(80 - 01) The Effects of Yoga Practices on Self-Regulation in Children with Autism Spectrum Disorder: A Systematic Review

Abstract: A systematic review was performed using PubMed and PsycInfo databases. Search terms were yoga and autism as test searches revealed that use of these two terms were most effective in retrieving the broadest set of relevant articles. Abstract screening, quality assessment, and data extraction reliability was performed. Children with autism have been shown to have difficulty with self-regulation and with regulation of emotions, specifically. Research has demonstrated that yoga practices are effective in increasing self-regulation skills in this population, which has important clinical implications.

Summary of Presentation :

Background: Worldwide, about 1 in 100 children are diagnosed with autism spectrum disorder or ASD (World Health Organization, 2022). Children with ASD struggle to develop self-regulation abilities (including emotional self-regulation capacities) which often results in irritability, anxiety, aggression, impulsivity, and even self-injury (Mazefsky et al., 2013). Yoga has been proven effective in increasing self-regulation skills. It is referred to as a “mind-body” practice, meaning that mental awareness of the physical body state is integrated with calming exercises (Menezes et al., 2015). Yoga is categorized as a “mindfulness practice” because it emphasizes awareness of thoughts, reactions, and emotions and regulation of these through focused attention (Riggs et al., 2014). When yoga is practiced, this area of executive functioning (i.e., focused attention) may be enhanced, leading to increased self-regulation abilities.

Objective: The primary objective of this systematic review was to identify and compare all quantitative research articles that have described the effectiveness of mindfulness practices on self-regulation in children with ASD. A secondary aim was to identify and compare research articles that contained qualitative assessments of the effectiveness of mindfulness practices on self-regulation in these children.

Methods: A systematic review was performed using PubMed and PsycInfo databases. Search terms were limited to yoga and autism as test searches revealed that use of these two terms was most effective in retrieving the broadest set of relevant articles. A total of 72 articles were retrieved. To determine whether the articles were on-topic and therefore to be included in this review, screening of all titles and abstracts was performed using a syllabus containing inclusion and exclusion criteria. Using this syllabus, the first author removed 60 total articles (including 11 identified as duplicates between databases). No additional articles were identified by means of a hand search of reference lists of on-topic systematic reviews and meta-analyses. This resulted in 12 unique results: PubMed, 9 and PsycINFO, 3. Screening reliability of 25% of the titles and abstracts (selected at random from each database) was performed by a co-author. In the case of disagreement, keep/reject decisions were agreed upon following discussion between authors. A completed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram of records will be included on this poster. Reliability procedures were performed at each stage of the protocol, in accord with Cochrane standards.

Findings: Children with autism experience difficulties with self-regulation that result in negative emotional and behavioral outcomes. (Mazefsky et al., 2013). Difficulties with self-regulation are directly tied to executive functioning deficits in focused attention and inhibitory control (Demetriou et al., 2019; Macoun et al., 2020). It has been shown that executive functions related to self-regulation can be improved (Diamond, 2013; as cited in Tanksale et al., 2020).
Research has demonstrated that yoga practices are effective in enhancing these executive functions, suggesting important clinical implications for those with ASD. Primary results from this systematic review revealed that yoga interventions for children with ASD result in decreased symptoms of anxiety and aggression and increased attentional capacities (Rosenblatt et al., 2011). Yoga practice was correlated with improved self-monitoring of thoughts and emotions, as well as willingness to reflect on and analyze emotions, which are essential skills for adequate self-regulation (including emotional regulation; Tanksale et al., 2020). Litchke et al. (2018) demonstrated an increase in emotional control in children with ASD following a period of yoga practice. Additionally, participants expressed more emotion overall and experienced corresponding enhanced mood states (Litchke et al., 2018). Findings suggest that yoga and mindfulness practices increase a critical area of executive functioning (i.e., focused attention) that support self-regulation skills in children with autism. Further research is needed to more identify more specific protocols for this population and to determine optimal frequency this therapeutic approach.