about tina allen - american massage therapy association · massage therapy for infants and children...

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The information provided herein does not replace medical advice

About Tina Allen With over a decade of service to children and families, Tina Allen, founder of leading children’s health and nurturing touch organization Liddle Kidz™ Foundation, has become a respected international lecturer, author and authority on infant and pediatric massage. She is a Pediatric Massage Master Teacher, Developmental Baby Massage Teacher, a Licensed Massage Therapist with specialized training in providing massage therapy for infants and children with special healthcare needs. Ms. Allen understands the varied physical and emotional needs of hospitalized and medically complex infants, children and their families. Because of her dedication to the well-being of the entire family, she has studied and become certified in pregnancy massage and is a Trainer of Peaceful Touch®, which implements a healthy touch approach for children in school based environments. Ms. Allen managed the United States first comprehensive pediatric massage program at Children’s Hospital Los Angeles (CHLA), where she trained volunteer massage therapists and medical professionals to work with

hospitalized Rehabilitation patients, medically complex infants in the Center for Newborn and Infant Critical Care (CNICC), Neonatal Intensive Care Unit (NICU), Children with Retinoblastoma, Spina Bifida and Cerebral Palsy. She developed pediatric massage programs at Mattel Children’s Hospital at UCLA and Cedars-Sinai Medical Center, as well as developed a program focusing on introducing gentle compassionate touch to women and children who have survived domestic abuse. She is currently consulting on the development of comprehensive pediatric massage programs for The Mayo Clinic, Nemours/Alfred I. duPont Hospital for Children, Connecticut Children’s Medical Center, Shriner’s Hospital and Sutton Children’s Medical Center. Her innovative approach to children’s health has allowed her the unique opportunity to educate families and professionals throughout the world in the many benefits of nurturing touch. At personal request, Ms. Allen has taught in England, France, Sweden, Canada, Japan, Thailand and Vietnam. Every year, Ms. Allen and the Liddle Kidz Foundation take volunteer groups to orphanage and child care settings all over the world. Recently, she took a group of 20 volunteers to Vietnam to provide hands-on care to orphaned infants and children. The volunteers care ranged from providing infant and pediatric massage to educating staff and medical professionals to continue this much needed care. During the two week outreach the group traveled south from Ho Chi Minh City to Hanoi in the north and provided massage and nurturing touch in 7 orphanages and children’s care centers. The Liddle Kidz Ambassadors easily worked with several hundred babies and children who received direct hands-on care during the time spent in the centers. The children that received nurturing touch have the effects of trauma associated with being isolated and abandoned, as well as, a host of special healthcare needs and birth defects including AIDS/HIV, Cerebral Palsy, Hydrocephelus, Spina Bifida, Down Syndrome, Autism/ASD, Muscular Dystrophy, landmine survivors, children with visual and hearing impairments, mental, neurological and physical impairments. A widely known expert in her field, Ms. Allen has appeared on NBC, The Learning Channel’s “Bringing Home Baby”, KCET and PBS’ “A Place of Our Own”. Her work has also been featured in many international publications including Massage Magazine, Massage and Bodywork Magazine and Massage Therapy Journal. She is a featured columnist with Massage Today Magazine. She is featured as the Infant and Children’s Massage Expert on Canadian Parents and Parent Guide Canada. Ms. Allen has also received recognition as First 5 California’s Champion for Children, was honored with the Richard Ryder Award for her dedicated and passionate service, is a 2009 Massage Therapy Hall of Fame Inductee, and 2011 International Massage Therapist of the year.



As an invited lecturer, Ms. Allen has presented for organizations such as The Mayo Clinic, Mattel Children’s Hospital at UCLA, Childrens Hospital Los Angeles, Cedars-Sinai Medical Center, Northwestern University of Health Sciences, Nemours/Alfred I. duPont Hospital for Children, Connecticut Children’s Medical Center, Sutton’s Children’s Hospital, St. Mary’s Children’s Hospital and Healthcare System, Shriner’s Children’s Hospital, World Massage Conference, Massage Hall of Fame, World Massage Festival, American Massage Therapy Foundation (AMTA), Society for Oncology Massage, First 5 LA, Infant Childhood and Relationship Enrichment Network, Department of Mental Health, Los Angeles Child Guidance Clinic, Valley Presbyterian Hospital, Glendale Memorial Hospital, Little Company of Mary Hospital, South Bay Counseling Center, PAC/LAC (Perinatal Advisory Council: Leadership Advocacy and Consultation), The International Association of Infant Massage, ELNEC (End of Life Nursing Education Consortium), Los Angeles Gay and Lesbian Center, Boston Children’s Museum and major school districts throughout the United States.

