Understanding the Wilbarger Brushing Protocol

The Wilbarger Brushing Protocol, also known as the Wilbarger Deep Pressure and Proprioceptive Technique (DPPT), is a sensory-based intervention developed to support individuals who experience sensory processing difficulties, particularly sensory defensiveness or heightened sensitivity to touch.

The protocol combines deep-pressure tactile input with joint compressions and is typically recommended by an occupational therapist as part of a broader sensory support plan.

What Is the Purpose of the Protocol?

The goal of the Wilbarger Protocol is to provide consistent sensory input that may help some individuals better regulate and process sensory information.

Supporters of the technique suggest that it may help with:

• Sensory defensiveness
• Difficulty tolerating touch or certain textures
• Emotional regulation
• Attention and focus
• Transitions between activities
• Participation in home, school, and community environments

It is important to note that every individual responds differently, and the protocol should be tailored to the person's unique sensory profile.

How Does the Protocol Work?

The protocol consists of two parts:

1. Deep Pressure Input

A specialized sensory brush is used to apply firm, even pressure to specific areas of the body, including the:

• Arms
• Hands
• Back
• Legs
• Feet

Although commonly referred to as "brushing," the technique is not intended to feel like gentle brushing. Instead, the pressure is similar to a firm massage, providing deep tactile input to the nervous system.

The face, chest, stomach, and other sensitive areas are never brushed.

2. Joint Compressions

Following the deep-pressure input, gentle joint compressions are applied to selected joints as instructed by a trained occupational therapist.

These compressions provide proprioceptive input, helping the body better understand where it is in space and supporting body awareness and regulation.

The full protocol typically takes only a few minutes to complete.

Important Guidelines

The Wilbarger Protocol should only be implemented after receiving training and guidance from a qualified occupational therapist.

When using the sensory brush:

✓ Apply firm, even pressure
✓ Keep the brush flat against the skin or clothing
✓ Move slowly and methodically
✓ Ensure the skin moves slightly under the pressure
✓ Maintain a calm and predictable pace

Avoid:

✕ Light tickling or sweeping motions
✕ Brushing the face, stomach, or chest
✕ Using the protocol without professional guidance
✕ Continuing if the individual shows signs of significant distress

Creating a Positive Experience

Responses to the protocol vary from person to person.

Some individuals find the deep-pressure input calming and may actively seek it out, while others may take time to adjust or may not enjoy the sensation.

To promote a positive experience:

• Use the protocol in a calm, quiet environment
• Follow your occupational therapist's instructions carefully
• Pair the activity with preferred toys, music, or calming activities if appropriate
• Monitor the individual's response over time

If the person becomes increasingly distressed, agitated, or uncomfortable, discontinue the protocol and consult your occupational therapist.

Hygiene and Safety

• Each individual should have their own sensory brush.
• Brushes should be cleaned regularly according to the manufacturer's recommendations.
• The protocol may be performed over clothing or directly on the skin, depending on therapist recommendations.
• Consistency is important, and the protocol should only be carried out according to the schedule provided by the occupational therapist.

What Does the Research Say?

The Wilbarger Protocol has been widely used by occupational therapists for many years and continues to be used in sensory integration practice around the world.

Many families and clinicians report positive outcomes, including improvements in sensory regulation, attention, participation, and daily functioning.

However, current research evidence remains limited, and studies have not yet conclusively demonstrated the effectiveness of the protocol across all individuals or populations.

Because of this, the Wilbarger Protocol is generally considered a sensory support strategy rather than a scientifically proven treatment. It is most effective when used as part of a comprehensive, individualized therapy programme developed by a qualified occupational therapist.

A Personalized Approach Matters

Sensory needs are unique to every individual. What works well for one person may not work for another.

The Wilbarger Protocol should always be viewed as one potential tool within a broader sensory support plan, guided by professional assessment, ongoing observation, and the individual's specific needs and preferences.