Yoga Techniques Applied to Autism Spectrum Disorder (ASD) — Part 2 of 3

Silvia Edith Fernández, (Sadhana), Ciudad de Tolhuin, Provincia de Tierra del Fuego, Argentina

It is necessary to include in the present work, diagnostic criteria used nowadays to identify a person with autism. For that reason, the Diagnostic and Statistical Manual of Mental Disorders 5® (DSM5), is used and applied in most countries and specifies the following:

AUTISM SPECTRUM DISORDERS, CRITERIA AND DIAGNOSIS

A. Persistent gaps in social communication and social interaction through many contexts, expressed in the following pre sent or past symptoms:

  1. Gaps in socio-emotional reciprocity; behaviour ranges that show for example, unusual social approaches and problems in maintaining the normal feedback flow in conversations; a reduced disposition to share interests, emotions and esteem due to a failure to begin social interaction or answer it.
  2. Gaps in non-verbal communication behaviour used in social interaction, behaviour ranges that go from showing the difficulty with integrating verbal and non-verbal communication behaviours to anomalies in the visual contact and body language, or deficiencies in the understanding and use of gestures to a total failure of emotional expressiveness of non-verbal communication.
  3. Gaps in developing, maintaining and understanding relationships, a behaviour range that goes from difficulties in adjusting adequately to different social contexts to difficulties in sharing fiction games or making friends and up to an apparent lack of interest in people.

Specify the present severity: Severity bases itself on the social and communicative alteration and on repeated and restricted behavioural patterns.

B.Repeated and restricted behavioural patterns, activities and interests that express themselves in at least two of the following present or past symptoms:

1.Motor movements, object use, stereotyped or repeated language. Examples: simple stereotyped motor movements to line up objects, to twirl objects, to echo what people say, idiosyncratic phrases.

2.Emphasis in equality, inflexible adhesion to routines or ritualized verbal or non-verbal behaviour patterns.

Examples: extreme discomfort to little changes, transition difficulties, rigid thinking patterns, ritual to greet, the need to follow the same way or eat the same food.

3.Highly restricted and obsessive interests that are unusual for their intensity or aim. Examples: excessive devotion or concern for unusual objects, circumscribed and justified interests.

4.Hyper or hyposensorial activity or unusual interest in environmental sensorial aspects. Examples: apparent indifference to pain/temperature, adverse response to sounds or specific textures, to smell or to touch objects in excess, fascination for lights or objects that spin.

C.Symptoms must be present in the early period of development.

D.Symptoms which cause significant clinical disorders to a social or occupational level or in other important areas of current performance.

E.Disorders which are not better explained by the presence of an intellectual disability, intellectual developmental disorder, or a global delay in development. The intellectual disability and the autism spectrum disorder frequently go together. Social communication must fall far below the expectations in accordance with the general level of development, to make a simultaneous diagnosis of the autism spectrum disorder and intellectual disability.*2

Biomarkers regarding what we know up to now about ASD are non-existent. This has resulted in a varied sort of intervention methodologies developed in different fields: educational, social, medical fields, etc. Clinical observation is still the one that regulates and determines treatments to follow, though some statistics can be made within pharmacology.

CONTENT – EXPERIENCE ENVIRONMENT

The project was implemented in two consecutive different social environments. First, in a city with 120,000 inhabitants where financial backing is diverse depending on the countryside, industry and tourism. Its medical assistance includes specialized professionals and public and private health centres. It has a wide educational provision from kindergarten to university. It also has four special schools that deal with the entire range of mental health disorders. The experiences were implemented in one of them that offers care for students with Severe Emotional Disorders (SED). This experience lasted one year.

As a second stage, the work was implemented in a city of 100,000 inhabitants, an estimate based on oil, factories, civil service, cattle and agri-tourism development. It has medical help specialized through public and private health centres. The project was conducted in the mental health section of a regional hospital over a period of one year and after that, in a private, interdisciplinary research centre over a period of four years.

The project coordinators didn’t choose the cases, but the involved children came diagnosed by specialists. More than 90% of the children had received two or more independent diagnoses, agreeing 100% with the ASD diagnosis.

