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Fine Motor Skills– Handwriting, Keyboarding, Feeding

It feels like a stabilizing hug. A simple intervention that can do so much!

Wearing a OTvest, denim weighted vest, can help those who struggle with fine motor skills, such as handwriting, keyboarding, drinking from a cup or holding a spoon, comb, or toothbrush, buttoning or fastening one’s clothes, coloring, cutting with scissors, or putting a puzzle together.
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The deep pressure (provided by the weights lying directly upon muscle fibers) can stimulate the brain to produce neurotransmitters which effect our sense of calmness, focus and well-being, and an increased attention-to-task. In addition to the calming, focusing effect of the application of deep pressure, trunk stability is also increased because of the patented weight placement inside of the vest–which helps reduce tremors and stabilize the trunk for increased distal (hand) coordination–providing increased control of arm and hand use. Person’s with movement disorders such as Parkinson’s disease, dystonia, cerebellar ataxia, multiple sclerosis, athetoid cerebral palsy, and intention tremors can often see improved fine motor and upper extremity function when wearing a OTvest.

 Handwriting  can be a particular struggle for those with ADHD or difficulty with hand control, as staying within the lines of ruled paper, forming the “points of juncture” necessary to create letters, and the visual attention and fine motor skill needed to “cross all the t’s and dot all the i’s” requires an extreme amount of  visual attention-to-task and motor coordination. Tremors can further impair fine motor function.

In the research published in The American Journal of Occupational Therapy by Nancy VandenBerg, OTR/L, the ADHD children in the study showed an increase in attention-to-task while performing fine motor tasks such as cutting, drawing, pasting and writing by 18-25% while wearing a weighted vest. Using her experience with sensory integration treatment, Bobath and NDT theory, and knowledge of the central nervous system, Ms. VandenBerg created the OTvest, as she was excited by the outcomes of the research study, but realized that a weighted vest needed to provide weight directly to the muscles receptors and could therefore, use less weight than often found in other available weighted vests through this more effective use of direct weight placement on the body, rather than weight supported by the garment by hanging inside pockets.

A first grade teacher excitedly showed Ms. VandenBerg a class assignment by a boy in her class, done while wearing a OTvest–completing a page for the first time, and coloring within the lines of the triangles and geometric shapes for the math assignment, which he rarely, if ever, could do without wearing the OTvest, weighted vest. The teacher said that the young child told her, “I feel like a brand new boy.” He typically had papers and pencils all over the floor around his desk, being very unfocused and disorganized. He was so proud of himself as he could see the difference in his work. What an improvement in self-esteem!

Occupational therapists have reported that wearers of the OTvest, weighted vest have shown almost total elimination of tremors. Improvement has been seen with elderly wearers, for example, in improvement in daily living skills such as being able to hold a cup of coffee without spilling due to the increase in trunk stability.

1. VandenBerg, N.L. (2001). The use of a weighted vest to increase on-task behavior in children with attention difficulties. American Journal of Occupational Therapy, 55, 621-628. November/December 2001. This research is also in the book, Pediatric Issues in Occupational Therapy: A Compendium of Leading Scholarship (Royeen, 2004) published by AOTA (N. VandenBerg, Chapter 25.)

Stress, Anxiety, Agitation, Traumatic Brain Injury (TBI), PTSD, Sleep Disorders, Alzheimer’s

The OTvest™ denim weighted vest is useful in reducing stress, anxiety, and agitation due to the calming effects of the deep pressure applied to the body. The OTvest is a simple, non-invasive intervention that can make a difference in relaxation!

Think of someone pressing gently but firmly down upon your upper back, shoulders, and the front of your shoulders. It feels good and has a wonderfully calming effect. We naturally do that to others when we see that they are anxious or overstimulated, and might even say, “Calm down” as we do it. That is similar to what the OTvest provides through the administration of calming, deep pressure applied by the patented weight insert hidden inside. By wearing the OTvest, calming deep pressure can be administered throughout the day, discreetly, and inexpensively, without the need of another individual providing the deep pressure. Persons putting the OTvest on for the first time almost always spontaneously say, “It feels good!”

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Just as we hear runners say that running gives them a “natural high” because of the increase in dopamine, deep pressure changes the chemistry in our brains and can create a calming, focusing effect. The OTvest is a noninvasive, holistic treatment approach to promote a sense of well-being.

When using the OTvest™, denim weighted vest to address problems with inattention, stress reduction, anxiety, restlessness or agitation (TBI, PTSD and Alzheimer’s), and sleep disorders or insomnia, medication may still be necessary when recommended by a physician, but often at a lesser dose than would otherwise be needed. When medication is prescribed and doesn’t seem to be totally addressing the distractibility or lack of attention to task, trying a OTvest, weighted vest as a non-invasive addition to treatment is often a good start before increasing medication levels. Wearers have reported decreased sleeplessness when wearing the OTvest prior to bedtime, and often less need for medication to promote sleep or even the discontinuation of medication.  Many physicians are recommending the OTvest to patients. (Please view video for live interview with Robin who has cerebellar ataxia, and talks about her increased ability to sleep after wearing the OTvest, and discontinuing use of sleep medication.

Sleep deprivation in children can be mistaken for ADHD, as children often get more “wound up” when they lack sleep. The OTvest can be used prior to bedtime for those who have trouble falling asleep, as the calming effect promotes relaxation. Some wearers find that they no longer need medication previously prescribed for insomnia or narcolepsy when they wear the OTvest for about an hour prior to going to bed.

