Child First Occupational Therapy Services

Hi ABC,

You may find the following useful-

Ayres (1972) postulated that deep pressure and proprioception have a

central inhibitory effect. It activates the parasympathetic system.

Physiologically, the parasympathetic nervous system helps the body to

feed, breed, rest or repose. In other words it has calming effects on

the body (e.g. relaxed muscles, tone etc.).

Keeping this postulate in mind even if the input (deep pressure via

squeasewear) is applied to a specific area the effect may be more

generalised. In other words even a strong localised input (covering

less surface area) may be sufficient to activate the parasympathetic

system. I hope it provides a possible answer for the following part of

your query- “whether there is enough compression to be effective in a

bigger body”. Fortunately the squeasewear appear to be covering a

significant amount of the body.

Frankly speaking, I have never used the “squeasewear” with my Clients.

In fact I saw it for the first time even virtually when you posted the

link to it. However, I have been applying the above theory ( i.e. deep

pressure has a generalised effect) e.g. joint pressure on small joints

like PIP, DIP, wrist and elbow can be as effective as applying direct

pressure to the large joints like knee.

Also I know a family who used a “pressure suit” (they got it from a

sports gear shop) with their child with sensory issues. It was

reported to be successful in addressing some maladaptive behaviour.

As far as high level research evidences are concerned, I am not aware

of any such study measuring the outcome of “pressure suit/

squeasewear”. Of course, there are a few studies on “weighted vests”.

I think weighted vests provide more “proprioceptive input (gravity

dependent). However, the pressure suits provide more of sustained

uniform “deep pressure” (which is not much dependent on gravity).

Hence, we cannot rely much on the “weighted vest” research outcomes.

Based on the physiological facts and my clinical experience I would

still use it wherever indicated. However, I would keep the following

things in minds-

• Not to use it with every client. It can be trialled with those

clients who seek significant amount of deep pressure. For example, the

case you have mentioned- frequently seeking hugs.

• To use functional goals as the outcome of the success of the use of

the pressure suite.

• To ensure that the suite will not affect distal blood circulation

(e.g. doing Blanch test: pressure is applied to a fingernail or

toenail until normal color is lost. The pressure is then removed, and,

if the circulation is normal, color should return almost immediately,

within about 2 seconds)

• To monitor signs of skin inflammation (redness, swelling, warmth).

• To monitor signs of breathlessness.

• To avoid using it in case of a medical condition like epilepsy,

cardiac issues.

• Monitoring physical signs and symptoms will be more significant in

the non verbal clients.

I will look forward for the views of other group members.

Thank you

Regards,

Harsh