Aromacare for Children with Autism & Disabilities

This blog is a short reflection of my work with children with autism and the development of the IFA Aromacare Course which was created for Carers who work with people with special needs or disabilities. I originally trained as a teacher, my specialism was in the expressive arts, using, Sherborne Developmental Movement, drama games and singing to promote a sense of self and well-being in children who struggled to make sense of the world and experienced high levels of anxiety just by participating in familiar day to day activities. I noticed that when I introduced activities that involved gentle rocking, holding and stroking, some children produced an out-breath sigh of relaxation, and I could feel their bodies start to relax under my touch. Some gave prolonged eye contact or smiled, others with language requested ‘more’ or placed my hand back on their body.

Researching into child development it became clear that early stimulation provided by parents, touching, holding and stroking, combined with simple language, was important for higher order brain functioning and the formation of trusting relationships, the development of communication skills, and the ability to solve problems such as creating ways of self-calming during periods of distress. At this time there were no courses that specifically addressed touch with children until the formation of the IFA Aromacare course. 

Understanding Autism

Current research has identified that 1 in 100 people are affected by autism, that means that every school, care home or local community will have someone with autism. Autism is a lifelong developmental disability that affects the way a person communicates with and relates to other people. It affects how they make sense of the world. Those severely affected by autism perceive the world in a very fragmented way, what they taste, hear, see, feel and smell can lead to a heightened level of anxiety. Autism is also associated with behaviour difficulties, muscular tension and increased pulse rate leads to screaming, shouting, spitting and hitting. These mannerisms are often the result of frustration because the children have no strategies to manage their arousal levels.

Most people with autism experience some sensory sensitivity or under-sensitivity, and associated difficulties such as attention deficit hyperactivity disorder (ADHD) dyspraxia and a learning disability. Key areas of difficulty include processing spoken language, holding onto abstract thoughts, attending to the important features in a given situation, seeing the big picture. Despite these sensory difficulties I discovered that the majority of children that I worked with responded to aroma and very quickly made the link to the positive nurturing touch that would follow either in the form of massage stories to an aroma-sensory object to hold, smell, feel it, shake it and play with. Research by a Clinical and Educational Psychologist identified that 48 out of 52 children would choose massage with essential oils as their preferred way of calming. Sharing these ideas with carers meant that nurturing touch started to be woven through the day from “welcome and settle” times in the morning, “calm and relax” times after a period of work and a favourite massage story reflecting the day’s activity in the evening.

Parents started requesting help to use these activities at home and reported positive changes in sleeping and eating patterns and a reduction in behaviour outbursts.

IFA Aromacare Programme

The IFA Aromacare programme was originally designed as an enrichment curriculum, but it was also found to be applicable to the disabled and the elderly who were experiencing difficulty in their social communication skills and using their imagination to self occupy. Aromacare provides a core programme of experiences to address what is described as the “triad of impairments”, social communication, impaired imagination and high levels of anxiety. By creating an environment where carers and parents participated in more nurturing activities they created a programme that enabled the children they cared for to cope better in their everyday lives.

IFA Aromacare Practitioners

Aromacare Practitioners spend 70 hours in the study of massage and are able to use 20 essential oils. They learn massage with a flat or gently curved hand and work on their arms, hands, legs, feet and shoulders and work on the back through clothing. The front of the body is not touched because this is the domain of an aromatherapist.

How it Works

Throughout the day children need to be calm to give their attention to learning or new social situations. The Aroma Practitioner provides the skills and knowledge to create a balance for the child by reducing their stress levels and enabling them to feel supported in a caring relationship.

Ideas to try

The starting point is always difficult, I have a small toolkit in a bumbag so my hands are always free, I move to wherever the child is sitting or standing indicating my presence with a small rattle with ribbons sprayed with essential oils. I might rub a small amount of aroma cream in my hands, rubbing them briskly to generate heat and then present my hands saying “mm-mm smell”. As the child starts to pay attention to me I might add the words “look it’s magic – gone - mm-mm smell”. Sometimes I walk around with a small spray saying “shake, shake, shake” and “spray, spray, spray” allowing the children to feel the droplets adds they fall on their skin. 

After a while when the children are used to my presence I start to add the language and symbols that allow the children to point or sign to ask for “more” or “finish”.  Observing changes in posture, eye movement, rate of breathing also indicate when children want to engage.

I have found that children quickly identify this ritual with the start of a massage story session, but you must always be prepared to spend several weeks introducing yourself and new ideas.

In a group setting we start with some simple breathing and  use the mantra ‘breathe and blow’. Carers blow on their own hands and then on the children’s hands between each gesture. Staff then use their hands on top of the children’s hands or physically shape a response. This enables the children to get used to touch that is nurturing and not purely functional. Children take it in turns to use the aroma-spray or waft the aroma-scented ribbons or fans.

• Hands on my head helps me think
• Hands on my chest helps me breathe
• Hands on my tummy helps me calm

We then introduce an aroma-tray containing materials to hold and smell.  Carers are very creative in making scented toys and artefacts, from hats, scarves, badges, balls, bags and books. Gradually we start to introduce aroma-dough and aroma-cream with the mantra ‘We’re learning to play’, and add the words, ‘rub, rub, rub, pat, pat, pat, stroke, stroke, stroke’, changing the tone and rhythm of our voice as we slow our breathing and movement patterns.

When we start hand massage we sit facing the child with a cushion across our laps; we rub and present out hands and wait for the child to show a response by placing their hands on ours. Slowly we enclose the child’s hand in ours to create a “containment hold”. The first strokes from the wrist to the finger tips stroke away from the child’s body allowing them to withdraw their hands at anytime and we whisper ‘calm and relaxed’ to slow the breathing pattern.

Helping children with autism think about what they know and can do, enables them to have an understanding of who they are and start to make sense of the world around them. Each chid has a “chatty bag” containing materials to touch, the aroma spray or cream to be used and the picture cards or massage story that elicit a sense of fun, reflection and collaboration. Examples of simple picture cards include ‘patting’ the dog, ‘stroking’ the cat, ‘washing’ the car, ‘sweeping’ the leaves.

Making “Happy Books” helps remind children with autism of good times and gives them something positive to think about at times of stress.  By building a portfolio to recreate happy memories, carers also reinforce positive aspects of themselves. Finally the best way to reward children is through praise and smiles, to let them know that you are happy as well. Using simple language or graphics to say ‘good blowing’, ‘you’re calm and relaxed’ ‘happy and smiling’.

Outcomes

My work with children with autism has given me the opportunity to introduce Aromacare in South Africa, Kuwait, Japan and Romania. Observation and feedback from carers and parents has indicated that this is a positive way of helping children deal with their anxiety and find ways of promoting increased wellbeing. The use of simple language and graphics has helped more able children make choices, between more/finished, harder/softer, higher/lower and faster/slower, making them truly in charge of the body experiences they receive. 

For children with severe autism, their responses vary from day to day but we have found that they respond to the use of sprays, shakers and cream for short periods of time. It has been wonderful to see the games created by carers from sticking smiley faces on feet or knees prior to a foot massage and using hand puppets to gain attention prior to hand massage. Very often these children fall asleep during a session and carers are rewarded by knowing that their nurturing care has made a difference.

By Stephanie Lord, IFA Member (MIFA), MSA, FRSA