Stress, anxiety, agitation and sleep deprivation are often seen in post traumatic stress disorder, traumatic brain injury, Alzheimer’s, and in movement disorders.  “Behavior deficits have been shown to occur in up to 70% of clients hospitalized with TBI (McNett, Sarver, & Wilczeski, 2012)¹. This study also reported that the most common behaviors associated with agitation include impulsiveness, restlessness, and a decreased attention span. These behaviors have shown to be a substantial obstacle to participation in the inpatient rehabilitation process, attaining goals, and achieving functional independence (Lequerica et al, 2007)².” Patient goals for rehabilitation can include initiatives designed “to gradually increase his attention span and reduce restless behaviors”. ³

The OTvest, weighted vest can provide deep, sustained pressure using less weight than is necessary in other weighted vests on the market because of the density of the weights (dense steel rather than bulky sand or pellets) and the PLACEMENT of the weight directly UPON the body–not hanging in pockets supported by the garment rather than the body itself. This sustained deep pressure can create a sense of well-being, increasing focus and function, promoting better sleep, and decreasing anxiety, stress and agitation. Improvement in balance and awareness of where one is in space–where one’s body is positioned–often shows improvement with the applied weight in the OTvest (proprioceptive input), and this also helps to decrease the accompanying anxiety that the lack of feeling “grounded” produces.  (also see information on MOVEMENT DISORDERS)

Psychiatric facilities, schools, specialized treatment programs, adults and parents across the country and internationally have been ordering the OTvest since 2002.

Why does the OTvest, weighted vest have this calming effect? Deep pressure is registered in the limbic system, hippocampus, and reticular activating system and may stimulate production of neurotransmitters to modulate arousal levels, similar to the effects of medications. The use of the OTvest applies this deep pressure in a holistic, non-invasive and easily applied, discreet manner.

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As Ms. VandenBerg, MS, OTR, occupational therapist, who created the OTvest after being excited by the outcomes of her research, explains in her published and often referred to manuscript,”The Use of a Weighted Vest to Increase On-Task Behavior in Children with Attention Difficulties:” 4

“Farber (1982) supported a beneficial response to the application of deep pressure, suggesting that maintained pressure is calming as it facilitates an increase in parasympathetic or relaxed tone. In describing her own autism, Temple Grandin related her experience of severe anxiety and how deep pressure ultimately helped her reduce the anxiety’s debilitating effects by reducing overall arousal and facilitating attention and awareness (Grandin & Scariano, 1986). In studies done with children with autism, deep pressure has been found to have a calming effect (Edelson, Edelson, Kerr, & Grandin, 1999; Krauss, 1987; McClure & Holtz-Yotz, 1991; Miller et al., 1999; Zissermann, 1992).”

“Proprioception and deep touch-pressure are types of sensory information that can produce a calming effect (Ayres, 1972; Farber, 1982; Knickerbocker, 1980). Both are carried by the dorsal column system to higher levels in the thalamus and the reticular formation and then up to sensory areas in the parietal lobe of the cerebral cortex. According to Royeen and Lane (1991), “Since the reticular formation mediates arousal, the reticular projections of the dorsal column pathway may be related to the efficacy of these inputs in decreasing arousal and producing calming” (p. 115). The dorsal column system also has some connections with the limbic system via the hypothalamus and the anterolateral system. This functional redundancy in the nervous system may play a role in the efficacy of sensory integration intervention (Fisher et al., 1991).

An example of the nervous system’s functional redundancy is seen in the registration of deep pressure. Deep pressure is registered in the limbic system, hippocampus, and reticular activating system and may stimulate production of neurotransmitters to modulate arousal levels, similar to the effects of medications. The action of the neurotransmitters norepinephrine, epinephrine, and serotonin is associated with the limbic structures and components of the reticular system, hypothalamus, and cortex (Ashton, 1987). Medications allow more of these neurotransmitters to be available to the brain, influencing the level of arousal in the nervous system of [an individual] and thereby controlling hyperactivity and helping to increase the [individual’s] ability to attend (Cohen, 1998; Hallowell & Ratey, 1994). The reticular system is aroused to varying degrees of alertness by sensory stimuli (Ayres, 1972), and touch-pressure appears to be particularly effective in dampening overly activating stimuli.

Deep pressure also sends sensory information into the Purkinje cells in the cerebellum, which then work to dampen stimulation entering the reticular formation through brain chemistry or neurotransmitters (Hanschu, 1998; Reeves, 1998). Purkinje cells are rich in serotonin and are responsible for inhibition of motor activity (Edelson, 1995). Children with ADHD have been found to have high levels of hyperactivity related to lower levels of serotonin in their blood (Gainetdinov et al., 1999; Taylor, 1994). Deep pressure may stimulate the increase in serotonin, as well as other neurotransmitters, to create a natural calming on the central nervous system in  those] with ADHD [and autism], anxiety, stress, traumatic brain injury (TBI), and post-traumatic stress disorder (PTSD).

Ms. VandenBerg realized that the weight had to be in a more effective position, lying upon the body, after her research was published–and was driven to create that better weight placement than that used in her research. Here is the entire research manuscript published in The American Journal of Occupational Therapy by Nancy VandenBerg, MS, OTR, occupational therapist whose work in the public schools with children and young adults with attention difficulties, such as ADHD, traumatic brain injury,  children with autism and sensory processing disorders lead her to create the OTvest, weighted vest:

http://fileserver.daemen.edu/~rholmstr/weighted_vest_and_adhd.pdf

¹ McNett, M., Sarver, W., & Wilczewski, P. (2012). The prevalence, treatment and outcomes of agitation among patients with brain injury admitted to acute care units. Brain Injury, 26, 1155-1162.

² Lequerica, A., Rapport, L., Loeher, M., Axelrod, B., Vangel, S., & Hanks, R. (2007). Agitation in acquired brain injury: Impact on acute rehabilitation therapies. Journal of Head Trauma Rehabilitation, 22, 177-183.

³ Morro, K., Farley, J. (2016). Brain Injury in an Inpatient Rehabilitation Facility: Occupational Therapist’s Role in Interdisciplinary Approach to Behavior Management. OT Practice, June 6, 2106, 15-18.

4 Quoted with permission by Nancy VandenBerg, MS, OTR, American Journal of Occupational Therapy, November/December 2001, Vol. 55, 621-628. doi:10.5014/ajot.55.6.621

References in the above AJOT quote can be found on the Links page to the entire AJOT manuscript.

 

Mailing Payment for an OTvest

PURCHASE ORDERS ARE ACCEPTED and can be emailed to otvest@otvest.com or faxed to 269-324-2012.

