Outcome of Blanket Wrapping as a Deep Pressure Therapy for Children with Autism Spectrum Disorder: A Quasi-Experimental Study

Abstract

Background: Deep Pressure Therapy (DPT) is widely used as a sensory integration intervention for children with Autism Spectrum Disorder (ASD). In Bangladesh, occupational therapists frequently prefer blanket wrapping as a DPT technique because it is believed to promote relaxation and improve attention. However, there is limited empirical evidence comparing the effectiveness of blanket wrapping with other commonly used deep pressure techniques, such as weighted vests, manual compression, and therapeutic brushing. Aim: This study examined the effects of structured blanket wrapping on behavioral responses and functional goal attainment in children with ASD, compared with an active control group receiving alternative DPT methods. Method: A quantitative, quasi-experimental design was employed involving 36 children with ASD, divided equally into an experimental group (blanket wrapping) and an active control group (other DPT techniques). Immediate behavioral changes following DPT sessions were assessed using the Visual Analogue Scale (VAS) across five domains: calmness, engagement, responsiveness, happiness, and communication. Functional outcomes were evaluated using Goal Attainment Scaling (GAS). Blinding of data collectors and assessors was implemented to reduce bias. Results: The experimental group demonstrated significantly greater immediate behavioral improvements on the VAS in calmness (100%), engagement (88.9%), responsiveness (88.9%), and happiness (72.2%) (P < 0.05). Improvements in communication were less pronounced (44.4%). In contrast, the control group showed lower rates of significant improvement across all domains, including calmness (56.3%), engagement (37.5%), responsiveness (25%), happiness (18.8%), and communication (12.5%). GAS results indicated statistically significant functional gains in calmness, engagement, and responsiveness (P < 0.001) in the experimental group, with modest improvement in happiness and no significant change in communication. The control group showed significant improvement only in calmness. Conclusion: Blanket wrapping appears to be more effective than other DPT methods in promoting immediate relaxation, engagement, and responsiveness in children with ASD, although it does not significantly enhance communication abilities. Keywords: Autism Spectrum Disorder, Deep Pressure Therapy, Blanket Wrapping, Sensory Integration.