Yoga for the Special Child
Reprinted with the permission of Jeffrey Volk|
The following case history chronicles the progress of a child with Down Syndrome. It includes her parents' observations, Sonia Sumar's personal evaluation, and comments by the child's doctor.
My husband and I married two years ago, and the birth of Mariana introduced us to an entirely new world. The delivery was easy, but a long time seemed to pass before Mariana was returned to our room in the hospital. We experienced many positive feelings during those first hours of her existence; she was our first daughter.
The next day we were informed by a group of doctors that Mariana showed many of the characteristics of Down Syndrome, and they had also detected a murmur in her heart. Our first reaction was feelings of doubt, uncertainty, and sadness. Then we resigned ourselves to the situation and decided to search for appropriate information and treatment.
Soon after, we heard through friends about the work of Sonia Sumar in Belo Horizonte. We found it interesting that yoga was being taught to special children, and when Mariana was a month old, we enrolled her in a program of yoga therapy at Sonia's Center. We also started taking lessons there, which piqued Mariana's interest in yoga and helped her become more receptive to her own practice. The asanas, relaxation techniques, breathing exercises, and chants that Sonia taught us, changed our family environment, which is now more harmonious and calm.
The physical characteristics of Down Syndrome present at birth diminished as time went by. Now Mariana has an expressive face, a bright look, and an ever-present smile, showing, in her own way, that she is a happy child. She cats well and sleeps soundly. At no time has she had a serious problem with her health.
She is now thirteen months old and is crawling all over the house. She walks with assistance and likes to ride in the car and visit shopping centers. For her age, she is affectionate and clever, learns quickly, and has a fundamental grasp of how and why things work. Most important, the heart murmur disappeared.
According to her pediatrician, Mariana's development is nearly normal. We believe that her remarkable progress is the result of Sonia's program of yoga therapy. Sonia's work is done with love: a love that encompasses her fellow human beings just as they are, with all their limitations. She receives everybody with open arms and an open heart. Her work is serious, beautiful, and filled with sincere emotion. Knowing her has been a great help to us in our daily lives.
Finally, we can say that Mariana has taught us many things, made us meet very special people, and put us in touch with a whole new world. That is why we are so proud of her and satisfied with her accomplishments.
Born by Caesarean section on September 29, 1990 in Belo Horizonte, Mariana is the older of two sisters in the Tolentino family. I met Mariana and her parents, Juarez and Eliana, in November of the same year, when she was one month old. After an evaluation of Mariana and a consultation with her parents, she and both parents enrolled in my yoga school and began taking classes there. Each of the parents participated in two 1½- hour adult classes per week, and Mariana attended two 30-minute yoga therapy sessions per week.
My work with Mariana started out rather slowly, due to the child's congenital heart problem. According to her pediatrician, the murmur required corrective surgery, so I had to be especially careful not to stress Mariana's heart in any of the postures or exercises. One basic precautionary measure was to provide her with rest periods whenever she appeared to be tiring from a particular exercise. Another measure, even more important, was not to place her in any of the inverted postures. Any movement that raised both her lower trunk and legs above the chest, thereby increasing the pressure within the heart, might aggravate her problem.
My approach was to strengthen Mariana's heart and circulatory system through a series of preparatory exercises and postures that were totally safe for her to practice. As she gradually improved, I could increase the duration of these exercises and add new exercises with a greater degree of difficulty. The objective was to stimulate her development by helping her expand her limits, yet never going beyond these limits at any one time. This type of therapeutic work is painstaking and delicate, requiring sensitivity on the part of the yoga therapist and a thorough attunement with the child.
Besides a heart problem (which occurs in 40% of all cases with Down Syndrome), Mariana presented many of the characteristic features of a Down child, including hypotonia (lack of muscle tone), a flattened nose and midface, low placement of the ears, and slightly slanted eyes with epicanthal folds of skin at the inner corners. In order to help her overcome the hypotonia and prepare her body for the practice of asanas, I incorporated many muscle strengthening exercises in her yoga routine. Key areas to strengthen were the muscles of her neck, arms, feet, legs, and abdomen, as well as the joints in her shoulders and hips. These exercises included leg and arm lifts, and movements that flexed the shoulders, hips, knees, ankles, and joints of the feet. Each session ended with a ten-minute period of deep relaxation, giving Mariana's body an opportunity to absorb the benefits of all the previous exercises.