If you are mailing payment, include the order form–(or this information on your own sheet of paper)  indicating the size and quantity you want to order (or mark information at the bottom of this payment form), with a check made to OTvest, LLC  including shipping (10% for USA, 35% for Canada) 6% tax in Michigan,  and send to :

OTvest, LLC
4646 Wishing Well Ct.
Portage, MI  49024

Name: _______________________________________________________
Address: _____________________________________________________
______________________________________________________________
City: ___________________ State: _______ Zip: ____________________
Phone: __________________________Email: ______________________

Institutions / Schools:
Include Tax exempt number with Purchase Order Number

Quantity: ______ Size(s): _____________________________________

Total Price: _______________

Tax 6% if in Michigan: __________________
10% Shipping USA: _____________________
35% Shipping Canada: __________________
45% International shipping other than Canada__________________

Total Enclosed: __________________________

Look for the yellow “OTvest” label  on the chest pocket to make sure you are getting the genuine OTvest. Others may look like the OTvest from the outside, but the weight placement is important. Only the OTvest has the patented weighted insert with weight lying directly upon the body. This makes the difference!

Tourette’s Syndrome, Tics

When we feel better, we do better, and that’s what is seen when wearing the OTvest! A simple intervention that can do so much.

The Tourette Association of America makes the suggestion for wearing a weighted vest for those with sensory processing difficulties, often associated with Tourette’s Syndrome.¹ The occupational therapist who designed the OTvest worked in the public schools with children with Tourette’s Syndrome who showed an increase in attention-to-task when wearing the OTvest, such as being better able to perform fine motor tasks and classroom assignments. After putting the OTvest on, they were able to stay focused to complete a coloring activity, for example–staying within the lines–and asked to do more coloring–something previously never done without the weighted vest. Children with Tourette’s Syndrome in older grades often show trouble completing their class work, and wearing the OTvest helps increase focus and attention-to-task for those students, as well.

teachershandsTics are often reduced through the calming effect of the deep pressure from the weighted insert in the OTvest, denim weighted vest. Some of the anxiousness, often seen in those with Tourette’s Syndrome, shows reduction when wearing the OTvest, as students frequently say that “It feels good” when first putting the OTvest on, and request to wear it at school–appearing better able to function within the classroom setting. Tics often increase in stressful situations, and the  weights in the OTvest provide deep pressure to the muscles and their sensory nerves leading to the brain—stimulating a calming response. Brain research has shown that mood is affected by brain chemicals called neurotransmitters. Among the more important ones are serotonin, dopamine, norepinephrine, melatonin, insulin and prostaglandin. Deep pressure increases production of neurotransmitters which helps promote sleep, tic reduction, and a sense of calmness and well-being. The OTvest is non-invasive, holistic treatment approach to calm and reduce stress and anxiety in those with Tourette’s Syndrome.

An Educator’s Guide for Developing Plans for Students with Tourette Syndrome¹, which includes using weighted vests for those with sensory processing difficulties. The OTvest can help reduce tics, and those with handwriting difficulties often show improvement when attention is improved through wearing the OTvest.

 

¹The Tourette Association of America
http://tourette.org/Education/EducatorsGuideforDevelopingPlans.htm

Temple Grandin, Ph.D (1992), Calming Effects of Deep Touch Pressure in Patients with Autistic Disorder, Journal of Child and Adolescent Psychopharmacology.

VandenBerg, N.L. (2001). The use of a weighted vest to increase on-task behavior in children with attention difficulties. American Journal of Occupational Therapy, 55, 621-628. November/December 2001. This research is also in the book, Pediatric Issues in Occupational Therapy: A Compendium of Leading Scholarship (Royeen, 2004) published by AOTA (N. VandenBerg, Chapter 25.)

 

Sensory Processing Disorder, Sensory Modulation Disorder, Sensory Integration Disorder

Thinkstockwebsizerowofkids-78181969How does wearing an OTvest, weighted denim vest help those with a sensory processing disorder? “It Feels Good,” and when We Feel Better…We Do Better–and that’s what we see when wearing the OTvest!                                     

The OTvest is a simple, non-invasive intervention that can do so much! Please read Kim Grosline’s letter, in “testimonials” of the experience wearing the OTvest had for her son–and for others with sensory processing disorders, including those with autism and ADHD.
Sensory processing disorder is often referred to as sensory integration disorder, or sensory modulation disorder. Think of someone pressing gently but firmly down upon your upper back,  and front of your shoulders. It feels good and has a wonderfully calming effect. We naturally do that to others when we see that they are anxious or over-stimulated, and might even say, “Calm down” as we do it. A calming, focusing effect is what the OTvest provides for those with a sensory processing disorder, and the OTvest can be worn throughout the day, discreetly, inexpensively, without the need of another individual providing the deep pressure. Persons putting the OTvest on for the first time almost always spontaneously say, “It feels good!”
Just as runners say that running gives them a “natural high” because of the increase in dopamine, deep pressure changes the chemistry in our brains and can create a calming effect, focusing effect through the increase in neurotransmitters that deep pressure touch therapy stimulates. Use of the OTvest offers a holistic treatment option.

Problems of sensory processing disorder can be seen in those who show:

  • Hypersensitivity to movement or hyposensitivity to movement (under responding such as never getting dizzy upon continuous spinning, and always having to be moving, OR the opposite–being over overly sensitive to movement such as avoiding escalators and being fearful of going up steps (such as a bus), and only wanting to participate in sedentary activities. The OTvest can help with body awareness because of the proprioceptive feedback sent to the brain as joint compression  occurs, thus making one more comfortable with movement.
  • Hypersensitivity to touch or hyposensitivity to touch (avoiding touch from others, inability to stand close to others like in a line, strong reaction to tags in clothes,  the feeling of fabrics, walking on toes to avoid touching the floor, hating to have hair cut or teeth brushed, strong reaction to textures of foods or things on hands OR the opposite– craving touch and seeking it out, having to touch everything, not feeling touch unless with great, excessive force so that they love “roughhousing” and may hurt pets or children because they can’t gage how hard they are touching, may prefer very messy play.
  •  Poor coordination so that gross motor and/or fine motor skills are not appropriate for their age level, such as difficulty writing, coloring, cutting, buttoning or catching a ball, jumping, climbing stairs when age appropriate  The increase in body awareness and body position that can occur from wearing the OTvest helps improve coordination. Fine motor skills often show improvement through increased focus and awareness of arm, hand,
    finger positioning and trunk stabilizing across the shoulder-girdle area.
     
