What is the Wilbarger Brushing Protocol?
The Wilbarger Deep Pressure and Proprioceptive Technique (DPPT) was developed by Patricia Wilbarger, Med, OTR, FAOTA. Based on the theory of Sensory Integration, the brushing technique uses a specific method of stimulation to help the brain organize sensory…
Understanding Sensory Brushing
Sensory brushing is a layperson’s term for the Wilbarger Deep Pressure and Proprioceptive Technique (DPPT) & Oral Tactile Technique (OTT). In the past, it was simply referred to as the Wilbarger Brushing Protocol, or the Wilbarger Protocol. The DPPT refers to the specific sensory modulation techniques developed by Patricia Wilbarger, MEd, OTR, FAOTA. Patricia Wilbarger is an occupational therapist and a clinical psychologist who is also known for coining the phrase “sensory diet.” She is a leading expert in the area of sensory defensiveness (the over-responsiveness of the protective responses of the nervous system). Wilbarger, P. Wilbarger, J. (1991). Sensory Defensiveness in Children Aged 2-12⁚ An Intervention Guide for Parents and Other Caretakers, Avanti Educational Programs⁚ Santa Barbara, CA.
The History of the Wilbarger Protocol
Based on the theory of Ayres Sensory Integration, the DPPT, or sensory brushing technique, uses a prescribed method of providing stimulation through pressure touch massage, to help the mind-brain-body self-organize. The protocol also includes a series of joint compressions that are always used in conjunction with the brushing to enhance joint perception and feedback. This is based on proprioceptive input through the joints and deep input through the skin. The Wilbarger Protocol is designed to be used in conjunction with an individualized sensory diet based on the specific needs of the child and carried out under the guidance of someone familiar with the protocol and trained in sensory integration theory and practice. Check out this sensory processing disorder chart on the OT Toolbox for more information on sensory processing. Please note⁚ training in sensory brushing is absolutely necessary before attempting to use this technique in practice, otherwise harmful or ineffective influences may be the result. Be sure to receive the most up to date brushing protocol training as it has changed over the years.
Benefits of Sensory Brushing
Sensory brushing can do several things, and depending on the individual and their sensory preferences or sensory needs, there can be different results following use of a sensory brush. The tactile system sends information into the touch receptors from our skin. There is much to consider when thinking about touch. Pressure (light versus heavy), texture, (rough, sticky, soft, wet, dry, silky, smooth, bumpy) temperature, (hot, warm, cold), and emotions regarding texture, (will I be able to wash my hands?) People react differently to different types of touch depending on their system. Children with difficulty integrating the tactile system tend to look like this⁚
How Does the Wilbarger Brushing Protocol Work?
The Wilbarger Protocol is designed to be used in conjunction with an individualized sensory diet based on the specific needs of the child and carried out under the guidance of someone familiar with the protocol and trained in sensory integration theory and practice.
The Brushing Step⁚ A Specific Brush is Required
The DPPT requires the use of a special, soft, plastic surgical brush and no other kind. This brush is believed to be the most effective for the delivery of the specific type of stimulation to the nerve endings of the skin that is required by this protocol. The brushing portion of the DTTP applies deep pressure to the skin, which helps to calm the nervous system and improve sensory processing. The brush should be used in a specific way, with long, firm strokes that cover the entire body. The brushing should be done twice a day, for a total of 10 minutes each time. The brushing should be done in a calm and relaxing environment, and the child should be allowed to take breaks if needed. The brushing should be followed by joint compressions, which are also an important part of the Wilbarger Protocol.
Joint Compressions
Joint compressions are an important part of the Wilbarger Protocol, as they provide proprioceptive input, which helps to improve body awareness and coordination. They are performed after brushing and involve applying firm pressure to the joints, such as the elbows, knees, wrists, and ankles. This pressure helps to stimulate the sensory receptors in the joints, which send information to the brain about the position of the body. This information is essential for movement, coordination, and balance. Joint compressions can be done in a variety of ways, such as by holding the joint firmly or by using a weighted object. They should be held for a few seconds at a time, and repeated several times. The number of repetitions and the amount of pressure will vary depending on the individual’s needs.
The Importance of Sensory Integration
Sensory integration is the process by which the brain organizes and interprets sensory information from the body and the environment. This information is essential for developing motor skills, language, and social skills. Children with sensory processing difficulties may have difficulty integrating sensory information, which can lead to challenges with learning, behavior, and social interaction. The Wilbarger Brushing Protocol is based on the theory of sensory integration, and it aims to help children with sensory processing difficulties by providing them with specific sensory input. This input helps to stimulate the brain and improve its ability to process sensory information.
Who Can Benefit from the Wilbarger Brushing Protocol?
The Wilbarger Brushing Protocol can be beneficial for individuals who have difficulty processing sensory information, such as those with sensory defensiveness or autism spectrum disorder.
Sensory Defensiveness
Sensory defensiveness is a common challenge for many children, and it can manifest in various ways. It often involves an over-sensitivity to certain sensory input, such as touch, sounds, or smells. This can lead to difficulties in daily activities, such as getting dressed, brushing teeth, or participating in social interactions. The Wilbarger Brushing Protocol, also known as sensory brushing, is a specific technique that uses deep pressure and proprioceptive input to help regulate the nervous system and reduce sensory defensiveness. The protocol involves brushing the body with a special, soft brush, followed by joint compressions. This combination of sensory stimulation helps to calm and organize the nervous system, making it easier for individuals to tolerate sensory input and participate in everyday activities.
