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The Effects of Deep Pressure Touch on Anxiety

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Abstract

Occupational therapists who work with hyperactive children and adults who are in an aroused state sometimes employ deep pressure touch (DPT) as a therapeutic method to achieve calmer behavior. This pilot study attempts to measure effects of DPT on objective and subjective anxiety. Twenty-three healthy college students, serving as their own controls, self-administered DPT via a specially designed apparatus. Heart rate and self-reported anxiety were compared under conditions of DPT (experimental) and confinement without DPT (control). Data on subjects' trait anxiety also were analyzed. Although the group as a whole did not relax significantly more under experimental conditions than under control conditions, the degree of subjective relaxation was greater in the experimental group. These results, coupled with a significant intragroup difference in the response of subjects with high trait anxiety, were encouraging. This study provides direction and focus to investigators interested in further research on the validation of an empirically useful treatment technique.

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... Autonomic Nervous System: " the component of the peripheral nervous system that controls smooth muscle, glands and cardiac muscles… comprises two major division, the sympathetic and the parasympathetic nervous systems " (Cohen, 1999, p.443). Deep Pressure: a type of tactile sensory stimulation arising from firm touching, holding, hugging, squeezing, stroking or swaddling (Fertel-Daly, Bedell, & Hinojosa, 2001; Grandin, 1992; Krauss, 1987). Electrodermal Activity (EDA): a measurement of skin conductance of electricity (Dawson, Schell, & Filion 2000). ...
... Psychophysiological indicators of stress such as electrodermal activity (EDA), peripheral skin temperature (PST), surface electromyography (sEMG) and heart rate (HR) have been shown to reliably correlate with self-report measures of anxiety in the adult population (Barron & Blair, 1999; Brownley, Hurwitz, & Schneiderman, 2000; Dawson, Schell, & Filion, 2000;). Deep pressure, a technique used by occupational therapists, has been shown to reduce anxiety in the healthy adult population, children with autism, and animals (Blairs & Slater, 2007; Edelson, Edelson, Kerr, & Grandin, 1998; Grandin, 1992; Krauss, 1987; Kumazawa, 1963). My study will examine the use of deep pressure to reduce psychophysiological indictors of stress in an adult with severe mental retardation. ...
... Deep pressure is the type of tactile sensory stimulation arising from firm touching, holding, hugging, squeezing, stroking or swaddling (Fertel-Daly, Bedell, & Hinojosa, 2001; Grandin, 1992; Krauss, 1987). There are numerous ways to provide deep pressure including a tightly tucked in blanket, tight clothing or garments, a " Hug Machine " , the " squeeze machine " (Blairs & Slater, 2007; Edelson, Edelson, Kerr, & Grandin, 1998; Grandin, 1992; Krauss, 1987; Zissermann, 1992). ...
Article
This single subject ABAB study explored whether the use of a commercially available deep pressure vest would decrease physiological arousal in a male with profound mental retardation during nail care activities. Psychophysiological responses of electrodermal activity, skin temperature, electromyography, and heart rate were used as indicators of physiological arousal and recorded using the NeXus-10. Visual and statistical analysis revealed that the use of the deep pressure vest did not reduce physiological arousal during nail care. M.S.
... The deep pressure technique has been used in the past by Krauss [12]. It is a device called Hug'm Apparatus. ...
... However, it was found the Hug'm had a calming effect, as evidenced by a significant reduction in the state of anxiety in the control group. Thus, a need for further studies is conducted on the calming effects of deep pressure [12]. ...
... The first phase was participated in by healthy adolescents to investigate the mean comfortable pressure. The selection of healthy adolescents rather than children with ASD as respondents was because children with ASD cannot provide appropriate feedback (verbal) of comfort when using deep pressure [12]. The second phase was participated by ASD children randomly chosen from Putra Mandiri Public Special School, Central Java, Semarang, Indonesia. ...
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This preliminary study proposes to investigate (i) the mean comfortable deep pressure of Autism Hug Machine Portable Seat (AHMPS) manual pull and inflatable wrap models; and (ii) the effect of using AHMPS in reducing anxiety in children with autism spectrum disorder (ASD). The first phase was done to determine the comfort test. Fifteen healthy adolescents (13 men and 2 women; aged 19-25 years) individuals volunteered to participate in the comfort test in determining the pressure of AHMPS, both manual pull, and inflatable wrap. The second phase was completed in children with ASD, in which the comforting pressure from the first phase was then applied to five children with ASD (4 boys and 1 girl; aged 8-15 years) from the Putra Mandiri Public Special School Semarang. All children were administered both the AHMPS inflatable wrap and manual pull as a deep pressure apparatus while traveling by bus. A pulse oximeter was used to measure heart rate variability (physiological arousal). The mean comfort pressure was obtained from 15 healthy subjects, which was 0.81 psi on the chest and 0.80 psi on the thigh for the manual pull; and 0.65 psi on the chest and 0.45 psi on the thigh for the inflatable wrap. In the second phase, the AHMPS manual pull did not significantly decrease heart rate with p=0.114, but the AHMPS inflatable wrap significantly decreased heart rate with a significance value of p=0.037. We conclude, therefore, the AHMPS inflatable wrap decreases physiological arousal in children with ASD.
... A profound kind of touch, referred to as deep pressure touch, is perceived as relaxing and has been proven to have a calming effect on children with psychiatric disorders, such as ASD (Grandin 1992). In addition to a therapeutic history of using specially shaped jackets (Krauss 1987) to confine patients' movements, several research studies and commercial development reports have described the use of deep pressure sensa- tions for the purpose of calming patient. Grandin (1984) described a device that pro- vided lateral pressure when the user lay down inside of it. ...
... In this study, the "squeeze machine" was used on children with a neurodevelopmental history at six different therapeutic facilities, and was reported to be beneficial for disor- ders related to hyperactivity. Later, Krauss (1987) described the development of a sleep- ing bag-like assembly by sandwiching users between two air mattresses with possibility of exerting circumferential pressure from all directions by pulling a strap around them. The subjects used to evaluate the system were chosen from groups of normal college students who showed different levels of anxiety based on a questionnaire. ...
... The prototype system was tested on two female and one male student volunteers who had no history related to ASD, who were between 19-25 years of age, and who weighed in the range of 48-73 kg. They subjectively rated the efficacy of deep pressure touch and vibration to exert a relaxing and soothing sensation (Grandin 1984;Krauss 1987) accord- ing to a five-grade scale (Excellent > Very Good > Good > Fair > Poor). ...
Article
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Children suffering from autism spectrum disorder are often reported to encounter sleeping disorder several causes such as hypersensitivity as result of irregular brain and muscle functions. Disturbance in sleep affects not only their health but also daytime activities including the risk of other cognitive and behavioral impairments. Such hindrance in sleep have been demonstrated to treat therapeutically by measures like application of deep pressure touch and full body vibration which can be beneficially integrated into the sleeping environment such as on the textile-based platform around the bed. With such a vision, this pilot design project aimed to develop a smart textile based sleeping bag incorporated with sensors to detect awakening stage of the child and thereby actuating stimuli for assuaging the child to fall asleep. To serve the purpose, a micro-controllable body movement detection sensor, based on conductive yarns connected to a vibrating motor was prosperously embedded at the interior of the sleeping bag along with weighted slots to exert deep touch and soothing sensation in the form of wearable technology.
