guide and to think about what things to keep in it.

A “Grounding” Example

The picture below shows an example of a “grounding kit” created by an individual who wanted to keep items that were helpful in a meaningful place for grounding purposes. She created her own beanbag for self-tapping and found other tactile manipulatives to be helpful. Additionally aromatherapy, colored sunglasses and a specific relaxation tape were some of her initial choices for her kit.

Common Kit Themes

The following are some common kit theme ideas and some examples of things people may want to keep in them:

Sobriety kit: important phone numbers, 12 step meeting lists, daily reflections book, AA Big Book, pictures of people who are motivating, sensory items to help distract from cravings (hot balls, stress balls/fidgets, rubber bands for wrist snapping, etc.), humor tapes/books, journal, etc.

Safety kit: phone numbers of primary supports, the person’s list of self-created treatment goals, top five reasons why it is important for them to stay safe, stress balls/fidgets, aromatherapy oils, hot balls or sour candies, pictures of people who are motivating, humor tapes/books, brushes or bean bags used for brushing or tapping, mindfulness items, journal, etc.

Relaxation kit: relaxation CDs, aromatherapy oils, pictures of soothing scenes, stress balls/fidgets, nature items, journal, humor tapes or comics

Spirituality kit: meditation CDs, daily reflections book, journal, mindfulness items, rubbing stones, positive affirmations, nature clippings, aromatherapy oils, crystals, etc.

Self-care or ADL Kit: a variety of scrub brushes and cloths, assorted lotions, soaps, bath foams/salts and scrubs, and other assorted skin, hair and nail care items (include options for both men and women).

Patricia Wilbarger, M.Ed, OTR, FAOTA coined the term “sensory diet” and it has been traditionally used in occupational therapy when using a sensory integration or sensory modulation framework. A “sensory diet” refers to those experiences an individual's system “needs” in order to self-organize and function throughout each day. Although these experiences are typically engaged in without the conscious awareness of their complexity or of the purposes they serve, it is often beneficial to facilitate an increased awareness of one's unique system tendencies, patterns and preferences. With this increased awareness, it is generally useful to support the consumer and/or caregivers in the creation of an individualized sensory diet.

When creating a “sensory diet” it is important to assist each individual in considering meaningful and purposeful ideas for both preventative purposes and for use during crisis states. Practice may also be necessary with some of the chosen techniques, in order to experience the full benefit. Creating a daily or weekly schedule incorporating those things the person finds most beneficial is one of the ways to begin planning for the implementation of the sensory diet. Once in use, it should be initially and then periodically monitored to determine if any changes need to be made.

When an individual is unable to create a sensory diet, even with assistance, therapists and caregivers must collaborate and gather as much information from the consumer as possible. Some of the ways to communicate with individuals with cognitive or physical limitations may include: the observation of body language, the use of equipment (e.g., word boards or adapted computers), the use of assessment tools, the assistance of caregivers who are more skilled at communicating with the consumer, and through collaboration with caregivers to collect a comprehensive history – with the consumer's permission.

Instead of waiting for an individual to become “ready” or “safe enough” for therapy it is typically helpful to provide some options to facilitate the grounding or self-organizing of one's system. Occupational therapists have the education and training necessary to provide such therapeutic exchanges and are instrumental in providing the consumer, treatment team and caregivers with such valuable information. Currently, sensory diets are being created and utilized in innovative ways across all age groups and among a variety of populations in psychosocial practice. Sensory approaches are being included in individualized treatment plans, crisis prevention plans, daily programming and in a host of other creative ways. This increased sensitivity to each individual's sensory tendencies, patterns and preferences has also assisted in avoiding crises and in reducing the use of restraint and seclusion within mental health settings.