Special Smashwords Edition
Pediatric Massage Revised
For the Child with Special Needs
By
Kathy Fleming Drehobl and Mary Gengler Fuhr
Pediatric Massage Revised
Special Smashwords Edition
This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each person you share it with. If you are reading this book and did not purchase it, or it was not purchased for your use only, then you should return to Smashwords.com and purchase your own copy. Thank you for respecting the hard work of the author.
Copyright © 2011 Kathy Fleming Drehobl and Mary Gengler Fuhr
All rights reserved, including the right to reproduce this book, or portions thereof, in any form. No part of this text may be reproduced, transmitted, downloaded, decompiled, reverse engineered, or stored in or introduced into any information storage and retrieval system, in any form or by any means, whether electronic or mechanical without the express written permission of the author. The scanning, uploading, and distribution of this book via the Internet or via any other means without the permission of the publisher is illegal and punishable by law. Please purchase only authorized electronic editions and do not participate in or encourage electronic piracy of copyrighted materials.
The publisher does not have any control over and does not assume any responsibility for author or third-party websites or their content.
ePublished and distributed by Smashwords
http://www.smashwords.com
© 2000, 2006 by PRO-ED, Inc. 8700 Shoal Creek Boulevard Austin, Texas 78757-6897 800/897-3202 Fax 800/397-7633 www.proedinc.com
All rights reserved. No part of the material protected by this copyright notice may be reproduced or used in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without prior written permission of the copyright owner.
NOTICE: PRO-ED grants permission to the user of this material to make unlimited copies of the reproducible workbook pages for teaching or clinical purposes. Duplication of this material for commercial use is prohibited.
Portions of this work were published in previous editions.
ISBN-13: 978-141640306-7 ISBN-10: 1-4164-0306-X
Previously printed by Therapy Skill Builders, a division of the Psychological Corporation, under ISBN 0-7616-4092-4.
Printed in the United States of America 12 3 4 5 10 09 08 07 06
Dedication
Past revisions of this book have been dedicated to individuals whose careers and caring have made significant differences in the lives of families. This work has evolved through the efforts of a number of infant massage instructors, physicians, therapists (OT, PT, SLP, Massage), early childhood specialists, social workers, and others who have offered their expertise and shared this tool with parents and children with special needs.
Our dedication now is to the most important people that have given this work value in their lives and relationship… the families and children we serve. Families have given us insight into the many ways they have incorporated massage into their home routine and their children's positive responses.
Pediatric massage provides many physiological, sensory-motor, and psychological benefits. Families share with us that after massage, their children:
sleep better
have decreased hypersensitivity to touch
feed more easily
achieve a calm-alert state
are better able to move and use their extremities
make eye contact with family and toys
connect and communicate better
Many parents and caretakers also report enjoying the positive benefits of being the giver of a massage.
All of these contribute to positive family routines and relationships. Our families have used massage to make the intense, and sometimes overwhelming experience of parenting, more joyful and less stressful. In essence, the real experts in using these techniques are parents and caregivers. They have taken an ancient practice and made it an important part of every-day life. Thus, we would like to honor the families who have used massage and shared their experiences and wisdom with us. We are continually amazed by the power of touch to enhance communication and deepen the parent-child relationship.
About the Authors
Kathy Fleming Drehobl graduated from Indiana University with a B.S. degree in occupational therapy. She has practice occupational therapy since 1983 with emphasis on the 0-3 population. Kathy is certified in both infant massage and myofacial release. Kathy has also completed the 8-week basic Neuro-Developmental Therapy (NDT) course as well as the Advanced Baby NDT course. Kathy has also has assisted in NDT courses.
Kathy has taught academically at the Arizona School of Health Sciences and clinically in workshops around the country. She was awarded the Arizona Distinguished Achievement award through the Arizona OT Association in 1996. Kathy has worked and consulted with children and their families in hospitals, developmental centers, high-risk newborn follow up, private practice, public schools, and infant-stimulation programs.
Mary Gengler Fuhr graduated from the University of Wisconsin - Madison with a B.S degree in occupational therapy. She has worked in pediatrics since 1982. Mary currently has a private practice, Maple Valley Pediatric Therapy (a division of Relaxing Resources, PLLC) in the greater Seattle, WA area. Mary is a certified educator of infant massage and is on the advisory board of Infant Massage USA. She is certified in Neuro-Developmental Treatment (NDT) and has completed the NDT baby course. Mary's background in sensory integration includes practicum coursework as well as certification in the administration and interpretation of the Sensory Integration and Praxis Tests.
