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Effects of Ball-Vests for Children Exhibiting Sensory Seeking Behaviour: A Pragmatic Randomized Controlled Trial

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Title: Effects of Ball-Vests for Children Exhibiting Sensory Seeking Behaviour: A Pragmatic Randomized Controlled Trial
Language: English
Authors: Ann Natasja Nielsen, Sören Möller (ORCID 0000-0003-0858-4269), Karen la Cour, Åse Brandt
Source: Child Care in Practice. 2026 32(1):104-119.
Availability: Routledge. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 16
Publication Date: 2026
Document Type: Journal Articles
Reports - Research
Descriptors: Perceptual Impairments, Sensory Experience, Tactual Perception, Stimuli, Intervention, Children, Preadolescents, Attention, Time on Task, Competence, Equipment, Attention Deficit Hyperactivity Disorder, Autism Spectrum Disorders, Foreign Countries
Geographic Terms: Denmark
DOI: 10.1080/13575279.2024.2387665
ISSN: 1357-5279
1476-489X
Abstract: Children with challenges processing sensory information can have difficulties affecting their ability to participate in school activities, which may affect their potential for learning. The aim of this study was to examine the possible effects of an intervention with three weeks use of ball-vests that provide proprioceptive-tactile stimulation for children exhibiting sensory seeking behaviour. Methods: The study was a pragmatic randomized controlled trial that included 142 children (105 boys and 37 girls, mean age 8.9 years) with dysfunction in sensory processing and sensory seeking behaviour. The children's ability for attention was measured with the "Test of Everyday Attention--Children" (TEA-Ch), their occupational competence in school activities with the "Child Occupational Self-Assessment" (COSA) and the extent of off-task behaviour with the "Observational off-task Behavior among School--children" (OBS-Children). Data was analysed using linear mixed model regression. Results: Children in the intervention group had a significantly larger increase in self-assessed occupational competence than children in the control group (B = 5.78, p = 0.004). No differences regarding attention or extent of off-task behaviour between intervention and control group were found.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1500760
Database: ERIC
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  Value: <anid>AN0191102788;j2301jan.26;2026Jan28.00:55;v2.2.500</anid> <title id="AN0191102788-1">Effects of Ball-Vests for Children Exhibiting Sensory Seeking Behaviour: A Pragmatic Randomized Controlled Trial </title> <p>Children with challenges processing sensory information can have difficulties affecting their ability to participate in school activities, which may affect their potential for learning. The aim of this study was to examine the possible effects of an intervention with three weeks use of ball-vests that provide proprioceptive-tactile stimulation for children exhibiting sensory seeking behaviour. Methods: The study was a pragmatic randomized controlled trial that included 142 children (105 boys and 37 girls, mean age 8.9 years) with dysfunction in sensory processing and sensory seeking behaviour. The children´s ability for attention was measured with the "Test of Everyday Attention-Children" (TEA-Ch), their occupational competence in school activities with the "Child Occupational Self-Assessment" (COSA) and the extent of off-task behaviour with the "Observational off-task Behavior among School-children" (OBS-Children). Data was analysed using linear mixed model regression. Results: Children in the intervention group had a significantly larger increase in self-assessed occupational competence than children in the control group (B = 5.78, p = 0.004). No differences regarding attention or extent of off-task behaviour between intervention and control group were found. Trial registration: ClinicalTrials.gov identifier: NCT04173871..</p> <p>Keywords: Sensory processing; sensory integration; primary school; Deep Touch Pressure Therapy; assistive device</p> <hd id="AN0191102788-2">Introduction</hd> <p>This study investigated the possible effects of an intervention with the use of ball-vests for children with sensory processing dysfunction and sensory seeking behaviour that affect their ability to participate in school activities (referred to as children exhibiting sensory seeking behaviour). Sensory processing/sensory integration was first described by Dr A. Jean Ayres as a brain-behaviour relationship where the neurological processes are seen in relation to the behaviour of the child (Bundy & Lane, [<reflink idref="bib8" id="ref1">8</reflink>]). Sensory processing refers to the ability to be able, upon receiving sensory information, to regulate and organize responses in an adaptive and graded manner (Bundy & Lane, [<reflink idref="bib8" id="ref2">8</reflink>]; Dunn, [<reflink idref="bib10" id="ref3">10</reflink>]). Studies have found associations between sensory processing and academic performance (Parham, [<reflink idref="bib34" id="ref4">34</reflink>]), as well as a correlation between sensory processing dysfunction and challenges with reading, spelling, and math (Ashburner et al., [<reflink idref="bib2" id="ref5">2</reflink>]; van der Wurff et al., [<reflink idref="bib41" id="ref6">41</reflink>]).</p> <p>Children learn by engaging in activities, and their ability to participate in them is key to their development (Bundy & Lane, [<reflink idref="bib8" id="ref7">8</reflink>]). Learning is defined as both academic learning, social learning, and motor behavioural learning (Bundy & Lane, [<reflink idref="bib8" id="ref8">8</reflink>]), and research suggests that children with dysfunction in sensory processing have lower levels of enjoyment of and participation in everyday activities at home and at school (Chien et al., [<reflink idref="bib9" id="ref9">9</reflink>]). Children with sensory processing dysfunction have been found to have challenges regarding concentration, attention, (Bundy & Lane, [<reflink idref="bib8" id="ref10">8</reflink>]; Dunn, [<reflink idref="bib10" id="ref11">10</reflink>]; Nielsen et al., [<reflink idref="bib32" id="ref12">32</reflink>]; Yung, [<reflink idref="bib45" id="ref13">45</reflink>]), and academic learning (Koenig & Rudney, [<reflink idref="bib18" id="ref14">18</reflink>]; Mimouni-Bloch et al., [<reflink idref="bib28" id="ref15">28</reflink>]). Furthermore, sensory processing dysfunction in childhood has been linked to anxiety in youth and obsessive-compulsive symptoms in adulthood (Bar-Shalita et al., [<reflink idref="bib4" id="ref16">4</reflink>]; Chien et al., [<reflink idref="bib9" id="ref17">9</reflink>]).