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Give us a cuddle!
“Why is that man squashing that boy?”
I was trailing a group of keen new student nurses around a service for young men with autism and challenging behaviour when a straggler piped up from the rear. All eyes instantly swiveled to the source of the query, where indeed the member of staff in question appeared to be grappling with a noisy teenager.
This was not the first time I found myself talking about the benefits of deep pressure as a calming method for people with autism. Given that the technique variously involves pressing down on the head, shoulders or arms of a service user, or bearhugging them, it can appear to the unaware as an assault or restraint.
For people with autism, there is often a severe confusion around the body and the understanding of what is ‘you’ and where that starts and ends. Sensory processing difficulties from birth can lead to confusion about the body and how it fits in the rest of the world, giving the feeling of ‘falling apart’ or causing extreme discomfort and even pain.
You may find a person with sensory processing disorder is highly sensitive to touch, noise or other sensory input, and will find some relief in covering themselves in blankets, climbing under or behind things, or holding themselves and rocking. When sensory input becomes too much to handle, the storm of competing sensations can lead to physical agony for many.
Occupational therapists have observed that a very light touch alerts the nervous system, but deep pressure is relaxing and calming. Consider the now rather outdated method of swaddling babies; this creates a safe and secure feeling and can calm newborns who until recently had been curled up tight in a vey enclosed space. Many of us like to have a deep bath as a comfort; the feeling of safety and warmth in the tub is another response to deep pressure on the body. In crisis, the return to the womb is a strong psychological pull for humans.
How to go about it as a therapy
There are various forms of deep pressure and not all techniques work for everyone. Indeed, some people cannot deal with the method at all and find it seriously challenging, so the best way to approach the introduction of this form of support is to consult a specialist OT. They will be able to observe the way the person responds to sensations and suggest a range of possible support activities. This can be known as a ‘sensory diet’, forming a daily routine of sensory input and therapy that helps the person deal with the world they live in and reduces the discomfort and trauma they experience.
Interventions in use in care settings include the use of ‘bear hug’ weighted jackets or vests, which can be worn to create a constant deep pressure sufficient to calm the wearer and enable them to participate in activities. Another way is through the use of tight elastic support bandages worn on arms – if you know someone who continually pulls their arms inside their clothing and stretches sleeves over their hands, this is what they are seeking. Also, cocoon sleeping bags to sleep in instead of ordinary bedding, or even tightly tucked in blankets (I still harbor fond memories of being ‘tucked in’ as a child!)
There is a wealth of information out there on the value of deep pressure, so why not have a look and see if this form of contact could help someone you support?
Ginny Tyler – QCS Learning Disability Expert Contributor