Mary is also a registered yoga teacher, specializing in work with children. She has presented workshops and provided consultation throughout the US, and internationally. Mary has had the opportunity to work with children and their families in their homes, developmental centers, and the public schools.
Mary and Kathy share a passion for this work and developed a workshop, "Pediatric Massage for the Child with Special Needs," for parents and professionals. Feed back from those attending the courses have richly contributed to the expansion and application of the techniques. Mary and Kathy are grateful to those who have shared their personal experiences and expertise so that this work can continue to grow.
Acknowledgements
Writing this book has been an ongoing journey and the fulfillment of a dream for us. We have been committed to exploring, developing, and sharing the benefits of pediatric massage since we met in 1987. We both were inspired by our infant massage certification training and the work of Vimala Schneider McClure. Our goal was to expand upon it to include the infants and children we were working with in our therapy practices.
Throughout the process of sharing infant massage with parents, presenting workshops and writing this book, we have benefited from the expertise and help of parents, children, and professionals from around the world. We are indebted to all oí those who have offered their knowledge, skills, and enthusiasm to us. Massage for children with special needs continues to be a work in progress.
We are especially grateful to:
Our parents, families, and Bob Fuhr for their constant support and encouragement throughout both the ideation and creation of our workshop, video, and this book.
Our children Erik, Matthew, Michael, and Emma for their patience and love during the lengthy process of authoring this book. Sharing massage with our children has been a deeply enriching experience. They continue to inspire us to expand this work and keep us aware of the therapeutic value of touch in parenting.
Victoria Ryecroft, Cody Brown, Seth Rich, Katie Layzell, and Trevor Barton and their families, who shared their massage experiences in photographs so line art could be rendered.
Rhoda Erhardt, M.S., OTR, FAOTA, for her generosity, support, and encouragement of our work throughout the years and especially for her insightful contribution to this book.
Dr. Melvin Morse for his sensitivity to children's health and well-being and ongoing support of our infant massage projects.
Shereen Farber, Ph.D., OTR, FAOTA, who has shared her time, wisdom, and expertise in helping us integrate the world of caring touch with solid neurological principles.
Gay Lloyd Finder, Ph.D., CCC-Sp, for sharing her positive energy, and expertise in the area of oral motor development and treatment.
Marsha Dunn Klein, M.Ed., OTR, who gave invaluable encouragement with enthusiasm and kindness.
Rodd Hedlund, M.Ed., for providing us with excellent resources, information, and feedback about developmental care in the intensive care nursery, infant behavior, and early intervention.
Workshop participants who continually share their expertise and enrich our knowledge base.
The Touch Research Institute that has expanded the body of knowledge related to massage by expansive research with diverse populations. We support their work and look forward to their continued, admirable efforts in research.
Vimala Schneider McClure, a pioneer in the practice of infant massage in the United States, and the International Association of Infant Massage for providing inspiration for the development of this work
Preface
As pediatric clinicians, we are constantly seeking methods of facilitating developmentally appropriate adaptive responses as well as promoting parent-infant interaction. Tactile intervention has long been a successful way to impact sensory systems. The authors would like to present this publication as a guideline to massage for children with special needs.
We hope this book will assist parents and practitioners in safe and effective use of massage for children with special needs. We are confident that gentle touch and massage can be a positive and enjoyable experience for most children.
There are many excellent texts describing massage strokes for children. The authors have chosen the strokes in this text, based on the work of Vimala Schneider McClure and the International Association of Infant Massage because they:
are easily adapted for children with special needs.
can be used in conjunction with therapeutic positioning and handling
help promote the attainment of therapeutic and educational goals
enhance parent-child interaction
have proved to be clinically valuable
A powerful sensory intervention, massage introduces many physical, social, and somatosensory benefits for children. This material is best used as a supplement to existing team-oriented therapeutic and educational programming. Massage is a holistic contribution to family-centered intervention and may be utilized by a variety of people involved with the child and parents including therapists, educators, nursing staff, care providers, relatives, and friends.
As is always the case when children with special needs are involved, it is important to consult with medical personnel to assure that massage will be safe. Each member of the team, including parents, has unique knowledge and expertise to contribute which enriches the total experience.