</p> <p>The prevalence of children with sensory processing dysfunction has been found to be 5–21% for preschool or primary school aged children (Ahn et al., [<reflink idref="bib1" id="ref18">1</reflink>]; James et al., [<reflink idref="bib16" id="ref19">16</reflink>]; Loh et al., [<reflink idref="bib22" id="ref20">22</reflink>]; Nielsen et al., [<reflink idref="bib30" id="ref21">30</reflink>]; Román-Oyola & Reynolds, [<reflink idref="bib35" id="ref22">35</reflink>]; Tomchek & Dunn, [<reflink idref="bib39" id="ref23">39</reflink>]). A study among Danish school children found that about 20% of children attending primary school (not including special needs classes) had dysfunction in sensory processing, and 70% of these children exhibited sensory seeking behaviour (Nielsen et al., [<reflink idref="bib30" id="ref24">30</reflink>]). When children exhibit sensory seeking behaviour, they may experience clumsiness and postural control difficulties (A. E. Lane, [<reflink idref="bib19" id="ref25">19</reflink>]), and they have been found to have inferior attention compared to children without sensory processing dysfunctions (van der Wurff et al., [<reflink idref="bib41" id="ref26">41</reflink>]). Additionally, children exhibiting sensory seeking behaviour can tend to jump between activities frequently, which can interfere with their ability to participate in learning activities (Dunn, [<reflink idref="bib10" id="ref27">10</reflink>]). Children exhibiting sensory seeking behaviour can have difficulty with keeping attention, sitting still, and remaining on-task (Nielsen et al., [<reflink idref="bib32" id="ref28">32</reflink>]), which are important skills for successful participation in school activities (Finneran et al., [<reflink idref="bib11" id="ref29">11</reflink>]).</p> <p>Deep Touch Pressure Therapy is a complementary programme for sensory processing that paediatric therapists use for children with dysfunction in sensory processing, which studies have found to have varying effects (Losinski et al., [<reflink idref="bib23" id="ref30">23</reflink>]). A method for deep touch pressure is wearable technology that provides proprioceptive stimulation, such as compression garments or weighted vests (Losinski et al., [<reflink idref="bib23" id="ref31">23</reflink>]).</p> <p>Deep touch pressure garments that provide both proprioceptive and tactile stimulation such as the ball-vest are used in clinical practice and leaning institutions like schools, but research into their potential effects is lacking. These garments are classified as clothing for sensory stimulation in the international classification of assistive technology ISO 9999:2022 (International Standards Organization, [<reflink idref="bib15" id="ref32">15</reflink>]). This study used the Protac MyFit® ball-vest (here from referenced to as the vest). The vest is filled with weighted balls that are either 25 mm or 38 mm in diameter, and the vest weighs 1–2 kg depending on size. It aims to provide the child with concentrated proprioceptive and tactile stimulation, which can be calming and give a distinct awareness of the body (A. E. Lane, [<reflink idref="bib19" id="ref33">19</reflink>]; S. J. Lane et al., [<reflink idref="bib20" id="ref34">20</reflink>]; Losinski et al., [<reflink idref="bib23" id="ref35">23</reflink>]).</p> <p>Deep Touch Pressure Therapy with weighted vests has been found to show improved attention, concentration, and on-task behaviour for children with Attention Deficit/Hyperactivity Disorder (ADHD) (Lin et al., [<reflink idref="bib21" id="ref36">21</reflink>]). To our knowledge, no previous studies have investigated the possible effects of ball-vests regarding the challenges for children exhibiting sensory seeking behaviour. Findings from a feasibility study of an intervention with ball-vests indicated that attention, extent of off-task behaviour, and confidence in own occupational competence would be relevant outcomes (Nielsen et al., [<reflink idref="bib31" id="ref37">31</reflink>]), with occupational competence defined as the children's occupational performance in activities that they find important (Keller, [<reflink idref="bib17" id="ref38">17</reflink>]). Children's assessment of own occupational competence is relevant since children develop and learn through engaging in activities and, importantly, also through their confidence to participate in these activities (Bundy & Hacker, [<reflink idref="bib7" id="ref39">7</reflink>]; Bundy & Lane, [<reflink idref="bib8" id="ref40">8</reflink>]).</p> <p>In the present study, we examined the possible effects of an intervention for children exhibiting sensory seeking behaviour carried out in an ordinary school setting. The intervention comprised use of the vest by the children and supporting educational elements with information regarding sensory processing for their teachers and parents. The possible effects of the vest as assessed by the children's parents and teachers are reported elsewhere and indicated positive effects for some of the children regarding attention (39%), body perception (34%), hyperactivity (33%), and coping skills in learning (30%) (Nielsen et al., [<reflink idref="bib32" id="ref41">32</reflink>]).</p> <p>The aim of the study was to investigate whether an intervention with the use of ball-vests for children aged 6–12 years exhibiting sensory seeking behaviour and supportive elements of knowledge regarding sensory processing for their teachers and parents would have effect on the children's abilities for attention, sense of occupational competence in school related activities, or their extent of off-task behaviour.</p> <hd id="AN0191102788-3">Materials and methods</hd> <p>The study followed the framework of the Medical Research Council (MRC) regarding complex interventions (Skivington et al., [<reflink idref="bib36" id="ref42">36</reflink>]), since the intervention consisted of both direct and supporting elements with a range of outcome variables. In accordance with the MRC guidance (Skivington et al., [<reflink idref="bib36" id="ref43">36</reflink>]), the feasibility of the intervention was tested and evaluated (Nielsen et al., [<reflink idref="bib31" id="ref44">31</reflink>]) and elements of process evaluation regarding adherence and beneficial and limiting factors for implementation were incorporated in this study. To increase impact and possible future uptake, this study was designed as a pragmatic randomized controlled trial.</p> <p>The study is registered at Clinicaltrials.gov registration number: NCT04173871, first registration date: 21.11.2019, and reported according to the CONSORT guide for pragmatic randomized trials (Zwarenstein et al., [<reflink idref="bib46" id="ref45">46</reflink>]).</p> <hd id="AN0191102788-4">Participants</hd> <p>The participants were children with sensory processing dysfunction and sensory seeking behaviour as measured with the Short Sensory Profile (SSP). The SSP is a short version of the 125 item Sensory Profile, created for screening programmes and research. The SSP contains the 38 items from the Sensory Profile that were the most indicative of sensory processing issues affecting performance (McIntosh et al., [<reflink idref="bib27" id="ref46">27</reflink>]). The SSP utilizes a five-point Likert scale where the child's parent assesses, from 38 items of statements regarding behaviour, how often they observe the described behaviour in the child, resulting in a score from 38 to 190 (McIntosh et al., [<reflink idref="bib27" id="ref47">27</reflink>]). SSP scores < 155 indicate challenges with sensory processing (i.e. a SSP score of 38–141 equals a definite difference in sensory processing and scores of 142–154 equals a probable difference in sensory processing). The SSP has section scores, where seven items indicate whether the child presents with sensory seeking behaviour (section scores < 26 indicate sensory seeking behaviour). The validity of the SSP compared to the full Sensory Profile has shown a discriminant validity of > 95% in identifying children with and without dysfunction in sensory processing (McIntosh et al., [<reflink idref="bib27" id="ref48">27</reflink>]). All eligible children within the criteria for inclusion were enrolled in the study, and their parents and teachers were invited to participate in process evaluation regarding adherence and quality of implementation.