Brushing Protocol (Wilbarger) for Sensory Defensiveness
The Wilbarger Brushing Protocol is a structured occupational therapy intervention designed to help individuals with sensory defensiveness regulate their responses to touch, promoting comfort, participation, and improved self-regulation.
Understanding Sensory Defensiveness
Sensory defensiveness occurs when the nervous system overreacts to ordinary tactile input, such as clothing tags, grooming, or light touch. Children and adults may respond with avoidance, anxiety, or behavioural outbursts. Occupational therapists (OTs) use the Wilbarger Protocol to provide structured, deep-pressure tactile input that helps retrain the sensory system.
What the Wilbarger Protocol Involves
The protocol uses a soft surgical brush, applied in firm, consistent strokes to arms, legs, and back. It is followed by joint compressions to provide proprioceptive input. Sessions are delivered multiple times a day, usually every 90 minutes to two hours, depending on the therapist’s recommendation. This repeated input helps reduce tactile hypersensitivity and improve tolerance to everyday sensory experiences.
Role of Occupational Therapists
OTs must train caregivers and families to implement the protocol safely. Proper pressure, sequence, and frequency are critical—incorrect application may cause discomfort or increased defensiveness. OTs also monitor client progress, adjusting frequency or combining the protocol with other sensory integration strategies as needed.
Evidence and Clinical Considerations
While many therapists report positive clinical outcomes, research evidence is mixed. Some studies show improvements in behaviour and daily participation, while others highlight the need for stronger trials. Therefore, OTs should always use clinical reasoning, consider individual needs, and obtain informed consent before implementing the protocol.
Integration with Broader Interventions
The Wilbarger Protocol is often combined with sensory diets, play-based activities, or environmental modifications. For example, children may receive brushing sessions before engaging in fine motor or classroom tasks, improving readiness and attention. AI-assisted tools can support OTs by tracking session frequency, documenting caregiver reports, and generating compliance-ready progress summaries.
Privacy and Compliance
Because this intervention is often part of NDIS or school-based plans, documentation must comply with the Australian Privacy Principles (APPs). AI platforms provide secure storage, encryption, and audit-ready reports, ensuring sensitive child information remains protected.
Conclusion
The Wilbarger Brushing Protocol offers a structured way to address sensory defensiveness through tactile and proprioceptive input. In Australia, OTs use it as part of broader sensory integration strategies, supported by family education and consistent monitoring. Therefore, while not a standalone cure, the protocol remains a valuable tool when applied safely, ethically, and in line with best-practice frameworks.