About the Liddle Kidz Foundation

Since its inception, the goal of the Liddle Kidz Foundation has been to empower families and professionals to provide nurturing touch: building stronger, more loving bonds with children. We provide education and support for families and professionals, giving them the tools necessary to ensure the safe, professional practice of nurturing touch and developmental movement with infants and children. Our training courses cover multiple facets of using nurturing touch and massage with healthy children and those with special healthcare needs. We offer courses for Certified Infant Massage Teacher, Certified Pediatric Massage Therapist, Touch Therapy for Liddle Kidz (Healthy Children), Touch Therapy for Liddle Kidz with Autism (Massage for Autism), Touch Therapy for Liddle Kidz with Cancer (Massage for Pediatric Oncology), Touch Therapy for Liddle Kidz with Cerebral Palsy (Massage for Cerebral Palsy), Touch Therapy for Liddle Kidz in the NICU (Massage for babies in the Neonatal Intensive Care Unit) and Peaceful Touch® (Healthy Touch Curriculum for Children in School). Annually we embark on global outreach journeys where volunteers trained by the Liddle Kidz Foundation visit orphanages, health care settings and children’s homes in countries where we can make the biggest impact in teaching caregivers how to use infant and pediatric massage, as well as, provide hands-on care for children. We have plans to visit Thailand, Vietnam, Cambodia, Laos, Haiti, India, Turkey, and Ghana.

At Liddle Kidz it is our true it is our true belief that children are our greatest gift and should be treated with extraordinary care!



What is Autism?

According to the Autism Research Institute, Autism is a severe developmental disorder that begins at birth or within the first two-and-a-half years of life. Most children with autism are perfectly normal in appearance, but spend their time engaged in puzzling and disturbing behaviors which are markedly different from those of typical children. Less severe cases may be diagnosed with Pervasive Developmental Disorder (PDD) or with Asperger's Syndrome (these children typically have normal speech, but they have many "autistic" social and behavioral problems).

Autism, ADD, ADHD, PDD, NLD, and Asperger's Syndrome were once either unknown or very rare. In 1980, autism diagnoses alone were 1 in 5,000; the most current data from the CDC says it's 1 in 88 children. Boys appear to be affected four times as much as girls, the rate could be as high as 1 in 70. There are many theories, however no one can say exactly what causes autism and its related disorders, including Asperger's Syndrome, an autism- like condition usually without language delay, and various Pervasive Development Disorders (PDDs).

Autism spectrum disorders (ASDs) interfere with normal development of the brain in the areas that influence reasoning, social interaction, motor skills, communication skills, and attention. Children with autism spectrum disorders are typically deficient in verbal and nonverbal communication, social interaction, and play activities. Characteristics are observed, to varying degrees, in social relationships, communicative competence, pattern and range of interests, and sensory responsiveness. These characteristics are generally evident during the child’s early years, and must adversely affect educational performance. The definition of ASD has been written sufficiently broad to encompass children who exhibit a range of characteristics related to ASD.

Developmental disorders occur across a spectrum, affecting individuals differently; some children lose the ability to speak, some might have motor impairment, and many lack social and emotional awareness. Behaviors range from hyperactivity to serious self-injury. Families and healthcare professionals often report that children may show lack of eye contact, as well as, have an aversion to touch and tactile stimulation. These disorders make it difficult for children with ASD to communicate with others, leading to frustrated social isolation. If left untreated, children do not develop the skills they need to become a fully functioning part of society.

What is ADD/ADHD? Attention deficit hyperactivity disorder -- also referred to ADD or ADHD -- is a biological, brain based condition that is characterized by poor attention and distractibility and/or hyperactive and impulsive behaviors. It is one of the most common mental disorders that develop in children. Symptoms may continue into adolescence and adulthood. If left untreated, ADHD can lead to poor school/work performance, poor social relationships and a general feeling of low self esteem. The most prevalent symptoms of ADHD are inattention and distractibility and/or hyperactive and impulsive behaviors. Difficulties with concentration, mental focus, and inhibition of impulses and behaviors are chronic and pervasive and impair an individual’s daily functioning across various settings -- home, school or work, in relationships, etc. It is estimated that between 3 and 5 percent of preschool and school age children have ADHD or approximately two million children in the United States. This means in a class of 25 to 30 students, it is likely that at least one student will have this common condition. ADHD begins in childhood, but it often lasts into adulthood. Studies estimate that 30-70 percent of children with ADHD will continue to have symptoms into adolescence and adulthood.



Benefits of Massage Therapy for Children ASD ADD/ADHD

May improve sleep and sleep patterns (helps children sleep through the night)

May improve parent and child communication, interaction and bond

May decrease aversion to tactile stimulation

May encourage more positive social interaction

May reduce Autistic behaviors

May improve language function

May improve motor skills & sensory function

May improve general health

May improve time showing on-task behavior

May improve sleep and sleep patterns (helps children sleep through the night)

May improve the child’s mood

May improve classroom behavior

May decrease hyperactivity

May improve attention and concentration

May decrease stress hormones (cortisol & norepinephrine)

May improve general health

May improve time showing on-task behavior

Contraindications of Massage Therapy for Children The contraindications & precautions listed below are not only for children with Autism (ASD), ADD/ADHD, but cover many pediatric conditions to ensure best practice of the use of pediatric massage therapy.