</p> <p>The following inclusion- and exclusion criteria were applied:</p> <p>Inclusion: Children aged 6–12 years with a total SSP score indicating dysfunction in sensory processing (i.e. 38–154) and SSP section scores indicating sensory seeking behaviour (i.e. sensory seeking behaviour section score of 7–25) attending public school.</p> <p>Exclusion: Children with intellectual and developmental disability or other cognitive impairment (to a degree that would have them attending special-needs classes) or severe sensory disability (i.e. blindness or deafness), as assessed by their teacher.</p> <hd id="AN0191102788-5">Intervention and control</hd> <p>The intervention comprised use of the vest by the participants and supportive educational elements regarding knowledge on sensory processing for teachers and parents (for participants in both intervention and control groups). Systematic daily use meant that the participants were requested to wear the vest from the beginning of every school day and through the first two lessons (i.e. 90 min). To ensure that the participants had time to get used to the vest, the intervention period was determined to be three weeks. The participants were welcome to have as much additional use of the vest as they pleased during the intervention period. At baseline, the vest was fitted to participants as per size, and the participants chose whether they wished to use a vest with balls that were 25 mm or 38 mm in diameter, depending on which they found most comfortable.</p> <p>The supporting educational element of knowledge regarding sensory processing for teachers was a 90-minute lecture on sensory processing and sensory seeking behaviour, with recommendations for how to adjust activities and classrooms environments to support attention. The lectures were mandatory for teachers from the primary level and held at the different schools, except for three schools where the lecture was held online due to pandemic-related restrictions on large gatherings. These were carried out by the first author prior to the recruitment of participants.</p> <p>The supportive element of knowledge regarding sensory processing for parents were individual counselling session by phone concerning challenges they had experienced with their child.</p> <p>During the study, participants in the intervention and control groups received the usual treatment if provided by the municipality and/or the family doctor.</p> <hd id="AN0191102788-6">Outcomes</hd> <p>The primary outcome in this study was attention; secondary outcomes were occupational competence and off-task behaviour. To measure participants' ability for attention, the Danish version of the standardized Test of Everyday Attention for Children (TEA-Ch) was used. The TEA-Ch comprises nine tests that examine the child's ability for three different types of attention (selective attention, sustained attention, and attentional control/switching) (Manly et al., [<reflink idref="bib25" id="ref49">25</reflink>]). The TEA-Ch is designed for retesting with two parallel versions, version A for baseline and version B for follow-up. The TEA-Ch has been found to be a discriminative assessment measure for children with ADHD (Heaton et al., [<reflink idref="bib13" id="ref50">13</reflink>]). The present study used the tests that examine sustained attention (Score, Walk Don´t Walk and Code Transmission) and the tests for attentional control/switching (Creature Counting and Opposite Worlds) (Manly et al., [<reflink idref="bib25" id="ref51">25</reflink>]). All included tests are so-called desk tests where the child sits at a desk and follows test instructions. Before each test, the child has at least two practice runs of the test.</p> <p>To measure the participants' occupational competence in school activities, the Danish translation of the Child Occupational Self-Assessment (COSA) was used (Baagø, [<reflink idref="bib3" id="ref52">3</reflink>]; Keller, [<reflink idref="bib17" id="ref53">17</reflink>]). The COSA is an assessment tool designed to capture children's perceptions of their own occupational competence, together with their rating of the importance of everyday activities. The COSA contains 25 items about typical childhood everyday activities at home, school, and in the community (Keller, [<reflink idref="bib17" id="ref54">17</reflink>]). This study used the 11 items concerning school-related activities, one item regarding sleep, and one introduction/test item. At every item, the children rated their perception of their own ability on a scale of four: "I have a big problem doing this", "I have a little problem doing this", "I do this okay", or "I am really good at doing this". Additionally, the children assessed the importance of the items on a scale of four: "not really important to me", "important to me", "really important to me", or "most important of all to me"(Keller, [<reflink idref="bib17" id="ref55">17</reflink>]). A study of the test–retest reliability of the COSA found with reasonable certainty that changes detected when using the COSA as an outcome measure are not due to children having fluctuating perceptions (Ohl et al., [<reflink idref="bib33" id="ref56">33</reflink>]).</p> <p>To measure the extent of the participants' off-task behaviour, the Observed Off-task Behaviour among School-Children (OBS-children) was used. The OBS-Children is an observational tool developed for the present study. The tool was developed based on theory of sensory processing and research regarding out-of-seat and fidgeting behaviour (Lin et al., [<reflink idref="bib21" id="ref57">21</reflink>]), off-task behaviour, and conducting observations in time sequences (Godwin et al., [<reflink idref="bib12" id="ref58">12</reflink>]). The OBS-Children comprises five items: "fidgets", "restless legs/feet", "tactile stimuli", "sits uneasy", and "oral stimuli". Scoring on the OBS-Children is based on a 20-minute observation divided into 15-second time-sequenses where it is registered whether the participant exbibits each of the five items within every time-sequense (resulting in a max score of 80 for each item). An interrater reliability study of OBS-Children found that the items in the OBS-children had intraclass correlation coefficient (ICC) values indicating poor to excellent reliability (Bech et al., [<reflink idref="bib5" id="ref59">5</reflink>]). Only one item had an ICC value showing poor reliability ("oral stimuli", ICC = 0.29) (Bech et al., [<reflink idref="bib5" id="ref60">5</reflink>]) and was therefore not included in this study.</p> <p>To investigate adherence, teachers and parents of children allocated to the intervention group received study-specific surveys regarding whether the participant had used the vest (i.e. "the requested 90 min", "additionally at school", "at home"). Additionally, to gain insight into beneficial and limiting factors for implementation, the survey had study-specific open-ended questions where teachers and parents were asked what factors had had a profitable or inhibitory influence on the participants' use of the vest.</p> <hd id="AN0191102788-7">Data collection</hd> <p>The TEA-Ch testing and the COSA interviews were conducted at the participants' schools by four research assistants (psychology students). Participants were videoed while completing the TEA-Ch test. The video material was used for registration on the OBS-Children, which was conducted subsequently by three additional research assistants (occupational therapists). The registration with the OBS-Children began when the participant started the TEA-Ch test "Walk, Don't Walk and lasted 20 min. Data regarding the TEA-Ch, the COSA, and the OBS-Children were collected/registered by the same research assistant at baseline and follow-up.