Academic journal article International Journal of Child and Adolescent Health

Does a Program of Massage Improve Gross Motor Development in Orphans Aged between 1-12 Months? A Randomized Controlled Trial

Academic journal article International Journal of Child and Adolescent Health

Does a Program of Massage Improve Gross Motor Development in Orphans Aged between 1-12 Months? A Randomized Controlled Trial

Article excerpt


The number of abandoned children who live in the orphanages of developing countries, especially Thailand, increases rapidly every year. For example, the total number of orphaned children aged 1-6 years increased from 84 to 212 between the years 2003 and 2009 at the Khaengthong orphanage in Khon Kaen province (1). A dramatic increase in the number of abandoned children results in an inappropriate caring ratio between orphanage staff and children. Many institutions in South Korea with an average number of 60-70 infants employ few caregivers (2). This is consistent with the situation in Thai orphanages. For example, at Khaengthong orphanage only a few caregivers tend to 50 babies aged 1-12 months.

Most infants are abandoned at a hospital or in a public place. Some are abandoned due to parents having chronic diseases, passing away or being in prison. Therefore, infants in an orphanage have a similar environment to hospitalized infants; they are separated from their mothers at a time when they require physical and mental nurture. Due to inappropriate caregiver:child ratios and inconsistencies in caregiver service, orphanage infants face an increased risk of delayed development and poor health conditions, for example infection of respiratory and gastrointestinal systems (3-4). It has been reported that 14% of children in orphanages have global developmental delay (5).

Much literature reports that children living in orphanages show signs of delayed growth and development compared with children living with their parents (5-7). The developmental delays are also related to the length of time children spend in an orphanage. Miller and Hendrie (2000) (6) found that delays in gross motor skills were most common (55%), followed by delays in language (43%), cognitive (32%) and socio-emotional skills (28%). Results from Rettig and McCarthy-Rittig surveys (2006) (8) were also consistent with previous studies, indicating that 62% of 240 children adopted from China were reported as having developmental delays and 91% of this number were reported to have had delays in motor skills.

Gross motor development is an essential basis of global development because gross motor development shows significant progress and can be clearly observed within the first year of life. It is important for infants to gain normal gross motor development in order to fulfill other learning skills in life. Cohen and colleagues (2008) (9) suggested that deprivation in experience in the first year of life has more longlasting effects on physical growth and development than mental development. Therefore, child care and development need to be started early and given continuously from the first year of life.

In order to promote good health and development, massage is a program which can be easily performed by child care staff or parents (1011). The effects of massage on growth and development have been reported in full-term infants (12), on weight gain and motor behavior of preterm infants or low birth weight infants (13-14). Massage helps to reduce cortisol hormone and increase sedative hormone, which makes possible a longer and deeper sleep in stressed babies and facilitates an improvement in motor behavior (15). Massage also enhances the relationship between fathers or mothers and infants, or between caregivers who give massage and infants (16-18).

It has been reported that orphaned infants increased their body length and head circumference after receiving multisensory stimulation including massage for 4 weeks (2). Moreover, massage decreases the number of incidences of diarrhea in orphanages (19).

These previous studies suggest strongly that additional care through massage, which is a sensory stimulation program, provides benefits to the health condition of orphaned infants. However, these previous studies performed massage in a younger age group of subjects, and there has been limited literature regarding the effect of massage on gross motor development of infants within their first year. …

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