An Historical Perspective
Touch and massage have always been part of the human experience. Many cultures have offered insights into the therapeutic value of tactile intervention such as swaddling, skin-to-skin contact, and massage. The Eskimo culture has demonstrated the importance of swaddling in preservation of body temperature and promotion of calming behavior in infants. Medical personnel in Bogota, Columbia, have introduced the kangaroo care method of providing skin-to-skin contact for preterm infants. In this method, the undressed infant is placed between the mother's breasts, underneath her clothing, to promote feeding, body temperature regulation, and calming (Anderson, 1986). In recent years fathers also have been involved in providing this ventral-to-ventral, tactile input. In some regions of India, infants are regularly bathed and massaged with a variety of oils. These cultural influences and many others have helped shape the current use of gentle touch and massage with children.
Recent research with healthy premature and term infants, as well as other populations with special needs, has led to the rediscovery of an ancient art to provide pleasurable touch to infants and children. The use of massage in pediatric care is further supported by clinical observations associated with the use of touch in therapeutic programming. The therapeutic benefits of touch/massage may range from parent-infant interaction to physiological changes. Touch and massage are done in many ways-swaddling; pressure; gliding strokes; gentle friction; or simple, sustained hand placement. This gives the massage giver conservative methods of providing tactile input to medically fragile children, as well as healthy, typically developing children.
We would like to see our culture embrace touch as essential for any child's health and well being. This revised edition expands on our initial observations and current knowledge about massage. Through our infant massage instruction with parents, teaching of workshops, and ongoing research, we have provided an updated, thorough resource to guide the massage giver toward the safe and therapeutic use of massage. We hope that massage will become a consistent, therapeutic interaction, and that children with special needs will be touched literally and emotionally. Kind, compassionate touch coupled with sound knowledge of massage principles is a powerful and therapeutic tool. We are convinced that parents and their children will experience a profound connection through pediatric massage.
Foreword
The publication of this revised edition of Pediatric Massage could not be timelier. For more than 9 years since the first edition was written, it has been widely used by therapists, nurses, teachers, and parents to benefit children with special needs. During that time, there has been an explosion of interest and research in the fields of touch and massage, as well as more variety of accessible resources, such as web sites, books, music, and training programs, which are listed with addresses and phone numbers in the resource section. The authors have expanded this edition with new information gained not only from their many years of clinical experience and teaching but also from their perspective as parents, since each has a child with sensory integration issues. Their own children have especially enhanced their understanding of the significance of sensory input related to behavioral responses.
At a time when technology is escalating rapidly, it is essential for professionals to ensure that the art of healing is balanced with the science of healing. Emphasis continues to be placed on family centered care, and the role of massage in bonding and attachment has been expanded. The techniques so carefully described and illustrated are especially empowering for parents in creating successful interactions with their child.
Readers familiar with the first edition will find the organization and structure of the book unchanged, with new material inserted into the easily located chapters. For example, the chapter Potential Benefits of Massage now includes specific information for infants and children with colic, self-regulation disorders, sensory defensiveness, and autistic spectrum disorders, as well as children with spina bifida, congenital malformations, vision and/or hearing impairments, different types of cerebral palsy, terminal illness, and those affected by physical or drug abuse. Also, the chapter Getting Started now includes aromatherapy as part of the preparation process.
The research chapter has been updated with reported studies of the effects of massage on a greater variety of diagnoses, including cystic fibrosis, asthma, ADHD, dermatitis, diabetes, HIV, prematurity, and self-injurious behavior, as well as studies on typical preschoolers. Each abstract is summarized according to diagnosis, subjects, researchers, conditions, and results, giving the reader a birds'-eye view of each. In addition, the bibliography has been expanded and updated to include both current and historical listings of references relating to touch and massage.
The Massage Strokes chapter provides much more detail, adding specific clinical implications of each stroke. For example, one lower extremity stroke is done with the pattern of hair growth, thus producing inhibition or relaxation. It is useful and pleasurable for children with increased muscle tone since the pressure is very even and rhythmical. The stroke can be used therapeutically to elongate hamstring and adductor muscles, preparing for lower-extremity weight bearing. At the same time it promotes visual attention to the feet, assisting in downward gaze and convergence of eye muscles.
Detailed instructions and clear illustrations are provided to insure correct positioning, movements, and safety, and they are especially useful for teaching students and parents. It is with great enthusiasm that I recommend this practical manual as an outstanding source of information for all practitioners who recognize the value of the power of touch and the importance of its use as a clinical tool.
