The Wilbarger Deep Pressure and Proprioceptive Technique & Oral Tactile Technique (OTT) (formerly referred to as the Wilbarger Brushing Protocol or WBP) are techniques developed by Patricia Wilbarger, MEd, OTR, FAOTA. Dr. Wilbarger, is an occupational therapist and clinical psychologist who has been working with sensory processing theories for over 30 years. She is a cofounder of Sensory Integration International and AVANTI camp and well known for her clinical work in the NICU, schools, etc. She lectures internationally on sensory processing disorders and sensory integration. She has produced videotape, audiotape, and an intervention guide on the subject of sensory defensiveness.
More information on these publications or training courses are available from Professional Development Programs (Phone: (651) 439-8865, or at www.pdppro.com)
Based on the theory of Sensory Integration, the brushing technique uses a specific method of stimulation to help the brain organize sensory information. Ms Wilbarger and her daughter Julia Wilbarger, MS, OTR offer training courses on a regular basis for professionals who wish to use it in their practice. Additionally, through their continuing research, the technique is occasionally revised in method, and it is important for therapists to be aware of the most current method.
To use this technique with out instruction from a trained therapist could be harmful at the extreme, and at the minimum, useless.
The Theory:
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 systems feed information from our environment, through sense receptors, and neural impulses via our nervous system, directly to the brain. The brain then organizes it, sends it back through the nervous system for use as understanding, adaptation, learning, and skill development.
When this system functions well, it allows a person to interact with their environment efficiently, developing necessary motor and language skills, and appropriate social/emotional behavior. When this system is unable to organize the information appropriately, a variety of symptoms can present; motor delays, tactile defensiveness, learning disorders, social or emotional difficulties, speech, and language deficits or attention disorders.
The Purpose and Benefit:
The DPPT has been found very beneficial to children with sensory integrative dysfunction, as outlined in the previous paragraph. This technique helps the brain and body work together more effectively. Benefits noted are:
Ø Can improve ability to transition between activities (calming after emotional outburst, improving tolerance levels.)
Ø Can help children who have a fear of discomfort in being touched (tactile defensiveness)
Ø Can increase self regulation, self calming.
Ø Can increase the ability of the nervous system to use information from the senses more effectively, i.e. speech/motor skills.
Ø Can improve attention and focus.
Ø The students generally like the procedure!
Benefits received are directly related to correct administration and consistency.
The Technique:
To use this technique with out instruction from a trained therapist could be harmful at the extreme, and at the minimum, useless.
Therapists interested in offering this technique should contact the above mentioned group to be trained at an official seminar. Families should ensure the therapist offering this technique has the most recent training available.
Pediatric Building Blocks recommends that anyone who has been shown this technique be "updated" annually and their technique checked out by a trained therapist.
The DPPT uses a specific pattern of stimulation delivered through a specific type of brush and gentle joint compression or “pushing” to send information to the brain in an organized fashion. Simply put, it primes the brain to receive and organize information in an effective and useful way. It is done approximately every two hours for a specified number of days and then according to the needs of the child. Consistency is a critical factor! However, the protocol can be administered in between scheduled sessions, to assisting with transitions between activities, reducing overwhelm reactions, and re- organizing the nervous system after emotional upset.
The brush used for this technique, is a soft plastic surgical brush. OTHER TYPES OF BRUSHES ARE NOT APPROPRIATE FOR THIS TECHNIQUE! This brush has been found to be the most effective in stimulating nerve endings in the skin. The actual brushing is done using a very firm pressure, starting at the arms and working down to the feet, avoiding the chest and stomach. Brushing these sensitive areas may cause urination, defecation or vomiting. The brushing is slow and purposeful providing “proprioception” (input through muscles and joints.) It is not ‘scrubbing’, and should never be painful, or cause damage to the skin. Children may initially react with crying or other avoidance measures because it is new, and the re-organizing can be disquieting. Generally within a few sessions, it becomes pleasurable and children will often ask for it or do it themselves.
The joint compression is also done in a specific pattern; ten count repetition, using light pressure. Students can be taught to do this themselves, by using an alternative method of ‘wall’ push-ups, and jumping.
The final component is the oral swipe, used for Oral defensiveness, although this is sometimes omitted in schools due to hygiene and/or safety concerns, as it requires fingers in the mouth. Again, students can be taught to do this themselves.
