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THIS ISSUE:
Pediatric
Care
Swedish Institute on-line newsletter for our students, faculty and community.
It Takes a Planet
The Worldwide Search for CAM for Children
Contributions by pioneers in the field of integrative therapies for pediatric
care—whether from
researchers, teachers or practitioners—are increasingly of value as we face changes in the biomedical
approach to common childhood illnesses and the growth of problems that drugs can’t fix.
In an effort to do all they can for their children, many parents are turning to complementary and
alternative medicine (CAM). As interest in CAM has grown, new research has also been accumulating. The
use of CAM for children is being investigated worldwide, taking place in the U.S., as well as in
countries that include Australia, China, Turkey, Ecuador, Russia, Sweden and France.
This issue of SInews takes a look at some of the professionals bringing the benefits of massage and
acupuncture to children, whether it’s to relieve acute conditions like the common cold, alleviate
painful procedures, or manage the long term challenges of disability and chronic illnesses. They are
part of a global effort to demonstrate how these timeless remedies can improve the lives of children,
their parents, their doctors and nurses. Read
more.
—Barbara Goldschmidt, editor
Photo above courtesy of International Loving Touch Foundation.
Acupuncture for Respiratory Conditions
Acupuncture Program faculty member Ann Cecil-Sterman (‘03) sees many pediatric patients in her
Manhattan practice. So far, most come for treatment for asthma and other issues common to
children, such as coughs and cold. Her approach is gentle, using acupuncture and dietary
changes together. It is based on the view in Chinese medicine that asthma involves lung
function as well as the kidney’s ability to “grasp” the lung energy. Because cold can weaken
both the kidney and lung functions, Ann feels it is important to consider the energetic effects
of everyday lifestyles.
“I have found the principles of Chinese medicine to be highly successful with pediatric
asthma cases when acupuncture treatment is combined with dietary changes,” Ann said. “Some
children improve so much just with the dietary changes suggested, that they don’t even need
to come in. Others respond with one or a few treatments. Children have had very little damage
done to their network of meridians, so they respond very well to acupuncture.”
Read
more.
Innovative Massage in a Pediatric Oncology Unit
Evelyn Li, LMT (‘94) is part of the Integrative Therapy Program (ITP) at Columbia-Presbyterian’s Pediatric Oncology Unit, where children being treated for cancer are offered massage, acupuncture, Reiki and aromatherapy. “These services are used to help alleviate side effects such as nausea, pain, anxiety and fatigue,” Evelyn explained. “Family members can also receive our services, because children are very responsive to their caregivers and their well-being is an important part of the equation.” The Integrative Therapy Program provides services for in-patient as well as outpatient departments of the hospital.
Read
more.
Massage Therapy Overview
An overview of the literature in pediatric massage published in Pediatric Clinics of North America1 aims to provide clinicians with the proven and promising effects of massage therapy (MT) across disease-specific clinical applications. Its authors write that, “Given the current literature highlighting the benefits of MT in adults and the growing interest in the use of MT with children, examining the potential healing effects of MT in children who have various medical conditions has become critical.”
In defining MT for use with children who have acute or chronic illness, the authors bring up an interesting point that highlights an evolution that is taking place as massage becomes mainstreamed into clinical practices. “One of the challenges in studying and defining MT is that it encompasses an increasing number of treatment modalities, each with distinct practice characteristics. The type of pediatric MT appropriate for children who have chronic and acute illness may differ substantially from classic Swedish or circulatory massage…New names are being used to describe these integrative MT treatments, such as Integrative Touch and Compassionate Touch.”
The authors also point to the need to look at differing notions about what constitutes therapeutic MT. “At one end of the spectrum, MT is directed primarily at symptom management, while on the other, MT can be viewed as creating enhanced well-being through multisystem integration (MSI), which can lead to an optimal healing experience. MSI has similar goals to those expressed in acupuncture literature, emphasizing balance, homeostasis, healing, well-being, and a departure from symptom abatement alone.” Those working with children will appreciate this overview.
