Monday, May 2, 2011

Attention Deficit Hyperactivity Disorder: How Yoga Can Improve the Lives of Children - by Grace B. Maskell


Introduction

Attention Deficit Hyperactivity Disorder, better known as ADHD, “is characterized by behavioral symptoms of inattention and hyperactivity–impulsivity” (Martel, Gremillion, Roberts, Eye and Nigg, 2010, pg. 816). Symptoms are most commonly treated with stimulants, antidepressants and antihypertensive medications. As someone who has been training to be an early childhood educator I have witnessed children who have been medicated to control the symptoms of ADHD.

Common physiological short-term side effects of stimulant medication are insomnia, appetite loss, stomach-aches, dizziness and daytime drowsiness, in addition to emotional and motor symptoms, such as mood lability and tics… In the last 10 years, a five-fold increase in methylphenidate prescription and consumption has been seen, with as many as 30–40% of children in some American schools receiving stimulant medication. (Harrison, 2004, pg. 480)

These statistics say that now more than ever alternative treatments need to be researched. For some children who are suffering from this disorder medication may not be the best or only answer. Yoga offers an alternative or a supplement treatment that may be beneficial for some children and although the research is still in its fetal stages, I think there appears to be some hope in its success.

Yoga

Yoga is a practice that has aspects for the body, the mind, and a person’s spirituality. It can calm the mind and the body and create an inner sense of peace. Involving concentration and physical movement, westernized yoga can appear to be the solution for a disorder that manifests as high-energy with a lack of focus. In schools children are required to sit still and apply themselves, unerringly, to the task at hand. Society expecting children to know how to concentrate instinctually is presumptuous and those who are unable tend to be punished. Yoga offers fluidly moving postures that call for low to high levels of concentration to make possible. Most children have the ability to move their bodies and this release of tension may very well increase their attention when they do have to sit still. The important part of a yoga class for children with a disorder like ADHD is to make the environment welcoming and accepting (White, 2009). There should be no pressure to succeed because yoga is about the success of the individual compared to that same person. If a child tries, they have already succeeded (White, 2009).

Study Number One

A study done by Jensen and Kenny in 2004 that involved nineteen boys with ADHD showed positive results. “The yoga sessions included respiratory, relaxation, postural, and concentration training” (Rojas and Chan, 2005, p. 127). Allowing children time to focus on their breathing is important because breath control is not typical in early childhood. The idea is that children will not understand that specialized breathing can be helpful to them. I have seen and participated in activities, however, that benefit the students even without their full understanding. Relaxation and concentration training is not an integral part of Western culture and lastly, the postures give the children an outlet for controlled movement instead of confining them to a desk.

Despite low power, varied attendance, and lack of determination of quality and duration of home practice, there was a reported reduction of mood swings, temper outbursts, and crying fits on the Conners Global Emotional Liability Index for the eleven boys in the intervention group compared to the eight boys in the control group. (White, 2009)

For the children to gain some form of control over their actions and emotions even when the study did not have highly motivated participants shows that yoga has its benefits. The fact that the control group differed from the nineteen boys involved also increases the validity of the study. The benefits are not only for the boys’ physical and mental health, but will increase their emotional stability. A portion of the issues surrounding ADHD has to do with social ramifications because peers, parents and teachers may find it difficult and confusing to witness the reactions of children suffering from ADHD. This can create a divide between the child with the disorder and the people that they need to remain balanced and happy. According to this study yoga helps to decrease ‘mood swings’ and ‘temper outbursts’ and the boys involved may find that their relationships with others improve, which will then lead to an overall increase in quality of life.

The limitations of the study are the small number of participants. This can be problematic because such a small group represents merely a fraction of the entire population. Another limitation is that the study worked with only boys. This cuts down the representation to a half of that fraction. I believe, however, that although small, the positive results of this study can only increase the chances for yoga as beneficial to be taken seriously and larger studies to be done.

Study Number Two

Besides the postural part of yoga practice, other aspects of yoga are rising in popularity. A study done in Australia delved into meditation as part of family therapy for children with ADHD. Forty-four families participated in a six week program during which they were required to attend bi-weekly meditation sessions. Out of the forty-eight children, ages ranging from four to twelve, thirty-one were on medication for the disorder. For half of the program, the children and adults were separated during the on-site meditation sessions although continuation of the meditation practice was encouraged at home. After these first three weeks, the families were transitioned back together (Walters, 2006, p.57).

The results were very positive: core symptoms of ADHD were improved, parent ratings of hyperactivity and impulsivity were reduced, children reported feeling calmer, measures of anxiety and low confidence were reduced, and social abilities improved. There was less parent-child conflict, approaches to schoolwork improved, sleep improved, and the children reported better ability to concentrate at school. (p. 58)

These results show improvement in both the children’s and parent’s lives. I believe that this is very positive for the evolution of yoga and ADHD because children cannot advocate for themselves and if parents are skeptical of yoga then their children may never get the chance to try it. By involving the parents, the study gave the adults in control evidence of the benefits. They were able to see the improvement in their children and in themselves and have a clear understanding of the source of that improvement. This is backed up in Linda Harrison (2004) writes in her article Sahaja Yoga Meditation as a Family Treatment Programme for Children with Attention Deficit-Hyperactivity Disorder that “[t]he most promising interventions are those that work with the whole family system and use medication in association with nonmedical interventions” (pg. 481).

