Brushing therapy, formally known as the Wilbarger Protocol, is a specific tactile intervention technique utilized in Occupational Therapy (OT). This structured program uses specialized deep pressure and proprioceptive input to help individuals regulate their nervous system’s reaction to touch and movement. The goal is to improve a person’s ability to process and tolerate everyday sensory experiences more effectively. This systematic approach acts as a temporary regulator, helping to stabilize a person’s sensory state throughout the day.
The Sensory Foundation of Brushing Therapy
Brushing therapy is grounded in sensory integration theory, which suggests that the nervous system must effectively organize sensory input for a person to function smoothly. The technique specifically targets the tactile system, which is responsible for processing touch, pressure, temperature, and pain sensations. For some individuals, this system is over-responsive, leading to a condition called tactile hypersensitivity or sensory defensiveness.
A person with tactile hypersensitivity may perceive light touch as irritating or even painful, causing them to withdraw or react defensively to routine activities like wearing certain clothing or being lightly touched by another person. The protocol aims to address this over-sensitivity by providing consistent, deep, and firm pressure. This deep pressure is thought to activate the calming pathways within the nervous system, helping to modulate the brain’s interpretation of subsequent touch stimuli.
By repeatedly exposing the nervous system to this organizing input, the therapy seeks to gradually reduce defensive reactions to touch. This firm stimulation helps the brain filter out non-threatening sensory information, leading to a more regulated and less reactive state. The consistent application of deep pressure provides a reliable sensory anchor, normalizing the individual’s sensory processing ability over time.
Mechanics of the Brushing Protocol
The application of the Wilbarger Protocol requires a specific tool, typically a specialized plastic Therapressure Brush, which is a small surgical brush with soft, dense bristles. The procedure involves applying firm, steady pressure with the brush, using long, linear strokes down the skin. The brush should be held to ensure the bristles bend slightly, providing a deep pressure massage-like sensation rather than a light, ticklish one.
The brushing technique must be applied to the arms, back, hands, legs, and feet, following a systematic pattern. Specific, highly sensitive areas of the body, such as the face, chest, stomach, and groin, are strictly avoided to prevent adverse reactions or overstimulation. The entire brushing process is brief, generally lasting no more than two to three minutes per session.
This tactile input is immediately followed by a proprioceptive component, which involves applying firm joint compression to the major joints. The joints of the shoulders, elbows, wrists, fingers, hips, knees, and ankles receive ten rapid compressions each. This proprioceptive input works synergistically with the skin brushing to help organize and calm the nervous system. The complete sequence is typically recommended to be repeated every 90 minutes to two hours throughout the day for a prescribed period.
Target Populations and Behavioral Outcomes
Brushing therapy is often recommended for individuals diagnosed with Sensory Processing Disorder (SPD), particularly those exhibiting tactile defensiveness and sensory modulation issues. It is also frequently utilized as a component of a sensory diet for people with Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) who present with sensory challenges. The intervention is not a standalone treatment but is integrated into a broader sensory program designed by a trained professional.
The protocol’s functional outcomes center on improved self-regulation and a reduction in defensive behaviors. Individuals often show an increased tolerance for everyday touch, manifesting as reduced resistance to hygiene tasks like hair brushing or tolerating different clothing textures. The therapy can also lead to increased attention span and improved focus in academic or social settings, as the child is less distracted by sensory input.
Over time, consistent regulation helps improve a person’s ability to transition between activities or environments without emotional outbursts. Implementation requires professional training and supervision from an Occupational Therapist to foster a more organized and calm state. Benefits also include better body awareness and motor coordination, allowing for greater participation in daily life activities.