Approximately 15 percent of all children experience some type of sensory integration problem. Now, a functional, yet fun garment has been developed to help meet the therapeutic and play needs of preschool children with sensory integration dysfunction.
Sherry Haar, assistant professor of apparel and textiles at Kansas State University, and Joann Boles, retired professor of clothing and textiles at Virginia Tech, have received a patent for "Therapy Apparel for Children Diagnosed with Sensory Integration Dysfunction" (Patent No. 6,401,249, June 11, 2002).
Haar used the clothing design process developed by Boles to develop a theme-decorated therapy garment for pre-school children for use during occupational therapy. It was the first study of the clothing related therapy needs of preschool children with sensory integration dysfunction.
These dysfunctions occur in the sense of touch (tactile), sense of balance (vestibular), and sense of body awareness (propriopception). Children with sensory integration dysfunction may have difficulty maintaining balance and have difficulty with tasks that require coordinated use of opposing muscle groups, such as wringing out a wash cloth or pouring milk from a heavy container. Some children are overly sensitive to touch while others crave tactile input. In addition, these children may also have developmental delay of fine and gross motor skills.
Therapy includes activities that provide enhanced sensory experience. The patented ensemble is a tool to enhance therapy as far as the therapist is concerned and gives the therapy aspects of play as far as the child is concerned.
The outfit is made up of a sleeveless pullover top, cape, helmet, and weights. The prototype had a bug superhero theme. The top contains a series elastic straps designed for selective placement around the child's arms, knees, and feet to provide proprioceptive and tactile input. "An unanticipated benefit was that the foot straps decreased toe walking," said Haar.
There are pockets for weights, which are designed to look like baby beetles. The weights also provide proprioceptive and tactile input.
"Since dysfunction affects your awareness of your body in space and awareness of movement, you may feel weightless, which is why weights are used -- to provide an awareness of muscles and joints," Haar said. "Working against resistance and the use of weights stimulates muscles and joints. Weights and pressure can also have a calming effect. Most people can relate to the comfort provided by a heavy blanket," she suggested.
There are 15 different textures in the patented garment. The child can rub their hands down the front of the costume or rub the bug wings on their body to feel different types of surfaces.
The cape has handholds so the child can extend it, wing like, and has pockets with different fastening systems to provide opportunities for fine and perceptual motor skills. The pockets also aid in transition between activities, as the tools for each task can be stored in a different pocket. The cape promotes the use of such vestibular integrating equipment as swings. "In my opinion, every child needs a cape," Haar said.
The headgear provides low level protection, but was actually developed at the children's request to complete the outfit. It allows the child to attach such fanciful attachments as antenna, wings, and ears, which enhances motor skill development and social interaction.
As a clothing and textile major at Virginia Tech, Haar became aware of the therapy benefits of clothing when she observed her neighbor, Judy, with her 5-year-old autistic daughter. Judy's efforts to engage her daughter included creative uses of clothing and textiles. She developed a fabric hamburger costume to provide her daughter with social contacts and with tactile and proprioceptive stimulation. Different textures were used to create the bun, hamburger, cheese, etc; plus, when the children stacked themselves into a hamburger, Judy's daughter received the pressure she craved.
Haar determined to develop apparel products for preschool children diagnosed with sensory integrative dysfunction for use in therapy. Boles was interested in Haars' proposed line of research for both professional and personal reasons. "She was interested and supportive because of her work with the design process, and because of a family member, who has a related dysfunction," Haar said.
Boles' design process provided guidelines for problem development, needs assessment, prototype development, and evaluation. Haar used the process as a framework to guide the project from conception through evaluation.
Boles first developed her design framework in 1982 to meet the criteria of other scholars in the field of clothing and textiles. It has subsequently been used in design coursework and research. For example, it was used to identify wearer preferences and garment criteria for female flight attendant uniforms and to develop garment criteria for kayakers' paddling jackets Boles is presently working with a graduate class designing costumes for 13-year-old jazz dancers. "Every time you develop clothing, you have to become involved with the people," says Boles. "Today's 13-year-old girls are not like 13-year old girls when I was that age, or even when my graduate students were 13."
