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Focusing on A.D.D.
By Fernando Pages Ruiz
Excerpts from The Yoga Journal December 2001
Adults and children living with Attention Deficit Disorder know the daily struggles of hyperactivity, social isolation, and drug side effects. But yoga may help control these symptoms as well as reduce long-term dependency on medication.
When 8-year old Clayton Petersen began taking yoga he had a hard time staying focused. He would assume a posture and then get distracted. His teacher, Kathleen Randolph, had to recapture his attention about once every minute, guiding him back to the center of the room and then into the next asana. She recalls these first lessons, staged within the confines of her small basement studio, were "like being inside a pinball machine." Clayton bounced from wall to wall, scattering his considerable energies throughout the studio in a way any parent of a hyperactive child with ADD would immediately recognize.
The clinical label ADD describes one of the most commonly diagnosed behavioral impairments of childhood, affecting an estimated 3 to 9% of the school-age population and 2% of adults. While most outgrow their hyperactivity in adolescence, about two-thirds carry other symptoms like distractibility into adulthood.
ADD's core symptoms include inattention, difficulty following directions, poor
control over impulses, excessive motor activity in many but not all cases, and difficulty conforming to social norms. But low intelligence is not among these, despite the fact that ADD can hamper learning. On the contrary, a great majority of those diagnosed enjoy above average intelligence. Bonnie Cramond, Ph.D., associate professor of education at the University of Georgia, authored a provocative paper comparing the symptoms of ADD with creativity. She found the children diagnosed with ADD share traits with such innovators as Robert Frost, Frank Lloyd Wright, and Leonardo Da Vinci.
Looking for a New Drug. There is no cure for ADD, so learning how to control the condition is the focus of treatments. And when it comes to ADD treatments, medication has long been accepted as the best medicine. Ritalin became the best known and most prescribed psychoactive drug for ADD children as well as the most scrutinized: by now hundreds of studies have backed its safety and effectiveness.
Drugs are what continue to make ADD treatments controversial. The greatest fallout's with any stimulant medication are lifelong dependency and possible side effects from such long term use. General use of ADD drugs can trigger some immediate reactions, such as loss of appetite, insomnia, weight loss, delayed puberty, irritability and the unmasking of latent tics. Usually these drugs stop working after six months, so medication alone won't help in the long term.
Today, more health-care professionals recommend a multidisciplinary, multi-modal approach to the treatment of ADD, which includes medication but also therapy and dietary changes as well as a host of mind-body approaches, such as biofeedback, neurofeedback, and yoga. These treatments work to help ADD sufferers learn how to control their symptoms and relieve both emotional and physical stress.
A study published in Biofeedfack and Self-Regulation revealed something interesting: The effects of EMG biofeedback closely resembles the type of neural relaxation work that occurs in yoga. Why is this important? Some experts now believe a combination of physical and mental discipline may be the best approach in treating ADD safely and effectively for the long term. According the John Ratey, MD, exercise that integrates both the body and mind engages the attention system more readily than meditation alone. Many studies have shown that the greatest yield of nerve growth factors happens when the body engages in complex movement patterns.
Tadasana (mountain pose) The primary standing posture, Tadasana balances the cerebral hemispheres and engenders confidence, body awareness, and concentration. Stand erect, with feet together. Spread the toes and straighten the legs without locking your knees. Extend the spine in both directions. Align the ears, shoulder, and hip joints directly over the ankles. Without constricting your breath, lightly engage the abdominal muscles. Face squarely forward, keeping your head level, side-to-side and front-to-back.
The Yoga Connection It's important to realize, though, that while yoga may help those with ADD, it is not a miracle worker. It requires time and discipline - concepts that can be difficult for those with ADD to master. In many cases, it takes a year or more for the effects of yoga to make any difference, while medication works in minutes. But the benefits of medication wear off along with the prescription. The effects of yoga - which include suppleness, poise, and better concentration - are much longer lasting: They develop gradually through a type of learning that transforms the entire person. There is no leaning or transformation involved in taking a pill.
Self-Awareness - People with ADD lack it,notoriously underreporting their own symptoms. The ADD brain, struggling with an overload of sensory stimuli, lacks the mental space for introspection. By emphasizing physiological self-perception, yoga strengthens self-awareness, which can represent the first step in self healing.
Structure - Many with ADD leave considerable creative potential unfulfilled because they can't seem to organize their creative energies. Therefore positive, life enhancing routines that establish order can be a very important part of ADD management. Systematic patterns of movement help organize the brain. A highly systematized approach, like Ashtanga Vinyasa Yoga, for example, provides consistent, reliable patterning along with the progressive challenges that ADD people require to sustain long-term interest in an activity.
Coordination and Physical Fitness - Children with ADD frequently miss out on physical education not because of physiological limitations but because their inability to "play by the rules", this tends to make them unpopular. Yoga provides physical fitness without the competition. The relative safety of yoga allows a child to explore his/her body and gain a sense of physical self-confidence, thus shedding the feeling of awkwardness they have suffered most of their life.