Gliding towards outer extremities (towards hand(s)/foot(feet)) may cause fluid to accumulate or pool if child has circulation issues

Gliding towards heart (towards shoulder/toward thigh) may cause blood to overload the heart, especially if there are preexisting cardiac conditions

See Contraindications & Precautions (below)

Some Considerations: Always follow the guidance of the healthcare provider

Always ask the child’s permission to receive touch

Adjust and adapt the massage strokes for the comfort and care of the child

Always consider both the child’s medical and emotional needs, begin massage where there is the most

access for skin-to-skin contact

Use care and caution in areas where the child may have experienced pain

Always begin with Nurturing Touch



Always make eye contact during massage, especially with a child who may have any hearing impairments

Always continue speaking throughout massage, especially with a child who may have any visual impairments

Do not provide massage when child has:

Fever Inflammation High Blood Pressure Acute infection, staph infection, illness or Infectious Disease Hernia (on that area, other areas may be okay) Osteoporosis Varicose Veins Broken Bones (on that area, other areas may be okay) Open wounds, sores or lesions (on that area, other areas may be okay) Deep Vein Thrombosis Pain (on that area, other areas may be okay, practice caution if the massage causes discomfort) Lability/ emotional response, emotions all over the place Thrombocytopenia/ low platelet count in blood Skin conditions/disorders which may be contagious or cause inflammation (fungus, rash, herpes) Recent immunization/vaccination (wait 72 hours before providing massage) A life threatening medical condition An uhealed umbilical cord (do not massage the abdominal area) Swollen lymph nodes Blood clots or a blood condition Diarrhea or other sickness (diarrhea that has gone on for some time and is unexplained)

Precautions Proceed with care in regards to a child who exhibits, or diagnosed with any of the following conditions.

Seizure Disorders – disorder of cerebral function

Agitation - an unhappy and worried mental state, not calm

Impulsivity - Lack of impulse control

Lack of Insight – unable to discern the true nature of a situation

Easily Distracted

Severe Myalgias (pain) – “muscle pain”

Bleeding/bruising

Infection or open sores

Multiple invasive lines

Possible Isolation – Isolation is typically required due to possible contagious infection or disease, research the reason for isolation



Apnea – temporary cessation (pause) of breathing

Bradycardia – slow heart rate, low pulse rate

Tachycardia – rapid heart rate, fast pulse rate

Abdominal Distention – Bloating or swelling of the abdomen/tummy

Gastrointestinal or Jejunostomy feeding tubes – check with healthcare provider for specific reason

for use, use care not to dislodge

Hydrocephalus – abnormal buildup of cerebrospinal fluid in the ventricles of the brain. The fluid is often under increased pressure and can compress and damage the brain. Check with healthcare provider prior to providing massage. Use caution around shunt area, risk of infection and of being dislodged. Use caution near abdomen for fluid drainage

Inflammations – response of body tissues to injury or irritation; characterized by pain and swelling and redness and heat

Edema – May be a local or generalized condition, abnormal accumulation of fluid in the body tissues or in the body cavities causing swelling or distention of the affected parts

Recent Surgery – check with healthcare provider for specific protocol, may be beneficial to provide nurturing touch

Endangerment sites are areas of the body where you should practice additional caution so as not to do harm. Providing massage for a prolonged time or with too much pressure in such areas may cause damage to structures within and underneath the skin’s surface such as nerves, blood vessels, organs and lymph nodes. Areas to practice to caution, use lighter pressure or avoid, include:

Orbital (eyes) Anterior triangle of the neck (front of neck & throat) Posterior aspect of the neck (back of the neck) Axilla (under arm) Brachial region (medial aspect of the upper arm) Cubital area (front of the elbow) Near olecranon process (back of elbow, funny bone) Upper lumbar region (mid-back, kidney area) Umbilical area (naval, belly-button) Femoral triangle (inner upper leg) Popliteal fossa (back of the knee) Inguinal area (groin)

Adaptations & Approach considerations:

Establish a trusting relationship with the parent(s) of child/pediatric client:

Introduce yourself to the parents and the child; acknowledge each person individually Smile, maintain eye contact, be gentle



A gentle touch of the parent can help to ease a child’s anxiety. It is a very concrete way of establishing a connection.

Provide brief explanation of who you are and the service you are introducing. Reassure them that you just want to meet the family, get to know them and that you are not providing

services at this time. Get to know the child on a personal level; talk about school, items in their room, and other topics familiar

to them. Talk with the child at a comfortable level; squat down to be at eye level with the child. Maintain a comfortable distance from the child; being too close at first may be anxiety provoking.

Explain what you are going to do before you start:

Talk directly to the parent but keep in mind that the child is listening to every word you say. Use appropriate language for the developmental level and age of the child.

Assume that the child may be listening to you even though they may appear absorbed in the television or an activity.

Explain what you will be doing during the session; use a step-by-step approach. Tell the child what they will feel, hear, smell and what they can expect from the session; i.e. “I may ask

you to move your arm this way or that way, I may help you to be more comfortable”, etc. Explain how the child may participate during the session. This may include such things as breathing

deeply, holding a favorite toy or “distraction toy”, wiggling toes or fingers, telling you how the experience feels.

Explain the role that the parent may take during the session (i.e. standing nearby, holding child’s hand, reading a story, etc.)

Take care to set the tone for a positive experience; avoid conjuring up negative thoughts for the child. Reassure them that there will be no surprises. Be mindful of the child’s attention span; avoid overwhelming the child with too much information. Explain that you will stop if they want to stop the experience. Leave the room for a short period of time before returning to begin the session. This allows time for

child and parents to process the information before you begin. The therapist should be outside the room when the client disrobes or dresses and should utilize proper

draping. Continue support during the session:

Use appropriate draping to protect the client’s physical and emotional privacy. Provide on-going explanations of what you are doing and why it is helpful (i.e. “Now, let’s lift this arm

and move it over here”) Take it slowly and transition slowly Give frequent reinforcement (i.e. “Good job, that is perfect, you are doing this part really well”, etc.) Whenever possible, allow child to make choices. Even very simple choices offer the child the

opportunity to have control and promotes mastery. Be aware of subtle changes in the child’s behavior. They may become quiet or agitated when they feel

uncomfortable with the experience. Explain what the child may be experiencing during the session (i.e. “You may be feeling a warm feeling

in your muscles, your breathing is deep and steady now, that tickled a little bit, I’ll be careful not to tickle you again”, etc.)