  • Hyper or hypo sensitivity in the mouth May avoid putting normal things into their mouth or always putting things into mout, show need for constant chewing, may have very limited foods they will eat or can’t tell the difference in tastes and wants very spicy. For those with feeding problems due to oral motor sensitivity, the trunk stability provided by the OTvest can help isolate the oral motor muscles and increase the effectiveness of oral motor exercises (to increase or decrease oral sensitivity).  The calming generated by the OTvest helps decrease the mealtime stress due to sensitivity.  Tip: Wear the OTvest for restaurant outings for a calmer dining experience.

  • Over response or under response to sounds, smells, visual input such as inablilty to find a specific item when among other objects, inability to see a word on a page of other sentences or pictures, can’t concentrate when there are background sounds. May need to smell objects, can’t tolerate normal household or cooking smells. Calming from the OTvest can reduce this stress and help increase visual attention-to-task (functional activity). 
  • Problems with self-regulation such as difficulty calming oneself, unable to fall asleep by oneself, very difficult to wake up from sleep, inability to adapt to daily changes in the environment, being easily overwhelmed.  The use of the OTvest, weighed vest can help improve self-regulation as one learns what calmness and focus feels like, one can better learn to self regulate or modulate one’s own arousal level. 
  • Difficulty with language Having difficulty putting thoughts into words, unable to follow the sequence of directions, difficulty locating where someone is who is calling their name.  The OTvest can help reduce the stress and feeling of being overwhelmed that language impairment can create, and increase focus and calm for improved function. 

Alternative to Medication, Movement, and Proprioceptive Input

“IT FEELS GOOD,” and When We Feel Better, We Function Better — and That’s What We See with The OTvest!

The OTvest is a simple, non-invasive, alternative holistic intervention that can do so much!

20160615 Josh GorslineWhen using the OTvest™, denim weighted vest to address problems with inattention, anxiety, restlessness or agitation, medication may still be necessary when recommended by a physician, but often at a lesser dose than would otherwise be needed. When medication is prescribed and doesn’t seem to be totally addressing the distractibility or lack of focus to task, trying a OTvest, weighted vest as a non-invasive addition to treatment is often a good start before increasing medication levels. Many physicians are recommending the OTvest to patients and appreciate the holistic treatment option.

Deep pressure is registered in the limbic system, hippocampus, and reticular activating system and may stimulate production of neurotransmitters to modulate arousal levels, similar to the effects of medications. The use of the OTvest applies this deep pressure in a non-invasive, easily applied, discreet manner.

Sleep deprivation in children can also be mistaken for ADHD. The OTvest can be used prior to bedtime for those who have trouble falling asleep, as the calming effect promotes better sleep. Some wearers find that they no longer need medication previously prescribed for insomnia when they wear the OTvest for about an hour prior to going to bed.

Providing the opportunity to participate in movement activities is also important when increasing attention-to ask or decreasing restlessness, anxiety or agitation is a desired goal.  Recess, jumping on a mini trampoline, wall or chair push ups, “heavy work” like carrying groceries or playing games with weighted balls, rocking chairs, or movement “wiggle” cushions on a chair provide movement opportunity so that inattention, anxiety, restlessness and agitation can be reduced. The OTvest is not to stop an individual from moving– as activity is fundamental to the nervous system–but to help provide improved attention-to-task by producing a calming, settling effect through the use of effectively placed weights for deep pressure.  The proprioceptive input provided by the OTvest, weighted vest is calming, as is the proprioceptive input gained  through activities such as ” heavy” work (carrying heavy items, pushing, lifting, jumping, swinging, jumping on mini trampolines, wall or chair push-ups) which should be a part of an intervention program in addition to use of the OTvest.

Feeding Problems, Picky Eater, Oral Motor Problems, Stuttering, Speech

Picky Eaters, often due to Oral Motor problems, can make meals very stressful, and the OTvest “Feels Good,” helping the wearer RELAX. Stuttering can also be reduced due to the relaxation through deep pressure therapy. The OTvest is a holistic intervention that can do so much!

When you child is a “picky eater,” mealtimes can be highly stressful for everyone. If a child screams, cries, tantrums, refuses foods or falls apart when new foods are presented, these can be red flags that there is a feeding problem.

The use of the OTvest™ to help address feeding or oral motor problems such as difficulty in swallowing (dysphagia), chewing, and sucking is a useful intervention because the stabilization of the trunk is fundamental to stabilizing the neck, followed by the head, and then the oral muscles needed to address oral motor dysfunction. The calming effect of wearing the OTvest can be very extremely helpful in reducing the stress that mealtime can present for picky eaters.

Speech and language therapists have found the OTvest helpful in treatment sessions because of the calming and focusing effect, which makes sessions more productive. A decrease in stuttering has also been noted when wearing the OTvest, weighted vest because of the calming, anxiety reducing effects of the deep pressure touch therapy. The pressure also causes the wearer to respond physiologically (reflexively) by opening up their chest and standing/sitting with better posture, gaining better respiration.

Nancy VandenBerg, MS, OTR, is the creator of the OTvest and has over 35 years of direct treatment experience working with infants through young adults with feeding and swallowing disorders. She is Bobath (directly from Berta and Karle Bobath), NDT, sensory motor integration trained, as well as experienced with a variety of physical disabilities and treatment of oral motor dysfunction. She has worked closely with speech and language pathologists and parents in their home, as part of a treatment team–as well as within early intervention classrooms.

