Adaptive Yoga for Classroom and Clinic

Yoga can be used as a treatment modality and enhancer to meet many goals within a hospital, clinic or school setting. Adaptive yoga is a process by which we might alter a pose to the capability of the clients, with props or assistance. Whether we are trying to bend forward to pull socks up and choose to practice a seated version of forward bend, gain balance with Tree pose against a wall, or reduce anxiety with a hand mudra, yoga can be applied at any age to assist in learning daily living skills.

As an OT in the schools, I often suggested Mountain pose to teachers for children with sensory processing issues and with poor line-up skills. Teachers would often use it for the entire class.

Line-Up Cues: Mountain Pose and Grounding Pole
•  Ask the children to come to stand.
•  Invoke the image of a mountain: still, strong, even and steady.
•  Have the children stand in a natural pose, placing their arms at their sides, and feel their feet melt into the earth while standing straight.
•  Imagine a grounding pole going from their feet down to the center of the earth holding them still and steady.

In a school for autistic and profoundly handicapped children, a physical therapist was successful having a session using the following protocol:
•  Secure a quiet space familiar to the student. (In this case, all the other students left the classroom for another activity, and the therapist worked at the circle time rug near where the student sat, so as not to disturb him.)
•  Play quiet music (can use Pandora Radio on the iPad).
•  Use a gentle soft voice and touch to communicate your presence.
•  Use the same set routine of postures.
•  Start with a seated pose on the floor, legs extended.
•  The therapist sits facing the student with legs extended also.
•  Therapist places her legs on the outside of the child’s legs.
•  Bending at the waist, the therapist pulls the student’s arms gently creating a gentle rocking motion backward and forward.
•  Facilitate the following sequence of poses for the child: Happy Puppy (quadruped and rock hips laterally), Cat and Cow, Child’s pose, Tree pose with assistance, Happy baby, Conclude with guided imagery meditation

Patty is a bright teen who has cerebral palsy. She wears a scoliosis jacket, is tube fed, is non-verbal and uses an eye gaze-driven computer to communicate. One day, during my session, she was very uncomfortable and couldn’t settle down. She was rejecting her fluid through the tube, and so we tried breathing together. She also liked it when I talked to her about anatomy, and put her hand on my bones and then placed her hand on her bones. We tapped the sternum and I asked her to focus on the front of the spine and the digestive tract. I took her hand and put it on my belly so she could feel me breathing. Then I put her hand on her own belly. Slowly she was able to lengthen her breath, relax, and accept the fluids.

The Attunement Lifestyle Profile (a self-processing tool) is an integrative or holistic group of questions to assist families or clients in assessing what might be needed to arrive at a healthy lifestyle in mind, body and spirit. The Profile can be helpful for any family and for those coping with the stress of raising a child who has trauma, sensory processing issues, autism or any special needs or just the typical stress of raising children. The profile is designed so that families can assess what strengths they have already, or have the potential for, and what areas need strengthening. The profile also offers in the questions some yogic and mindfulness principles that parents might not have realized could help them to reduce stress. Examples such as eating a meal together to encourage communication, taking time for silence and contemplation and everyone taking a break from electronics in the name of family time, can be vitally helpful for quality of life.

Lucy is a 12-year-old girl who lost the use of both her legs. She uses a Hoyer lift for transitions, a motorized chair, and has good cognitive and verbal language skills. Lucy had spent the first 8 years of her life as neuro-typical and had an unfortunate situation that led to her disabled state. She could easily make her needs known and had conversations that a typical 12-year-old would have, although her articulation was slurred. At times it was difficult for others to understand what she wanted which was frustrating for her. She had one functional upper extremity, but the other affected arm didn’t function as a consistent stabilizer. Lucy was more mature than her age due to her unusual transition to disability. She was observed helping other children in the house reach for things with her functional extremity and she clearly enjoyed that role.

During her occupational therapy intake for her group home, after covering the basic OT assessment areas, we discussed the profile with a staff member present. We looked together at the PowerPoint version of the Attunement Profile adapting it to the community and family milieu of the group home setting. The profile is available through a certification course and ebook: The Attunement Lifestyle Profile: Cultivating Balance taught by the author.

Lucy was able to see the pictures that accompany the questions. She looked carefully at each slide and took in the emotionality of the visuals. She was very interested in the visual slides and questions such as, “do you have family meetings?” “do you go on educational outings?” and, “do you have friends to laugh with?”

The house assistant supervisor and I gleaned many of Lucy’s important feelings from the use of the profile. The conversation that ensued allowed us to problem solve in the moment. We identified possible options to enhance quality of life that the program already had in place but hadn’t yet considered for Lucy. The profile shed light on Lucy’s feelings at this time, and illuminated the subtleties of her lifestyle preferences. It was a true game changer and empowered Lucy and encouraged the staff to deliver quality services that were already available but not yet implemented for her.