MassagePedOncology Handout TAllen (1)

7/21/2019 MassagePedOncology Handout TAllen (1)

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Copyright 2005 2011 Liddle Kidz Foundation All Rights ReservedThe information provided herein does not replace medical advice

About Tina AllenWith over a decade of service to children and families, Tina Allen, founder ofleading childrens health and nurturing touch organization Liddle KidzFoundation, has become a respected international lecturer, author and authorityon infant and pediatric massage.

She is a Pediatric Massage Master Teacher, Developmental Baby Massage

Teacher, a Licensed Massage Therapist with specialized training in providingmassage therapy for infants and children with special healthcare needs. Ms.Allen understands the varied physical and emotional needs of hospitalized andmedically complex infants, children and their families. Because of herdedication to the well-being of the entire family, she has studied and becomecertified in pregnancy massage and is a Trainer of Peaceful Touch, whichimplements a healthy touch approach for children in school basedenvironments.

Ms. Allen managed the United States first comprehensive pediatric massageprogram at Childrens Hospital Los Angeles (CHLA), where she trainedvolunteer massage therapists and medical professionals to work withhospitalized Rehabilitation patients, medically complex infants in the Center forNewborn and Infant Critical Care (CNICC), Neonatal Intensive Care Unit

(NICU), Children with Retinoblastoma, Spina Bifida and Cerebral Palsy. Shedeveloped pediatric massage programs at Mattel Childrens Hospital at UCLA and Cedars-Sinai Medical Center, aswell as developed a program focusing on introducing gentle compassionate touch to women and children who havesurvived domestic abuse. She is currently consulting on the development of comprehensive pediatric massageprograms for The Mayo Clinic, Nemours/Alfred I. duPont Hospital for Children, Connecticut Childrens Medical Center,Shriners Hospital and Sutton Childrens Medical Center.

Her innovative approach to childrens health has allowed her the unique opportunity to educate families andprofessionals throughout the world in the many benefits of nurturing touch. At personal request, Ms. Allen has taughtin England, France, Sweden, Canada, Japan and Thailand.

At the close of 2006, Ms. Allen led a group of volunteer massage therapists to Thailand where they provided care toinfants and children affected by HIV/AIDS and living in orphanages. These children, often considered untouchable,received much needed touch therapy and compassionate care. Their caregivers were taught by Ms. Allen to provide

healing touch for these children, so they would continue to receive much needed TLC long after the volunteer groupreturned to the United States.

In 2008, Ms. Allen returned to Thailand to provide specialized training in infant and pediatric massage at the BannFuang Farr Orphanage just outside of Bangkok, Thailands only government orphanage for children with specialhealthcare needs and disabilities. After providing the course, Ms. Allen stayed on and volunteered providing pediatricmassage for the children in the various wards at the orphanage. The children at Bann Fuang Farr have specialhealthcare needs ranging from severe hydrocephalus, cerebral palsy to blindness.

Recently, she took a group of 20 volunteers to Vietnam to provide hands-on care to orphaned infants and children.The volunteers care ranged from providing infant and pediatric massage to educating staff and medical professionalsto continue this much needed care. During the two week outreach the group traveled south from Ho Chi Minh City toHanoi in the north and provided massage and nurturing touch in 7 orphanages and childrens care centers. TheLiddle Kidz Ambassadors easily worked with several hundred babies and children who received direct hands-on care

during the time spent in the centers. The children that received nurturing touch have the effects of trauma associatedwith being isolated and abandoned, as well as, a host of special healthcare needs and birth defects including

AIDS/HIV, Cerebral Palsy, Hydrocephelus, Spina Bifida, Down Syndrome, Autism/ASD, Muscular Dystrophy,landmine survivors, children with visual and hearing impairments, mental, neurological and physical impairments.

A widely known expert in her field, Ms. Allen has appeared on NBC, The Learning Channels Bringing Home Baby,KCET and PBS A Place of Our Own. Her work has also been featured in many international publications including


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To a child who has been hospitalized or diagnosed with adebilitating medical condition, their symptoms are often

accompanied by pain, anxiety, loneliness and fear. So, itonly makes sense that healthcare staff, medical facilities,and parents are looking to pediatric massage as treatment

for some of these symptoms.


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Treatment for Pediatric Cancer

Conventional treatments, (treatments typically used by health care professionals), are

often harsh and cause multiple side effects for children. Childhood cancers can be

treated by a combination of therapies (surgery, radiation, and chemotherapy).

