Research evidence exists that shows massage therapy may be helpful in effecting some of the symptoms and behaviours associated with autism spectrum disorder. (J Clin Psychiatry 2011;72(3):406-411). Around 1 in 68 children are diagnosed with an autistic spectrum disorder (ASD) and anecdotal reports and studies such as the one sited here, continue to suggest that massage therapy may benefit people with ADS. Nurturing touch and regular sensory integration appear to reduce the social, communication, behavioural and learning challenges associated with ADS.
Symptoms associated with ASD include aversion to touch, gastrointestinal (GI) disorders, anxiety, hyperactivity, sleep disturbances, repetitive behaviours as well as the inability to verbally communicate, make eye contact or interact with others. I have worked with both adolescents and children who have ASD, and for every client there are a diverse range of symptoms.
The massage therapists must be extremely adaptable as the ASD behaviours you confront in clinical massage practice are caused by their sensory system is either over-registering or under-registering stimulation. This can make a person with ASD uncomfortable moving around their world; sheet/towel texture, music, a massage room smell or lighting, your touch-all these things may be acceptable at one moment but not the next.
Some sensory precautions may be relevant for the massage therapist working with the ASD individual:
- Perception: approach someone with ASD from the side or from a place where they can perceive you ‘with time’ as not in their face immediately. Perception of who you are takes time and one should be prepared to abandon a session if the client seems agitated.
- Auditory: Acute sensitivity to sound may elicit fear in an ASD client. Noise-cancelling headphones, soft voice of even tone may be helpful.
- Tactile: Individuals with ASD can be either over or under-sensitive to touch; if over-registering, everything could feel like things are coming in too quickly and the fear response could be elicited, and if under-registered, there may be very little awareness of any tactile stimulation. In either case, my approach has been to move slowly towards the table, giving the individual time to perceive all that is happening. There will be times when I use light or quite firm pressure depending on the ‘registration’ I can feel.
Encourage a parent or trusted adult to be part of the massage session as this may dispel any fear or anxiety in the ASD individual that may range between mild or severe. Massage chair may be more appropriate that a table and I suggest 10 to 15-minute massage sessions rather than longer periods.
While there have not been any large-scale studies conducted on massage therapy specifically aimed at the ASD individual, it is suggested that deep pressure massage may benefit several common physical ands cognitive symptons associated with ASD. The quality of this touch should be slow and consistent, using long strokes with the palm and not with the fingers.
One study found that deep pressure massage may decrease the stereotypical touch aversion associated with autistic children.
One study found that deep pressure massage may decrease the stereotypical touch aversion associated with autistic children. Perhaps further analyses could also discover that the present treatment for autism incorporating hyperbaric oxygen therapy (HBOT), combined with this deep pressure massage approach might reinforce the promise of massage therapy when combined with other interventions.
I hope this piece has given you some useful hints and techniques to use when you are working with the client who might be on the autistic spectrum.
It was my privelidge to work at the Forestville Autistic Centre way back in the 1980’s where, as a very young teacher I worked with the educator and author, Eleanor Spence who wrote the book, ‘October Child’ about the a child who has autism. This book explores a wide range of issues relating to autism and would be appropriate reading for the massage therapist to gain an understanding of the condition in a very humanistic way.
NB I originally wrote this article for Firm n Fold in 2019 and have updated it for this article in my BLOG.
Those practitioners who would like further clarification or advice on working with the client who is on the spectrum are welcome to call me on 0409600300.