**3.6. Task-oriented treatment approaches**

their total sleep time or other qualitative and quantitative sleep measures. Parents of the children in the study, however, reported an improvement in next-day behaviors, a finding that the authors hypothesized might have been due to improved bedtime behaviors, improved parent/child interactions, or inflated reports by parents wishing to please the study team.

Gee and associates conducted a study to explore the efficacy of weighted blankets with children with an ASD and sleep disturbances using a single case, multiple baseline design [44]. This study focused on two children with an ASD and sensory over-responsivity. The authors found that there were minimal changes reported via caregivers after 14 nights of use, yet they indicated improvement in the areas of time to fall asleep, number of wakings in the night, duration of sleep and behavior in the morning. Gee and associates, utilizing a similar demographic, sample size, and measures, reported that children with ASD and sensory overresponsivity demonstrated a correlation between their morning mood and the number of hours slept the previous night [53]. Furthermore, it was reported that morning mood of the

Overall, the evidence supporting the use of weighted blankets continues to be weak, as such,

Weighted vests have been used for individuals with ASD presumably to influence their somatosensory systems [54]. Specifically, weighted vests are often used to provide deep pressure for individuals who demonstrate sensory over-responsiveness, and resistance to those with sensory under-responsiveness/seeking behaviors. However, the use of weighted vests has become popular with children with ASD in hopes of increasing attention, on-task behav-

A weighted vest is a type of sensory-based intervention. A weighted vest is a garment that typically has 1–4 lbs. (approximately 10% of the child's total body weight) of total weight evenly distributed across it [56]. These vests are primarily applied to preschool and elementary school-aged children with the diagnoses of ASD or attention deficit disorder [56]. The weighted vest is worn according to a pre-determined schedule at certain times of the day, including during everyday activities and for specified tasks at home, in the classroom, or in the community. The vest is typically applied for less than 1 h, one to two times per day during tabletop type tasks [56]. These are general intervention recommendations, but not a manualized approach. Lacking a standardized protocol for the weighted vest, most occupational

therapists rely on clinical reasoning in devising an appropriate wearing schedule [57].

According to reviews, studies regarding the use of weighted vests are limited in size, scope, and quality. In a meta-analysis study of single subject designs, Stephenson and Carter

participants improved during the intervention phase of the ABA design.

**3.5. Weighted vests**

*3.5.1. Purpose of the technique*

12 Occupational Therapy - Therapeutic and Creative Use of Activity

*3.5.2. Overview of the technique*

*3.5.3. Review of the evidence*

this technique is considered experimental and should be used with caution.

iors, and social engagement [55], while decreasing stereotypical behaviors [56].

Task-oriented treatment approaches assist children with ASD to develop the skills necessary to complete a particular task. Children with ASD often have difficulty completing tasks due to a variety of difficulties in communication, socialization, motor skills, and sensory processing. Task-oriented approaches consider the task to be completed and ways in which to accomplish the goal. Task-oriented approaches are utilized by both occupational and physical therapists to teach functional skills.