... Additionally, Smith, Press, Koenig, and Kinnealey (2005) showed that 95% of children with ADHD benefited from using sensory modulation-related interventions, including those providing DPTS, along with taking medications. Krauss (1987) examined the influence of DPTS among college students who used a self-controlled mechanical device to selfadminister DPTS with a pulley system, by administering qualitative surveys and measuring body temperature to measure anxiety. Although the results of Krauss's study were inconclusive, this study demonstrates the value of the use of psychophysiological and self-report measures when researching the influence of DPTS (Edelson, Edelson, Kerr, & Grandin, 1999;Krauss, 1987). ...
... Krauss (1987) examined the influence of DPTS among college students who used a self-controlled mechanical device to selfadminister DPTS with a pulley system, by administering qualitative surveys and measuring body temperature to measure anxiety. Although the results of Krauss's study were inconclusive, this study demonstrates the value of the use of psychophysiological and self-report measures when researching the influence of DPTS (Edelson, Edelson, Kerr, & Grandin, 1999;Krauss, 1987). Edelson et al. (1999) used electrodermal activity (EDA) and the Connors Parent Rating Scale to explore the influence of Grandin's Squeeze Machine on the anxiety levels of children with autism. ...
Article
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The weighted blanket (WB) is a modality used to self-comfort, rest, sleep, and decrease anxiety. This exploratory, pilot study investigates the safety and effectiveness of the standardized use of the 30-pound WB with 30 adults during an acute inpatient mental health hospitalization. Safety measures include blood pressure, pulse rate, and pulse oximetry monitoring, with and without the 30-pound WB. The State Trait Anxiety Inventory-10 (STAI-10), a self-rating 0–10 anxiety scale, and electrodermal activity (EDA) readings measure effectiveness for anxiety reduction. No statistical differences in vital signs indicate WB safety. The STAI-10 and self-ratings indicate 60% had a significant reduction in anxiety using the WB. EDA readings were inconclusive.
... Deep touch pressure (DTP) is a therapeutic method for treating sensory processing defcits [10]. The intention is to provide a calming efect through somatosensory sensation arising from hugging, cuddling, squeezing, stroking, or holding [43]. So far, DTP is relatively unexplored in interaction design research (with some notable exceptions [18,22,26,27]). ...
... Deep touch pressure (DTP) is a method used in sensory integration therapy, aimed at treating sensory processing difculties related to, amongst others, anxiety disorders, in particular anxiety experienced by those on the autism spectrum. [31,36,43]. The therapy involves using tools such as weighted garments and blankets to provide a comforting pressure sensation. ...
... Deep pressure has been defined as the "sensation produced when an individual is hugged, squeezed, stroked, or held" [1]. It is widely used by occupational therapists working with children with autism spectrum disorders (ASD) [2] and is thought to be rewarding, reducing symptoms of stress and anxiety and improving performance in school [3]. ...
... A "squeeze machine" controlled by participants themselves (cf. Grandin's "hug machine") was found to feel more relaxing than a control treatment, although objective measures showed no difference [1]. Edelson et al. [12] tested deep pressure in the Grandin style squeeze machine using a randomized allocation of 12 young people with autism compared with being placed in the machine but without any pressure. ...
Article
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Background: Deep pressure is a touch therapy technique widely used by occupational therapists for people with autism spectrum disorders. It is conceptually related to Ayres’ Sensory Integration Therapy and to the “hug” machine of Temple Grandin. There is limited research evaluating deep pressure. Objective: to evaluate the immediate effects of deep pressure on young people with autism and severe intellectual disabilities. Methods: Mood and behaviour were rated by staff working with the pupils before and after sessions of deep pressure and diary records were kept of other significant events. 13 pupils with ASD and severe ID took part in the study. Results: Sufficient data was available from 8 participants to be analysed using tau-u, a non-parametric technique that allows for serial dependence in data. Six showed benefits statistically. Five of these showed benefits across all domains, and one showed benefits on three out of five domains. Relevance to Clinical Practice: Deep pressure appears to be of immediate benefit to this population with autism and severe ID, but the heterogeneity of response suggests that careful montoring of response should be used and deep pressure discontinued when it is no longer of benefit. Limitations: This is an open label evaluation study using rating scales. Recommendations for future research: Future studies of the use of deep pressure should use physiological response measures, in addition to blinded raters for aspects of psychological health not captured in physiology.
... The calming effects of the machine may be due to such deep touch pressure it provides, 3,4 that is a mechanical deformation of the skin and is coupled with stimulation of the underlying fascia and periosteum. 5 While other methods of providing deep touch, pressure have been developed and have achieved clinically observed effects in anxious, inattentive, and hyperactive children especially with autism, such as rolling in a gym mat, 6 using weighted blankets (or gravity blankets), 7,8 or weighted vests, 9,10 it appears that the squeeze machine is as effective as these other methods. To Grandin, the machine opens a door connected to the emotional world and tells her what or how to feel empathy for others is. 2 The squeeze machine thus not only creates a connection between deep touch pressure and relaxation but also between physical matter and one's state of mind with regard to an unknown external. ...
... He found that the self-controlled pressures reduced the user's anxiety, but the alternative did not. 5 Additionally, the self-tickling machine investigated by Blackmore and her colleagues made users ticklish only when the reaction from the machine was activated, such as when an unexpected temporal delay was added. They concluded that tickling sensation relative to tactile stimuli would change depending on whether the stimuli was felt as produced by oneself or by another. ...
Article
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How is our bodily self-consciousness acquired, and how does it affect cognition? To investigate this, we conducted an experiment using the squeeze machine, a device that provides pressure along the length of the user's whole body. The squeeze machine is used to help autistic people relax. The inventor of the machine, Dr. Temple Grandin says that the squeeze machine, beyond bringing her relaxation, enables her to feel empathy for others. This claim is of considerable interest and raises the following two points; first, the problem of empathy in autism is an important issue and Squeeze Machine could be effective. Second, it suggests that the physical action of Squeeze Machine could provide an insight of mind-body problem to us. Here, we hypothesize that the squeeze machine focuses conscious to direct the bodily self, transforming bodily self-consciousness itself. Such intentionality could bring empathy to others. In this study, we tested whether bodily self-consciousness would be transformed through the squeeze-machine experience. In the first part of the protocol, we simplified the original design of Grandin's squeeze machine but ensured that it retained its relaxing effect. In the second part of the protocol, we adopted a preestablished method of peri-personal space (PPS) measurement to estimate changes in extended bodily space. The results showed that the boundaries of PPS that appeared in the control experiment disappeared during the use of the squeeze machine. Indeed, collected subjective reports suggest that bodily self-consciousness continually drifted between the point of action of the external force (squeeze-machine pressure) and of an internal force (balance among body parts that are usually not consciously controlled), leading to the abandonment of the immobilization of individual PPS.
... In the health domain, mental and psychological issues, such as depression, autism, infantile autism, and mania, have garnered increasing attention. Indeed, some studies have demonstrated that the clinical effect of combined psychotherapy with adjuvant therapy is better than that of conventional drugs, and intelligent clothing with contact comfort is an auxiliary psychotherapy tool [15,16]. Healthcare personnel suffer from an increased risk of stress, burnout, and depression due to the challenges of the COVID-19 pandemic. ...