Help child identify their own coping strategies (i.e. “You seem to like it this way instead”, etc.)

Following the session, review what happened:

Assess how they felt during and after the session.



Give feedback about the child’s success during the session. Ask – “What was their favorite part of the experience?” Ask for suggestions for the next experience. End on a positive note to set the tone for the next session.

Cultural Considerations:

Be aware that different cultures maintain different beliefs and practices regarding touch. Asking permission and seeking guidance from families regarding the use of touch is an important part in

establishing trust and developing respect for individual and family cultures. Assess what the family believes with respect to gender equality, health and wellness practices, child-

rearing, religious practices, language differences (Non-English speaking as well as specific words for body parts involved), religious observations, political issues, etc.

Become aware of etiquette and manners of various cultures (i.e. body language, personal space, response to authority figures).

Previous experiences with feelings of discrimination may be of concern. Carefully consider pertinent history with touch (appropriate and inappropriate i.e. child abuse).

During Children’s Massage Session:

Provide for client privacy and maintain appropriate draping at all times. Cease touch immediately at any point during the treatment if requested by the child or a family member. Cease treatment if the child demonstrates significant change in color, respiratory effort, heart rate,

sweating, hiccupping, vomiting, gagging, crying, or prolonged coughing. Cease treatment if child indicates (verbally or non-verbally) an increase in their experience of pain.

use your skills to observe cues which indicate permission to touch. you may not receive direct eye-to-eye contact or a verbal “Yes”

allow child to direct the session (choosing tactile items, positioning, pace)

start with one touch at a time recognizing the child’s needs

use slow transitions

vary your pressure and pace. deeper pressure is better received by many children who have been diagnosed with ASD & ADD/ADHD

using compression and “hugs” may be better received by children on the spectrum and with ADD/ADHD

may try providing touch over clothing or cloth

use tactile items to initiate contact and provide developmentally appropriate pediatric approach

starting with hands and feet may be more comfortable to the child



Massage Techniques

How to get started:

- Take a moment to relax yourself

- Meet the child “where they are at” (do not force the child into any position, massage may be performed with child sitting, lying down or standing)

- Ask the child’s permission

- Begin where the child welcomes massage & nurturing touch

Rock & Walk™

Hand massage is often well received by children, as it is a safe and non-threatening introduction to massage therapy. One technique that works well for children with Autism (ASD) and ADD/ADHD is called “Rock & Walk”

Liddle Kidz™ Foundation

Pediatric Massage Strokes | Simple Massage for Child with ASD Nurturing Touch

Begin with Nurturing Touch on the child’s back. Use gentle/firm pressure and hold your hands still on one section. Then gradually lift each hand and place on another section of the back, pause and hold each time before moving. Cover the entire back. CAUTION: do not put any pressure on the spine.

Rub the Back

With warm palms, gently and firmly, stroke the back from the shoulders downward. Take care to pause and hold as necessary.

Hug the Arm (1st arm)

Use firm strokes and “hugs” to move from the shoulder down one arm. NOTE: you should continue to speak to the child and let them know which section of the arm you are massaging

Massage the Hand (1st hand)

Gently and firmly massage the hand at the base of the arm you just hugged.

Hug the Arm (2nd arm)

Return to the shoulders. Use firm strokes and “hugs” to move from the shoulder down one arm. NOTE: you should continue to speak to the child and let them know which section of the arm you are massaging

Massage the Hand (2nd hand)

Gently and firmly massage the hand at the base of the arm you just hugged.

Soothing Palms

With warm palms firmly walk the back from the shoulders downward to finish the massage.



Liddle Kidz™ Foundation

Children’s Massage Strokes | Tummy Massage

Simple Pattern |Tummy Massage

Nurturing Touch

Loving and still – this nurturing stroke introduces our touch to the area where we will begin.

Sun

Place left hand on child’s tummy and make a large clockwise circle

Moon

With your right hand trace a half circle (moon shape) on child’s tummy from 12 o’clock - 6 o’clock

Rainbow

With child lying down looking at you, draw a big rainbow, starting on child’s right side (your left) draw to child’s left side (your right) REMEMBER: clockwise motion only

Stars

Using the pads of your finger tips, march across child’s tummy from child’s right side to child’s left side

Soothing Stroke

Loving and gentle – this gliding stroke let’s child know we’ve finished with the Tummy



Nurturing Touch for the Growing Child

Massage Fairytale

Once upon time there was a bright summer land. Where the sun was shining bright and had great big sunbeams covering the sky

Draw a big sun with your hand, Draw warm sunbeams

One day clouds begin to cover over the sky Press softly and gently all over the back It started to become cold and windy

