Massage for People with Special Needs
By Michael
Regina-Whiteley, LMT
As practicing massage therapists, we’ve all read
considerable literature touting the therapeutic benefits of massage: the positive affects on the immune system,
the improvement in skin condition, and the physical and mental health benefits
of relaxation. However, information addressing massage for people who have
developmental and physical and psychological disabilities is relatively
non-existent. This is a special population of people whose need for positive
human touch is neglected and most massage therapists are unaware of their
needs. Their “special needs” results
from the challenges they face daily from their developmental disabilities of mental
retardation, Down Syndrome, and Autism; physical disabilities of Cerebral
Palsy, seizure disorders and arthritis; and psychiatric disabilities. Some of
these people are challenged with more than one disorder and are considered
“dually diagnosed”.
Unfortunately, because of behaviors that are labeled
“maladaptive” (drooling, spitting, aggressiveness, compulsive biting and
banging, other self-inflicted injuries), these clients are usually deprived of
positive, caring human touch. The touch
they receive is often limited to that which is required to carry out basic
personal care needs and activities of daily living. Negative experiences with
touch may occur if a person requires restraint for control or frequent
transfers from wheelchairs and/or beds.
In addition, the majority of people who have been institutionalized due
to their disorders are victims of abuse (either institutional or at home) and
experience varying degrees of tactile defensiveness. These individuals need positive touch to regain trust.
A study [1]done
in 1987, at the Wayne County Intermediate School District in Detroit, Michigan
concluded that a program of massage therapy “…appeared to benefit three of the
five subjects who showed both quantitative and qualitative behavior
improvements…” after receiving two to three 45 minute massages per week to
treat self-injurious behaviors (SIB) such as head-banging or biting
oneself. The study further concluded
“…Massage therapy is considered an especially appropriate relaxation technique
with this group because it’s physical methodology does not require higher level
cognitive skills on the part of the recipient as other relaxation techniques
do…”
Massage therapy is also beneficial in controlling
physically aggressive and obstinate behaviors by providing relaxation for the
client. Over time building this trust through positive experiences reduces both
the incidence and duration of behavior that often necessitates the negative
experience of physical restraint. Both
the client and the direct care staff benefit from the results of massage therapy.
The benefits of massage therapy are not just limited
to the behavioral issues of people who have special needs but address some
physical concerns as well. It is an
excellent approach for temporary relief of muscle spasms in people with
Cerebral Palsy and other neurological disorders. It improves their range of motion and enables them to be more
independent in basic activities of daily living like getting dressed or
facilitating their ability to reach and use communication devices. Massage also
decreases the pain and stiffness suffered by individuals who have difficulty
communicating pain.
Did you know that roughly 25% of people who have
Down Syndrome have a susceptibility for Atlanto-Axial Instability, primarily
due to laxity of the transverse ligaments in the C1-C2 region? Subluxation of C1 and subsequent compression
of the spinal cord may occur during head rotation from as little as 2-15 kgs.
of pressure from a therapist. Massage therapists must be aware of this and know
the proper massage techniques for this population. In brief, this includes placing the person in the prone position,
using no traction or rotation, and massaging the occipital area.
In conclusion, it is obvious that these special
people have everything to gain from massage therapy. Massages meet their basic
need for human contact and provide them with positive experiences with touch.
Who is in a better position to provide this positive sensory experience than a
massage therapist? In most cases a massage therapist is not required to use
special or different massage techniques when providing services to people with
special needs. What is required is sensitivity to their need for touch, to
develop the communication techniques to understand and meet those needs, and
the interest and willingness to provide these services. To do so is not likely to result in radical
changes in the person’s disability but it is likely to improve the quality of
their lives. Consider this a new
challenge and direction for your healing touch. ©Michael Regina-Whiteley,
LMT, Healing HouseCalls
[1] McEvoy, Christopher and others: “The use of Massage Therapy in the Treatment of Self-Injurious Behaviors”, 1987. ,ERIC Document #ED308687