Occupational Therapist, yoga

Support individuals with limited language through yoga therapy

Limited language can be caused by a variety of disabilities—including developmental disabilities such as autism, Down syndrome, and cerebral palsy; various types of brain injuries such as traumatic brain injuries, strokes, and seizure disorders; or disorders such as PTSD, anxiety, and dementia. 

What do they all have in common? Each of these disabilities can activate the autonomic nervous system’s stress response when dealing with life’s daily challenges. Language use decreases in this state. Think of the last time you were upset about something. Was it difficult to find words? 

Yoga therapy can support individuals with limited language by down-regulating the stress response through using various limbs of yoga. Yoga is not just a physical practice: we can also use breathing practices (pranayama), meditation, yoga nidra, and mantras to support individuals with limited language.

How do we work with clients or loved ones when they can’t tell us what’s wrong?

When someone has limited language, look to the actions of the person and attempt to define what they mean. Then take steps to support them. 

Not long ago, I began working with a young adult—who I will call Daniel*—on the autism spectrum who does not use verbal communication. He uses an iPad with language software and typically states one word at a time. The professionals who had worked with Daniel previously told me he was very aggressive and they were not convinced that I could help. There was a history of trauma due to abuse from adults. Daniel presented with pulling of the face and stomach. There were medical complications. When his wisdom teeth were removed, pulling on the face stopped. Gastrointestinal concerns continue to include gastroesophageal reflux disease (GERD) and chronic constipation—hence pulling on the stomach. Understanding the meaning behind actions of individuals with limited language is valuable: actions offer clues as to where there might be pain or discomfort, informing us about ways to support them even if they can’t tell us what’s wrong. 

Use mantras to calm the stress response

Just because Daniel did not use verbal language, I did not assume he could not produce sounds. It took more than a month for minor aggressions to stop and I continue to remind Daniel that I am a safe human in his world—that I would not do anything to harm him. I assume that he understands everything I am saying. 

To work on the breath and calm the nervous system, I teach mantras: repetitions of sounds. With Daniel, I don’t expect a response when I ask him to repeat a mantra, and yet now there is an attempt to say “Om” and “Sh-an-t” in response to my “Om Shanti.” The mantra’s end sound (“tee”) is coming. I’ve found that Daniel is less likely to engage in aggressive behavior when he is focused on chanting. 

Recognize a heightened sense of arousal

I use a pulse oximeter to measure heart rate when students don’t have the language to tell me how they are feeling. When we first started working together, Daniel typically had a resting heart rate of about 100 bpm, which was above average for his demographic. Increased heart rate can be caused by pain, anger, fear, frustration, or just physical activity. Because processing verbal language is difficult even when the heart rate is within a normal range, our goal was to not elevate the heart rate even more. Therefore, we would start the yoga practice with relaxation, breathing, and postures that would not increase the heart rate. On average, Daniel’s heart rate now stays within the normal range of  70–80 bpm throughout the session.  

Trust in the process

In the Bhavagad Gita, an ancient yogic text, the first chapter discusses the main character Ajurna’s internal fight against the thoughts, beliefs, and routines that are no longer serving him. When we consider this through the lens of working with someone neurodivergent, we understand that routines and obsessions are comforting even when they are no longer serving the person.

Every action a person performs has a purpose for that person. One student I work with becomes obsessed with checking that doors are locked. To him, it serves a purpose; but it also interrupts the ability to complete a task or daily activities. Helping someone bring those rituals (which are often fear-based) to conscious awareness takes patience. I tell the caregivers that I work with that this is not a quick fix. I need their trust in the process. 

Stick with your personal practice 

Staying calm when the person in front of you is not can be a challenge. Keeping the mind calm in the chaos takes practice. I’ve found that I cannot connect with someone if I am feeling heightened stress or take the behaviors personally. I have to stay completely present in the moment. This is why I block out time in my calendar for a regular personal yoga and meditation practice. Practice on the mat supports my ability to be fully present with clients with limited language off the mat. As our practice evolves, so does our sense of empathy. This is why cultivating a regular self-care practice is crucial for supporting clients and loved ones with limited language.

Working with people that have limited language skills is challenging and not for everyone. I can’t “fix” the diagnosis. But if I can make the person as comfortable as possible in the body they were given, I have done my job. 

This post originally appeared on yogatherapy.health, published by the International Association of Yoga Therapists. Used with permission.

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