By Sarah King, Rmt Rmt4kids
Treating children is exceptionally rewarding but often not what people think. It’s definitely not like treating adults. Massage therapists who work with children or want to work with children should be prepared to be constantly considering new ways to connect, motivate, communicate, and teach, to meet the needs of children from diverse backgrounds. Age, cognition, physical abilities, learning, communication and social skills, as well as sensory needs can make a dramatic difference in the approach to treatment. Let’s dive into a couple of the unique aspects to treating children.
One of the most important things to realize is that children are not tiny adults. They have significantly unique physical, social, cognitive, and language capacities. While each adult is different, the difference between one child and another can be significant. A 2-year-old and a 3-year-old can have vastly different developmental skills. Having knowledge of developmental stages when you work with children can help guide a therapist in developing a treatment plan. For example, having an idea of what developmental language skills children have will assist a therapist develop a more appropriate consent process. Social and cognitive differences will change length of treatment, techniques you can use and the level of trust and communication you receive from a child. And awareness of physical differences should guide techniques, location and position of treatment. Understanding developmental stages also means, understanding that there are normal variations in how children develop their respective skills and it helps us recognize when a referral may or may not be necessary. Knowledge of developmental processes is merely a starting point in understanding how these tiny humans learn, communicate, move, and socialize and how it changes our approach to treatment.
Another important thought for massage therapists who want to work with children is that there should never be any doubt about, the importance of clarity regarding what we can and cannot accomplish within our treatment and scope of practice. Parents are intelligent and uniquely knowledgeable about their children but they’re also looking for help and resources with a lot of input and opinions coming at them. When a parent brings their child to you with an expectation based on something they've read or heard, it might be hard to say, “That might not work for your child” or “That’s not something I can help you with. What I can do is......,” but it is a more genuine client centered approach. It does not preclude you from treating them. It means you might have to explain why a different approach or technique is better or it may mean focusing on a different aspect of their care. There is no doubt massage therapists have a role to play in the paediatric therapy world. It’s simply important for us to be clear about what outcomes are possible and how they can be accomplished for individual clients. Beyond the child's and parent’s trust in us, there is also the confidence of other health care providers, agency leads, and other professionals that matter. I’ve had conversations with these professionals that were clearly testing me on what I would say I could do for their patients and clients. I’ve heard audible sighs of relief when I was clear about my scope of practice and what I can and can’t do. Being clear and honest, increases trust in our profession. It does not in any way diminish our importance or value or what we're capable of. They are more likely to refer because of it, not less.
The last thought for this article about the uniqueness of working with children, is that when you treat children you have to balance the expectations of at least two people, all the while remembering that your client is the child. Gaining the trust of two people at the same time can be complex, especially when one of them has an existing idea of how a massage appointment should go. Consent with a parent in the room (which is most of the time), will often cause the parent to give instructions instead of options. Parents try to make our life easier, which is not necessary or ideal. It is our job to respectfully, let them know, how important it is that the child be given options about their treatment. It can be challenging to tell parents it’s time for the treatment to end, even though the “time” is not up or that what they are suggesting is not effective, or in the child's best interest. We must ensure that a parent doesn’t feel judged when their child is not “behaving” as expected and let them know that we understand their child is trying to communicate. Massage therapists have to ensure parents understand that it’s OK for us to change the directions of the treatment, for the day, or for the future, if it is not going as planned or if the child is not up for it. Being sensitive to parent concerns, while we build trust with the child is a key component of treating children. Making sure the child knows they have a choice, can ask questions, give input, and ask for change, is fundamental. It’s our job to make sure they are not being compliant for the sake of being compliant. It takes time, and skill to navigate the needs and expectations of two people at the same time without offending or breaking the trust of one of them, especially when it involves a parent child relationship. Obtaining, consent, giving instructions, and asking for feed back from two people with vastly different perspectives and maturity is a unique skill to develop when you work with children. It is a skill that evolves and grows over time. It takes confidence and self-awareness.
I love my job and I recognize how blessed I am to have found what I’m most passionate about in our field. It is truly a unique experience to be the person in the room whose job it is to make sure everyone understands, everyone is relaxed, and everyone trusts you to provide the best care for the little person you’re treating. I have learned so much over the years from other therapists, other professions, parents, and especially the kids I treat. I could write about so many things on the topic of paediatric massage, but I decided to start with the things I had a crash course in at the start of this adventure when there weren’t as many paediatric focused massage therapists to connect with. The learning is ongoing. Every kid I treat teaches me something, and every family I meet teaches me something. I think the most important thing about treating kids, is the need to be open, flexible and always ready to learn and be taught something new.
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