</p> <hd id="AN0191102788-8">Sample size, randomization, and blinding</hd> <p>The sample size was calculated based on results from the feasibility study (Nielsen et al., [<reflink idref="bib31" id="ref61">31</reflink>]) using the primary outcome of attention measured with the "Walk, Don't Walk" test (SD 3.69) in the TEA-Ch. The required target sample size was determined to be <emph>N</emph> = 138 (1:1 intervention and control group), calculated for the two sample t-test (Borm et al., [<reflink idref="bib6" id="ref62">6</reflink>]) and with an anticipated difference of 1.5, a standard deviation of 3.69, power of 0.9, and significance level at 0.05.</p> <p>Eligible participants were randomized 1:1. Randomization was computer generated with a distribution key written by an impartial data manager. Due to the higher prevalence of dysfunction in sensory processing among boys than girls, the randomization was stratified by sex.</p> <p>It was not possible to blind the participants, the teachers, the parents, or the research assistants providing the intervention, since the vests were clearly visible. Upon enrolment, participants' parents and schools were contacted by phone and informed about participation and whether the participant was randomized to the intervention or control group.</p> <hd id="AN0191102788-9">Data analysis</hd> <p>Descriptive statistics with mean, standard deviation (SD), counts, and proportions were used to summarize participant characteristics. The TEA-Ch subtest results were grouped into sustained attention and attentional control/switching, which accords with the TEA-Ch manual (Manly et al., [<reflink idref="bib25" id="ref63">25</reflink>]). Each OBS-Children item was analysed individually. The percent of maximum possible (POMP) (Keller, [<reflink idref="bib17" id="ref64">17</reflink>]) approach was used for analysis of the COSA interviews. For the use of the POMP approach, the rating of the participants' own competence regarding the different items was given a numeric value ranging from one to four (with one being "I have a big problem doing this" and four being "I am really good at doing this"). The items that the participant rated as "not really important to me" were discarded from the analysis. The score of the remaining items was summarized (i.e. the actual score). The lowest possible score (i.e. one for each included item) and the highest possible score (i.e. four for each included item) were calculated as requested by the COSA manual (Keller, [<reflink idref="bib17" id="ref65">17</reflink>]). The POMP is calculated using the following equation:</p> <p>Graph</p> <p> <ephtml> <math xmlns="http://www.w3.org/1998/Math/MathML"><mrow><mi mathvariant="normal">POMP</mi></mrow><mo>=</mo><mrow /><mo stretchy="false">[</mo><mrow><mo stretchy="false">(</mo><mrow><mrow><mi mathvariant="normal">actual</mi><mspace width="thinmathspace" /><mi mathvariant="normal">score</mi><mtext>–</mtext><mi mathvariant="normal">lowest</mi><mspace width="thinmathspace" /><mi mathvariant="normal">possible</mi></mrow></mrow><mo stretchy="false">)</mo><mrow><mrow><mo>/</mo></mrow><mspace width="thinmathspace" /></mrow><mo stretchy="false">(</mo><mrow><mrow><mi mathvariant="normal">highest</mi><mspace width="thinmathspace" /><mi mathvariant="normal">possible</mi><mtext>–</mtext><mi mathvariant="normal">lowest</mi><mspace width="thinmathspace" /><mi mathvariant="normal">possible</mi></mrow></mrow><mo stretchy="false">)</mo></mrow><mo stretchy="false">]</mo><mo>×</mo><mn>100</mn><mo>.</mo></math> </ephtml> </p> <p>Differences between the intervention and control groups were investigated by a linear mixed model regression with the dependent variable being the individual changes in scores from baseline to follow-up, including a random intercept for each participant to consider the two repeated measurements from each participant. This analysis is often referred to as a change score analysis (Tu et al., [<reflink idref="bib40" id="ref66">40</reflink>]).</p> <p>Additionally, an analysis was conducted to explore whether sex, diagnosis, or degree of dysfunction in sensory processing had influence on the results using linear regression analyses (Mould, [<reflink idref="bib29" id="ref67">29</reflink>]) adjusting for sex, diagnosis, and degree of dysfunction in sensory processing. Analyses stratifying the intervention group by extent of vest use were conducted to explore the possible effects of extent of vest use.</p> <p>All data were analysed according to intention to treat principles (McCoy, [<reflink idref="bib26" id="ref68">26</reflink>]). The statistical significance level was set at <emph>p</emph> < 0.05. Data analysis was conducted using the statistical software, Stata 17.0 (StataCorp LLC, [<reflink idref="bib37" id="ref69">37</reflink>]).</p> <p>Data from the open-ended questions regarding profitable or inhibitory factors were subjected to thematic analysis (Thompson, [<reflink idref="bib38" id="ref70">38</reflink>]).</p> <hd id="AN0191102788-10">Ethics</hd> <p>The study was conducted in accordance with ethical principles and recommendations from the Declaration of Helsinki 2008 (World Medical Association Inc, [<reflink idref="bib42" id="ref71">42</reflink>]). Additionally, permission for the study was sought from the National Committee on Health Research Ethics that declared the study not applicable for notification to the scientific ethics committee system, according to §14 cf. 1 of the Act on Science Ethical Treatment of Health Science Research Projects case no. S-20182000-155. Permission to obtain and store data was sought and approved from the Danish Data Protection Agency journal no. 10.135. All parents of possible participants received written information about the study, about data management, that participation was voluntary, and that there were no consequences to withdraw at any time. Participants who were eligible for enrolment in the study and their parents additionally received verbal information regarding study procedures. Written consent was obtained from the parent/legal guardian of the child.</p> <p>Teachers of participants were thoroughly introduced to the study and given written information where they were encouraged to introduce the study for the participants' classmates to reduce the potential risks for stigmatization. Additionally, the schools received a brief introduction to the study that they distributed on the internal web-communication for the school, the pupils, and their parents to further reduce any potential risk of stigmatization of the children participating in the study. Participants allocated to the control group were provided with an opportunity to try out the vest for three weeks after participation out of ethical considerations.</p> <hd id="AN0191102788-11">Recruitment</hd> <p>The management at 128 schools from eight randomly selected Danish municipalities that accepted participation in the study was contacted and offered participation. In all, 31 schools accepted, 53 schools did not return the invitation, and 44 schools declined to participate. The schools declining the invitation had various reasons, mostly practical ones—for example, "our meetings are already fully booked for the year". Others had ethical reasons—for example, "What if it works? We don't have funding to provide the children with vests afterwards". The 31 schools that chose to participate varied in location and size—i.e. both rural and urban schools, schools with only primary level (up to sixth grade), and some with both primary and secondary school level (up to 10th grade), with between 75 and 1,000 pupils per school. Based on knowledge regarding sensory processing and sensory seeking behaviour provided at the lecture, teachers handed out written materials about the study to the parents of children they found relevant for the study. Interested parents then filled out a questionnaire with demographic information and the SSP. Based on this, all eligible children were enrolled in the study.