Chemotherapy and Radiation are the two most common treatments which can cause

adverse symptoms, including nausea, pain, anxiety, depression, weight loss and hair

loss. Invasive treatments can leave patients feeling physically, mentally and emotionally

drained.

Chemotherapy

Special Massage Considerations

can compromise immune system

avoid areas of skin breakdown

adjust amount of pressure for those at risk for thrombocytopenia-induced bruising and

peripheral neuropathy

minimize massage movements that create a rocking motion in patients with nausea or

vomiting

Radiation

Special Massage Considerations

can compromise immune system

consider not providing massage within the field of radiation treatment so as not to further

irritate the irradiated skin

choose topical lubricants wisely and avoid the area receiving radiation treatment


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Why Massage?

Massage therapy can provide nurturing touch in environments where painful touch is often

medically necessary

Massage addresses the many concerns of the pediatric client/patient (physical, psychological,

emotional and spiritual)

Research Benefits | Massage for Cancer

Decreased pain, anxiety and fear

Increased levels of relaxation

Increased white blood cells and neutrophils

Improved immune function

Decreased depression

Increased production of endorphins (natural painkillers)

Decreased production of stress hormones (cortisol)

Research on Massage Therapy for Children with Cancer

Massage was more effective than quiet time at reducing heart rate, anxiety in childrenless than age 14 years, and parent anxiety. Children reported that massage helped them

feel better, lessened their anxiety and worries, and had longer lasting effects than quiet

time.

Massage in children with cancer is feasible and appears to decrease anxiety in parents

and younger children.(Post-White et al., 2009)

Children receiving massages benefitted in that their anxiety and depressed mood levels

decreased.

The children also experienced a significant increase of white blood cells, and neutrophils

over the course of the month. The increase of white blood cells and neutrophils can be

attributed to an improved immune function for the children.(Field et al., 2001)


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Hospitalized cancer patients experience an extreme amount of discomfort due to their

therapies.

Therapeutic massage may be beneficial to hospitalized cancer patients in that it has the

potential to decrease pain and anxiety, as well as increase levels of relaxation. (Ferrell-Torry & Glick 1993)

Children require a unique approach

What Makes a Good Massage for this Child?

Clarity of Intent

Contact with the Child

Sensitivity of Touch

Continuity

Focus

Communication


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5 Ps of pediatric massage

Presence

Permission

Pace

Pressure

Parents

Presence

Remain calm and nurturing

Welcome creativity and flexibility

Permission

Permission should always be obtained from the child and

should be granted by child throughout session. May be

withdrawn by child at anytime.

Consent should be obtained from the attending physician

to ensure the childs safety

Parental Consent should be obtained

Pace

Therapeutic touch sessions with children are often much shorter than those with adult clients

Massage Strokes and Touch Therapy should be introduced slowly

Pressure

Pressure should be adapted for each individual child on a specific case by case basis

Ensure children know they can direct the amount of pressure used during the session

Massage therapy in children with cancer

need not be aggressive in nature to achieve its maximumpotential.

Most types of massage (i.e. Swedish, light touch, andfoot) result in various levels of

symptom relief for patients; however, thosereceiving Swedish or light touch massages reported a

significantly greater reduction in symptoms.

Parents

Share some techniques with parents to encourage a healthy bond

Show parents some simple techniques to help them relax

Massage may aid in alleviating stress and depression for the caregiver


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Pediatric Massage Techniques

Some Considerations:

Follow all known contraindications and precautions

Always follow the guidance of the healthcare provider

Always receive physician and parental/caregiver consent in writing

Always ask the childs permission to receive touch

Complete an appropriate and detailed intake, may include questioning physician, healthcarestaff, parent/caregiver and child

Adjust and adapt the massage strokes for the comfort and care of the child

Provide comfortable and appropriate positioning

Always consider both the childs medical and emotional needs, begin massage where there isthe most access for skin-to-skin contact

Use care and caution in areas where the child may have experienced pain

Practice care due to childs compromised immune system

Always begin with Nurturing Touch


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Liddle Kidz FoundationPediatric Massage Techniques

How To

Begin with Nurturing Touch and then follow with the remaining strokes on each areaof the body where the child welcomes touch.

Nurturing Touch Loving and still this nurturing stroke introduces our touch to the area where we wilbegin.

Gentle Warming Glide With warm open palms, gently stroke the body in motions moving towards the heart.Swedish Effleurage.

Open Heart Draw Heart shapes on the area you are working. Vary the size of the hearts fromlittle to big, depending on the size of the area.

Criss-Cross Alternating hands, glide them back and forth across the area you are working. Onthe back, chest and other larger areas you may also draw Xs with you finger padsand palms.

