Massage Today Get the Latest News FASTER - View Digital Editions Now!
Massage Today dotted line
dotted line

dotted line
Share |
  Forward PDF Version  

Pediatric Massage

By Tina Allen, LMT, CPMMT, CPMT, CIMT

About the Columnist
Other Articles

The Permission Process: Infant & Pediatric Massage

Providing massage therapy for children, is always linked with a "permission process."  When used together these practices help to reinforce respect for the child and begin to establish positive boundaries.

Permission is really one of the most important elements in massage for children. Pediatric massage therapists, and parents trained to administer massage for their children, should always ask permission prior to beginning any touch therapy session.

Open Communication

Let the child know what is about to happen. Checking in with the child, rather than just assuming touch is okay, shows respect and gives them a choice to receive nurturing touch, or not.

Over time, the child begins to recognize this permission cue as "Massage Time," and will respond that they are ready for massage. At no other time will you use this specific signal, or cue, to indicate what will happen next. This distinct permission process communicates your intention, and allows the child time to evaluate how they are feeling prior to responding.

Understand the Cues

Provide the opportunity to check-in and observe their cues. Touch is our first form of communication, so, it is natural to assume that communicating through touch enhances your ability to understand a child's needs and respond appropriately.

Massage increases confidence and sensitivity to unique cues and forms of communication. By relaxing, taking your time and making eye contact, you can accurately observe a child's expression, and non-verbal language. Over time, you will become more attuned to their needs.

The Permission Process: Infant & Pediatric Massage - Copyright – Stock Photo / Register Mark Healthy Touch & Boundaries

A simple permission process supports healthy touch and helps establish good boundaries. When we start asking permission to touch during the most formative years, we reinforce the concepts of good touch versus touch that may not be seen as good or positive touch.

A young child will carry with them these healthy and strong boundaries around touch. Not only will they know the difference between healthy touch and touch which is considered detrimental, they will also trust themselves and know when to request nurturing touch.

Permission Teaches Respect

Asking for permission establishes respect between you and the child, instilling lifelong benefits including self-worth and self-esteem. When children receive attentive responses to their needs, they grow to become healthier and more secure in adulthood. Children who learn positive views of touch and receive nurturing touch are much more likely to grow into adults with healthy self-esteem, a sense of their boundaries and increased self trust.

For Children in the Hospital

When children spend time in the hospital or health care setting, they are subject to unwelcome poking and prodding on a routine basis. This type of touch, ay be necessary for examination, evaluation and administration of medial care. However, at the same time it often causes fear and anxiety around touch.

Pediatric massage therapists working in the healthcare setting should spend additional time explaining the touch therapy session to the child, indications, benefits and clearly ask for permission prior to beginning their treatment. In many cases, it is imperative to start slowly by just massaging the hands, or demonstrating the massage first by providing shoulder massage to the parent or nurse.

There are times when working with hospitalized children, they will refuse the massage therapy session. This is not what the therapist expects, but is super empowering to the children especially considering their lack of choices with so many other medical interventions. It doesn't mean they will refuse the treatment the next time it is offered, but it is great that the therapists can allow for this possibility and take time to introduce again in the future.

For Children Who Are Non-Verbal

If a child is non-verbal, it might appear difficult to ask and receive permission. This isn't so. You should still ask permission in the same manner as you would with another child. However, instead of expecting a verbal "yes" or "no" look at the body language and cues.

You should look for cues such as a relaxed, happy child who is smiling with wide open eyes that are looking at you.  You may notice their eyes and face brighten, or their head gently turned towards you. If a child looks uncomfortable, grimacing or is turning away from you, this may not be the best time to start a massage.

Knowing When to End the Massage

The need for recognizing cues is why you cannot continue massage for a child who falls asleep, or begin when they are sleeping. You do not have permission.  They have given no indication of their desire to receive massage. They can not tell you if it is uncomfortable or if they have any preferences.

Many adults enjoy receiving massage, and drifting in and out of sleep. Children however have different cognition and recognition. If they fall asleep during a session, they could very well wake up quite confused as to why they are being touched. In some cases, there are children who would greatly benefit from massage therapy. However, as it is a new activity, they may be unsure, scared or in pain.  In such a circumstance even if they are curled up in a ball and withdrawn, finding a way to gently introduce this may be of great value.

Starting slowly, and being sure you have informed the child of the massage benefits, why massage might be appropriate, options for positioning and pressure, is often helpful in establishing a connection, building rapport and communication.

In many cases we start by using a tactile item to begin the touch session, such as a puppet or textured ball. We can also employ songs and story telling to make the session more developmentally appropriate. When we start asking permission to touch during the most formative years, we reinforce the concepts of good touch versus touch that may not be seen as good or positive touch.

As the child grows, they will carry with them these healthy and strong boundaries around touch. Not only will they know the difference between healthy touch and touch which is considered detrimental, they will also trust themselves and know when to request nurturing touch.

dotted line