Patricia Wilbarger Brushing Program

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Occupational Therapy HEP: Brushing and Joint Compressions Page 1/1 Occupational Therapy Home Exercise Program: Brushing & Joint Compressions (.Adapted from Wilbarger Protocol) Child’s Name: Date:.Complete the below exercises every 2 hours. This should take no longer than 5 minutes to complete! Davis gets his 'Brushies and Squishies.' Also known as Wilbarger Brushing Protocol.

What Is The Wilbarger Brushing Protocol?

The Wilbarger Deep Pressure and Proprioceptive Technique was developed by Patricia Wilbarger, Med, OTR, FAOTA. Based on the theory of Sensory Integration, the brushing technique uses a specific method of stimulation to help the brain organize sensory information.

Our skin is our largest sensory organ, followed closely by our muscles and skeleton, connected by our nervous system and governed by our brain. The sensory system feeds information from our environment, via our central nervous system, directly to our brain. The brain then organizes it, and sends it back through the nervous system for the purposes of understanding, adapting, learning and skill development. When our nervous system functions well, it allows a person to interact with their environment efficiently, developing necessary motor and language skills as well as appropriate social/emotional behavior. When our system is unable to organize the information appropriately, a variety of symptoms can be present: motor delays, tactile defensiveness, learning disorders, social or emotional difficulties, speech and language deficits and attention disorders.

Patricia Wilbarger Brushing Program

Many children have atypical sensory processing. They have difficulties with too much (hypersensitive) or too little sensory (hyposensitive) inputs, including tactile inputs (touch) and proprioception inputs (deep pressure). This can be called the Goldilocks and The Three Bears Principle. Not too much, not too little, just the right amount of touch and proprioception is desired. The Wilbarger technique is used to help children widen their “just right” zone so they are not as hyper- or hyposensitive to touch and proprioception. You should notice gradual improvement with tactile and proprioception sensitivity and seeking behaviors when you consistently apply this technique.

Patricia Wilbarger Brushing Program

The Purpose and Benefits:

Patricia wilbarger brushing programming
  • Can improve ability to transition between activities (calming after emotional outburst, improving tolerance levels).
  • Can help children who have a fear or discomfort of being touched (tactile defensiveness).
  • Can increase self-regulation and self-calming.
  • Can increase the ability of the nervous system to use information from the senses more effectively, i.e. speech and/or motor.
  • Can improve attention and focus.
  • Children generally like the procedure!

The Wilbarger Brushing Technique should be introduced and practiced with a caregiver by the child’s occupational therapist so it can be integrated into the their daily routine. The technique uses a surgical scrub brush just like the brush that surgeons use to scrub their hands and arms before surgery. This plastic brush is not rough and will not scratch. It provides just the right amount of pressure and sensations to the skin.

The Wilbarger Protocol is a therapy program designed to reduce sensory or tactile defensiveness. Children who exhibit symptoms of tactile defensiveness are extremely sensitive to touch. This can cause a fear or resistance to being touched, difficulty transitioning between activities, and/or lethargy. The therapy was developed by Patricia Wilbarger, MEd, OTR, FAOTA.


There is not much documented research on the Wilbarger Protocol. However, many parents of children with autism have reported seeing decreases in sensory defensiveness and anxiety as a result of using this technique. Some of the benefits of the Wilbarger Protocol may include improved ability to transition between daily activities, improved attention span, a decreased fear or discomfort of being touched, enhanced coordination, and self-regulation.

Patricia Wilbarger Brushing Protocol

The complete routine usually only takes 2-3 minutes.The first step in the therapy involves using a sensory brush or wilbarger 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 sensitive areas that can cause adverse reactions.

The brushing with the therapressure brush 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.
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 may also be obtained by engaging in jumping-jacks, push-ups, or jumping on a trampoline.

Patricia Wilbarger Brushing Program


Patricia Wilbarger Brushing Programmer

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 their texture or hate having their teeth brushed.)

Patricia Wilbarger Brushing Programming


Patricia Wilbarger Brushing Programme

If you think that your child would benefit from the Wilbargar Protocol, it is important to seek guidance from an Occupational Therapist. The OT must be trained in sensory integration and know how 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.