A yoga-based multimodal intervention for children with Down syndrome: development, validation, and feasibility study

Background Children with Down syndrome (DS) experience a range of developmental challenges that restrict their participation in various activities. Therefore, effective rehabilitation approaches are essential.Objective To develop, validate, and examine the feasibility of a yoga-based multimodal intervention for children with DS.Methods This is a three-phase methodological study comprising Yoga module development, content validation, and a feasibility trial. Practices were included from classical yoga texts, contemporary literature, research articles, and experts’ suggestions. Fifty experts evaluated the module using Lawshe’s Content Validity Ratio (CVR), and practices meeting the predefined threshold were retained. A four-week feasibility trial was conducted with six children with DS, with five 60-minute sessions weekly. The outcomes were assessed using Pure Tone Audiometry (PTA), the Vineland Social Maturity Scale (VSMS), and qualitative feedback.Results Forty-eight of 53 practices were retained, with a mean CVR of 0.68. All a priori feasibility criteria (≥80% recruitment, retention, and session adherence) were met, with no adverse events reported. The mean reduction in hearing thresholds across the two ears was 1.75 dB. Exploratory analysis showed a change in the VSMS locomotion domain, although not statistically significant (p = 0.063). Parents and teachers reported calmer behaviour, improved attentional engagement, and greater stability in routines.Conclusion The intervention demonstrated content validity and feasibility in children with DS. Further controlled studies with larger sample sizes are required to confirm long-term therapeutic effectiveness.