World Autism Awareness Day: Autism and Yoga

As it's World Autism Awareness Day, just on the heels of a recent CDC release of a 23% increase of children diagnosed with Autism Spectrum Disorder since 2009, I thought I'd write a few thoughts on Yoga and Autism.

As a health professional who is typically the first person to say that scary word to parents, I often see the progression through grief and joy during the first years of diagnosis and therapy. During my time working as an SLP on the Autism Program Team in BC, I was dismayed to see how often parents were taken for their money and their hope by alternative therapy techniques.

These parents are at a delicate place of vulnerability and shouldn't be manipulated into spending their money on a treatment that may or may not prove effective.

Should Yoga Instructors like to be part of the Health Professional Team, it's important that Complementary Alternative Medicine treatment techniques be evaluated in an unbiased manner and parents are provided with unbiased information regarding the efficacy and evidence based research behind the intervention in question.

For example, most research that comes up citing the benefits of Yoga for children with Autism are published in alternative medicine or yoga journals. Typically, the scientific value of these studies are lower than other, more established, scientific journals. Therefore, results from these studies have to be interpreted with extreme caution.

Let's take the study titled: 'Application of integrated yoga therapy to increase imitation skills in children with autism spectrum disorder' published in the International Journal of Yoga.
This study claims to find that yoga will help increase imitation in children with Autism.
Taking a closer look and we realize that the study is flawed on many levels.

• there are only 6 participants in the study. Much too small to make a sweeping population statement.
• No information is given regarding the age or severity of their diagnosis. Autism is called a 'Spectrum' for a reason- symptoms and severity can vary greatly per child, as can the responsiveness to treatment. These two first bullets are enough to negate the entire study completely.
• It wasn't a double blind study- or even a single blind study. Children were rated using no standardized tools to assure the researchers were rating similar behaviours, or what behaviours they wanted to rate at all. Further, parents were asked to rate their children's behaviours afterwards. Typically, we can't assume that parents will subjectively rate an improvement just based on the hope that there is one. As no standardized tools were reported- we can't even assume any measure of objectivity were used.

This study is a complete bust.

If we look at a study published in the Journal of Child and Adolescent Psychiatry Clinical North America: Complementary and Alternative Medicine Treatments for Children with Autism Spectrum Disorder' we see a different approach.

This article provides a rich and recent literature review critically analyzing studies published on various alternative medicines. They've rated the therapies from C (lowest) to A (highest). You can see Yoga receives a 'C' mostly due to the fact that no appropriate studies have been released so far on the effectiveness of Yoga and Autism (as of 2008).

This isn't to say that yoga may not be an effective complement to traditional western therapy approaches for children with Autism. It's to recognize that as Health Professionals we need to take a step back and do what is best for these families by providing them with all the unbiased information we have at our disposal.

This may mean helping families:

1. Research Yoga programs for children with Autism. 
2. Look into that instructor's experience with children with Autism, 
3. Question specific modifications that are made for the program
4. Set up a meeting with the Yoga Instructor to discuss the reasoning. 
5. It may also mean sharing with the family that to date research into the effectiveness of Yoga with children with Autism is scant and to make this financial decision of paying for yoga (which can be expensive).

Finally, it will mean supporting the family should they choose to enroll their child in a Yoga for children with Autism. As an SLP this might look like my willingness to contact the Yoga Instructor and offer any input or suggestions regarding my client (with the parent's consent), from their communication skills to visual scheduling or alternative communication strategies.

article copyright of EcoYogini at ecoyogini.blogspot.com