Wilbarger Deep Pressure Protocol

by Denise
(Ohio)

Some friends who went to an Autism Symposium said that the OT presenting said that the Wilbarger Protocol should only be done for 2 weeks and then discontinued. Is this a change that the Wilbargers have recommended?

The SPD Help Line Answers...

It appears there are often misconceptions about the brushing protocol and this is NOT a good thing, for sure!

Here is what I know... In Patricia and Julia Wilbarger's own book,
"Sensory Defensiveness in Children Aged 2-12", copyright 1991, they say on page 16:

"How long do you continue the procedure (brushing and joint compressions)?"

"Each individual responds to this technique differently and will need to continue for a different length of time.
It is often helpful to begin with brushing for two weeks and then re-assess the level of sensory defensiveness. At that time the consultant can make further recommendations to continue or modify the program."

Initially, for the first two weeks, yes, the brushing is intense and very frequent (every two hours)! And at the two week point, it is not meant to be discontinued altogether. The Wilbarger's suggest a re-assessment which often means the brushing can be reduced to say, 3-5 times a day... done regularly, with commitment and on a consistent daily schedule until the OT decides the child does not need it daily. He may still need it during certain situations however, as a calming or preparatory strategy.

Michelle Morris's experience with brushing and direct knowledge from her son's amazing OT (who is also a researcher) is this:

"At this point, many OT's, if seeing some level of improvement, will reduce the brushing to 3-5 times a day, instead of the recommended initial - every two hours for two weeks. And then? It goes on as long as that individual child needs it to, until the therapist and parent sees a significant reduction in defensiveness as exhibited by the child. Then... we go on as "as needed" basis, in times of great stress, developmental changes, or used as a tool, also recommended by Wilbarger, to prevent defensiveness in an upcoming situation."

If there are any OT's out there who have heard differently from the Wilbargers (not any OT, just the Wilbargers, as it is their protocol) PLEASE let us know. The Wilbarger Protocol is the protocol. Individual interpretations of this don't count. Only what the Wilbargers have said.

So, I don't believe that recommendation at the conference was correct. I do believe it was a misinterpretation or based on misguided information. We will assume that to be true UNTIL we hear directly from the Wilbarger's, ok? For now... two weeks of intense brushing; every two hours followed by joint compressions. A reassessment at two weeks with the OT and the parents trying a less intense schedule... usually 3-5 times per day. Then as needed once this schedule has helped the child regulate his system well enough.

Comments? Concerns? Questions? Reply below! Let's make sure we are all on the same page.

Michele Mitchell