The most basic, essential, and effective treatment for children, teens and adults with neurogenic disorders who have feeding/swallowing problems is positioning of the head, trunk and the oral area through symmetrical alignment. The OTvest aids in the important first step of  facilitating trunk and head alignment by stabilizing in a symmetrical manner with the use of the unique, patented, insert with weights that surround the shoulder-girdle area. The OTvest distributes the quilted in, flat weights uniformly across the front and back of the wearer, promoting scapular (shoulder-blade) stability–important to trunk stabilization and deep pressure touch therapy for calming the wearer.

A secure trunk provides increased neck and head control which in turn, helps promote oral motor control, influencing the stability and movement of the oral structures needed for feeding, drinking and language skills.

This is similar to stabilizing the ankle, for example, to address problems in the knee and hip–like building blocks that have to rely on the straight bottom block for the next block to stack without being out of alignment. Each block depends on the secure, symmetrical foundation below.

It is important, for example, that a child is positioned with support in a properly fitted chair to help teach self-feeding with hips and feet properly supported. This positioning helps provide the trunk stabilization. Proper trunk stabilization insures that an individual has the necessary foundation to help develop the finer muscles of the lips, tongue and throat.  The OTvest is particularly helpful as the weights surround the shoulder-girdle, putting mild pressure on the scapula (shoulder blades) which aids in trunk stabilization.   Weights only hanging inside pockets in a weighted vest, like most on the market, do little to help stabilize the trunk–and often only rest upon the chair when the individual is seated.

“Eating is a complex task influenced by the child’s [or adult’s] personal and contextual factors. Appetite, motivation, stress, gastrointestinal problems, prematurity, respiratory disorders, cardiac disorders, sensory differences, and developmental disabilities are personal factors that can influence eating…the interaction of the child’s [or adult’s] personal factors (low muscle tone) and environmental (stress) negatively affects occupational performance.”1

The soothing, calming deep pressure provided by the weights from the OTvest help reduce the stress that can be a part of the eating difficulty, as well as addressing the tone issues through increasing trunk stability and postural security. This is also true with stuttering, where improved relaxation and stress reduction can help in decreased stuttering.

Occupational therapy integrates posture, sensory, motor, behavioral/learning, medical and nutritional factors to comprehensively evaluate and manage children and adults with feeding/growth problems. (see SPF web site for resources www.spdstar.org). Speech and Language therapists also work to promote the oral motor skills that are fundamental to speech and language skills.

An infant, child’s, teen’s or adult’s work on oral motor function and/or dysphagia can benefit from trunk stabilization by using the OTvest, weighted vest because of the unique, patented weight insert. The deep pressure from the strategically placed weights in the OTvest can increase kinesthetic body awareness, promote calm and a sense of well-being–reducing stress while eating, and improve body stability.

Where the weight is placed makes a difference, and that is the important difference in the OTvest, weighted vest–with less weight necessary than other weighted vests on the market to be effective–because of the effective USE of PHYSICS. Less weight is needed when pressing down, as in the OTvest,  than with weights only pulling down (with weights inside pockets or hems).

1. Berry, J., Foster, L. Unraveling the reasons for food refusal in children. OT Practice, May 23, 2016. 21-23.

Hippotherapy, Equine Therapy, Therapeutic Riding

The OTvest™ denim weighted vest provides trunk stability and calms while engaging in hippo therapy, equine therapy or therapeutic riding!

Hippo-therapy is administered by an occupational or physical therapist who have been trained specifically to use a horse in therapy. The therapy goals of special needs individuals are achieved by using the movement of the horse. The horse is used to influence the person instead of the person directing the horse. When the therapist observes the client’s response to how the therapist directs the horse, goals can be adjusted. In this setting, the OTvest can be useful in helping focus and calm an individual that is transitioning to equine-assisted therapy. The mild pressure on the scapula (shoulder-blade) and across the upper chest and back increases trunk stability and can stimulate pressure down into the saddle.

Wearing a OTvest and applying the deep pressure from the weight around the shoulder-girdle or upper back and upper chest of the rider can:

  • Help balance a beginner rider and provide the increased trunk stability when lacking or diminished.
  • Provide proprioceptive input for increased body/kinesthetic awareness so that the rider can have a greater sense of security on the horse.
  • Increase the impact of the rhythmic movement from the gait of the horse by stabilizing the trunk, so that the desired pelvic movement is more synchronized.
  • Help increase the awareness of the body in space, which is particularly helpful with those lacking coordination and difficulty with movement.
  • Encourage the rider to have more trunk awareness and increased stimulus to press down into the pelvis and saddle.

Therapeutic riding, on the other hand, focuses on teaching riding skills for health, education, sport and recreation. Horseback riding lessons are adapted to those with disabilities. Therapeutic riding doesn’t require a medical professional but most instructors are PATH International (Professional Association of Therapeutic Horsemanship) certified. These certified riding instructors are trained in working with people with disabilities. The use of the OTvest, as described above, applies in the same ways for use in therapeutic riding.

A woman with dystonia wrote us after receiving the OTvest. She had also been attending therapeutic riding. This is her first letter, as she wrote almost daily after receiving the OTvest, as she was amazed at the difference it was making in her movement, sleep, and abilities:

11198620_10206408006055924_779807506_nDear Nancy [OTvest creator],

Just received my OT Vest less than an hour ago. I love it and can already tell I am using my arms better. I am even being more accurate with the keyboard as I sit to type this. My PT and therapeutic riding instructor have been working very hard on my shoulders and arms this week, as they were extremely tight. I put on the vest and they went immediately limp. It is as if I don’t have any tone at all in that area, which of course has calmed my whole system down. The vest feels very much like my therapists hands constantly on my shoulders. First impressions are that I love it!

I don’t want to take it off!

Thank you for everything.
Jennifer Zubko, Canada

Horseback riding offers many benefits to development:

  • Improve Balance and Coordination
  • Core Strength Improvements
  • Posture
  • Sensory integration
  • Awareness of one’s Body in Space (Kinesthesia or the sense that detects bodily position, weight, or movement of the muscles, tendons, and joints.)
  • Attention Improvement

Who benefits from Hippotherapy and Therapeutic riding?

