© 2017 Lorelei Woerner, OTR/L, C-IAYT, RYT500

Integrative Wellness Therapy TM for Attention Deficit Disorders, With Hyperactivity

Body – Breath – Brain

Approximately 11% of children 4 to 17 years of age (6.4 billion) and about 4% of

American adults are diagnosed with ADHD, according to 2011 CDC statistics. Symptoms

of inattention, impulsivity and hyperactivity interfere with daily functioning, flourishing

and sattva. The lifestyle creates a great allostatic load and stimulates stress and cortisol

release, the sequelae of which has wide-spread negative impact on the body. These

characteristics also inhibit efficient Executive Functioning.

Six clusters of EF that are associated with ADD/ADHD:

1. Activation: organizing tasks/materials, estimating time, getting started, planning

2. Focus: focusing, sustaining focus, shifting focus between tasks, vigilance

3. Effort: regulating alertness, sustaining effort and processing speed.

4. Emotion: managing frustration and modulating emotions.

5. Memory: using working memory and accessing recall.

6. Action: monitoring/regulating actions. Regulation of affect-motivation-arousal

7. Inhibition: behavioral analysis and synthesis

______________________________________________________________

Lorelei Woerner, OTR/L, C-IAYT, RYT500 -- Owner and Founder Integrative Wellness TherapyTM

Registered and Licensed Occupational Therapist Specializing in intensive, holistic treatment for neurological, pediatric, transition & mental health

Certified Yoga Ed Instructor Yoga training lineage: Krishnamacharya/Desikachar

Certified in Sensory Integration and Praxis Test Extensive training in Hippotherapy

Certified in Myofascial Release and Reiki Clinical Instructor for USC and Northern Arizona University

© 2017 Lorelei Woerner, OTR/L, C-IAYT, RYT500

Emotions and the Autonomic Nervous System

ANS distinguishes between positive and negative emotions (as well as between

different negative emotions)

Intense emotions (fear, frustration, anxiety, anger) result in heart rhythms that are

spiked and jagged. Neural connections between heart and brain, result in intense

emotions negatively affecting the ability to think clearly.

These internal networks affect the way you think and perceive reality.

Brake

Parasympathetic NS

Learning mode

Thrive

“Rest and digest”

Gas Pedal

Sympathetic NS

Protective mode

Survive

“Fight or flight”

Effects of Stress

On Mood

Anxiety

Restlessness

Lack of motivation or focus

Irritability or anger

Sadness or depression

On Behavior

Can’t think straight

Overeating or undereating

Angry outbursts

Substance abuse

Social withdrawal

45

Alert Relaxed

Mundane

Conservative

Shift attention

Protective

Emotions

Exploratory

Focused

Receptive

N

© 2017 Lorelei Woerner, OTR/L, C-IAYT, RYT500

The ADHD-Hormone Paradox

Dopamine--Plays a role in reward-motivated behaviors and memory

formation. Boosts focus and concentration. Increases with physical

movement and meditation.

Norepinephrine--Linked with arousal and attentiveness. Increases with stress.

Stimulants (drugs or movement)

increase dopamine and norepinephrine

• People with ADHD are hyperactive or take risks because dopamine helps

them to focus, to think clearly.

• Dopamine is implicated in impulsive behaviors, and research shows ADHD

associated with higher dopamine levels.

• We need to help stimulate first to allow for focus. Once the need to elevate

dopamine levels is removed, the person with ADHD can focus and

concentrate without having to engage in hyperactive, adventurous, or risk

taking behavior

• Western model is stimulant medications. Yoga therapy is to begin with

brmhana.

• Lack of stimulation is a key to causing hyperactivity and distraction

The paradox about people with ADHD is that

they need the dopamine to feel calm.

© 2017 Lorelei Woerner, OTR/L, C-IAYT, RYT500

OT PRINCIPLES TO CONSIDER Sensory Processing:

1. Tactile 2. Proprioceptive 3. Vestibular 4. Visual 5. Auditory 6. Olfactory 7. Gustatory

Consider rhythms when facilitating input

Intensity (high intensity is alerting, lower is more calming)

Frequency (more frequent the input, the more alerting and intensive)

Duration (greater duration is more alerting and intensive)

Complexity (Higher complexity and overlapping of sensory input is

more alerting. A singular input is more calming)

Rhythm (Arrythmical input is more alerting, rhythmical more calming)

Novelty (Novel input is more alerting, familiar tends to be more calming

– depending on the type and person’s sensitivity to the input)

Praxis: the neurological process by which cognition directs motor action. It

is a very complex activity involving many parts of the brain -- frontal lobe,

parietal lobe, thalamus and cerebellum. 3 Parts: Ideation, Motor Planning,

and to a lesser degree, Execution

Bilateral/Cross Midline Movements: The Corpus Callosum is involved in

communication between the hemispheres, eye movement and vision,

balancing arousal and attention, sensory registration, cognition and

processing speed.

