Use of sand vests to calm children with ADHD sparks concern

German schools are increasingly asking unruly and hyperactive children to wear heavy sand-filled vests in an effort to calm them and keep them on their seats, despite the misgivings of some parents and psychiatrists.

The controversial sand vests weigh between 1.2kg and 6kg and are being used by 200 schools across Germany.

Advocates of the vests, which cost between €140 and €170, say they have witnessed a remarkable change in behaviour in many of the children who have worn them, claiming the heavy vests help to curb children’s restlessness.

A growing number of children are being diagnosed with attention deficit hyperactivity disorder (ADHD) each year in Germany, as elsewhere. Schools that use the vests argue they are an uncomplicated way of tackling the phenomenon head on, and a gentler and less complicated form of therapy than drugs such as Ritalin.

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“Children love to wear the vests and no one is forced into wearing one against their will,” claimed Gerhild de Wall, head of the inclusion unit at the Grumbrechtstrasse school in the Harburg district of Hamburg, which has been one of the sand vest pioneers.

But critics say the vests are reminiscent of straitjackets used to constrain violent patients in psychiatric hospitals, and are in danger of stigmatising their wearers.

One parent who vented her anger over the use of the vests on Facebook, wrote: “It would be best if we avoided such torture methods. How can you say to a child, ‘You’re sick, and as a punishment you have to wear this sand-filled jacket which is not only physical agony but will make you look like an idiot in front of the rest of the class.’ I think some people have lost the plot”.

Therapy

But another parent, Barbara Truller-Voigt, whose nine-year-old son Frederick has worn a 2kg sand vest at his Hamburg school for the past three years as a kind of therapy for his ADHD, said she was convinced it had a positive influence on him.

“He voluntarily puts it on,” she said, “and has the feeling that it helps him. He can concentrate better and is more able to take an active part in lessons because he’s not spending the whole time trying to keep his arms and legs under control.”

Frederick confirmed as much to the German newspaper Hamburger Abendblatt: "The vest helps to calm me down," he said. "And when I have it on my handwriting isn't as scrawly."

Ms de Wall first came across the vests when she taught in the United States, where they are sometimes used for children with autism and are variously referred to as compression vests or squeeze jackets. She said that, far from constraining a child, they can help them to feel centred.

“Kids who fidget a lot or have a sensory disorder, often have problems being able to sort out one stimulus from another,” she said. “The vests help them to have a better sense of themselves, and that in turn helps them to concentrate.”

She said the vests should never be worn for more than 30 minutes at a time, but claims their weight is not a problem for most children because it is spread evenly over the upper body.

She also said there was great competition in her school to wear the vest. “The pupils jump at the opportunity to wear them, so we make sure to also let the kids wear them who don’t actually need them, which helps to ensure there’s no stigma attached to having one.”

One teacher, who declined to be named, said the experience of using the vests in her class led her to compare the use of the vests to “laying a hand on a child’s shoulder or giving them a hug, which the children often need, but which we’re obviously not allowed to do”.

But many psychiatrists are sceptical about the vests’ use, particularly without knowing the long-term effect of them.

Michael Schulte-Markwort, director at the Child and Youth Psychiatry University Clinic in the northwestern Hamburg district of Eppendorf, told German newspaper Die Tageszeitung the vests were "ethically questionable" and could easily be interpreted as a single remedy to fit all attention deficiency disorders.

Mr Schulte-Markwort also criticised the fact that in schools too much emphasis was placed on ensuring a child changed their behaviour to fit the class, rather than focusing on the child’s individual problems. “We should be doing that far more,” he added.

Happy customers

Yvonne Gebauer, schools minister for the western state of North Rhine Westphalia, has said she could not support the use of the vests in her region. "This is an unusual method, whose application I can only view with a great deal of criticism," she said in an interview with the Westdeutsche Allgemeine Zeitung newspaper. "Neither are there any verified findings or studies about their effectiveness."

The main manufacturer of sand vests in Germany, Beluga Healthcare in Lower Saxony, said the company had made vests for “thousands of happy customers” and had been doing so for the past 18 years.

But the controversy unleashed following reports of the vests’ use in German schools has forced the company to put out a statement on its website. In it, Roland Turley owner of Beluga, which also produces diving vests for the German navy, states: “We don’t want the vests to be viewed as a magic solution to be deployed in every case of concentration disorder. Not every restless child needs a sand vest. Children need to wear them voluntarily and it’s necessary to have an informed diagnosis from an occupational therapist or a paediatrician.”

He admitted that no study has been carried out on the long-term effectiveness of the vests. “We’ve tried to find an institute that might do it, but so far there’s been no interest,” he added.

– Guardian