Effectiveness of Wilbarger Protocol on Tactile Defensiveness in Children with Autism Spectrum Disorder

Maryam Ashraf; Sikander Ghayas Khan; Ifrah Kaleem; Jazib Haider

doi:10.61919/eww4ya57

Authors

Maryam Ashraf Occupational Therapist, University of Lahore, Lahore, Pakistan Author
Sikander Ghayas Khan Head, Department of Rehabilitation Sciences, University of Lahore, Lahore, Pakistan Author
Ifrah Kaleem Occupational Therapist, University of Lahore, Lahore, Pakistan Author
Jazib Haider University of Lahore, Lahore, Pakistan Author

DOI:

https://doi.org/10.61919/eww4ya57

Keywords:

Autism spectrum disorder; tactile defensiveness; sensory over-responsivity; Wilbarger Protocol; deep pressure; occupational therapy; Sensory Profile-2.

Abstract

Background: Tactile defensiveness may restrict self-care, play, social interaction, and participation among children with autism spectrum disorder. Evidence supporting the Wilbarger Deep Pressure and Proprioceptive Technique remains limited. Objective: To evaluate short-term changes in tactile-response classification following a three-week Wilbarger Protocol intervention. Methods: This single-group quasi-experimental pretest–posttest study included 16 children aged 3–14 years with autism spectrum disorder and tactile defensiveness recruited from two clinical settings in Lahore, Pakistan. Caregivers administered firm-pressure brushing followed by joint compressions four times daily for three weeks after therapist training. Tactile responses were assessed before and after intervention using the relevant Sensory Profile-2 classification. Changes were summarized as category transitions and analyzed using an exact two-sided sign test. Results: All participants were classified as having tactile responses “much more than others” at baseline. After intervention, five children (31.3%) moved to “just like the majority of others,” five (31.3%) moved to “more than others,” and six (37.5%) remained unchanged. Overall, 10 children (62.5%) improved by at least one classification level, while none worsened. The directional change was statistically significant (p = 0.002). Conclusion: Short-term improvement in tactile-response classification was observed among some participants, but the uncontrolled design, small sample, and ordinal caregiver-reported outcome prevent causal conclusions

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