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Autism spectrum disorder (ASD) is a complex neurodevelopment disorder with estimated prevalence rate of 61.9/10,000 globally, 1% in the United Kingdom, 1.5% in the United States and it has been estimated that more than 2 million people may be affected with ASD in India (Chauhan et al., 2019). The core characteristics of ASD are impairments in cognition, communication, social-interaction, restricted and repetitive or stereotyped behaviours. The multisystem fragility is prone to proprioceptive and motor coordination dysfunction and thus it causes trauma and chronic pain. The inter relation between musculoskeletal disabilities and hypermobility-related disorders is disregarded in the ongoing system of specialization of care by various medical fields although both conditions usually occur simultaneously more often than for this to be a coincidence (Baeza-Velasco et al., 2018).
It is mentioned in Thirumandiram, a classical tamil text on yoga, “Maadha udharam malamigil mandanaam, maadha udharam jalamigil moongaiyaam, maadha udharam irandokkil kannillai, maadha udharatthil vanda kuzhavikke” (Thirumandiram, 465), which means, during intercourse if the female has heavy bowels then this leads to impaired cognition in the infant; if her bladder is full then this leads to speech disorders in the infant; if her bowels and bladder are both heavy then this leads to blindness in the infant (Natarajan, 2002). This may be due to chromosomal alterations and neurodevelopmental plasticity in the offspring (Gluckman et al., 2009). Heavy bowels or bladder which can be attributed to dysfunction in elimination process is mainly due to the psychopathology of stress. Several subclinical physiological changes with respect to maternal stress have been described, including alterations in immune, brain, cardiovascular, autonomic, endocrine, and metabolic functions, such as changes in fetal heart rate, insulin resistance, increased concentrations of immunoglobulin E in cord blood and changes in hypothalamic–pituitary–adrenal (HPA) axis function (Monk et al., 2011; Entringer et al., 2008; Lin et al., 2004). Variations in HPA axis activity have also been linked with other diseases, such as mental disorders, respiratory diseases, diseases of the skin, and infectious diseases (Buske-Kirschbaum et al., 2010; Priftis et al., 2009).
The primary purpose of this study was to measure the effectiveness and feasibility of yoga therapy, both quantitatively through handgrip strength (HGS) and visual reaction time (VRT), and qualitatively through high functioning Childhood Autism Rating Scale, second edition (CARS2-HF) in children with ASD. Foley (2018) found that yoga along with complementary alternative medicine (CAM) increases attention, awareness, self-control and decreases anxiety and self-stimulatory actions. It has been shown that yogic techniques such as jattis, kriyas, asanas and pranayama help improve physiological functions, loco-motor skills, psycho-motor coordination, attention and sleep in children with ASD (Ramanathan & Bhavanani, 2018; Ramanathan et al., 2019).