BACKGROUND:
The massage pilot took place from Friday the 24th of May until Friday the 19th June in a primary school in South Ayrshire. The children participating were aged between 6 and 8 years old. None of the children who participated had ever engaged in peer massage, or massage with their parents before.
Eight families participated in the pilot with either a mother or grandmother attending for each family. For one family both a grandmother and mother attended all sessions, and for another a father attended in the last session, so he too could be involved in the massage routine at home.
The number of families attending each session can be found in the table below:
| Number of sessions attended | Number of families attending |
| 5 | 3 |
| 4 | 3 |
| 3 | 1 |
| 2 | 0 |
| 1 | 1 |
IMPLEMENTATION:
The five sessions were delivered according to the structure outlined in the MISP Instructors Manual. In addition, to the massage routine, families were introduced to other touch-based activity including; making a pizza, drawing pictures / writing words on the back, massage with a ball, Once Upon a Touch stories, Papa Goat etc
Parents were given an information letter and consent form at the first session. The letter provided information on MISP, and the consent form gained consent for information and photos to be shared with MISA. Anonymity of personal information was assured. (see appendix i)
Parents were given both a pre and post evaluation questionnaire (see appendix ii/iii). Children were given an evaluation form on the last session (see appendix iv). Families were also given a weekly log to keep / write in at home which allowed them to document when they carried out massage at home and how they felt afterwards (see appendix v)
PRE-EVALUATION:
Within the pre-evaluation parents identified concerns with anxiety, IBS, sleep, and stress in their children, and identified these concerns as being the reason that they were attending the sessions. None of the parents had any knowledge of the potential benefits of massage.
OBSERVATIONS:
I completed and documented observations weekly for two families who attended all five sessions. These were also the only families who completed and returned the weekly logs.
Family 1:
Mother and daughter attended all sessions. During the first session mum had expressed concern regarding her daughter having IBS which caused a great deal of abdominal discomfort. The pain was having an adverse effect on sleep, mood, and engagement with the rest of her family. Mum had completed some reading on the potential benefits of massage for pain relief in IBS and was hopeful that introducing massage at home may be beneficial.
Week 1: Daughter was very quiet. She interacted with mum very rarely and did not appear to enjoy the touch games but seemed eager to learn the massage routine and make sure she got the strokes perfect. Mum herself was very withdrawn and did not participate in group discussion but sought out facilitator to raise her concerns about her daughter.
Week 2: Weekly log handed back from the first week of practice at home. Mum advised that her daughter had wanted to complete the log herself. Words such as comfortable, calm, helpful, and relaxed were provided for how she felt after receiving and giving a massage. Daughter was again unsure about touch-based activity but did sit closer to mum. Positive feedback was given to daughter about how well she was at learning the massage routine which resulted in a huge smile. Noted that daughter was more at ease at the end of the session (shoulders down, smiling, engaging in conversation with peers)
Week 3: Weekly log handed back from previous week. Mum and daughter are now carrying out the massage routine every evening. Words / phrases identified by daughter as to how she feels afterwards include; peaceful, unanxious, happy place, positive, tranquil and chilled out. Daughter appeared excited to get started with touch activity of drawing on mum’s back and assisted facilitator in handing out the pictures to others in the group. Noted that daughter sat with her arm around mum and gave her a hug periodically. Daughter was generally more confident in the group which was demonstrated by her answering questions and making jokes with mum.
Week 4: Weekly log handed back from previous week. Words identified by daughter as to how she feels afterwards include; connected, joyful, serene, restful and sleepy. Mum reports that the information provided last week on adrenaline, cortisol, and anxiety has helped her understand that her daughter’s abdominal discomfort may be caused by anxiety. Mum reports that since implementing daily massage at night, that her daughter’s pain has gone almost completely, and that she is sleeping better. Mum also feels that she has a closer bond with her daughter which in turn has allowed conversation to occur at to what may be worrying her daughter and causing her to feel anxious.
Week 5: Weekly log handed back from previous week. Words identified by daughter as to how she feels afterwards include; chilled, sleepy, relaxed, calm and connected. Mum reports that she cannot believe the change in her daughter over the last 5 weeks. She has noticed a change in her mood, confidence, and anxiety levels. She feels that the sessions have given her an understanding of her daughter’s anxiety, in addition to a tool that she can use to help her in managing it. The closeness of mum and daughter is evident for all to see with daughter draping arms around mum’s neck and with jokes / laughing between the two during the session. Daughter appears so relaxed by the end of the session that she looks as though she may fall asleep. Mum reports that she plans to continue the massage each evening in the long term.