1 Beider S, MPH, LMT, Mahrer N, BA, Gold JK,
PhD. "Pediatric Massage Therapy: An Overview for Clinicians." Pediatric
Clinics of North America, 2007 Dec; 54(6): 1025-1041. Shay Beider can be reached at
shay@integrativetouch.org.
The Ethics of Working with Minors
Acupuncturists and massage therapists who plan to work with children should consider creating written, ethical guidelines to give to parents, as well as a consent form that parents can sign. In an excellent article in Massage Therapy Journal, Dianne Polseno, LMT, provides a basis for developing such guidelines and gives examples of consent forms.
Basically, Dianne recommends the following:
Know if the local licensing laws pertaining to your profession contain specifications for working
with minors.
In the absence of any such specification, be aware that only those who are 18 or older have the legal
capacity to consent to medical care and treatment; all minors must have parental or guardian consent.
Create a formal policy about your procedure for working
Communicate to parents and the child that your policy includes such things as taking a medical
history, having parental consent, parental attendance during the treatment, a doctor’s referral when
necessary, and what amount of disrobing may be required.
Obtain parental consent
The fact that parents seek services for their children implies that they give consent, yet it is
still wise to obtain written consent as well.
Provide all aspects of the treatment with minors in the presence of a parent or guardian.
“The Ethics of Working with Minors” by Dianne Polseno, LMT, Massage Therapy Journal,
Spring 2004; 43(1): 134-38 is archived on the American Massage Therapy Association website,
where viewers can read the whole article.
Dianne Polseno, LMT, is President, Cortiva Institute - Boston. She can be reached at
dpolseno@cortiva.com.
Current Classes for Infants and Children
Many parents turn to the gentle remedies offered within complementary and alternative
health care for help with issues that arise while raising children. Massage therapists and
acupuncturists working in this arena will need continuing education courses that specialize
in pediatrics, as well as an expanded spectrum of techniques that will appeal to children.
One of the courses in this semester’s Professional Continuing Education (CE) Program is
“Alternative Treatments for Children with Learning, Behavioral and Emotional Issues”,
offered by Mariola Strahlberg, LAc. Mariola will be presenting her approach in a two-day
workshop on April 27 and May 4, 2008.
“I enter the mystery of a human being through the senses, which I find appeals to children,”
Mariola explained. “I use the senses of sight (color), hearing (tuning forks and music),
smell (essential oils), touch (tapping and Raindrop Technique), and taste (healthy eating).
Those are the five basic senses, and then I add others: movement and balance (Brain Gym ®),
words and thoughts (conscious language) and warmth. (A colorpuncture treatment
is pictured above.)
Practitioners in the class may want to eventually pursue certification in modalities
useful for pediatrics, such as Acutonics®,
Brain
Gym®, and Raindrop
Therapy, which are also offered this semester. Other courses specific to infant and children health are:
Helping Fertility Naturally with Reflexology
Relieving Postnatal Symptoms with Reflexology
Techniques for Labor and Birth
Parent care at the Ronald McDonald House of New York
Anyone who works with pediatric care knows that the state of mind of the parent influences the well-being of the child. About eight years ago the Massage Therapy Program at the Swedish Institute began sending interns to The Ronald McDonald House of New York to offer relaxing chair massage sessions for parents. Student interns go as a supervised group to “The House”, as it’s called by residents, to provide half-hour sessions in the Greenhouse. Located on a spacious top floor room filled with plants, huge windows and skylights, the Greenhouse has a spa-like quality that enhances the effects of the students’ hands-on therapy.
Read
more.
Helping these families out is something that students in the Massage Therapy Program look forward to, and going to RMDH of New York is a popular option for
offsite internships. The Acupuncture Program also offers
offsite internships
that take supervised students into the community. Both programs aim to provide massage therapy and acupuncture to populations that might otherwise not have access to these valuable therapeutic modalities.
No Child is an Island
Practitioners of massage and acupuncture realize that there is a potent energetic field that bonds
parent and child, and many find ways to involve parents in the child’s care. Research that involves
massage applied by parents, grandparents or those who assume the parental role, has found that
educated touch can be beneficial for receivers as well as givers.
