Effect of Foot Reflexology Massage on Sleep Habits in Children with Autistic Spectrum Disorder: A Randomized Clinical Trial

Abstract

Background: Sleep plays a crucial role in children's motor, mental, and cognitive development. Due to the significant prevalence of sleep problems in children with autism and the side effects of pharmacological therapy, complementary interventions should be considered. Objectives: This study aimed to investigate the effect of foot reflexology massage on sleep habits in children with autistic spectrum disorder. Methods: This randomized clinical trial was conducted on 60 children with autistic spectrum disorder in Mashhad, Iran. The control group received routine care from the family. In the intervention group, in addition to the routine family care, a foot reflexology massage was performed for 15 min by parents for 30 nights before bedtime for children. The standard Children's Sleep Habits Questionnaire (CSHQ) was completed 3 times in both groups. In the control group, the questionnaire was completed at the beginning of the study, on the 15th day, and on the 30th day after entering the study. In the intervention group, the questionnaire was completed before the intervention, on the 15th day after the intervention, and on the 30th day after the intervention. Data were analyzed using SPSS version 16 by the independent t-test, Mann-Whitney test, and repeated measures analysis of variance (ANOVA). Results: Among the children included in the study, 78.3% were male, and their mean age was 8.56 ± 2.4 years. The mean total score of children's sleep habits before the intervention was not significantly different between the control and intervention groups (P = 0.71). After the intervention, the mean total score of children's sleep habits was significantly different between the control and intervention groups (P = 0.001). The foot reflexology massage, with a score reduction of 8.13 ± 3.95 points, had a significant impact on the score of sleep habits in the intervention group (P = 0.002). Conclusions: Foot reflexology massage improves the quality of sleep in children with autism and can be recommended as a safe intervention for parents of children with autism.