Gentle Soothing Glide With warm palms, gently stroke the body area in a direction away from the heart.This gliding stroke lets the child know we have finished with this area.


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Training in Pediatric Massage

Specialized training should include:

Pediatric massage techniques, methodology & adaptations for children with special healthcareneeds

Age appropriate approach and communication

Benefits of pediatric massage

Overview of growth and development

Current relevant massage research and how best to stay in touch with current researchdevelopments

Supervised Practical Experience

Advanced training in pediatric massage therapy for specific diagnoses is recommended

Training Resources | Recommendations

For hands-on pediatric massage therapy training

Certified Pediatric Massage Therapy Training (CPMT)

Touch Therapy for Liddle Kidz with Cancer

For certification and training to teach parents in private and group settings

Certified Infant Massage Teacher Training (CIMT)(no prerequisites to take this course)

Liddle Kidz Foundationwww.LiddleKidz.com


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Nurturing Touch for the Growing Child

Massage Fairytale

Once upon time there was a bright summerland. Where the sun was shining bright andhad great big sunbeams covering the sky

Draw a big sun with your hands

Draw warm sunbeams alternate one hand to the oppositeshoulder/drawing an X on the back

One day clouds begin to cover over the sky Press softly and gently all over the back

It started to become cold and windy Move hands across back in swirling motion

First just a little wind, and then there wasmore

Move hands more rapidly

As it got colder, it began to rain, but not hardrain, it was sprinkling

Tap fingers lightly across back

Then soon it began to rain Tap fingers with a little more pressure on the back

It started to get colder and colder, and beganto snow

Lightly press hands all over the back

Lots of white fluffy snow covered the ground,the trees and all of the cars. Soon everythingwas covered in white and perfectly still

Rest your hands on the shoulders

And far off in the distance, we see a little,tiny kitty cat climbing up the side of houseand when he got to roof, he sat there andpurred and purred

Walk with your fingers from the base of the back to the shoulders,and gently massage the shoulders (purring)

And once again, far in the distance, we sawanother kitty cat, he is climbing all the wayup the side of the house, to the chimney andup the chimney to the tip top where he thensits and purrs & purrs

Walk with your fingers from the base of the back to the head, andgently massage the sides and top of the head (purring)

Soon the sun begins to shine again, meltingaway the snow and ice. So, children canplay, the birds can fly and the flowers andtrees begin to bloom and grow

Bring your hands from the head to the back, draw a great big suna few times, then sweep your hands up the back and over theshoulders 3 times (growing)


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Contraindications of Massage Therapy for Children

The contraindications & precautions listed below are not only for children with Autism (ASD), ADD/ADHD, butcover many pediatric conditions to ensure best practice of the use of pediatric massage therapy.

Gliding towards outer extremities (towards hand(s)/foot(feet)) may cause fluid to accumulate or pool ifchild has circulation issues

Gliding towards heart (towards shoulder/toward thigh) may cause blood to overload the heart, especiallyif there are preexisting cardiac conditions

See Contraindications & Precautions (below)

Some Considerations:

Always follow the guidance of the healthcare provider

Always ask the childs permission to receive touch

Adjust and adapt the massage strokes for the comfort and care of the child

Always consider both the childs medical and emotional needs, begin massage where there is the mostaccess for skin-to-skin contact

Use care and caution in areas where the child may have experienced pain

Always begin with Nurturing Touch

Always make eye contact during massage, especially with a child who may have any hearingimpairments

Always continue speaking throughout massage, especially with a child who may have any visualimpairments

Do not provide massage when child has:

Fever

Inflammation

High Blood Pressure

Acute infection, staph infection, illness or Infectious Disease

Hernia (on that area, other areas may be okay)

Osteoporosis

Varicose Veins

Broken Bones (on that area, other areas may be okay)

Open wounds, sores or lesions (on that area, other areas may be okay) Deep Vein Thrombosis

Pain (on that area, other areas may be okay, practice caution if the massage causesdiscomfort)

Lability/emotional response, emotions all over the place

Thrombocytopenia/ low platelet count in blood


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Skin conditions/disorders which may be contagious or cause inflammation (fungus,rash, herpes)

Recent immunization/vaccination (wait 72 hours before providing massage)

A life threatening medical condition

An uhealed umbilical cord (do not massage the abdominal area)

Swollen lymph nodes

Blood clots or a blood condition

Diarrhea or other sickness (diarrhea that has gone on for some time and is unexplained)

PrecautionsProceed with care in regards to a child who exhibits, or diagnosed with any of the following conditions.

