Date Presented 04/21/2023

This quasi-experimental study examined whether mother-performed moderate pressure massage could improve self-regulation and play in preterm infants. Results indicated that massage had a calming effect with improvements in self-regulation and play skills.

Primary Author and Speaker: Chaya Hendel

Study examined impact of mother-performed moderate pressure (mp) massage on self-regulation and play in preterm infants.

DESIGN: A-B nonconcurrent multiple baseline across subjects. Rationale: Self-regulation difficulties, more prevalent with preterm infants than full terms, may impact toy exploration. Research links preterm infant’s play to learning abilities at preschool age (1). Studies support use of mp massage to improve self-regulation (2,3). Subjects: 5 preterm infants (corrected age 12-18 months) with difficulties in self-regulation and play, and their mothers, Anglo-Jewish residing in Jerusalem area. Convenience sample recruited via flyers in pediatricians’ offices. Measurement Tools/data analysis (pretest/posttest): Infant Toddler Social Emotional Assessment-self regulation; t-score and # of areas of concern-graphic analysis. Revised Knox Preschool Play Scale-play age; graphed side-by-side with corrected age; Test of Playfulness-playfulness; graphed change on domain scores; Visual analog scales for self-regulation, play and playfulness-mother developed and scored; graphic analysis: baseline and intervention trend lines, 2-standard deviation band technique for statistical significance Process: baselines 3 to 7 weeks; six weeks of mother-performed intervention Variables: Independent: mp massage; dependent: self-regulation, play skill, playfulness.

RESULTS: Standardized assessments-positive change for three subjects; mixed results for two subjects. VAS’s demonstrated most consistent positive outcomes: 2-SD band method yielded statistically significant change on all but three VAS’s.

CONCLUSIONS: Use of mp massage is supported for improved self-regulation & improved play skill and playfulness. Implications: added evidence re: effectiveness of strategies used with preterms; imparts information on use of mp massage with preterms;

IMPACT STATEMENT: adds evidence on effectiveness of mother-performed intervention, in line with early intervention best practices.


Lawson, K. R., & Ruff, H. A. (2004). Early focused attention predicts outcome for children born prematurely. Developmental and Behavioral Pediatrics, 25(6), 399–406. (Reference formatting here did not copy italics).

Field, T., Diego, M., & Hernandez-Reif, M. (2010). Moderate pressure is essential for massage therapy effects. International Journal of Neuroscience, 120, 381–385.

Hernandez-Reif, M., Diego, M., & Field, T. (2007). Preterm infants show reduced stress behaviors and activity after 5 days of massage therapy. Infant Behavior & Development, 30, 557–561.