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Pediatric Massage

By Tina Allen, LMT, CPMMT, CPMT, CIMT

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Hospital Based Massage Therapy: Communicating With the Pediatric Patient

Many Certified Pediatric Massage Therapists (CPMT) work as part of a multi-disciplinary team at a hospital. When first meeting their pediatric patient, the therapist will have already reviewed the child's Electronic Medical Records (EMR), spoken to bedside staff and in some cases met their parents or family members.

The therapists often feel they have a clear understanding of the medical needs and indications for the touch therapy session you plan to provide. However, one consideration that is not always readily available through the review of an EMR, is the correct method in which to establish rapport, communication and trust with a hospitalized pediatric patient.

Hospitalization for children is stressful, as they may not completely understand their treatment and prognosis. As massage therapy is often used as a therapeutic intervention to manage stress and anxiety, it becomes more important to ensure that the child understands the purpose of the therapy. Pediatric massage requires extra communication to alleviate everyone's concerns, and address the opportunity for education and increased awareness.

Prior to beginning any hands-on therapy, the pediatric patient must have a good understanding of the therapy so that we are employing informed consent along with a structured permission process. The child will ultimately make the decision if they wish to have an approved massage therapy treatment.

Informed Consent

pediatric patient - Copyright – Stock Photo / Register Mark Informed consent is required from children of every age group. Under the guidelines of informed consent, the pediatric patient must be fully informed of the therapeutic care that is being presented for treatment. The child, just as a patient of any age, would have the legal and ethical right to direct what happens with their care plan, their body and to consent to, or refuse therapy. Many children don't understand what massage therapy is, or how it may be beneficial for their individual health care needs. Using a thorough and age-appropriate explanation of massage therapy in language the child will understand is imperative.

Considerations for Different Age Groups

Think of each age group as a person with a different diagnosis. They all have very different physical and psychological needs. How successful you are at interacting with a child and their family will depend on how familiar you are with the variations in needs by age group.

When speaking with children in the health care setting, it is very important to consider how a child may interpret the information shared. Always keep in mind the child's age, cognitive function and understanding. When formulating a question, or phrase, avoid using words or phrases that cause fear or confusion such as, "The nurse will move you to the floor before your massage session."

Possible implications to the child— Why can't I have a bed? Will I be on the ground? Children are often confused as they don't understand all terminology. Instead, it would be better to spend time explaining the process of transferring to the unit; why/where they will go. Use only words that should be understood by a child of specific physical age and cognitive understanding.

As you choose your words to use with children, you will want to consider the "hardness" or "softness" of your phrasing. Consider the following language choices. A "harder" phrase would be, "The session will last as long as ..." Instead use a "softer" phrase, such as "The procedure will be shorter than..." For example you may want to compare to the length of a TV program, or another familiar length of time for the child.

Words or phrases that are helpful to one child may be threatening to another. Health care providers must listen carefully, watch cues, nonverbal body language and be sensitive to the child's needs and understanding. It is advised to speak with other members of the health care team and also the child's family to best understand how the child communicates. If they are using non-verbal forms of communication such as sign language, picture communication or an augmentative communication device, it is advisable to have a good understanding how these work or the way the child uses them.

Working with pediatric patients, is rewarding and different than working with any adult population. You are constantly learning and adapting to ensure the child's care is provided in the safest, most effective manner with the child's informed consent. When a pediatric massage therapist learns how best to communicate with the health care team, the family and the pediatric patient, it improves our role as an integral part of the health care team.

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