Attention deficit-hyperactivity disorder (ADHD) is a neurologic disorder in which the affected person displays behaviors of inattentiveness, hyperactivity, & impulsivity, or a combination of these. Estimates indicate that 4% of adults have this disorder (1). Studies investigating the effects of massage on persons with ADHD usually involve children or adolescents.
ADHD is divided into three subtypes, each with different symptoms. They are predominantly inattentive with the majority of symptoms falling under inattention, predominantly hyperactive-impulsive with the majority of symptoms falling under hyperactivity & impulsivity, & a combination of the two; the latter is the most common subtype in the U.S. Typical ADHD behaviors can be observed at any age, but symptoms are often present before the age of 7. Children diagnosed with ADHD usually retain symptoms of the disorder throughout life. Conversely, adults diagnosed with ADHD usually have had traits of the disorder since childhood. Activities that were challenging for a child with ADHD become even more difficult in adulthood as life often becomes more demanding & complicated. ADHD is more commonly diagnosed in males than females, but research suggests an almost equal balance during adulthood.
Persons who are predominantly inattentive fail to give close attention to details, make careless mistakes, have difficulty in sustaining attention, & are unable to organize activities, which may lead to missed deadlines & forgotten appointments & social events. These individuals tend to avoid activities that require sustained attention, effort, concentration, & organization. These persons often fail to prioritize, do not follow through, & may not complete tasks. Additionally, these individuals may appear not to listen when spoken to, may lose items necessary for tasks, & are easily distracted.
Persons who are predominantly hyperactive & impulsive struggle with self-control issues, from impatience waiting in line or driving in heavy traffic to outbursts of anger, often leading to troubled relationships. These individual may engage in excessive talking & struggle if expected to remain quiet. They may move excessively or claim to feel restless & have difficulty engaging in leisure activities quietly. They may have difficulty waiting for their turn or fail to listen to directions; they may appear to behave as if driven by a motor.
The exact cause of ADHD is not known. However, research has indicated that sleep deprivation & sleep disordered breathing are risk factors (2). Children with ADHD have lower levels of dopamine compared to children without ADHD (3). Other risk factors include genetics, exposure to environmental toxins such as lead, maternal drug use, alcohol use, or tobacco use, & premature birth (4,5).
Massage Therapy & ADHD – Adapt the length of the session to the client; the therapist may find that shorter-than-normal sessions are more appropriate for some clients.Therapists will most likely face challenging situations when working with adult clients who have ADHD. These situations range from excessive fidgeting & talking during the massage to missed appointments & forgotten wallets. Being tolerant is advisable, but too much tolerance may lead to unenforced office policies.
When working with children with ADHD, teaching the parents or caregivers how to give relaxing massage to the affected child is best, making massage more accessible & giving caregivers another tool to care for & nurture their loved one. Limit the techniques taught to light effleurage or similar techniques & convey the same precautions that licensed therapists follow such as avoiding skin lesions. Some children and adolecents with ADHD are hypersensitive to some forms of stimulation and may not like to be touched, so be patient and accepting.
Reported outcomes from massage therapy include improved mood, increased focus in the classroom, better anger control, improved social functioning, & more restful sleep (6-8). Maddigan (8) used several techniques during the investigation including Swedish massage, craniosacral therapy, & manual lymph drainage.
Articles and Journals Referenced:
- Adult ADHD. https://www.adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/adult-adhd
- ADHD and Sleep. https://sleepfoundation.org/sleep-disorders-problems/adhd-and-sleep
- Deficits in Brain’s Reward System Observed In ADHD Patients; Low Levels of Dopamine Markers May Underlie Symptoms. https://www.sciencedaily.com/releases/2009/09/090908193432.htm
- Attention Deficit Hyperactvity Disorder. http://www.hoffmancenter.com/page.cfm/609?Template=Default_Print
- Attention-deficit/hyperactvity disorder (ADHD) in children: Symptoms and causes. http://www.mayoclinic.org/diseases-conditions/adhd/symptoms-causes/dxc-2019681
- Field, T., Quintino, O., Hernandez-Reif, M., Koslovsky, G. (1998) Adolescents with attention deficit hyperactivity disorder benefit from massage therapy. Adolescence, 33(129):103–8.
- Khilnani, S., Field, T., Hernandez-Reif, M., Schanberg, S. (2003). Massage therapy improves mood and behavior of students with attention-deficit/hyperactivity disorder. Adolescence. 38(152):623-38.
- Maddigan, B., Hodgson, P., Heath, S., Dick, B., St. John, K., McWilliam-Burton, T., Snelgrove, C., White, H. (2003). The effects of massage therapy & exercise therapy on children/adolescents with attention deficit hyperactivity disorder. Can Child Adolesc Psychiatr Rev. 12(2):40-43.
Susan Salvo is a board certified massage therapist with 30+ years of experience. Susan is passionate about massage therapy and massage education. You can contact her at firstname.lastname@example.org.