By: Stephanie Montana, MS, OTR/L
If an occupational therapist has performed “brushing” during your child’s therapy session or recommended it to be part of their home program or “sensory diet,” it is important that you first understand who is a candidate, what is brushing, and why it is important.
Who is a Candidate?
Brushing is part of the Wilbarger Brushing Protocol and is used among children with sensory processing and self-regulation difficulties. Self-regulation is the ability to maintain a regulated state and stay in the “just right zone” despite changes in the environment. Every day, the central nervous system takes in information through the eight senses, processes the information, and creates an appropriate response to allow us to engage in our environment and function in our daily life. Children with sensory processing difficulties may exhibit signs of over-responsiveness or under-responsiveness because they have difficulty using the sensory information they take in from their environment to behave in an effective way. As a result, this may cause the nervous system to go into “fight or flight.” Not responding appropriately to sensory information can make it difficult for a child to effectively engage in daily tasks and the world around them.
What is Brushing and How to Perform it?
When performing brushing, it is important to know a typical hairbrush or toothbrush is not being used. Instead, a special sensory brush that looks like a soft surgical brush is used to provide the right sensation to the skin. While holding the brush horizontally, long strokes with firm, even pressure are used across the arms, legs, feet, and back to apply deep pressure tactile input. Due to increased sensitivity, the stomach, chest, and face areas are avoided. Following brushing, ten joint compressions are performed to the wrist, elbow, shoulder, ankle, and knee joints to provide proprioceptive input, which tells your body where it is in space. Providing both tactile and proprioceptive input on a regular basis has a calming effect on the central nervous system. However, before completing the brushing protocol at home, it is important to be taught by a trained occupational therapist to ensure the techniques are being performed correctly. If an occupational therapist prescribes a home program or “sensory diet” that includes brushing and joint compressions, try to make it fun while performing it with your child. For example, pretend to “paint” your child’s arms and legs with the brush, followed by “drying” the paint with the joint compressions.
Why is Brushing Important?
The brushing protocol is utilized to help calm and organize the central nervous system to improve self-regulation and sensory processing. Brushing provides tactile input which releases dopamine, while joint compressions provide proprioceptive input which releases serotonin. Dopamine and serotonin are neurotransmitters that make us feel good and counteract the effects of the stress hormones adrenaline and cortisol. This decreases the “fight or flight” response and keeps a child in the “just right zone” to engage in everyday tasks. Providing tactile and proprioceptive input regularly will begin to change your child’s neurochemistry, leading to improvements in the ability to effectively engage and interact within their environments. These benefits may include improvements in focus and attention, regulating emotions and actions, transitioning smoothly between tasks, increased balance and coordination, and decreased sensitivity to touch. For any additional information on sensory processing, self-regulation, and the brushing protocol, please feel free to contact the occupational therapy department at CommuniKids or learn more here and here.