Autism and the Effects of Massage Therapy - Coursework Example

Autism and the Effects of Massage Therapy Autism is a condition commonly misunderstood by those not directly affected by it. The numerous therapies such as music, touch, speech, physical, audio/visual and drugs are designed to alleviate symptoms and the subject of debate as to their effectiveness in particular cases among those more knowledgeable of this affliction. While no therapy can cure autism, their use whether individual or combined has been shown to ease the debilitating effects of the ailment. Playing sports is recognized as beneficial for most growing youths but has traditionally been an activity discouraged for autistic children because they lack the social skills required to compete. Therefore, as critics attest, the autistic child is handed yet another psychological setback in their life. However, therapy choices can be as varied as the individual child. Parents who want their autistic child to reap some of the same benefits other children derive from playing sports are trying methods such as massage therapy in combination with the chosen sporting activity. This discussion first provides a brief explanation of autism then examines the merits of autistic children engaging in sports. It will also review sensory integration and massage therapy, the physiological explanation for its proven effectiveness, its possible applications and several techniques involved in gaining the most from this therapeutic approach. Whether contracted in the early fetal development stage or inherited, autism is a disorder which affects cognitive brain functions thus impeding a person’s ability to communicate effectively. The disorder distorts not only how people perceive sensory information but how the brain processes it as well. Autism is the most prevalent developmental disorder affecting one in every 166 children (“How Common?”, 2006). Symptoms of the disorder can be generally described as the incapability to adequately interact socially along with a disinterested demeanor. It is an abnormality in the structure of the brain caused by genetic predispositions or from damage occurring during the development phase (Bryson & Smith, 1998). The severity of autism varies widely among individuals as does its related symptoms but there are certain aspects relating to social interaction shared by all with the disorder. Avoiding direct eye contact, distinctive body posturing and facial expressions as well as other nonverbal communication deficiencies are a common trait. Autistic children seldom associate with those of their own age-group as well as show a general disinterest in interacting with any other people. They also do not demonstrate empathy because they lack the understanding of another person’s sorrow or pain. Deficiencies in communication skills can include symptoms such as a delay in speaking development or not being able to speak at all. About half of those with autism never learn to talk. Of those that do, most have great difficulty focusing and staying within the subject parameters of a conversation. Habitual repetitiveness of words or phrases is a common trait as is the lack of understanding satire or an implied, underlying meaning. A lack of interest in play or other activities is common as is being fixated on a single item. Young autistic children usually focus their concentration on one part of a toy instead of playing with the toy as a whole. Lastly is the well-recognized rocking back and forth behavior commonly observed in those with autism (Volkmar, 2000). Autism and other neurological disorders are defined by characteristics of behavior and are commonly considered to be biological in origin and not caused by improper parenting or by varying social situations a young child may have experienced. The precise fundamental neurological causes have not been identified but remain the source of the condition. However, there are strategies that have proven to help all autistic children to enhance overall physical and cognitive functions and to realize their potential. For example, “behavioral training and management uses positive reinforcement, self-help, and social skills training to improve behavior and communication” (Committee on Children with Disabilities, 2001). Also included are specialized treatments to improve speech and physical deficiencies. Medication to treat hyperactivity, depression and/or compulsive behaviors are commonly prescribed as well which put the child in state of mind more susceptible to learning modified behaviors. The objective of treatment is to enhance the child’s language and social development and to curb behaviors which impede the child’s learning capabilities. A cure is not possible because autism is a chronic cognitive disorder, its disabling effects last for a lifetime. This affliction that causes anti-social actions is a product of nature and the effects can be greatly reduced by nurturing its behavioral aspects. Biological causes and environmental solutions function in an interdependent fashion. Environmental stimulation influences the maturation process of all people, autistic persons are no exception. When people seldom interact with others, they cannot effectively learn and