Sunday, April 5, 2009

Deep Pressure and Proprioceptive Technique (DPPT) or the Walbarger Brushing Technique and Joint Compression

Our son doesn't like us to touch his right hand and always makes a "yucky" face with the first bite of every meal. We continue to expose his hands to different textures, which will hopefully help desensitize his hands. He seems to have decreased proprioception in his hands and feet, as well as some tactile sensitivity.

If you're anything like me, you're probably thinking "What is proprioception?". Well, proprioception means "one's own" perception. It is the awareness or sense of one's own limbs in space. I found this information from interesting "Without proprioception, we'd need to consciously watch our feet to make sure that we stay upright while walking." Our son does tend to watch his feet while walking.

One technique that may help with these issues is Deep Pressure and Proprioceptive Technique (DPPT) or the Walbarger Brushing Technique and Joint Compression.

** This should only be done with supervision from an Occupational or Physical Therapist. **

The brushing technique was developed by Dr. Patricia Wilbarger. Dr. Wilbarger, is an occupational therapist and clinical psychologist who has been working with sensory processing theories for over 30 years.

"The DPPT uses a specific pattern of stimulation delivered through a specific type of brush and gentle joint compression or “pushing” to send information to the brain in an organized fashion. Simply put, it primes the brain to receive and organize information in an effective and useful way. It is done approximately every two hours for a specified number of days and then according to the needs of the child. Consistency is a critical factor! However, the protocol can be administered in between scheduled sessions, to assisting with transitions between activities, reducing overwhelm reactions, and re- organizing the nervous system after emotional upset.

The brush used for this technique, is a soft plastic surgical brush. This brush has been found to be the most effective in stimulating nerve endings in the skin. The actual brushing is done using a very firm pressure, starting at the arms and working down to the feet, avoiding the chest and stomach. The brushing is slow and purposeful providing “proprioception” (input through muscles and joints.) It is not ‘scrubbing’, and should never be painful, or cause damage to the skin. Children may initially react with crying or other avoidance measures because it is new, and the re-organizing can be disquieting. Generally within a few sessions, it becomes pleasurable and children will often ask for it or do it themselves.

The joint compression is also done in a specific pattern; ten count repetition, using light pressure. Students can be taught to do this themselves, by using an alternative method of ‘wall’ push-ups, and jumping."



  1. My six year old daughter has Cerebral palsy as well. We discovered it at a year of age. We had experience using the Walbarger technique. It seemed to work well for a while but she eventually stopped responding. At any rate you mentioned that your son tends to stare at his feet. This is common in children with CP especially as they learn to walk. According to our PT its not just a propriception issue but also a visual focus and processing issue ie. too much input by looking further out then the feet. I don't know but it sounded reasonable. Anyway I'm glad I found your site. Have you done any research on selective dorsal rhizotomy yet? How about Bo-tox?

  2. Kevin - it's great to hear that your daughter responded to the Walbarger technique. I haven't done any research on selective dorsal rhizotomy yet. I've heard about Botox and it's on my list of topics to write about. Thanks for the comment.

  3. We have done a spurt of Brushing and helped my daughter get over a 'sensory hurdle' as we call it. 'Brushing' calmed my daughter down and slowed a lot of her sensory seeking behaviors. Her Pre-School teacher immediately noticed a difference as she would not get overstimulated and into trouble, if I forgot to brush her, chances are a time-out was needed at some point in the day.