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Mindfulness and the Autism Spectrum

Donald McCown, MAMS, MSS, LSW
July 28, 2008

It may be more than coincidence that our cultural awareness of both the therapeutic potential of mindfulness and the prevalence of developmental disorders on the autism spectrum is increasing simultaneously.

In 1993, Bill Moyer's television special "Healing and the Mind" brought the power of Jon Kabat-Zinn's Mindfulness-Based Stress Reduction (MBSR) program to the attention of the general public. MBSR is now taught in hundreds of hospitals across the country and around the world. It has become a part of mainstream medicine, with a growing evidence base. And it has inspired development of applications of mindfulness for a wide range of medical and psychological conditions and populations.

In 1994, Asperger's syndrome was added as an official diagnosis to the American Psychiatric Association's "bible" of disorders, the DSM-IV. Awareness of, and identification of those with autism spectrum disorders (ASD) increased substantially. For decades the incidence rate of autism was considered to be 4 or 5 in 10,000; the latest estimate from the CDC is 1 in 150. As people with ASD and "neurotypicals" collaborate to create a world that accommodates everyone, we are learning what is helpful. Mindfulness is being shown to help us all.

What is mindfulness?
If you've read this far, I'm assuming you have some understanding of ASD. Mindfulness is simple, in a way. Jon Kabat-Zinn defines it as "paying attention in a particular way: on purpose, in the present moment, and non-judgmentally." It is cultivated by formal practices of meditation and by informal practice in daily life. As a result, you show up for what's happening with and in you, become more accepting of what cannot be changed, and more aware of what can. It's a path that leads to kindness towards yourself and compassion towards others.

Mindfulness is helping individuals on the spectrum.
Perhaps the best way to describe what mindfulness does for individuals with ASD is to listen to their first-hand accounts. Two individuals with Asperger's syndrome have written eloquently about the value of mindfulness in changing their lives. From Chris Mitchell of the UK, whose book "Asperger's Syndrome and Mindfulness" is due out in December of 2008:

"The abilities of my mind, I have begun to realize are those that I often experienced difficulty with relating to my Asperger's Syndrome, including flexibility of thought and being able to recognize reasoning for actions of others, as well as the roots of my own states of mind from anger to excitement. This, I feel has increased my awareness of myself to the extent that I can recognize the roots of low self-esteem I often experience."
And from A.J. Mahari, diagnosed with AS at age 40, from her book "Asperger's Syndrome in Adulthood from the Inside Out":
"Mindfulness practice will benefit not only the Aspie but also will enable the family member or loved one.to put a stop to being swept away by the Aspie's stress, anxiety and/or meltdown.. Mindfulness renders everyone associated with or who has AS to be free to be who he/she is, even in the face of all the incumbent challenges of Asperger's Syndrome."

The professional literature also reflects the value of mindfulness-based interventions with individuals who are more limited in their functioning in the world than Mr. Mitchell and Ms. Mahari. Both one-to-one and group mindfulness instruction have been shown to reduce aggressive behavior, improve social skills, and increase happiness with such folks.

Mindfulness is helping caregivers.
As Ms. Mahari suggests, family members and others who care are also challenged by ASD. A number of studies have shown that the whole system changes when the folks who care for those with ASD are trained in mindfulness. Parents have reported increased satisfaction with their parenting abilities, more social interactions with their children, and lower parenting stress. Outside caregivers have shown considerably enhanced ability to manage aggressive behavior and were observed to be "more responsive, patient, creative and adaptable in giving care."

A study just published showed that when adolescents with ASD, Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, and Conduct Disorder and their parents were trained in mindfulness - through MBSR classes - both groups improved. The adolescents reported "substantial improvement on personal goals, internalizing and externalizing complaints, attention problems, happiness, and mindful awareness," and showed better performance on a test of sustained attention. For their part, parents reported that they improved on their own goals, as well as noting improvements in their adolescent's attention and impulsivity problems.

Mindfulness training and psychotherapy.
Training in mindfulness can be a central part of psychotherapy for individuals on the autism spectrum, particularly as they struggle with the anxiety and depression that are so often a product of meeting the neurotypical world, with its vast potential for misunderstanding and disrespect. And, of course, it can be a feature of family therapy, to create a more mindful, kinder, compassionate environment in which everyone can realize the possibilities of the present moment and their lives in the future.

If you'd like a bibliography on mindfulness and ASD, please send a request via the contact form.

Donald McCown, MAMS, MSS, LSW is a Staff Therapist in CFR's Paoli and University City offices. He can be reached at 215-382-6680 ext. 4239.

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