Therapeutic Massage and Bodywork for Autism Spectrum Disorders

A Guide for Parents and Caregivers

Virginia S. Cowen

• Publisher: Singing Dragon
• Year: 2011
• Print ISBN: 9781848190498
• eBook ISBN: 9780857010629
• Topic: Psychology
• Subtopic: Autism Spectrum Disorders
• Index: Psychology

Massage techniques are widely and effectively used in the treatment of autism spectrum disorders (ASDs) to address sensory issues, motor problems and touch receptivity. However, the variety of different styles of massage available often leaves parents baffled and unsure about which touch therapy treatment is best for their child.

This practical guide explains how massage works, how the body senses touch, and how touch therapy can benefit children with ASDs. It describes exactly what each type of massage entails. Covering anatomy-oriented massages, energy-based massages and therapeutic bodywork, this is the book that helps readers tell Reiki from reflexology, a Swedish from a sports massage, or tuina from a Thai massage. With recommendations for selecting the right style of massage, advice on locating a practitioner, and tips on preparing a child with an ASD for massage, this is the perfect resource to find a therapy – or combination of therapies – to suit each individual child.

This book will be essential reading for all parents and caregivers interested in the benefits of therapeutic massage and bodywork for children and adolescents with ASDs, and practitioners looking at alternatives for therapeutic intervention.

1

Introduction

Massage is touch that is systematically applied with the intention to encourage relaxation, relieve aches and pains, promote circulation, and to facilitate a feeling of well-being. While massage is not often a regular part of therapy for a child with autism spectrum disorder (ASD), it offers many potential benefits. There are many different approaches to massage and bodywork from around the world. The words massage and bodywork are sometimes used interchangeably to describe efforts to improve a person’s health by touching the body. By definition, massage is a general term used to describe manipulation of the soft tissues of the body that is done for therapeutic purposes. This manipulation can include techniques such as stroking, pressing, kneading, along with joint movements such as stretching. It can also include efforts to manipulate the human energy biofield. Bodywork is a term that is used to describe different types of energy and movement-based styles. Some forms of bodywork include breathing, stretching, and conversation, and are used to engage the client as an active participant in the therapeutic process.

In some areas of the world, massage is routinely used for healthcare. In most Western countries, massage and bodywork are considered complementary or alternative medicine (CAM) because they are not part of the conventional medical system. Surveys in Western countries have found that a large percentage of people use some form of CAM to promote health or treat medical conditions.

In the United States, the National Center for Complementary and Alternative Medicine (NCCAM) recognizes massage and touch-based therapies as a form of CAM. Different styles (also called modalities) are grouped into different categories. Styles that focus on muscles and other soft tissues (such as tendons, ligaments, or skin) are considered manipulative or body-based. These styles rely on information from anatomy and physiology that is used in conventional medicine. Other styles of bodywork that treat the energy of a person’s mind/ body/spirit are called biofield therapies. The existence of an energy field has not been substantiated by scientific research. Yet there are many traditional and newly developed forms of bodywork rooted in the belief that smooth energy flow in and around the body is necessary for good health. Any massage or touch treatment that is taken from a traditional medical system is considered traditional healing even when it is used independently of other components of that traditional medical system. NCCAM recognizes that the field of massage and bodywork, along with other forms of alternative medicine, is growing and changing. Globalization has enabled people around the world to learn about and study traditional medicine. Sometimes modern interpretations are fashioned from traditional techniques. Interest and enthusiasm in non-pharmacologic self-care has also contributed to the creation of new forms of massage and bodywork.

The body of research on the benefits of massage has been slowly growing during the past few decades. Studies have evaluated a wide variety of techniques to treat signs and symptoms of many different health disorders including ASD. The variety of massage styles and techniques used in research makes it difficult to draw a single conclusion on the benefits of massage. In general the research results suggest that massage and bodywork do have physical and psychological benefits. Research indicates that massage can increase joint range of motion and decrease physiological measures of stress such as heart rate, blood pressure, and hormones. Massage also promotes relaxation, reduces pain and decreases feelings of depression and anxiety. Studies on massage in infants and children have consistently found that massage can promote healthy weight gain, improve attentiveness, and reduce aggressive behavior and behavior problems.^1–3 A few studies have evaluated the benefits of massage for children with autism spectrum disorders. Findings indicated that massage was helpful in decreasing self-stimulating behaviors, promoting sleep, and increasing receptivity to touch.

Many children with autism spectrum disorders have sensory issues. Occupational therapy aims to help the child manage sensory issues by learning to play, interact socially, manage transitions, and develop fine motor skills. Speech therapy interventions aid in learning to talk and communicate; it can also help with feeding problems. For children with ASD who have poor gross motor skills or too much (hyper) or too little (hypo) muscle tone, stretching and exercise may be learned in physical therapy. Sensory integration therapies are sometimes incorporated into occupational therapy to improve body awareness (proprioception) and balance (vestibular function), encourage appropriate response to stimulation, and assist in development of motor skills. Touch techniques used in sensory integration include tactile play, manipulation of joints, and brushing. This array of therapies is designed to meet the sensory and social needs of each individual child.

