By Megan-Lynette Richmond, MS, CCC-SLP and Kimberly Mielke, MSOT, OTR/L
Editor’s note: This article focuses on children; but, yoga works for adults, too!
I started using yoga to enhance speech and language therapy sessions while working with one of my favorite patients. She was a five-year-old girl with Down syndrome, who required oxygen every evening, had a g-tube, and received speech and language therapy two times a week. She also saw an occupational therapist to work on fine motor skills and self-regulation.
While I enjoyed working with this patient, therapy was not always fun for us. In our first session, she threw all of my therapy materials on the floor. She verbally and physically refused to work with materials I had chosen to use to increase her communication.
When her OT sessions decreased, we had established a routine: 10 minutes at the table, three minutes in the ball pit, 10 minutes at the table, two minutes on the therapy swing. I discovered that by incorporating movement into her speech and language therapy and not demanding she sit at a table for 30 minutes, her communication skills improved tremendously! She inspired me to take a week-long workshop to learn how to use yoga (movement) in therapy to increase communication, self-regulation and fine motor and gross motor skills. Therapy sessions with this patient blossomed even more after starting yoga!
Children with developmental, genetic, or neurological disorders all have unique therapeutic needs. While there is no global therapeutic treatment for all children with special needs, using components of yoga to enhance therapeutic intervention may benefit all children. With correct instruction, yoga can improve communication, fine motor and gross motor skills.
Yoga began over 3,000 years ago and the word is Sanskrit, meaning “union.” Yoga principles combine relaxation, physical postures, and imagery ? allowing almost all ages and ability levels to benefit from it. Rehabilitation therapists have a long history of using yoga poses to enhance therapy. Many reports highlight the therapeutic benefits of yoga for children with Down syndrome, autism spectrum disorder/pervasive developmental delay, cerebral palsy, attention deficit hyperactivity disorder and sensory processing disorders.
So, how is yoga beneficial? Literature reveals numerous physiological, neurological, and/or emotional gains for each pose. Specifically, there are significant benefits that target using yoga with individuals with DS.
Yoga teaches an individual to breathe effectively and may improve respiratory functioning. Breathing effectively increases the amount of oxygen moving to the brain, therefore improving concentration, learning and vocal support (speech and voice), as well as encouraging deep relaxation to calm and self-regulate. Additionally, effective breathing enhances postural stability, as the same muscle groups are necessary for both activities.
Yoga also improves strength and encourages body awareness. As a child practices a posture, it increases muscle strength, range of motion and flexibility. Yoga uses slow and fluid movements, which brings awareness to the muscles we use when practicing different postures. When a child feels a muscle working while stretching and holding postures, it reinforces awareness of the body and what it is doing. Additionally, many yoga poses require a child to use muscles in the mid-range rather than fully bent or straight. This teaches a child how to grade the force of movements. It is important that you never push a child into a pose, but allow the child to be in control of the motion/amount of stretch. (Caution: Practicing poses with children who have DS should be under the observation and advisement of a physician and/or supervision of a trained professional or therapist.)
Additionally, yoga can help a child learn to concentrate. Using guided imagery leads a child to focus on various situations or thoughts. A therapist, parent or teacher can choose how long a child should focus/attend to a topic by telling the child to close the eyes and visualize the story until it is finished. A child’s attention span can increase over time ? improving a child’s ability to learn
Yoga may improve a child’s vocabulary. Many yoga poses are named after animals, nature, actions, furniture, shapes and body parts. Doing poses that represent objects may give a child a physical representation or an alternative method to comprehend or use different words (in addition to books and flash cards). Strong vocabulary skills help individuals with DS achieve educational and functional communication goals.
So, how can you incorporate yoga into your child’s daily activities? Play simple yoga games. For example, have a child pretend to be a tree in a forest. (While standing, lift one foot up and rest the heel right below the knee ? on the fleshy part of the leg, with the bent knee pointed out to the side.) Have her hold Tree pose with both hands over her head or on her hips. Work on balance and concentration to see if she can hold the pose. If a child has physical limitations, have another child or adult help support her in the pose by holding on to the child’s trunk (stomach area). Another child or adult may help hold the child’s leg up in place. Don’t push children to hold poses too long. Always give a break between poses. Use imagery to pretend the wind is blowing, and encourage slow fluid movements like bending and swaying.
Do poses during stories by using children’s books with animals in them to practice and combine poses. For example, when reading about a farm, every time you talk about a cow, have the child do Cow pose (have the child come down on all fours, encouraging him to press palms deep into the floor and keep his back flat). If a story talks about a cat, have the child do Cat pose (while the child is on all fours with knees and palms pressed into the ground, have the child arch his back up “like a Halloween cat”). Want to increase speech and language skills? Have the child imitate the sounds the animal makes while in each pose. These stories and poses keep the child engaged in the story and help him learn the pose and about the animal.
Use imagery before naptime or bedtime. Have the child lie on the floor (preferably on an exercise or yoga mat) on her back, with palms facing up. Instruct the child to close her eyes. Begin to tell the child to focus on a scene such as the beach. Encourage deep breathing by telling the child to let her tummy rise and fall like the ocean’s tides. You can place a small, light object on the child’s belly so she can watch the object go up and down each time she breathes in and out. Use descriptive words to paint a picture about what the child sees, hears, and feels while at the beach.
Back to my favorite patient — we started each therapy session with stretching and breathing to slow music. If we were working on understanding and using vocabulary about transportation, we would get into a pose that formed an airplane or drive our car (sitting in a pose as if we were driving a car). If we were learning vocabulary about fruit, we may stand in Tree pose (balancing on one foot while extending our arms up and out like branches). If balance was a problem, we worked as a team as I held her foot up. Then we talked about what kind of fruit was on her tree (apples, oranges, etc.), did she like it, why or why not. We even worked on her feeding aversion when we tried applesauce as a new food. We worked on sequencing skills when we talked about how we picked the apples, boiled them, and then mashed them up to make applesauce. It was exciting to see how far and how much we could work on by just starting with a song that focused on one pose or one language concept. I loved how just doing yoga poses – activities that she enjoyed – led this patient to take turns in conversations, stay on topic, form sentences about the vocabulary we learned and led her to make five to six word sentences on one breath. Yoga poses were a great addition to our therapy sessions to help achieve communication and motor goals.