Rhoda P. Erhardt, M.S., OTR, FAOTA
Consultant in Pediatric Occupational Therapy
Maplewood, Minnesota
Contents
Chapter 1
General Physiological Effects of Therapeutic Massage
Introduction
Benefits
Summary
Chapter 2
Psychosocial Considerations
Birth History
Bonding and Attachment
The Role of Massage in Bonding and Attachment
Summary
Chapter 3
Potential Benefits of Massage
Introduction
Common Benefits of Massage
The Child With Hypertonicity
The Child With Hypotonicity
The Child With Spina Bifida
The Infant With Colic
The Child With Self-Regulatory Disorders
The Child With Sensory Defensiveness
The Child With Terminal Illness
The Child With Autistic Spectrum Disorder
The Child With Congenital Malformations
The Child With Visual Impairment
The Child With Hearing Impairment
The Preterm Infant
Infants Affected by Maternal Drug Abuse
The Physically Abused Child
Other Situations
Chapter 4
Infant States
Introduction
Definitions
State and the Introduction of Massage
Crying
Responses to Crying
Crying and Massage
Effects of Massage on State-Related Behaviors
Summary
Chapter 5
The Autonomic Nervous System and Massage
Overview
Functional Anatomy
The Parasympathetic Division
The Sympathetic Division
Balance Within the Autonomic Nervous System
ANS and Massage
Neurotransmitters
Involuntary Control
Functions of the Parasympathetic and Sympathetic Systems
Measurement Criteria
Range of Norms for Vital Signs
Altering Touch
Pressure
Direction
Speed/Frequency
Temperature
Duration of Stimulus
Implications for Massage
Chapter 6
Signs and Symptoms of Overstimulation
Adaptive Responses
Guidelines for the Preterm Infant
Research
Definitions of Types of Tactile Input
Responding to Cues
Stress Signals
Listening to Infants
Engagement and Disengagement
Crying
Modifying the Massage Experience
Summary
Chapter 7
Medical Considerations
Introduction
Acute Infections
Cardiac and Circulatory Conditions
Skin Disorders
Orthopedic Conditions
Abdominal Conditions
Inflammatory Conditions
Neurological/Nervous System Conditions
Respiratory Conditions
Digestive System Disorders
Other Medical Concerns
Endangerment Sites
Summary
Sample Physician Approval Form for Pediatric Massage
Sample Letter to Physician or Primary Healthcare Provider
Chapter 8
Research
Introduction
Chapter 9
Some Common Questions
Chapter 10
Getting Started
Introduction
Materials
Oils and Lotions
Aromatherapy
Preparation
Environment
Chapter 11
General Positioning Principles
Introduction
Supine and Prone
The Supine Position
The Prone Position
Other Positions
Sidelying
Sitting
Prone Suspension—the Football Hold
At the Shoulder
Positioning Devices
Summary
Chapter 12
Massage Strokes
Introduction
Making Contact
Lower Extremities
1. Indian Milking—Away From the Heart
2. Wringing
3. Thumb Press
4. Squeeze Each Toe
5. Stroke Top of Foot
6. Circle Around the Ankles
7. Swedish Milking—Toward the Heart
8. Rolling
Abdomen
1. Gentle Pressure on the Abdomen
2. Paddle Wheel
3. Paddle Wheel With Legs Lifted
4. Sun Moon
5. I Love You
6. Gentle Pressure on the Abdomen
Chest
1. Heart
2. Criss-Cross
3. Shoulder to Toes
Upper Extremities
1. Symmetrical Starting Stroke
2. Indian Milking—Away From the Heart
3. Wringing
4. Thumb Press in Palm
5. Small Circles in Palm
6. Squeeze Each Finger
7. Stroke Top of Hand
8. Circles Around the Wrist
9. Swedish Milking—Toward the Heart
10. Rolling
Back
1. Swooping to the Bottom
2. Swooping to the Ankles
3. Back and Forth
4. Small Circles All Over the Back
5. Combing
Face
1. Forehead to Mouth
2. Eyebrows to Mouth
3. Nose to Mouth
4. Pressure Toward the Mouth
5. Finishing Stroke for the Face
Resources
Information and Training
Supplies, Books and Music
References
Bonding/Attachment
The High-Need Baby
Infant Massage
Development/Medicine/Neurophysiology
Research
Sensory Integration
Tactile Intervention/Massage
Aromatherapy
Chapter 1
General Physiological Effects of Therapeutic Massage
Introduction
Adults who have received a massage know that it can relax the muscles and relieve stress, tension, pain, and stiffness. Conversely, massage can have an invigorating effect. The effects of massage vary from client to client as each person’s specific needs differ. It is critical to have an understanding of a child’s medical history and current status as well as a thorough assessment before beginning massage. It also is important to understand the physiological changes that can be produced by massage.
