Integrating Touch and
Massage into Early Childhood
Special Education Services
TWENTIETH ANNUAL ALASKA STATEWIDE
SPECIAL EDUCATION CONFERENCE
FEBRUARY 22, 2011
AGENDA
  Introductions
  What
is touch?
  Why is touch/massage important?
  Why is touch/message important to the child with
special needs?
  Cultural aspects of touch
  Why is touch controversial?
  Effective techniques
  Videos
  Conclusion
INTERACTIVE EXPERIENCES
PRESENTERS
 Philip P. Patterson, Ph.D.
University of Alaska Fairbanks
([email protected])
IN SPIRIT
  Elaine
Fogel Schneider, Ph.D., CCC-SLP
Nova Southeastern University
([email protected])
ANTICIPATED AUDIENCE
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Early Childhood Teachers/Early Interventionists
Speech and Language Therapists
Physical Therapists
Occupational Therapists
Counselors
Social Workers/Service Coordinators
Parents
Forster Parents
Teen Parents
College/University Students
Administrators
Nurses
Others?
ACCIDENTAL TOURISTS
GRACIOUSLY EXCUSED IF:
- ALREADY WELL VERSED IN USING TOUCH AND
MASSAGE
- EXPECTING A COMPREHENSIVE TRAINING ON
TOUCH AND MASSAGE
- YOU’RE A KNOW-IT-ALL
HOUSEKEEPING
- QUESTIONS
HOLD TO THE END
- EVALUATIONS
PLEASE REMEMBER TO COMPLETE
- HANDOUTS
WHAT IS TOUCH?
• 
• 
• 
• 
Physical contact between two objects
One object applying physical force upon another
The sensation that the brain perceives when skin
comes in contact with an object or person
One of the 7 basic senses
EXAMPLES OF TOUCH
 Holding
 Cuddling
 Stroking
 Kissing
 Rocking
 Tickling
 Patting
 Bouncing
MASSAGE WITH CHILDREN =
INTENTIONAL TOUCH
  Massage
is a structured and systematic form of
touch
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Permission-based
Energy exchange
Attunement
Reciprocal
Relationship builder
OTHERS TERMS
  TouchTime™
  Tactile
Communication
  Touch Therapy
  Tactile - Kinesthetic Stimulation
  Primal Communication™
  Disciplinary Touch
  Exploitative Touch
TOUCH DISTINCTION
  Procedural
Touch
  Nurturing Touch
(Harrison, 2001)
HISTORICAL OVERVIEW
  3000
BC
  2300 BC
  1800 BC
  129AD
  5th C
  16th C
  17th – 18th C
  19th C
©Schneider, EF. (2006).
China
Egypt
India
Rome
Greece
Italy
Tahiti
Russia
America
France
Ayur Vedic practice
Julius Ceasar
Hippocrates
Mercurialis
Capt. Cook
Swedish Institute
Swedish Institute
Swedish Institute
HISTORICAL OVERVIEW (CONTINUED)
  20th
C
  21st C
©Schneider, EF. (2006).
U.S.
WWII
Esalen, CA
International studies around
the world profess the benefits of
massage for infants, children, and
adults with or without
disorders and illnesses/and adults
who massage children.
WHY IS TOUCH/MASSAGE IMPORTANT?
  Basic
means of perceiving information
  First sense developed in utero
  Fundamental means of perceiving caregiver’s intent
  Means by which caregiver perceives child’s well
being
VIDEO
WHY IS TOUCH/MASSAGE IMPORTANT?
(CONTINUED)
  Structures
brain development (Siegel)
  Speeds up hospital discharge for premature infants
(Field, et.al.)
  Enhances attachment
  Furthers social-emotional well-being
  Increases immune system functioning
  Releases “feel good” hormones
WHY IS TOUCH/MASSAGE IMPORTANT
TO FOSTER PARENTS AND TEEN
PARENTS?
TOUCH DEPRIVATION
  Harlow
– Contact comfort is more important than
nursing comfort
  Schanberg, et.al. – Growth hormones are reduced
  Perry - Brain size is reduced
  Field, et al. - Motor development is delayed
VIDEO
STUDIES FROM DR. BRUCE PERRY, M.D., PH.D. AT THE
CHILD TRAUMA ACADEMY (WWW.CHILDTRAUMA.ORG)
BABE = BRAIN & BODY EMOTIONS
©SCHNEIDER, EF. (2006)
THE SIGNIFICANCE OF THE SKIN
  Skin
is made from the same cells as the brain
  It is the largest organ in the body
  Organ size is related to the multiplicity of functions it
performs
SOCIAL RECIPROCITY
Parent/Caregiver
Infant/Toddler/Preschooler
Touch/Massage
Relationship building
Social Reciprocity
Health & well-being
Growth & Development
Bonding and Attachment
© E.F. Schneider (1996). The power
Of touch. Infants and Young Children,
8(3), 40-55.
HAVING A CHILD WITH SPECIAL NEEDS OR
WHO IS AT-RISK MAY INTERFERE WITH THE
BONDING PROCESS
  Some parents may:
  Be fearful
  Hold additional stress
  Not know if their child will survive
  Be unable to engage in eye contact
  Have a mismatched portrait of child
  Have their rhythmicity interrupted
  Exhibit less smiling, vocalizing, touching
  Have different or difficult quality of interactions with their
 
