If you are the parent of a child with the Hyperactive-Impulsive presentation of ADHD, you likely know the feeling of exhaustion that settles in by 10:00 AM. You might watch your child bounce from the sofa to the table, crash into walls, or fidget relentlessly, and wonder, “Does this child have an off switch?”
Standard diagnostic criteria describe these children as acting as if “driven by a motor,” fidgeting, leaving their seat when they shouldn’t, or talking excessively. You may have been told to teach them to “sit still.” But if you’ve tried that, you know it often backfires. The more you demand stillness, the more they seem to wiggle.
At OTogether, we want to shift the lens from “behavior” to “biology.” What if that constant motion isn’t defiance, but a desperate attempt by their nervous system to feel grounded?
The OT Perspective: It’s Not Just Energy, It’s Proprioception
To understand the “motor,” we have to look at the sensory systems. While we all know the basic five senses, your child relies heavily on a hidden sense called proprioception.
Proprioception is the body’s internal sense of position and movement. We have receptors located in our muscles, joints, and ligaments that send constant signals to the brain, telling it where our body parts are in space and how much force we are using.
For many children with the Hyperactive-Impulsive presentation, their proprioceptive system is “under-responsive”. Their brain isn’t getting enough feedback from their muscles and joints to feel secure and organized. To compensate, they seek out intense sensations – jumping, crashing, bumping, and running- to “wake up” those receptors and tell their brain where they are.
They aren’t trying to tear the house down; they are trying to feel their own bodies.
Why “Heavy Work” Works Better Than “Sit Still”
When a child is seeking proprioceptive input, telling them to sit still is like telling a hungry child not to be hungry. It doesn’t solve the biological need.
In Occupational Therapy, we use a strategy called “Heavy Work.” This refers to any activity that involves pushing, pulling, lifting, or carrying heavy objects.
While it seems counterintuitive to give an energetic child more physical work, heavy work is actually one of the most effective ways to calm the nervous system. Deep pressure and resistance activities release calming chemicals in the brain (like serotonin) and decrease sympathetic arousal (the “fight or flight” response).
Think of it like a “Sensory Cup.” A sensory seeker needs to have their cup filled to feel satiated. If the cup is empty, they will run and crash until it is full. Heavy work fills that cup faster and more efficiently than random running, allowing the child to feel regulated, focused, and calm.
Your Home “Heavy Work” Menu
You don’t need a fancy sensory gym to provide this input. You can integrate heavy work into your daily routine using items you already have. Here are practical ways to help your child regulate their “motor” at home:
Functional Chores (The “Helper” Strategy)
Turn household tasks into therapeutic opportunities. Because these tasks involve resistance, they are naturally grounding.
• Grocery Haul: Let your child carry the heavier grocery bags (within reason) from the car to the kitchen.
• Laundry Duty: Have them push a full laundry basket across the room or carry a hamper up the stairs.
• The “Push” Crew: If you are rearranging furniture or cleaning, let them push the vacuum cleaner or help slide heavy dining chairs.
Play with Purpose
When the wiggles set in during homework or before dinner, try these quick regulators:
• Wall Push-Ups: Have your child place their hands on the wall and do push-ups against it. This provides deep input to the wrists and shoulders.
• Animal Walks: Challenge them to a race doing the “Bear Crawl” (hands and feet on the floor) or the “Crab Walk.” These movements engage multiple muscle groups and provide intense proprioceptive feedback.
• The Sensory Burrito: Lay a blanket on the floor and tightly (but safely) roll your child up in it like a burrito. You can add firm squishes with pillows (if they enjoy it). This deep pressure is incredibly organizing for a chaotic nervous system.
Weighted Tools
For times when movement isn’t an option (like dinner or car rides), weighted items can help.
• Weighted Lap Pads or Blankets: These provide deep pressure touch, which can reduce anxiety and improve the ability to sit still.