There were limitations to this study, yet, just like the small study done by Jensen and Kenny it opens the door to possibility that yoga may turn out to be extremely helpful in the treating of certain kinds of disorders. A gateway study, such as this, can only improve the chances of more studies with more people and more definitive results.

Further Evidence

In a randomized control trial thirty children ranging from seven to eighteen years old were treated with either relaxation or massage therapy for twenty minutes twice a week for one month (Powell, 2008). The results showed that the “massage group children rated themselves as happier, and their teachers (who were blind to the group assignment of each child) rated them as less hyperactive, more attentive and their emotional indulgent scores were improved” (pg. 404). This further demonstrates that alternative methods of treatment that do not involve drugs can be beneficial to ADHD sufferers.

This is not a new concept, and thirty years ago, in 1981, Redfering and Bowman conducted a study that involved the style of yoga that we are more familiar with today in the United States. It was a “yoga program that incorporated meditation [and ultimately] decreased children's hyperactivity, inattention, and anxiety, and improved their peer relationships and sleep patterns” (Peck, 2005, pg. 416). Learning that studies like this have been going on for at least thirty years is both disheartening and promising. Even after all this time, yoga is yet to be viewed with the same respect as medication but the inquiries have not ceased and every study is a step forward.

Scientific Benefits

Yoga combines controlled patterns of movement and breathing techniques that calm the thoughts and increase circulation. This in turn affects the central and autonomic nervous system, which regulates heartbeat and respiration. The autonomic nervous system is made up of two separate systems that do very different things. The sympathetic system releases adrenaline while the parasympathetic system counteracts this by conserving energy. Basically, yoga increases the activity of the parasympathetic system and shuts down the sympathetic system resulting in a far more relaxed body and mind (Peck, Kehle, Bray and Theodore, 2005). Laura Santangelo White (2009) also writes about more biological factors in her Yoga for Children article:

Yoga may also influence neurotransmitter function. For example, a significant 27% increase in brain yaminobutyric acid (GABA) levels that may affect mood was found in 8 experienced adult yoga practitioners compared with 11 non- practicing controls. Decreased GABA is associated with depression and anxiety. (p. 280)

Both the increase in activity of the parasympathetic system and possible heightened levels of GABA provide a scientific platform to validate the practice of yoga to those who need it. It also proves that the benefits of yoga definitely go beyond physical and possibly spiritual advantages.

Conclusion

I believe that Attention Deficit Hyperactivity Disorder is an issue that needs to be addressed with more than just medication. Because yoga is a form of treatment that does not involve pills the children practicing can either not be on medication or they can continue to take it without negative repercussions. Although it may not benefit everyone the same way, yoga that involves postures, meditation and breathing exercises could help some children regain some control over their lives. Yoga for children should not be isolated to children with ADHD. According to Melissa Fedosh (2010) yoga can improve bodily awareness, health, mobility and help with socialization. With so many benefits, I find it hard to believe that simplified practices based on yoga would have nothing but positive affects on children in and out of school.

Bibliography and Works Cited

Fedosh, M. C. (2010). Yoga with a Twist: A Perfect Fit with OT. Alternative & Complementary Therapies, 16(5), 272-276. doi:10.1089/act.2010.16501.

Harrison, L. J., Manocha, R., & Rubia, K. (2004). Sahaja Yoga Meditation as a Family Treatment Programme for Children with Attention Deficit-Hyperactivity Disorder. Clinical Child Psychology & Psychiatry, 9(4), 479-497. doi:10.1177/1359104504046155.

Martel, M. M., Gremillion, M., Roberts, B., von Eye, A., & Nigg, J. T. (2010). The structure of childhood disruptive behaviors. Psychological Assessment, 22(4), 816-826. doi:10.1037/a0020975.

Peck, H. L., Kehle, T. J., Bray, M. A., & Theodore, L. A. (2005). Yoga as an Intervention for Children With Attention Problems. School Psychology Review, 34(3), 415-424. Retrieved from EBSCOhost.

Powell L, Gilchrist M, Stapley J. (2008) A journey of self-discovery: an intervention involving massage, yoga and relaxation for children with emotional and behavioural difficulties attending primary schools. European Journal of Special Needs Education [serial online]. 23(4):403-412. Available from: Academic Search Premier, Ipswich, MA.

Rojas N, Chan E. (2005). Old and new controversies in the alternative treatment of attention-deficit hyperactivity disorder. Mental Retardation & Developmental Disabilities Research Reviews [serial online]. 11(2):116-130. Available from: Academic Search Premier, Ipswich, MA.

Walters J. (2006)Child Psychology Selection. Child & Adolescent Mental Health [serial online]. 11(1):57-59. Available from: Academic Search Premier, Ipswich, MA.

White L. Yoga for Children. (2009) Pediatric Nursing [serial online]. 35(5):277-295. Available from: Academic Search Premier, Ipswich, MA.

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