Massage can be provided to children aged 3 years into adolescence. This time frame encompasses the preschool period, middle childhood, and adolescence, which begins with the onset of puberty, and ends with adult identity and behaviors, which ranges from 12 years to 19 years of age (Feldman, 2013).
Research has been conducted on children and adolescents, and positive effects were noted within a variety of conditions. Burned adolescents experienced less pain, less itching and were less anxious following massage therapy (Parlak, Polat, & Akçay, 2010). Massage reduced chemotherapy-induced nausea and vomiting in pediatric patients diagnosed with cancer (Mazlum et al., 2013). Adolescents with HIV-infections reported feeling less anxious and less depressed after 12 weeks of massage. Additionally, massage enhanced immune functions evidenced by reductions in HIV disease progression markers (Diego et al., 2001).
Grade-school children who were experiencing severe posttraumatic stress one month after a natural disaster reported feeling happier and less anxious following massage, and they had lower salivary cortisol levels (Field et al., 1996). Massage decreased aggressive behaviors and increased empathetic behaviors in violent adolescents, perhaps because physical stimulation reduced dopamine levels and increased serotonin levels in these participants (Field, 2002).
Jones and Field (1999) found that combining massage and music therapy attenuated frontal electroencephalogram (EEG) asymmetry in depressed adolescents; this effect is associated with a decrease in depressive symptoms. Child and adolescent psychiatric patients were less depressed, less anxious, and had lower salivary cortisol levels after massage, and they slept more at night. Nurses rated these patients as less anxious and more cooperative on the last day of the study (Field et al., 1992).
Massage Therapy & Adolescents
Be sure the parent or guardian and minor child are present during treatment planning and discussions of policies and procedures. When working with younger children, be sure to use terms the child will understand. Even with parental/guardian consent, massage is inappropriate on a minor who does not want it. It is recommended that a parent or guardian remain in the room during the massage. If the parent or guardian elects not to be in the room, the massage room door should be opened during the massage, preferably with the parent or guardian within view.
Touch is a powerful experience, one that cannot be undone. The potential for influencing the attitude and acceptance of touch cannot be underestimated. How touch is given, and how the child receives it, will determine whether the child becomes a person who views touch, especially during massage treatments, as nurturing, positive, and beneficial or as something to be avoided.
When working with younger children, consider having a few toys such as finger puppets, simple puzzles, stickers, and crayons and paper in the office. Also, consider asking the parent to have the child bring a blanket, toy, or a stuffed animal to the appointment which will remain with the child during the entire session.
For younger children, massage room lighting should be bright and not as dark as massage room lighting for adults. Darkly lit rooms may cause younger children to become anxious, especially if they have a fear of the dark. Older children and adolescents may have unique preferences for lighting. They may want to listen to their own music during the massage.
Positioning is child-directed. The child may feel more comfortable with a blanket on the floor, be totally fine on the massage table, or content sitting in comfy chair. Be sure to have plenty of pillows, blankets, a comfy chair, and extra floor space to accommodate a range of child preferences.
Children should wear loose clothing during the massage rather than disrobe completely. Younger children and children living with developmental delays may not understand the importance of the top drape and fling it across the room without warning leaving the therapist with an exposed child on the table. If the child is receiving massage for therapeutic reasons such as injury rehabilitation or sports-related issues, suggest athletic-type shorts and a tank top with a sports bra for female children. Drape your clothed minor client with a sheet just as you would other clients.
When working with younger children, consider demonstrating what massage is like on the item they brought with them, on a parent or caregiver, or on his or her forearm. Allow children to direct the massage, which helps them feel empowered and more relaxed about the session. In a child-directed session, the therapist may find themselves using a finger puppet during the massage while telling stories or making a pizza using gliding and kneading techniques.
The duration of the massage depends on many factors including the child’s age, developmental stage, and attention span. A 3-year old toddler may receive a 15-minute session and a 10-year-old child may receive a 45- to 60-minute session.
Special thanks to Kim Corpus for her contribution to this blog post.
Articles and Journals Referenced:
- Diego, M.A., Field, T., Hernandez-Reif, M. (2014). Preterm infant weight gain is increased by massage therapy and exercise via different underlying mechanisms. Early Hum Dev, 90(3), 137–140.• Feldman, R. S., (2013). Development Across the Life Span, 7th ed. Upper Saddle River, NJ: Pearson.• Field, T. (2002). Violence and touch deprivation in adolescent, Adolescence, 37(148), 735-749.• Field, T., Morrow, C., Valdeon, C., Larson, S., Kuhn, C., Schanberg, S. (1992). Massage reduces anxiety in child and adolescent psychiatric patients. J Am Acad Child Adolesc Psychiatry, 31(1), 125-131.
• Field, T., Seligman, S., Scafidi, F., Schanberg, S. (1996). Alleviating posttraumatic stress in children following hurricane Andrew. J Appl Dev Psychol, 17(1), 37–50.
• Jones, N.A., Field, T. (1999). Massage and music therapies attenuate frontal EEG asymmetry in depressed adolescents. Adolescence, 34(135), 529–534.
• Mazlum, S., Chaharsoughi, N.T., Banihashem, A., Vashani, H.B. (2013). The effect of massage therapy on chemotherapy-induced nausea and vomiting in pediatric cancer. Iran J Nurs Midwifery Res, 18(4), 280–284.
• Parlak, G.A. Polat, S., Akçay, M.N. (2010). Itching, pain, and anxiety levels are reduced with massage therapy in burned adolescents. J Burn Care Res, 31(3), 429-432.
Dr. Susan Salvo is a massage therapist who works with massage therapists and students to promote best practices. Susan knows that education and research are the most effective ways to advance the profession. She teaches, is actively involved in research, and has written two widely used textbooks: Massage Therapy: Principles and Practice and Mosby’s Pathology for Massage Therapists. Susan has been honored with numerous awards and frequently presents at conferences and conventions across the country. Susan has a doctorate in education from Lamar University. You can contact Susan at firstname.lastname@example.org.