Of course, in the beginning Mariana was totally passive during our yoga sessions. I had to perform all the movements with her body, like a puppeteer who pulls the strings attached to the different parts of a marionette in order to make it move. However, she improved noticeably with each yoga session, and was soon participating in all the exercises.
Right from the very start, Mariana's development took an even, uphill course. She was always calm, understanding, and receptive. I believe her steady progress was due, in great part, to her parents' active participation in yoga, our consultations together, and their belief that Mariana would improve.
In the consultations, I explained the various stages of development that Mariana would have to pass through, and how to set up and conduct their daughter's yoga classes at home. I always set aside time for Juarez and Eliana to ask questions, and sometimes I questioned them, especially if I had noticed a recent change in Mariana's behavior. The end result of having this open communication between Mariana's parents and myself was that they were able to create a more supportive home environment, which included weekly yoga classes taught by one of the parents.
At Mariana's monthly medical examination, her pediatrician was always surprised by the vast improvement in her since the previous checkup. This encouraged me to experiment with more advanced exercises and postures, which I always monitored closely to make sure that her response was positive (see photos on page 48a). However, I never included these advanced exercises in the routines which I designed for Mariana at home.
At eight months, Mariana was able to sit on her own; at nine months, to crawl; and at ten months, to stand alone. With the achievement of each new milestone, I was able to add new poses to her yoga routine. These included the Spinal Twist and variations of the Forward-bending Pose (all of which begin from a sitting position), and several standing poses (which begin with the child on her feet). The standing poses develop equilibrium and strengthen the muscles of the legs and lower back. They are an important aid in preparing a young child to walk (see photos of standing poses on page 48b). During this same period, I also introduced one of the yogic breathing exercises, the Cleansing Breath. However, as is the case with many children her age, Mariana just watched me and smiled each time I demonstrated this exercise to her.
In Mariana's eleventh month her pediatrician examined her and was unable to detect any sign of a heart murmur. This was a great triumph for all of us, and a great relief to know that Mariana no longer needed surgery. Now I could finally begin to work with the inverted postures. These poses are especially beneficial for any child with a nervous system dysfunction because of their powerful effect on the sense organs, brain, and upper endocrine glands1 (see Headstand and Shoulder Stand photos on page 48b).
As she continued to progress in her development, I often tested Mariana by placing her in a standing position, back against the wall, and coaxing her to come to me. I knew that she possessed the necessary strength and balance to walk because she was now performing several of the standing poses without any assistance on my part. Then one day, during a yoga session, I placed her against the wall and she took three wobbly steps. This was in her sixteenth month. After the session, when I saw Eliana, I told her that she was in store for a pleasant surprise. That same evening she called me back with the good news that Mariana had taken her first steps at home.
In Mariana's eighteenth month, I decided to place her in a group yoga class with other children. She had already mastered all the basic poses, performing most of them without any assistance on my part. Now it was time for her to move on to a more independent type of practice, which would help her to develop greater communication and socialization skills, in addition to refining and expanding her practice of asanas, pranayama, and deep relaxation.
Today, Mariana is a healthy, happy, well-adjusted child of six. She attends regular classes at a public school and is doing well in all her subjects. Her diction is excellent, and she socializes well with her schoolmates and friends. She rides a bicycle, dresses and cares for herself, and loves to dance. She has a good relationship with her younger sister, and participates in all the activities and social events that her school friends do. Despite the fact that Mariana discontinued formal yoga classes at the age of four (due to her parents relocating to another neighborhood), it is clear that her three years of practice have held her in good stead.
Little Mariana Tolentino has been my patient since the gestation period. Down Syndrome was verified at delivery by her hypotonia and other characteristic features. In her second month, she began a program of yoga therapy, with accompanying stimulatory exercises provided by her parents at home.
During her first year of life, Mariana showed no sign of a delay in her development. However, what surprised us most, along with the strengthening of her muscles, were some physical alterations, such as the shifting of her ears from a low to normal position in her head. Another physical alteration, even more noteworthy, was the complete disappearance of her heart murmur, which we had believed could only be corrected through surgery.