Seizure Disorders disorder of cerebral function

Agitation - an unhappy and worried mental state, not calm

Impulsivity - Lack of impulse control

Lack of Insight unable to discern the true nature of a situation

Easily Distracted

Severe Myalgias(pain) muscle pain

Bleeding/bruising

Infection or open sores

Multiple invasive lines

Possible Isolation Isolation is typically required due to possible contagious infection ordisease, research the reason for isolation

Apnea temporary cessation (pause) of breathing

Bradycardia slow heart rate, low pulse rate

Tachycardia rapid heart rate, fast pulse rate

Abdominal Distention Bloating or swelling of the abdomen/tummy

Gastrointestinal or Jejunostomy feeding tubes check with healthcare provider for specific

reason for use, use care not to dislodge

Hydrocephalus abnormal buildup of cerebrospinal fluid in the ventricles of the brain. Thefluid is often under increased pressure and can compress and damage the brain. Check withhealthcare provider prior to providing massage. Use caution around shunt area, risk of


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infection and of being dislodged. Use caution near abdomen for fluid drainage

Inflammations response of body tissues to injury or irritation; characterized by pain andswelling and redness and heat

Edema May be a local or generalized condition, abnormal accumulation of fluid in the bodytissues or in the body cavities causing swelling or distention of the affected parts

Recent Surgery check with healthcare provider for specific protocol, may be beneficial toprovide nurturing touch

Endangerment sites are areas of the body where you should practice additional caution so as not todo harm. Providing massage for a prolonged time or with too much pressure in such areas maycause damage to structures within and underneath the skins surface such as nerves, blood vessels,organs and lymph nodes.

Areas to practice to caution, use lighter pressure or avoid, include:

Orbital (eyes) Anterior triangle of the neck (front of neck & throat)

Posterior aspect of the neck (back of the neck)

Axilla (under arm)

Brachial region (medial aspect of the upper arm)

Cubital area (front of the elbow)

Near olecranon process (back of elbow, funny bone)

Upper lumbar region (mid-back, kidney area)

Umbilical area (naval, belly-button)

Femoral triangle (inner upper leg)

Popliteal fossa (back of the knee)

Inguinal area (groin)


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Contact:

Tina Allen | Founder & Director

Liddle KidzFoundation |www.LiddleKidz.com

references:

Barrie R. Cassileth and Gary Deng Complementary and Alternative Therapies for Cancer Oncologist,Feb 2004; 9: 80 - 89.

Cassileth BR, Vickers AJ. Massage therapy for symptom control: outcome study at a major cancercenter. Journal Pain Symptom Management2004;28:244-9

Fernandez C, Stutzer C, MacWilliam L, et al. Alternative and complementary therapy use in pediatriconcology patients in British Columbia: prevalence and reasons for use and nonuse. Journal of ClinicalOncology. 1998 Apr;16(4):12791286.

Ferrell-Torry A.T.; Glick, O.J. The use of therapeutic massage as a nursing intervention to modifyanxiety and the perception of cancer pain. Cancer Nursing, 1993; 16(2):93-101.

Field T, Hernandez-Reif M, Diego M, Schanberg S, Kuhn C. Cortisol decreases and serotonin anddopamine increase following massage therapy. International Journal Neuroscience. 2005;115:1397-413.

Gecsedi, R. A. Massage therapy for patients with cancer. Clinical Journal of Oncology Nursing, 2002 6,52-54.

Hughes D, Ladas E, Rooney D, Kelly K. Massage therapy as a supportive care intervention for childrenwith cancer. Oncology Nurse Forum. 2008;35:431-42.

Liddle Kidz Foundation, Touch Therapy for Liddle Kidz with Cancer Course Manual, 2005 2010 Phipps S, Dunavant M, Gray E, Rai SN. Massage therapy in children undergoing hematopoietic stem

cell transplantation: results of a pilot trial. Journal of Cancer Integrative Medicine2005;3(2):62-70. Phipps, S. Reduction of distress associated with paediatric bone marrow transplant: complementary

health promotion interventions. Pediatric Rehabilitation2002;5(4):223-234. Post-White et al. Journal of Pediatric Oncology Nursing, 2009 Vol. 26, No. 1, 16-28

Post-White et al. Future directions of CAM research in pediatric oncology. Journal of Pediatric OncologyNursing, 2006; 23(5):245-48.

Post-White J, Kinney ME, Savik K, Gau JB, Wilcox C, Lerner I. Therapeutic massage and healing touchimprove symptoms in cancer. Integrative Cancer Therapy.2003;2:332-44.