Article
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During the COVID-19 pandemic, some special populations—groups of early childhood and people with autism, among others—faced more profound challenges than the common people. The lack of real physical contact such as embracing greatly affected the effectiveness of development, psychiatric treatment, and other processes for these populations. This study is aimed at developing clothing with appropriate contact pressure based on the contact comfort principle of psychology and providing a type of pressure clothing that can relieve the wearer’s tension by simulating hugging, alleviating the lack of physical contact for early childhood education and special education groups during the pandemic. First, the elementary requirements of clothing design are attained using a questionnaire survey and test method. The analysis revealed that clothing should fulfill the four requirements of pressure comfort, fabric softness, wearing and taking off comfort, and visual beauty. Second, we realized the performance requirements in the fabric and accessories, style design, structure design, and functional design. Finally, the product experience is proposed through a fitting, and the reasonable opinions were fed back to the product design to enhance the functionality of clothing. The research shows that clothing can simulate hugging and can ease the loneliness of the wearer. This study can be used as a good tool to assist during the pandemic for early childhood education and special psychological symptom groups, as well as a broader group of people living alone at home, to play an adjunctive treatment and loneliness relief functions.
... It is worth noting that this study consisted of a small sample of children and focused entirely on nonnormative populations. One other study evaluated the effects of a similar contraption on college students, and although Krauss (1987) found no clear effect on state anxiety, subjective relaxation did increase. These conflicting results may be due to the unusual contraptions employed by Krauss and Grandin, the small samples used in each study, or the different qualities of the samples. ...
... Krauss suggested that "self-control" mediates the effectiveness of deep touch pressure on anxiety and that individuals with an "internal locus of control (LC) are likely to attempt to actively master their environment, whereas those characterized by an external LC generally demonstrate more passivity to their environment" (p.367). 27 We believe that this principle is extremely important in maximizing the effectiveness of the intervention. In order to increase internal LC, the deep touch pressure should be administered voluntarily, so that the patient controls its intensity and duration. ...
Article
Previous studies have shown that individuals with autism spectrum disorders and attention- deficit/hyperactivity disorder (ADHD) experience sensory over-responsivity (SOR) in which a heightened response is evoked by stimuli in the environment. These individuals also display symptoms of anxiety such as irritability, avoidance, and sweating. Deep touch pressure, a technique in which firm touch is applied to the body either by the self or by a machine, has been shown to improve functioning and reduce symptoms of anxiety in these populations. A patient presenting with bipolar I disorder and comorbid anxiety, ADHD, and dyslexia was taught deep touch pressure strategies to alleviate severe symptoms of sensory over-responsivity and anxiety. The patient reported that the techniques were helpful as they allowed her to cope with potentially overwhelming situations in her environment. Clinician-rated functioning also improved over the course of treatment. This case study suggests that deep touch pressure may be useful in patients with bipolar disorder who have SOR and anxiety as comorbid conditions. (Journal of Psychiatric Practice 2014; 20:71-77).
... The use of what is termed deep pressure touch as a clinical intervention as been reported with other clinical groups (e.g. children with diagnoses of attention deficit hyperactive disorder (King 1998;Vandenberg 2002) and in non-clinical groups for the reduction of over-arousal (Krause 1987), as well as with people with severe learning disabilities (Hegarty & Gale 1996). What is termed deep touch pressure (Tagaki & Kobagasi 1956) i.e. forms of touch involving hugging, stroking the skin or swaddling can be distinguished from light touch pressure, i.e. superficial stimulation involving tickling or stroking of body hair, the latter is arousing of the sympathetic nervous system leading to increased pulse rate and respiration, whereas the deep pressure touch is calming and leads to reduction in pulse rate and respiration. ...
Article
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Accessible summary• Many people who show challenging behaviour continue to be tranquilised and  physically restrained.• There have been claims that deep pressure touch can be of beneficial in reducing  agitation and distress, particularly in people with autism spectrum disorders.• Deep pressure touch is demonstrated to have a beneficial effect on extreme  agitation, including lowering increased heart rate and respiration, as well as  reducing the need for physical restraint and medication• This paper describes a ‘‘low tech’’ approach to the systematic use of deep pressure  touch that can be readily applied in many settingsSummaryAlthough there have been claims of significant therapeutic benefits arising from the use of deep touch pressure techniques with children with autistic spectrum disorders, to date there have been few empirical investigations of its use with adults with autistic spectrum disorders and anxiety in clinical practice. This paper reports on the systematic use of deep touch pressure within a structured programme for a man with autism who was presenting with severe challenging behaviour. The programme led to significant reductions in the use of both physical restraint and medication, as well as appropriate physiological changes, with a parallel increase in the person's quality of life. The implications of this approach are discussed with regard to both theory and practice with the aim of increasing the provision of more appropriate forms of support for people who present with challenging behaviour.
... Weighted blankets and deep pressure touch may work well for insomniacs, both through psychological means (e.g. calming and 'cocooning', releasing anxiety [27]) and physiological means (e.g. tactile input that decreases activity of the sympathetic nervous system [28]).As increased sympathetic arousal likely affects sleep quality negatively, reducing it may aid sleep. ...
Article
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Insomnia is a common occurrence and can have a negative impact on physiological, psychological and social well-being. There is a need for simple, effective solutions to increase sleep quality. It has been suggested that weighted blankets and vests can provide a beneficial calming effect, especially in clinical disorders. Hence, we aimed to investigate the effects of a chain weighted blanket on insomnia, using objective and subjective measures. Objectively, we found that sleep bout time increased, as well as a decrease in movements of the participants, during weighted blanket use. Subjectively, the participants liked sleeping with the blanket, found it easier to settle down to sleep and had an improved sleep, where they felt more refreshed in the morning. Overall, we found that when the participants used the weighted blanket, they had a calmer night's sleep. A weighted blanket may aid in reducing insomnia through altered tactile inputs, thus may provide an innovative, non-pharmacological approach and complementary tool to improve sleep quality.
... The pressure-based CPM correlation with anxiety could be in line with the fact that deep pressure touch is used in occupational therapy as a therapeutic method to achieve a calmer behavior and to reduce the anxiety level. [85][86][87] Our findings show a negative correlation, such that higher anxiety levels are associated with a more efficient CPM response; this could possibly be explained by the enhanced central noradrenalin levels; higher plasma and CSF noradrenalin levels were observed in patients with generalized anxiety disorders 81,88 and are also related to a higher CPM response, as drugs that increase the noradrenalin tone improve the CPM efficiency in diabetic neuropathic pain patients. 9,10 In addition, deceasing noradrenalin levels using the alpha2 agonist dexmedetomidine reduced the CPM response in healthy individuals. ...
