I don’t know what it is lately. Cali says “My feet are dirty!” about 5 or more times a day. To you, this may seem like a very easy issue to figure out. A child tells you their feet are dirty. What do you do? You help them clean the “dirty” off. The child’s problem is fixed and they move on with their day.
I agree. The expression “My feet are dirty!” seems easy enough to fix, but not when “dirty” is code for who knows what! Sometimes Cali’s feet are legitimately dirty, but other times I look at her feet and they are squeaky clean. I look in her shoes to find no rocks, sticks, or sand. What in the world does dirty mean?? Are her feet hot and sweaty? Are they tingling or burning? Do they feel sticky?? I have no idea. So where do I go to find the answer when Cali is not able to explain her meaning of “dirty”…her therapists of coarse! Every child needs there own personal therapist. Seriously! I feel like they are my walking handbook to parenting. Thanks Dawn, Madi, and Krisanne. Y’all are my secret weapon to unanswered questions!!!
This particular issue called for Krisanne’s knowledge. Cali not being able to tolerate her dirty feet is a sensory defense issue which falls under the occupational therapy realm. Yesterday was therapy with Krisanne, so I asked her, “Do you know why Cali has this obsession with kicking off her shoes and passionately expressing her dislike for having dirty feet?” Not a second past before Krisanne pulled out a box from her closet and starting working with this magic brush. It’s called a Therapressure Brush and it specifically works to help alleviate sensory defensiveness and to put the mind at ease.
She didn’t just stick with the brush though. She coupled the brush with joint compressions that together work as a sensory protocol called The Wilbarger Protocol (Deep Touch Protocol). Rather than try to describe the details of this method, I’ll allow Krisanne to speak for herself and educate us all a bit more than I ever could…
The Deep Touch Protocol (also referred to as “brushing” or “therapeutic brushing”) is a specific technique used primarily with children exhibiting sensory defensiveness. The technique involves the application of deep pressure (through the use of a specific type of brush) over the arms, legs, and back, followed by joint compressions. It is important to note that there is very little documented research regarding the effectiveness of the Deep Touch Protocol. However, anecdotal evidence exists in which the technique has resulted in decreased anxiety, a reduction in sensory defensiveness, improved social interactions, and improved behavior. The technique is not appropriate for every child and it is important that it be administered under the supervision of a trained occupational therapist.
The technique begins with the application of deep pressure to the arms, legs, and back, using slow, methodical strokes. The face and stomach are NEVER brushed (sensitive and cause a sensory overload), and the inner arms and thighs should be avoided (although Krisanne did inform me that if your child can handle it and you, as the parent, feel comfortable brushing your own child on the inner arms and thighs, than this is acceptable). It is important to avoid “scrubbing” the same area repeatedly (the entire process should take 3-4 minutes). The deep pressure input is always followed immediately by joint compressions to the shoulders, elbows, wrists, fingers, hips, knees, and ankles. The routine should be repeated every 90 minutes to 2 hours throughout the day (this helps to maintain the effects of the brushing at a constant level, and keep the child’s sensory modulation at an optimal level; however, see my own personal not below).
The following precautions should be followed carefully:
1. Do NOT brush over cuts, rashes, burns or other areas of sensitive skin.
2. Monitor the child carefully and note any unusual or unexpected behaviors/responses.
3. Do NOT scrub back and forth over the same area of skin. If the skin reddens, you are probably spending too much time on one spot, and this may indicate a histamine reaction.
4. The protocol should be monitored closely by a trained occupational therapist. (or in other words, my words, have an OT show you how and then continue on your own at home or wherever else)
5. The specific protocol should be followed carefully in order to maximize results
How to hold the brush:
It is important to apply smooth and even deep pressure directly to the skin. Hold the brush horizontal to the direction of the stroke when going over the skin. Hold the brush vertical to the direction of the stroke when going over fabric. If brushing over clothing, it is important to stabilize the clothing so it does not move over the surface of the skin as the stroke is made.
Brushing should be followed by quick compressions (shown in the video below). Compression is given as 10 quick presses to the key joints of the upper and lower extremity. Give compression into the shoulders, elbows, wrists, and into the hips, knees, and ankles. Quick compressions fool the brain into thinking the bone may become displaced so all the proprioceptors in the immediate area fire at once to stabilize and protect the joint. (Krisanne also mentioned certain chemicals that become released when these proprioceptors are activated. The chemicals help to calm and focus the body. You can read a previous post about this subject here. She compared it to yoga. In yoga your proprioceptors are constantly being activated and in the end you always leave feeling calm yet alert. Yes, these two seem to contradict one anther, but it’s true. Im no yoga person but when I have participated in a session I do leave feeling this way.)
Here is a video of the Wilbarger Brushing Protocol in action…
Krisanne gives a suggested amount of time to use this technique. For a kid like Cali who doesn’t deal with major sensory defensiveness, I don’t think it would be necessary to carry out the protocol for the recommend amount of time. But remember I am no therapist, I’m just throwing out my own opinion here.
Go purchase a Therapressure Brush. They are inexpensive and I think a pretty unique and affective tool.