Move hands across back in swirling motion

First just a little wind, and then there was more

Move hands more rapidly

As it got colder, it began to rain, but not hard rain, more sprinkling

Tap fingers lightly across back

Then soon it began to rain

Tap fingers with a little more pressure on the back

In the sky we begin to see lightening and, we could hear thunder Soon it was so cold, it started to snow

Zig Zag hands across the back Cup hands and pat them on the back Lightly press hands all over the back

And it grew colder and colder, and soon everything was quiet and still

Rest your hands on the shoulders

And far off in the distance, we see a little tiny kitty cat climbing up the side of house and when he got to roof, he sat there and purred and purred

Walk with your fingers from the base of the back to the shoulders, and gently massage the shoulders (purring)

And once again, far in the distance, we saw another kitty cat, he is climbing all the way up the side of the house, to the chimney and up the chimney to the tip top where he then sits and purrs & purrs

Walk with your fingers from the base of the back to the head, and gently massage the sides and top of the head (purring)

The kitties both sit perched above, watching as the sun begins to appear again melting away the snow and soon the flowers begin to bloom and grow

Bring your hands from the head to the back, draw a great big sun a few times, then sweep your hands up the back and over the shoulders 3 times (growing)



Making a Pizza

Do you think we should make a pizza? Let’s start by pressing flour all over our table before we roll out the dough

Lightly glide down the back and begin to lightly press all over the back

Now we’re ready to knead the dough Glide your hands up to the shoulder and gently knead the shoulders

Let’s begin to roll out the dough in a great big circle

Move hands in a big circle covering the entire back

Let’s go ahead and add some tomato sauce

Gently glide your hands back and forth across the back

Now we need to sprinkle on some cheese

Lightly tap fingers all over back

Let’s start adding the toppings, how about some pepperoni first

Draw small circles all over the back

And maybe some mushrooms

Draw small circles all over the back

Let’s try some tomatoes

Using soft cupped hands, place them and move them in a circular motion on the back

And a little more cheese

Lightly tap fingers all over back

Now we just wait for a pizza to get nice and hot

Move your hands in a circular motion a few times

Note: When making a pizza, planting a garden, baking cookies – it’s a great idea to ask the children what they would like to add. Over time they will learn what types of touch they prefer and request it in the form of rain, snow and chocolate chips!



All about Oil for Children’s Massage All oils put on the skin are absorbed and then move through the capillaries into the blood stream. A child’s skin is still developing, and can absorb more than an adult’s, so it is important to choose oil that is most suitable for their young skin. When choosing oil for children’s massage, look for something that has been cold-pressed or expeller-pressed, as they last longer and have more organic properties. Do not store oil in heat or under direct light. The best method of storing oil is to keep in a cool dark place. Before using any stored oil, smell, and if necessary, taste the oil. Oil that has spoiled, or become rancid, will have an unusual smell and taste bitter. If unsure, throw the oil away, and purchase more. It’s always best to proceed on the safer side when it comes to massage oil for children. If providing massage therapy in a healthcare setting, follow the advice of the healthcare team as to the best oil for touch therapy. In any setting practice care and follow these standard guidelines:

Always use one bottle of oil per pediatric client Never share the same oil bottle with more than one pediatric client Do not move oil from room to room Do not remove the oil from the healthcare setting Do not bring in oil from outside the healthcare setting as this may cause contamination Do not use any aromatherapy oils as this may cause allergic reaction to your client or others

Unscented, natural, cold-pressed, organic, fruit or vegetable oils are recommended for massage

Suggested oils include: Olive Oil, Grapeseed Oil, Sweet Almond Oil, Jojoba Oil & Coconut Oil

What is cold-pressing? Cold-pressing is a method of extracting the oil without changing the chemical makeup of the oil molecule. Heat based extraction methods chemically change the makeup of the oil molecule, and can in some cases be poisonous. Petroleum based products Petroleum is an odorless, tasteless, greasy substance obtained as the residue after the more volatile components of oil have been boiled off. The purified residue is obtained in the form of a yellowish semisolid, known as petroleum jelly, or by various trademark names, such as Vaseline. The clear liquid form of petroleum is mineral oil, and when fragrance is added is also known as baby oil. Mineral oil, or liquid petrolatum, is a by-product in the distillation of petroleum to produce gasoline. Mineral oil does not easily absorb into the skin, is non-edible, is a substance of relatively low value, and is produced in very large quantities. Classed as a petrochemical pollutant and xenohormone, Mineral Oil can have negative effects on hormones and the skin's ability to breathe, attract moisture and detoxify Skin Patch Test Before using oil for pediatric massage, it is a good idea to perform a patch test to ensure the child does not have any allergic reaction to the oil chosen. Some children have allergies to nut based and wheat based oils. To perform a patch test, apply a small amount of oil to the child’s skin at least thirty minutes prior to massage. A good place to perform the skin test is on the inside of the child’s arm near the wrist. Observe the skin and notice if any blotches or discolorations appear. If there is any sign of an allergic reaction, do not use the oil. If any red blotches appear they should disappear in approximately one and a half hours.

FAST FACT

Almond is a fruit



Research on Massage Therapy for Children | Autism (ASD) & ADD/ADHD specific

“Research that proves the benefits of massage therapy is a useful tool in explaining the power of massage to your clients”.