</p> <hd id="AN0191102788-12">Results</hd> <p>In all, 236 children were assessed for eligibility, and a total of 142 children (105 boys and 37 girls, mean age 8.9 years) participated in this study. Participant flow through the intervention is presented in Figure 1, and the characteristics of participants and baseline scores on the TEA-Ch, COSA, and OBS-Children are presented in Table 1.</p> <p>Graph: Figure 1. Participant flow through the intervention.</p> <p>Table 1. Characteristics and baseline scores of the TEA-Ch, COSA, and OBS-Children of participants in the PRCT (<emph>N</emph> = 142).</p> <p> <ephtml> <table><thead valign="bottom"><tr><td /><td>Intervention (<italic>n</italic> = 71)</td><td>Control (<italic>n</italic> = 71)</td><td>Total sample (<italic>N</italic> = 142)</td></tr></thead><tbody><tr><td>Boys, % (n)</td><td char="(">71.8 (51)</td><td char="(">76.0 (54)</td><td char="(">73.9 (105)</td></tr><tr><td>Mean age, years (SD)*</td><td char="(">8.93 (1.7)</td><td char="(">8.99 (1.55)</td><td char="(">8.9 (1.62)</td></tr><tr><td><bold>SSP, mean (SD)</bold></td><td char="("><bold /></td><td char="("><bold /></td><td char="("><bold /></td></tr><tr><td> Total</td><td char="(">130 (16.01)</td><td char="(">134 (17.06)</td><td char="(">132 (16.63)</td></tr><tr><td> Sensory seeking</td><td char="(">17.9 (3.9)</td><td char="(">18.6 (4.29)</td><td char="(">18.2 (4.09)</td></tr><tr><td><bold>Diagnoses, % (n) **</bold></td><td char="("><bold /></td><td char="("><bold /></td><td char="("><bold /></td></tr><tr><td> None</td><td char="(">71.8 (51)</td><td char="(">85.9 (61)</td><td char="(">78.2 (111)</td></tr><tr><td> ADHD</td><td char="(">16.9 (12)</td><td char="(">8.5 (6)</td><td char="(">12.7 (18)</td></tr><tr><td> Autism</td><td char="(">4.2 (3)</td><td char="(">2.8(2)</td><td char="(">3.5 (5)</td></tr><tr><td> Other***</td><td char="(">11.3 (8)</td><td char="(">2.8(2)</td><td char="(">7.0 (10)</td></tr><tr><td><bold>Baseline TEA-Ch</bold></td><td char="("><bold /></td><td char="("><bold /></td><td char="("><bold /></td></tr><tr><td>Sustained attention, mean (SD)</td><td char="(">20.87 (8.40)</td><td char="(">18.07 (7.68)</td><td char="(">19.49 (8.15)</td></tr><tr><td>Attention control/switching, mean (SD)</td><td char="(">29.19 (10.74)</td><td char="(">28.25 (8.66)</td><td char="(">28.72 (9.72)</td></tr><tr><td><bold>Baseline COSA</bold></td><td char="("><bold /></td><td char="("><bold /></td><td char="("><bold /></td></tr><tr><td> POMP, mean (SD)</td><td char="(">62.38 (12.68)</td><td char="(">61.85 (14.31)</td><td char="(">62.11 (13.49)</td></tr><tr><td><bold>Baseline OBS-Children</bold></td><td char="("><bold /></td><td char="("><bold /></td><td char="("><bold /></td></tr><tr><td> Fidgets, mean (SD)</td><td char="(">32.35 (17.48)</td><td char="(">27.02 (13.08)</td><td char="(">29.49 (15.45)</td></tr><tr><td> Restless legs/feet, mean (SD)</td><td char="(">57.93 (18.94)</td><td char="(">56.02 (18.84)</td><td char="(">56.94 (18.84)</td></tr><tr><td> Tactile stimuli, mean (SD)</td><td char="(">24.42 (13.63)</td><td char="(">28.78 (15.23)</td><td char="(">26.78 (14.62)</td></tr><tr><td> Sits uneas<bold>il</bold>y, mean (SD)</td><td char="(">38.18 (24.35)</td><td char="(">37.77 (19.55)</td><td char="(">37.97 (21.9)</td></tr></tbody></table> </ephtml> </p> <p>1 * n = 138 (4 missing). ** Some participants had more than one diagnosis. *** Epilepsy, tremors, arthritis, attention deficit disorder, Tourette's syndrome, asthma, and learning difficulties. ADHD = Attention Deficit/Hyperactivity Disorder. SS<emph>P</emph> = Short Sensory Profile, scores ranging from 38 to 190, scores < 142 indicating definite difference in sensory processing. Sensory seeking score ranging from 7 to 35, score < 24 indicating definite difference. TEA-Ch = Test of everyday Attention—Children. Sustained attention = combined test scores from the tests Scoring, Walk Don't Walk, and Code Transmission, scores ranging from 3 to 57 (higher score indicating better sustained attention). Attention control/switching = combined test scores from the tests Creature Counting, Creature Counting time score, Same Worlds, and Opposite Worlds, scores ranging from 4 to 76 (higher score indicating better attention control/switching<bold>)</bold>. COSA = Child Occupational Self-Assessment. POM<emph>P</emph> = Percent of Maximum Possible (higher scores indicating better assessment of own occupational abilities). OBS-Children = Observational Off-task Behaviour among School-Children, scores ranging from 0 to 80 (higher scores indicating more Off-task behaviour).</p> <p>Of the 71 participants in the intervention group, 43 (60%) were reported as having used the vest for the requested 90 min every school day throughout the three-week intervention period, 13 of the participants had additional use at school or at home, 9 had additional use both at school and at home, and 27 had not used it as requested, at school or at home (one missing in regard of extent of use).</p> <p>No difference was found between the intervention and control groups regarding sustained attention or attention control/switching measured with the TEA-Ch test. Additionally, no difference regarding off-task behaviour as measured with the OBS-Children was found. The results of the COSA interviews showed a significant difference in the increase of participants' self-assessed occupational competence: coefficient = 5.78 (CI: 1.80, 9.77), <emph>p</emph> = 0.004. The results of within-group and between-group analysis of the TEA-Ch, the COSA, and the OBS-Children are presented in Table 2.</p> <p>Table 2. Results of within group change over time and between-group difference in the TEA-Ch, COSA, and OBS-Children.</p> <p> <ephtml> <table><thead valign="bottom"><tr><td /><td>n</td><td>Control group Mean change (CI)</td><td>n</td><td>Intervention group Mean change (CI)</td><td>n</td><td>Between-group difference Mean difference (CI)</td><td><italic>P</italic>-value*</td></tr></thead><tbody><tr><td>TEA-Ch</td><td /><td char="(" /><td /><td char="(" /><td /><td char="(" /><td char="." /></tr><tr><td><bold>Sustained attention</bold></td><td char=".">63</td><td char="(">0.62 (−0.58, 1.82)</td><td char=".">59</td><td char="(">−0.15 (−1.66, 1.36)</td><td char=".">122</td><td char="(">−0.77 (−2.69, 1.14)</td><td char=".">0.430</td></tr><tr><td><bold>Attention control/switching</bold></td><td char=".">67</td><td char="(">6.99 (4.68, 9.29)</td><td char=".">63</td><td char="(">6.13 (4.21, 8.04)</td><td char=".">130</td><td char="(">−0.86 (−3.88, 2.16)</td><td char=".">0.577</td></tr><tr><td>COSA</td><td /><td char="(" /><td /><td char="(" /><td /><td char="(" /><td char="." /></tr><tr><td><bold>POMP</bold></td><td char=".">70</td><td char="(">−1.39 (−3.71, 0.94)</td><td char=".">64</td><td char="(">4.40 (1.10, 7.70)</td><td char=".">134</td><td char="("><bold>5.78</bold> (<bold>1.80, 9.77)</bold></td><td char="."><bold>0</bold>.