Effectiveness of Nurse-Led Home Based Massage Therapy in Improving the Behavior of Children with Autism

Abstract

The Research Problem:

Autism is one of the most common childhood development disorders, even more prevalent than Down Syndrome. Children with autism exhibit a wide array of symptoms and behaviors that can range from mild to severe. Autism is usually diagnosed at the age of 18 months and above, affecting males three times more than the females and it is characterized by unusual social interaction, speech and language problems, repetitive and ritualistic behaviors, sometimes self-injuring behaviors such as biting and head banging, aggressive behaviors, frequent tantrums occurring for no apparent reason, and sensory processing impairment. Sensory integration in the form of massage therapy is one of the complimentary interventions that contribute to behavior changes among children with autism and other development disorders.

This study was conducted to determine the effectiveness and nurse-led home-based massage therapy utilizing the parents as therapists in improving three problems commonly associated with autism namely, self-injurious behavior, stereotypic behaviors and agitation.

The objectives of this study were:

1. To determine the extent of following behaviors among children with autism before the implementation of the intervention: a. Stereotype behaviors b. Self-injurious behaviors c. Agitation

2. To determine the extent of the following behaviors among children with autism after the implementation of the intervention:

a. Stereotype behaviors b. Self-injurious behaviors c. Agitation

3. To determine the difference in the behavior of the children with autism before and after the implementation of the intervention. 4. To identify the problems encountered by the caregiver in the implementation of the program.

Methods:

The study utilized a two-group quasi experimental research design. The subjects were selected based on the inclusion-exclusion criteria and were assigned to either the study or control group. The sample consisted of thirty children with autism ranging from 3 to 6 years of age and are currently attending a special school who were assigned to massage therapy (study group) performed by the caregiver and massage therapy performed by a professional therapist as the control group. Parents in the massage therapy group were trained by a registered nurse to massage their children for 15 minutes prior to bedtime every night for one month. Random assignment was used, and the study was conducted in two selected schools namely: Starflight Development Center for Special Children located in Rocka II Annex, Sta. Rita, Guiguinto, Bulacan and Bicol Development and Learning Center in Iriga City.

SUMMARY OF THE FINDINGS Respondents of this study were the caregivers of the children with autism who completed the training program. They were all mothers, educated and have learned the massage techniques taught by the nurse.

There were a total of 30 subjects (15 for the study group and another 15 for the control group).

The mean differences noted in the standard deviations imply that as a whole, the behavior of the children with autism had improved satisfactorily after the massage therapy.

There was a significant difference in the behavior of both the control group and study group after receiving massage therapy in regard to stereotypic behavior, self-injurious behavior as well as agitation.

The findings showed that massage done by parents could make a difference in the behavior of children with autism. The application of the massage therapy to autistic children gave positive results that led to the decrease in most of the behaviors manifested by children with autism.

These findings are very encouraging as they indicate that, massage therapy done by caregivers who were previously trained by a nurse can minimize the manifestations of stereotypic behaviors, self-injurious behaviors and agitation in children with autism. Massage can be part of the holistic nursing intervention not only for pediatric patients in the ward but also for children with autism in the home setting.

CONCLUSIONS:

The findings led to the following conclusions:

• Nurses are effective trainers for caregivers of children with autism, hence, nurses working in the community setting can conduct training programs on massage for caregivers of children with autism. • Home caregivers trained by a nurse to do massage can be effective therapists of their child with autism. • Massage therapy done by caregivers who were previously trained by a nurse can minimized the manifestations of stereotypic behaviors, self-injurious behaviors and agitation in children with autism. • Massage therapy implemented as home program by caregivers can affect a change in the behavior of children with autism. • The training program has effected a change on the caregivers in terms of level of understanding about autism and the importance of massage as an intervention in controlling the behaviors of their child with autism.

RECOMMENDATIONS

Based on the results of the study, the following recommendation are drawn:

Nursing education:

1. Nursing schools should include detailed massage therapy as part of nursing skills so that the students will gain competence in massage therapy, that they may be able to rain more parents of children with autism during their stint in the community. 2. Massage therapy be part of nursing intervention in the car of children with autism in the home or hospital setting.

Future trainings: 1. Future massage training in the community must also include the other members of the family utilizing the same massage therapy program used in this study.

Future studies: 1. Future researchers can look into the effectiveness as well of the other members of the household (siblings, yayas, and grandparents) as therapist of the child with autism. 2. Future researches can look into the effectiveness of this therapy for similar symptoms in conditions other than autism.