- American Massage Therapy Association

Autism & Massage Sixty (60) autistic children, mean age 4.67 ± 1.82, were recruited. No statistical differences were seen in the demographic and baseline data among both groups. From both the Conners' Teacher Questionnaire and SD, statistical improvement was detected for conduct problem, hyperactivity, inattention-passivity, hyperactivity index, and sleeping behavior. However, results from the Conners' Parent Questionnaire revealed an improvement only for anxiety (p = 0.04) in the massage group, whereas when both groups were compared, a significant improvement in conduct problem (p = 0.03) and anxiety (p = 0.01) was found. Results indicated that TTM may have a positive effect in improving stereotypical behaviors in autistic children. Piravej, K, Tangtrongchitr, P, Chandarasiri, P, Paothong, L, and Sukprasong, S. Effects of Thai Traditional Massage on Autistic Children’s Behavior. The Journal of Alternative and Complementary Medicine. 2009 15(12); 1355-1361.

____________________________________________________________________ Autism is commonly associated with sensory and self-regulatory disturbances. This article presents a randomized controlled study evaluating the effect of a 5-month intervention directed toward improving sensory impairment, digestion, and sleep in 46 children with autism < age 6. The intervention, Qigong Sensory Training (QST), is a qigong massage intervention based in Chinese medicine. It is two-pronged: Trainers work with children directly 20 times over 5 months, and parents give the massage daily to their children. Improvement was evaluated in two settings--preschool and home--by teachers (blind to group) and parents. Teacher evaluations showed that treated children had significant classroom improvement of social and language skills and reduction in autistic behavior compared with wait-list control participants. These findings were confirmed by parent data, indicating that the gains had generalized across contexts. A model and supporting data for understanding and treating sensory and self-regulation problems in autism is presented. Silva LM, Schalock M, Ayres R, Bunse C, Budden S. Qigong massage treatment for sensory and self-regulation problems in young children with autism: a randomized controlled trial. Am J Occup Ther. 2009 Jul-Aug;63(4):423-32.

____________________________________________________________________ In clinical research, sensory impairment is considered one of the core deficits in autism and is associated with impaired socialization, behavioral disturbances and bowel and sleep problems. The effectiveness of the Cignolini methodology, an original Qigong massage methodology, in treating sensory impairment in young children with autism was evaluated in a small, controlled study. Thirteen children with autism between the ages of three and six received daily treatment according to the methodology for 5 months. Compared with untreated children, treated children experienced significant improvement of their sensory impairment (p < 0.01), and demonstrated increased social skills (p < 0.04) and basic living skills (p < 0.02) on standardized measures. In addition, all of the children with bowel and sleep abnormalities demonstrated improvement after treatment. Silva, L. et. al (2007) Improvement in Sensory Impairment and Social Interaction in Young Children with Autism Following Treatment with an Original Qigong Massage Methodology, The American Journal of Chinese Medicine (AJCM), Volume: 35, Issue: 3 393-406 ____________________________________________________________________ Children with autistic spectrum disorders (ASD) characteristically display a lack of shared attention behaviours and the lack of these behaviours impacts on their ability to develop social interactions and relationships with others. Steve Solomons, assistant headteacher at Rectory Paddock School and Research Unit in the London Borough of Bromley, set out to explore these issues as an aspect of practice when he was working at St. Ann's School in the London



Borough of Merton. He carried out this research as part of his MEd in special education at the University of Birmingham, for which he received the prestigious Annie Deakins prize in 2003. The aim of his study was to investigate whether aromatherapy massage could increase shared attention behaviours in a sample of four children with autistic spectrum disorders and severe learning difficulties (SLD). Aromatherapy massage was introduced into the daily timetable and children's responses were observed. The results indicate that children's shared attention behaviours increased during aromatherapy massage and that other aspects of their behaviour also changed over the course of the research. Family involvement in the study enabled these changes to be transferred from school to home. In this article, Steve Solomons explores the implications of his research for new teaching and learning opportunities for children with autistic spectrum disorders and severe learning difficulties. Solomons,, S. (2005) Using aromatherapy massage to increase shared attention behaviours in children with autistic spectrum disorders and severe learning difficulties, British Journal of Special Education, Volume 32 Issue 3, Pages 127 - 137 ____________________________________________________________________ This exploratory study aimed to address two questions: (1) What does touch mean between parents and their children

with autism on completion of a massage intervention? (2) Do parents feel that their relationship with their children has changed on completion of a massage intervention? Fourteen parents agreed to be interviewed. Data were collected before the massage intervention (baseline), immediately after the massage intervention and 16 weeks from baseline and were analysed using interpretative phenomenological analysis. At baseline, parents felt distressed that they felt unable to get ‘close’ to their children. After the intervention, parents reported feeling physically and emotionally closer to their children. Children expressed a range of cues to initiate massage at home. These benefits were maintained at follow-up for parents who continued to use massage at home. In conclusion, giving massage to children with autism may help to enhance the emotional bond between parent and child.

