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Relaxation Techniques for Handicapped Children: a Review of Literature

Dvora Zipkin
J Spec Educ 1985 19: 283
DOI: 10.1177/002246698501900305

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 RELAXATION TECHNIQUES FOR HANDICAPPED
CHILDREN: A REVIEW OF LITERATURE

Dvora Zipkin, MS
Consultant, Children’s Creative Response to
Conflict/Nonviolence Project
Social Justice Center of Albany

Relaxation exercises have been used effectively
with handicapped children as an intervention
treatment for behavior management. Tech-
niques such as progressive muscle relaxation,
isometrics, yoga, movement exercises, massage,
guided fantasy and imagery, meditation, concen-
tration, suggestion, music, breathing control,
self-relaxation, and biofeedback training have
been applied with successful results to decrease
hyperactivity and impulsivity, improve academic
achievement, increase attention span, and im-
prove communications and interpersonal rela-
tionships. This paper discusses four major relax-
ation training approaches used with handi-
capped children: progressive muscle relaxation,
biofeedback, yoga, and mental relaxation, which
includes guided fantasy, imagery, and medita-
tion. Descriptions of these techniques, the effects
of their use with various populations, and reviews
of recent studies of their use, are presented.

Handicapped children often experience high levels of tension and anxiety. Al-
-

though some tension may be due to physiological problems, additional anxiety

may be the result of academic and social conflict.
Relaxation therapy has begun to gain attention as a viable method of reducing
muscular tension and promoting behavior change in disabled children (Braud,
1978; Gerler and Omizo, 1981; Lupin, Braud, Braud, and Duer, 1976). Various
relaxation techniques have been used successfully to influence many types of
behavior-from increasing attention span (Omizo, Loffredo, and Hammett,
1982) to improving handwriting (Carter and Synolds, 1974); from improving
academic skills (Carter and Russell, 1980) to decreasing impulsivity (Rivera and
Omizo, 1980); from improving communication (Seiler and Renshaw, 1978) to
eliminating psychosomatic symptoms (Braud, Lupin, and Braud, 1975). Tech-
niques used to induce relaxation include progressive muscle relaxation, isometrics,
yoga, movement exercises, massage, guided fantasy and imagery, meditation,
concentration, suggestion, music, breathing control, self-relaxation or autogenic
training, and biofeedback training. These techniques have been used successfully
both independently and in various combinations.
Traditional methods of behavior management rely on outside influences, such
as drugs, reinforcement, or therapist intervention, to effect change. Relaxation

therapy is an effective, self-regulatory intervention treatment, which allows the

child to develop direct self-control of his or her own behaviors. According to
Omizo (1980), inner control is an essential prerequisite to learning.
This paper reviews four major approaches used with handicapped children:
progressive muscle relaxation, biofeedback, yoga, and mental relaxation, which

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284

includes guided fantasy, imagery, and meditation. With the exception of biofeed-
back, most relaxation training techniques do not require extensive training of the
teacher and need not be highly structured or formalized (Walker, 1979).

REVIEW OF RESEARCH

Progressive Muscle Relaxation

Most relaxation procedures in use in the United States today derive from the
work of Jacobson who, in the 1920s and 1930s, pioneered the field by developing
progressive muscle relaxation exercises (Jacobson, 1962). These exercises in-
volve the systematic tensing and releasing of muscle groups, leading to an in-
creased awareness of the resulting sensations of tension and relaxation.
Tension, produced by stress, affects the muscles of the body, causing them to
contract. Since the opposite of contraction is relaxation (Brockberg and

Brockberg, 1980), the tensing and releasing of muscles eliminates muscle contrac-
tions, resulting in a feeling of deep relaxation.
The effects of progressive muscle relaxation on handicapped children have
been examined in several studies. In a relaxation program for first- and second-
grade learning-disabled students and their parents, Omizo, Loffredo, & Hammett
(1982) found that the children had developed longer attention spans and had
become more relaxed after taking part in the program. After the first session, the
parents’ inhibitions disappeared; additionally, parent-child relationships im-
proved as a result of the relaxation program.
Carter and Synolds (1974) used a series of progressive relaxation tapes to
decrease muscle tension and pressure with a group of minimally brain-injured
children. Their program was effective in enhancing the quality of handwriting in
their students, as well as effecting an increase in speed and a decrease in muscular
tension and pressure while writing. There was a transfer effect to nonexperimen-
tal situations, and changes were stable as time passed.
Deep relaxation exercises and stories to reinforce relaxation were used by
Lupin et al. (1976) with minimally brain-injured subjects. Commercially prepared
tapes of relaxation exercises and visual imagery were used. Results were an im-
provement in interpersonal relationships, with behavior improvements generaliz-
ing from home practice to the students’ classrooms.
Most reports studied showed success in the use of prerecorded taped instruc-
tions. Beiman, Israel, and Johnson (1978) and Bernstein and Borkovec (1973),
however, have found little success with recorded instructions, and report that live
progressive relaxation training was superior to taped training in reducing muscle
tension.