child
Be at increased risk for committing child abuse
©Schneider, EF. (2004)
OUTCOMES OF TOUCH/MASSAGE
  Provides
children with information about their
bodies, the location of their bodies, and body parts
  Allows for a means of communication between
children and caregivers
  Offers a means of expressing affection resulting in
bonding
  Promotes weight gain, growth, and social-emotional
development
  Aids in brain structuring and development
  Increases caregivers ability to read cues from the
child building caregiver confidence
WHY IS TOUCH ESPECIALLY IMPORTANT TO
CHILDREN WITH SPECIAL NEEDS?
 
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Helps relax tight muscles
Increases body alert state
Facilitates weight gain
Promotes general relaxation and stress reduction
Helps sleep longer and deeper
Decrease gas, constipation, GI tract problems
Helps regulate hypo or hyper sensitivity
Increases hand to midline
Decreases fisting
Improves socialization, eye contact, & communication
Drehobl, K.F. & Fuhr, M.G. (2000). Pediatric massage revised for the child with special needs. NY: Harcourt Health Sciences.
VIDEO
VARIABLES TO APPROPRIATE TOUCH
  Cultural
Standards
  Religious Practices
  Gender
  Age
  Familiarity
  Social standing
  Location
GENERALIZATIONS ABOUT TOUCH AND
CULTURE
  Northern
European and Northern American
societies minimize physical contact
  Similarly, Asian societies avoid physical
contact
  In Contrast, Latin Americans use close
physical proximity and high levels of tactile
interaction.
  Likewise, African communication styles
involve high rates of gesture and touching.
CAN’T TOUCH THAT
  Many
schools and agencies have
established “no touching policies” as a result
of:
 
 
 
 
The AIDS Epidemic of the 1980’s
Resulting awareness of viral and bacterial
transmission
Education efforts concerning universal health
care precautions
A media which sensationalized allegations of
improper teacher and caregiver conduct
THE TIDE MAY BE TURNING
“Programs should not institute “no-touch policies” to
reduce the risk of abuse. In the wake of wellpublicized allegations of child abuse in out-of-home
settings and increased concerns regarding liability,
some programs have instituted such policies, either
explicitly or implicitly. No-touch policies are a
misguided effort that fail to recognize the
importance of touch to children’s healthy
development.”
National Association for the Education of Young Children (1996). Prevention of
child abuse in early childhood programs and the responsibilities of early childhood
professionals to prevent child abuse: A position statement of the National
Association for the Education of Young Children. Washington D.C: Author.
CONSIDERATIONS
AND
BEST PRACTICES
KNOW THY SELF
© EF SCHNEIDER & PP PATTERSON (2007)
  Identify
your own comfort level with the sense of
touch
  What is your personal “touch history”?
  How is your “touch foundation”?
KNOW THY CHILD AND THY FAMILY
  Observe
 
 
 
 
caregivers use of touch:
Do they hug their children?
Do they reward their children with a pat on the back?
Do they stay a particular distance from their children?
Do they offer one child more touch than another?
  What
is the child/family touch history?
PILLOW TALK
© EF SCHNEIDER & PP PATTERSON (2007)
  Stay
open for conversations about touch
with caregivers:
 