Those with…

  • Autism Spectrum Disorders
  • ADHD
  • Sensory Processing Disorders
  • Cerebral Palsy
  • Muscle Weakness
  • Speech and Language Impairments
  • Cognitive Disorders

For more detailed information, please visit http://herosource.com/blog-test/top-12-therapeutic-riding-centers-in-se-michigan.html  The above information is adapted from this source.

Colorado State University’s Temple Grandin Equine Center http://tgec.agsci.colostate.edu/

Movement Disorders, Tremors, Spasms, Cerebellar Ataxia, Parkinson’s Disease, Balance Problems

The OTvest™ denim weighed vest can benefit those with movement disorders such as cerebellar ataxia (spinocerebellar ataxia), ataxic dysarthria, dystonia, athetoid cerebral palsy, Parkinson’s disease, multiple sclerosis, and other balance problems due to lack of body awareness in space or cerebellar damage. As the information sheet from the National Ataxia Foundation describes, “Affected individuals might notice difficulty knowing where their feet or hands are in space (impaired position sense).”

The deep pressure from the weight insert in the OTvest provides proprioceptive input to the joint receptors, which send messages to the brain about body position. Proprioceptive input allows us to know, without looking at our arm, for example, that our arm is behind us, next to our body, or up in the air.  Deep pressure and an increase in proprioceptive input can, therefore, help improve coordination through the increased sense of body positioning awareness. This sense of body position is called kinesthesia–or the sense that detects bodily position, weight, or movement of the muscles, tendons, and joints.Weighting helps compress the joints and therefore adds sensory stimuli for co-contraction, so that the OTvest, with the strategically positioned weights inside,  can be beneficial for postural stability and increase the wearer’s awareness of where their body is positioned. The calming effects of deep pressure touch therapy, are important, as well, as anxiety is reduced with an increased sense of body awareness and sense of security.

AND if overheating is a problem, the weight insert inside the OTvest can be detached and cooled in the refrigerator (or put the entire garment in the freezer before wearing over an undergarment).


The pressure on the shoulder blades (scapula) and across the shoulder-girdle provides increased trunk stability for improved balance and upper extremity function–decreasing tremors and spasms–and improving body position awareness–helping the wearer to feel more grounded and less anxious

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The OTvest also stabilizes the trunk with the applied weight to the shoulder-girdle area, which helps control balance and improves the distal movement of the arms and hands. The weight across the back puts mild pressure upon the scapula, which encourages the scapula to lie flatter upon the back, which improves trunk stability. As the trunk is stabilized, drinking from a cup, combing one’s hair, keyboarding, holding a pencil or spoon, and other activities of daily living can be more controlled–especially if due to tremors or spasms.

The occupational therapist, N. VandenBerg, MS, OTR  whose expertise is fundamental in the design of  the OTvest, received training directly from Berte and Karl Bobath, who are the founders of Neuro Developmental Treatment, or NDT. NDT or Neuro Developmental Treatment uses an in-depth knowledge of the human movement system, including the understanding of typical and atypical development, and expertise in analyzing postural control, movement, activity, and participation throughout the lifespan, [in order to] form the basis for examination, evaluation, and intervention. Therapeutic handling, used during evaluation and intervention, consists of a dynamic reciprocal interaction between the client and therapist for activating optimal sensorimotor processing, task performance, and skill acquisition to enable participation in meaningful activities.*

One example of the use of NDT treatment and how occupational treatment experience helped in the strategic weight placement design of the OTvest is described in the following:  Ms. VandenBerg was providing occupational therapy treatment to a three-year old with severe ataxia, and very limited vision, who was unable to pick up a toy because of too much uncontrolled arm movement. Working with the youngster at the home with the mother was difficult, as the child was severely involved and progress was very slow, and Ms. VandenBerg was facilitating the child learning to sit and play. She was unable to pick up any toy as she over-reached or could not coordinate her hand to touch the object. The young child was able to pick up a toy when Ms. VandenBerg applied weight around the shoulder-girdle, stabilizing the trunk , decreasing the excessive arm movement or athetoid movements, and improving her hand function. By being able to pick up a toy, she was gaining some necessary experience with hand and finger manipulation she would someday need for self feeding–or meaningful activity–and showed hope for the important developmental child skill of PLAY!  Ms. VandenBerg observed the effect of the strategically placed weight placement and its impact upon trunk stability and improved hand function–utilizing this important weight placement concept in the OTvest design (as well as the calming effect observed on hundreds of children and adults she worked with).  This is one small example to help illustrate how direct experience with disabled individual’s and the knowledge of neurology and neurodevelopmental treatment  impacted where the weight is placed in the OTvest. The evidence is further seen in those who have benefitted since the creation of the OTvest in 2002, with over 20,000 in use. Person’s even into their 90’s are seeing improvement with tremor and spasm reduction and increased ability in functional daily living activities such as combing their hair, drinking coffee, and brushing one’ s teeth when wearing the OTvest because of the stabilizing weight placement across the upper chest and upper back (shoulder-girdle).

