A Hands on Approach for Pediatric ADHD
, LMT, CPMMT, CPMT, CIMT
A Hands on Approach for Pediatric ADHD
Tina Allen, LMT, CPMMT, CPMT, CIMT
As 16-year-old Samuel describes it, when you have Attention Deficit Hyperactivity Disorder (ADHD), you can't concentrate on the things you want to focus on. It is challenging to clearly focus enough to distinguish between important items and those which are not. Everything comes in all at once and it's impossible to filter. Sometimes, it's challenging to distinguish what is real and what is in his head. Often times, he says he feels like he has a cloud on top of his head that won't go away.
It can take an extreme amount of motivation and focus to do tasks that come naturally to others. When he does have the motivation and focus, Samuel can do amazing things and come up with amazing ideas. One of the worst parts about having a diagnosis of ADHD is the social imparities you have from not being able to concentrate. Each and every day, Samuel feels like he has to be someone else to satisfy everyone else and himself. He has stopped taking his medications because of the comedowns and the desire to not be different from others.
What is ADHD?
How do you describe ADHD to someone who doesn't have this condition? When ADHD is mentioned, often times we conjure up images of a child who is uncontrollable, can't sit still and appears to be bouncing off the walls. This is not always the case. Just as with any diagnosis, the symptoms may present differently for each individual. It is common for people to use the term ADD to describe Attention Deficit Disorder without hyperactivity and ADHD to describe Attention Deficit Disorder with Hyperactivity. Many people use these terms interchangeably, adopting the term that is most comfortable and easier for them. In doing so, they are not necessarily describing the symptoms, but providing a generic name for the disorder. The American Psychiatric Association lists three main types of Attention Deficit Disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), which is used by physicians in the diagnostic process.
ADHD, Predominantly Inattentive Type: This type includes the following symptoms: not paying close attention to detail, makes careless mistakes, difficulty sustaining attention, failure to follow through on instructions, difficulty with organization, reluctance to engage in tasks that require sustained mental effort, often loses items, is easily distracted and forgetful.
ADHD, Predominantly Hyperactive-Impulsive Type: This type includes the following symptoms: fidgeting, gets up from seat at inappropriate times, talking excessively, restlessness, difficulty being still or sitting quietly, acting as if driven by a motor, interrupting others, difficulty waiting turns and blurting out answers.
ADHD, Combined Type: This type includes symptoms from both of the above groups.
What Causes ADHD?
It is believed that ADHD may stem from sensory deprivation. Having such an interference with the perceptive senses or movement may produce a central nervous system that behaves as if it is overcharged, causing energy to build up until there is some outlet to expend it. As a result, movement and extra stimulation are required to use this excessive energy. If a child with ADHD is not provided with a method of using this energy, he or she may become irritable, upset or even lash out in anger or rage. Children with ADHD often appear to have difficulty holding attention or focus, display impulsive behaviors and activity levels beyond what might be typically expected. Often, they show poor academic performance as compared with their peers and have difficulty with social and emotional skills.
How Many Kids are Affected?
The number is higher than you might think. Many kids go day-by-day just trying to fit in without knowing they have ADHD. Sometimes healthcare providers miss the signs or parents may not wish to have their child diagnosed officially. Then, there are those occasions where parents and caregivers try to have their child diagnosed, when there is really nothing going on, other than having a healthy, energetic child. Whatever the reason, the evidence points to a high incidence of the diagnosis Attention Deficit Hyperactivity Disorder, or ADHD, and is rising as the most common psychiatric diagnostic label for children. According to the Centers for Disease Control and Prevention (CDC), close to 10 percent of children aged four to 17 in the United States have ever been diagnosed with ADHD. This number has continued to rise in recent years. The National Institutes of Health, states that ADHD is the most common behavioral disorder among children. Historically boys have been diagnosed at a much higher rate then girls, nearly nine times as many boys appear to be affected. However, the rate for girls diagnosed with ADHD is on the rise.
Benefits of Pediatric Massage
The question for the massage therapy profession is what are the benefits for children with ADHD? Because under stimulation might be a cause, and excess energy is the result, pediatric massage may be a very effective intervention to provide comfort and relief of some the child's symptoms. Aside from only the symptom of hyperactivity, a child may present with a strong temper, defiance and lack the ability to "sit still" for long periods of time.
Two studies conducted by the Touch Research Institute at the University of Miami reported that regular massage therapy can be an effective treatment for kids with ADHD. One study found adolescent boys who received ten 15-minute daily massages were observed by their teachers to be more focused in their schoolwork and they fidgeted less. In addition, the children rated themselves as happier than those who participated in a relaxation therapy program.
Another study involved kids aged 7-18, 20 percent of whom were girls. Each subject received a 20-minute massage twice a week. They showed immediate improvement in their moods and longer-term behavioral improvement in the classroom. They also reported feeling happier and their teachers found them to be more attentive.
In adult studies, massage has been shown to reduce levels of the stress hormone cortisol, helping to mitigate the active fight-or-flight response. Massage also helps improve math computation performance and raises alertness levels, as measured on electroencephalograms (EEGs). Finally, massage decreases depression and increases mental focus. The same effects are seen in children and teenagers with ADHD. With this diagnosis on the rise, pediatric massage therapists need to arm themselves with tools, techniques and approaches to best serve children with ADHD. By doing our part now to support these children, we positively impact their future.
- Attention Deficit Hyperactivity Disorder, or ADHD. (2010). Data and Statistics. Retrieved September 1, 2011, from Centers for Disease Control website: www.cdc.gov/ncbddd/adhd/data.html.
- Attention Deficit Hyperactivity Disorder, or ADHD. (2010) Data Retrieved September 1, 2011, from National Institutes of Health website: www.nlm.nih.gov/medlineplus/attentiondeficithyperactivitydisorder.html.
- Attention Deficit Hyperactivity Disorder, or ADHD. Statistics and Definitions Retrieved September 1, 2011, from National Institute of Mental Health website: www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/complete-index.shtml.
- Attention Deficit Hyperactivity Disorder (ADHD) in children. Retrieved September 1, 2011, from Mayo Clinic website: www.mayoclinic.com/health/adhd/DS00275.
- Field, T., Quintino, O. & Hernandez-Reif, M., & Koslovsky, G. (1998). Adolescents with attention deficit hyperactivity disorder benefit from massage therapy. Adolescence, 33, 103-108.
- Khilnani, S., Field, T., Hernandez-Reif, M., & Schanberg, S. (2003). Massage therapy improves mood and behavior of students with attention-deficit/hyperactivity disorder. Adolescence, 38, 623-38.
- The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). (2000). Arlington: American Psychiatric Association, www.psych.org/.