Mindfulness in Intellectual and Developmental Disabilities

Background: Though mindfulness based interventions, which teach individuals to focus their attention in a nonjudgmental way, have been successfully used in a variety of medical and psychiatric conditions to reduce stress and anxiety and improve quality of life, they have only recently been studied in the context of intellectual and developmental disabilities (IDDs). Before mindfulness programs become more widely accepted and applied in the IDD field, it is important to demonstrate their feasibility. As not all individuals with IDD are able to provide verbal report of their experiences during mindfulness sessions, physiological measures such as cortisol, a neuroendocrine hormone, can provide objective accounts of stress and arousal.

Objectives: Examine the effects of daily mindfulness practice on cortisol levels in individuals with developmental disabilities, including Autism Spectrum Disorders (ASD). 

Methods: Participants included 68 individuals (22.8±7.9 years; 24% female) with an intellectual or developmental disability, including ASD, Down syndrome, and Williams syndrome. As part of their attendance in camp programs, individuals participated in a daily 20-minute mindfulness session for five consecutive days. Activities in the sessions included Qigong yoga, deep breathing, seated meditations, body scans, and lessons on incorporating mindfulness into everyday life. Prior to and 20-minutes after each session, participants provided saliva samples for cortisol. Hierarchical linear models were used to assess cortisol responses to the mindfulness sessions.

Results: Cortisol values >3 standard deviations were considered outliers and removed, resulting in a total of 623 cortisol data points available for analysis. Cortisol values were natural log transformed for normality. The random effects model revealed that while there was significant individual variability in cortisol values (i.e., model intercept variability; p<.001), there was not significant variability in the cortisol response to each session (i.e., model slope variability; p>.5). Indeed, there was a significant decline in cortisol levels in response to each day’s mindfulness session (p<.001). Though individuals with ASD did not differ in overall cortisol levels from individuals with other IDDs, there was a trend for them to have a greater decline in cortisol levels in responses to mindfulness sessions (p=0.075).

Conclusions: To our knowledge, this is the first study to assess levels of a biomarker in response to a mindfulness intervention across individuals with a variety of IDDs including ASD. These results extend our previous work and demonstrate the feasibility of mindfulness training for a wider population. We will discuss how individual and disorder specific characteristics relate to participation in the mindfulness training. Findings have implications for the ability of people with IDD to engage in mindfulness and the usefulness of mindfulness as an intervention tool for people with IDD.