Mindfulness in Individuals with Autism Spectrum Disorder: a Systematic Review and Narrative Analysis

  • Renee L. Cachia
  • Angelika Anderson
  • Dennis W. Moore
Review Paper

Abstract

Individuals with autism spectrum disorder (ASD) are more susceptible to stress, anxiety and depression than typically developing individuals. Previous research suggests that mindfulness is effective in reducing a myriad of psychological health problems in a wide variety of populations. This review systematically investigated the efficacy of mindfulness interventions in reducing stress, anxiety, depression, rumination and aggression and increasing positive affect and psychological well-being in individuals with ASD. Six studies met inclusion criteria; each mindfulness program curriculum and process of delivery were analysed. A quality assessment rated three studies as weak, one as adequate and two as strong in research design strength. Results indicate that mindfulness training leads to a reduction in anxiety and thought problems in children in addition to increased social responsiveness, broad psychological well-being and reduced aggression in adolescents. Mindfulness training reduced anxiety, depression and rumination whilst increasing positive affect in adults with high-functioning ASD. The studies included a range of participants, methodologies and measures corroborating the robustness of mindfulness interventions resulting in positive psychological changes in individuals with ASD. Future research should address the methodological limitations of the studies in this review in order to develop superior mindfulness interventions that are to be considered evidence-based practice aimed at enhancing the quality of life of individuals with ASD.

Keywords

Autism Behavioural problems Mindfulness Stress 

References

References marked with an asterisk indicate studies included in the Systematic Review