Article
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Conditioned pain modulation (CPM) responses may be affected by psychological factors such as anxiety, depression and pain catastrophizing, however most studies on CPM do not address these relations as their primary outcome. The aim of this meta-analysis was to analyze the findings regarding the associations between the CPM responses and psychological factors in both healthy subjects and pain patients. After a comprehensive PubMed search, 37 articles were suitable for inclusion. Analyses employed DerSimonian and Laird's random effects model on Fisher's z-transforms of correlations; potential publication bias was tested using funnel plots and Egger's regression test for funnel plot asymmetry. Six meta-analyses were performed examining the correlations between anxiety, depression, and pain catastrophizing, and CPM responses in healthy subjects and pain patients. No significant correlations between CPM responses and any of the examined psychological factors were found. However, a secondary analysis, comparing modality-specific CPM responses and psychological factors in healthy subjects revealed that (i) pressure-based CPM responses were correlated with anxiety (grand-mean correlation in original units r=-0.1087, 95% confidence limits -0.1752 to -0.0411); (ii) heat-based CPM with depression (r=0.2443, 95% confidence limits 0.0150 to 0.4492); and (iii) electrical-based CPM with pain catastrophizing levels (r=-0.1501, 95% confidence limits -0.2403 to -0.0574). Certain psychological factors seem to be associated with modality-specific CPM responses in healthy subjects. This potentially supports the notion that CPM paradigms evoked by different stimulation modalities represent different underlying mechanisms.
... There are also different sensory modulation techniques, which could be scheduled into the child's sensory diet programme. These include giving the child deep pressure touch (Krauss 1987); using latex-free rubber tubing as a 'chewy' (Scheerer 1992); using a weighted vest (VandenBerg 2001); and allowing the child to sit on a therapy ball chair while doing his or her schoolwork (Schilling et al 2003). The therapist should integrate the use of a visual timetable with a sensory diet programme. ...
Article
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An occupational therapy delineation model of practice is presented, which guides a multidimensional understanding of the psychopathology of attention deficit hyperactivity disorder (ADHD) and its management. Previous research has established that occupational therapists lack detailed training or theory in this field. The delineation model of practice is based on a literature review, clinical experience and a consensus study carried out with occupational therapists to determine their priorities for the evaluation of, and intervention with, children with ADHD. Part 1 of this article presents the model and examines its implications for evaluation and intervention at the levels of child, task and environment. A family-centred assessment and treatment package, based on the delineation model, is described. Part 2 of this article will report the results of a multicentre study, which was designed to evaluate the effectiveness of this package.
... bar 12 in Ex. 2). The third characteristic of the embrace is that it is experienced in terms of shifting patterns of gentle "deep pressure", evaluated by the partners as pleasant and calming [Krauss 1987], possibly due to the association of this kind of tactile encounter with «the protection and safety conferred by being held by others» [Case et al. 2020]. It is not difficult to relate the shifting patterns of finger and arm pressure in producing the specific gesture in the E minor Corrente on the instrument of the piano to the shifting patterns of deep pressure experienced in an embrace. ...
Article
If there is one trope that has become the lynchpin of the origin narratives of the young discipline of music performance studies, it is the idea that musical performance represents the "other" of the musical score. Many of the recent debates that effected a paradigm shift in music scholarship highlight the ontological and epistemological divergences between the score and musical performance, and also debunk the various myths and prejudices that have been woven around music performances and performers through the textualist paradigm, which essentialised and naturalised the musical score as the holder of "the music" and "the" source of disciplinary knowledge. Following the disciplinary "performative turn" during the twenty-first century, the effects of textualist habits of thought on scholarly discourses have been steadily on the wane. Nevertheless, the myth of a direct and immediate route between the score and performance - between the page and the stage - appears especially obstinate and continues to lurk around, particularly in the context of the analysis and performance literature. In this article, I discuss some of the complex embodied-affective processes that connect the page and the stage for performers, through case studies involving my performance experiences of a Corrente by J. S. Bach, a keyboard sonata by Domenico Scarlatti, and an excerpt from Rachmaninoff's "Rhapsody on a Theme of Paganini". I argue that eradicating the deleterious effects of the textualist urge to discipline the performer's body and emotions, to assimilate their individuality into an enforced utopia and homogenise performance expression requires introducing, into scholarly thinking and discourses, all the deep level contingencies that I emphasise in this article as essential elements connecting musical texts and performances. It also requires analysts to give up the modernist de-historicising fantasy that allows them to regard themselves as privileged and exemplary listeners standing in for all auditors, and in the case of the analysis and performance literature, standing in for all performers. However much textualist habits might sideline the drastic qualities of musical performance in scholarly discourses, performers continue to be fleshly, willful, creative individual affectively committed to the unruly and dynamic realm of performance making, and invest their performances with aesthetic qualities that grow out of their lived experiences and intentions as they continually move between the page and the stage. In this article, I aim to open up and explore the meaning making processes, from a performer’s perspective, that unfold in the creative space between the page and the stage that textualist approaches eliminated through their disembodied, ahistorical, essentialising and naturalizing discourses, and show the thoroughly contingent nature of these processes. One of the most significant arguments that will emerge from my discussion is that between the page and the stage are a large number of factors, including the uniquely embodied senses, artistic sensibilities, experiences and expert practical knowledge of each performer, that together constitute her artistic intentions, in the absence of which there would be no artistic musical performance. My discussion proceeds by drawing together critical evaluation of relevant scholarly literature, analytical thought, phenomenological enquiry and, most significantly, artistic research: the latter mobilizes the artistic processes of performance making as research tools and opens up novel lines of enquiry motivated by a performer’s expert knowledge about, as well as situated experiences of, performing music.
... One related non-robotic approach is the creation of inflatable or weighted vests and jackets to help calm children with sensory processing disorder, children with attention deficit hyperactivity disorder, and individuals with autism spectrum disorder [37]. Deep touch pressure, the kind received from hugging or firmly touching, has been shown to relieve anxiety for people with these disorders [19]. Because they require a loud pump and air flow, inflatable garments are often obtrusive and conspicuous. ...
Article
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Hugs are one of the first forms of contact and affection humans experience. Due to their prevalence and health benefits, roboticists are naturally interested in having robots one day hug humans as seamlessly as humans hug other humans. This project’s purpose is to evaluate human responses to different robot physical characteristics and hugging behaviors. Specifically, we aim to test the hypothesis that a soft, warm, touch-sensitive PR2 humanoid robot can provide humans with satisfying hugs by matching both their hugging pressure and their hugging duration. Thirty relatively young and rather technical participants experienced and evaluated twelve hugs with the robot, divided into three randomly ordered trials that focused on physical robot characteristics (single factor, three levels) and nine randomly ordered trials with low, medium, and high hug pressure and duration (two factors, three levels each). Analysis of the results showed that people significantly prefer soft, warm hugs over hard, cold hugs. Furthermore, users prefer hugs that physically squeeze them and release immediately when they are ready for the hug to end. Taking part in the experiment also significantly increased positive user opinions of robots and robot use.
... Deep pressure touch is a sensation produced when an individual is hugged, squeezed, stroked, or held (Krauss, 1987). Activities associated with deep pressure are frequently used in occupational therapy interventions. ...
Article
Pediatric occupational therapists often use specific activities associated with deep pressure touch as a modality when providing services based in sensory integration theory. This study investigated the effects of these activities contingent on choice responding. Initially, preference assessments identified that activities such as being swaddled in a blanket or sandwiched between halves of a therapy mat were potential reinforcers for each of the three participants. Then, the stimuli were presented contingently under a two-response concurrent schedule. The results suggested that for each participant, the application of these activities functioned as a positive reinforcer. Given that such activities are often used in pediatric occupational therapy interventions, the clinical implications of these findings are discussed.
