Using Salivary Cortisol to Measure the Effects of a Wilbarger Protocol–Based Procedure on Sympathetic Arousal: A Pilot Study

Abstract

, MSOT, were students in entry-level master' s studies in the occupational therapy program at the University of New England at the time of this study.OBJECTIVE. This study investigated changes in salivary cortisol, the stress hormone, after administration of a procedure based on the Wilbarger protocol to children diagnosed with sensory defensiveness (SD), a type of sensory modulation dysfunction.METHOD. Using a single-subject design across participants, we studied 4 boys with SD ages 3 to 5 years.Each participant completed four sessions consisting of the collection of a saliva sample, administration of a procedure based on the Wilbarger protocol, 15 min of quiet neutral activities to allow time for any changes in cortisol level to manifest in the saliva, and the second collection of saliva. Saliva samples were analyzed using enzyme-linked immunosorbent assay (ELISA).RESULTS. Salivary cortisol levels in all participants changed after each of four applications of a procedure based on the Wilbarger protocol. The cortisol levels of 2 children whose levels were relatively higher on pretest decreased at each posttest. The levels of 1 child whose cortisol was higher on pretest three times decreased those three times and increased the one time the pretest cortisol was lower. The levels of 1 child who had the lowest cortisol levels of any of the children increased each time. Therefore, in all participants, cortisol moved in the direction of modulation.CONCLUSION. In these 4 boys, a procedure based on the Wilbarger protocol modulated cortisol levels toward a middle range. This pilot study indicates that there is an association between sympathetic nervous system response and the Wilbarger protocol-based procedure, as indicated by salivary cortisol levels.

Feasibility of a Research Protocol to Investigate the Effect of the TherapressureTM Program Using Salivary Cortisol

“…This conclusion was drawn from the low number and poor methodological quality of available studies on this topic, rather than the presence of high quality evidence to refute its effectiveness (Weeks et al, 2012). In the absence of high quality research, it is acknowledged that subjective anecdotal evidence, from occupational therapists and parents, support the efficacy of this approach for children in reducing their behavioral responses to environmental stimuli (Kimball et al, 2007 …”

“…Sensory modulation is the ability to respond "to sensory input with behavior that is graded relative to the degree, nature, or intensity of the sensory information" (Miller, Anzalone et al, 2007, p. 136). This is achieved through harmonious interaction between the CNS's ability to decrease its responsivity to familiar stimuli ("habituation") and increase its responsivity to significant or potentially dangerous stimuli ("sensitization") (Kimball et al, 2007). It is proposed that failure to modulate sensory stimuli can lead to a physiological stress response, in turn causing anxiety and stress-related behaviors (Reynolds & Lane, 2009).…”

“…Researchers theorize that the effectiveness of the Wilbarger protocol is due to its ability to assist the central nervous system (CNS) to modulate its responses to sensory input (Kimball et al, 2007). Sensory modulation is the ability to respond "to sensory input with behavior that is graded relative to the degree, nature, or intensity of the sensory information" (Miller, Anzalone et al, 2007, p. 136).…”

“…Assessment of cortisol via saliva is a wellestablished, valid, and reliable method to study stress and appears within five min of a stimulus (Kelly et al, 2008;Kimball et al, 2007). Timing during the day is crucial because cortisol levels rise after waking for 30 to 45 min, then fall across the remainder of the day.…”

“…It is proposed that failure to modulate sensory stimuli can lead to a physiological stress response, in turn causing anxiety and stress-related behaviors (Reynolds & Lane, 2009). Thus, researchers suggest that the Wilbarger protocol influences the CNS by modulating the physiological stress response (Kimball et al, 2007).…”