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The Wilbarger Brushing Protocol also known as DPPT is a very specific technique used for tactile defensiveness and sometimes other sensory processing challenges. The technique can be effective, BUT it is misunderstood, and often not taught correctly, and way over used in my professional opinion. Here are some very important points to remember about brushing. WILBARGER THERAPRESSURE PROTOCOL FOR SENSORY DEFENSIVENESS. The Wilbarger Therapressure Protocol is a very specific somatosensory intervention that uses deep, deep touch pressure and joint proprioception at 90 minute to 2-hourly intervals (in waking hours), in combination with a sensory diet to encourage the sensory system to address the underlying sensory defensiveness.
Authors Weeks, Boshoff, Stewart
Received19 August 2012
Accepted for publication 25 September 2012
Published 3 December 2012 Volume 2012:3 Pages 79—89
DOIhttps://doi.org/10.2147/PHMT.S37173
Checked for plagiarism Yes
Review bySingle-blind
Peer reviewer comments 4
Scott Weeks, Kobie Boshoff, Hugh Stewart
School of Health Sciences Occupational Therapy Program, University of South Australia, Adelaide, South Australia, Australia
Background: Sensory processing disorders have an estimated prevalence of 5%–10% in children without disability and 40%–88% in children with disability. A subtype of sensory processing disorder is sensory overresponsivity, which can result in fear, irritability, aggression, or avoidance behaviors in children. The Wilbarger protocol is the most prescriptive program used to treat sensory overresponsivity in children aged 2–12 years. Strong anecdotal evidence suggests that the Wilbarger protocol successfully reduces challenging behavior in children with sensory overresponsivity. The aim of this systematic review was to identify and appraise the existing evidence for the effectiveness of the Wilbarger protocol with children aged 0–18 years.
Methods: A systematic review was conducted of the peer-reviewed literature written in English. The electronic databases searched up to April 2012 included CINAHL, Ovid Medline (R), Embase, Scopus, the Cochrane Library, AMED, and the Web of Science. OT Seeker and Google Scholar were searched for missed literature, along with hand-searching of retained articles. Adult studies were excluded. The Critical Review Form for Quantitative Studies by McMaster University and the levels of hierarchy from the Australian National Health and Medical Research Council were used to appraise the literature.
Results: A total of 341 studies were found, and 302 were screened for eligibility after duplicates were removed. Four level IV intervention (case series with pretest/posttest) studies were included for indepth review. All four studies had very small sample sizes, exhibited low methodological quality, differed in outcome measures used, and lacked homogeneity of samples and treatment fidelity.
Conclusion: A lack of high quality evidence currently exists to support or refute the use of the Wilbarger protocol with children. While the grade of recommendation, as proposed by the Australian National Health and Medical Research Council, suggests that the Wilbarger protocol should be applied with caution, emerging evidence from these studies warrants future robust research on this topic. Clinicians are advised to use clear outcome measures when using the Wilbarger protocol with clients.
Keywords: Wilbarger protocol, pediatrics, allied health
School of Health Sciences Occupational Therapy Program, University of South Australia, Adelaide, South Australia, Australia
Background: Sensory processing disorders have an estimated prevalence of 5%–10% in children without disability and 40%–88% in children with disability. A subtype of sensory processing disorder is sensory overresponsivity, which can result in fear, irritability, aggression, or avoidance behaviors in children. The Wilbarger protocol is the most prescriptive program used to treat sensory overresponsivity in children aged 2–12 years. Strong anecdotal evidence suggests that the Wilbarger protocol successfully reduces challenging behavior in children with sensory overresponsivity. The aim of this systematic review was to identify and appraise the existing evidence for the effectiveness of the Wilbarger protocol with children aged 0–18 years.
Methods: A systematic review was conducted of the peer-reviewed literature written in English. The electronic databases searched up to April 2012 included CINAHL, Ovid Medline (R), Embase, Scopus, the Cochrane Library, AMED, and the Web of Science. OT Seeker and Google Scholar were searched for missed literature, along with hand-searching of retained articles. Adult studies were excluded. The Critical Review Form for Quantitative Studies by McMaster University and the levels of hierarchy from the Australian National Health and Medical Research Council were used to appraise the literature.
Results: A total of 341 studies were found, and 302 were screened for eligibility after duplicates were removed. Four level IV intervention (case series with pretest/posttest) studies were included for indepth review. All four studies had very small sample sizes, exhibited low methodological quality, differed in outcome measures used, and lacked homogeneity of samples and treatment fidelity.
Conclusion: A lack of high quality evidence currently exists to support or refute the use of the Wilbarger protocol with children. While the grade of recommendation, as proposed by the Australian National Health and Medical Research Council, suggests that the Wilbarger protocol should be applied with caution, emerging evidence from these studies warrants future robust research on this topic. Clinicians are advised to use clear outcome measures when using the Wilbarger protocol with clients.
Keywords: Wilbarger protocol, pediatrics, allied health
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Download Article [PDF]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.
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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.
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.)
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.