Yoga Therapy and Autism Spectrum Disorder (ASD)

As defined by Leo Kanner back in 1943, children with autism have an innate inability to form the usual biologically provided affective contact with people. He suggested that individuals with autism have difficulty reacting to the input of new stimuli encountered on a daily basis and that they live in a world of sameness and aloneness, which if disturbed, causes them to fall into a major panic that does not cease until removal of the perturbation agent. These days, it is well known that a dysfunction of the GABAnergic signaling early in a child's development leads to a server excitation/inhibition imbalance in neuronal circuits, which may be responsible for some of the behavioral deficits observed in individuals on the autism disorder spectrum. GABA is an amino acid in the body that acts as a neurotransmitter in the CNS and plays a role in anxiety. GABAnergic pertains to the action of gamma-aminobutyric acid (GABA) or to neural or metabolic pathways in which it functions as a transmitter. According to researchers Studnitzer and Miller, this inability to react and process sensory stimuli affects 80-90% of children on the autism spectrum, and their sensory processing deficit may contribute to the maladaptive behavioral profile of these children and impact their ability to participate in social, school and home activities.

Autism is a group of developmental brain disorders, collectively called ASD. The term spectrum refers to the wide range of skills, levels of impairment, functioning, symptoms, and disability. The DSM-5 diagnostic creativity specifies the diagnostic for ASD as having persistent deficits in social interaction across multiple contexts in conjunction with restrictive or repetitive patterns of behavior. The spectrum of disorders identified as ASD includes autistic disorder, Asperger's disorder, pervasive developmental disorder, Rett’s disorder, childhood disintegrative disorder. 

Children with ASD exhibit deficits in social-emotional reciprocity such as having a reciprocal conversation, responding to or intimating social interactions, sharing or understanding emotions, affect and interests of others. People with ASD also exhibit deficits in non-verbal as well as verbal communication. Children with ASD may have difficulty with eye contact, understanding and using gestures, body language or context cues in social interactions and communication. Children with ASD vary widely in intelligence, abilities, and behaviors. Restrictive or repetitive motor movement with the use of objects or with speech such as repetitively lining items up in an organized pattern or using echolalia (Repetitive words or phrases) According to the National Institute of Child Health and Human Development (NICHD)  children with ASD may also develop co-occurring mental disorders including ADHD, Anxiety, or Depression or ASD. NICHD explains that the main signs and symptoms of ASD involve problems in the following areas: Difficulty using and understanding language expressive and receptive; difficulty relating to people, objects and events; unusual play or fixation with toys and other objects; difficulty with changes in routine or familiar surroundings; repetitive body movements or behavior patterns, such as hand flapping, hair twirling, foot-tapping, nose hair strokes or more complex movements; inability to cuddle or be comforted; difficulty regulating behaviors and emotions, which may result in temper tantrums, anxiety and aggression. Basically there is a struggle across all environments with language, communication, social skills, sensory issues, body awareness, handling change in routine or environment, awareness of their and others' emotions, anxiety, and many other issues. Explicit teaching of social skills, language, emotional regulation, and body awareness are necessary for children with ASD.

Yoga may be a beneficial therapy because it utilizes the influence of the mind in balancing physical performance with the calm and serenity of positive thoughts. Furthermore, it is believed that yoga interventions may increase brain gamma-aminobutyric acid (GABA) levels and can be used as complementary therapies in conditions such as depression, anxiety, and autism spectrum disorder (ASD). Researchers Streeter and colleagues’ results indicate that in experienced yoga practitioners, brain GABA levels are significantly increased and anxiety reduced after a session of yoga. This suggests that the practice of yoga could be explored as a treatment for disorders with low GABA levels.

In accordance with researcher Ehleringer, the evidence allows us to state that yoga can improve focus and attention, sensory information processing, communication, self-regulation, and motor control, in children with ASD, helping them to lead a more balanced, healthy, socially integrated, and independent life. Yoga practice may help these individuals to improve their cognition and emotional processing. According to the Autism Society in 2004, 1-125 had ASD, in 2016 1-68 had ASD and 1 in 54 boys have ASD. The Autism Society estimates the lifetime caregiving costs of ASD are $2.4 million and the US is facing $90 billion in annual costs for ASD. These values take into account research, insurance costs, and non-covered expenses, Medicaid waivers, educational spending, housing, transportation, employment, related therapeutic services, and caregiver costs. In young adults with ASD symptoms include significant problems developing nonverbal communication skills, such as eye-to-eye gazing, facial expressions and body posture, failure to establish friendships with children the same age; lack of interest in sharing enjoyment, interests, or achievements with other people, and lack of empathy.

Yoga increases self-esteem, emotional bonding, focus, tolerance to touch, proximity, sharing of attention, skills in eye contact, sitting tolerance, nonverbal communication and receptive skills to verbal commands related to spatial relationships, imitation, cognitive skills, and social-communicative behaviors, in addition to reducing maladaptive classroom behavior and improving family relationships. Possible mechanisms for these effects of yoga practice are an increase in brain GABA levels and mirror neuron activation through teacher observation. Treatment Room Considerations are to pick a room that has the least amount of doors and remove sharp objects; schedule appointments during off-peak times so that the child can make loud noises without disrupting others care; Takedown loud art and remove objects that resemble toys; Change challenges artists have the room set-up the same for each session; Calm and serene is not the same for all individuals and artists are sensory, sensitive. IS your space really sensory neutral (e.g. strong odors, fans, bright lights, and so on); Use yoga mat to define personal space; Autists like predictability, structure, and consistency. Teach them to take their shoes and socks off, greet with Namaste and find the mat and sit quietly. To lower autists’ anxiety consider answering these questions each time that you see them with a visual board: what am I supposed to do? What is next after the task is finished? How will I know when the task is complete?

Quotes:

Temple Grandin “The most important thing people did for me was to expose me to new things.”

Kerry Margo “Autism can’t define me. I define Autism.”

Temple  Grandin “See the person, not the label” 

Resources:

Principles and Practice of Yoga in Health Care (2016-04-29) https://www.amazon.com/dp/B01HC1GWMO/ref=cm_sw_r_cp_tai_C0-HDb94Y28T1

Asanas for Autism and Special Needs: Yoga to Help Children with their Emotions, Self-Regulation and Body Awareness https://www.amazon.com/dp/1849059888/ref=cm_sw_r_cp_tai_zA.HDb2YFGQ3K

Yoga Therapy for Children with Autism and Special Needs https://www.amazon.com/dp/0393707857/ref=cm_sw_r_cp_tai_ZA.HDbNJG5ZWR

Reframe Your Thinking Around Autism https://www.amazon.com/dp/1849056722/ref=cm_sw_r_cp_tai_ca6IDbKCFP6AC