Biofeedback
Although requiring more training and equipment than other relaxation meth-
ods, biofeedback has received much attention in recent studies. This is the process
of feeding back to a person, through the use of graphs, lights, sounds, and the like,

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 285

information about the status of the body’s functions, such as muscle tension. It is
believed that by mentally recognizing a biological function, one can gain control
of it (Benson, 1975).
In a study with learning-disabled children, Carter and Russell (1980) concluded
that biofeedback relaxation training could result in more efficient ability to cope in
school. They found improvements in self-control, in finishing seat work, and in
attention span, as well as in the academic subjects of reading, spelling, and
arithmetic. Also observed were decreases in out-of-seat behavior, increased school
work production, and enhanced general cooperation among the children with
whom they worked.
Hughes and Davis (1980) reported on the effective use of biofeedback with
hyperactive and cerebral-palsied populations. In their study, the authors found
biofeedback to be effective in reducing physical and verbal aggressive responses in
subjects who exhibited autistic behaviors.
Biofeedback has also been found to be effective in improving the social and
academic adjustment of learning-disabled children (Omizo, Loffredo, & Ham-
mett, 1982). Other studies of various biofeedback procedures found gains in
visual-perceptual abilities, decreases in hyperactivity, and increases in visual and
auditory attention spans.

Biofeedback and Progressive Muscle Relaxation

Biofeedback and progressive muscle relaxation used together have shown

promising results. Using a combination of taped relaxation exercises and biofeed-
back techniques, Rivera and Omizo (1980) found a decrease in impulsivity and an
improvement in attention to task in a group of 36 male hyperactive children.
Carter, Lax, and Russell (1979) reported on studies using a combination of
biofeedback, muscle relaxation, and prerecorded home relaxation exercises.
They found highly significant gains in basic academic skills and handwriting
quality. Parents and teachers reported greater self-control, less impulsivity and
distractibility, and a greater degree of responsiveness in school.
In another study, Braud, Lupin, & Braud (1975) found that relaxation can
dramatically reduce muscle tension. Using biofeedback along with relaxation
tapes, the authors reported a general improvement in the behavior of a 61/2-
year-old hyperactive boy, both in class and at home. Results were an elimination of
the boy’s psychosomatic symptoms of headaches, allergies, asthma, and runny
nose; a dramatic improvement in confidence and self-concept; improvement on
achievement tests; and a decrease in emotionality and frustration.
Comparting the effects of prerecorded relaxation tapes and biofeedback mus-
cle relaxation exercises, Carter, Lax, & Russell (1979) reported that the biofeed-
back relaxation resulted in more significant gains in cognition, memory, and
handwriting in a group of educable retarded boys. However, Walker (1979) has
reported that the same relaxation effects can be achieved by muscle relaxation
exercises alone, without biofeedback, at a great savings in terms of equipment and
amount of trained technician time.

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286

Yoga
Yoga is an ancient and complete system of physical, mental, and spiritual
development which incorporates physical postures (asanas), breath control, men-
tal concentration, and deep relaxation, It can calm disruptive students and stimu-
late tired ones. Yoga as a relaxation technique has been found to reduce and
relieve stress and tension, dissipate excess energy, relieve tiredness and lethargy,
lengthen attention span, improve and maintain general physical health, develop
sharper concentration and greater mental clarity, and cultivate better interper-
sonal relationships (Diskin, 1977; Hopkins and Hopkins, 1976; Seiler and Ren-
shaw, 1978).
Hopkins and Hopkins (1976) suggested that a yoga program could benefit
children, especially those with psychomotor deficits. They reported that yoga
postures promote body awareness, balance, and laterality. In addition, yoga can
produce a calming effect, which helps children get into a frame of mind conducive
to learning. Hopkins and Hopkins further reported that children often comment
on feelings of well-being after taking part in yoga sessions; they become more
aware of their bodies and of bodily tensions which the yoga exercises help to
release. Additionally, the yoga sessions benefit the teacher as well.
Seiler and Renshaw (1978) reported on a study in which adolescent inpatients at
a mental health center participated in half-hour yoga sessions twice a week. The
students made positive changes in observable attitude and behavior and showed a
decrease in impulsivity. Also seen were increased and improved communications
with staff and increased verbalized awareness of body functions.
In comparing a yoga program with a moderately strenuous exercise program,
Hopkins and Hopkins (1976) found that the children who participated in the yoga
program were more relaxed, less active, and better able to concentrate. Their
general performance tended to be better following yoga, compared with the
group who exercised.

