“I am different, not less” ~Temple Grandin
Hey Readers! The topic of Autism is near and dear to my heart. When I am not teaching yoga or blogging, I work as a pediatric speech-language pathologist (aka speech therapist), where I provide speech, language, and feeding therapy to many individuals with autism (IWA). My years of clinical work has repeatedly demonstrated to me that IWA are some of the most unique, amazing people I have ever met. IWA have so many incredible gifts and talents that us “typical” people could likely never experience. IWA see, and perceive, the world differently than a “neurotypical” person. Sometimes they see, or perceive, the subtle details in objects and situations that “typical” individuals miss. Other times they might see, or perceive, a larger, more holistic view of a situation, where “typical” brains may get stuck on insignificant details. In my opinion, Autism may be better viewed as a difference, rather than a disorder. And yes, IWA face challenges with becoming independent members of society due to the biological nature of Autism re: communication and social interaction. But, there is nothing “wrong” with IWA; their brains simply work differently than the mainstream population. And quite honestly, I think our world needs people who see things a little differently.
This blog post will review recent scientific research that describes the benefits that a yoga practice can have on some of the core features of Autism. None of the information in this blog post is intended to “cure” or “fix” IWA, and it is also not intended to change the inherent personalities of IWA. Rather, my goal of this blog post is to show that scientific studies overwhelmingly demonstrate many benefits of practicing yoga regularly for IWA. In general, the research shows that a consistent, regular yoga practice can improve communication, cognition, social interaction, sensory processing, and motor planning skills in IWA, allowing these wonderful humans to potentially have an independent role in society. Future blog posts will delve deeper into how often yoga should be completed to reap the benefits and how it might be modified for IWA.
What is Autism Spectrum Disorder, Clinically Speaking?
Autism, or Autism Spectrum Disorder (ASD), refers to a broad range of conditions characterized by persistent challenges with social skills, repetitive behaviors, sensory processing, motor skills, speech, and language.
IWA can have difficulty with social reciprocity (e.g. back and forth conversation, sharing of interests and emotions) and/or developing and maintaining friendships. IWA often demonstrate restrictive repetitive patterns of behavior, including excessive adherence to routines and/or resistance to change, highly restricted interests with a high intensity or focus, and/or repetitive speech or motor movements (e.g. hand flapping, vocal stimulation behaviors).
IWA can have disordered sensory processing, where the individual can demonstrate hyperarousal (increased sensitivity to sensory stimuli) or hypoarousal (decreased sensitivity) to sensory information. For example, some IWA are highly sensitive to lights or sound, where the sensory information can cause actual discomfort or anxiety to the person. Other IWA may be highly sensitive to tactile (i.e. touch) information, making simple ADL (activities of daily living) tasks, such as dressing or grooming, very dysregulating to the individual. Still other IWA may have heightened sensitivity to smell or taste, causing these individuals to avoid certain foods. This makes eating and mealtime really challenging and puts the individual at-risk for malnutrition. Conversely, some IWA may require high amounts of sensory information before their nervous system "registers" that information. For example, some IWA overstuff their mouth when eating simply because their sensory system does not detect the food in their mouths until the amount of food becomes high enough to trigger a sensory response. Other IWA seem to require a ton of tactile input, often through deep pressure, so that they can sense where their body is in space. Still others may require a high amount of proprioceptive input which could manifest as leaning on a wall when walking down a hallway, or constantly running from one activity to the next.
Individuals with ASD can exhibit less imitation than typically developing individuals. Difficulties with imitation may be observed for gross and fine motor movements, play, gesturing, facial expressions, vocalizations, and/or words and sentences. Imitation plays a crucial role in the development of cognitive, social, communication, language, play, and joint attention behaviors. Imitation is often considered a pre-requisite for learning other developmental skills, such as walking or speaking. Reduced imitation skills in Autism may partly explain some of the social communication challenges seen in IWA.
Autonomic nervous system (ANS) dysfunction can also be seen in ASD, and this could be responsible for the difficulties in social behavior, emotional regulation, concentration, response inhibition, and adaptive functioning that is sometimes seen in IWA. The ANS contains two branches – the sympathetic branch and the parasympathetic branch. The sympathetic branch is responsible for up-regulating your nervous system, which increases arousal level and prepares you to respond to stressful situations. The parasympathetic nervous system is responsible for down-regulating the nervous system which brings about a sense of calmness and safety and prepares you to do digest food and get rid of waste. When a person feels calm and safe, it frees up energetic resources for communicating, learning, and growing. IWA can present with increased Sympathetic tone (or activity) and/or decreased parasympathetic tone (or activity). Low parasympathetic activity, and/or high sympathetic activity, in ASD can cause the IWA to become “stuck” in a “fight or flight” response, where most sensory information seems “dangerous” to the person. If this happens, it is very challenging for the individual to meaningfully connect with others.
