EFFECT OF YOGA ON ATTENTION LEVEL OF ORPHAN GIRLS WITH ADHD.

* Mrs. Lavanyashree Indudhar 1 , Mrs. Sahana Murthy 2 , Dr. Vijay Kumar BAMS 3 and Dr. R. Venkatram 4 . 1. MBA(Sales & Marketing), MSc (Yoga). 2. Msc (Clinical psychology), Assistant Professor-VYASA University, 3. MD (Yoga&rehabilitation), Msc (psychology). 4. PhD, Vice President VYASA. ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History


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Children living in the orphanage face unsafe environment which impacts their overall development because of malnutrition, lack of adequate space and lack of parental love( (Nikulina V, Widom et al, 2015) and also they have some neuropsychological difficulties which include inattention, hyperactivity and impulsivity ( Vadalà R et al, 2011).
Neuropsychiatry is concerned with disorders of attention, cognition and behaviour that arise from overt disorder in cerebral function, or from indirect effects of extra cerebral disease (Pitkanen MLS et al,2010).
ADHD is a neuropsychiatric disorder characterized by inattention, hyperactivity and impulsivity either alone or combination ( Krain AL et al, 2006) that commonly occurs among school-aged children, with approximately 5-8% of children being affected. Moreover, the symptoms of the disorder persist into adulthood in up to 60% of childhood cases, meaning that roughly 4% of adults suffer from ADHD ( Froehlich TE et al, 2007) and it is also associated with functional impairments across multiple academic and social domains and is commonly accompanied by a range of externalizing and internalizing disorders ( Vadalà R et al, 2011).
Yoga is a systematic body of knowledge concerned with the physiological and mental processes that change the physiology of the body through respiratory manipulation(breathing techniques), postures, and cognitive control(relaxation and meditation) ( Jensen PS, et al, 2004). Yoga interventions aim to help an individual to develop self-regulatory behaviors and monitoring techniques in which he or she can become more aware of his or her physical sensations and impulses ( Zipkin D et al, 1985).
ADHD is frequently co morbid with Oppositional Defiant Disorder, Conduct Disorder, anxiety disorders, and other behaviour disorders that contribute to its severity and persistence. Yogic practices have been found to improve emotional states and the symptoms of anxiety ( Jensen PS et al, 2004). Rauhala et al. (1990) and Telles et al.(1997) demonstrated that boys and girls suffering from social and emotional difficulties, anxiety, fear and aggressive behaviour benefited from practicing yoga ( Jensen PS et al, 2004).Yoga has been shown to be a viable alternative to the traditional treatment methods for ADHD, particularly with regard to improving the attention and concentration levels of students ( Petsche A et al, 2016 ).
However, the changes in the attention level of the orphan female children that characterise the efficacy of ADHD Yoga module have not been reported adequately. Hence, the present study was designed to assess the effect of yoga intervention on the attention level of the orphan female children. The main objective of the study was to assess the attention level of the orphan female children by using ADHD yoga module.

Materials and Methods:-
The subject for the study was obtained from Navajeevan and Rainbow home, Chamarejpet, Bengaluru.
Inclusion criteria:-1. Children between the age group of 6-10years. 2. Children who were willing to participate in yoga training. 3. Children who were diagnosed with ADHD. 4. Children who could understand the instruction given in Kannada and English.
Exclusion criteria:-1. Children who were not willing to participate yoga training. 2. Children who were not diagnosed with ADHD Design of the study:-A single group pre-post test research design was chosen for the study.

Informed consent:-
The informed consent was obtained from both the participants and head of the orphanage home before the commencement of the study. The study was approved by the Institutional Review Board (IRB) of S-VYASA University.
318 Intervention:-Yoga intervention was given for 8weeks, 1hour daily for 5days/week and one day of Krida yoga as a motivational factor. Yoga was taught by an expert yoga instructor. The initial assessment scales, parent and teacher, have two components: Symptoms assessment and Impairment in performance. On both parent and teacher initial scales, the symptoms assessment screens for symptoms that meet criteria for inattentive (item1-9) and hyperactive (item10-18) ADHD. Impairment in performance screens meet the criteria for Oppositional-Defiant Disorder (item19-26), Conduct Disorder(item 27-40) and Performance questions(item 48-54) for Parent assessment scale. In Teacher assessment scale Impairment in performance screens meet the criteria for Oppositional-Defiant/Conduct Disorder (item 19-28), Anxiety/Depression (item29-35) and performance questions (item36-43).
It follows closely the criteria set forth in DSM-IV (Diagnostic and Statistical Manual -IV).
The estimates of coefficient alpha ranged from 0.91 to 0.94 (Bard DE et al, 2013) Data analysis:-Statistical analysis of the data was performed by using SPSS version 20.0. The Shapiro Wilk test showed that the data was not normally distributed. Wilcoxon signed rank test was used to compare the means of the data before and after the yoga intervention.

Discussion:-
Yoga includes practices such as physical postures, regulated breathing, and meditation among other techniques. Krida yoga is also one of the techniques introducing in the schools which helps the kids in improving their concentration and attention level.
The practice of yoga is as beneficial as in itself, leading to improved health, emotional well-being, mental clarity, and joy in living (Hinduwebsite.com).
Yoga, as an ancient system of exercise, has a great potential to teach children to be mindful of factors that impact their health and improve their total well-being (Chen & Pauwels, 2014). The above studies depict that various unconventional intervention like Yoga has a great potential to teach children to be mindful of all the factors and result in improved their overall well being.
In the present study, yoga was used as an intervention to increase the attention level of the ADHD female children in orphanage. The major findings of this study are that yoga for eight week time period did result in a statist ically significant improvement in Attention level.
The NICHQ Vanderbilt Assessment Scale was used to assess the attention level, which has proven that yoga is helpful in improving the attention level along with the Oppositional-Defiant Disorder, Conduct Disorder and Anxiety/Depression among the female orphan children.
The intervention for this study was carried out on a group of 38 female children from the orphanage. Result depicts significant improvement in the attention level of the study group along with all the dependent variables. This could be attributed to the fact that the government school in general, has yoga in its curriculum which is conducted weekly once. The children of this age need much care for the overall wellbeing and for the society. Further research need to be carried out to understand the same.

Conclusion:-
The present study suggests that Yoga enhances the attention level among the orphan female children along with other variables, thus paving the way for their development of overall wellbeing. Additional well designed studies need to be conducted to develop awareness about the efficacy of yoga.