Brushing and Joint Compression

You may have heard parents in support groups or online message boards mention “brushing” their children with sensory integration disorder. If so, you've probably wondered what that could possibly mean.

The brushing referred to is properly called the Wilbarger protocol, developed by occupational therapists Patricia Wilbarger and Julia Wilbarger as a way to reduce oversensitivity to touch. It involves rubbing a soft plastic brush, the kind surgeons use to clean their hands, along your child's skin in a specific way.

Done many times throughout the day on a specific schedule, it eventually reduces your child's sensitivity to touch and makes him more able to deal with things like clothing, tags, sock seams, and hugs.

While the protocol seems harmless — rub the brush against your own skin, and you'll see that it doesn't hurt and feels a little stimulating — it must be done in the prescribed way or it could actually be harmful for your child. For this reason, it must be done under the supervision of your occupational therapist.

If your therapist doesn't bring the subject up, don't hesitate to ask whether this would be a good option for your child. Have the therapist instruct you in what direction to move the brush, how frequently to do the treatments, and what sort of reaction on your child's part might signal a problem with the therapy.

Your occupational therapist will probably provide you with the sort of brush you'll need to do the Wilbarger protocol with your child. You may also be able to pick one up at a medical supply store. If not, they can be ordered from occupational therapy Web sites like and Abilitations.

Along with brushing, the Wilbarger protocol includes joint compressions (pushing) and traction (pulling). These must also be done in a particular way and in a particular sequence to ensure that they are as helpful as possible. However, you may find in playing with your child that games that include pushing against the joints — pushing against your child, palm to palm, or sole of foot to sole of foot, for example — have a calming effect. Ask your therapist how to do joint compressions along with brushing, and get instructions on the proper way to do it.

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