Adolescents with attention deficit hyperactivity disorder benefit from massage therapy

Adolescence, Spring, 1998 by Tiffany M. Field, Olga Quintino, Maria Hernandez-Reif, Gabrielle Koslovsky

Teachers' assessments included observed time on task in the classroom and the Conners Rating Scales (Conners, 1985), which were administered on the first and last days. The 10-item Conners Hyperactivity scale identifies behavior problems in children 3 to 17 years old.

RESULTS

Analyses of variance with pre/postsession and first/last day of treatment as repeated measures were performed. Table 1 reveals that (1) the massage therapy group selected happier faces after the sessions on both the first and last days of the treatment; (2) the massage therapy group demonstrated less fidgeting after the sessions; and (3) no significant pre/postsession changes were noted for the relaxation therapy [TABULAR DATA FOR TABLE 1 OMITTED] group. Repeated measures analyses of variance yielded the following first day/last day changes: (1) the massage therapy adolescents averaged more time on task in the classroom as observed by their teachers; (2) the massage therapy group received significantly better scores on the Conners scale; (3) no significant changes were noted on the depression or empathy scales; and (4) no changes were noted on any of the measures for the relaxation therapy group.

DISCUSSION

While drug therapy and behavior modification techniques are commonly employed to treat ADHD, two alternative therapies, relaxation and massage therapy, were investigated here. The positive effects of massage therapy were perhaps not surprising inasmuch as that intervention has helped reduce depression and anxiety levels as well as stress hormones in child and adolescent psychiatric patients (Field et al, 1992) and has enhanced on-task behavior in autistic children (Field et al., 1996). Although the comorbid problems of depression and lack of empathy were not altered in this study, the adolescents reported feeling better (happier) after their massage sessions, and they were observed to fidget less. Longer term effects were reported by their teachers, including more time on task in the classroom and lower Conners Hyperactivity scores.

Since hyperactivity, not depression, is the salient problem in ADHD, it is interesting that hyperactivity was uniquely reduced in this study. Although the underlying mechanism for the massage therapy/lesser activity relationship is not known, increased serotonin levels noted in other studies of massage (Field et al., 1996; Ironson et al., 1996) might help modulate elevated dopamine levels noted in ADHD youth (Rogeness, Javors, & Pliszka, 1992). Future studies might assay dopamine levels as well as its known regulators, norepinephrine and serotonin.

Although relaxation therapy has also been effective with depressed adolescents (Platania-Solazzo et al., 1992), no changes were noted :in the present study. The lack of effects may relate to the fact that several adolescents reported not enjoying the relaxation therapy. This more active form of therapy was called "hard work" by those who complained.

Massage therapy could become an important tool in the management of ADHD, in conjunction with currently used therapies. It may, for example, potentiate methylphenidate and other drugs or complement behavior modification. In cases where present therapies are not effective or are accompanied by undesirable side effects, massage therapy could be a substitute treatment for children and adolescents diagnosed with ADHD.