Autism also referred to as autism spectrum disorder (ASD) is a set of heterogeneous neurodevelopmental conditions. 1 in 100 children have autism spectrum disorder in 2023 as reported by the World Head Organization (WHO). The needs of children with ASD vary and it is reported that often children with ASD have difficulty processing and integrating sensory information. Studies show that children with attention deficit hyperactive disorder (ADHD) also may be at increased risk of deficit sensory processing. Sensory overload on the child increases their anxiety levels. Various treatment methods are being adopted like behavioral analysis therapy, occupational therapy, restricted diets, acupuncture, animal therapy, etc. A weighted vest is often suggested by occupational therapists for sensory regulation. Though weighted jackets are available through e-commerce in India it is expensive and beyond the reach of average families with ADHD and ASD children. Moreover, there is no systematic study to understand the specific needs and requirements of weighted vests for Indian children in terms of functional, physio-thermal comfort, technical, and aesthetic needs. Therefore, the objective of this research is to design and develop weighted vests for ASD and ADHD children based on a user-centered research approach. The ethnographic methods used for the study include participant and non-participant observation, and interviews with stakeholders, teachers, therapists, and parents. Additionally, cognitive mapping and empathy mapping were also done. Co-design workshops were conducted with parents and therapists to design the architectural requirement of the weighted vest. The prototypes developed were user tested before finalization of the design. The designed jackets could be used by children in the age group of 3–10 years, washable, and take into account the sensitivity of the children.