Brushing used with Joint Compression Protocol

Brushing is a technique used in sensory integration treatment to promote self-organization and attention as well as to decrease signs and symptoms of sensory defensiveness.

“Our skin is our largest sensory organ, followed closely by our muscles and skeleton, connected by our nervous system, and governed by our brain.  The sensory systems feed information from our environment, through sensory receptors, and neural impulses via our nervous system, directly to the brain.  The brain then organizes it, sends it back through the nervous system for use as understanding, adaption, learning, and skill development.  When this system functions well, it allows a person to interact with their environment efficiently, developing necessary motor and language skills, and appropriate social/ emotional behavior.  When this system is unable to organize the information appropriately, a variety of symptoms can present; motor delays, tactile defensiveness, learning disorders, social or emotional difficulties, speech, and language deficits or attention disorders.” (Champagne, T., 2007)

Benefits of deep pressure and proprioceptive technique: (1) improving ability to transition between activities/ tasks (2) decreasing tactile defensiveness (3) increasing self-regulational skills (4) improving ability of the nervous system to process information from the surrounding environment (5) increased attention and focus. (Champagne, T., 2007)

Brushing Protocol (Houser, K. B., 2013):

Brushing should be completed 4x/day for 15 minutes each session.

Once the brush (soft plastic surgical brush –ONLY) has been placed on the body do not lift until brushing strokes are complete.

Step 1. Place brush onto palm of the left hand and begin strokes both up and down with enough pressure to indent the skin, but not enough to cause pain.

Step 2.  Continue with continuous motion up the left arm, then across the back (vertical or horizontal movement only), then up and down the right arm, and finish with the right palm.

Step 3. Place brush onto the sole of the left foot and begin strokes both up and down with enough pressure to indent the skin, but not hard enough to cause pain.

Step 4. Continue with continuous motion up the left leg, then up and down the right leg, and finish with the right sole of the foot.

Joint compressions may be used after brushing.

Joint Compression Protocol (Houser, K. B., 2013):

Step 1. Place the child on his/ her back with their feet flat and knees bent.

Step 2. Kneel in front of the child and place both of your hands on their knees.

Step 3. Apply pressure in a downward motion towards their feet on top of their knees with 10 quick thrusts.

Step 4. Angle the pressure into the hip joints and repeat 10 quick thrusts.

Step 5. Hold the child’s wrist with one hand placed below the wrist joint and one hand above. Apply 10 quick thrusts.

Step 6. Repeat the sequence with the elbow and shoulder joints making sure that one hand holds above the joint to stabilize while the opposite hand applies the pressure.

Step 7. Complete the entire sequence again on the opposite arm.


Barker, K. H. (Director) (2013, January 3). Brushing and Joint Compression Protocol. Lecture conducted from Center for Pediatric Therapies, Inc, Danville, Va.

Tina Champagne, OTD, OTR/L, CCAP . (2007, May 7). Retrieved December 26, 2014, from

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