Examining the Wilbarger’s deep pressure and proprioceptive technique for treating children with sensory defensiveness using a multiple single case study approach

The need for occupational therapy services has risen exponentially (Royeen, 2010) especially in paediatrics, and the sensory integration framework is used commonly when working with children. A variety of intervention approaches are used within this framework. The Wilbargers’ approach is one such approach that is known to be used by occupational therapists for children presenting with sensory defensiveness or over responsivity. However, lack of sufficient research in this area leads to a need for examining this approach. Purpose The purpose of this study was to examine the Wilbargers’ Deep Pressure and Proprioceptive Technique (DPPT) in children presenting with sensory defensiveness and to investigate parent/carer perspectives on the effectiveness of DPPT. Method A prospective multiple single case design was used with convenient sampling. Five children eligible for early childhood intervention services were recruited for this study and three tools were used to collect data, namely the Sensory Profile (Dunn, 1999), sensory interviews and parent questionnaire at the end of the study. Goals were drawn with the parent/carer, and Goal Attainment Scaling (GAS), (Kiresuk & Shermann, 1968) was used as an outcome measure. Each child participated in a six week regime involving the Wilbargers’ DPPT every two hours along with sensory diet activities concurrently at least three times per day (Wilbarger & Wilbarger, 2007). Participants were reviewed weekly using GAS. Results The results indicated a significant statistical difference in scores on Sensory Profile scores and GAS scores. The parent questionnaires also indicated that the parents rated ‘importance’ as highest indicating that it is very important for them to reduce their child’s sensory defensive behaviours and 4 out of 5 parents reported that they felt the intervention was effective for their child. Implications Implications for future research include completing similar studies using larger sample sizes and over larger geographical regions. Also including children with varying diagnostic groups (such as child and adolescent mental health, paediatric neurology, paediatric genetic disorders and from school aged population) where sensory defensive behaviours may be interfering with school function is suggested. Conducting randomised control studies and qualitative studies investigating the parents/caregivers experiences of implementing the DPPT regime with their child is recommended. Conducting more studies within Australian context is required as the majority of studies are from the United States. Conclusion The results from the Sensory Profile scores and GAS scores in this study seem to support the use of the DPPT in children presenting with sensory defensiveness. The comments and results from parent questionnaires and interviews support the use of DPPT and most parents found it conducive to family centred practice principles of providing information and empowerment to them as well as increased participation of their children in everyday routines and settings.