According to a 2016 Yoga in America Study conducted by Yoga Alliance and Yoga Journal, the number of American yoga practitioners has risen to over 36 million. That includes an increase of more than 15 million in just the preceding four years. In addition to the increased popularity of yoga overall, numerous research studies in recent years have indicated that yoga might have benefit for those with Autism Spectrum Disorder (ASD), which has generated a growing interest in yoga as a complementary therapy for these individuals.
In 2014, the CDC reported that 1 in 68 children were being diagnosed with some form of ASD. While the studies show that yoga can benefit both kids and adults with ASD, this article will focus specifically on the benefits for adults.
Autism Spectrum Disorder is comprised of a number of developmental disorders that exhibit a wide spectrum of symptoms and challenges. Individuals with ASD often face heightened levels of anxiety, sensitivity to the environment around them (resulting from sensory integration issues), challenges with communication and social relationships, and difficulty with self-regulation. In many cases, people with autism also struggle with motor coordination, body awareness, focus and concentration, and common physical ailments such as chronic pain and fatigue, digestive conditions, and autoimmune issues.
Along with these common challenges associated with ASD, many with autism face additional challenges related to the disorder. A recent CDC study documented a 32 percent rate of obesity among adolescents with autism. Health issues related to obesity can include asthma and headaches, bone and joint problems, sleep apnea, and social and psychological problems such as stigmatization and poor self-esteem. And, according to Dr. Robert Fortuna, professor at the University of Rochester Medical Center, as individuals with autism mature into adulthood they often have less access to healthcare services, which means that health issues will often go untreated.
The Benefits of Yoga
When presented in a way that is safe and accessible, yoga can offer tremendous benefits to adults with ASD. Because lack of body awareness and struggle with motor coordination and gross motor skills are common in people with ASD, yoga can be an effective tool for reconnecting them to their bodies—supporting balance, coordination, bilateral movement, and strengthening of gross motor development. In addition, yoga can also add to their strength, flexibility, and muscle endurance.
Along with the physical benefits, yoga can also be of great emotional benefit for those living with ASD. Harvard Health conducted several studies that attributed a reduction in both anxiety and depression to the practice of yoga. Yoga has also been shown to be a particular support in reducing anxiety related to obsessive compulsive disorder, which afflicts many individuals with ASD.
In my private sessions with adults with ASD, I’ve seen that specific poses and breathing strategies can help them release difficult or uncomfortable emotions (which can, if unexpressed, contribute to anxiety, depression, and agitated mood and behavior). Abdominal or “belly breathing” has been a particularly helpful breathing strategy for my students with ASD. I have also found using visualization very effective for helping them let go of difficult emotions with the exhalation and through movement, such as “tossing the emotion away” or “releasing the emotion” with the hands. If accessible, encouraging the student to extend the exhale—what I refer to as 2–4 breath—is a helpful breathing strategy for reducing anxiety.
Irregular sleep, a common challenge for individuals with ASD, can also contribute to increased anxiety, depression, and general agitation. But recent research has suggested that a consistent practice of yoga can improve sleep patterns among those suffering from chronic insomnia.
The Immune System
Immune dysfunction and autoimmune conditions are often found to coexist with ASD. Immune dysfunction can impact digestion, respiration, and allergic response, which are all areas of concern in individuals with ASD.
Yoga can help this as well, with studies indicating that a regular yoga practice can strengthen the immune system overall.
A common challenge for people with autism is heightened sensitivity to their environment, as well as difficulty with sensory processing. Occupational therapist and neuroscientist A. Jean Ayres, PhD, explains in her book, Sensory Integration and the Child, that “sensory processing” refers to the way the nervous system receives messages from the senses and converts them into appropriate motor and behavioral responses. These senses include the five senses as well as the two “hidden senses”: the proprioceptive and vestibular systems. The vestibular system governs movement and balance, with common indicators of vestibular dysfunction including difficulty with attention, bilateral coordination challenges, poor core muscle strength, poor postural control, emotional insecurity/dysregulation, difficulty following instructions/directions, and gravitational insecurity. The proprioceptive system is our “body awareness” sense, which includes spatial awareness, and awareness and control of our body parts and movements. Proprioceptive dysfunction can include poor motor planning, poor posture, weak muscles, poor endurance, difficulty following motor actions, poor dynamic balance, difficulty judging force or distance, and frequently seeking out proprioceptive/deep pressure feedback (which can create behaviors such as stomping feet, banging into walls or other objects or people in the environment, chewing clothing, pinching/hitting oneself or others, and seeking out bear hugs or deep pressure on the body).
