Massage therapy improves mood and behavior of students with attention-deficit/hyperactivity disorder

Adolescence, Winter, 2003 by Sonya Khilnani, Tiffany Field, Maria Hernandez-Reif, Saul Schanberg

ADHD researchers emphasize the importance of employing a multimodal treatment approach with ADHD children. Multimodal therapy involves integrating pharmacotherapy with a number of environmental, educational, psychotherapeutic and school-based approaches to meet the child's particular needs. A combined intervention of medication management and behavioral treatment has been found to be more successful than either approach alone in reducing core ADHD symptoms in children from more educated families (Rieppi et al., 2002). In their literature review of the long-term treatment of ADHD, Schachar et al. (2002) noted that combination therapy adds to the effects of medication.

Massage Therapy

A nonmedication intervention that has only recently been explored with ADHD children is massage therapy. In a recent study, ADHD adolescents who received ten massage treatments over the course of two weeks rated themselves as happier than those who participated in relaxation therapy; observers rated the massage therapy group as less fidgety, and teachers reported more on-task behavior, when compared to the relaxation therapy group (Field, Quintino, Hernandez-Reif, & Koslovsky, 1998). Teachers also noticed a significant decrease in hyperactivity for the massage therapy group but not for the relaxation therapy group.

Similar changes have been noted for child and adolescent psychiatric inpatients diagnosed with adjustment and depressive disorders; they showed significantly less depression and anxiety following massage therapy (Field, Morrow, Valdeon, Larson, Kuhn, & Schanberg, 1992). The massage group's salivary and urinary cortisol levels decreased, indicating a decrease in stress. Staff nurses also rated the inpatients who received massage therapy as being less anxious and more cooperative when compared to a control group, which viewed relaxing videotapes. In addition, nightwakings decreased and time spent in quiet sleep increased for the massage group.

Touch therapies have also been successful in reducing off-task behavior in autistic children. In one study, massage therapy with autistic children led to a decrease in both off-task behavior and attention to irrelevant sounds and to an increase in social relatedness during classroom observations (Field, Lasko, Mundy, Henteleff, Talpins, & Dowling, 1996). Another study involving autistic children, many of whom had sensory processing deficits, suggested that physiological stimulation from deep touch pressure (a hug machine) reduced hyperactive and self-stimulatory behaviors (Imamura, Wiess, & Parham, 1990).

Furthermore, massage therapy has been shown to significantly reduce anxiety as well as systolic and diastolic blood pressure (Cady & Jones, 1997; Shulman & Jones, 1996). In addition, Field, Ironson, Scafidi, Nawrocki, Goncalves, Burman, Pickens, Fox, Schanberg, and Kuhn (1996) have reported an increase in alertness and EEG wave changes conforming to increased alertness (decreased alpha and beta and increased delta) and better performance on math tasks (half the time required with half the errors) following massage therapy. These studies suggest that touch therapy may attenuate stress and enhance attentiveness in children and adolescents with ADHD. Improved psychological functioning would be expected to result in less acting-out behaviors in the classroom.