No part of this technique should ever be painful or cause physical damage
We do this with my daughter, not as often as directed, my fault........ it does seem to help calm her during a meltdown. REMEMBER to always give a deep pressure massage afterwards, I learned this the hard way, and ended up with a WIRED child. Brush, than massage!!
More information on these publications or training courses are available from Professional Development Programs (Phone: (651) 439-8865, or at www.pdppro.com)
Based on the theory of Sensory Integration, the brushing technique uses a specific method of stimulation to help the brain organize sensory information. Ms Wilbarger and her daughter Julia Wilbarger, MS, OTR offer training courses on a regular basis for professionals who wish to use it in their practice. Additionally, through their continuing research, the technique is occasionally revised in method, and it is important for therapists to be aware of the most current method.
To use this technique with out instruction from a trained therapist could be harmful at the extreme, and at the minimum, useless.
The Theory:
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 systems feed information from our environment, through sense receptors, and neural impulses via our nervous system, directly to the brain. The brain then organizes it, sends it back through the nervous system for use as understanding, adaptation, learning, and skill development.
When this system functions well, it allows a person to interact with their environment efficiently, developing necessary motor and language skills, and appropriate social/emotional behavior. When this system is unable to organize the information appropriately, a variety of symptoms can present; motor delays, tactile defensiveness, learning disorders, social or emotional difficulties, speech, and language deficits or attention disorders.
The Purpose and Benefit:
The DPPT has been found very beneficial to children with sensory integrative dysfunction, as outlined in the previous paragraph. This technique helps the brain and body work together more effectively. Benefits noted are:
Ø Can improve ability to transition between activities (calming after emotional outburst, improving tolerance levels.)
Ø Can help children who have a fear of discomfort in being touched (tactile defensiveness)
Ø Can increase self regulation, self calming.
Ø Can increase the ability of the nervous system to use information from the senses more effectively, i.e. speech/motor skills.
Ø Can improve attention and focus.
Ø The students generally like the procedure!
Benefits received are directly related to correct administration and consistency.
The Technique:
To use this technique with out instruction from a trained therapist could be harmful at the extreme, and at the minimum, useless.
Therapists interested in offering this technique should contact the above mentioned group to be trained at an official seminar. Families should ensure the therapist offering this technique has the most recent training available.
Pediatric Building Blocks recommends that anyone who has been shown this technique be "updated" annually and their technique checked out by a trained therapist.
The DPPT uses a specific pattern of stimulation delivered through a specific type of brush and gentle joint compression or “pushing” to send information to the brain in an organized fashion. Simply put, it primes the brain to receive and organize information in an effective and useful way. It is done approximately every two hours for a specified number of days and then according to the needs of the child. Consistency is a critical factor! However, the protocol can be administered in between scheduled sessions, to assisting with transitions between activities, reducing overwhelm reactions, and re- organizing the nervous system after emotional upset.
The brush used for this technique, is a soft plastic surgical brush. OTHER TYPES OF BRUSHES ARE NOT APPROPRIATE FOR THIS TECHNIQUE! This brush has been found to be the most effective in stimulating nerve endings in the skin. The actual brushing is done using a very firm pressure, starting at the arms and working down to the feet, avoiding the chest and stomach. Brushing these sensitive areas may cause urination, defecation or vomiting. The brushing is slow and purposeful providing “proprioception” (input through muscles and joints.) It is not ‘scrubbing’, and should never be painful, or cause damage to the skin. Children may initially react with crying or other avoidance measures because it is new, and the re-organizing can be disquieting. Generally within a few sessions, it becomes pleasurable and children will often ask for it or do it themselves.
The joint compression is also done in a specific pattern; ten count repetition, using light pressure. Students can be taught to do this themselves, by using an alternative method of ‘wall’ push-ups, and jumping.
The final component is the oral swipe, used for Oral defensiveness, although this is sometimes omitted in schools due to hygiene and/or safety concerns, as it requires fingers in the mouth. Again, students can be taught to do this themselves.
No part of this technique should ever be painful or cause physical damage
We do this with my daughter, not as often as directed, my fault........ it does seem to help calm her during a meltdown. REMEMBER to always give a deep pressure massage afterwards, I learned this the hard way, and ended up with a WIRED child. Brush, than massage!!