withdraw knowledge from social activities. Those that focus too much of their concentration on the same type of activity or thing are not developing and learning at an optimum rate. People who tend to do this the majority of the time are labeled as autistic. Interaction is the founding principle of the behavioral approach to teaching autistic students: “… they need specially prepared programs that will teach them to learn from their parents, siblings, peers and others” (Rutter, 1997). The principal objective in the treatment of autism is to enhance the overall capacity of a child to function in society at the highest level possible given the unique circumstances for each individual. Autistic children frequently experience difficulty when faced with a change in everyday surroundings or routine. Behavioral issues often arise when exposed to unfamiliar settings. Public outbursts justifiably cause family members to become uncomfortable in social situations therefore most avoid placing their autistic child in organized sporting activities. Seemingly, it is the worst possible set of circumstances in which to place the autistic child. Sports are played in an unfamiliar place; touching and social interactions are generally required as is a fair amount of coordination. Autism experts such as Yale University professor Fred Volkmar agree that autistic children are ill-suited for athletic activities involving team play such as basketball, soccer and baseball. Volkmar suggests that autistic children “have trouble making social connections or engaging in the kind of thinking required in team play” (cited in Manning, 2005). However, experts widely acknowledge that autistic children are able to master other physical endeavors such as running, swimming and the martial arts, etc. These are activities that do not require the child to understand nuances of the game such as where to pass the ball or when in given situations and social signals such as clapping ones hands together as the universal sign for ‘give me the ball.’ “A lot of autistic children are never going to play on a team, but they can do really well in individual sports,” according to Donna Asher, camp director at the North East Westchester Special Recreation Program in Hawthorne, N.Y. “It’s not their physical skills that keep them from participating, it’s their social skills, not being able to interact with others or having a breakdown on the field in the middle of a game” (cited in O’Connor, 2006).   Until relatively recently, the vast majority of parents and health care professionals did not believe that autistic children were not capable of playing any type of sport but that misconception is evaporating. There are barriers to overcome in that autistic children are often resistant to physical training and motivating them can prove difficult but increasingly they are being encouraged to participate in challenging athletic programs suited to their particular degree of ability. Experts in the field are encouraging this trend. Research has consistently shown that specific sporting activities generally diminish repetitive behaviors commonly associated with autism such as head-banging and pacing. Participation in sports also provides a means for socialization. Physical education programs designed for autistic children commonly referred to as ‘adapted sports programs,’ are designed to inhibit behavioral and social difficulties.  Though the benefits of sports are well documented, many parents place physical activities low in their list of priorities. Typically, parents are busy trying to locate special education services including speech and behavioral therapists all while trying to find a way to pay for this costly care. “Parents of autistic kids have a lot of battles to fight,” said associate professor of kinesiology at Indiana University in Bloomington Georgia Frey. “So when it comes to getting their kids involved in recreation and physical activity, it can seem too exhausting. But I do think that parents see the value in these programs, because the demand for them is very high” (cited in O’Connor, 2006).   Sports are known to be of great value for children afflicted with autism. Studies conducted for the past quarter century have overwhelmingly demonstrated that vigorous physical exercise diminishes the frequency of repetitive actions and enhances the child’s attention span. For exercise to be effective, however, at least moderate effort should be exerted. For example, a study demonstrated that when autistic children jogged for 15 minutes without rest, this resulted in a noticeable reduction of the characteristic repetitive behaviors. This same study examined the results of another group that exercised passively by playing with a ball by themselves for 15 minutes. This resulted in no perceptible changes in these behaviors.  Exercise regiments that mimic rhythmic, repetitive movements typical to autism, the way the motions of swimming are similar to hand-flapping for instance, may actually serve to help focus autistic children’s attention on the task at hand. “People with autism experience levels of sensory perception that most of us wouldn’t know or understand,” according to professor of adapted physical education at Montana State University-Northern, Dr. O’Connor. “It overloads them, so they engage in behaviors that distract them. Exercise gives them the same benefits but it doesn’t have the negative social connotations” (O’Connor, 2006).    