Prainito Pediatric Therapy
Aimee Prainito, MA, OTR/L
1885 Meadowchase Court
Snellville, Georgia 30078
Phone: (770) 601-5004 Fax: (770) 797-5928
Email: aprainito@prainitopediatrictherapy.com
www.prainitopediatrictherapy.com
The Wilbarger Protocol for Sensory
Defensiveness
The Wilbarger Protocol (Wilbarger & Wilbarger, 1991) is a specific professionally guided
treatment regime designed to reduce sensory defensives which involves the provision of
deep touch pressure throughout the day. This technique was developed by Patricia
Wilbarger, an occupational therapist, who specializes in sensory defensiveness. The
technique has its origins in sensory integration theory.
This technique needs to be taught and supervised by a trained occupational therapist that
has expertise in the area of sensory integration. Here is a sample of the instruction sheet
that we provide our clients.
Purpose: To treat sensory defensiveness by decreasing the state of arousal (calm),
normalize responses to touch, help the child relax and become more aware of his/her body
to improve attention and purposeful movements.
Wilbarger Protocol
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Apply heavy, consistent pressure, on the arms, hands, back, legs and feet in an up
and down motion using the special surgical brush provided.
Always keep in physical contact with the child.
The brush should be held horizontally to provide input on the arms and legs. You can
brush over the clothes of a sensitive child who isn’t comfortable with the brush
directly against their skin. When brushing over the clothes, hold the brush
vertically for stronger input.
Repeat the procedure every 90 minutes to two hours (six times per day). The input
provided by this protocol to the nervous system lasts approximately two hours.
Repetition on this schedule keeps the input to the nervous system consistent.
The order of the body parts brushed does not matter. Following with joint
compression is essential.
Prainito Pediatric Therapy
Aimee Prainito, MA, OTR/L
1885 Meadowchase Court
Snellville, Georgia 30078
Phone: (770) 601-5004 Fax: (770) 797-5928
Email: aprainito@prainitopediatrictherapy.com
www.prainitopediatrictherapy.com
Method
Brush up and down the arms three times while holding the hand and rotating the arms to
brush the surfaces of the front and back.
 Brush the back of the hands in the same manner as the arms but scrub the palms of
the hand quickly for approximately five seconds.
 Perform the process on both arms and both hands.
 Brush the back (up and down, side to side and in circles – all strokes are acceptable
(brush back between brushing of right and left arms).
 Brush legs and feet in same manner as arms. Scrub the bottoms of the feet as well.
 Order of the body parts brushed does not matter. Following with joint compression
is essential.
Note: Brushing must be followed by the following joint compressions, repeating
compressions 10 times. Ensure joints are supported in alignment and again, order of joint
compressions does not matter.
Numbers 1 -5 are done on both sides of the body.
1. Hand to Elbow
Elbow – hold hand in handshake position, stabilize elbow and quickly press hand
back into direction of elbow.
2. Elbow to Shoulder
Shoulder – stabilize elbow and quickly press down at shoulder
3. Hips to Knees
Hips – preferable in seated position, press knees back into hips
4. Knee to Foot
Knees – press down on knees through the ankles and onto the floor
5. Fingers to Elbow
Fingers – stabilize palm and quickly pull out and in on fingers
6. Shoulders – press down on both shoulders 10x
Prainito Pediatric Therapy
Aimee Prainito, MA, OTR/L
1885 Meadowchase Court
Snellville, Georgia 30078
Phone: (770) 601-5004 Fax: (770) 797-5928
Email: aprainito@prainitopediatrictherapy.com
www.prainitopediatrictherapy.com
What to keep in mind:
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The brush needs to be held horizontally to the arms or leg and sufficient pressure
needs to be exerted to flatten the bristles.
The complete routine should only take about three minutes.
PRECAUTIONS:
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Avoid brushing over skin lesions, burns, rashes or other sensitive areas.
Report any unexpected responses to the occupational therapist.
Avoid reddening the skin.
Joint problems or deformities must be taken into account.
CAUTION: NEVER BRUSH THE FACE, INSIDE OF THIGHS OR
STOMACH (can elicit vomiting and rapid heartbeat!!)
AVOID BRUSHING THE HEAD, NECK AND CHEST!!
ONLY USE THE BRUTH GIVEN TO YOU BY THE THERAPIST.
AVOID LIGHT BRUSHING AND TOUCH.
Notations: Observe the child. The effects last approximately 90 minutes. When the child
starts showing signs of disorganization, stress, etc. intervene with brushing if after 90
minutes. If questions arise or if really unusual behavior occurs, please notify your
therapist.
Consistency is important. Technique is important. Timing or scheduling is important.
Expect the child’s reactions to brushing to vary, change over time or from brushing to
brushing.
ALWAYS USE UNDER THE DISCRETION
OF AN OCCUPATIONAL THERAPIST!!!