Cullen-Powell, L. A., et. al (2005) Exploring a massage intervention for parents and their children with autism: the implications for bonding and attachment, Journal of Child Health Care, Vol. 9, No. 4, 245-255 ____________________________________________________________________

The aims of this study were (1) to explore the experience of touch between parents and children with autism before, during, and after a Training and Support Programme (TSP), and (2) to develop a model of the process of touch therapy for this group of parents and children. Fourteen parents and their children agreed to take part in the study. Five of these parents withdrew. Reasons for withdrawal included personal circumstances and ill health. Data were collected by semi-structured interviews with parents before attending the TSP and Home Record Sheets completed by parents during the TSP. Results indicate that before the TSP touch was experienced as out of parents' control. During the TSP, the experience of touch appeared to change. A key benefit gained by parents was the feeling of closeness to children. The key benefits gained by children were perceived by the parents as improved sleep patterns, children were more relaxed after receiving the massage and appeared more amenable to touch. Of interest was children's request for massage at home. At 16-week follow-up both parents and children continue to enjoy giving and receiving touch therapy, respectively. Cullen LA, Barlow JH, Cushway D.(2005) Positive touch, the implications for parents and their children with autism: an exploratory study. Complement Ther Clin Pract. 11(3):182-9.

____________________________________________________________________ A medical Qigong protocol was applied to a group of eight autistic children under the age of six. The children received medical Qigong massage twice weekly from the physician and daily Qigong massage from the parents for a five-week period, followed by daily parent massage for an additional four weeks. Standardized tests showed a decrease in autistic behaviors and increase in language development in all the children, as well as improvement in motor skills, sensory function and general health. Silva LM, Cignolini A. A medical qigong methodology for early intervention in autism spectrum disorder: a case series. Am J Chin Med. 2005;33(2):315-27.

____________________________________________________________________ The aim of this qualitative study was to explore the experiences and meaning of touch between parents and children with autism before and after attending a Touch Therapy Programme. The sample comprised 12 parents (1 father and 11 mothers) of children (1 female and 11 male) with autism. Parents were interviewed before and immediately after



the 8-week programme. Pre-programme results suggested that children were controlling the experience of touch. Parents felt 'hurt' in response to the 'aloof nature of autism, and natural parenting instincts (e.g. spontaneous cuddles) were restricted. Post-programme results suggested that children appeared to tolerate touch. Parents reported that routine tasks (e.g. dressing) were accomplished more easily and that children appeared generally more relaxed. Parents reported feeling 'closer' to their children and felt that the touch therapy had opened a communication channel between themselves and their children. Cullen L, Barlow J. Kiss, cuddle, squeeze: the experiences and meaning of touch among parents of children with autism attending a Touch Therapy Programme. J Child Health Care. 2002;6(3):171-181.

____________________________________________________________________ Children in the massage group exhibited less stereotypic behavior and showed more on-task and social relatedness behavior during play observations at school, and they experienced fewer sleep problems at home. Escalona, A., Field, T., Singer-Strunck, R., Cullen, C., & Hartshorn, K. (2001). Brief report: improvements in the behavior of children with autism following massage therapy. Journal of Autism & Developmental Disorders, 31, 513-516. ____________________________________________________________________ Thirty-eight children with autism were given movement therapy in small groups led by a trained movement therapist. After two months of biweekly sessions, the children spent less time wandering, more time showing on-task behavior, less time showing negative responses to being touched, and less time resisting the teacher than those in the control group.

Hartshorn,K., Olds, L., Field, T., Delage, J., Cullen, C. and Escalona, A. (2001) Creative movement therapy benefits children with autism. Early Child and Development and Care,166,1-5. ____________________________________________________________________ This study investigated the effects of touch therapy on three problems commonly associated with autism including inattentiveness (off-task behavior), touch aversion, and withdrawal. Results showed that touch aversion decreased in both the touch therapy and the touch control group, off task behavior decreased in both groups, orienting to irrelevant sounds decreased in both groups, but significantly more in the touch therapy group, and stereotypic behaviors decreased in both groups but significantly more in the touch therapy group. Field, T., Lasko, D., Mundy, P., Henteleff, T., Talpins, S., & Dowling, M. (1986). Autistic children's attentiveness and responsitivity improved after touch therapy. Journal of Autism and Developmental Disorders, 27, 329-334. ____________________________________________________________________

ADHD

Thirteen adolescents with Attention Deficit Hyperactivity Disorder (ADHD) participated in Tai Chi classes twice a week for 5 weeks. Teachers rated the children's behaviour on the Conners Scale during the baseline period, after the 5 week Tai Chi session period and 2 weeks later. After the 10 Tai Chi sessions the adolescents displayed less anxiety, improved conduct, less daydreaming behaviours, less inappropriate emotions, and less hyperactivity. These improved scores persisted over the 2-week follow up (no Tai Chi period). Hernandez-Reif, M., Field, T. & Thimas, E. (2001). Attention deficit hyperactivity disorder: benefits from Tai Chi. Journal of Bodywork and Movement Therapies, 5, 120-123. ____________________________________________________________________

Anxiety

Compared with a control group who viewed relaxing videotapes, the massaged subjects were less depressed and anxious and had lower saliva cortisol levels after the massage. In addition, nighttime sleep increased for both groups over the study period and urinary cortisol and norepinephrine levels decreased, but only for depressed patients. Field, T., Morrow, C., Valdeon, C., Larson, S., Kuhn, C., & Schanberg, S., (1992). Massage reduces anxiety in child



and adolescent psychiatric patients. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 125-131. ____________________________________________________________________