The National Institute of Mental Health reports that about half of those children afflicted with autism cannot and will never learn to speak. Those who have the ability to communicate verbally exhibit only limited language skills, speaking in incomplete, sometimes one-word sentences and tend to replicate sounds they hear. Autistic children do not possess sufficient means to effectively communicate their thoughts which is a great hindrance to forming personal attachments.  It had long been theorized that autistic children did not have the capability of developing attachments.  Of course, parents have always known that this is untrue and recent studies have confirmed this. Autistic children do feel and show an emotional attachment to close family members yet are not able to demonstrate these feelings adequately. “Many autistic children have sensory malfunction and dysfunction of the tactile system making them averse to certain sights, sounds, smells or touch” (Allen, 2007).   Autistic children do not normally demonstratively share feelings of affection. They shy away from hugs and show little if any noticeable response when experiencing pleasure.  This emotional disconnection, or more precisely, the inability to show appropriate emotions, is the most difficult aspect of this affliction for parents. The use of massage therapy has proved beneficial for autistic children who typically dislike being touched. Following massage techniques a lesser degree of autistic mannerisms are discernable. Studies have shown that autistic children become more attentive, socially aware, are less averse to touch and not as likely to withdraw after receiving a massage treatment from their parents. Massage therapy offers the nurturing all children crave and is perceived by the autistic child as non-threatening. “Given that autistic children have been reported to be opposed to physical contact, it is interesting that many massage therapists, and parents, are finding great success in the use of massage therapy with autistic children” (Allen, 2007).   Oxytocin is a hormone that is significantly deficient in autistic children. This hormone is related to emotions such as feelings of affection.  Increasing the level of Oxytocin triggers relaxed sensations, decreases stress and promotes congenial reactions when interacting with others. Several studies have confirmed that the body releases Oxytocin not only during but also following a gentle massage or touch. A study that concentrated solely on autistic children reported oxytocin helped these individuals maintain the capability to appraise the emotional nuances of language usage. This hormonal release decreases the instances and severity of repetitive behaviors distinctive to autism. Autistic children seldom remain asleep the entire night and are generally restless even while sleeping. Massage therapy promotes a more restful, less disrupted and longer duration of sleep. “Through the use of massage therapy, our basic human need for safe, nurturing contact is met with often wonderful results.  For children with autism, it provides not only a positive experience of being touched, but the effects hold lifelong benefits” (Allen, 2007). All five senses are essential for correctly interpreting life experiences. The autistic child suffers from a synaptic disconnect which means they often misinterpret what is sensed and how it is perceived. For instance, when most people eat a peach, they use the sense of smell, taste and touch to identify the experience. However, the autistic child might interpret the fuzz of the peach as painful to the touch and what is a pleasant smell to others might cause them to become physically ill. Some autistic children find common, everyday sounds to be extraordinarily annoying, even painful. Professionals in the field have termed this disconnection between what is interpreted by senses of autistic children and what is reality as ‘sensory integration difficulty’. The sense of touch, as discussed, for many autistic children is not thought of as comforting but irritating. The automatic retraction after being touched, displaying violent behaviors and declining to eat specific types of food because of its texture are all indications of autism manifested as a ‘sensory integration dysfunction’ of the nervous system (Cutler, 2007). The nervous system and skin emanate from the same component of the embryonic tissue. Because of this, those with an underdeveloped nervous system such as autistics, have an extreme sensitivity to even gentle touching. “A properly functioning tactile system accurately transmits information from the skin’s receptors to the central nervous system. When the tactile system is immature and working improperly, neural signals sent to the brain’s cortex interfere with other brain processes. This interference causes over-stimulation of the brain, making it difficult to both organize behavior and concentrate and can cause a negative emotional response to touch” (Cutler, 2007). A typical indication