A 7-year-old male (pseudonym Tom) presented with Apert and Asperger's Syndrome exhibiting the characteristics of difficulty following directions, lack of emotions, irritability, shyness, and poor coordination. In addition, his unusual mannerisms of looking around frequently impaired his engagement with yoga program. Looking around was characterized by his gazing off in the distance or up at ceiling. Tom attended 8, 45 min multisensory enriched yoga, twice a week, during a 4-week camp for children with ASD. The study was approved by Institutional Review Board of local university, and parental consent was obtained during the camp enrolment. Throughout the entire day camp, Tom was partnered with a college counselor to assist with any needs. Thirty-one poses were performed in a small group of five males. Multisensory enrichment aspect included singing of familiar children's songs, counting, rhythmic gesture chanting, and a personalized yoga bin containing yoga colored picture binder, cut outs of hands and feet, feather, pinwheel, small flashlight, bean bag animal, and a large towel. Each multisensory feature was goal oriented based on his diagnosis. For example, the binder contained illustrations and instructions of each pose in sequential order to compliment all learning styles; a pinwheel and feather were used during the breathing exercises to promote calmness and focus; repetitive rhythmic chants and clapping were added to increase vocalization and engagement; singing the familiar children's songs aided time on task and improving language; towel placed over the body in ragdoll to promote tranquility; a miniature flashlight was used during call-repeat mantra to emphasize "light within" to focus on self-awareness. Yoga pose samples are presented in Table 1.
The pre- and post-test measures of behavior, social skills, and physical pose performance were obtained from Sparks Target Behavior Checklist (STBC; measured 59 on task and interactive behaviors using a dichotomous scale: Yes = 1 and no = 0), Treatment and Research Institute for ASD Social Skills Assessment (TRIAD; measured 18 problematic behaviors on a Likert scale from 0 = never to 4 = consistent), Yoga Pose Rating Scale (YPRS; rated 31 poses on Likert scale: 1 = rarely to 5 = mastery), and field notes (FN; rated four multidimensional quality of life domains). All four forms were completed by trained yoga instructor based on a video recording of yoga. Finally, Tom's parent and school behavior specialist were asked to comment on any changes noted at the end of sessions.
Results of YPRS showed the overall total score change from 80 = emerging (partial body engagement) to 115 = consistently (whole body engagement) indicating he held poses more accurately for a longer period of time. TRIAD depicted improvement in the total score from 19 to 7, indicating less disruptive behaviors specifically in shyness and unusual mannerism of looking around. STBC illustrated the elimination of seven out of eight behaviors in the area of staying on task; all that remained was the behavior of looking around. The results of FN indicated that Tom initially was disengaged, shy, rejected help, frequently looked around, and was unexpressive emotionally. He was able to transition to seeking help appropriately, expressing emotions such as laughter and smiling, spending less time looking around, and taking on a leadership role for last yoga session. By a report from behavior school specialist and parent, he also improved his timely utilization of lion's breath and super brain as a means to self-regulate during stressful situations outside the yoga.