The steps and considerations of defining the problem helped Haar decide what group of children to design therapy clothing for and to select a site for observations and testing. "Sometimes she would have to reign me in, when I would go off on a tangent or become too ambitious. She would say, 'Let's put this in the model.'"
Haar said, "During the observation phase I spent four weeks at the center and didn't interact. The therapists thought I was a dud. Then I came back with the costume and it was, 'ah ha' and 'Why didn't I think of that?'"
While an autistic child had spurred her research, autistic children were not included in the study because Haar wanted to be able to talk to the children who would use her therapy apparel.
"The verbal communication of subjects was important in this study as wearer response to needs, to prototype development, and to field testing evaluation," Haar wrote in her dissertation.
Her observations and interviews provide lively and poignant moments in Haar's 228-page dissertation. For convenience, she called the boys who wore the garment Matthew, Bryan and Aaron.
She wrote that, "Immediately after donning the garment, Matthew would raise his arms and declare, 'I am Bug Man!'" He no longer required his baby-doll security toy. To fulfill a fine motor goal to draw circles and vertical strokes, he drew a bug, and then continued to draw other insects and animals for the therapist. Previously, he had not been able to remain seated for more than a few minutes at a time.
"One reason for the noticeable improvement in Matthew could be that the elastic bands and weights provided the correct amount of arousal, modulation and discrimination, which lead to skill output," Haar wrote. It could also be that "the bug superhero theme helped to organize Matthew by focusing his session around his role as Bug Man."
Bryan pretended he was Batman and his therapist was Robin. Suspended equipment, which helps develop motor skills, became Batmobiles. He asked to show the costume to other children, giving him an opportunity to practice social skills. When he took the costume off, he became Bruce Wayne.
"The prototype garment enabled Bryan to increase the amounts of muscle resistance and joint compression gained by challenging him in a play situation," Haar reported. "The Batman theme created by Bryan kept him wanting to wear the garment even though he had to work harder when he was wearing the garment. As Batman, Bryan was able to achieve a timed swinging goal."
The third little boy, Aaron, didn't want to take his costume off at all. He became so upset that he could no longer be used for the prototype tests.
Other children at the rehabilitation center where Haar was testing the therapy apparel also wanted to wear the costume. She reports that one boy declared, "I need to be Batman."
Why the bug theme? "That was a result of trend research," Haar said. Dinosaurs were on the way out. Insects were showing up in books and toys. Even before the 'Bug's Life' movie, I anticipated the insect trend."
The bug superhero theme reflected a toy trend of the time, but the patent covers a variety of themes to fire children's imaginations. For example, a worker theme includes fire fighters, which are popular now.
The children themselves suggested improvements on the costume, such as loops to allow straps to attach to the feet. The original design was for the top and the cape, but both Bryan and Matthew indicated the need for a helmet, Haar reported. Bryan found a padded helmet to wear with the outfit and Matthew found a fire helmet to use. After receiving her Ph.D. at Virginia Tech and joining the faculty at Kansas State University, Haar developed the helmet that is a part of the patent.
Haar dedicated her dissertation to Judy and Judy's children.
"The prototype garments will not address the needs of all children with sensory integration dysfunction and impaired motor development, but other cases with similar dysfunction profiles may benefit from the resulting garment product," Haar wrote. Funded by K-State, she is continuing her research on apparel product design for children with sensory dysfunctions.
The patent is assigned to the Kansas State University Research Foundation and Virginia Tech Intellectual Properties Inc. (http://www.vtip.org). One company is looking at the product, Boles reported. And Haar is looking at other options to make the therapy apparel available to consumers.
"The goal -- my passion -- is to make this garment available," Haar said, "But it has to be manufactured."
Haar, who grew up in Wilber, Neb., as Sherry Kreshel, earned undergraduate and master's degrees in clothing, textiles, and design from the University of Nebraska at Lincoln. She was doing custom bridal design when she decided to return to school for a Ph.D. at Virginia Tech. "I wanted to focus on a population whose design needs were not being addressed." She continues to develop therapeutic apparel for children. She is also involved in research studying the effects of costume on literacy development. In addition, Haar creates one-of-a-kind wearable art.
Boles is completing her book on the idea development and creativity process in the portable environment, is developing a fully-articulated half-scale manikin to be used to develop patterns and works on juried art that expresses the power of clothing.
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