<bold>004</bold></td></tr><tr><td>OBS-Children</td><td /><td char="(" /><td /><td char="(" /><td /><td char="(" /><td char="." /></tr><tr><td><bold>Fidgets</bold></td><td char=".">64</td><td char="(">1.72 (−1.59, 5.03)</td><td char=".">57</td><td char="(">1.88 (−2.01, 5.76)</td><td char=".">121</td><td char="(">0.16 (−4.91, 5.23)</td><td char=".">0.951</td></tr><tr><td><bold>Restless legs/feet</bold></td><td char=".">64</td><td char="(">−0.69 (−4.90, 3.53)</td><td char=".">57</td><td char="(">0.04 (−3.36, 3.43)</td><td char=".">121</td><td char="(">0.72 (−4.78, 6.22)</td><td char=".">0.797</td></tr><tr><td><bold>Tactile stimuli</bold></td><td char=".">64</td><td char="(">−5.75 (−8.97, −2.53)</td><td char=".">56</td><td char="(">−2.46 (−5.56, 0.63)</td><td char=".">120</td><td char="(">3.29 (−1.21, 7.79)</td><td char=".">0.152</td></tr><tr><td><bold>Sits uneasily</bold></td><td char=".">64</td><td char="(">−0.55 (−4.30, 3.20)</td><td char=".">56</td><td char="(">−4.07 (−7.76, −0.38)</td><td char=".">120</td><td char="(">−3.52 (−8.81, 1.76)</td><td char=".">0.191</td></tr></tbody></table> </ephtml> </p> <ulist> <item>2 Linear mixed model regression analysis was applied.</item> <item>3 * Concerns between-group analysis.</item> <item>4 TEA-Ch = Test of Everyday Attention—Children (an increase in TEA-Ch scores indicates improved attention). Sustained attention = combined test scores from the tests Scoring, Walk Don't Walk, and Code Transmission, scores ranging from 3 to 57. Attention control/switching = combined test scores from the tests Creature Counting, Creature Counting time score, Same Worlds, and Opposite Worlds, scores ranging from 4 to 76.</item> <item>5 COSA = Child Occupational Self-Assessment. POM<emph>P</emph> = Percent of Maximum Possible (an increase in COSA POMP score indicates better assessment of own occupational abilities).</item> <item>6 OBS-Children = Observational Off-task Behaviour among School-Children, scores ranging from 0 to 80 (a decrease in OBS-Children score indicates less off-task behaviour).</item> </ulist> <p>Additional analyses adjusting for sex, diagnoses, and degree of dysfunction in sensory processing and analyses stratifying the intervention group by extent of vest use showed no significant difference in effects and are presented in a supplementary file.</p> <p>The analysis of data regarding profitable or inhibitory factors showed that the most common profitable factors were that the participants felt that the vest had a calming effect and/or made them feel comfortable and able to better concentrate. One teacher described: "he calmed down with the vest, he enjoyed it, and it gave him a surplus of mental resources to concentrate on the teaching". Some also noted that the vest made the pupils feel safe, for example: "He felt safe. It gave him peace of mind". Additionally, some teachers commented that participation in a research project gave a positive status for the participant; as one described it, "He got superhero status in the class when he had to help brainy people [referencing to researchers]".</p> <p>Regarding inhibitory factors, parents and teachers commented that the most common reasons for participants not to use the vest were discomfort with the vest (for example, it was too heavy or warm) and/or that the participant found the balls on the backside of the vest to be uncomfortable; as one teacher described, "A participant has expressed that the vest is annoying in relation to chairs with backrests". Another participant stopped wearing the vest after not feeling an initial effect, for example: "He stopped because he did not sense a beneficial effect". Additionally, teachers commented that there had been insufficient communication between them and the research team during the three-week intervention period, for example: "Along the way, we as teachers lost a little contact with the project". Parents commented that it was impractical to carry the vest back and forth from school, for example: "She thought it was too much trouble to remember and to drag it [referencing to the vest] back and forth every day". Additionally, teachers commented that support from teachers and/or other pupils in some cases was a profitable factor; in other cases, a lack of support was an inhibitory factor for using the vest. Lastly, multiple parents and teachers commented with a wish regarding a longer time to use the vest, for example: "It was a very short time to see a change".</p> <hd id="AN0191102788-13">Discussion</hd> <p>The aim of the study was to investigate the possible effects of an intervention with three weeks of using ball-vests for children aged 6–12 years exhibiting sensory seeking behaviour. No significant difference between the intervention group and the control group regarding the children's ability for attention or off-task behaviour was found, but there was a statistically significant higher increase in occupational competence by children in the intervention group than by children in the control group.</p> <p>Children's belief in their occupational competence is known to play a vital part in their motivation for seeking out, planning, and exploring adaptive behaviours and participating in meaningful activities (Bundy & Lane, [<reflink idref="bib8" id="ref72">8</reflink>]). Hence, the increase in assessment of own occupational competence is important and can possibly be the first step in seeking out new adaptive behaviours and activities. Children learn and develop skills, self-control, and confidence by engaging in activities (Bundy & Lane, [<reflink idref="bib8" id="ref73">8</reflink>]; Hinojosa et al., [<reflink idref="bib14" id="ref74">14</reflink>]), so children's confidence to participate in activities may impact their learning from school activities. A sense of competence can be the driving force for children to seek out and participate in new and perhaps more challenging activities (Bundy & Hacker, [<reflink idref="bib7" id="ref75">7</reflink>]; Bundy & Lane, [<reflink idref="bib8" id="ref76">8</reflink>]). Additionally, an increase of confidence in own occupational competence can affect the children's quality of life, and their engagement in challenging activities during school can facilitate accumulations of meaningful activities later in life (Yokoi et al., [<reflink idref="bib44" id="ref77">44</reflink>]).</p> <p>That no effect of the intervention was found on the children's ability for attention, like some findings from interventions utilizing deep touch pressures garments (Losinski et al., [<reflink idref="bib23" id="ref78">23</reflink>]), may in part be because attention develops in nonlinear ways (Yan et al., [<reflink idref="bib43" id="ref79">43</reflink>]); this could make it doubtful to provide definite results regarding children's attention. Additionally, the TEA-Ch might not have been the most suitable measurement since the psychometric properties of the test to non-clinical children are limited (Malegiannaki et al., [<reflink idref="bib24" id="ref80">24</reflink>]).</p> <p>No effects were found regarding the extent of off-task behaviour, which may be due to the limitations of the OBS-Children, which has not gone through thorough validation. Additionally, the behaviours registered as off-task on the OBS-Children could be described as observable sensory seeking behaviours, which might not make the child off-task, though it may disturb the classroom environment. For instance, if a child sits uneasily while listening to instructions, this does not necessarily make them off-task, since they may still hear what is instructed but would have been registered as such on the OBS-Children.