Author: Kayla Tweedt
Contents of article:
- Autism Spectrum Disorder
- The practice of yoga and yoga therapy
- Benefits of yoga on ASD
- Future research
Autism, also known as autism spectrum disorder (ASD), refers to a broad range of symptoms or conditions that are represented by challenges in the areas of social skills, repetitive behaviors, speech and nonverbal communication (Autism Speaks, 2018). Each person on the autism spectrum is different from one another, this is because there are many subtypes to the autism spectrum (Autism Speaks, 2018). What this means, is that every individual with autism has unique challenges and strengths, thus the type of treatment must be specific to the individual.
There are many different treatments out there for individuals on the autism spectrum. There are pharmacological interventions such as psycho-stimulants, atypical anti-psychotic drugs, and antidepressants. There are also non-pharmacological therapies such as complementary and integrative medicine, music therapy, cognitive-behavioral therapy, and social behavior therapies (Sharma et al, 2018). In this article I want to show another approach to a non-pharmacological intervention; the use of yoga as an intervention for children diagnosed with autism spectrum disorder. Before going too far into the topic, I want to cover some helpful terminology and abbreviations that will be mentioned.
- Autism spectrum disorder (ASD): A group of complex neurodevelopmental disorders with deficiencies in many developmental milestones during infantile childhood (Narasingharao et al, 2016; Sharma et al, 2018).
- Complementary and alternative medicines (CAM): A group of diverse medical and health care practices and products that are not presently considered to be part of conventional medicine (NLM, 2018).
- Integrated movement therapy: An individual and group therapy approach that combines speech-language pathology, behavioral and mental health counseling, and yoga (Kenny, 2002).
- Co-morbidity: The presence of two chronic diseases or conditions in a person at the same time.
- Yoga: A non-invasive and alternative therapy that brings change in both physiological and psychological levels of an individual (Narasingharao, 2016).
- Sensory integration: The ability of the brain to receive, organize, and use sensory input in order to participate effectively and satisfactorily in the world (Goldberg, 2013).
Autism spectrum disorder (ASD)
The term autism was coined by Swiss psychiatrist named Eugen Bleuler in 1908 and was initially a way to explain a patient with schizophrenia being withdrawn from reality (Sharma, 2018). It eventually evolved to more closely resemble what we know autism to be today. Hans Asperger changed the meaning to the autistic-like disorder called Asperger’s syndrome in 1944 (Sharma, 2018). In 1994, it was entered into the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). Children who were diagnosed with a disorder in this category had to show deficits in their social interactions, communication, and repetitive/restricted behaviors (Sharma, 2018).
When the DSM-V came out, it shifted some of the definitions defining the disorders. It went from grouping autistic-like disorders together to breaking them down into separate diagnoses under an umbrella of pervasive developmental disorders; thus the diagnostic criteria changed. At this point, for a child to get diagnosed with ASD, they must have deficits in two domains. This means that a patient would have to show a minimum of three symptoms in the social communication domain and a minimum of two symptoms in the restricted interests/repetitive behavior domain (Sharma, 2018). The diagnosis of ASD is still quite subjective, but the current diagnostic tests can help differentiate between ASD and other possible developmental delay disorders.
These changes in diagnosing ASD have made the disorder more prevalent. Today, as many as every 1 in 36 children are diagnosed with ASD, with it being more prominent in boys (Sharma, 2018). Studies looking at identical and fraternal twins, as well as non-twin siblings, have shown genetics play a prominent role in ASD.
Along with having ASD, many individuals experience co-morbid neurological and psychological disorders as well. Some of those are:
- Attention deficit hyperactivity disorder (ADHD)
- Anxiety disorders
- Bipolar disorder
- Tourette syndrome and tic disorders
- Childhood-onset schizophrenia
Due to the different way individuals with autism process information, it can affect their ability to:
- Understand and use language to interact and communicate with people
- Understand and relate in typical ways to people, events and objects in the environment
- Understand and respond to sensory stimuli
- Learn and think in the same way as typically developing children
Seeing as children can never outgrow autism, the best thing studies show is that early diagnosis and intervention will lead to significantly improved outcomes (Goldberg, 2013).
The practice of yoga and yoga therapy
The terms yoga and yoga therapy are somewhat interchangeable. Yoga is thought of as being a system for attaining undisturbed calmness of mind, and yoga therapy is a way of applying the teachings and practices of yoga in a therapeutic context meant to engage the student’s energy in the direction of the desired goals (Goldberg, 2013). Yoga can strengthen bodies, focus, and confidence. Yoga can teach children how to quiet and focus their mind by using stress relief and relaxation, energizing, and mindfulness techniques. It also helps to improve balance, strength and flexibility due to equal exertion of all parts of the body (Goldberg, 2013). Yoga utilizes sensory integration which helps to overcome excess stimuli and improve motor skills, both of which will in turn improve language and social skills (Goldberg, 2013; Narasingharao, 2016). The use of imitation and play is important in helping to build a child’s social and language skills, and can be incorporated in an individual’s yoga therapy.
