A mindfulness-based strategy for self-management of aggressive behavior in adolescents with autism Nirbhay N. Singh a, *, Giulio E. Lancioni b , Ramasamy Manikam a , Alan S.W. Winton c , Ashvind N.A. Singh a , Judy Singh a , Angela D.A. Singh a a American Health and Wellness Institute, Verona, VA, USA b University of Bari, Italy c Massey University, Palmerston North, New Zealand 1. Introduction Current epidemiological research suggests an increasing prevalence of autism spectrum disorder (ASD) during the last decade (Matson & Kozlowski, 2011). In recent studies, Kogan et al. (2009) reported 110 per 10,000 point-prevalence of parent-reported diagnosis of ASD among US children aged 3–17 years in 2007, and the Center for Disease Control and Prevention (CDC, 2009) reported 90 per 10,000. Even when variation in terms of age of the children, gender, race/ethnicity, and sociometric status, and survey sample size is taken into account, the prevalence of ASD appears to be increasing dramatically. Further, although early behavioral interventions may provide a positive prognosis for some children (Matson & Smith, 2008; Peters-Scheffer, Didden, Korzilius, & Sturmey, 2011), this is a lifelong condition with its attendant educational, social, and therapeutic challenges for the majority of children with ASD. Many children with ASD will evince challenging behaviors in their developmental years, and for some these behaviors will persist in adolescence and adulthood. Although there is a paucity of prevalence studies on these types of behaviors in individuals with ASD, rates as high as 45% have been reported (Poppes, Putten, & Vlaskamp, 2010). Challenging behaviors, especially aggression, often constitute major barriers to independence and a reasonable quality of life in the community (Hastings, 2002; Singh, Lancioni, Winton, & Singh, in press). Research in Autism Spectrum Disorders 5 (2011) 1153–1158 ARTICLE INFO Article history: Received 12 December 2010 Accepted 31 December 2010 Available online 26 January 2011 Keywords: Autism Aggression Meditation on the Soles of the Feet Treatment for aggression ABSTRACT Some individuals with autism engage in physical aggression to an extent that interferes with not only their quality of life, but also that of their parents and siblings. Behavioral and psychopharmacological treatments have been the mainstay of treatments for aggression in children and adolescents with autism. We evaluated the effectiveness of a mindfulness- based procedure, Meditation on the Soles of the Feet, in helping three adolescents to manage their physical aggression. This procedure required the adolescents to rapidly shift the focus of their attention from the aggression-triggering event to a neutral place on their body, the soles of their feet. Incidents of aggression across the three adolescents ranged from a mean of 14–20 per week during baseline, 4–6 per week during mindfulness training, including zero rates during the last 4 weeks of intervention. Aggression occurred a rate of about 1 per year during a 3-year follow-up. Our results suggest adolescents with autism can learn, and effectively use, a mindfulness-based procedure to self-manage their physical aggression over several years. ß 2011 Elsevier Ltd. All rights reserved. * Corresponding author at: American Health and Wellness Institute, P.O. Box 5419, Midlothian, VA, USA. E-mail addresses: nnsingh52@ahwinstitute.com, nnsingh@ahwinstitute.com (N.N. Singh). Contents lists available at ScienceDirect Research in Autism Spectrum Disorders Journal homepage: http://ees.elsevier.com/RASD/default.asp 1750-9467/$ – see front matter ß 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.rasd.2010.12.012