This book describes tactile intervention for children that differs from traditional adult massage (such as Swedish massage) in intensity, positioning, interaction, and goals. Pediatric massage is a powerful sensory tool that offers many benefits to children. It is a highly interactive experience with the massage giver carefully monitoring the child’s responses and adjusting their intervention accordingly. This book was developed specifically for the purpose of introducing the benefits of massage to children with special needs in a safe, therapeutic, and pleasurable manner.
This chapter provides an overview of the general physiological benefits of massage, typically based on literature pertaining to adults. A detailed summary of the current research with children is provided in Chapter 8. Chapter 3 discusses specific benefits of massage for children with special needs based on clinical observations and experiences.
Massage benefits are objective and subjective. Fritz (1995) acknowledged that massage benefits must be measured by objective (observation) and subjective (client report) measures. She further elaborated that the global term massage might be quite varied in application. For instance, under the term massage are techniques such as Swedish massage, Indian massage, reflexology, and shiatsu. This makes it difficult to define the specific benefits of massage, as each technique offers different therapeutic value.
The Touch Research Institute at the University of Miami has made great strides in helping quantify and validate the efficacy and expansive benefits of massage. The institute’s extensive research with infants, children, and adults has broadened our knowledge of the powerful therapeutic effects of massage.
Benefits
Massage increases and improves circulation—especially venous and lymphatic flow. According to Beck (1994), massage increases blood flow to the massaged area, enabling better cellular nutrition and elimination. The increased blood flow occurring at a local level is accomplished by compression of soft tissues that empty venous beds and increases capillary blood flow (Fritz, 1995). An additional benefit is facilitation of the flow of venous blood and lymph back toward the heart for the process of elimination. Beck (1994) estimated that blood passes three times more rapidly through muscles being massaged than those at rest. Clinically, improved circulation is observed as healthy, pink, even skin coloration with an increase in skin temperature. Tappan (1998) suggested that regular use of massage in a health-care routine might reduce blood pressure and heart rate. In addition, she advocated the use of gravity as an assist to promote venous flow. Fritz (1995) concurred with the therapeutic use of gravity as well as range of motion to improve venous flow and return. Fritz also stated that circulation is improved primarily by biomechanical effects and secondarily through reflexive responses encouraging chemical secretions. She also related the importance that improved circulation offers in delivering nutrients and oxygen to local and general areas. Conversely, massage assists in eliminating carbon dioxide, metabolites, and other toxins. Effleurage strokes (long, sweeping, gliding strokes), moving from distal to proximal, particularly help in the movement of blood and lymph, clearing the interstitial spaces of metabolic wastes. This is important to optimize cellular nutrition and oxygenation (Newton, 1998).
Massage reduces certain types of edema. Edema occurs as a result of excess accumulation of fluid in the interstitial spaces. It often occurs in cases of immobility in which massage may prove therapeutic. Beck (1994) referred to edema as a circulatory abnormality that generally is described as puffiness in the extremities, with some cases being more widespread. Tappan (1998) discussed it not as a disease process but as a manifestation of altered physiological function. This may be mechanical or of a more serious nature such as protein imbalance, increased capillary permeability, or obstruction of lymph flow. Massage is contraindicated in the case of edema due to cardiac or kidney failure, torn tissues, internal bleeding, or the pitted type of edema. Refer to Chapter 7 for more information.
Massage improves skin nutrition and helps remove dry, scaly skin. Massage activates sensory receptors in the skin and increases the superficial circulation (Tappan, 1998). The friction associated with massage assists in removing dead skin. Moisture or lotion may facilitate this process. Tappan (1998) advocated the use of oil in massage where there is a dry climate, aging skin, or specific dry skin conditions. Natural oils from cold-pressed fruits and nuts are some of the best massage lubricants. It is important to consult with a dermatologist if there are skin allergies or fragility of the skin. Fernadez, Patkar, Chawla, Taskar, and Prabhu (1987) used corn oil in a study with preterm infants in India in an effort to preserve body temperature and provide nutrition. This study supports the therapeutic role of oils in massage.
