After I read this book about sensory defensiveness I became very curious about sensory brushing, but it was hard to find much information about what it actually was, what it felt like and whether it would be a good fit for my personal sensory issues. I also wanted to know whether research confirmed its efficacy, since the author swore by it and said it truly changed her life. Many occupational therapy techniques do not have a strong backing with research, and sensory brushing is no exception to that. That said, many clinicians still like using the technique. Occupational Therapists (OTs) are pragmatists and problem solvers and if something works for some of their patients, they will continue to try it. However, I would be a bit hesitant to trust an OT that raves about sensory brushes, overstates its benefits or doesn’t see the downsides.
First off, let me say that sensory brushes are extremely cheap and easy to acquire. I would not recommend trying them without guidance from an OT or other trained professional. When I bought mine I saw reviews from parents who had “identified” their kids as having autism or sensory processing disorders and were just rubbing them on their kids. I can’t speak to the circumstances or health histories of these children, but the reviewers would say they just rubbed them on random parts of their children’s bodies during a meltdown and they instantly calmed down. While it’s not impossible, randomly rubbing a sensory brush would be very unlikely to actually calm down an autistic or sensory-defensive child. I’m sure there are kids where if you introduced it correctly they could grow to use it that way. But I think more likely some people may be getting some benefits using them strangely as a placebo.
But trust me when I say there is a dark side to sensory brushing that is truly distressing in a way an autistic child might not be able to communicate. I don’t intend to scare anyone away from sensory brushing, but it should be taken seriously and watched for if you intend to add it to your own or your child’s sensory diet. I have an exfoliating brush I used to use that would cause physical illness later in the day if I brushed too hard, even though it felt good when I was brushing, as it would disrupt my system so much. A sensory brush is softer but can still disrupt your system if you apply pressure incorrectly. After several weeks of use in OT, the first week I was doing it myself at home (as an intelligent adult) I was holding the brush the wrong way and it made all the parts of my body feel much more sensitive and I was on edge emotionally. Basically the brushing felt ok with too much pressure, but the rebound sensation was awful, and much worse than if I hadn’t brushed at all those days. Some OTs don’t use it because of the possible downsides, when other options are much more harmless.
So why do I do it? For me, sensory brushing is used to help lessen my startle response and discomfort when my neck is lightly touched. At its worse it is bad enough I might push my child out of my lap and yelp if their hair brushes against my neck during story time, but most of the time I can suppress that (but suppressing it still leads to pain and anxiety and an increased likelihood I might meltdown later). I look at sensory brushing as a sort of controlled exposure therapy and when I do it for myself I focus on staying mindful and present in the midst of unpleasant sensations.
Others use sensory brushing to manage behavior or increase overall sensory input for calming. A lot of the research focuses on the behavioral management.
So what is the process like? How does it feel? Remember, I am only speaking for myself and my own experience. We do ten strokes in a specific direction on specific parts of my body. When the pressure is right (for me) the first few strokes will feel a bit bad, like a very annoying light tickle or kind of a vibrating pain (like how getting a haircut with clippers might hurt on a sensitive day), but the bad feeling lessens as we get to ten. We take breaks when it is too much and if negative sensations are increasing too much. We have not gotten to the point where we actually brush the area that is sensitive, the therapist plans where the strokes go based on which nerves would feed to that area. He talks about “waking up the nerves” which honestly sounds like woo to my very analytical brain, but I also recognize that for most medical or therapeutic practices the actual mechanism for why it works or doesn’t work isn’t really understood. (For example, scientists don’t really understand why anti-depressants work, but they clearly do for some people.)
The book I mentioned earlier is very enthusiastic about the The Wilbarger Protocol. I don’t know a lot of the specifics in terms of direction of brushing and how it differs from the way my OT uses the sensory brush, but the Wilbarger Protocol requires brushing at a minimum every two hours. Personally, I’m pretty skeptical of its effectiveness. It seems likely taking a break every two hours to do anything would help with emotional regulation. A lot of adults take a break every two hours to smoke and if they quit. I’ve known people to quit smoking and just keep vaping without the nicotine so they continue to have that break. I am sure there exist people who sensory brushing every two hours is the best way for them to stay emotionally regulated, but I’d say for most people they’d be better off just wrapping up in a weighted blanket and zoning out (or meditating).
Sensory brushing is said to help because of Deep Pressure Touch. There are other ways to get this. Weighted blankets, scarves, wraps, stuffed animals, etc. are a better at home option, in my opinion, if you can’t get into OT. While weighted objects don’t always help, I think it’s easier as an adult (or child) to be able to quickly tell it’s not helping and push it off. The impacts of sensory brushing, in my own experience, tend to be on a delay. Which is why just incorporating it into your day randomly could be detrimental. I find weighted blankets to be overstimulating unless I’m fully melting down and certainly can’t sleep with one, but I love my lap pad and my weighted scarf. They have helped me tremendously with driving, which can be an overwhelming experience for me.