Yoga, Mindfulness, and Meditation Interventions for Youth with ADHD: Systematic Review and Meta-Analysis
- 3.7k Downloads
Attention-deficit/hyperactivity disorder (ADHD) is a chronic developmental disorder affecting 3–7% of children. In light of the growing utilization of yoga, mindfulness, and meditation in ADHD populations and potential benefits it has on ADHD symptoms, executive function deficits, and social functioning, we sought to evaluate these interventions for youth with ADHD. The primary aim of this review paper is to identify the efficacy of these programs for the treatment of youth with ADHD through a systematic review and meta-analysis. A systematic literature search was conducted in the following electronic databases: PsychINFO, ERIC, PubMed, and MEDLINE. Studies were included in the meta-analytic review if participants were between 5–17 years old, had a diagnosis of ADHD or met symptom threshold on psychometrically-validated measure of ADHD symptoms, was a treatment outcome study, and was published in a peer-reviewed English-language journal. The effect sizes of eleven studies demonstrate that yoga, mindfulness-based interventions, and/or meditation had a statistically significant effect on the outcomes of ADHD symptoms, hyperactivity, and inattention (parent and teacher report), as well as parent-child relationship, executive functioning, on-task behavior, parent stress, and parent trait-mindfulness (p < 0.05). The effect sizes range from small to large effects across these outcomes. Considerable risk for bias was found across studies. Given significant methodological limitations of the literature, positive effect sizes found in studies should be interpreted with caution; these interventions should not be considered first-line interventions for ADHD. However, preliminary findings suggest yoga, mindfulness, and meditation may be beneficial for youth with ADHD, but extensive research is required to validate the efficacy of these interventions.
KeywordsAttention deficit/hyperactivity-disorder ADHD Yoga Mindfulness Meditation
A.L.C.: designed and executed the study, assisted with data analyses, and wrote the paper, V.D.: assisted with design and analyzed data, wrote results and assisted with discussion, A.P.: assisted with analyzing the data and editing of manuscript, K.G.: assisted with systematic review and editing, K.F.: assisted with systematic review, A.C.: collaborated in the writing and editing of final manuscript.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
- Abadi, M. S., Madgaonkar, J., & Venkatesan, S. (2008). Effect of yoga on children with attention deficit/hyperactivity disorder. Psychological Studies, 53(2), 154–159.Google Scholar
- American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric.Google Scholar
- Anastopoulos, A. D., Smith, T. F., Garrett, M. E., Morrissey-Kane, E., Schatz, N. K., Sommer, J. L., SpringerAmpamp; Ashley-Koch, A. (2011). Self-regulation of emotion, functional impairment, and comorbidity among children with AD/HD. [Research Support, N.I.H., Extramural]. Journal of Attention Disorders, 15(7), 583–592. https://doi.org/10.1177/1087054710370567.CrossRefPubMedPubMedCentralGoogle Scholar
- Bergen-Cico, D., Razza, R., & Timmins, A. (2015). Fostering self-regulation through curriculum infusion of mindful yoga: a pilot study of efficacy and feasibility. Journal of Child and Family Studies, 24(11), 3448–3461.Google Scholar
- Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., & Carmody, J., et al. (2004). Mindfulness: a proposed operational definition. Clinical Psychology: Science and Practice, 11(3), 230–241.Google Scholar
- Borden, L. A., Hankinson, J., Perry-Parrish, C., Reynolds, E. K., Specht, M. W., & Ostrander, R. (2016). Family and maternal characteristic of children with co-occuring ADHD and depression. Journal of Attention Disorders. https://doi.org/10.1177/1087054716666321.
