Autistic Clients and the Value of Touch Therapy

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Autism, or autism spectrum disorder, refers to a range of conditions characterized by challenges with social skills, repetitive behaviors, speech and non verbal communication, as well as unique strengths and differences. There is not one autism, but many types, caused by different combinations of genetic and environmental influences. The term “spectrum” reflects the wide variation in challenges and strengths possessed by each person with autism.

Autism primarily impacts social interaction and communication skills. A 2012 report from the Centers for Disease Control and Prevention (CDC) indicates the prevalence of Autism Spectrum Disorder in the United States for those areas surveyed range from that 1 in 68 children to as high as 1 in 41 children.

Although there is no cure for autism, appropriate treatment and education can help many children with this disorder adequately learn and develop. Early detection is critical in order to reduce the developmental challenges autism poses. Treatment is tailored to the individual and typically includes a combination of behavioral modification, communication therapy, dietary modifications and medications. Proven effective in rigorous clinical trials, massage therapy has been shown to positively impact some of the more characteristic behaviors of autism.

Autism Traits

People with autism process and respond to information in several unique ways. Those with autism typically exhibit some of the following traits:

Resistance to change, need for repetition
Difficulty in expressing needs, use of gestures or pointing rather than words
Repeating words or phrases in place of normal, responsive language
Laughing/crying for no apparent reason
Preference to being alone, aloof manner
Tantrums
Difficulty interacting with others
Not wanting to cuddle or be cuddled
Little or no eye contact
Unresponsive to normal teaching methods
Obsessive attachment to objects
Seemingly over-sensitivity or under-sensitivity to pain
No real fears of danger
Noticeable physical over-activity or extreme under-activity
Uneven gross/fine motor skills
Non-responsive to verbal cues, acts as if deaf despite hearing tests in normal range

Sensory Integration

For most of us, the integration of all five senses helps us understand what we are experiencing. For example, our sense of touch, smell and taste work together in the experience of eating a ripe peach. The fuzz on the peach may be experienced by someone with autism as painful and the smell may make the child gag. Some children with autism are particularly sensitive to sound, finding even the most ordinary daily noises painful. A majority of professionals agree that some of the typical autistic behaviors, like the ones listed above, are actually a result of sensory integration difficulties.

Often described as a lack of attachment, failing to cuddle as an infant and disassociation from the environment, autism often involves a defensive reaction to touch. Withdrawing when touched, displaying aggressive behaviors or even refusing to eat certain foods due to their textures, all point to autism manifesting as a sensory integration dysfunction of the tactile system.

A properly functioning tactile system accurately transmits information from the skin’s receptors to the central nervous system. When the tactile system is immature and working improperly, neural signals sent to the brain’s cerebral cortex interfere with other brain processes. This interference causes over-stimulation of the brain, making it difficult to both organize behavior and concentrate and can cause a negative emotional response to touch.

Massage Therapy

Interestingly, the nervous system is formed from the same layer of embryonic tissue as skin. As such, excessive sensitivity to light touch is one of the most common symptoms of nervous system immaturity. The self-affliction of vigorous physical stimuli (such as striking one’s head against a wall) while avoiding tactile interactions with others (a light touch may cause the child to scream in pain) is typical of autism. Since light touch is over-stimulating to those with autism, deeper massage techniques and joint compression are better tolerated. Utilizing methods of sustained moderate pressure such as Swedish Massage and Neuromuscular Therapy, can help dampen the nervous system’s over-reactivity.

Michael Regina-Whiteley, LMT, who has been working with children and adults with special challenges for over 33 years, shares the following nine tips to enhance relaxation and reduce tactile defensiveness in autistic children:

Begin sessions with deep touch (as opposed to light strokes) for the client to accept nurturing touch.
Engage the child in music of their choice and a quiet atmosphere.
Place your hands on his/her upper back or back of the head for as long as they allow. If no resistance is met, proceed and do a back or head massage using deeper strokes. If there is resistance, remove your hand, wait a few seconds, and then return your hand to its original position.
Although some children will resist the touching of their hands, another approach for an apprehensive child is to use their own hand to do the massage on their arm or hand. Be sure to calmly explain to the child what you are going to do in a low voice.
Keep the sessions brief at first to acclimate your client to the touch.
While getting a client with autism to participate in a full-body massage is unlikely, work as much as the client will allow.
When the focus is to decrease distractibility or hyperactivity, your primary objective would be to provide the “relaxation effect.” If the client has a high enough cognitive level, you can incorporate some tense-relax-tense exercises into the routine to teach relaxation skills.
Breathing exercises may be used to facilitate the client’s participation in their treatment. Be sure to acknowledge the client’s active involvement with verbal praise.
Many children with autism also experience hypertonicity of foot and leg muscles. Deep kneading and petrissage are helpful on the gastrocnemius and soleus; however, don’t go too deep with the tibialis anterior and peroneus brevis. Be sure to spend time on the plantar muscle groups at all three layers.

In 1997, researchers at the Touch Research Institute published results of its first study involving autistic children. Building on the success of previous studies demonstrating anxiety reduction and increased attention span using massage therapy for children, the Institute surmised touch therapy may be beneficial in reducing the autistic behaviors of inattentiveness, touch aversion and withdrawal. The researchers found that autistic children receiving touch therapy exhibited significant beneficial effects for orienting to irrelevant sounds and reducing stereotypic behaviors. Additionally, participants received improved scores on the Autism Behavior Checklist and Early Social Communication Scales. These beneficial effects of massage on autistic children may be credited to its active physical contact, relaxation effect and recruitment of the central nervous system.

The dysfunction of the nervous system’s sensory integration typically seen with autism can be minimized with touch therapy. Massage therapists showing interest in this condition can be a child’s bridge between autism’s seclusion and normal, developmental socialization.

Earn continuing education credit for this article contained in our Nervous System Disorders series.