... Although only a marginal reduction in anxiety was revealed using SC, a significant decrease in tension (a behavioral measure of anxiety) occurred, and researchers concluded, "deep pressure appears beneficial for children with high levels of anxiety or arousal, and there may be a threshold of anxiety or arousal required for deep pressure to be beneficial" (Edelson et al., 1999, p. 151). Krauss (1987) examined the influence of DPS among college students using a self-controlled mechanical device to self-administer DPS with a pulley system, using qualitative surveys and body temperature to monitor anxiety. Temperature is also a measure of sympathetic arousal (Boucsein,1992). ...
Article
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This paper presents the results of a concurrent, nested, mixed methods exploratory study on the safety and effectiveness of the use of a 30 lb weighted blanket with a convenience sample of 32 adults. Safety is investigated measuring blood pressure, pulse rate, and pulse oximetry, and effectiveness by electrodermal activity (EDA), the State Trait Anxiety Inventory-10 and an exit survey. The results reveal that the use of the 30 lb weighted blanket, in the lying down position, is safe as evidenced by the vital sign metrics. Data obtained on effectiveness reveal 33% demonstrated lowering in EDA when using the weighted blanket, 63% reported lower anxiety after use, and 78% preferred the weighted blanket as a calming modality. The results of this study will be used to form the basis for subsequent research on the therapeutic influence of the weighted blanket with adults during an acute inpatient mental health admission.
... Deep pressure touch is also 49 a component of numerous manual therapies, in particular 50 massage therapy, which is commonly regarded as a plea-51 surable experience. Massage therapy is known to signifi-52 cantly reduce depression, stress and pain as well as 53 improve immune responses in adults and promote weight 54 gain in infants (Field et al., 2007;Perlman et al., 2012 Deep pressure touch is also practiced by occupational 56 therapists and has been found to reduce anxiety and 57 increase calm (Krauss 1987;Grandin 1992). Further, 58 moderate (versus light) pressure has been found to be 59 necessary for the beneficial effects of massage therapy 60 (Field et al., 2010), and leads to greater stress and anxi-61 ety reduction as well as higher ratings of pleasantness 62 (Diego et al., 2004) Lower and upper error lines display the 5th and 95th percentiles, and filled circles display data falling outside these percentiles. ...
Article
Neuroscientific research on pleasant touch has focused on the C-tactile pathway for gentle stroking and has successfully explained how these sensory fibers transmit information about affective social touch to the brain and induce sensations of pleasantness. The C-tactile social/affective touch hypothesis even proposes that C-tactile fibers form a privileged pathway underlying social touch. However, deep pressure is a type of touch commonly considered pleasant and calming, occurring in hugs, cuddling, and massage. In this paper we introduce a paradigm for studying pleasant deep pressure and propose that it constitutes another important form of social touch. We describe development of the oscillating compression sleeve (OCS) as one approach to administering deep pressure and demonstrate that this touch is perceived as pleasant and calming. Further, we show that deep pressure can be imaged with functional magnetic resonance imaging (MRI) using the air-pressure-driven OCS and that deep pressure activates brain regions highly similar to those that respond to C-tactile stroking, as well as regions not activated by stroking. We propose that deep pressure constitutes another social touch pathway of evolutionary importance signaling the close proximity of conspecifics.
... As clinical reports, these case studies did not empirically test the efficacy of deep pressure. Finally, Krauss (1987) investigated the effects of deep pressure on college students using a device called the Hug'm Apparatus. Anxiety level was determined with a physiological measure (heart rate) and a self-report measure (State-Trait Anxiety Inventory). ...
Article
One symptom common to many persons with autism is a high arousal or anxiety level. This study investigated the effects of deep pressure on arousal and anxiety reduction in autism with Grandin's Hug Machine, a device that allows self-administration of lateral body pressure. Twelve children with autism were randomly assigned to either an experimental group (receiving deep pressure) or a placebo group (not receiving deep pressure but in the disengaged Hug Machine). All children received two 20-min sessions a week over a 6-week period. Arousal was measured behaviorally with the Conners Parent Rating Scale and physiologically with galvanic skin response (GSR) readings. Behavioral results indicated a significant reduction in tension and a marginally significant reduction in anxiety for children who received the deep pressure compared with the children who did not. Additionally, children in the experimental group, whose GSR measures decreased, on average, after deep pressure, were somewhat more likely to have higher GSR arousal a priori. These preliminary findings support the hypothesis that deep pressure may have a calming effect for persons with autism, especially those with high levels of arousal or anxiety.
... Especially after the publication of Emergence in 1986, the machine influenced scientific studies on autism and methods of treatment; its clinical value was progressively acknowledged (cf., e.g., Krauss 1987). Even before the release of her autobiography, Grandin also began to author and co-author articles in the area of autism research (cf. ...
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In the past, our ideas of psychiatric hospitals and their history have been shaped by objects like straitjackets, cribs, and binding belts. These powerful objects were often used as a synonym for psychiatry and the way psychiatric patients were treated, yet very little is known about the agency of these objects and their appropriation by staff and patients. By focusing on material cultures, this book offers a new perspective on the history of psychiatry: it enables a narrative in which practicing psychiatry is part of a complex entanglement in which power is constantly negotiated. Scholars from different academic disciplines show how this material-based approach opens up new perspectives on the agency and imagination of men and women inside psychiatry.
... Caregiver and case study reports have highlighted that AADs can prevent elopement effectively while providing a sense of security for both parents and children (Burgoyne et al., 2014;Burrows, Adams, & Spiers, 2008). Further, AADs can also be trained to provide a modi ed form of pressure touch therapy practiced by occupational therapists that has been found to help autistic individuals reduce arousal and anxiety levels (Bestbier & Williams, 2017; Grandin, 1992;Krauss, 1987). Essentially, AADs can be trained to use their weight and warmth to not only apply physical pressure on their child (e.g., leaning, laying atop) bur to also stop promptly on command. ...
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Autism-Assistance Dogs (AADs) are highly-skilled service animals trained primarily to ensure the safety of an autistic child by preventing elopement and mitigating “meltdowns”. Whereas families with AADs attest anecdotally to the psychosocial and behavioral benefits of their dogs above and beyond safety, quantitative, empirical support for these reports is lacking. The present study investigated the effects of well-trained AADs using validated clinical, behavioral, and physiological measures. We recruited families (N=13) from the top of an accredited training dog organization’s wait-list for AADs and collected pre/post-AAD data using a within subject, repeated measures design. Our findings demonstrate that, in addition to enhancing child outcomes, the integration of well-trained AADs can impact families positively across multiple domains of health and function.
... In line with a fear of pain account, we found that deeper pressure was more effective for individuals high in trait anxiety. Previous research has revealed benefits of deep body compression 85 and interoceptive exposure 55 in highly anxious individuals, potentially related to greater negative appraisals of pain and bodily sensations in such individuals. 93 "Interoceptive exposures" that expose patients to bodily sensations in order to decondition the associated fear reduce anxiety sensitivity 16 and pain-related distress, 56 as well as increase pain acceptance. ...
