What is brushing?

Brushing, also known as the Wilbarger Deep Touch Pressure Protocol is a therapeutic technique used to decrease tactile defensiveness and reduce over-responsiveness to touch. It involves applying deep touch pressure to the skin on a regular schedule throughout the day using a special surgical brush. Deep touch pressure is known to be calming and organizing.

What areas of the body are brushed?

Deep touch pressure is applied to the arms, legs, and back. The face and stomach are never brushed. Brushing is followed by joint compressions to the joints in the shoulders, elbows, wrist, fingers, hips, knees, and ankles. The compressions are a critical component of the protocol because they provide powerful sensation to the joints and muscles of the body (proprioceptive input).

How often do I need to brush my child?

The brushing protocol is done every two hours (range: 1 hour 45 minutes to 2½  hours). The entire routine should only take about three or four minutes to complete. It is best if you can embed the technique within your family’s routine- wake up, bath times, and bed time. Older children can be taught to do it to themselves.”

Brushing must be done under the guidance of an occupational therapist who will teach you how to implement the technique accurately. There is a right way and a wrong way to brush.

How long do I need to do this for?

You should see results from brushing within 2 weeks. The protocol will be followed as long as you continue to see results.

Can I expect the school to follow through?

Your child’s teacher, a school-based occupational therapist, or the school nurse can do the brushing during the school day. If it is impossible for the school to follow through, be certain that you do the brushing before and after school.

How do I get my child to comply with brushing?

Many children enjoy the sensation of the intense deep touch pressure and proprioceptive input. They may even bring the brush over to a parent or teacher and ask to be brushed. Other children may be somewhat resistant. Listed below are some suggestions to make the experience pleasant for you and your child:

1.      Allow your child to experiment with the brush on his own terms. Let him brush different parts of his body, or try it out on you

2.      Give choices- let your child pick which arm or leg you will brush first

3.      Have your child pick where you will do the brushing- – a bean bag, cozy corner, or stack of pillows

4.      Allow your child to pick a before or after activity

5.      Sing a song

6.      Play background music

7.      Play pretend

8.      Make up silly stories that will be distracting

9.      Offer your child a fidget toy

10. Give your child gum or a mouth toy

Blog written by: Aviva Goldwasser, MS, OTR

Chaye Lamm Warburg, MA, OTR, Director POTS

For additional information on sensory defensiveness and treatments:

1.      Biel, Lindsey and Peske, Nancy (2005). Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Integration Issues. Penguin Publishing.

2.      Heller, PhD, Sharon, (2002). Too Loud, Too Bright, Too Fast, Too Tight: What To Do If You Are Sensory Defensive in an Overstimulating World. Harper Collins Publishers Inc. NY, NY.