The Wilbarger Brushing Protocol: 4 Reasons to Be Careful
The Wilbarger brushing protocol, formally known as the Wilbarger Therapressure Program, has grown in popularity as a way to help kiddos with sensory challenges through the use of deep pressure.
The basic idea of the Wilbarger Brushing Protocol is to run a special brush throughout various patterns over a child’s body, which is then followed by joint compression.
This protocol was designed by Patricia and Julia Wilbarger, a mother daughter team of occupational therapists who specialize in tactile defensiveness and sensory integration. It wasn’t long before it took the OT world by storm and now can be seen all over the internet.
For better and, sometimes, worse.
Now, let me be clear that the Wilbarger brushing protocol was developed by some of the top experts in the sensory field and should definitely be taken seriously.
The problem is that the Wilbarger brushing protocol has become popularized, which can give the false allusion that it can be easily learned from a YouTube video. This isn’t the case. Anyone who performs this protocol should have specialized training that usually takes the form of an extensive workshop or mentorship from another expert. Failing to do so can result in mistakes and performing the protocol in an improper way that could make things worse. Don’t be tempted by how easy the videos make it look. Be sure to work with a therapist who is trained in this protocol if you want to learn more about whether it’s a good choice for your kiddo.
In this post, we’re going to talk about why it’s so important to work with a trained therapist when considering the jump into the Wilbarger brushing protocol.
1) Is the Wilbarger brushing protocol effective?
Like many things, it depends.
When it comes to sensory issues, very few things are black and white. Every kiddo is different and will respond to different treatments. Even two kiddos that respond the same way to the same treatment will have nuances in the way that treatment needs to be performed to be the most effective for their specific needs. This is why sensory issues can be such a fun, but frustrating, challenge.
There is a lot of information online claiming that the Wilbarger brushing protocol is effective. Sure, it definitely can be. But, for who? Blanket statements about effectiveness are never true, as everyone is different. If a cure-all for any problem was ever discovered, there’s no doubt it would be a top headline in the New York Times and you would hear about it.
Certain treatments work for certain people based on their needs. I mean, have you seen Temple Grandin’s Squeeze Machine?
The research on the Wilbarger brushing protocol demonstrates the importance of this individual adaptation. Instead of there being a conclusive answer as to whether it works or not, each study shows varying results depending on who was being studied and the circumstances under which the treatment was being carried out. Here are some of the results that studies are pointing to:
Reading the results of those studies, you may be wondering why there is any question about whether the Wilbarger Therapressure Program is effective. Not so fast.
In the grand scheme of research, the amount of formal research that has been done on the Wilbarger technique is pretty minimal. The handful of research available makes it hard to take a firm stance on who, when, where, and how this technique is most beneficial. In fact, some research has found that the lack of high quality evidence available means that we can’t prove or deny whether the Wilbarger brushing protocol is effective or not.
I’m of the opinion that the Wilbarger brushing protocol is an interesting technique developed by some amazing OTs who have an insane amount of knowledge about sensory issues and how to treat them. The reason I want to highlight the lack of research is not because I want to knock the protocol in any way, but because we need more of it to ensure that we all are performing the technique correctly. As we’ll talk about next, a lack of information can lead to mistakes that can actually make sensory issues worse instead of better.
Anecdotal evidence is great, sometimes, but confusing
There’s no doubt that anecdotes can be helpful in making a decision about something. We hear that a friend loves a restaurant, so we decide to go there the next weekend. The problem with anecdotes though is that it’s impossible to control the factors and know exactly why someone had a positive or negative experience. Maybe this friend really loves seafood, but we would have preferred a place that serves chicken. Maybe this friend loves loud sports bars, while we would have preferred a quieter environment. By design, anecdotes are infused with personal opinion, which makes it hard to know whether it is applicable to us or not.
Looking through blog posts about the Wilbarger brushing protocol, you’ll see a wide range of positive and negative experiences that people have had with it. While these stories tell us the results, they don’t tell us the circumstances. Maybe someone who had a negative experience didn’t perform the technique properly. Maybe someone who had a positive experience made adjustments to the technique that we don’t know about.
While anecdotes can be helpful, they can’t be a replacement for scientific research.
2) It’s hard to find an official Wilbarger brushing protocol training
A study of 153 practitioners who claim to use the Wilbarger Therapressure Protocol in their practice found that only 48% had received hands-on training and 39% attended a class taught by the Wilbargers. It’s not surprising, as workshops seem to be infrequent from what I can tell.
In addition to the lack of hands on workshops, a standardized protocol for implementation hasn’t been published. This means that there are quite a few people that are using the Wilbarger brushing protocol without formal training and little way of determining what the best practices are.
As a result, when you research specifics on performing the technique, you’ll see some differences in the instructions. This doesn’t mean they’re wrong, but it also doesn’t mean they’re right. We just don’t know.
To make matters worse, there are many variations in brushes you can buy on Amazon that say they’re for the Wilbarger brushing protocol. Supposedly, there is an official Wilbarger Therapressure brush, but I can’t find it.
Since I love being repetitive, let me say again that you should never ever implement any new type of treatment for your kiddo without looping in your occupational therapist and receiving specific instructions on what to do. This includes the Wilbarger brushing protocol. Ask questions about what your therapist knows about the technique, the impacts they believe it would have on your child, and whether they have received any formal training in it. If you have a great therapist, they’ll guide you in the right direction.
3) It’s easy to do the Wilbarger brushing protocol wrong
Yes, we just talked about how it’s hard to tell the difference between right and wrong to begin with. But, you will definitely find out the hard way if you did it wrong.
As you know, the Wilbarger brushing protocol involves a lot of deep pressure and sensory stimulation. More often than not, we’re applying this technique with kiddos who have sensory challenges and are really sensitive to sensory input. If done incorrectly, the Wilbarger brushing protocol could actually aggravate and worsen sensory issues instead of calming and improving them.
Have you ever gotten a massage that did more harm than good? Maybe the masseuse used too much pressure and made it a painful experience. Maybe you left feeling sore instead of relaxed. Doing the Wilbarger brushing protocol incorrectly is like getting a bad massage, but 10x worse. Delivering sensory input to kiddos with sensory defensiveness isn’t something to take lightly. Doing so incorrectly could have negative consequences that are tricky to resolve.
The Wilbarger brushing protocol is extensive and requires a big and strict time commitment. In order to perform it correctly, you need to know exactly what to do and what not to do to achieve the results you’re looking for.
It’s worth repeating that you need to be working with someone who is trained in the technique and can give you very specific instructions on how to do it properly.
4) Every kiddo is different
We’re going to close out this post the way we started it. The problem with every therapy treatment, including the Wilbarger brushing protocol, is that all kiddos have specific needs and will respond to treatment differently. Just because another child in your therapy group has had a positive experience doesn’t mean that your child will too.
In the same way that kids prefer different colors, foods, TV shows, and activities, they’ll also prefer different treatment styles. Everything requires experimentation and guidance. As the proud broken record that I am, it’s important for me to say again that it’s important to be working with great therapists and doctors you can trust.
If you made it to the end of this post, you’ll realize that I can’t say whether the Wilbarger brushing protocol is a good choice for your kiddo. It will depend on what they need. As with any treatment, it’s important to be discerning about the choices you make for your child. Work with your treatment team to determine the best strategies that will lead your kiddo to success.