Sagar SM, et al. Massage therapy for cancer patients: a reciprocal relationship between body and mind.Current Oncology14(2):45-56.

The American Cancer Society. Cancer Facts and Figures 2009. Atlanta: American Cancer Society;2009.

Van Cleve L, Bossert E, Beecroft P, Adlard K, Alvarez O, Savedra MC. The pain experience of childrenwith leukemia during the first year after diagnosis. Nurse Res. 2004;53:1-10.


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Infant & Pediatric Massage Courses

Liddle Kidz Foundation | Pediatric Massage Education and Training Courses | Professionals

Liddle Kidz Certified Infant Massage Teacher Training |CIMTOur professional trainers experience great joy in sharing the art ofinfant massage with others. Teaching Infant Massage is a rewardingopportunity, promoting well being and enhancing bonding andattachment between infants and their caregivers. As a Certified InfantMassage Teacher (CIMT) you have the unique opportunity to helpparents to bond with their babies through the use of an age old

tradition infant massage.

Liddle Kidz Pediatric Massage Therapist Training | CPMTThe comprehensive Pediatric Massage Training for Massage

Therapists and health care professionals provides educational andprofessional training to those who wish to enhance their skills.Through this training, participants learn to provide massage therapyfor children with special health care needs, who are hospitalized orhave been diagnosed with a terminal illness in hospice care.

Touch Therapy for Liddle Kidz with AutismThe comprehensive Touch Therapy for Liddle Kidz with Autism(Massage forChildren with Autism)Course for massage therapists and healthcare professionalsprovides educational and professional training to those who wish to enhance their skills.

Through this advanced training,participants learn to provide massagetherapy, nurturing touch techniques,touch therapy, tactile introduction,sensory stimulation & integration forchildren who have been diagnosed on theAutism Spectrum Disorder.

Touch Therapy for Liddle Kidz with CancerThe comprehensive Touch Therapy for LiddleKidz with Cancer(Massage for Children with

Cancer)Course for massage therapists andhealthcare professionals provides educational andprofessional training to those who wish to enhancetheir skills. Through this advanced training,participants learn to provide massage therapy,nurturing touch techniques and touch therapy for


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children who have been diagnosed with Cancer.

Touch Therapy for Liddle Kidz with Cerebral PalsyThe comprehensive Touch Therapy for Liddle Kidz with Cerebral Palsy(Massagefor Children with Cerebral Palsy)Course for massage

therapists and healthcare professionals provideseducational and professional training to those who wishto enhance their skills. Through this advanced training,participants learn to provide massage therapy, nurturingtouch techniques, range of motion and touch therapy forchildren who have been diagnosed with Cerebral Palsy(CP).

Touch Therapy for Liddle KidzThe comprehensive Touch Therapy forLiddle Kidz(Massage for HealthyChildren) Course for massage therapists

and healthcare professionals provideseducational and professional training tothose who wish to enhance their skills.Through this training, participants learn toprovide massage therapy, nurturing touchtechniques, and touch therapy for children.

Touch Therapy for Liddle Kidz with CommonChildhood AilmentsThe comprehensive Touch Therapy for LiddleKidz with Common Childhood Ailments Coursefor massage therapists and healthcare professionalsprovides educational and professional training tothose who wish to enhance their skills. Through thistraining, participants learn to provide massagetherapy, nurturing touch techniques, and touchtherapy for children.


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Peaceful Touch | Healthy TouchApproach for Children in SchoolsPeaceful Touch training programsintegrate safe and nurturing touch intochildren's schools, (early school readiness,preschool and elementary school), andorganized childrens activities. In order to

integrate Peaceful Touch into schools, weintroduce educators to the use of healthy touch activities through the use of age specificcurriculum. This curriculum includes games and storytelling, as well as adaptations forreading, math, and science. The Peaceful Touch curriculum encourages childrensdevelopment through the use of nurturing and healthy touch.

Liddle Kidz Massage Program | Neonatal IntensiveCare Unit | NICUResearch has demonstrated that nurturing touch for aninfant is critical in establishing the foundation of theirpsychological well-being. During this course, medicalprofessionals are trained to communicate with medicallyfragile infants in the hospital-based Neonatal Intensive Care

Unit through the use of comforting touch.

For more information on the Liddle Kidz Foundation:

www.LiddleKidz.com

For more information on overseas outreach to orphaned & abandoned children:

www.LiddleKidz.org

MassagePedOncology Handout TAllen (1)

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