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

Pre-Post Treatment Measures (Immediate Effects)

Faces. The ANOVA on the faces scale revealed a significant group by session interaction effect, F(1, 27) = 5.46, p < .05. Post hoc t tests revealed that the massage therapy group reported feeling happier after the first and last day sessions (see Table 1).

Thermometer. The ANOVA on the thermometer scale revealed a significant group by session interaction effect, F(1, 27) = 4.70, p < .05. Post hoc t tests indicated that the massage therapy group rated themselves as feeling bettor after the first and last day sessions (see Table 1).

Cortisol. No significant effects were obtained for salivary cortisol in either group (see Table 1).

First-Last Day Measures (Longer-Term Effects)

Conners Teacher Rating Scale. There were significant group by day interaction effects, showing reductions in hyperactivity, F(1, 28) = 7.92, p < .01, anxiety, F(1, 28) = 14.70, p < .01, and daydreaming/ inattention, F(1, 28) = 4.42, p < .05, only for the massage group. Both groups improved on the emotional-indulgent factor, F(1, 28) = 14.39, p = .001 (see Table 1).

DISCUSSION

Massage therapy appeared to benefit the children and adolescents with ADHD. Students who received massage therapy twice per week over the course of a month rated themselves as happier and feeling relatively better after the treatment sessions. The present findings are consistent with a recent massage therapy study in which ADHD adolescents showed improvements in fidgetiness, hyperactivity, on-task behavior, and subjective feelings of happiness (Field et el., 1998) and another study that reported less anxiety after massage therapy (Shulman & Jones, 1996).

The enhanced mood states found in the present study may have contributed to the improved classroom behavior. Teacher ratings of ADHD students who participated in the massage therapy suggest that the therapy reduced the problems most associated with ADHD, namely hyperactivity and daydreaming/inattention, over the course of the treatment period. The convergence of self-report measures and teacher ratings highlights both the immediate and longer-term effectiveness of massage therapy and supports the use of this treatment with this population.

As predicted, ADHD students who received massage therapy showed improvements in short-term (immediate) mood state and longer-term (over the course of a month) classroom behavior. While the findings look promising, they cannot be definitively applied to all ADHD students. The participants in the present study attended a small, private learning center and came from middle to upper socioeconomic status families. As previously noted, they also were receiving school-based interventions. Whether massage therapy would benefit students who had other socioeconomic backgrounds and were in regular classrooms at larger, public schools remains to be studied.

Future studies are needed to ascertain how massage therapy impacts academic achievement in students with ADHD. Incorporating additional measures such as vagal tone and EEG might also help explain the relationship between massage therapy and on-task behavior in ADHD children and adolescents. Several studies suggest that massage therapy enhances cognitive performance (Hart, Field, Hernandez-Reif, & Lundy, 1998), including improved math computations following EEG changes to a pattern of heightened alertness (Field, Ironson, Scafidi, Nawrocki, Goncalves, Burman, Pickens, Fox, Schanberg, & Kuhn, 1996). In the Hart et el. (1998) study, massaged children improved their performance on the Block Design and Animal Pegs subtests of the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R). In the present study, the increased attentiveness observed in the classroom (using the Conners scale) could be related to enhanced vagal activity that occurs during massage therapy (Field, 1990). Increased vagal control of the heart may enhance the ability of the hyperactive child to mediate spontaneous activity (Porges, 1998).