© 2017 Lorelei Woerner, OTR/L, C-IAYT, RYT500

Yoga Therapy “Modalities”

Asana

Mudras

Pranayama

Sound Singing bowls, Sound baths

Chant/sing/mantra/Humming

Listen to a metronome

Svadhaya – Self Awareness, Mindfulness

Exteroceptors – stimuli from outside the body

Proprioceptors – stimuli from muscles, joints and fascia as to position

and movement of the body

Interoceptors – stimuli from within the body (viscera, blood vessels,

hormone responses, etc)

Reflective Thinking and thought shifting

Bhavana – Visualization

Students scored significantly higher on standardized tests over a 3

year period relative to control groups by using relaxation and

imagery exercises. As they visualized themselves as relaxed,

successful students, they learned more quickly and retained more

information.” (Maureen Murdock)

Dr Emoto’s water crystal work -- Beautiful crystals after giving

good words, playing good music, and showing, playing, or offering

pure prayer to water. Disfigured crystals with negative thoughts.

Our bodies are 72% water, at minimum

Growth Mindset – When students believe they can get smarter, they

understand that effort makes them stronger. They put in extra time

and effort, which leads to higher achievement. (Dr. Carol Dweck)

Meditation (Active)

Gardening

Petting an animal

Walking in nature

Doing a puzzle

Coloring

Music

Whatever you “link”

with is a meditation

Group energy may

help maintain focus

© 2017 Lorelei Woerner, OTR/L, C-IAYT, RYT500

Lifestyle Diet and importance of gut health --

More than 30 neurotransmitters (most identical to those found

in CNS) are found in the gut.

The gut releases about 50% of the body's dopamine (EF, motor

control, motivation, arousal, reinforcement, reward) and about

95% of the body’s serotonin (regulation of feelings of well-

being, mood stabilizer).

Gut microbiota communicate with the CNS through neural,

immune and endocrine pathways, and influence the brain’s

function and behavior.

Studies have shown that these microoranisms are involved in

regulation of anxiety, pain, cognition and mood

Researchers are beginning to note correlations between ADHD

and gut disorders

Circadian Rhythms and Sleep --

Research indicates sleep of individuals with ADHD is

disrupted in a variety of ways, such as: narcolepsy, sleep

apnea, as well as circadian rhythm disorders such as delayed

sleep phase syndrome.

Proper sleep helps with growth of tissues, cognitive function

and enhances longevity

(Ayurveda)

© 2017 Lorelei Woerner, OTR/L, C-IAYT, RYT500

YOGA THERAPY TREATMENT:

© 2017 Lorelei Woerner, OTR/L, C-IAYT, RYT500

© 2017 Lorelei Woerner, OTR/L, C-IAYT, RYT500

Research shows that relationship is

60% of effectiveness in therapeutic interventions

© 2017 Lorelei Woerner, OTR/L, C-IAYT, RYT500

SHAPING A THERAPEUTIC CLASS FOR ADHD (considering krama): (Always first consider individual needs, modifications, adaptations and principles for safe movement practices – such as proper sequencing and contraindications, etc. “No pain, No pain!”)

1. Releasing: Lion’s breath, Choo choo breath, breath of joy, washing

machine (gentle and active trunk rotation) Crossed arm squat (Master

Choa Kok Sui, a prayer to Ganesh to remove obstacles), mat

movement with self-expression,

2. Awakening: Back bends, W-arms, faster movements and vinyasa

sequences progressing to slower.

3. Grounding: Resist the wind in mountain pose, Walking meditation,

proprioceptive input to hips, seated verses standing

4. Centering: Eagle, Cross Crawl, Alligator, Frog, Flower, twists

5. Calming: forward bends, proprioceptive input, rhythmical vestibular

6. Focus: balance poses, feeling breath and progressing to complex

pranayama (such as: pratiloma pratihara)