There was fluent communication with the professionals, parents, and all those who helped take care of each child with the different therapies: psychologists, therapist aides, motor development experts and others. The yoga teacher worked together with a speech therapist and a child psychiatrist, both specialized in ASD, in the experiences carried out in the hospital and interdisciplinary research centre.

The project was implemented in the first city during a year and in the second one for five years.

Registrations were obtained in the course of the last five years through various formats: stories, films and reports.

Group of children

The children involved in this experience were a heterogeneous group, not only regarding age and sex, but also intelligence quotient, diagnosis and human communicative behaviour. In order to describe it, let’s take into account these variables:

  • Out of a total of eleven children diagnosed with ASD, three girls aged between eleven and fifteen and eight boys aged between four and fifteen.
  • In terms of intellectual quotient, three children showed intellectual performance score lower than the average level; one of them showed a notorious low average intellectual quotient. The other eight members of the group had a medium to high functioning intellectual quotient.
  • The group included autism, non-specified autism and the Asperger Syndrome diagnosis using the DSM4.
  • The human communicative behaviour of a child, which includes communication, language and speech, constitutes as a double display. On one hand, it is the starting point to develop the task and on the other hand, it is one of the displays that will be used for evaluating. Four well-defined variables were used (5). They are:
    • A: A child that can speak and communicate using verbal language with communicative function.
    • B: A child that can communicate through gestures, pictograms, etc., but doesn’t speak.
    • C: A child that neither speaks nor communicates.
    • D: A child that can speak but cannot communicate: to echo what people say, word repetition without communicative function.

Development

The carried out methodology is called Connected Integration Pattern®. Its principal approach acts on the perception channels, purifying them to enable the free flow of energy. Cellular intercommunication will be encouraged through its implementation. First of all an anamnesis, an accounting of the medical history, is carried out on each child. It consists of:

A. Report of a medical professional who is in charge of the monitoring.

B. Personal interview between the yoga teacher and parents to collect a description of the child’s capabilities, priorities, emotional ties, sensorial gaps, self-stimulations, and more.

C. Registration of the child’s behavioural observations. This provides knowledge of the child’s present evolutionary state and to orient the way in which yoga techniques will be applied. The application of the model will be developed as follows:

  1. Context of a yoga session
  2. Work one-on-one, teacher and student
  3. Condition of space: quiet, clean, ventilated and warm
  4. One hour regular weekly meetings. The scheme and procedure of the meeting are based on three principles, being the relational framework of this methodology.

Nexus without attachment: This means to establish a teacher-student relationship where this distinction is kept. The teacher is required not to get emotionally involved by supporting himself and acting as a facilitator.

Pedagogical instrument: It consists of moulded, modelling and precise verbal instruction techniques.

Moulded techniques: This program is carried out when the child doesn’t have the ability to imitate another gesture or movement. In this case, the teacher helps the child by guiding the child’s poses and movement through corporal contact while the verbal instruction is given. In this way, a relationship is established between the word and the action that leaves a motor registration in the body itself, omitting the cognitive aspect that manifests a gap. Imitation – modelling: By modelling, it is understood that the learning is achieved through observation and has its basis in the theory of social learning. Its primary theory is that any behaviour acquired or modified by a direct experience can be learned or changed through the observation of others and the consequences that follows the behaviour. This theory is reinforced by the existence of mirror neurons. Verbal instruction: It consists of using the spoken word to guide the task bearing in mind the following guidelines:

  • Shortness: Use the fewest words possible, one to three maximum depending on the child’s particular characteristics.
  • Specific language: Give the same instruction each time you expect the child to perform the same action; avoid changing terms by using synonyms.
  • Pro-positive expressions: Instructions will be done through positive phrases, avoiding the use of ‘no’.
  • Regarding time: To recognize the time that each child needs to process the given instruction and reasonably waiting for execution of the answer.

References:

2. DSM-5. Diagnosis Statistic Manual of Mental Disorders 5. Dr. Daniel Valdez, Congress Conference Calafate-Argentina, 2016.