What is The Wilbarger Protocol?
The Wilbarger Deep Pressure and Proprioceptive Technique (DPPT) & Oral Tactile Technique (OTT), which in the past was referred to as the Wilbarger Brushing Protocol, refers to the specific sensory modulation techniques developed by Patricia Wilbarger, MEd, OTR, FAOTA., an occupational therapist and a clinical psychologist who is also known for birthing the phrase “sensory diet.” She is a leading expert in the area of sensory defensiveness. Simply stated, sensory defensiveness is the over-responsiveness of the protective responses of the nervous system.
Some of the benefits of following a brushing protocol may include:
An improved ability to transition between various daily activities
An improvement in the ability to pay attention
A decreased fear and discomfort of being touched (tactile defensiveness)
An increase in the ability of the central nervous system to use information from the peripheral nervous system more effectively, resulting in enhanced movement coordination, functional communication, sensory modulation, and hence, self-regulation.
The complete protocol usually takes 2-3 minutes to administer. The first step involves using a soft, plastic, sensory brush or Therapressure 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 very sensitive areas.
The brushing therapy 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. This program may be a part of sensory integration therapy.
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 by the client can also be done by pushing against walls, doing 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 the texture or may 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 should be trained in sensory integration and must be specifically trained 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, resulting in harmful or ineffective results.
If you are wanting to use the brush WITHOUT the help of an OT to desensitise feet before wearing socks, we recommend that the child brushes their own feet. This way they can stop when they wish and avoid overstimulation or discomfort. We do not recommend parents brush their children unless they have sought advice and been shown how to brush properly by an Occupational Therapist trained with the brushing protocol.