Massage Therapy Journal Fall 2024

Fall 2024 • 19

5 Quick Tips for Making Your Practice Welcoming to Neurodiverse Clients Ann Blair Kennedy is the associate professor and director of the Patient Engagement Studio at the University of South Carolina School of Medicine Greenville and a massage therapist with 25 years of experience. Her experience with neurodiversity began young, growing up with an autistic brother and having ADHD herself. Now, she’s raising two neurodiverse kids and describes herself as neurospicy. Here, she offers five tips to help massage therapists make their practices more welcoming to neurodiverse clients. Consider sensory adaptations . Understanding that individuals with autism spectrum disorder (ASD) and sensory processing disorders (SPD) may experience sensory inputs more intensely is crucial. It’s important for therapists to be adaptable, as clients’ reactions to sensory stimuli like touch, sound and smell can change rapidly. Techniques such as using weighted lap pads and blankets, adjusting room lighting and noise levels, and being mindful of the textures of sheets and massage oils can help create a more comfortable environment. Employ communication strategies . Establishing clear communication methods, especially for non-verbal cues, is essential. This can involve using hand gestures or other signs to indicate comfort levels or the need for a break. Building rapport through initial sessions without massage to familiarize the client with you and the practice environment can also be beneficial. Consider using deep pressure massage . For some neurodiverse individuals, deep pressure massage has been shown to be effective. Utilizing flat palms and long, firm strokes can provide proprioceptive feedback, which might help with body awareness and reduce stress. However, it’s important to communicate clearly about the process and observe the client’s reactions carefully. Ensure client-led sessions . It’s critical to follow the client’s lead, allowing them to dictate the pace and extent of the massage. This might mean that some sessions are very short or don’t involve traditional massage at all initially. Establishing trust and a sense of safety is paramount, and this often requires patience and flexibility from the therapist. Educational and collaborative approach . Continuously educating oneself on the latest research and techniques for working with neurodiverse populations is important. Collaborating with other professionals involved in the client’s care can provide a more comprehensive understanding of their needs and how best to meet them​.

concentration. “By promoting relaxation and reducing hyperactivity, massage therapy can potentially help individuals with ADHD improve their ability to concentrate and focus,” she says. The same holds true for the sometimes high levels of anxiety experienced by people with ADHD. By lowering anxiety levels, massage may be able to help people improve their emotional regulation. Some research bolsters these claims. An early systematic review and meta-analysis examining the effects of massage therapy for children and adolescents with ADHD 1 showed some positive results, though was small, comprising only eight randomized controlled trials and three case studies for systematic review. A meta-analysis of four of the eight randomized controlled trials was also conducted. “Pooled analysis showed that massage produced more improvement in ADHD symptoms in terms of effective rate compared to Ritalin,” researchers noted. “Individual randomized controlled trials suggested that massage differed significantly from waitlist control in improving the conditions of anxious-passive and asocial behavior.” A more recent pilot randomized controlled trial 2 explored the effects of parent-administered pediatric tuina massage for ADHD symptoms in preschool children. Tuina is a modality similar to Shiatsu. Participants were assigned to either a parent administered tuina group or a parent-child interaction group, where parents were coached on a progressive muscle relaxation exercise. Both interventions were carried out every other day for at least 20 minutes for a two-month intervention period. Researchers found that both intervention groups showed improvement with moderate within-group effect size. The between-group effect size was minimal. “Perceived improvements on children’s appetite and sleep quality, and parent child relationship was observed in qualitative data,” researchers noted. “Parent-administered pediatric tuina provided beneficial effects on improving core hyperactivity/impulsivity symptoms in preschool children.”

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