Can a Single Session of Mindfulness Training Help Children with ADHD?

What you need to know

• A single brief session of mindfulness training did not significantly improve attention, hyperactivity/impulsivity symptoms, or mood in children and adolescents with ADHD.
• The mindfulness intervention showed a small benefit for heart rate variability, which may indicate improved emotional regulation.
• Brief mindfulness exercises were well-tolerated by children with ADHD and may be feasible to implement in settings like classrooms, but more research is needed on their effectiveness.

Background on ADHD and Mindfulness

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental health conditions diagnosed in children and adolescents. It is characterized by difficulties with attention, hyperactivity, and impulsivity that interfere with daily functioning. While medications and behavioral therapy are effective treatments for many children with ADHD, some do not respond well to these approaches or experience side effects. This has led researchers to explore complementary strategies like mindfulness training.

Mindfulness involves purposefully paying attention to the present moment without judgment. Mindfulness-based interventions have shown promise for improving symptoms of ADHD in previous studies, but most of these programs involve many weeks of training. Since children with ADHD often have difficulty staying engaged in lengthy activities, the researchers wanted to examine if even a single brief session of mindfulness training could provide benefits.

What Did the Researchers Do?

The researchers conducted a randomized controlled trial with 70 children and adolescents (ages 6-17) diagnosed with ADHD. Half of the participants were randomly assigned to receive a single 10-minute session of mindfulness training, while the other half listened to an audiobook for the same amount of time as an active control condition.

The mindfulness training involved three short exercises:

1. A breathing exercise focusing on slow, deliberate breaths
2. A body scan to increase awareness of physical sensations
3. A mindful attention exercise to enhance moment-to-moment awareness

The researchers assessed several outcomes before and after the intervention:

• Attention and hyperactivity/impulsivity symptoms using a computerized continuous performance test
• Heart rate variability as a measure of autonomic nervous system functioning
• Mood using ratings of emotions like anxiety, sadness, and anger

They also followed up with participants 4 weeks later to see if any effects were maintained.

What Were the Key Findings?

Overall, the single brief mindfulness session did not lead to significant improvements in ADHD symptoms or mood compared to the control condition. Specifically:

• There were no significant differences between groups in measures of attention, hyperactivity, or impulsivity on the computerized task.
• Mood ratings did not differ significantly between the mindfulness and control groups.

However, the researchers did find a small but significant improvement in one measure of heart rate variability (called RMSSD) in the mindfulness group immediately after the intervention. This may indicate a short-term enhancement in autonomic nervous system functioning.

Some other notable findings:

• Both groups showed some improvements in performance on the attention task over time, likely due to practice effects.
• The mindfulness exercises were well-tolerated, with no adverse effects reported.
• Adherence to the intervention was high, suggesting brief mindfulness may be feasible to implement with children who have ADHD.

Interpreting the Results

The lack of significant effects on ADHD symptoms and mood does not necessarily mean brief mindfulness is ineffective. There are a few important points to consider:

1. The study may have been underpowered to detect small effects, given the relatively small sample size.

2. A single 10-minute session may be too brief to produce measurable changes in complex behaviors like attention. Longer or repeated practice may be needed.

3. The computerized attention task used may not have been sensitive enough to capture subtle improvements in real-world functioning.

4. The active control condition (listening to an audiobook) may have also had some benefits, making it harder to see differences between groups.

The small improvement in heart rate variability is intriguing, as it suggests mindfulness may influence physiological regulation even after brief practice. Heart rate variability is associated with emotional and behavioral regulation, so this could be a promising avenue for future research.

Conclusions

• A single brief mindfulness session was not sufficient to significantly improve core ADHD symptoms or mood in children and adolescents.
• There was a small short-term benefit for heart rate variability, which may reflect enhanced autonomic nervous system functioning.
• Brief mindfulness exercises appear feasible and well-tolerated in youth with ADHD, but more research is needed on their effectiveness.

While this study did not find strong evidence supporting brief mindfulness for ADHD, it provides a starting point for future investigations. Researchers may want to examine the effects of repeated brief sessions or slightly longer interventions. It will also be important to use a variety of outcome measures, including real-world behavioral assessments, to capture potential benefits.

For families and clinicians, these results suggest that very brief, one-time mindfulness exercises are unlikely to produce dramatic improvements in ADHD symptoms. However, given the safety and feasibility demonstrated here, there is little downside to experimenting with short mindfulness practices as a complementary approach alongside established treatments. More intensive mindfulness programs may still hold promise, and interested families should consult with their healthcare providers about evidence-based options.