  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC.Google Scholar
  2. Biegel, G. M., Brown, K. W., Shapiro, S. L., & Schubert, C. M. (2009). Mindfulness-based stress reduction for the treatment of adolescent psychiatric outpatients: a randomized clinical trial. Journal of Consulting and Clinical Psychology, 77, 855–866. doi:10.1037/a0016241.CrossRefPubMedGoogle Scholar
  3. Breslin, F. C., Zack, M., & McMain, S. (2002). An information‐processing analysis of mindfulness: implications for relapse prevention in the treatment of substance abuse. Clinical Psychology: Science and Practice, 9, 275–299. doi:10.1093/clipsy.9.3.275.Google Scholar
  4. Burke, C. A. (2010). Mindfulness-based approaches with children and adolescents: a preliminary review of current research in an emergent field. Journal of Child and Family Studies, 19, 133–144. doi:10.1007/s10826-009-9282-x.CrossRefGoogle Scholar
  5. Cachia, R. L., Anderson, A., & Moore, D. W. (2016). Mindfulness, stress and well-being in parents of children with autism spectrum disorder: a systematic review. Journal of Child and Family Studies, 25, 1–14.CrossRefGoogle Scholar
  6. Corbett, B. A., Mendoza, S., Abdullah, M., Wegelin, J. A., & Levine, S. (2006). Cortisol circadian rhythms and response to stress in children with autism. Psychoneuroendocrinology, 31, 59–68. doi:10.1016/j.psyneuen.2005.05.011.CrossRefPubMedGoogle Scholar
  7. de Bruin, E. I., Ferdinand, R. F., Meester, S., de Nijs, P. F., & Verheij, F. (2007). High rates of psychiatric co-morbidity in PDD-NOS. Journal of Autism and Developmental Disorders, 37, 877–886. doi:10.1007/s10803-006-0215-x.CrossRefPubMedGoogle Scholar
  8. *de Bruin, E. I., Blom, R., Smit, F. M., van Steensel, F. J., & Bögels, S. M. (2014). MYmind: mindfulness training for youngsters with autism spectrum disorders and their parents. Autism, 1–9. Advance Online Publication. doi: 10.1177/1362361314553279.
  9. Dumas, J. E. (2005). Mindfulness-based parent training: strategies to lessen the grip of automaticity in families with disruptive children. Journal of Clinical Child and Adolescent Psychology, 34, 779–791. doi:10.1207/s15374424jccp3404_20.CrossRefPubMedGoogle Scholar
  10. Ghaziuddin, M., & Greden, J. (1998). Depression in children with autism/pervasive developmental disorders: a case–control family history study. Journal of Autism and Developmental Disorders, 28, 111–115. doi:10.1023/a:1026036514719.CrossRefPubMedGoogle Scholar
  11. Gillott, A., & Standen, P. J. (2007). Levels of anxiety and sources of stress in adults with autism. Journal of Intellectual Disabilities, 11, 359–370. doi:10.1177/1744629507083585.CrossRefPubMedGoogle Scholar
  12. Gillott, A., Furniss, F., & Walter, A. (2001). Anxiety in high-functioning children with autism. Autism, 5, 277–286. doi:10.1177/1362361301005003005.CrossRefPubMedGoogle Scholar
  13. Groden, J., Cautela, J., Prince, S., & Berryman, J. (1994). The impact of stress and anxiety on individuals with autism and developmental disabilities. In E. Schopler & G. B. Mesibov (Eds.), Behavioral issues in autism (pp. 177–194). US: Springer.CrossRefGoogle Scholar
  14. Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits: a meta-analysis. Journal of Psychosomatic Research, 57, 35–43. doi:10.1016/s0022-3999(03)00573-7.CrossRefPubMedGoogle Scholar
  15. *Hwang, Y. S., Kearney, P., Klieve, H., Lang, W., & Roberts, J. (2015). Cultivating mind: mindfulness interventions for children with autism spectrum disorder and problem behaviors, and their mothers. Journal of Child and Family Studies, 24, 2093–3106. doi: 10.1007/s10826-015-0114-x.
  16. Kabat-Zinn, J. (1990). Full catastrophe living: using the wisdom of your mind and body to face stress, pain, and illness. New York: Delacorte.Google Scholar
  17. Kabat-Zinn, J. (1994). Wherever you go, there you are: mindfulness meditation in everyday life. New York: Hyperion.Google Scholar
  18. Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217–250. doi:10.1097/00005053-197105000-00012.Google Scholar
  19. Keng, S. L., Smoski, M. J., & Robins, C. J. (2011). Effects of mindfulness on psychological health: a review of empirical studies. Clinical Psychology Review, 31, 1041–1056. doi:10.1016/j.cpr.2011.04.006.CrossRefPubMedPubMedCentralGoogle Scholar
  20. Khaddouma, A., Gordon, K. C., & Bolden, J. (2015). Mindful M&M’s mindfulness and parent training for a preschool child with disruptive behavior disorder. Clinical Case Studies, 14, 407–421. doi:10.1177/1534650115570708.CrossRefGoogle Scholar
  21. *Kiep, M., Spek, A. A., & Hoeben, L. (2015). Mindfulness-based therapy in adults with an autism spectrum disorder: do treatment effects last?. Mindfulness, 6, 637–644.Google Scholar
