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Brushing Techniques for Sensory Integration

People with sensory integration issues have difficulty processing sensory stimuli. This can involve over-stimulation or under-stimulation of the different senses. The result is varying levels of sensory defensiveness or hyposensitivity, as seen in conditions such as autism. The field of occupational therapy has developed many effective techniques to help treat these challenges. Therapeutic brushing is one of those techniques.

  1. What's Therapeutic Brushing?

    • Therapeutic brushing is a very specific protocol developed by Patricia Wilbarger, an internationally renowned occupational therapist. It is formally known as the Wilbarger Deep Pressure and Proprioceptive Technique (DPPT). As the name implies, it entails more than simple brushing of the skin. Additionally, it is never practiced in isolation of other occupational therapies for sensory integration. Occupational therapists devise an individualized treatment plan to meet the "sensory diet" needs of each client. Therefore, therapeutic brushing should always be done under the direction of a trained occupational therapist.

    How's It Done?

    • Therapeutic brushing is done with a particular type of brush, much like a surgical brush. The bristles are very close to one another and not too stiff. Brushing is done beginning with the arms down to the feet and is never done on the neck, chest or stomach. A very prescribed pattern is followed, with pressure applied according to a client's needs. For those individuals with oral sensitivity issues, there is also an Oral Tactile Technique (OTT), used in the mouth.

      The occupational therapist devises an individualized regimen, beginning with very frequent sessions and gradually tapering off as progress is assessed. Following each brushing session, joint compression therapy is done to complete the deep pressure stimulation. This is done by gently pushing together from both sides of where the targeted joint comes together. The OT will specify which joints to work on and in what recommended order. Pressure is never applied to the point of hurting in either brushing or joint compression, only to offer sufficient stimuli to the client's central nervous system. Neither therapy is ever done in isolation of the other. Thus, it is apparent therapeutic brushing is a very specialized treatment and requires the expertise of an occupational therapist. The therapist, however, will instruct the individual or the parent how to proceed with the treatment at home.

    Effectiveness

    • Even though therapeutic brushing is not backed by extensive scientific research, its anecdotal success has made it an increasingly popular treatment option of occupational therapists. It often decreases the sensory integration issues measurably, resulting in improved life skills such as tactile responsiveness, focus, alertness, improved coordination and self-regulation. To ensure a successful outcome, make certain your occupational therapist is trained not just in the area of sensory integration, but also in therapeutic brushing.

    Resources

    • Check out the references listed in this article to help locate an occupational therapist in your area. Otherwise, you can also begin with a primary physician, though not all physicians are familiar with sensory integration issues, nor endorse this type of therapy even if they are. Because of the lack of scientific studies, it is still considered an alternative therapy by many, which can also affect insurance coverage. In the case of children, a developmental pediatrician is much more likely to be knowledgeable in this area.

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