Tag Archives: sensory sensitivity

Brush It Off! Brushing Protocol for Sensory Integration

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Therapeutic brushing may be recommended for your child due to tactile defensiveness, or difficulty tolerating a variety of textures. However, engaging in a therapeutic brushing protocol may also help to ease sensory-based anxiety, promote falling asleep, increase attention to task, increase coordination, and overall self-regulation.

What is Therapeutic Brushing?

The Wilbarger Deep Pressure and Proprioceptive Technique (DPPT), also known as the Wilbarger Brushing Protocol, is often used by occupational therapists to promote sensory integration. It is typically used with children demonstrating sensory defensiveness, or children who exhibit signs of over-responsiveness in the protective responses of the nervous system. Oftentimes, it is used with children who exhibit tactile defensiveness, or difficulty being touched by people or a variety of textures.

What Does the Protocol Look Like?

DPPT begins with systematic brushing of the body, followed by joint compressions to a child’s arms, legs, hands, feet, and head. Brushing is completed using a soft surgical scrub brush, often called a Therapressure brush. The correct brush is required in this protocol, as it provides a specific type of sensation to the nerve endings in the skin. Firm, even pressure is used to sequentially brush the arms, back, legs, and feet. Areas such as the stomach and chest are always avoided, as they are particularly sensitive. Following brushing, 10 joint compressions are provided to the child’s hands, wrists, elbows, shoulders, hips, knees, ankles, and feet using gentle pressure. This provides the child with deep pressure proprioceptive input which is calming to the nervous system. The protocol is repeated approximately every two hours while the child is awake. DPPT must always be taught by a trained therapist to ensure that it is safe, effective, and beneficial for the child.

What Does Brushing Do for Sensory Integration?

The brushing portion of DPPT stimulates the nerve endings of the skin, generally serving to “wake up” the nervous system. The joint compressions provide the body with deep pressure proprioceptive input, which typically calms nervous system. Performing the two elements of the protocol helps the central nervous system to better utilize information from the nerve endings of the peripheral nervous system more effectively. This can result in increased overall regulation, decreased anxiety to sensory triggers, and improved ability to transition between challenging tasks.

Who Would Benefit from Therapeutic Brushing?

Your child may benefit from DPPT if he or she:

  • Demonstrates difficulty being touched, wearing a variety of clothing, or tolerating a messy play.
  • Becomes reactive with grooming activities, including having his or her hair washed, or fingernails clipped.
  • Demonstrates difficulty maintaining a calm, alert, and organized state.
  • Experiences difficulty calming down and falling asleep at night.
  • Demonstrates difficulty transitioning between activities
  • Appears to have trouble noticing when he or she is hungry or needs to go to the bathroom.

Questions or concerns?

If you think your child could benefit from DPPT, please reach out to your occupational therapist or  us at info@playworkschicago.com or 773-332-9439.

Natalie Machado, MS, OTR/L
Occupational Therapist

References:

OT-Innovations.com. (2018). Therapeutic brushing techniques. Retrieved from https://www.ot-innovations.com/clinical-practice/sensory-modulation/therapeutic-brushing-techniques/.

Activities for All: December Family-Friendly Events

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Sensitive Santa

Time: Sunday, December 8 from 9:00am-11:00am.

Location: Lincolnwood Town Center

Cost: Free

About: Visiting Santa is a winter tradition for many families. However, if your child has sensory sensitivities, it can be a difficult experience. Opening before regularly scheduled activities begin, Sensitive Santa allows for a sensory-friendly environment so that all can enjoy meeting Santa.

Play for All

Time: Saturday, December 14th from 9:00am to 10:00am

Location: Chicago Children’s Museum

Cost: Free to the first 100 visitors to register

About: On the second Saturday of every month, the Chicago Children’s Museum opens one hour early and invites children and families with disabilities to come explore the museum in a quieter, less stimulating environment.

Sensory Friendly Beatrix Potter Tea

Time: Sunday, December 15th at 11:30am and 2:30pm

Location: The Station, 100 S. Racine Ave. Chicago, IL. 60607

Cost: $45

About: This puppet show, staring Peter Rabbit and his animal friends, is performed in a sensory-friendly environment. Guests are encouraged to dress in their holiday best, or wear whatever is most comfortable for them. Cookies and hot cocoa will be served following the show.

Sensory Friendly Performance of A Christmas Carol

Time: Monday, December 23rd at 2:00pm

Location: Goodman Theatre

Cost: Tickets start at $15

About: The Goodman Theater is putting on a sensory-friendly performance of A Christmas Carol. The sensory-friendly accommodations include lower sound level, lower lighting level, small crowds, designated quiet areas, and a space for movement breaks.

Sarah Lydon, MA, CCC-SLP
Speech-Language Pathologist

Photo Credit: Cooper Le on Unsplash

Boom, Bang, Chirp: the Sounds of Summer and the Auditory System

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Summertime is filled with distinct noises, like that of a fire engine in the Fourth of July parade, fireworks exploding in the sky, or the steady hum of crickets chirping in the yard. For some children, these sounds can be quite stressful. Like the other sensory systems (touch, taste, smell, sight, etc), your child’s sense of hearing, or their auditory system, takes in information, processes it, and produces an external response. Sometimes, this information isn’t processed correctly. In these cases, your child may demonstrate hypersensitivity or hyposensitivity to sound, and those fun summertime activities become a source of anxiety for your little one.

What is hypersensitivity?
If your child seems to overreact to everyday sounds or seems easily distracted by noise that you are able to tune out, she is demonstrating auditory hypersensitivity. Your child may experience an intense fear of mechanical items with “whirring” sounds, such as vacuum cleaners, hand dryers or flushing toilets in public restrooms, blender, hairdryer, and coffee grinder. She may overreact to unexpected sounds by covering her ears or crying. She may seem to be overly tuned in to background noise in the environment, such as the fan spinning or the clock ticking.

What is hyposensitivity?
If your child seems to enjoy loud noises in his environment, demonstrates difficulty figuring out where a sound is coming from (localizing), and/or has difficulty figuring out what a sound is (distinguishing), he is demonstrating auditory hyposensitivity. Your child may constantly create noises with his mouth throughout the day. He may prefer to keep the television very loud, but become upset when others speak loudly. He may have difficulty hearing and responding when his name is called, especially from another room.

What causes these kinds of sensory auditory dysfunction?
The stapedius is a middle ear muscle that contracts in response to loud noise in order to protect the small hair follicles on our inner ears. Scientists say that sensory-based auditory issues may be due to a poorly-functioning stapedius. The middle and inner ear muscle systems are also important in the function of other sensory structures, such as the vestibular system – which determines your child’s equilibrium and balance.

What can I do?
If your child is demonstrating some of the behaviors above, consider contacting one of our occupational therapists, who can provide your family with helpful tips and tricks to minimize distraction, utilize noise-cancelling items, work through difficult school-based tasks, and more! If your child is demonstrating difficulty with language interpretation, difficulty learning to read, and/or a speech delay that are accompanied with the symptoms listed above, he may be experiencing Auditory Processing Disorder (APD). APD is dysfunction in the brain’s ability to translate sounds. An audiologist can help identify the issue and provide suggestions for next steps.

Questions or concerns?
If you have questions or concerns about your child’s responses to noise, please contact us at info@playworkschicago.com or 773-332-9439.

Jen Brown, MS, OTR/L
Director of Occupational Therapy Services

Reference: Dodd, George. (2002). Distinguishing sound from noise- the significance of attention and noise sensitivity. The Journal of the Acoustical Society of America 112, 2243. 25 October 2002. https://doi.org/10.1121/1.4778910