For an individual with ASD who has sensory issues, therapeutic massage and bodywork can offer substantial benefits to meet tactile and proprioceptive needs and to address problems with muscle tone. However, it is not routinely used in therapy for ASD. The main providers of therapy for ASD—educators, occupational therapists, and speech therapists—are not trained in massage. Nor are they permitted to administer massage in areas where the massage profession is regulated.

Where regulations exist, they limit the ability to perform massage to licensed or certified practitioners who have substantial training in massage techniques as well as anatomy, physiology, and kinesiology (the study of human movement). Professional massage therapists are trained in the art and science of touch. The art of massage involves listening, feeling, and communicating with the hands, fingers, fists, forearms, elbows, knees, or feet. The science of massage is based on training in anatomy and physiology of the human body including extensive study of the muscles, bones, joints, nerves, and circulation.

The art and science of massage intersect when the massage practitioner chooses appropriate techniques, and alters or adjusts the techniques based on feedback from the client. This feedback may be verbal, but more often it is visual or tactile. Visual feedback is gleaned through observed changes in facial expressions, breathing patterns, or body positions. Tactile feedback is felt through changes in the pliability or temperature of skin and muscles and the relaxation or increase of muscle tension. Many massage therapists are trained in different styles of massage. Regardless of the particular style or techniques used, massage therapists are taught to communicate through touch.

Despite popular claims, no single type of massage therapy is known to be better than another for ASD. The different sensory issues presented and the possibility for massage to address these issues varies considerably among individual children across the autism spectrum. A single massage style is not likely to successfully meet such a wide variety of needs. The success of massage for ASD relies on using appropriate techniques that are selected based on each child’s unique sensory integration difficulties. For one child that might mean a gentle craniosacral therapy session, while another might respond best to a vigorous Swedish massage. Still another child might need a more eclectic approach that draws from a massage style that has a broad array of techniques or a treatment that integrates aspects of massage from several different styles. A parent or caregiver has many choices ranging from an eclectic practitioner who is experienced at practicing different styles of massage to seeking treatment from many different practitioners who are each experts in a single style. What is important is to match the intervention to the sensory needs of the individual with ASD.

The term pediatric massage refers to any type of massage given to infants and children. It can refer to general massage performed by a massage therapist. A unique aspect of pediatric massage is teaching parents to massage their children. For a typical child, this is often recommended to help the child sleep or to encourage bonding between the parent and child.

The sensory stimulation of massage can increase or decrease arousal of the nervous system. For a typical massage client, pressure and strokes are considered to be either stimulating or relaxing. Deep pressure, compression, kneading, and stretching techniques are stimulating techniques. Light pressure, gentle rubbing, and slow range-of-motion techniques are relaxing techniques. Selection of the appropriate techniques in massage for each massage client can promote a desired effect on the nervous system. In children with ASD, the choice of stimulating or relaxing strokes is more complicated. With sensory problems, the response to a stimulus is often unpredictable. Sometimes deep pressure can be more relaxing than light pressure, whereas light pressure may be more stimulating. Knowledge of how the body perceives touch can help make this a more logical and beneficial process.

The myriad of massage and bodywork options available can be confusing. Yet, the opportunity for choice offers a lot of hope for parents seeking a touch intervention to supplement their child’s therapies. What is most important is to attempt to find the style of massage or bodywork that can help to treat a child’s tactile problems and complement their other therapies and treatments.

HOW TO USE THIS BOOK

This book provides an overview of massage and touch and addresses how massage and bodywork can benefit a child with ASD. It is not intended to be a “how to” guide. Rather it provides information to help parents and caregivers make choices that are best for their child’s care. Everyone has a preference for how he or she prefers to be touched. But parents’ preferences may not be shared by their child. This is especially true for a child with ASD who has sensory problems. That is an important consideration because preference for touch is an essential factor in encouraging receptivity to touch. The book’s emphasis on massage and bodywork focuses specifically on the touch-oriented or sensory benefits for a client with ASD. This book may also be useful for any clients with sensory problems, as well as proprioceptive or motor skill difficulties.

The aim of this book is to help parents and caregivers understand the variety of massage and bodywork styles as well as understand how to choose a style that has potential as an addition to the therapy program for their child. For readers who have received professional massage, some of the styles discussed herein may be familiar. Others might be less well known because the field of massage and bodywork is very broad. Sometimes the unknown can hold the key for a client with ASD. If parents have a basic awareness of other styles, they may be more open to pursuing massage and bodywork for their child. It might be necessary to find a practitioner who takes an eclectic approach to treatment or to visit several practitioners who specialize in one style in order to find the right therapy for a client with ASD.

The terminology used in this book has been selected to be inclusive, compassionate, and instructive to the reader. The terms parents and caregivers are intended to be inclusive referring to any adult who has a responsibility caring for a child with ASD. Sometimes the caregiver may not be the biological parent of the child. When only the word parent is used in context, it does not exclude non-biological caregivers for the child. It is used for readability. The author assumes that any reader of this book (regardless of the relationship) has a caring interest in how massage can help someone with ASD.