Persons with movement disorders who have purchased the OTvest have written letters telling us how much the OTvest has benefitted them. Here are just a few:


profile The vest has been amazing. ..It has actually made my arms usable again…to play the keyboard. [I] learned that if I wear the vest, I have more use of my more affected left hand, and can isolate the keys better…The dystonic movements are almost gone with the [OTvest] on.”
Jennifer Zubko, dystonic adult in Canada (ataxic)


profile The OTvest makes my feet feel more like they are touching the ground. I feel grounded, more secure when walking.
Lili Kazepis, Brooklyn, New York, cerebellar ataxia


profile I got the OTvest (sic)…and I was able to sleep through the whole night. Usually I have to take medication but I haven’t had to touch it since I got the vest. The OTvest helps me to stabilize my trunk…with the vest, I am able to walk without swaying back and forth and having to hold on and grab things. It helps give me a feeling of security..it helps me get things done.
Robin Stevenson, Gainsville, Florida, cerebellar ataxia (quoted from video above)


profile In physical therapy we have been working on stability and core control (with Robin). We have noticed a remarkable difference when walking with the OTvest and walking without it. When she first came to physical therapy, she wouldn’t walk in a crowd because she thought she would fall and now she is able to walk through the gym with other patients coming in when she wears the OTvest. She is far more stable and confident.
Eileen Branham, physical therapist, Gainsville, FL (quoted from video above)


profile Just received my OT Vest less than an hour ago. I love it and can already tell I am using my arms better. I am even being more accurate with the keyboard as I sit to type this. My PT and therapeutic riding instructor have been working very hard on my shoulders and arms this week, as they were extremely tight. I put on the vest and they went immediately limp. It is as if I don’t have any tone at all in that area, which of course has calmed my whole system down. The vest feels very much like my therapists hands constantly on my shoulders. First impressions are that I love it! I don’t want to take it off! Thank you for everything.
Jennifer Zubko,  Canada, dystonia


The vest seems to keep me straight not going to one side like I do. It makes me walk more straight without leaning towards one side. I am 50, had Ataxia SCA1 since 38, 130 pounds, wear 10 or 12. The vest has the 3 pounds… It works good with keeping me more balanced and grounded. My muscles are very weak and sore from the ataxia.I also can’t button things. The snaps work great.
Cathy Letson, Claxton, GA,  Sca 1 cerebellar ataxia    6/16


“Why I Love My OTvest”:

Normally, I am a very private person but.. I wanted to share with you how the OTvest has affected my life. I have now reached the stage that I am unwilling to go out alone and find it challenging to walk more than a short distance. My OTvest has given me new self-confidence, my walking is so much better to the point that I held on to my husband’s arm yesterday in the supermarket carpark and asked him to make me walk as quickly as possible. Yes, my sense of fun is back and I am doing more and more things independently….The OTvest is like a comfort blanket and every day, I am doing more independently. Yesterday, I crossed a quiet road alone and walked around a small shop…Physically, I am also noticing differences and I don’t know if this is due to the weights, or the reduction in my stress levels, or both.

I seem to have improved manual dexterity. I had got to the stage where the zip on a particular coat had become quite difficult and now, for four consecutive days, I have been able to do the coat up without any help. I have also begun to find the buttons on the duvet cover easier.

My hips are beginning to move freely which is giving me a longer gait and rather than being restricted to shoes that I wear all the time, I am now alternating between three pair.

Finally, I have never slept so well in years and now occasionally sleep through the night, and I am sleeping much more deeply.

It takes a while for the vest to have an effect. The vests are so comfortable that it is easy to forget that you have got it on.

I have experienced such physical changes in the last two weeks that I can hardly believe it myself. My typing speed has at least trebled but I still lack stamina and so I can only type quickly for a short period of time. My son noticed how quickly I was typing and made a comment– he couldn’t believe it. The other problem that I have always had is putting a key in a lock and it has always been the cause of embarrassment. I have always looked like someone who was drunk but today I did it first time.

Finally, at the shops we generally use a card machine to pay for the groceries and I usually struggle to such an extent that I have to ask my husband to do it if he is there but for the last two/three weeks, I have done it, first time every time. You cannot imagine how wonderful such a tiny thing is.
I believe that within about two weeks most people will feel different. Everyday tasks will take less effort and before they know it, they will want to lead more active lives by choice, not necessity. Even my skeptical husband can no longer believe what he is seeing.

Stacey Goodeve, Great Britain, cerebellar ataxia


Research by Lucy and Hayes ¹ has shown that weight applied in the shoulder area of persons with cerebellar ataxia (some had multiple sclerosis) improved their lateral (side-to-side) sway when six pounds of weight was applied. Another study by Widener, Allen, Gibson-Horn, ² also demonstrated improvement in lateral sway using less weight. In the video above of Robin wearing an OTvest with weight applied around the shoulder-girdle, reduction in lateral sway is also demonstrated so that she does not have to hold onto a wall or depend on support from her physical therapist, Eileen. Robin is wearing a size medium with 4 lbs. of weight in this video.

*Instructors Group of NDTA. (2016, May 27). The NDT/Bobath (Neuro-Developmental Treatment/Bobath) Definition. Retrieved fromhttp://www.ndta.org/whatisndt.php

Note: The OTvest is not recommended for those with spinal cord problems and the accompanying balance problems associated with those disorders, such as herniated or dislocated discs, degenerative disc disease, or other spinal cord injuries. The balance problems that benefit from the OTvest, weighted vest are those with upper motor neuron and/or cerebellar problems described in the first paragraph.

More information can be found on the LINKS page for the National Ataxia Foundation blog (USA) and the United Kingdom Ataxia Blog


References:

1.  Lucy SD, Hayes KC. Postural sway profiles: normal subjects and subjects with cerebellar ataxia. Physiother Can 1985;37: 140-8.

2. Widener GL, Allen DD, Gibson-Horn C. Balance-based torso-weighting may enhance balance in persons with multiple sclerosis: preliminary evidence. Arch Phys Med Rehabil 2009;90:602-9.

Smedal T, Lydren H, Myhr KM, et al. Balance and gait improved in patients with MS after physiotherapy based on the Bobath concept. Physiother Res Int 2006;11:104-16.

 Chase RA, Cullen JK, Sullivan SA. Modification of intention tremor in man. Nature 1965;4983:485-7.

Hewer RL, Cooper R, Morgan MH. An investigation into the value of treating intention tremor by weighting the affected limb. Brain 1972;95:570-90.

Morgan MH, Hewer RL, Cooper R. Application of an objective method of assessing intention tremor–a further study on the use of weights to reduce intention tremor. J Neurol Neurosurg Psychiatry 1975;38:259-64.

Morgan MH. Ataxia and weights. Physiotherapy 1975;61: 332-4.

Clopton N, Schultz D, Boren C, Porter J, Brillhart T. Effects of axial loading on gait for subjects with cerebellar ataxia: prelimi- nary findings. Neurol Report 2003;27:15-21.