Tolasana (scales pose) Challenging poses like Tolasana improve focus. You can't lift and balance on your hands if you're distracted. Sit in the lotus pose. Place your hands next to your thighs, fingers spread apart. On an exhalation, press your body away from the floor, pulling the knees up toward your chest while supporting yourself on your hands. Dangle like a balanced scale for 10 - 30 seconds, lower yourself and change the crossing of your legs, repeat.
One Child's Class - It takes a special yoga teacher to work with ADD kids. "The teacher must have access to a variety of specialized techniques for dealing with anger, distractibility, and impulsivity, as well as a solid foundation in yoga, " says Sonia Sumar, author of Yoga for the Special Child. Sumar trains and certifies yoga teachers, like Kathleen Randolph, to work with developmentally challenged children. Randolph combines Sumar's special education approach with 30 years of hatha yoga practice in her classes with Clayton.
She works patiently, often on-on-one for several months, before integrating a child with ADD into a group setting, which includes two or three kids at the most. "These kids can be very intense," says Randolph. " A yoga teacher who works with children with ADD must develop patience, boundless energy, and a keen focus herself. These children need someone who can think faster and more creatively that they do; otherwise, they soon get bored."
Every Thursday, Clayton steps into Randolph's studio at The Yoga Center in Reno, Nevada. "Sometimes it's a struggle to get him there," says his mother, Nancy Petersen, "but in the end, he's always glad he went." Children with ADD struggle with transitions, so Randolph enlists a brief ritual, including candles and incense, to help Clayton shift into yoga mode. The structure of Clayton's classes generally follows the same basic pattern every week, with a few alternating poses chosen for variety.
The Yoga Center has a sunny room with large windows and mirrored walls, but Clayton's classes take place in the basement studio, where the ivory paint and sienna carpet keep distraction to a minimum, concentration comes more easily when the stimulation level remains low.
To encourage body awareness, Randolph begins by asking Clayton how tight his body feels and how much warm-up he needs. Depending on the answer, Randolph begins with Suryanamaskar (sun salutation) in either a 12 or 28 posture sequence. This cycle challenges Clayton's ability to focus and helps increase his attention span. Learning a complex series like sun salutation "recruits a lot of nerve cells in the prefrontal cortex," says Ratey. "The brain is like a muscle: When you strain it, your strengthen it."
Following sun salutation, Randolph leads Clayton through a succession of forward bends, lateral bends, triangle poses, and backbends. In addition to their psychological benefits, the yoga poses help children with ADD learn to coordinated their bodies in space, which is important since they tend to have higher injury rates than their peers. Similar to the work of a physical therapist, careful performed asanas engage alignment, balance, and coordination to train a child's sensory motor system.
Balancing poses like Vrksasana (tree pose) are Clayton's favorites, and he frequently practices them outside of class. "Kids gravitate toward play that involves balance," such as skateboards, pogo sticks, swings, merry-go-rounds and tumbling, because it excites what physiologists call the vestibular system. The inner ear's vestibular system allows you to judge your position in space and informs the brain to keep you upright.
Vrksanana (tree pose) Balancing poses build concentration. From Tadasana, bend you left knee and ;ace the left heel on you inner right thigh as high as possible toward the groin. Turn the left leg out to the left as far as possible, taking care not to rotate the top of your pelvis back. Balance on the right leg, stand erect without locking the knee, and raise both arms straight up. Stay in this position for 30 seconds, breathing deeply. Repeat on the other leg.
Randolph employs asanas like Tolasana and an exercise she's dubbed Roll Asana, in which the student rocks back and forth on the floor like a teeter-totter. Each new position in yoga provides a different plane of stimulation for neurological circuits of the vestibular system. Inverted positions like headstands and supported shoulderstands are especially beneficial because they also calm the nervous system and help curb hyperactivity while training the attention system. Near the end of class, Randolph guides Clayton through a series of relaxation poses to calm his breath, quiet his mind, and prepare for meditation. Meditation lasts approximately one minute - which can seem like a lifetime for ADD children.
After four months of yoga, Clayton can finally complete a half-hour yoga session, flowing from one posture to the next with minimum interruption. Though Clayton's significant progress in yoga has not yet translated into better concentration at school, it's difficult to imagine that the focus he has developed in yoga would be confined to the sticky mat. On at least one occasion, Clayton says he used techniques learned in mediation to train his attention during a mathematics exam. On another, his mother spotted him practicing Bakasana (crane pose) in the outfield during Little League - although, unfortunately, he wasn't paying much attention to the game.
His yoga teacher accepts this gradual pace as a fact of life. "Quieting the mind is a long haul for any of us," says Randolph. " It can be an epic journey for those with ADD, but they need it most." Talking with Clayton about his yoga practice, one gets the sense that he's found something important and personal at which he can excel - a refuge for his spirit and a tool for establishing harmony between his body and mind.
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