Adolescents with Attention Deficit Hyperactivity Disorder Benefit from Massage Therapy
Field, Tiffany M., Quintino, Olga, Hernandez-Reif, Maria, Koslovsky, Gabrielle, Adolescence
Twenty-eight adolescents with attention deficit hyperactivity disorder were provided either massage therapy or relaxation therapy for 10 consecutive school days. The massage therapy group, but not the relaxation therapy group, rated themselves as happier and observers rated them as fidgeting less following the sessions. After the 2-week period, their teachers reported more time on task and assigned them lower hyperactivity scores based on classroom behavior.
Attention deficit hyperactivity disorder (ADHD) is a condition affecting as many as 3 to 6 percent of all youth, and is characterized by developmentally inappropriate degrees of inattention, impulsiveness, and hyperactivity. Overactivity is typically the most prominent feature (DSM-III-R, American Psychiatric Association, 1987; Anderson, Williams, McGee, & Silva, 1987).
Treatment is made more difficult by the comorbidity of ADHD with other disorders, such as conduct disorder, anxiety, learning disability, and depression (Biederman, Newcorn, & Spirch, 1991). Treatment usually includes drug therapy and training parents and teachers in behavior modification techniques. Drug therapy features psychostimulants, such as methylphenidate or d-amphetamine, which alter the concentration and physiology of catecholamines, namely dopamine (Barkley, 1989; Evans, Gualtieri, & Hicks, 1986). This stimulates the frontal and striatal regions of the brain, which are associated with attention, arousal, and inhibition and help regulate these processes (Evans et al., 1986). Although drug therapy improves ADHD symptoms in over three-fourths of the cases, it is not a curative measure, its effects lasting only as long as medication is taken. Another drawback of drug therapy is the occasional side effects, such as appetite loss and insomnia (Barkley, McMurray, & Edelbrock, 1990).
Behavior modification by parents and teachers involves such techniques as adjusting the time, amplitude, and frequency of consequences for the child's actions, rearranging home and classroom settings to facilitate attention, breaking down tasks into smaller subtasks that can be completed within the child's attention span, and setting up schedules to aid the child in overcoming organizational problems (DSM-III-R, American Psychiatric Association, 1987). Behavior modification is a way to adjust the surroundings to facilitate the ADHD child's performance. However, as with drug therapies, behavior modification is only effective during the time that it is administered.
Alternative forms of therapy, namely massage therapy and relaxation therapy, were investigated in the present study because they have been effective with children and adolescents with attention problems. For example, relaxation therapy (Platania-Solazzo, Field, Blank, Seligman, Kuhn, Schanberg, & Saab, 1992) and massage therapy (Field, Morrow, Valdeon, Larson, Kuhn, & Schanberg, 1992) were found to reduce anxiety and activity levels in child and adolescent psychiatric patients. In addition, following massage they had more organized sleep and lower stress hormone (cortisol and norepinephrine) levels. Massage therapy has also been noted to decrease off-task behavior in children diagnosed as autistic (Field, Lasko, Mundy, Henteleff, Talpins, & Dowling, 1996). It was hypothesized here that massage therapy would lower the activity level of adolescents with ADHD.
Twenty-eight adolescents (mean age = 14.6 years) were recruited from self-contained classrooms for emotionally disturbed adolescents. All subjects were male, 90% were middle socioeconomic status, 29% were nonwhite Hispanic, and 71% were white. All were diagnosed with ADHD according to DSM-III-R criteria. They were randomly assigned to massage therapy or relaxation therapy based on a stratification procedure to ensure equivalence between groups on background variables.
Massage therapy. …