Child & Family Development Child & Family Development

April 29, 2016

Occupational therapists recommend Therapressure for sensory defensiveness


The occupational therapy team at Child and Family Development often recommends the Therapressure Program‚Ñ¢ Protocol for treating sensory defensiveness.

This protocol was developed Patricia Wilbarger M.Ed., OTR, FAOTA and there are many online resources to learn more:

WHEN?  For optimal benefit, the Therapressure Program (both the deep touch input with a brush and the joint proprioception) should be applied every 90-120 minutes or 8-10 times per day.  If performed less often, the benefit may be lessened.  Each routine takes approximately 3-5 minutes.  The program may be used before the 2 hours are up if the child is having difficulty with waking up after having a night terror, acts overwhelmed, and before/after a difficult transition.  The objective is to keep the calming input in the child‚Äôs system to help the child remain in optimal zone of sensory modulation (calm and alert and not overly aroused).  

HOW?  Deep touch input is provided with a specially recommended brush using firm, even pressure.  Do not sweep with the brush.  Hold the brush horizontally.  Think of steam cleaning and press hard enough to bend the bristles.  You may brush over clothing if you pull the clothing tight to maximize the pressure.  Effectiveness is lessened over clothing. 

  • Begin with the arms, then hands, back, legs, and feet
  • Spread your fingers over the brush to apply pressure across the entire surface of the brush.
  • Use long, even strokes in an up and down motion covering as much area as possible

Joint Proprioception immediately follows the deep touch input with the brush.

  • Shoulders: Put one hand on top of child‚Äôs shoulder and the other hand at the elbow.  Push towards the shoulder 10 quick compressions.
  • Elbows: With one hand grasp arm just above the elbow and with the other, grasp the child‚Äôs forearm.  Push towards the elbow 10 quick compressions while keeping the elbow straight. 
  • Wrists: With one hand grasp just above the wrist and the other hand grasps the child‚Äôs hand. Push the hand gently towards the wrist 10 times.
  • Hips/Knees/Ankles: Place one hand firmly over the hip bone and the other hand at the base of the foot.  Push the foot towards the hip, keeping the knees straight, for 10 quick compressions. 
  • Fingers/toes: Place one hand across the knuckles of the fingers/toes and with the other hand gently cup the tops of the fingers/toes and gently push towards the knuckles 10 times. 
  • Back/Chest: Place one hand on the back, between the shoulder blades and place the other hand on the breastbone.  Gently push both hands down and in at the same time 3 times (not 10 times)

 Additional sensory diet recommendations are provided by an occupational therapist.