Article
Pleasant sensation is an underexplored avenue for modulation of chronic pain. Deeper pressure is perceived as pleasant and calming, and can improve sleep. Although pressure can reduce acute pain, its effect on chronic pain is poorly characterized. The current remote, double-blind, randomized controlled trial tested the hypothesis that wearing a heavy weighted blanket – providing widespread pressure to the body – relative to a light weighted blanket would reduce ratings of chronic pain, mediated by improvements in anxiety and sleep. Ninety-four adults with chronic pain were randomized to wear a 15-lb. (heavy) or 5-lb. (light) weighted blanket during a brief trial and overnight for one week. Measures of anxiety and chronic pain were collected pre- and post-intervention, and ratings of pain intensity, anxiety, and sleep were collected daily. After controlling for expectations and trait anxiety, the heavy weighted blanket produced significantly greater reductions in broad perceptions of chronic pain than the light weighted blanket (Cohen's f = .19, CI [-1.97, -.91]). This effect was stronger in individuals with high trait anxiety (p = .02). However, weighted blankets did not alter pain intensity ratings. Pain reductions were not mediated by anxiety or sleep. Given that the heavy weighted blanket was associated with greater modulation of affective versus sensory aspects of chronic pain, we propose that the observed reductions are due to interoceptive and social/affective effects of deeper pressure. Overall, we demonstrate that widespread pressure from a weighted blanket can reduce the severity of chronic pain, offering an accessible, home-based tool for chronic. The study purpose, targeted condition, study design, and primary and secondary outcomes were pre-registered in ClinicalTrials.gov (NCT04447885: “Weighted Blankets and Chronic Pain”). Perspective: This randomized-controlled trial showed that a 15-lb weighted blanket produced significantly greater reductions in broad perceptions of chronic pain relative to a 5-lb weighted blanket, particularly in highly anxious individuals. These findings are relevant to patients and providers seeking home-based, nondrug therapies for chronic pain relief.
... Especially after the publication of Emergence in 1986, the machine influenced scientific studies on autism and methods of treatment; its clinical value was progressively acknowledged (cf., e.g., Krauss 1987). Even before the release of her autobiography, Grandin also began to author and co-author articles in the area of autism research (cf. ...
Chapter
Full-text available
In the past, our ideas of psychiatric hospitals and their history have been shaped by objects like straitjackets, cribs, and binding belts. These powerful objects were often used as a synonym for psychiatry and the way psychiatric patients were treated, yet very little is known about the agency of these objects and their appropriation by staff and patients. By focusing on material cultures, this book offers a new perspective on the history of psychiatry: it enables a narrative in which practicing psychiatry is part of a complex entanglement in which power is constantly negotiated. Scholars from different academic disciplines show how this material-based approach opens up new perspectives on the agency and imagination of men and women inside psychiatry.
... Using the waterbed with heated water, or soft large pillows that are capable of rapping the child and enhancing a sense of security is recommended. Research has shown that deep touch pressure has been used to provide a calming effect (26) and to enhance relaxation (27). Auditory stimulation according to the child preference will add to building up a safe haven for the child to be treated on regular intervals or when the child seems troubled and in need of immediate relaxing intervention. ...
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Rett syndrome is a neurological disorder resulting from an X-linked dominant mutation. It is characterized by a variety of physical and perceptual disabilities, resulting in a need for constant therapy programs to be administered on a regular basis throughout life. Resistance to physical activity has driven the authors in a search for new intervention techniques which might improve the ability to cope while reducing difficulty in handling an external physical facilitator. Snoezelen, or multi-sensory environment, can provide a soothing environment appealing to the child or adolescent with Rett syndrome while at the same time improving physical abilities. The article reviews Rett syndrome typical phenotype and suggests suitable activities that might take place in the multi-sensory environment.
... One seminal study noted that the contribution of service dogs to family outcomes extended beyond physical welfare to behavioral and psychosocial domains; parents reported that they experienced improved quality of sleep and a greater sense of independence while their children exhibited fewer negative behaviors (e.g., "meltdowns", "tantrums", "bolting") and families overall experienced an increase in social acknowledgement and a decrease in embarrassment or shame in public (Burrows et al., 2008). AADs have also been trained to disrupt potentially harmful repetitive or self-stimulating behaviors as well as provide a modified form of pressure touch therapy practiced by occupational therapists to help autistic individuals reduce levels of arousal and anxiety (Bestbier & Williams, 2017;Grandin, 1992;Krauss, 1987). Further, because simple language is used to work with AADS, children may gain rewarding interactive experiences that then scaffold socialization with other humans (Solomon, 2010). ...
Article
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Autism-Assistance Dogs (AADs) are highly-skilled service animals trained primarily to ensure the safety of an autistic child by preventing elopement and mitigating ‘meltdowns’. Although anecdotal accounts and case-studies have indicated that AADs confer benefits above and beyond safety, empirical support anchored in validated clinical, behavioral, and physiological measures is lacking. To address this gap, we studied children and their families before and after receiving a well-trained AAD using a within-subject, repeated-measures design. Notably, this study is the first to assess change in a biomarker for chronic stress in both autistic children and their parents. Final analyses included pre-/post-AAD data from 11 triads (parent/handler-dog-child) demonstrating significantly positive psychosocial and biobehavioral effects of AADs.
... The parents of children with ASD often face emotional and behavioral disorders with their children, especially when the child is overwhelmed with sensory stimulation [40]. In the late 1980s, a study reported the effect of deep-pressure touch as an occupational therapy to provoke a calming effect in a child and an adult with anxiety with hyperactivity manifestation through parasympathetic nerve escalation [41,42]. Deep pressure has been proven to decrease sympathetic arousal, increase parasympathetic response, and improve behavioral performance [41]. ...
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Children with autism spectrum disorder (ASD) have challenging behaviors, which are associated with difficulties in parenting. Deep pressure is a therapeutic modality in occupational therapy, and it was reported to produce a calming effect. This study aimed to determine whether the short-term use of an autism hug machine portable seat (AHMPS) improves behavioral and neurobiological stress in children with ASD, and to determine whether AHMPS with an inflatable wrap or manual pull is more effective. This study enrolled children with ASD who were administered with the inflatable wrap (group I) and manual pull (group II) for 20 min twice a week for 3 weeks. Conners’ Parent Rating Scale-48 (CPRS-48) was used to rate behavioral improvements, and galvanic skin response (GSR) was used to measure sympathetic stress response. A total of 20 children with ASD (14 boys and 6 girls; aged 7–13 years) were included. CPRS-48 presented conduct problems: behavior was significantly decreased in the inflatable group (p = 0.007) compared to the manual pull group. The GSR captured a significant reduction in sympathetic response (p = 0.01) only in group I. Neurobiological stress was reduced in children who were wearing the AHMPS inflatable wrap; therefore, AHMPS inflatable wrap is an effective method to reduce emotional arousal.
Article
ABSTRACT Many people with autistic disorder have problems with oversensitivity to both touch and sound. The author (an autistic person) developed a device that delivers deep touch pressure to help her learn to tolerate touching and to reduce anxiety and nervousness. The "squeeze machine" applies lateral, inwardly directed pressure to both lateral aspects of a person's entire body, by compressing the user between two foam-padded panels. Clinical observations and several studies suggest that deep touch pressure is therapeutically beneficial for both children with autistic disorder and probably children with attention-deficit hyperactivity disorder. Only minor and occasional adverse effects have been noted. Data are reported that show a similar calming effect in nonreferred college students. A review of the animal literature reveals that animals have similar calming reactions, and also suggests possible additional physiological effects of deep touch pressure. At present, there are increasing anecdotal reports of the clinical value of the squeeze machine, including suggestions that it can be used to reduce required doses of psychostimulant medications. More clinical studies are needed to evaluate the potential role of this seemingly beneficial form of "physiological" stimulation.