Mental Relaxation
Mental relaxation includes guided fantasy and imagery, and meditation and
concentration. Guided imagery uses fantasy &dquo;trips&dquo; in which the children imagine
or visualize peaceful and restful places or situations. Auditory and/or visual

suggestions are given of a fantasy or of passive, nature scenes. These experiences

focus concentration and have a positive effect on creative thinking abilities (Frey,
1980; Hershey and Kearns, 1979).
Guided fantasy and imaginative experiences have been applied in a variety of
situations to help children work through emotional problems and blocks. These
techniques have been useful in controlling acting-out behaviors, in reducing test
anxiety, and in helping children relax in various school situations. By employing
fantasy approaches, children can be taught to understand and manage their
emotions. Additionally, it has been found that students repond with more creativ-
ity and motivation, and are more relaxed when fantasy is used as a mode of
instruction (Anderson, 1980).
Meditation and concentration refer to a focusing, directing, or centering of

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 287

thoughts, feelings, attention and/or awareness on a particular object, thought, or

theme (Morris, 1976). Sensory awareness exercises can also be used to achieve
mental relaxation.
Children’s concentration on tasks immediately following meditation becomes
longer and more intense. Morris (1976) and Murdock (1979) reported on a group
of disadvantaged, urban third graders, who participated in an 18-week course in
which they meditated for 20 to 25 minutes twice a week. The results were a
significant lowering of anxiety and increased articulated thinking in the children.
Transcendental meditation (TM) is a means of easing anxiety and coping with
stress through the repetition of a specific word or phrase; this technique has
definite implications in special education. Ferguson (1976) has proposed that
teaching TM to developmentally disabled persons could have substantial and
significant educational and therapeutic benefits, providing the damaged nervous
system with a unique state of rest. He suggested that this procedure be investi-
gated as an adjunct to existing special education programs.

SUMMARY AND CONCLUSIONS

Relaxation exercises decrease activity levels, thereby increasing academic per-
formance and attention span. Students in a more relaxed state are able to concen-
trate moreeasily.
As suggested by Frey (1980), Lupin et al. (1976), and others, the techniques of
progressive muscle relaxation, biofeedback, yoga, imagery experiences, medita-
tion, and other relaxation exercises can be used by teachers to control classroom
behaviors and can be beneficial in improving interpersonal relations and academic
achievement. Relaxation can be an effective therapy, used successfully by almost
every identifiable group-adults (Walker, 1979), the emotionally handicapped
(Braud, 1978), hyperactive children (Dunn, 1982), the retarded (Carter, Lax, &
Russell, 1979), the learning disabled (Carter and Russell, 1980), the cerebral
palsied (Hughes and Davis, 1980), the minimally brain injured (Lupin et al., 1976;
Carter and Synolds, 1974), gifted children (Hershey and Kearns, 1979), &dquo;normal&dquo;
children (Murdock, 1979), and college students (Fiebert and Mead, 1981).
As mentioned, traditional treatment approaches for hyperactivity and other
behavior disorders use an outside agent, such as a drug, reinforcement, or
teacher/therapist intervention to regulate the child’s behavior. Treatment that
allows the child to develop direct self-control of her or his own behaviors may be
more effective. Teaching the child relaxation techniques could be such a treat-
ment.
Recent studies have affirmed the success and validity of various relaxation

techniques with
handicapped children. This paper has focused on only a few of
these techniques. Information on relaxation exercises and guidelines concerning
their implementation in the classroom or other special education setting remains
fragmented and somewhat limited. What is needed is a well-integrated, com-
prehensive source containing information on not one or two, but many different
relaxation techniques-in essence, a &dquo;how-to&dquo; reference or curriculum, readily
available and easily understood. Such a source would enable and encourage a

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288
wider range of educators to incorporate
techniques into the classroom.
Anderson, R. F. (1980). Using guided fan-
tasy with children. Elementary School Guid-
ance and Counseling, 15, 39-47.
Beiman, I., Israel, E., & Johnson, S. A.
(1978). During training and posttraining
effects of live and taped extended pro-
gressive relaxation, self-relaxation, and
electromyogram biofeedback. Journal of
Consulting and Clinical Psychology, 46,
314-321.
Benson, H. (1975). The Relaxation Response.
New York: William Morrow, 1975.
Bernstein, D. A., & Borkovc, T. D. (1973).
Progressive relaxation training: A manual for
the helping professions. Champaign, Il-
linois : Research Press.
Braud, L. W. (1978). The effects of frontal
EMG biofeedback and progressive relax-
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ioral concomitants. Biofeedback and Self-
Regulation, 3, 69-89.
Braud, L. W., Lupin, M. N., & Braud, W. G.
(1975). The use of electromyographic
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21-26.
Brockberg, H. F., & Brockberg,
(1980). Relaxation is for children,
Lutheran Education, 116, 108-114.
Carter, J. L., Lax, B., & Russell, H. (1979).
Effects of relaxation and EMG training
on academic achievement of educable re-
tarded boys. Education and Training of the
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Carter, J. L., & Russell, H. L. (1980).
Biofeedback and academic attainment of
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Carter, J. L., & Synolds, D. (1974). Effects of
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Diskin, E. (1977). Yoga for Children.
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