Last year, the centers for disease control and prevention (CDC) reported that 1 in 54 children in the United States is diagnosed with an autism spectrum disorder (ASD). Although there is no cure for ASD, there are complementary therapies—including massage—to help support and work to manage the common sensory overload issues faced by young people living with ASD. 

Getting Involved

Tami Goldstein, WLMT, UCST-D, BCTMB, didn’t start off as a massage therapist early in her life. In fact, she first enrolled in massage therapy school at age 40. The motivation? She saw the positive effects massage therapy had on her young daughter, Heather, who was diagnosed with ASD. “The Upledger craniosacral therapy made such a difference for her, I decided to go back to school in my early 40s to become licensed as a massage therapist and to certify in Upledger craniosacral therapy,” Goldstein remembers.  

Other massage therapists, like Dan Vidal, LMT, CNS, explored the benefits of massage therapy for autism through research. Vidal wrote a case study report, Massage and Atlanto-Occipital Mobilization to Improve Symptoms in a Boy with Autism, on the experiences of working with a three-year-old client with ASD. “Part of my mission as a massage therapist is to spread the word about the potential benefits of massage therapy for autism, chronic pain, and other medical conditions,” he explains.

Rachel Benbow, CST-T, LMT, MLIS, specializes in pediatric massage therapy and pediatric craniosacral therapy. “I believe strongly in a team approach. As a massage therapist and certified craniosacral therapist I spend a lot of time in direct contact with my clients, and thus I can have valuable insights and information to share with my client's other health care providers,” she says. All three of these massage therapists share a passion for helping an often misunderstood population.

Honoring Uniqueness

All pediatric clients are individual and unique, and that is no different for your clients with ASD. Different interests, challenges, and needs are hallmarks of all youth. But paying attention to your ASD clients, and what they want and don’t want, is especially important. As Benbow explains, “Some might like music, others may not be able to tolerate sound. Autistic clients can easily swing into a state of overwhelm depending on the variables of the day. What they enjoyed or tolerated last session may not work the next session.”

Goldstein notes, “Many times with individuals on the spectrum, their sensory system can get into overload and they begin to escalate. So, when you perceive signs of the sympathetic response in the body, sometimes it’s easier to back off, maybe introduce a calming sensory toy and then go back to the massage therapy.” 

Communication Is Paramount

We all have trouble communicating sometimes, whether because we’re shy, overwhelmed or new to a situation. For your autistic clients, however, communication may be especially difficult, and requires massage therapists to be flexible, check in throughout the massage session and be attuned to both the client and the client’s parent. “It’s important to be in constant communication with them and/or their caregivers,” Vidal says. 

Parental Support

As a parent of a child with ASD, Goldstein has an acute awareness of the power and progress associated with parent support and education in the care of their children. “A lot depends upon the age of the child and the diagnosis of the child. It is not uncommon when working with an infant to have the infant held by the parent,” she explains. “If it’s a toddler or young child with autism, I always try to engage the parents so we can work together to facilitate touch on the child.” That “bonding bubble,” as she calls it, between the parent, child, and massage therapist, is paramount to helping all involved. 

Having a parent in the treatment room with a pediatric client is a great opportunity for massage therapists to educate the parent on techniques to use at home. “I usually demonstrate breathing techniques for clients and their parents, as these are safe, effective, and easy to implement at home,” explains Vidal. “Showing parents how to do basic soft-tissue work on the suboccipitals and neck can sometimes be helpful as well.” Vidal has three helpful tips for massage therapists to keep in mind as they work with both their pediatric client and their parent: 

1. Demonstrate to the parent that you care about the client's happiness and well-being. 

2. Establish good rapport with your pediatric client.

3. Help parents understand how you will assess and treat their child, as well as how progress will be tracked.

Advice for Practitioners 

Goldstein encourages all massage therapists to keep learning and being open to educational opportunities. “If we can combine our massage therapy training with a little bit of education about autism, we can make a profound difference in the lives of these individuals.”  

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