When Tiffany Fields, PhD, Director of the Touch Research Institutes, used parents to massage their
children with diabetes every night for one month, the children’s blood sugar levels returned to
normal.1 Grandparents who massaged infants showed improvements in their own well being.2 In a European
study where parents used Tuina (a form of Chinese massage) on children with autism, all children
showed a reduction in autistic behaviors as well as an increase in markers of normal development. Five
children in that group who had chronic diarrhea showed mild to marked improvements.3
Another study funded by a grant from the Massage Therapy Foundation used massage specifically for
diarrhea in children. Authors reported that approximately two million children younger than five
die each year as a result of diarrhea and associated dehydration, usually in developing nations.
Researchers went to an orphanage in Ecuador where they taught caregivers a therapeutic massage.
Results of this pilot study showed that infants who were massaged daily had significantly fewer
days of diarrhea and slightly lower rates of overall illness than infants in the control group.4
Read more.
Our Continuing Education Program regularly offers certification courses for
professionals who want to teach infant massage. This semester's course, offered
by Diana Moore, MS, LMT, founder and director of the International Loving Touch
Foundation, is filled to capacity.
For information on other classes focusing on the needs of infants and children go to our Continuing
Education catalog to search the Women’s and Children’s Health section.
Read about an alumna who went to teach infant massage at a children’s hospital in
Cambodia.
Teaching the Children
Practitioners in Europe have set out to teach children a structured approach to healthy touch in classrooms and other settings. The
Peaceful Touch
project brings teachers into preschool and elementary schools. In Sweden, where more than 300,000 children
practice Peaceful Touch on a regular basis, both teachers and parents report lower levels of anxiety and
aggression, and improved group functioning. This group now has instructors in Connecticut and California.
A
different organization, the Massage in Schools Association (MISA)
has branches in Sweden, Australia, UK, Ireland and Scotland. Hear an archived radio
broadcast
featuring a practitioner bringing massage to schools in Canada.
1 Field, Tiffany, PhD. Touch Therapy.
Churchill Livingstone, 2000.
2 idib
3 Silva, Louisa; Cignolini, Anita, MD.
"Medical Qigong Methodology for early Intervention in Autism Spectrum
Disorder." American Journal of Chinese Medicine; 33 (2): 315-327.
4Jump, Vonda, PhD; Fargo, Jamison, PhD;
Akers, James PhD. "Impact of Massage Therapy on Health Outcomes Among
Orphaned Infants in Ecuador." Family and Community Health, Dec 2006;
29(4): 314-19.
How crucial is touch to children?
In his well known book Touching: The Human Significance of the Skin
Ashley Montagu wrote about a 1915 report on U.S. orphanages in ten different cities which made the staggering disclosure that in all but one institution every infant under two years of age died. It was not until after World War II that “marasmus” as it was called, was understood to be the result of hospital conditions that were sanitary, but emotionally sterile. In response, several pediatric wards introduced the concept of “mothering”, establishing the rule to pick up, carry around and rock infants several times a day. At one such institution, Bellevue Hospital in New York, the mortality rate for infants fell from 30 to 35 percent to less than 10 percent that year.1
It was Montagu’s book which inspired Tiffany Field, PhD, to do her first research with massage therapy and premature infants. The success of her findings led to changes in hospital neonatal units and the establishment of the
Touch Research
Institutes, the first organization in the world to study the applications of touch to science and medicine. Thanks to these pioneering studies, we are beginning to understand how rhythmic touch can dramatically reduce the debilitating effects of trauma and stress, which in the case of infants seems to confer life-saving benefits.
1 Harper & Row, second edition, 1978, page 79.
All photos ©Barbara Goldschmidt 2008, except for the top photo
(courtesy of International Loving Touch
Foundation), the Ronald McDonald House images
(courtesy of RMDH of New York) and drawing of children embracing the planet
(courtesy of Massage in Schools
Association).
Click here
to get a printable PDF of this page.