ADHD, Autism and Research on Wearing a Weighted Vest

When we feel better, we do better — and that is what is seen in those wearing the OTvest!

Think of someone pressing gently but firmly down upon your upper back, shoulders, and front of your shoulders. It feels good and has a wonderfully calming effect. We naturally do that to others when we see that they are anxious or over-stimulated, and might even say, “Calm down” as we do it. This is similar to the feeling wearing the OTvest provides, and can be administered throughout the day, inexpensively, discreetly, without the need of another individual providing the deep pressure.

The OTvest looks like normal, “cool” clothing, making it a discrete intervention for those with autism and ADHD who need help organizing their behavior, and modulating levels of arousal and attention. The deep pressure often reduces self-stimulatory behavior (hand flapping, pacing, repetitive movements) so that the wearer can engage in more purposeful activity. 

Just as we hear runners say that running gives them a “natural high” because of the increase in dopamine, deep pressure touch stimulation changes the chemistry in our brains and can create a calming effect, focusing effect.  Deep pressure through the use of distributed weights across the upper back and upper chest in the OTvest stimulates the brain to produce the calming “brain chemicals” (norepinephrine, epinephrine, and serotonin).  The use of the OTvest is a holistic treatment approach to improve function and attention needed for daily activities–including the classroom. It can be worn when the family eats out, during homework, church, or even to help calm during the sensory overload of hair cuts! Adults can wear the OTvest while in social, work, or academic settings.

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As Ms. VandenBerg, MS, OTR, occupational therapist, who created the OTvest after being excited by the outcomes of her research, explains in her published, and often referred to, manuscript, “The Use of a Weighted Vest to Increase On-Task Behavior in Children with Attention Difficulties”:

“Farber (1982) supported a beneficial response to the application of deep pressure, suggesting that maintained pressure is calming as it facilitates an increase in parasympathetic or relaxed tone. In describing her own autism, Temple Grandin related her experience of severe anxiety and how deep pressure ultimately helped her reduce the anxiety’s debilitating effects by reducing overall arousal and facilitating attention and awareness (Grandin & Scariano, 1986). In studies done with children with autism, deep pressure has been found to have a calming effect (Edelson, Edelson, Kerr, & Grandin, 1999; Krauss, 1987; McClure & Holtz-Yotz, 1991; Miller et al., 1999; Zissermann, 1992).”

“Proprioception and deep touch-pressure are types of sensory information that can produce a calming effect (Ayres, 1972; Farber, 1982; Knickerbocker, 1980). Both are carried by the dorsal column system to higher levels in the thalamus and the reticular formation and then up to sensory areas in the parietal lobe of the cerebral cortex. According to Royeen and Lane (1991), “Since the reticular formation mediates arousal, the reticular projections of the dorsal column pathway may be related to the efficacy of these inputs in decreasing arousal and producing calming” (p. 115). The dorsal column system also has some connections with the limbic system via the hypothalamus and the anterolateral system. This functional redundancy in the nervous system may play a role in the efficacy of sensory integration intervention (Fisher et al., 1991).

An example of the nervous system’s functional redundancy is seen in the registration of deep pressure. Deep pressure is registered in the limbic system, hippocampus, and reticular activating system and may stimulate production of neurotransmitters to modulate arousal levels, similar to the effects of medications. The action of the neurotransmitters norepinephrine, epinephrine, and serotonin is associated with the limbic structures and components of the reticular system, hypothalamus, and cortex (Ashton, 1987). Medications allow more of these neurotransmitters to be available to the brain, influencing the level of arousal in the nervous system of a child and thereby controlling hyperactivity and helping to increase the [ individual’s] ability to attend (Cohen, 1998; Hallowell & Ratey, 1994). The reticular system is aroused to varying degrees of alertness by sensory stimuli (Ayres, 1972), and touch-pressure appears to be particularly effective in dampening overly activating stimuli.

Deep pressure also sends sensory information into the Purkinje cells in the cerebellum, which then work to dampen stimulation entering the reticular formation through brain chemistry or neurotransmitters (Hanschu, 1998; Reeves, 1998). Purkinje cells are rich in serotonin and are responsible for inhibition of motor activity (Edelson, 1995). Children with ADHD have been found to have high levels of hyperactivity related to lower levels of serotonin in their blood (Gainetdinov et al., 1999; Taylor, 1994). Deep pressure may stimulate the increase in serotonin, as well as other neurotransmitters, to create a natural calming on the central nervous system in [ those] with ADHD [and autism].

The OTvest, weighted vest can provide deep, sustained pressure. Current school-based occupational therapy practice in the United States often incorporates the use of weighted vests to increase children’s attention to school-based tasks (Joe, 1998; Maslow & Olson, 1999) ” ¹ , applicable for those with autism, ADHD, Asperger’s Syndrome, or autism spectrum disorder who need help with increasing focus and function.

Psychiatric facilities, autism centers, specialized treatment programs, and parents across the country and internationally have been ordering the OTvest since 2002. It is important to provide deep pressure by applying the weights directly to the body so that a calming effect is apparent. The OTvest require less weight than other weighted vests on the market that only hang weights inside of pockets, supported by the garment rather than the body. The OTvest contains DENSE steel weights rather than sand or pellets.

Ms. VandenBerg realized that the weight had to be in a more effective position, lying upon the body, after her research was published. Here is the entire research manuscript published in The American Journal of Occupational Therapy by Nancy VandenBerg, MS, OTR, occupational therapist whose work in the public schools (35 years) with children with attention difficulties, such as ADHD, autism and sensory processing disorders, led her to create the OTvest, weighted vest:

http://fileserver.daemen.edu/~rholmstr/weighted_vest_and_adhd.pdf

¹ quoted with permission by Nancy VandenBerg, MS, OTR, American Journal of Occupational Therapy, November/December 2001, Vol. 55, 621-628. doi:10.5014/ajot.55.6.621

References in the above quote can be found on the Links page to the entire AJOT manuscript.