Massage stimulates organs and body systems by reflex stimulation in the skin and subcutaneous tissues. Tappan (1998) described the reflex effects of massage as the result of pressure or movement in one part of the body having an effect on a different body part. She suggested that massage activates the sensory receptors of the skin and subcutaneous tissues, eliciting reflexive effects. This stimulation is passed along afferent (incoming) fibers of the peripheral nervous system directly to the spinal cord. From there it is possible that they disperse through central and autonomic pathways. Some examples may be capillary vasodilatation, vasoconstriction, or gooseflesh. There also may be potential sedation or stimulation of sensory reception with associated reduction or increase in pain. Massage must be monitored carefully to assure that these reflexive effects are therapeutic and do not produce undesirable effects. Some additional autonomic negative effects may include nausea, pallor, or sweating. The clinician should use massage so that desirable autonomic effects such as muscular relaxation, reduction of pain, and more focused attention may be produced. Fritz (1995) described some chemical reflexive responses associated with massage as being the secretion of endorphins and the release of histamine.
Field, et al. (1992) reported decreases in urinary cortisol (a stress hormone) and decreased norepinephrine levels as a result of massage, in a study of adolescents with depression. (Refer to Chapter 5 for more information about the tactile system's influence on the ANS.)
Massage prevents fíbrosis/adhesions in muscles and decreases the tendency toward muscular atrophy and/or contractures. Beck (1994) described fibrosis as the process where muscle tissue is being replaced with fibrous connective tissue. Tappan (1998) referred to fibrosis as an abnormal collagenous connective tissue. Immobility, chronic stress, and trauma, as well as muscular/fascial restriction may contribute to this process. Massage may assist in restoring soft and connective tissue pliability and improve the performance of the tissue. Massage will not prevent atrophy in deneravated muscles; however, it may assist in recovery after injury if typical innervation is present (Tappan, 1988).
Massage maintains muscles in the best possible state of nutrition, flexibility, and vitality so that they can function at maximum potential. Typical muscles release metabolic waste products by milking toxins via the lymphatic and venous systems. As muscles relax, fresh blood flow brings necessary nutrients to the area. This balanced process may be disturbed through overactivity or underactivity of muscular contraction. In the overactive muscle, there may not be sufficient relaxation time for nutritive products to be produced. In addition, the muscle may become loaded with irritants and subsequently be denied of proper oxygen or become ischemic. Conversely, in the underactive muscle, the milking action may not be present to carry away irritant products. Massage may be effective in this case to enhance this process. It also may be a therapeutic strategy to restore or preserve soft tissue integrity, mobility, and muscular nutrition. This allows more opportunity for effective movement and function (Tappan, 1998).
Massage has been noted to decrease pain. Field, et al. (1997) reported significant decrease in the pain of patients with Juvenile Rheumatoid Arthritis. It is theorized that the pain is decreased secondary to stimulation of seratonin, a natural painkiller that is the base of many manufactured painkillers.
Field and her colleagues also studied massage in patients with burns, chronic fatigue syndrome, low-back pain, and fibromyalgia, resulting in significant pain reduction. The researchers hope that massage will compliment the use of drugs and minimize the need for potentially addictive narcotic medication.
Massage decreases anxiety, stress, and depression. Field, et al. (1992) discussed the role of massage in adolescents diagnosed with depression and adjustment disorder. They discovered a decrease in cortisol, a hormone associated with stress. In addition they found less anxiety and stress behaviors when studying the role of massage with children who have asthma, atopic dermatitis, juvenile rheumatoid arthritis, cystic fibrosis, and diabetes. Field and her colleague's work continues to validate the psychological benefits produced by massage.
Massage may improve the general functioning of the immune system. Field and her colleagues (1992) continue to examine the role of massage in enhancing the immune system in patients with HIV and breast cancer. Additional studies in progress include pediatric oncology and prostate cancer (Cullen, et al., in preparation; Deiter, Field, Hernandez-Reif, in preparation).
Massage may contribute to general growth and development. The role of touch in growth and development has been historically documented in literature. Touch is vital to our well being, health, and relationships. Field, et al. (1986) has documented the role of massage in weight gain in pre-term infants. Massage also could be beneficial to children with failure-to-thrive syndrome. This must be confirmed through further research.
Summary