Symptoms of ASD must be present in early childhood, but may not become fully manifested until social demands exceed limited capacities. ASD is typically diagnosed by a pediatrician, developmental pediatrician, psychologist, or psychiatrist. ASD is often treated by a team of professionals, including physical therapists, speech-language pathologists, occupational therapists, behavioral therapists, music therapists, counselors, and more. The incidence of ASD has been increasing through the years, where the current estimates (from the CDC) suggest that 1 in 54 children has been identified with Autism.
Benefits of Yoga for ASD?
Many scientific research articles have examined the outcomes of a consistent yoga practice for IWA. In addition to the benefits gleaned from any physical activity program (e.g. muscle strengthening and flexibility, cardiovascular and respiratory function, immune system functioning, etc.), current scientific evidence shows that yoga for IWA can lead to improvements with:
Receptive language (i.e. language comprehension, or understanding)
Expressive language and speech production
Initiating communication with peers and adults
Imitation skills
Sleeping behaviors and patterns (e.g. sleeping through the night, not needing medicine to sleep, not snoring or mouth-breathing at night)
Feeding and digestion (e.g. improved bowel movements, chewing skills, willingness to try new foods)
Body awareness (which helps with gross and fine motor movements, including walking and speaking)
Balance (which helps with posture, movement, and emotional regulation)
Tolerance to touch (which can help with grooming, toileting, dressing, and other tactile therapies)
Parasympathetic nervous system activity (which helps with emotional regulation)
Behavior skills, including eye contact, following instructions, sitting tolerance (i.e. remaining at a work area for lengthy periods without eloping to preferred activity), and transitioning skills (i.e. shifting from one activity, or location, to another)
Self-confidence
Scientific research has also shown that a consistent yoga practice can lead to reductions with the following for IWA:
Self-injurious behaviors (e.g. hitting or pinching self)
Depression
Anxiety
Rumination (i.e. obsessive thoughts, especially negative in nature)
Sympathetic nervous system activity
Summary
A consistent yoga practice can lead to many positive outcomes for IWA, including social interaction, speech and language skills, imitation, motor skills, sensory processing, behavior, and mental health. Yoga is not intended to replace other therapies that an IWA may be receiving; rather, the information presented here is intended to show the reader that there is plenty of evidence to support the implementation of a regular yoga practice in combination with other therapies. Indeed, many therapists (especially physical and occupational therapists) use yoga postures and/or breathing techniques in their treatment sessions to support the individual's goals and objectives. If you have specific questions about Autism or beginning a yoga practice for a loved one with Autism, please consult with your child's physician or current therapists (e.g. physical, occupational, or speech therapist). Stay tuned for future blog posts that will more deeply explore yoga for autism. And a special thanks to my amazing husband who did the artwork for the two sketches in this post.
~Namaste, Jackie Allen, M.S., M.Ed., CCC-SLP, RYT-200, RCYT
References:
Autism Connect (2019). "10 Benefits of Yoga Therapy for Children with Autism." Article link here.
Brandstaetter, H. (n.d.). "Yoga Generates Huge Benefits for Children with Autism." Yoga International. Article link here.
Collins, B.(2015).Sensory Yoga for Kids:Therapeutic Movement for Children of All Abilities.Sensory World.
Hourston, S. & Atchley, R. (2017). Autism and Mind-Body Therapies: A Systematic Review. The Journal of Alternative and Complementary Medicine. 23(5): 331 - 339.
Narasingharao, K. et al. (2017). Efficacy of Structured Yoga Intervention for Sleep, Gastrointestinal and Behavioral Problems of ASD Children: An Exploratory Study. Journal of Clinical and Diagnostic Research. 11(3): 1 - 6.
Radhakrishna S. (2010). Application of integrated yoga therapy to increase imitation skills in children with autism spectrum disorder. International Journal of Yoga, 3(1), 26–30.
Rosenblatt, L.E., et al. (2011). Relaxation Response-Based Yoga Improves Functioning in Young Children with Autism: A Pilot Study. The Journal of Alternative and Complementary Medicine. 17(11): 1029 - 1035.
Vidyashree H.M. et al (2019). Effect of Yoga Intervention on Short-Term Heart Rate Variability in Children with Autism Spectrum Disorder. International Journal of Yoga.12(1):73-77.