At the Samarya Center, in Seattle, WA, they use integrated movement therapy, which is a yoga-based therapy that follows six core principles (Kenny, 2002):
- Structure and continuity
- Physical stimulation
- Social interaction
- Language stimulation
- Direct self-esteem building
These core principles are important for integrated movement therapy because they correspond with specific areas that a person with ASD may be deficient in (Kenny, 2002). The result would be specific positive effects in the overall therapeutic environment.
Results of yoga on ASD
Although the research out there is somewhat mixed, there were studies that showed positive results with the use of yoga therapy on children with ASD. Children with ASD tend to have lower muscle tone, and the strength, flexibility, and balance that yoga provides has been shown to benefit these individuals (Goldberg, 2013). Children with ASD thrive on routine and structure which yoga offers. The Samarya Center has shown that this type of therapeutic intervention has been successful in addressing areas associated with individuals diagnosed with ASD (Kenny, 2002). It has shown that yoga can aid behavioral problems associated with ASD such as irritability, agitation and self-stimulatory behaviors, as well as an increase in social and communicative behaviors (Campbell et al, 2017).
It has also been shown that daily yoga in the classroom setting can help improve student performance and behavior in children with ASD as reported by classroom teachers (Weaver, 2015). This was shown to be helpful if it was used daily and in a routine format, again reiterating the importance of routine and structure in children with ASD. Yoga has also been shown to increase the independence in individuals with ASD (Ehleringer, 2010).
Due to the mixed nature of the results, there needs to be much more research done to fully determine whether yoga therapy has any major effects on children diagnosed with ASD. Most of the current studies out there are of a small population size. ASD is one of the largest and fastest growing pediatric populations. This is why more research and specified research needs to be done, to give a better idea on the effects of non-pharmacological therapies such as yoga therapy (Weaver, 2015). Yoga has been shown to aid in treatment for non-ASD individuals that have some of the common co-morbidities of ASD, but more rigorous trials are needed to be aimed at both core ASD symptoms and commonly co-morbid psychiatric conditions before it is considered evidence-based treatment (Gwynette, 2015).
Even with the mixed review, there is some proof behind the use of yoga as an effective treatment for children with ASD. Since ASD is such a broad spectrum, the yoga therapy must be adapted to the specific needs of the individual (Goldberg, 2013). The therapy needs to be individualized and specific (goals and objectives) to the child (Goldberg, 2013). Also, the use of parental based yoga intervention has been shown as more effective for both the child and parents (Narasingharao, 2016), so why not get the family together and try something new. This is a fun, healthy activity that could benefit all.
- Autism Speaks. (2018). Retrieved from https://www.autismspeaks.org/
- Campbell, M., & Martin, S. (2017). Exploring Yoga as a Sensory Based Intervention for Children with Sensory Processing Difficulties: A Systematic Literature Review. MOJ Yoga & Physical Therapy, 2(4).
- Ehleringer, J. (2010). Yoga for Children on the Autism Spectrum. International Journal of Yoga Therapy, 20, pages 131-139.
- Gwynette, M.F., Warren, N.J., Warthen, J., Truleove, J.S., Ross, C.P., Snook, C.A. (2015). Yoga as an Intervention for Patients with Autism Spectrum Disorder: A Review of the Evidence and Future Directions. Autism Open Access, 5(3).
- Goldberg, L. (2013). Yoga Therapy for Children with Autism and Special Needs. New York, NY: W. W. Nortion & Company Inc.
- Kenny, M. (2002). Integrated Movement Therapy: Yoga-Based Therapy as a viable and Effective Intervention for Autism Spectrum and Related Disorders. International Journal of Yoga Therapy. 12, pages 71-79.
- Narasingharao, K., Pradhan, B., Navaneetham, J. (2016). Sleep Disorder, Gastrointestinal Problems and Behaviour Problems Seen in Autism Spectrum Disorder Children and Yoga as Therapy: A Descriptive Review. Journal of Clinical and Diagnostic Research, 10(11).
- Sharma, S.R., Gonda, X., Tarazi, F.I. (2018). Autism Spectrum Disorder: classification, Diagnosis and Therapy. Elsevier: Pharmacology and Therapeutics, 190. Pages 91-104.
- S. National Library of Medicine. (2018). Collection Development Manual: Complementary and Alternative Medicine. National Institutes of Health. https://www.nlm.nih.gov/tsd/acquisitions/cdm/subjects24.html
- Weaver, L.L. (2015). Effectiveness of Work, Activities of Daily Living, Education, and Sleep Interventions for People with Autism Spectrum Disorder: A Systematic Review. The American Journal of Occupational Therapy, 69(5), pages 1-11.