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  • Study: For Children With Autism, Yoga Improves Motor Skills, May Buffer 'Cascading' Effects

    In this review: Creative Yoga Intervention Improves Motor and Imitation Skills of Children With Autism Spectrum Disorder
    (PTJ, November 2019 )

    The message
    There's mounting evidence that motor impairments are particularly prevalent among children with autism spectrum disorder (ASD), but research on how to address these impairments is scant. Authors of a new study believe they may have hit upon an approach: physical therapist-led "creative yoga," which they say improved both gross motor skills and the ability to imitate movement patterns among children with ASD. Those gains, they believe, could play a role in improving social communication and behavioral abilities.

    The study
    Researchers divided 24 children with ASD, ages 5 to 13, into 2 groups: the first group received an 8-week "academic intervention" that focused on reading, arts, crafts, and other "sedentary activities usually practiced within school settings"; the second group participated in an 8-week yoga intervention, led by a physical therapist (PT), that "was made fun and creative through the use of songs, stories, games, and props." The children were assessed for motor skills using the Bruininks-Oseretsky Test of Motor Performance-2nd Edition (BOT-2) at baseline and after completion of the programs, and tested for imitation skills at 3 points (baseline, midpoint, completion) using a researcher-created instrument. Sessions were conducted 4 times a week for 8 weeks, divided into 2 expert-led sessions lasting 40 to 45 minutes per week and 2 parent-led sessions lasting 20 to 25 minutes per week.

    Participants included in the study had a confirmed ASD diagnosis and showed social communication delays. All scored at average or below on the BOT-2 at baseline, and the groups were matched for baseline mobility scores as well as demographic, IQ, and other characteristics.

    APTA members Maninderjit Kaur, PT, and Anjana Bhat, PT, coauthored the study.

    Findings

    • After 8 weeks, the yoga group improved subtest scores for gross motor performance and bilateral coordination, whereas the academic group showed no statistically significant improvements in these areas.
    • The academic group improved scores related to fine motor precision and integration, but not so the yoga group, which recorded no statistically relevant changes.
    • Imitation skills improved for both groups, but at different points: the yoga group began showing improvements in imitation skills by the midpoint assessment, while the academic group's improvements didn't register significant change until the last assessment.
    • Among child-specific factors such as age, autism severity, and IQ, the only element that seemed to correlate to improvement in scores was IQ: in the academic group, children with higher IQs tended to achieve larger individual gains in imitation skills, while in the yoga program, children with lower IQs were the cohort that achieved larger individual gains in imitation (specifically, pose imitation).

    Why it matters
    A growing body of evidence suggests that children with ASD also tend to experience motor impairments of balance, postural control, gait, and coordination, as well as worse dexterity skills than do children with typical development (TD). In fact, authors write, researchers have estimated that children with ASD typically display motor development that is consistent with children half their age. Deficits in the ability to imitate demonstrated behaviors or movements are also associated with ASD.

    The concern, according to authors, is the possibility that these impairments could have "cascading effects on the social, communication, and cognitive development of children with ASD."

    "Given the evidence for motor impairments and their broader impact on social communication development," authors write, "there is a clear need to devise interventions that could offer opportunities to improve both motor skills and their use in developing social communication skills in children with ASD."

    More from the study
    Authors were surprised that the yoga group didn't report any improvements in balance, but they speculate that the unchanged BOT-2 scores may be related to the test's reliance on a mix of static and movement-based activities, as opposed to the yoga classes' focus solely on static balance. Additionally, they write, the BOT-2's balance subtest includes assessments with and without visual input, whereas the yoga classes consistently used visual input to help children hold poses.

    As for the academic group's improvements in fine motor skills, the effect sizes were relatively small, but researchers believe that may be due to the fact that most of the children were already engaged in similar activities in their school settings, creating a "smaller scope for improvement."

    Keep in mind…
    The study population was small and heterogenous, and the training duration was relatively short. Additionally, researchers weren't able to assess the long-term effects of the classes.

    Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.  

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