Article
Since osteopathic medicine's inception its distinction has been proclaimed steadfastly in the osteopathic literature. The uniqueness has been claimed to reside in: (1) rigid adherence to A.T. Still's tenets; (2) osteopathic manipulative treatment (OMT); (3) claims of "holism"; (4) "osteopathic principles", (5) esoteric definitions; and (6) other suggested differences. None of these claims can be successfully defended. An aspect of the osteopathic distinction may lie in the didactic of OMT per se. Certain experiences in medical school contribute to the "reconstruction" of the student's view of the patient. Touch, through OMT, may be a quality that affects this change and helps make the osteopathic physician different. When blended with traditional medical modalities this may result in a unique medical perspective. The ideal approach for the osteopathic profession would be an honest evaluation of its function in society and its uniqueness in medicine. The profession may discover a uniqueness with touch as an integral part.
Article
Although touch is a basic element in the practice of physiotherapy, no research has been done to establish the type and purpose of practitioner touch in clinical settings. The purpose of the present study was to determine how physiotherapists use touch in inpatient acute and rehabilitation settings. Fifteen physiotherapists with three or more years' experience were videotaped treating two to three patients. The participant physiotherapists reviewed a videotape of themselves and described the types of touch used and their intent behind each touch. Cross-case analysis was used to determine common themes in the descriptions. Mutually exclusive categories of touch were then refined, based on the cases. The most common types of touch used by physiotherapists included assistive touch, touch used to prepare the patient, touch to provide information, caring touch, touch to provide a therapeutic intervention, and touch used to perceive information. The physiotherapists also used 33 different combinations of touch, that is, a single touch used for more than one purpose. Inpatient physiotherapists clearly perform in a 'high touch' arena. Clinical experience was reported as the strongest factor in developing the physiotherapists' sensitivity to patient needs and their skill in using specific types of touch. Further research is needed concerning the way patients perceive and respond to the presence or absence of these various forms of practitioner touch.
Article
A design process developed by Joann Boles was used to develop a therapy garment for three four-year-old boys with sensory integrative dysfunction who participated in occupational therapy using sensory integrative methods. The design process framework has four stages: (a) problem development, (b) needs assessment, (c) prototype development, and (d) evaluation. The problem was developed by observing children with sensory impairments; interviewing parents and professionals involved with sensory impairments; experiencing sensory integrative methods; and reviewing the literature. The needs were assessed for the wearers, the activity, and the environment through four weeks of observations, interviews with the child and significant others, and document reviews. The research design was multiple case studies. The data collection and analyses followed the grounded theory procedures of open and axial coding outlined by Strauss and Corbin (1990). The resulting needs of the wearers, the activities, and the environment were translated into garment specifications and criteria. The four garment specification categories were (a) movement, (b) sensory integration, (c) motor development, and (d) play. Prototypes were generated to meet garment specifications in terms of structure, materials, and assembly. System requirements: PC, World Wide Web browser and PDF reader. Available electronically via Internet. Title from electronic submission form. Thesis (Ph. D.)--Virginia Polytechnic Institute and State University, 1999. Vita. Abstract. Includes bibliographical references.
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Children described as having attention deficit hyperactivity disorder often demonstrate inability to sustain visual attention during classroom fine motor activities. This study investigated the effect of wearing a weighted vest (deep-pressure sensory input) on children's on-task behavior in the classroom. Four students with documented attention difficulties and hyperactivity were timed with a stopwatch to measure their on-task behavior during fine motor activities in the classroom. All 4 students were timed for six 15-min observations without wearing a weighted vest and for six 15-min observations while wearing a weighted vest. On-task behavior increased by 18% to 25% in all 4 students while wearing the weighted vest. Additionally, 3 of the 4 students frequently asked to wear the vest other than during the observation times. These preliminary findings support the hypothesis that wearing a weighted vest to apply deep pressure increases on-task behavior during fine motor activities.
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Background/purpose: Deep pressure input is used to normalize physiological arousal due to stress. Wisdom tooth surgery is an invasive dental procedure with high stress levels, and an alleviation strategy is rarely applied during extraction. In this study, we investigated the effects of deep pressure input on autonomic responses to wisdom tooth extraction in healthy adults. Methods: A randomized, controlled, crossover design was used for dental patients who were allocated to experimental and control groups that received treatment with or without deep pressure input, respectively. Autonomic indicators, namely the heart rate (HR), percentage of low-frequency (LF) HR variability (LF-HRV), percentage of high-frequency (HF) HRV (HF-HRV), and LF/HF HRV ratio (LF/HF-HRV), were assessed at the baseline, during wisdom tooth extraction, and in the posttreatment phase. Results: Wisdom tooth extraction caused significant autonomic parameter changes in both groups; however, differential response patterns were observed between the two groups. In particular, deep pressure input in the experimental group was associated with higher HF-HRV and lower LF/HF-HRV during extraction compared with those in the control group. Conclusion: LF/HF-HRV measurement revealed balanced sympathovagal activation in response to deep pressure application. The results suggest that the application of deep pressure alters the response of HF-HRV and facilitates maintaining sympathovagal balance during wisdom tooth extraction.
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In this article, the current status of the theory and practice of sensory integration in the United States since the 1960s is described and analyzed. In order to characterize current issues in this growing field of practice, historical developments in sensory integration are examined. The following four topics are explored: theoretical constructs, research, assessment, and practice. The article identifies a trend toward understanding sensory integration within the context of an individual's daily occupations.
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Contemporary psychoanalysis considers itself to be a discipline fundamentally concerned with meaning and meaning-making processes. Ed Tronick’s research provides scientific support for the theoretical position that meaning making is a central process in psychological development and in mental health/illness. His work collaborating with psychoanalysts has made major contributions to the psychoanalytic literature on therapeutic action, with a special emphasis on the means by which implicit meanings are activated and modified in analytic treatment—the something more than interpretation. This article is about a different something more, the even more that psychoanalytic theory and technique can evolve through further incorporating Tronick’s important findings. Tronick’s Dyadic Expansion of Consciousness Model will be briefly reviewed—emphasizing his conceptualization of meanings as being composed of multiple commingling layers (biological, psychological, relational, and social) coming together in a nonlinear “messy” mixture of mutually influencing (both bottom-up and top-down) currents. This multilayered model of meaning opens up the reconsideration of an exciting array of technical options—traditionally considered nonanalytic—to be reunderstood as truly psychoanalytic in that they address one or more of the implicit or explicit levels of meaning that a patient makes of his or her self and world. Examples of these interventions include parent work, work with teachers and schools, as well as interventions adapted from other disciplines such as Occupational Therapy. These technical possibilities are illustrated using case material from the psychoanalytic treatment of a nine-year-old boy.
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The application of deep touch pressure (DTP) has been suggested to provide positive effects on anxiety modulation. However, empirical and theoretical evidence linked to the clinical effects of DTP are relatively rare. This study conducts a quantitative analysis of behavioral assessments and performs physiological measurements, including those of electrodermal activity and heart rate variability, to understand the modulation of the autonomic nervous system (ANS), and the orchestration of sympathetic (SNS) and parasympathetic nervous systems (PsNS). The results suggest that the activation of PsNS plays a critical role in ANS modulation. This study provides physiological evidence to support the positive clinical effects of DTP for reducing anxiety in dental environments.
