What is the Wilbarger Protocol or Brushing Therapy?

The Wilbarger Protocol is a therapy program designed to reduce sensory or tactile defensiveness. Children who exhibit symptoms of tactile defensiveness are extremely sensitive to touch. This can cause a fear or resistance to being touched, difficulty transitioning between activities, and/or lethargy. The therapy was developed by Patricia Wilbarger, MEd, OTR, FAOTA.

There is not much documented research on the Wilbarger Protocol. However, many parents of children with autism have reported seeing decreases in sensory defensiveness and anxiety as a result of using this technique. Some of the benefits of the Wilbarger Protocol may include improved ability to transition between daily activities, improved attention span, a decreased fear or discomfort of being touched, enhanced coordination, and self-regulation.

The complete routine usually only takes 2-3 minutes.The first step in the therapy involves using a sensory brush or wilbarger brush which is run over the child's skin, using very firm pressure; it is like a deep pressure massage. Brushing starts at the arms and works down to the feet. The face, chest, and stomach area are never brushed because these are sensitive areas that can cause adverse reactions.

The brushing with the therapressure brush is initially recommended every 2 hours while the child is awake. Therapists usually re-assess the level of brushing after two weeks. At that time they may modify the program. The brushing continues as long as the individual benefits from it.

After the brushing therapy, therapists may also prescribe gentle joint compressions to the shoulders, elbows, wrists, fingers, hips, knees/ankles, and sternum for a count of ten. Self-administration of joint compression may also be obtained by engaging in jumping-jacks, push-ups, or jumping on a trampoline.

Finally, the therapist may also suggest the Oral Tactile Technique, or OTT. This technique requires a finger to swipe along the inside of the person’s mouth. This is helpful for kids with oral defensiveness. (These children may have trouble with foods because of their texture or hate having their teeth brushed.)

If you think that your child would benefit from the Wilbargar Protocol, it is important to seek guidance from an Occupational Therapist. The OT must be trained in sensory integration and know how to use the Wilbargar Protocol. Performing the therapy in a manner other than taught by a trained professional may not be effective and can be very uncomfortable for the individual.