The sensory processing challenges for those with ASD is directly correlated with the ability to self-regulate. According to Smith and Gouze in their book, The Sensory Sensitive Child, self-regulation helps us to monitor and control our own behavior, emotions, or thoughts, altering them in accordance with the demands of the situation. Because the physical poses in yoga support bilateral coordination, balance, strengthening weak muscles, motor coordination, attention, postural control, body awareness, motor planning, core strength and stability, and modulation of body movements—all areas of challenge for children and adults with sensory integration or sensory processing difficulties—the yoga postures, as well as breathing exercises, are helpful in supporting sensory integration.
It has been my experience that when people with ASD are better able to self-regulate, it can greatly strengthen their ability to interact with others in a positive and connected way. Physical poses and specific breathing strategies that provide opportunities to release difficult emotions or built-up energy in the body can support communication and expression of emotions and can lead to greater social/emotional regulation. For example, a popular breathing strategy I teach my students is “Let It Go Breath,” which involves identifying an emotion or worry, and then using breath and movement to let the worry go.
The ability to self-regulate leads to social skills such as understanding personal boundaries, working through conflict with peers, perspective taking, and reciprocal communication with others.
The Benefits of Restorative Yoga
It is my experience that restorative yoga, in particular, can be quite beneficial for people with ASD. This is likely due to the grounding it provides, the opportunities for deep pressure touch (which offers proprioceptive feedback), and the stimulation of the vagus nerve (with its calming effect on the nervous system). Restorative yoga offers props and supports that allow a person to let go.
Many adults with autism have trouble understanding what it means or feels like to experience calm. Heightened levels of anxiety related to the challenges of ASD often keep them in a constant state of “fight, flight, or freeze.” This constant state of anxiety can over-excite the sympathetic branch of the nervous system, which increases cortisol levels, impedes respiration, and impacts proper functioning of the brain and body. When the nervous system is given the proper environment and supports to relax, the parasympathetic nervous system is stimulated, which has a “rest and reset” or “rest and digest” effect. This opportunity for the nervous system to reset helps rewire the brain, and it changes the patterns of stress response.
One student of mine, a 26-year-old woman with autism, has been coming to yoga with her mom once a week for the past two years. She does a one-hour restorative yoga sequence in a private session, and a selection of yoga poses for her home practice. Recently she was able to forgo anesthesia for an MRI, instead practicing “sleepy butterfly” pose and “balloon belly” breathing during the test. This was a huge victory for her and for her family. The small things for “typical” individuals and their families often become big things for individuals with autism.
Making Practice Accessible
My experience has taught me that making yoga accessible for adults with ASD is a real challenge. Yoga poses, breathing strategies, and visualization strategies must be taught using visual supports (such as pictures of poses or images to support visualization), direct and concrete language, and the proper props and supports to ensure safety and effectiveness for the individual’s specific body type, level of cognitive understanding and communication, and physical ability. With proper observation and assessment, as well as an experienced and knowledgeable teacher who understands what is needed to support adults with ASD, yoga can be tremendously beneficial.
Yoga offers a holistic and healing system for supporting adults with autism and their families, and for helping them to live the healthiest, most vibrant, and meaningful lives possible. As we support these individuals in working with their challenges and building their confidence and self-esteem, we also help them to recognize their strengths and abilities—which will allow them to celebrate their unique inner light, and to shine that light brightly for all the world to see.
Helpful Tips for Teaching Yoga to Adults with ASD
• Use Visuals to Support Understanding. Language processing challenges can present difficulties when teaching yoga to adults with ASD. Using as many visual tools as possible such as pictures of poses and breathing strategies, visual sequences, visual timers, and modeling—will support your student with understanding, learning, and communication.
• Predictability. Making the yoga experience predictable will alleviate anxiety and help your student know what to expect. If there will be changes to their yoga routine, communicate those changes to the student in advance to prepare them for the change.
• Repetition. Repetition of poses and breathing strategies will allow your student to integrate the poses and breathing activities into their memory and body and support independence and self-esteem.
• Set them up for success. When teaching poses and breathing strategies, start off by making them accessible and easily attainable. Give the modified version of the pose first, and then move to other variations only if and when the student is ready. This will allow for proper alignment and safety and will give the adult a sense of success and accomplishment. Use props to support balance, coordination, and safety in the poses.
• Teach to their Strengths and Learning Styles. When leading trainings on yoga for children and adults with ASD, I talk a lot about the need to speak their language and use their interests, strengths, and specific learning styles as tools for teaching and reaching your students. The most important and effective tool for you to cultivate is connection and understanding. When your students see that you are meeting them where they are (rather than expecting them to meet you where you are), they will be more open and willing to trust you and let you into their world.