of autism is a child who will bang their head on the wall without feeling apparent pain but recoils sharply when lightly touched. Massage therapy applied to autistic children should take this into account. “Since light touch is over-stimulating to those with autism, deeper massage techniques and joint compression are better tolerated. Utilizing methods of sustained moderate pressure can help dampen the nervous system’s over-reactivity” (Cutler, 2007). Effective massage techniques have been designed specifically for those with an immature nervous system such as autistic children. The session should begin in a relaxed, quiet environment with deep massaging strokes, not light touches so that the child accepts the nurturing contact. Background music of the child’s choosing often helps to create a suitable atmosphere. Initiating the massage requires performing a task previously not considered by either the parent or child and should be approached with great care and forethought. After explaining in a calm, sure voice what is about to occur then “place your hands on his/her upper back or back of the head for as long as they allow. If no resistance is met, proceed and do a back or head massage using deeper strokes. If there is resistance, remove your hand, wait a few seconds, and then return your hand to its original position” (Regina-Whiteley, 2005). Some children will refuse to accept touching of any kind at first. Asking them to use their own hand to massage their leg, other hand, arm, etc. will act to reassure and calm them. The message sessions should be kept short in the beginning and slowly expanded over time. Only touch the parts of the body that the child considers comfortable and incorporate breathing exercises to help them relax. According to a 1997 study at the Touch Research Institute, touch therapy was shown to be useful in reducing the frequency and intensity of typical autistic behavior such as withdrawal, aversion to touch and inattentiveness. Researchers at the Institute further demonstrated that touch therapy improved communication skills and increased the attention span of autistic children. The benefits of massage are likely attributed to the relaxing nature of the event, the physical contact between parent and child, an act not previously a part of the relationship and the invigoration of the nervous system. “The dysfunction of the nervous system’s sensory integration typically seen with autism can be minimized with touch therapy. Massage therapists showing interest in this condition can be a child’s bridge between autism’s seclusion and normal, developmental socialization” (Regina-Whiteley, 2005). Touch therapy is proven to be an effective method by which to diminish the effects of autism and forge a deeper bond between parent and child. Organized, team sports are generally not advised but in a controlled environment, autistic children can participate in most activities enjoyed by all children, soccer included. In a situation where the child is grouped with others of a similar skill level and the rules are adjusted to the circumstances, soccer is not beyond the bounds of an autistic child. With frequent breaks to employ message therapy techniques, the experience can be productive. Massage during play will allow the child to participate for a longer period of time thus gain more from the experience. Parents should not be locked into past misconceptions regarding the limitations of autism and seek innovative ways to give their autistic child as ‘normal’ life as possible such as combining massage therapy with an activity previously thought impossible for the autistic child to enjoy. References Allen, Tina. (August 2007). “Massage Therapy for Children with Autism.” Healing Hands. Retrieved September 1, 2007 from Bryson, S. E. & Smith, I. M. (1998). “Epidemiology of Autism: Prevalence, Associated Characteristics, and Service Delivery.” Mental Retardation and Developmental Disabilities Research Reviews. Vol. 4, pp. 97–103. Committee on Children with Disabilities. (2001). “Technical Report: The Pediatrician’s Role in the Diagnosis and Management of Autistic Spectrum Disorder in Children. Pediatrics. American Academy of Pediatrics Vol. 107, N. 5, pp. 1–18. Cutler, Nicole. (August 22, 2007). “Autistic Clients and the Value of Touch Therapy” Institute for Integrated Healthcare Studies. Retrieved September 1, 2007 from “How Common are Autism Spectrum Disorders?” (April 5, 2006). Centers for Disease Control and Prevention. Retrieved September 1, 2007 from Manning, Anita. (October 3, 2005). “Autistic children find healing in waves.” USA Today. Retrieved September 1, 2007 from O’Connor, Anahad. (August 3, 2006). “A Can-Do Approach to Autistic Children and Athletics.” Retrieved September 1, 2007 from Regina-Whiteley, Michael. (February 2005). “Autism and Treatment With Therapeutic Massage.” Massage Today. Rutter, M. L. (1997). “Nature-Nurture Integration – The Example of Antisocial Behavior.” American Psychologist. Vol. 52, pp. 390-398. Volkmar FR & Klin A. (2000). “Pervasive Developmental Disorders.” Kaplan and Sadocks Comprehensive Textbook of Psychiatry. BJ Sadock, VA Sadock, (Eds.). Philadelphia: Lippincott Williams and Williams, Vol. 2, pp. 2659–2678. Read More