</p> <p>Between-group difference analysis of possible effects was conducted after intention to treat principles and may have been diluted due to the relative low adherence to the intervention. Of the children in the intervention group, 27 did not use the vest for the requested 90 min, 21 children only used the vest for the requested 90 min, 13 had additional use at school or at home, and 9 children had additional use both at school and at home. It was unfortunately not possible to depict the clear characteristics of children who did or did not use the vest, though the results from the teacher and parent surveys indicate that children who felt effects chose to use the vest, whereas children who did not feel effects chose not to use it as requested. This indicates that individual assessment and evaluation is important when implementing the vest for children exhibiting sensory seeking behaviour. The evaluations of the intervention from teachers and parents indicate that a three-week intervention period was too short to detect possible effects and that the children needed more support to use the vest than provided in the study. More support from teachers and/or classmates (i.e. to remember the vest or for moral support) for the children to use the vest might have heightened adherence, and a longer intervention period may potentially have provided different results.</p> <hd id="AN0191102788-14">Methodological considerations</hd> <p>The findings of this study should be interpreted with consideration of some limitations. The fact that teachers selected which children were offered participation may have introduced a selection bias, especially since the teachers may have offered participation to children who were disturbing, potentially overlooking children with less disturbing strategies for self-stimulation.</p> <p>In this study, we included children exhibiting sensory seeking behaviour unaffiliated with considerations of diagnoses, since possible diagnoses often are not determined at the primary school level. Unfortunately, twice as many children with a diagnosis and children with lower SSP scores (indicating a higher degree of dysfunction in sensory processing) were allocated to intervention than to control, which could have possibly weakened the differences in the between-group analysis, since children with a diagnosis might have additional challenges affecting the measurement of attention and off-task behaviour. However, this seems not to be the case, since the analysis adjusting for sex, diagnoses, and degree of sensory processing dysfunction showed no significant difference in effects.</p> <p>The fact that the study was conducted during a pandemic might have impacted the mental capacity for change among participants, possibly resulting in the relatively low adherence to the intervention. The relatively low adherence could have provided a significant confounding factor and might have weakened the differences in the between-group analysis. Otherwise, the pandemic should not have influenced the between-group analysis, since children in the intervention and control groups were probably impacted equally.</p> <p>Knowledge about sensory processing and sensory seeking behaviour was believed to be necessary for teachers to recommend children for participation in the study. Hence, the lecture on sensory processing and supportive measures that teachers could incorporate in the classroom environment was provided for teachers of children allocated to both the intervention group and the control group, which could have minimized the results of difference between the groups. Lastly, the study was not blinded, since the vests were clearly visible, which may limit the credibility of the results, since possible placebo effects were not examined.</p> <p>It was a strength that the study was conducted as a PRCT to be applicable to common practice for complementary interventions with assistive technology. The findings are believed to be representative of primary school children exhibiting sensory seeking behaviour in Denmark and in countries with similar culture and school systems, due to the relatively large sample size and diversity among participants and the schools they attend.</p> <p>To our knowledge, this is the first study of ball-vests for children with sensory seeking behaviour without focus on a specific diagnosis. The study was somewhat exploratory regarding the variety of outcome measurements, which was intended to provide a broad examination of possible effects, though not all possible effects were examined. Further research is recommended to include qualitative data from children regarding adherence and a higher level of support for adherence and a longer intervention period and outcome measures regarding the classroom environment.</p> <hd id="AN0191102788-15">Acknowledgements</hd> <p>We are grateful to the children, their parents, and teachers for their participation.</p> <hd id="AN0191102788-16">Disclosure statement</hd> <p>No potential conflict of interest was reported by the author(s).</p> <hd id="AN0191102788-17">Supplemental Material</hd> <p>Supplemental data for this article can be accessed online at https://doi.org/10.1080/13575279.2024.2387665.</p> <ref id="AN0191102788-18"> <title> References </title> <blist> <bibl id="bib1" idref="ref18" type="bt">1</bibl> <bibtext> Ahn, R. R., Miller, L. J., Milberger, S., & McIntosh, D. N. (2004). Prevalence of parents' perceptions of sensory processing disorders among kindergarten children. 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BMJ, 337 (nov11 2), a2390. https://doi.org/10.1136/bmj.a2390</bibtext> </blist> </ref> <aug> <p>By Ann Natasja Nielsen; Sören Möller; Karen la Cour and Åse Brandt</p> <p>Reported by Author; Author; Author; Author</p> <p></p> <p>Ann Natasja Nielsen , PhD of public health and occupational therapist, who researched the prevalence of children with sensory processing difficulties, and assistive technology to support these children´s participation in school-related activities.</p> <p>Sören Möller , PhD and associate Professor at the department of clinical research in the research unit of the Open Patient Data Explorative Network. He is a statistician with a focus on effective statistical and epidemiological advice for health science researchers and involving the teaching of health science students.</p> <p>Karen la Cour , is a professor at the research unit for user perspectives and community-based Interventions at the University of Southern Denmark. Karen la Cour has through her research, focused on ensuring that people with life-threatening illnesses are able to carry out necessary and desired activities to create meaning and content in the last part of life.</p> <p>Åse Brandt , PhD, and is an associate professor at the research unit for user perspectives and community-based interventions. Åse Brandt has conducted research focusing on people's everyday life activities and participation in social life and their interaction with the physical surroundings in the context of an intervention.