Two groups were formed for the study; the control group watched a one hour relaxing videotape, while the treatment group participated in a one hour class consisting of yoga exercise, a brief massage, and progressive muscle relaxation. Decreases were noted in both self-reported anxiety and anxious behavior and fidgeting as well as increases in positive affect in the relaxation therapy, but not the videotape group. Cortisol decreased following both relaxation therapies. Platania Solazzo, A., Field, T., Blank, J., Seligman, F., Kuhn, C., Schanberg, S., & Saab, P. (1992). Relaxation therapy reduces anxiety in child and adolescent psychiatric patients. Acta Paedopsychiatrica, 55, 115-120. ____________________________________________________________________

Sleep Following five 30-minute massages these children/ adolescents had better sleep patterns, lower depression and anxiety and lower stress hormone levels (cortisol and norepinephrine). Field, T., Morrow, C., Valdeon, C., Larson, S., Kuhn, C., & Schanberg, S. (1992). Massage therapy reduces anxiety in child and adolescent psychiatric patients. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 125-130. ____________________________________________________________________

Preschool children who had received massage fell asleep sooner and slept longer during nap time, had decreased activity levels and better behavior ratings. Field, T., Kilmer, T., Hernandez-Reif, M., & Burman, I. (1996). Preschool Children's Sleep and Wake Behavior: Effects of massage therapy. Early Child Development and Care, 120, 39-44. ____________________________________________________________________

Infants who received massage therapy before bedtime by a parent experienced less difficulty falling asleep and better sleep patterns. Field, T. & Hernandez-Reif, M. (2001). Sleep problems in infants decrease following massage therapy. Early Child Development and Care, 168, 95-104.



Infant & Pediatric Massage Courses

Liddle Kidz Foundation | Pediatric Massage Education and Training Courses | Professionals

Liddle Kidz™ Certified Infant Massage Teacher Training | CIMT™ Our professional trainers experience great joy in sharing the art of infant massage with others. Teaching Infant Massage is a rewarding opportunity, promoting well being and enhancing bonding and attachment between infants and their caregivers. As a Certified Infant Massage Teacher (CIMT) you have the unique opportunity to help parents to bond with their babies through the use of an age old tradition – infant massage.

Liddle Kidz™ Pediatric Massage Therapist Training | CPMT™ The comprehensive Pediatric Massage Training for Massage

Therapists and health care professionals provides educational and professional training to those who wish to enhance their skills. Through this training, participants learn to provide massage therapy for children with special health care needs, who are hospitalized or have been diagnosed with a terminal illness in hospice care.

Touch Therapy for Liddle Kidz™ with Autism The comprehensive Touch Therapy for Liddle Kidz™ with Autism (Massage for Children with Autism) Course for massage therapists and healthcare professionals provides educational and professional training to those who wish to enhance their skills. Through this advanced training, participants learn to provide

massage therapy, nurturing touch techniques, touch therapy, tactile introduction, sensory stimulation & integration for children who have been diagnosed on the Autism Spectrum Disorder.

Touch Therapy for Liddle Kidz™ with Cancer The comprehensive Touch Therapy for Liddle Kidz™ with Cancer (Massage for Children with Cancer) Course for massage therapists and healthcare professionals provides educational and professional training to those who wish to enhance their skills. Through this advanced training, participants learn to provide massage therapy, nurturing touch techniques and touch therapy for children who have been diagnosed with Cancer.

Touch Therapy for Liddle Kidz™ with Cerebral Palsy The comprehensive Touch Therapy for Liddle Kidz™ with Cerebral Palsy (Massage for Children with Cerebral Palsy) Course for massage therapists and healthcare professionals provides educational and professional training to those who wish to enhance their skills. Through this advanced training, participants learn to provide massage therapy, nurturing touch techniques, range of motion and touch therapy for children who have been diagnosed with Cerebral Palsy (CP).



Touch Therapy for Liddle Kidz™ The comprehensive Touch Therapy for Liddle Kidz™ (Massage for Healthy Children) Course for massage therapists and healthcare professionals provides educational and professional training to those who wish to enhance their skills. Through this training, participants learn to provide massage therapy, nurturing touch techniques, and touch therapy for children.

Touch Therapy for Liddle Kidz™ with Common Childhood Ailments The comprehensive Touch Therapy for Liddle Kidz™ with Common Childhood Ailments Course for massage therapists and healthcare professionals provides educational and professional training to those who wish to enhance their skills. Through this training, participants learn to provide massage therapy, nurturing touch techniques, and touch therapy for

children.

Peaceful Touch® | Healthy Touch Approach for Children in Schools Peaceful Touch® training programs integrate safe and nurturing touch into children's schools, (early school readiness, preschool and elementary school), and organized children’s activities. In order to integrate Peaceful Touch® into schools, we introduce educators to the use of healthy touch activities through the use of age specific curriculum. This curriculum includes games and storytelling, as well as adaptations for reading, math, and science. The Peaceful Touch® curriculum encourages children’s development through the use of nurturing and healthy touch.

Liddle Kidz™ Massage Program | Neonatal Intensive Care Unit | NICU Research has demonstrated that nurturing touch for an infant is critical in establishing the foundation of their psychological well-being. During this course, medical professionals are trained to communicate with medically fragile infants in the hospital-based Neonatal Intensive Care Unit through the use of comforting touch.

For more information on the Liddle Kidz Foundation:

www.LiddleKidz.com

For more information on overseas outreach to orphaned & abandoned children:

www.LiddleKidz.org

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