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This paper reports the results of a single subject study of an adult with sensory defensiveness. Psychophysiological measurements were used to assess the subject's autonomic responsiveness to touch, visual and auditory stimulation. As treatment, the subject self-administered firm tactile input which was, according to sensory integrative principles, expected to have a calming effect. Autonomic responses measured throughout the treatment period were compared to baseline responses. Significant changes in respiration rate, hand temperature and amplitude of skin conductance responses reflected reduced autonomic arousal. The study provides support for 1) the relationship of sensory defensiveness to autonomic arousal, 2) the potential for normalization of autonomic responses following treatment and 3) the use of psychophysiological measures in efficacy studies of sensory defensiveness.
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The current meta-analysis examined the use of deep touch pressure (DTP; e.g., weighted vests) with students with disabilities. DTP is a form of sensory integration therapy that is currently used extensively in schools with students with autism and other disabilities. Each study in the analysis was evaluated using the Council for Exceptional Children’s guidelines for evidence-based practices. In addition, noting the debate regarding appropriate single-case effect sizes, the current study calculated omnibus effect sizes utilizing a variety of single-case design effect sizes. Results of the current study suggest that DTP interventions are of generally poor quality and demonstrate effects that do not validate their current use for students with disabilities.
Article
Many medical conditions, including sensory processing disorder (SPD), employ compression therapy as a form of treatment. SPD patients often wear weighted or elastic vests to produce compression on the body, which have been shown to have a calming effect on the wearer. Recent advances in compression garment technology incorporate active materials to produce dynamic, low bulk compression garments that can be remotely controlled. In this study, an active compression vest using shape memory alloy (SMA) spring actuators was developed to produce up to 52.5 mmHg compression on a child's torso for SPD applications. The vest prototype incorporated 16 SMA spring actuators (1.25 mm diameter, spring index = 3) that constrict when heated, producing large forces and displacements that can be controlled via an applied current. When power was applied (up to 43.8 W), the prototype vest generated increasing magnitudes of pressure (up to 37.6 mmHg, spatially averaged across the front of the torso) on a representative child-sized form. The average pressure generated was measured up to 71.6% of the modeled pressure, and spatial pressure nonuniformities were observed that can be traced to specific garment architectural features. Although there is no consistent standard in magnitude or distribution of applied force in compression therapy garments, it is clear from comparative benchmarks that the compression produced by this garment exceeds the demands of the target application. This study demonstrates the viability of SMA-based compression garments as an enabling technology for enhancing SPD (and other compression-based) treatment.
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Small everyday gestures such as a tap on the shoulder can affect the way humans feel and act. Touch can have a calming effect and alter the way stress is handled, thereby promoting mental and physical health. Due to current technical advances and the growing role of intelligent robots in households and healthcare, recent research also addressed the potential of robotic touch for stress reduction. In addition, touch by non-human agents such as animals or inanimate objects may have a calming effect. This conceptual article will review a selection of the most relevant studies reporting the physiological, hormonal, neural, and subjective effects of touch on stress, arousal, and negative affect. Robotic systems capable of non-social touch will be assessed together with control strategies and sensor technologies. Parallels and differences of human-to-human touch and human-to-non-human touch will be discussed. We propose that, under appropriate conditions, touch can act as (social) signal for safety, even when the interaction partner is an animal or a machine. We will also outline potential directions for future research and clinical relevance. Thereby, this review can provide a foundation for further investigations into the beneficial contribution of touch by different agents to regulate negative affect and arousal in humans.
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The prevalence of autism in Indonesia was estimated approximately 2.5 million people. There are at least 500 new cases was diagnosed annually. Self-injurious behaviour is one of the most prevalence in autistic children. Only a few studies had been done in Indonesia regarding autism issue. Therefore, this study aims to design a hug machine portable seat for autistic children, called Autism Hug Machine Portable Seat (AHMPS), which can be used in public transportation (bus and train) to provide safety and for comfortability and can be used for therapeutic aid with deep pressure stimulation. The design was based on the morphological and decision-making matrix to get the best concept. The results of this study were obtained a selected design concept and certain technical specifications for the AHMPS.
Article
This research explores how tangible interactive technology might offer opportunities for socialization and sensory regulation. We present a study carried out in an educational setting during leisure activities with a small group of children with autism who like music. We introduce Όλοι (pronounced Olly), a sonic textile Tangible User Interface (TUI) designed around the observations of five minimally verbal children with autism aged between 5-10 years. The TUI was tested for an average of 24 minutes once per week, over a period of five weeks in a special education needs (SEN) school based in North-East London, UK. We propose a methodological approach that embraces diversity and promotes designs that support repetitive movements and self-regulation to provide the children with a favorable environment and tools to socialize with peers. The findings show positive outcomes with regards to spontaneous social interactions between peers particularly when children interacted with or around Olly. These were observed in the form of eye-contact, turn-taking, sharing (of the space, the object and experience), and more complex social play dynamics like associative and cooperative play. We illustrate how the TUI was a positive stimulus of social behaviors and discuss design implications for novel technologies that aim to foster shared experiences between children with autism.
Article
Background Emergence delirium (ED) is a significant problem in the post anesthesia care unit (PACU), resulting in dislodgement of medical devices, patient and staff injury, prolonged recovery, and parent dissatisfaction. Parental requests for the use of weighted blankets in the hospital setting have increased. However, while weighted blankets have shown potential as treatment for anxiety in adults and children, no studies have demonstrated their safe use with children in the hospital setting. Purpose To explore the safety of weighted blanket use with children in the PACU as an intervention for ED, a feasibility study was conducted. Design and Methodology: A convenience sample of 93 participants, aged three to 10 years were recruited. Watcha scores, vital signs, length of wear time, and reason for blanket removal were recorded for all patients. Results Eighty-five patients completed the study. Four participants experienced vital signs outside the defined safety parameters, with only one experiencing an adverse event (1.2%). This was consistent with the historic adverse event rate of 1% for the study site. Staff did not report issues with the use or cleaning of the blankets. Of interest, there was significant correlation between ED and suspected pain. Conclusion The study demonstrated weighted blanket use is safe and feasible with children in the hospital setting, Additional studies are needed to determine the effectiveness of weighted blankets as an intervention for ED and the impact pain may have on the severity and prevalence of ED.
Article
Rett syndrome is a neurological disorder resulting from an X-linked dominant mutation. It is characterized by a variety of physical and perceptual disabilities, resulting in a need for constant therapy programs to be administered on a regular basis throughout the client's life. As the child with Rett disorder (RD) is entering the more obvious, hectic phase of this syndrome (stage II), signs of extreme agitation and discomfort are usually exhibited. This behavior is suspected to reflect damaging chaotic processes accruing in the brain at that time. Experts advise that calming techniques might be helpful for children with Rett during this period. This may be our earliest opportunity to change the course of the disorder. Now that our knowledge of RD has increased and children are being diagnosed at a substantially earlier age, new intervention methods should be introduced for parents and therapists. This may ensure more suitable treatment. The multi-sensory environment may provide a soothing haven, which appeals to the child with RD. This article provides a short review of RD typical phenotype and suggests suitable activities that could take place in the multi-sensory environment with this population at the early stages of appearance of the Rett disorder.
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