Family 2:
Mum, grandmother, and daughter attended all sessions. During the first session grandmother had reported that her granddaughter is a very poor sleeper often not settling until midnight. This was causing major fall outs and difficulties in the morning due to having to get up early to go to school.
Week 1: Daughter is very restless and finding it difficult to sit still. Grandmother reports this is always how her grand daughter is. Both appear to have a good relationship, but it appears to be strained at times due to grandmother having to tell grand daughter to sit still and listen all the time. Daughter is disruptive at times and is keen to make the other children laugh.
Week 2: Grandmother, mum and daughter all attend. No weekly log provided. Mum reports they have tried the routine on one occasion but that her daughter’s sleep was no better. Daughter seemed keen to make sure she was doing the strokes correctly and asked facilitator for help on two occasions. Daughter continued to move around a lot today and try to make others laugh. Mum appeared stressed by this and was often telling her daughter to sit down and behave.
Week 3: Grandmother, mum, and daughter all attend. No weekly log provided. Mum reports that she has started to use the massage routine a bit more often and has noticed that this makes her daughter slightly calmer at bed time. Mum reports having found the information provided on oxytocin very helpful last week and feels that she can now see how massage may benefit both her and her daughter. Daughter and mum both enjoy the touch-based game Papa Goat, demonstrated by them smiling, engaging in conversation and laughing. Daughter can sit for the duration of her massage without chatting to others in the group and appears much calmer that previous weeks even once the massage is finished.
Week 4: Grandmother, mum, and daughter attend. No weekly log provided. Mum feels that her daughter is starting to settle into a better bed time routine now that she is using the massage routine every night. Grandmother is also using the routine if she has her grand daughter overnight. Daughter is much calmer coming into the session today (no running around, carrying on with others) and is able sit for her own massage and to give mum a massage. Mum appears more relaxed as she is not having to ask her daughter to sit down and listen, and at the end of the session mum and daughter hug each other before daughter returns to class.
Week 5: Grandmother, mum and daughter attend. Weekly log provided. The log demonstrates that daughter is enjoying massage. The comment box details the time that daughter has settled to sleep which has changed from midnight to nine o’clock over the 5 week period. Mum is much happier with her daughter’s sleep pattern and feels that getting her daughter up in the morning is much less stressful. She also feels like her daughter is more affectionate towards her. Mum and daughter both appear relaxed throughout the final session with daughter appearing like she will fall asleep at the end of the session.
Other observations:
A mum and son who were attending the workshops missed a week due to mum having a new baby. Mum had expressed concern regarding how her son would adjust to having a new baby in the home due to the 7-year age gap and had already noticed that his sleep pattern was not good on the lead up to the baby being born. She hoped that massage would help them maintain their bond once the new baby was born. During the first couple of weeks of workshops it was evident that the son was not keen to engage in massage with mum (often moving away and providing very light touch). However, as the weeks progressed, and mum started using massage at home, the son appeared to relax more and enjoy touch-based activity as well at the massage routine. During the last session mum brought the new baby and dad to the session. It was evident to see that the son was very loving towards his new brother with him giving him lots of kisses and cuddles. Mum advised that they had encouraged their son to lightly stroke the baby on his chest and legs whilst he received his massage. Dad was along at the last session, so he could also be part of the nightly massage routine. Mum also reported that her son’s sleep pattern had returned to normal.
One mum and son only attended one session. Mum did not return her pre or post evaluation. However, the change in the son’s behaviour was very evident to observe. At the beginning of the session he ran into the room and started throwing around a ball and climb on the wall bars in the gym. His mum was also having difficulty in getting him to calm down. However, as soon as mum started the touch-based activity and massage routine the son was able to sit still and quietly for the duration. Once the massage was finished he did get excitable again (verbally carrying on with others) but was less physically active than he was at the beginning of the session.
POST EVALUATION:
Six post evaluation questionnaires were completed (two of the families were not at the final session).
All parents who completed the questionnaire felt like the massage routine / information provided had addressed the concerns they had about their children in the pre-course evaluation. All parents were using the massage routine at home and all felt that they had a good understanding of the benefits of massage. Five of the six parents felt that they had a closer bond with their child or that their child was more affectionate towards them. All parents noticed a positive change in their children including them being calmer, more relaxed and sleeping better.
All parents plan to continue to use the massage routine at home and asked about the possibility of further sessions.
Report by MISP Instructor Gemma O’Neill (East Ayrshire) June 2019