  22. Kutz, I., Borysenko, J. Z., & Benson, H. (1985). Meditation and psychotherapy: a rationale for the integration of dynamic psychotherapy, the relaxation response, and mindfulness meditation. The American Journal of Psychiatry, 142, 1–8. doi:10.1176/ajp.142.1.1.CrossRefPubMedGoogle Scholar
  23. Marks, I. M. (1987). Fears, phobias and rituals. New York: Oxford University Press.Google Scholar
  24. Matson, J. L., & Kozlowski, A. M. (2011). The increasing prevalence of autism spectrum disorders. Research in Autism Spectrum Disorders, 5, 418–425. doi:10.1016/j.rasd.2010.06.004.CrossRefGoogle Scholar
  25. Matson, J. L., & Love, S. R. (1990). A comparison of parent-reported fear for autistic and nonhandicapped age-matched children and youth. Journal of Intellectual and Developmental Disability, 16, 349–357. doi:10.1080/07263869000034161.CrossRefGoogle Scholar
  26. Mercer, S. L., DeVinney, B. J., Fine, L. J., Green, L. W., & Dougherty, D. (2007). Study designs for effectiveness and translation research: identifying trade-offs. American Journal of Preventive Medicine, 33, 139–154. doi:10.1016/j.amepre.2007.04.005.CrossRefPubMedGoogle Scholar
  27. Reichow, B., Volkmar, F. R., & Cicchetti, D. V. (2008). Development of the evaluative method for evaluating and determining evidence-based practices in autism. Journal of Autism and Developmental Disorders, 38, 1311–1319. doi:10.1007/s10803-007-0517-7.CrossRefPubMedGoogle Scholar
  28. Schall, C. M., & McDonough, J. T. (2010). Autism spectrum disorders in adolescence and early adulthood: characteristics and issues. Journal of Vocational Rehabilitation, 32, 81–88. doi:10.3233/JVR-2010-0503.Google Scholar
  29. Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: a new approach to relapse prevention. New York: Guilford.Google Scholar
  30. Singh, N. N., Wahler, R. G., Adkins, A. D., Myers, R. E., & Mindfulness Research Group. (2003). Soles of the feet: a mindfulness-based self-control intervention for aggression by an individual with mild mental retardation and mental illness. Research in Developmental Disabilities, 24, 58–169. doi:10.1016/s0891-4222(03)00026-x.CrossRefGoogle Scholar
  31. Singh, N. N., Lancioni, G. E., Joy, S. D. S., Winton, A. S., Sabaawi, M., Wahler, R. G., & Singh, J. (2007). Adolescents with conduct disorder can be mindful of their aggressive behavior. Journal of Emotional and Behavioral Disorders, 15, 56–63. doi:10.1177/10634266070150010601.CrossRefGoogle Scholar
  32. Singh, N. N., Lancioni, G. E., Singh, A. N., Winton, A. S., Singh, J., McAleavey, K. M., & Adkins, A. D. (2008a). A mindfulness-based health wellness program for an adolescent with Prader-Willi syndrome. Behavior Modification, 32, 167–181. doi:10.1177/0145445507308582.CrossRefPubMedGoogle Scholar
  33. Singh, N. N., Singh, J., Adkins, A. D., Singh, A. N., & Winton, A. S. W. (2008b). A trainer’s manual for meditation on the Soles of the Feet: a mindful method for anger management. Midlothian: ONE Publications.Google Scholar
  34. *Singh, N. N., Lancioni, G. E., Manikam, R., Winton, A. S., Singh, A. N., Singh, J., & Singh, A. D. (2011). A mindfulness-based strategy for self-management of aggressive behavior in adolescents with autism. Research in Autism Spectrum Disorders, 5, 1153–1158. doi: 10.1016/j.rasd.2010.12.012.
  35. *Singh, N. N., Lancioni, G. E., Singh, A. D., Winton, A. S., Singh, A. N., & Singh, J. (2011). Adolescents with Asperger syndrome can use a mindfulness-based strategy to control their aggressive behavior. Research in Autism Spectrum Disorders, 5, 1103–1109. doi: 10.1016/j.rasd.2010.12.006.
  36. Spain, D., Sin, J., Chalder, T., Murphy, D., & Happe, F. (2015). Cognitive behavior therapy for adults with autism spectrum disorders and psychiatric co-morbidity: a review. Research in Autism Spectrum Disorders, 9, 151–162. doi:10.1016/j.rasd.2014.10.019.CrossRefGoogle Scholar
  37. *Spek, A. A., van Ham, N. C., & Nyklíček, I. (2013). Mindfulness-based therapy in adults with an autism spectrum disorder: a randomized controlled trial. Research in Developmental Disabilities, 34, 246–253. doi: 10.1016/j.ridd.2012.08.009.
  38. White, S. W., Oswald, D., Ollendick, T., & Scahill, L. (2009). Anxiety in children and adolescents with autism spectrum disorders. Clinical Psychology Review, 29, 216–229. doi:10.1016/j.cpr.2009.01.003.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Renee L. Cachia
    • 1
  • Angelika Anderson
    • 1
  • Dennis W. Moore
    • 1
  1. 1.Faculty of EducationMonash UniversityClaytonAustralia

Personalised recommendations