The Autism Spectrum & Pediatric Massage

By Tina Allen , LMT, CPMMT, CPMT, CIMT

The Autism Spectrum & Pediatric Massage


The Centers for Disease Control and Prevention (CDC), through their published report, "Morbidity and Mortality Weekly Report (MMWR) Surveillance Summary," states that there are approximately 1 in 59 eight-year-old children identified as having autism.1 The data utilized to generate this report was provided by the CDC's Autism and Developmental Disabilities Monitoring (ADDM) Network. ADDM Network is a tracking system that provides estimates of the prevalence and characteristics of autism spectrum disorder among more than 300,000 eight-year-old children. This new data suggests the rate of autism is twice as high as it was in 2004 (then at a rate of 1 in 125), and could calculate to as many as 1 in 54 boys affected.

Understanding Autism Spectrum Disorder

Autism spectrum disorder (ASD) is defined as a complex developmental disability with specific signs typically appearing during early childhood and affecting that person's ability to communicate, as well as, interact with others socially. ASD is defined by a specific set of behaviors and is a "spectrum condition" that may affect children in various degrees.

Some of the behaviors associated with autism may include delayed learning of language and difficulty engaging in conversation, lack of eye contact, narrow interests and poor motor skills. A child with an ASD diagnosis may have many of these behaviors, or just a few. These behaviors make it difficult for children with ASD to communicate with others, leading to frustration and in many cases social isolation.

Additionally, many children with ASD are characterized as having difficulty with sensory integration and then may be co-diagnosed with other diagnoses such as SPD (Sensory Processing Disorders). Families and health care professionals often report that children might have an aversion to touch and tactile stimulation. Many people hold the belief that children affected by autism may not like to be touched. This is not always the case, but rather how touch therapy is applied.

It is important to remember that each child with an autism spectrum disorder will have his or her own individual symptoms and behaviors. A diagnosis is only one factor in considering the best care of the pediatric client. As a practitioner working with children with autism, be prepared to take your time and proceed slowly. There is a great possibility you may not introduce massage therapy at your first session together, and this is normal. Start out by first trying to make the child feel comfortable.

The child must feel safe, and that respectful connection takes time. Take your time to allow the child to become comfortable with the environment and you. This is especially important if you have entered their safe space. Never insist that a child participate in the massage session. Speak calmly and lovingly, take your time and introduce slowly. Request that caregivers have items the child likes available during the session. A favorite blanket, toy or flashlight could become the engagement item the child needs to be comfortably present.

Forms of Communication

You want to give the child the opportunity to participate in the session as much as possible, and feel empowered by providing choices. For many children with autism, there is susceptibility to sensory overload. So, it is important to begin with gentle, but full contact and gradually work deeper, while being very aware of all cues the child is giving you. Some children may not use the same verbal skills as other pediatric clients, so it is imperative to be mindful of all non-verbal communication as well.

Always speak to the child with the intent that he or she understands. Be aware and observe cues which indicate permission to touch. You may not receive direct eye-to-eye contact or a verbal "yes." Vary your pace and pressure while recognizing the child's needs.

Investigate what forms of communication are being used (i.e., ASL, picture boards, spoken language and written language). To the best of your ability, incorporate these communication methods into the session, with the guidance of the family and other health care professionals.

Deeper pressure is often better received by many children who have been diagnosed with ASD. Consider providing touch over clothing or cloth, and beginning with the hands and feet may be more comfortable. Utilize structure around your sessions. Children with autism often prefer routine and structure. They may have difficulty with transitions and unexpected changes.

Every session you may have with a child should be unique and individualized. No two clients are identical, and when you practice care and caution you will find a strategy for success.


  1. Morbidity and Mortality Weekly Report (MMWR). Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years. Centers for Disease Control and Prevention (CDC), 27 April 2018.