• Weighted Vests: These are commonly used to support focus. If you use one, ensure it is no more than 5-10% of the child’s body weight. Note: Research suggests the nervous system gets used to the weight quickly, so only have them wear it for 15–20 minutes at a time for maximum effect.
A Note for Parents
If you see your child crashing into the sofa or playing too rough, try not to view it as bad behavior. View it as a signal: Their tank is empty, and they are trying to fill it.
By offering heavy work activities before the chaos peaks – for example, doing wall push-ups before sitting down for homework – you can help your child regulate their energy levels proactively. You aren’t just burning off energy; you are organizing their brain so they can engage with the world more successfully.
At OTogether, we believe in giving you the tools to support your child’s unique wiring. If you need help building a specific sensory diet for your child, our team is here to guide you.
Frequently Asked Questions
I’ve heard about weighted vests. Are they safe, and how heavy should they be?
Weighted vests can be a wonderful tool for providing passive “heavy work” (deep pressure) to calm the nervous system, but safety is paramount.
The general guideline is that a vest should weigh no more than 5% to 10% of the child’s body weight. For example, if your child weighs 50 pounds, the vest should not exceed 2.5 to 5 pounds. It is essential to ensure the vest fits properly and that the weight is evenly distributed to avoid discomfort or changes in posture.
Always consult with an occupational therapist before starting a weighted vest routine to ensure it is safe for your specific child.
Can my child wear their weighted vest all day at school?
We actually recommend against wearing it all day.
Research and clinical experience suggest that the nervous system “acclimatizes” or gets used to the sensory input after about 15 to 20 minutes, rendering it less effective over time.
To keep the vest effective, it is best used on a rotation schedule (e.g., 20 minutes on, followed by a break) or during specific times of high demand, such as transitions or seated homework time.
My child’s teacher says they can’t run around in class. How can they get “heavy work” at school?
Heavy work doesn’t always look like exercise! There are many “stealth” ways to integrate proprioception into the classroom that don’t disrupt the lesson. You can advocate for accommodations such as:
- Chair modifications: Using a “wobble stool” or tying a stretchy resistance band around the chair legs for the child to kick against.
- Classroom jobs: Asking the teacher if your child can be the designated “heavy lifter”—carrying the lunch crate, pushing the door open, or stacking chairs.
- Desktop tools: Using weighted lap pads during independent work to provide deep pressure without the need for a full vest.
Why does my child seem to get more hyper after doing these activities?
Every nervous system is different. While deep pressure is generally calming, some children are “sensory seekers” who may become dysregulated if the input isn’t quite right or if they become over-stimulated.
In OT, we talk about filling a “Sensory Cup” – some kids need a lot of input to feel satiated and calm, while others might get overwhelmed.
If a specific activity amps your child up, try switching to slower, more rhythmic heavy work (like slow wall push-ups or a “burrito roll” in a blanket) rather than fast-paced running or jumping.
Is there any scientific proof that this works, or is it just a theory?
While occupational therapists have observed the calming effects of proprioception and weighted tools for decades, the formal scientific research is still mixed and evolving.
Some studies show significant improvements in attention and on-task behavior, while others show limited effects. However, from a clinical perspective, many families report that these strategies are life-changing for managing daily transitions and focus.
We view it as a low-risk, non-invasive strategy that is worth trialing to see if it helps your individual child’s nervous system.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Children’s Hospital Colorado. (2024, April 19). What is Sensory Processing Disorder in kids?
Day in our Shoes. (n.d.). 50 Sensory Processing Accommodations in the Classroom.
Miller, L. J., Anzalone, M. E., Lane, S. J., Cermak, S. A., & Osten, E. T. (2007). Concept evolution in sensory integration: A proposed nosology for diagnosis. American Journal of Occupational Therapy, 61(2), 135–140.
Neff, M. A. (2023, April 21). Weighted vests and autism. Neurodivergent Insights.
Wood, V. (2025, September 16). Weighted vests and compression garments. The OT Toolbox.