Conflict of Interest. Patricia West-Low has no conflicts. Nechama Karman has no conflicts. Ashley Connolly has no conflicts

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2 Conflict of Interest Patricia West-Low has no conflicts Nechama Karman has no conflicts Ashley Connolly has no conflicts

3 Objectives 1. Identify the documented benefits of yoga and mindfulness practices for adults and children. 2. Discuss the literature and basic science support for the benefits of yoga and mindfulness for children with special needs 3. Demonstrate appropriate practice modifications for varied populations 4. Recognize opportunities for translating yoga and mindfulness practices into treatment.

4 What is Yoga? - a Hindu theistic philosophy teaching the suppression of all activity of body, mind, and will in order that the self may realize its distinction from them and attain liberation a system of exercises for attaining bodily or mental control and well-being ~ Merriam Webster 2016 A set of mind body practices aimed at decreasing stress and improving physical health Postures Breathing Practices Meditation

5 Why Yoga for Kids with Special Needs? Physical fitness Muscle strength and endurance Cardiopulmonary endurance Flexibility Stress release Stress-inattention connection

6 Why Yoga for Kids with Special Needs? Emotional and behavioral regulation Limbic system versus PFC Inclusive recreation Versatililty Yoga and mindfulness practices can be done anywhere!

7 Yoga and the Evidence Musculoskeletal Effects Improved flexibility and muscular strength and muscular endurance in school age asthmatics ~Chen et al (2009) Decreased DOMS ~Boyle et al (2004) Improved inspiratory mm strength in school aged children after 3 months of yoga training ~D'Souza, & Avadhany (2014)

8 Yoga and The Evidence Cardiopulmonary Effects Improved pulmonary function in asthmatics after 6 months of yoga training Madanmohan et al (2004) -improved pulmonary function in boys with DMD after 10 months of yoga breathing exercises ~Rodrigues et al (2014) increased in FVC, FEV1, PEFR, FEV1/FVC, MIP, and MEP after 3 months of yoga training in school aged children ~D'Souza, & Avadhany (2014)

9 Yoga and the Evidence Cardiopulmonary Effects Decreased HR, decreased diastolic & systolic pressures and increased heart rate variability in teen agers after 6 weeks of training in final resting pose. ~Madanmohan & Bhavanani (2004)013 Decreased diastolic blood pressure after 6 months of slow sun salutes compared to fast sun salutes. In year olds ~Madanmohan & Bhavanani (2013)

10 Yoga and the Evidence Gastrointestinal Effects Decreased functional disability, decreased avoidance and anxiety in adolescents with IBS ~Kuttener et al (2006) Improvements in parasympathetic drive with left nostril breathing ~Raghuraj, P. & Telles, S. (2008)

11 Yoga and the Evidence Neurological Effects in Children Improvements in Coordination ~Telles et al (2001) Improvements in spatial and verbal memory ~Manjunath & Telles (2001) Improved visual and auditory reaction time in cognitively impaired adolescents ~Bhavananai et al (2012)

12 Yoga and the Evidence Behavioral/Emotional Effects In Children Improvements in behavior and decreased self stimulatory behaviors in children with autism ~Rosenblatt et al (2011) Decreased sx of ADHD and improved academic performance ~Mehta et al (2012) Improved teacher reports of behavior, improved ability to be in control of behavior and manage anger in school aged children after 10 weeks of classroom based yoga ~Butzer et al (2014)

13 Yoga and the Evidence Hormonal -Significantly decreased cortisol production in 2 nd and 3 rd graders after 10 weeks of yoga. Butzer et al (2014) -Decreased cortisol production, decreased reported stress after one 90 minute session of yoga ~West et al (2004) Sensory Regulatory Promotion of self regulation and decrease in sensory overresponsiveness ~Mollo, Schaff and Benevides (2008)

14 What is Mindfulness? Mindfulness is a technique based on Zen Buddhist meditation Defined as paying attention, on purpose, to the present moment, without judgment. ~Jon Kabat Zinn The practitioner is encouraged to attend to external stimuli as well as internal stimuli

15 Why Mindfulness for Kids? Parents are looking for an alternative to medication Mindfulness training may be less expensive than medication Increased stressors in contemporary life

16 Mindfulness Practices and the Evidence Mindfulness training for kids with Autism Self reported improvement in QOL Self reported decrease in rumination Parent reported improvement in social responsiveness and social cognition Parent reported improvement in social motivation Parent reported decrease in preoccupations ~de Bruin et al (2014)

17 Mindfulness Practices and the Evidence Improved responses to stress after 12 weeks of mindfulness training in urban youth Mendelson et al (2014) Increased self-esteem and self-regulation as well as improved appraisal of stress in school age girls after mindful yoga. After 8 weeks of mindful yoga practices. White (2012)

18 Evidence to Practice Modifying Yoga and Meditation Practices for Children with Special Needs Most, if not all practices can be modified for children with special needs, using: Props Pictures Visual cues Verbal cues Physical assistance

19 Accessing Calm by Way of the Breath Ventilatory Strategies A ventilatory strategy is the intentional pairing of inhalation & exhalation patterns with movement in order to enhance the overall motor task. ~Dr. Mary Massery In yoga practice, proper use of ventilatory strategies is more important than the posture itself

20 Accessing Calm by Way of the Breath Thoracic spine Flexion Extension Auditory Cues Use of voice Use of words Visual Cues Eyes up versus eves down Visual regard for body versus surroundings Sound

21 Accessing Calm by Way of the Breath Other considerations Environmental Cues Lighting Manual Cues What are your hands conveying? Alerting, activating, inhibiting

22 Modifying Meditation for Children with Special Needs Positioning Sitting Lying down Walking Use objects for focus Rocks, shells, food Body Scan Allow them to touch body parts as you name them Breath awareness Seeing the breath Feeling the breath Hearing the breath

23 Modifying Meditation for Children with Special Needs Moments of Mindfulness Washing hands Taking off shoes Before or after meals Mantra based practices I am I can Let go love peace

24 Case Studies Using Yoga and Meditation practices for: ~children with mild physical and/or cognitive challenges ~children with moderate physical and/or cognitive challenges ~children with severe physical and/or cognitive challenges

25 Using Yoga and Mindfulness Practices for a Child with Mild Physical and/or Cognitive Challenges -use postures and breathing to enhance and improve the child s present abilities -choose postures that are challenging but accessible -choose combinations of postures that mimic functions the child hopes to improve -Use self imposed tactile or visual cues to bring mindfulness to given body parts

26 Using Yoga and Mindfulness Practices for a Child with Moderate Physical and/or Cognitive Challenges Empower the child to realize that the postures are accessible to them Use supports to allow the child to access postures with ease Speak to what the child is feeling in each pose, or during every day activities

27 Using Yoga And Mindfulness Practices for a Child with Severe Physical and/or Cognitive Challenges Have a plan but keep it flexible Aim to find the relaxation response rather than increase ROM Pay close attention to the environment, including your voice, the lighting, and sounds in the environment

Using Yoga and Mindfulness in Classroom / Counseling

Using Yoga and Mindfulness in Classroom / Counseling Zsuzsa Kiraly, PhD, RYT Hagin School Consultation Centers Fordham University, Graduate School of Education New York / NY / zkiraly@fordham.edu Overview