Autism Spectrum Disorder
Children with Autism Spectrum Disorder (ASD) often experience sensory processing difficulties, which can significantly impact their daily lives. The Wilbarger Brushing Protocol can be a valuable tool for supporting children with ASD who exhibit sensory sensitivities or defensiveness. The deep pressure and proprioceptive input provided by the brushing technique can help to calm and regulate the nervous system, reducing sensory overload and improving overall sensory processing. This can lead to improved self-regulation, reduced anxiety, and increased tolerance for sensory input. While the Wilbarger Brushing Protocol is not a cure for ASD, it can be a helpful intervention for addressing specific sensory challenges and improving overall quality of life for children on the spectrum. It is essential to consult with an occupational therapist who is trained in sensory integration and the Wilbarger Brushing Protocol for personalized guidance and implementation.
Implementing the Wilbarger Brushing Protocol
Implementing the Wilbarger Brushing Protocol requires a comprehensive approach involving careful instruction, consistent application, and ongoing evaluation.
Instructions and Resources
The Wilbarger Brushing Protocol typically involves a series of steps, including brushing the body with a specific brush, applying joint compressions, and incorporating the brushing into daily routines. Detailed instructions for implementing the protocol can be found in various resources, including books, articles, and online platforms. Patricia Wilbarger’s book, “Sensory Defensiveness in Children Aged 2-12⁚ An Intervention Guide for Parents and Other Caretakers,” provides a comprehensive guide to the protocol and its implementation. Other resources, such as the OT Toolbox website and the Sensory Processing Disorder Foundation, offer valuable information and guidance on sensory brushing techniques.
Considerations for Parents and Caregivers
Implementing the Wilbarger Brushing Protocol requires careful consideration and understanding from parents and caregivers. It’s crucial to emphasize that this technique should be implemented under the guidance of a qualified occupational therapist who is trained in sensory integration. Parents and caregivers should be aware of the specific instructions and techniques involved in the protocol, including the use of the proper brush, the appropriate brushing strokes, and the importance of joint compressions. Consistency is key to achieving positive results, and caregivers should strive to incorporate the protocol into daily routines as instructed by the therapist. Open communication with the therapist is essential for addressing any concerns or challenges that may arise during the implementation process.
Evidence-Based Practice
While the Wilbarger Brushing Protocol has gained popularity for its potential benefits, it’s important to acknowledge that the evidence supporting its effectiveness is somewhat inconsistent. Governing agencies strive for techniques backed by research, but sensory treatment often relies on trial and error, making definitive research challenging. The effectiveness of the protocol can be influenced by various factors like diet, weather, mood, concurrent techniques, and other variables. Despite the lack of conclusive evidence, the protocol is generally considered safe and worth trying, as it may provide positive results for some individuals. It’s essential to remember that personal experiences with the protocol can vary, and what works for one person may not work for another.
Additional Information and Resources
For more information on sensory brushing, consult with an occupational therapist or visit The OT Toolbox website.
The OT Toolbox
The OT Toolbox website offers a wealth of information on sensory processing, including articles, resources, and videos about the Wilbarger Brushing Protocol. This website is a great resource for parents, caregivers, educators, and therapists who are interested in learning more about this technique.
Colleen Beck, OTR/L, the owner and author of The OT Toolbox, provides insightful blog posts and resources designed to support therapy providers, educators, parents, counselors, and caregivers in promoting healthy child development. Her website features a comprehensive guide to sensory processing disorder and a variety of strategies for supporting children with sensory sensitivities.
Sensory Processing Disorder
Sensory processing disorder (SPD) is a neurological condition that affects how the brain processes sensory information. Individuals with SPD may have difficulty with sensory input, such as touch, sound, sight, smell, taste, and movement. This can lead to a variety of challenges, including difficulty with self-regulation, social interaction, and learning. The Wilbarger Brushing Protocol is often used as a therapeutic intervention for children with SPD, as it can help to improve sensory processing and reduce sensory defensiveness.
The protocol involves using a specific type of brush to provide deep pressure stimulation to the skin, which can help to calm the nervous system and improve sensory integration. The brushing is typically done in conjunction with joint compressions, which also provide proprioceptive input. The Wilbarger Brushing Protocol is often used in conjunction with other sensory integration strategies, such as a sensory diet.
Occupational Therapy Professionals
Occupational therapists (OTs) are healthcare professionals who specialize in helping people of all ages participate in meaningful activities. OTs use a variety of therapeutic approaches to help people improve their physical, cognitive, and social skills. OTs are trained in sensory integration theory and practice, and they can provide guidance and support to parents and caregivers who are implementing the Wilbarger Brushing Protocol.
OTs can assess a child’s sensory processing needs and develop an individualized sensory diet that includes the Wilbarger Brushing Protocol. They can also provide training and support to parents and caregivers on how to properly implement the protocol. If you are considering using the Wilbarger Brushing Protocol for your child, it is important to consult with an OT to ensure that it is appropriate for your child’s needs.