Therapeutic massage and bodywork in the various forms offer potential benefit to anyone of any age. This book refers to the individual with ASD to encompass any individual with an autism spectrum disorder. This acknowledges the treatment needs and potential benefits of massage for adolescents and adults with ASD as well as infants and children. The word typical is used in reference to anyone who does not have an autism spectrum disorder.

In general, the words patient and client are both used to describe the receiver of massage. Because massage is not part of conventional medicine in Western countries, the term patient is sometimes viewed as misleading. Massage is also most often performed outside of the medical setting. To be inclusive of the possible applications, the massage recipient will be referred to as the client.

Various titles used by professional massage practitioners include: massage therapist, masseuse, therapeutic bodyworker, and movement educator. In some areas of the world, where massage is part of the traditional medical system, the massage practitioner may be called doctor. There is substantial variety in the rules that regulate professional massage practices and who is eligible to give massage treatments in the United States, the United Kingdom, and Canada. Owing to the many possible titles for the giver of massage, the word practitioner will be used to describe the person giving the massage treatment.

The book is organized into three parts. The first part of the book, “Understanding Massage and Sensation,” provides information about massage, the sense of touch, and how massage and bodywork may benefit patients with ASD. This can aid parents and caregivers to understand why a child with ASD may have problems with touch, sensation, or proprioception, and how this fits with the characteristic signs presented by the child. The second part of the book, “Exploring Styles of Massage and Bodywork,” describes specific types of massage (modalities). For each modality the history, theory, and techniques are presented. Where available, general research on a modality or on how the modality may impact ASD is reported. The modalities are grouped into three categories: anatomy-oriented massage, energy-based bodywork, and other styles of therapeutic bodywork. The final part of the book, “Trying Massage for Your Child,” offers recommendations on how to select a style of massage and locate a practitioner. It also gives general precautions, tips on preparing the client for massage, and suggestions for working with the massage practitioner. Asking the right questions, creating a nurturing environment for a child to receive touch, and experimenting with different types of massage can help increase the success of massage as an additional therapy.

This book will help you to educate yourself about the possibilities for massage as a complementary therapy. Remember that what you enjoy in massage may not be enjoyed by your child. You might even learn about a modality that sounds interesting for you to try for your own health and well-being. Taking a first step by reading this book can open the door for you and your child to the benefits that can be received from the wonderful world of therapeutic massage and bodywork.

PART 1

UNDERSTANDING MASSAGE AND SENSATION

2

Massage and Bodywork

Therapeutic massage and bodywork are the application of touch or manipulation to improve health and well-being. Massage is used for health-related reasons, but it is not often considered conventional healthcare. It is a natural or holistic approach that has a lengthy history around the world. There are many different interpretations used in massage and bodywork. While touch is used for nurturing and communication, massage and bodywork are different. They involve deliberate use of techniques. The benefits of massage are related to the techniques used in massage treatment.

DEFINING MASSAGE

Massage does not have a single beginning or point of origin. It has a long history in Europe, Asia, and in other places around the world. The word massage is a combination of Greek and French words for kneading and pressing. In Ancient Greece, passive and active movements were used as a form of exercise. Vigorous rubdowns were provided in Italy and Turkey in bath houses. The earliest writings about massage as a therapy can be traced to China and “The Yellow Emperor’s Classic of Medicine.” Pressure, stretching, and massage were used as part of holistic healing. As a medical therapy, it has a long tradition elsewhere in Asia including Thailand and Japan. There is also evidence that massage techniques were practiced in the Middle East in Persia and Egypt. Massage has an extensive tradition as a healing art.

Massage in its various forms is considered to be complementary or alternative medicine because it is not part of the current conventional, biomedical system in the United States, Canada, the United Kingdom, and Australia. Complementary and alternative medical treatments are covered by the acronym CAM. Other healing arts that are considered to be CAM include: chiropractic, naturopathy, ayurveda, yoga, and acupuncture, as well as vitamin and herbal supplementation. The classification as CAM does not necessarily mean that these therapies are less effective than conventional approaches. They are just an alternative.

It is important for parents to understand the difference between using massage as a complementary therapy or as an alternative to conventional medicine. Massage is not a substitute for any other therapy prescribed by a physician, but massage is used as a therapeutic intervention for ASD. The aim of massage is to support or enhance the conventional treatment. For an individual with ASD, this means that massage would complement a biomedical stimulant used to increase physiological arousal. When massage is used instead of another therapy, it is considered alternative. The substitution of massage would aim to produce the same outcome as the other therapy. In this way, massage would be an alternative to the brushing treatment used in sensory integration therapy.

Western or European styles of massage are based on conventional medical anatomy and physiology of the body. This a...

Table of contents

• Cover Page
• Of Related Interest
• Title Page
• Copyright
• Dedication
• Contents
• Acknowledgements
• Preface
• 1. Introduction
• Part 1: Understanding Massage and Sensation
• Part 2: Exploring Styles of Massage and Bodywork
• Part 3: Trying Massage For Your Child
• References
• Useful Resources
• Index