Yoga programs for children, including children with special needs, are riding a current wave of popularity in communities across the country. Common to most health trends, questions as to benefits, effectiveness and efficacy are examined throughout the media. Books, magazine articles, TV documentaries and talk shows have recently promoted the health benefits of yoga practice in both adults and children. One may ask, "What about evidenced-based research?" A thorough look at this ancient mind/body practice allows responsible parents, caregivers and therapists to determine the value of this activity as an effective therapeutic modality for children under their care.

Archeological evidence from the Indus Valley officially dates yoga to about 3,000 B.C., however some evidence connects earliest traditions as far back as 5,000 years.

So, does the modern practice of western yoga interconnect with traditional pediatric interventions such as sensory processing techniques, positioning, posture, balance, flexibility, strengthening and calming (self modulation)? What exactly are the claims of practitioners utilizing yoga as a modality? What efficacy is observed? How widespread is the practice for this population and what research, if any, supports therapists in incorporating yoga as a therapeutic modality in intervention?

Yoga enthusiasts, both practitioners and instructors, claim yoga poses, or asanas, build muscle tone, flexibility, improve posture, balance and promote relaxation.

Of the six branches of yoga, Hatha is the one most widely practiced today and used as the foundation for special needs programs. This branch used physical poses, or asanas, in combination with breathing techniques, or pranayama, and meditation. In Paula Boyajian's article, "Yoga for the Child with Special Needs," (Exceptional Parent June, 2004) the term yoga is analogous with "join" or as other authors have stated "a yoke or a union." Three elements are joined - mind, body and spirit. In yoga practice the "spirit" is addressed through yoga breathing. This type of breathing, when combined with low lighting and olfactory sensations such as the scent of lavender is said to reduce stress, improve blood pressure and digestion, and promote deeper sleep. Calm comes to mind. For the types of conditions many therapists treat on a daily basis, calming (self-calming) is most beneficial before and after therapeutic activity.

For children with special needs, traditional Hatha poses such as the "mountain,""tree,""cobra," and "child's pose" are adapted. Certified yoga teachers with specialized training state these asana adaptations refine motor skills, increase body awareness induce calming and even improve eye contact among children with autism, pervasive developmental delay, attention deficit disorder and recovering traumatic brain injury patients.

In fact, the website www.nextgenerationyoga.com/specialneeds.htm includes conditions such as Down syndrome, cerebral palsy, and hyperactivity to the list of those that benefit from yoga as a therapeutic modality. This organization, Next Generation Yoga, encourages parents to participate in either an interactive or imitative approach.

A general Internet search revealed a surprising number of practitioners, both in clinics and private practice currently utilizing yoga as an adjunct activity ("adjunct" used in the occupational therapy academic sense of the preparatory activity followed by either enabling or purposeful activities). At the Children's Hospital Medical Center in Seattle, Washington a special yoga program, named "Bendy Kids," has been developed by physical and occupational therapy practitioners. The program involves two classes a week for pediatric oncology patients. Specialized instruction is based on goals to improve flexibility, balance, respiratory function, endurance, sleep patterns and improved general strength - a definite asset while enduring cancer treatment regimens, (www.seattlechildren's.org)

Private practitioners like Sande Rutstein, OTR from San Rafael, California have created a practice called "Yoga Nest" which utilizes the modality of specialized yoga techniques to address both children and adults with special needs. The websites.www.yogatherapy.com and www.iyogatherapy.com, describe programs developed by this occupational therapist who has specialized training to address special needs in both children and adults.

General literature for both pediatric practitioners and interested caregivers is abundant. Although general literature reflects various medical centers and private . practitioners using yoga, OT professional research literature specifically reporting use of yoga as an evidenced based pediatric modality in occupational therapy practice is scanty. Searches in the American Journal of Occupational Therapy, American Occupational Therapy Journal of Research or the OT Practice journal did not yield articles addressing yoga for children with special needs or similar key terms. Occupational therapy students studying at graduate levels, however, are involved in research at the present time. Publications of their results are forthcoming. Although practitioners are reporting positive results on web sites and in articles in journals other than professional research publications, yoga practice has not been as yet established as evidence based. This lack of evidence leads to the call for published clinical research focusing on the benefits and efficacy of yoga as a therapeutic modality in pediatric occupational therapy.

This being said, however, fellow practitioners with certification in yoga for special needs and certified yoga instructors with specialization in addressing special needs have reported positive outcomes in utilizing yoga as a therapeutic modality. These OT practitioners and specialized yoga instructors have graduated from courses specializing in yoga instruction for children with special needs. One of the most prominent courses is run by Sonia Suma, author of Yoga for the Special Child, out of the Satchidananda Yoga center in Evanston, Illinois. More than 300 graduates of this specialized instructors' program are currently working with special needs children across the country. It is important for parents to inquire about training and certification of therapists and instructors before enrolling their child in yoga classes.

Yoga has recently developed into a popular therapeutic activity for children with special needs. Although popular in this capacity, therapeutic yoga has limited evidence based research to qualify it as a researched based therapeutic modality. Although research designs are ongoing, parents and caregivers may benefit from exploring the parent resource list at the end of this article.

Parent Resource Guide

Author References

American Occupational Therapy Association. (2000 -2005). American Journal of Occupational Therapy. Bethesda, MD: Author ISSN 02729490

American Occupational Therapy Foundation. (2003-2005) American Occupational Therapy Research Journal. Bethesda, MD: Author. Slack Inc, Baltimore, MD

American Occupational Therapy Association. (2000-2005). OT Practice. Bethesda, MD: Author ISSN 1084-4902

Bendy Kids. Seattle Children's Hospital Medical Center Seattle, WA www.seattlechildren's.org

Boyajian, Paula, RYT; "Yoga for Children with Special Needs" Exceptional Parent Magazine; June 2004.

Maxilifestyle.net's "ABC of Yoga.com" History of yoga: A complete overview of yoga history. 2003-2005 Web site: www.abc-of-yoga.com/

Next Generation Yoga. (2005) www.nextgenerationyoga.com/ specialkids.htm LLC New York.

Suma, Sonia, et al., Yoga for the Special Child. August 1, 1998. Special Yoga Publications. Buckingham, VA. ASIN B0006QW8KI. www.yogatherapy.com

BY CAROLYN CANTU, MS, OTR

Copyright Psy-Ed Corporation Jun 2005