</p> </aug> <nolink nlid="nl1" bibid="bib10" firstref="ref3"></nolink> <nolink nlid="nl2" bibid="bib34" firstref="ref4"></nolink> <nolink nlid="nl3" bibid="bib41" firstref="ref6"></nolink> <nolink nlid="nl4" bibid="bib32" firstref="ref12"></nolink> <nolink nlid="nl5" bibid="bib45" firstref="ref13"></nolink> <nolink nlid="nl6" bibid="bib18" firstref="ref14"></nolink> <nolink nlid="nl7" bibid="bib28" firstref="ref15"></nolink> <nolink nlid="nl8" bibid="bib16" firstref="ref19"></nolink> <nolink nlid="nl9" bibid="bib22" firstref="ref20"></nolink> <nolink nlid="nl10" bibid="bib30" firstref="ref21"></nolink> <nolink nlid="nl11" bibid="bib35" firstref="ref22"></nolink> <nolink nlid="nl12" bibid="bib39" firstref="ref23"></nolink> <nolink nlid="nl13" bibid="bib19" firstref="ref25"></nolink> <nolink nlid="nl14" bibid="bib11" firstref="ref29"></nolink> <nolink nlid="nl15" bibid="bib23" firstref="ref30"></nolink> <nolink nlid="nl16" bibid="bib15" firstref="ref32"></nolink> <nolink nlid="nl17" bibid="bib20" firstref="ref34"></nolink> <nolink nlid="nl18" bibid="bib21" firstref="ref36"></nolink> <nolink nlid="nl19" bibid="bib31" firstref="ref37"></nolink> <nolink nlid="nl20" bibid="bib17" firstref="ref38"></nolink> <nolink nlid="nl21" bibid="bib36" firstref="ref42"></nolink> <nolink nlid="nl22" bibid="bib46" firstref="ref45"></nolink> <nolink nlid="nl23" bibid="bib27" firstref="ref46"></nolink> <nolink nlid="nl24" bibid="bib25" firstref="ref49"></nolink> <nolink nlid="nl25" bibid="bib13" firstref="ref50"></nolink> <nolink nlid="nl26" bibid="bib33" firstref="ref56"></nolink> <nolink nlid="nl27" bibid="bib12" firstref="ref58"></nolink> <nolink nlid="nl28" bibid="bib40" firstref="ref66"></nolink> <nolink nlid="nl29" bibid="bib29" firstref="ref67"></nolink> <nolink nlid="nl30" bibid="bib26" firstref="ref68"></nolink> <nolink nlid="nl31" bibid="bib37" firstref="ref69"></nolink> <nolink nlid="nl32" bibid="bib38" firstref="ref70"></nolink> <nolink nlid="nl33" bibid="bib42" firstref="ref71"></nolink> <nolink nlid="nl34" bibid="bib14" firstref="ref74"></nolink> <nolink nlid="nl35" bibid="bib44" firstref="ref77"></nolink> <nolink nlid="nl36" bibid="bib43" firstref="ref79"></nolink> <nolink nlid="nl37" bibid="bib24" firstref="ref80"></nolink>
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  Group: Ti
  Data: Effects of Ball-Vests for Children Exhibiting Sensory Seeking Behaviour: A Pragmatic Randomized Controlled Trial
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  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Ann+Natasja+Nielsen%22">Ann Natasja Nielsen</searchLink><br /><searchLink fieldCode="AR" term="%22Sören+Möller%22">Sören Möller</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-0858-4269">0000-0003-0858-4269</externalLink>)<br /><searchLink fieldCode="AR" term="%22Karen+la+Cour%22">Karen la Cour</searchLink><br /><searchLink fieldCode="AR" term="%22Åse+Brandt%22">Åse Brandt</searchLink>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22Child+Care+in+Practice%22"><i>Child Care in Practice</i></searchLink>. 2026 32(1):104-119.
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  Label: Availability
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  Data: Routledge. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 16
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2026
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  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Perceptual+Impairments%22">Perceptual Impairments</searchLink><br /><searchLink fieldCode="DE" term="%22Sensory+Experience%22">Sensory Experience</searchLink><br /><searchLink fieldCode="DE" term="%22Tactual+Perception%22">Tactual Perception</searchLink><br /><searchLink fieldCode="DE" term="%22Stimuli%22">Stimuli</searchLink><br /><searchLink fieldCode="DE" term="%22Intervention%22">Intervention</searchLink><br /><searchLink fieldCode="DE" term="%22Children%22">Children</searchLink><br /><searchLink fieldCode="DE" term="%22Preadolescents%22">Preadolescents</searchLink><br /><searchLink fieldCode="DE" term="%22Attention%22">Attention</searchLink><br /><searchLink fieldCode="DE" term="%22Time+on+Task%22">Time on Task</searchLink><br /><searchLink fieldCode="DE" term="%22Competence%22">Competence</searchLink><br /><searchLink fieldCode="DE" term="%22Equipment%22">Equipment</searchLink><br /><searchLink fieldCode="DE" term="%22Attention+Deficit+Hyperactivity+Disorder%22">Attention Deficit Hyperactivity Disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Autism+Spectrum+Disorders%22">Autism Spectrum Disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink>
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Denmark%22">Denmark</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1080/13575279.2024.2387665
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1357-5279<br />1476-489X
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Children with challenges processing sensory information can have difficulties affecting their ability to participate in school activities, which may affect their potential for learning. The aim of this study was to examine the possible effects of an intervention with three weeks use of ball-vests that provide proprioceptive-tactile stimulation for children exhibiting sensory seeking behaviour. Methods: The study was a pragmatic randomized controlled trial that included 142 children (105 boys and 37 girls, mean age 8.9 years) with dysfunction in sensory processing and sensory seeking behaviour. The children's ability for attention was measured with the "Test of Everyday Attention--Children" (TEA-Ch), their occupational competence in school activities with the "Child Occupational Self-Assessment" (COSA) and the extent of off-task behaviour with the "Observational off-task Behavior among School--children" (OBS-Children). Data was analysed using linear mixed model regression. Results: Children in the intervention group had a significantly larger increase in self-assessed occupational competence than children in the control group (B = 5.78, p = 0.004). No differences regarding attention or extent of off-task behaviour between intervention and control group were found.
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  Label: Entry Date
  Group: Date
  Data: 2026
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  Label: Accession Number
  Group: ID
  Data: EJ1500760
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1500760
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  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/13575279.2024.2387665
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 16
        StartPage: 104
    Subjects:
      – SubjectFull: Perceptual Impairments
        Type: general
      – SubjectFull: Sensory Experience
        Type: general
      – SubjectFull: Tactual Perception
        Type: general
      – SubjectFull: Stimuli
        Type: general
      – SubjectFull: Intervention
        Type: general
      – SubjectFull: Children
        Type: general
      – SubjectFull: Preadolescents
        Type: general
      – SubjectFull: Attention
        Type: general
      – SubjectFull: Time on Task
        Type: general
      – SubjectFull: Competence
        Type: general
      – SubjectFull: Equipment
        Type: general
      – SubjectFull: Attention Deficit Hyperactivity Disorder
        Type: general
      – SubjectFull: Autism Spectrum Disorders
        Type: general
      – SubjectFull: Foreign Countries
        Type: general
      – SubjectFull: Denmark
        Type: general
    Titles:
      – TitleFull: Effects of Ball-Vests for Children Exhibiting Sensory Seeking Behaviour: A Pragmatic Randomized Controlled Trial
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            NameFull: Karen la Cour
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            NameFull: Åse Brandt
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              Type: published
              Y: 2026
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