 
 
 
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Ask the caregiver how they offer affection to their
children.
Can they describe the amount of physical
contact in their home?
Is touch used for discipline or nurturing?
Do they have any touch or massage rituals?
Discuss the benefits of touch and massage.
MAY WE DANCE
© EF SCHNEIDER & PP PATTERSON (2007)
  Ask
 
 
permission to touch or massage
From the child
From the parent
  This
is something we do as a partnership
with the child, not to the child
  Let the child and caregiver know how you
will be proceeding
BEGIN THE BEGUINE
© EF SCHNEIDER & PP PATTERSON (2007)
  Start
touch or massaging at the child’s level of
acceptance
  Build slowly and gently
  Quality is more important than quantity
LET THE GAMES BEGIN
© EF SCHNEIDER & PP PATTERSON (2007)
  Bean
Box
  Ball Pit
  “Buried in the Sand”
  Rhyming through touch and sound
  Stickers everywhere!
CALMING THE STORM WITHIN
© EF SCHNEIDER & PP PATTERSON (2007)
  Getting
in touch with:
  Accupressure
points
  Breathing
  Relaxation
  Guided
imagery
LET YOUR FINGERS DO THE WALKING
 
© S. T. A. R. T. Tips for Massage:
  Stay encouraged
  Take the time you have/use the time wisely
  Adjust and be flexible
  Recognize and follow the child’s cues
  Talk to the child as you massage
©Schneider, EF. (2006). Massaging Your Baby. New York: Square One Publishers.
THE FOUR S’S FOR CHILDREN WITH SPECIAL
NEEDS
1. 
2. 
3. 
4. 
Soothe the child
Strengthen the child
Securely attach and bond with the child
Smile with the child
©Excerpt from Schneider, Elaine Fogel. (2006) Massaging Your
Baby. New York: Square One Publishers.
VIDEOS
COUNTER INDICATORS TO MASSAGE
  Has
a high fever
  Has an acute infection
  Has a skin disease
  Has had recent
immunizations
  Has any abdominal
difficulty
  Has any life threatening
medical condition
  Has
the knot of the
umbilical cord on
  Has swollen lymph
nodes
  Has a blood condition
(e.g., clots)
  Has any other acute
illness or diseases
©Schneider, EF. (2006).
Massaging Your Baby.
New York: Square One
Publishers.
REAL-WORLD CONSIDERATIONS
  Men
  Home
Visits
  Communities with recent allegations
  Physical conditions of the child
 
 
 
Skin sensitivity
Allergies
Medical fragility
  Good
touch/Bad touch
PROGRAM DEVELOPMENT
  How
might you include massage into your
program?
  What supports are in place?
  What supports do you need?
  Name 3 people you can approach
  List 5 steps to take to get started
Q AND A
WEB SITES
  Dr.
Elaine Fogel Schneider –
www.AskDrElaine.com
  National Association for the Education of Young
Children – www.NAEYC.org
  Touch Research Institute www.miami.edu/touch-research/
RESOURCES
 
 
 
 
 
Ackerman, D. (1990). A Natural History of the
Senses. New York: Vintage Books.
Bowlby, J. (1988). A Secure Base. Reading, Mass.:
Perseus Books.
Carlson, F. M. (2006) Essential Touch: Meeting the Needs of
Young Children. Washington, DC: National Association
for the Education of Young Children.
Drehobl, K.F. & Fuhr, M.G. (2000). Pediatric Massage
Revised for the Child with Special Needs. NY: Harcourt
Health Sciences.
Field, T. (2000). Touch Therapy. New York: Churchill
Livingstone.
RESOURCES
  Klaus,
MH & Klaus, PH. (1998). Your Amazing
Newborn. Reading, Mass.: Perseus Books.
  Perry, B.D. & Szalavitz, M. (2006). The Boy who
was Raised as a Dog: And Other Stories from a
Child Psychiatrist’s Notebook. New York:
Basic Books.
  Pert, CB. (1997). Molecules of Emotion. New York:
Scribner.
  Schneider, EF. (2006). Massaging Your Baby-The
Joy of TouchTime.™ New York: Square One
Publishers.