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Tactile Defensiveness: The Facts About the Wilbarger Brushing Protocol

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NBThis article is written for the parents of children who have SID and related problems. We publish it here because we know that therapists like to give their client's caregivers as much information as possible.

Tactile Defensiveness: The Facts About the Wilbarger Brushing Protocol

By: Debbie Woodward


Many children with Sensory Integration Disorders exhibit symptoms of tactile defensiveness. In layman’s terms this simply means that they have hypersensitivity to touch and/or tactile input. This in turn may cause:
  • Difficulty transitioning between activities
  • Lack of attention or focus
  • A fear or resistance to being touched

Your child may benefit from what is commonly known to most parents as “Brushing Therapy”. It is known in Occupational Therapy circles as The Wilbarger Deep Pressure and Proprioceptive Technique (DPPT) & Oral Tactile Technique (OTT). It was developed by Dr. Patricia Wilbarger, MEd, OTR, FAOTA, an occupational therapist and clinical psychologist that has been working with sensory processing theories for over 30 years.

When first introduced to this, many parents are a bit skeptical. How can “brushing” my child help them with their sensory integration issues and tactile defensiveness? The theory behind it is that our skin is the human body’s largest sensory organ, and therefore it is in constant contact with our nervous system; relaying information that allows us to interact effectively with our environment. Often times, the inability for the human body to process sensory input effectively can cause motor skill delays, tactile defensiveness, or social and emotional difficulties. Brushing therapy seeks to use this connection between the skin and the nervous system to assist kids who may be having difficulty organizing sensory information properly.

It is thankfully, quite simple to implement. The first step in the therapy involves using a soft, plastic, surgical brush which is run over the child’s skin, using a very firm pressure, starting at the arms and working down to the feet. The chest and stomach area are always avoided as these are sensitive areas that can cause adverse reactions. There can be some drama at first, until the child becomes accustomed to the therapy, but most children find it pleasurable after a few sessions and may even ask for it when they are feeling “off”. Along with the brushing, most practitioners will also prescribe joint compressions. In this phase of the treatment, the therapist or a parent trained by a therapist provides gentle compressions of each of the child’s major joints for a count of ten. Finally, the therapist may also suggest the Oral Tactile Technique, or OTT. This technique involves using a finger to swipe along the inside of the child’s mouth. This has been found to help with some children who have an issue with what is known as oral defensiveness. If your child is adverse to new foods because of their texture, or has a severe aversion to having their teeth brushed, they may have an issue with oral defensiveness.

If you think that your child would benefit from this form of therapy, it is important to seek guidance from an Occupational Therapist. Performing the therapy in a manner other than taught by a trained professional can be, at best, useless and could possibly do more harm then good.

Article Reprinted with Permission of Debbie Woodward

Tags: Proprioception Sensory Processing Disorder OT Article