Brushing Protocol



Brushing is used to reduce sensory defensiveness and improve overall regulatory function.  It helps your child take in sensory information in a more organized way so that he/she can function better throughout the day.  


  • Only use a brush that has been approved by your OT.
  • Never brush the stomach, head or neck
  • Bush arms, hands, legs, feet and back.  Bare skin is best, over the clothes is ok.  If brushing over clothing, stabilize the fabric to reduce scratchiness. 
  • Brush firmly (the most common error is a tendency to brush too lightly) for up to 10 seconds keeping the brush moving in long up and down strokes. 
  • Always follow the brushing with joint compressions (10 joint compressions to ankles, knees, hips, wrists, elbows, shoulders)
    • Count out loud to add verbal cue and rhythm and association 
    • Compressions: stabilize above the joint and push into the joint with lower hand
  • Brush every 1.5-2 hours that the child is awake (up to 5 times daily) for optimal effectiveness.  Less will still benefit your child.  During diapering is an excellent time.  This is a routine rather than an activity.  Be businesslike about it rather than playing and exploring.  You can massage for fun at other times. 
  • Replace the brush if it becomes scratchy (approximately every 3 months)

Additional Reminders:

  • Hold the brush horizontally when brushing on skin, vertically when brushing over clothing. 
  • Try to have strokes be long and rhythmic, moderately paced and continuous without picking up the brush between strokes. 
  • Only cover the area with one up and down stroke, then move on.