Co-designed yoga nidra targeting anxiety in autistic children: A mixed methods feasibility study.

Abstract

Autistic children experience disproportionately high rates of anxiety, yet common interventions such as cognitive behavioural therapy and traditional mindfulness practices may be less effective due to their cognitive and abstract demands. Yoga nidra, a form of guided meditation using concrete visualisations and breath awareness, may offer a more accessible alternative. This mixed methods study evaluated the feasibility and pilot efficacy of a co-designed six-week online yoga nidra intervention targeting anxiety in autistic children aged 8-14 years. Neurophysiological and psychological data were collected from 13 participants using parent- and self-reported measures of anxiety (ASC-ASD), intolerance of uncertainty (IUSC), and emotion dysregulation (EDI), alongside heart rate variability (HRV). Notably, the cohort included a minimally speaking child, which demonstrates the potential for the intervention to extend to autistic children with language support needs, a group who are often underrepresented in similar research. Results indicated no statistically significant changes in anxiety over time; however, medium effect sizes were observed in self- (Hedge's g = 0.55) and parent-reported anxiety (Hedge's g = 0.45), with three participants moving from clinically significant to non-significant anxiety levels post-intervention. Additionally, intolerance of uncertainty and emotion dysregulation demonstrated small to medium effect size reductions (IUSC, Hedge's g = 0.50; EDI-Reactivity, Hedge's g = 0.55; EDI-Dysphoria, Hedge's g = 0.25), suggesting potential benefits of yoga nidra in these areas. Greater attendance was significantly associated with self-reported reductions in anxiety (ASC-ASD-SR, r = .757, p < .05), but not the other outcome measures. Unexpectedly, HRV outcomes indicated reduced autonomic functioning post-intervention. Additionally, qualitative data from semi-structured interviews with three child participants and their mothers from the study were analysed using reflexive thematic analysis, revealing five key themes of their experience: Thinking About the Body is Hard; We Want More; Homework Sucks; Making Mindfulness Concrete; and On-Screen and At Home is Convenient. While the online format was appreciated for its accessibility, challenges with adherence and scheduling highlighted the need for more flexible delivery models. This study advances upon prior research by being the first to develop a co-designed yoga nidra intervention specifically for autistic children. Findings support the feasibility of yoga nidra as a complementary intervention for autistic children and suggest directions for future research, including larger trials and further co-design with the autistic community.