- Borenstein, M., Hedges, L., Higgins, J., & Rothstein, H. (2005). CMA: comprehensive meta-analysis (version 2.0) [computer software]. Englewood, NJ: Biostat.Google Scholar
- Borenstein, M., Hedges, L., Higgins, J., & Rothstein, H. (2009). Introduction to meta-analysis. West Sussex: John Wiley & Sons.Google Scholar
- Butzer, B., Day, D., Potts, A., Ryan, C., Coulombe, S., Davies, B., & Khalsa, S. B. (2015). Effects of a classroom-based yoga intervention on cortisol and behavior in second- and third-grade students. Journal of Evidence-Based Complementary & Alternative Medicine, 20(1), 41–49. https://doi.org/10.1177/2156587214557695.CrossRefGoogle Scholar
- Carboni, J. A., Roach, A. T., & Fredrick, L. D. (2013). Impact of mindfulness training on the behavior of elementary students with attention-deficit/hyperactive disorder. Research in Human Development, 10(3), 234–251.Google Scholar
- Chacko, A., Kofler, M., & Jarrett, M. (2014). Improving outcomes for youth with ADHD: a conceptual framework for combined neurocognitive and skill-based treatment approaches. Clinical Child Family Psychology Review, 7(4), 368–384.Google Scholar
- Cohen, J. (1988). Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Erlbaum.Google Scholar
- Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S. F., & Sheridan, J. F. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65(4), 564–570. https://doi.org/10.1097/01.psy.0000077505.67574.e3.CrossRefPubMedPubMedCentralGoogle Scholar
- Fried, R., Chan, J., Feinberg, L., Pope, A., Woodworth, K. Y., Faraone, S. V., & Biederman, J. (2016). Clinical correlates of working memory deficits in youth with and without ADHD: a controlled study. Journal of Clinical and Experimental Neuropsychology, 38(5), 487–496. https://doi.org/10.1080/13803395.2015.1127896.CrossRefPubMedPubMedCentralGoogle Scholar
- Gioia, G. A., Isquith, P. K., Guy, S. C., & Kenworthy, L. (2000). Behavior rating inventory of executive function. Child Neuropsychology, 6(3), 235–238.Google Scholar
- Grosswald, S. J., Stixrud, W. R., Travis, F., & Bateh, M. A. (2008). Use of the transcendental meditation technique to reduce symptoms of attention deficit hyperactivity disorder (ADHD) by reducing stress and anxiety: an exploratory study. Current Issues in Education, 10(2).Google Scholar
- Hagen, I., & Nayar, U. S. (2014). Yoga for children and young people’s mental health and well-being: research review and reflections on the mental health potentials of yoga. Frontiers in Psychiatry, 5, 1–6.Google Scholar
- Harrison, L. J., Manocha, R., & Rubia, K. (2004). Sahaja yoga meditation as a family treatment programme for children with attention deficit-hyperactivity disorder. Clinical Child Psychology and Psychiatry, 9(4), 479–497.Google Scholar
- Haydicky, J., Shecter, C., Wiener, J., & Ducharme, J. M. (2015). Evaluation of MBCT for adolescents with ADHD and their parents: impact on individual and family functioning. Journal of Child and Family Studies, 24(1), 76–94.Google Scholar
- Hedges, L. V., & Olkin, I. (1985). Statistical methods for meta-analysis. New York, NY: Academic Press.Google Scholar
- Househam, A.M., & Solanto, M.V. (2016). Mindfulness as an Intervention for ADHD. The ADHD Report, 24(2), 1-8.Google Scholar
- Hylander, F., Johansson, M., Daukantaitė, D., & Ruggeri, K. (2017). Yin yoga and mindfulness: a five week randomized controlled study evaluating the effects of the YOMI program on stress and worry. Anxiety, Stress, & Coping, 13(1), 1–14.Google Scholar
- Krisanaprakornkit, T., Ngamjarus, C., Witoonchart, C., & Piyavhatkul, N. (2010). Meditation therapies for attention-deficit/hyperactivity disorder (ADHD). Cochrane Database of Systematic Reviews 2010, Issue 6. Art. No.: CD006507. https://doi.org/10.1002/14651858.CD006507.Google Scholar
- Langberg, J. M., & Becker, S. P. (2012). Does long-term medication use improve the academic outcomes of youth with attention deficit/ hyperactivity disorder? Clinical Child and Family Psychology Review, 15, 215–233.Google Scholar
- Mehta, S., Mehta, V., Mehta, S., Shah, D., Motiwala, A., Vardhan, J., et al. (2011). Multimodal behavior program for ADHD incorporating yoga and implemented by high school volunteers: a pilot study. ISRN Pediatrics, 2011, 1-5.Google Scholar
- Miller, J., Fletcher, K., & Kabat-Zinn, J. (1995). Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders. General Hospital Psychiatry, 17(3), 192–200. https://doi.org/10.1016/0163-8343(95)00025-M.CrossRefPubMedPubMedCentralGoogle Scholar
- Murrell, A. R., Steinberg, D. S., Connally, M. L., Hulsey, T., & Hogan, E. (2015). Acting out to ACTing on: a preliminary investigation in youth with ADHD and co-morbid disorders. Journal of Child and Family Studies, 24(7), 2174–2181.Google Scholar
- Peck, H. L., Kehle, T. J., Bray, M. A., & Theodore, L. A. (2005). Yoga as an intervention for children with attention problems. School Psychology Review, 34(3), 415.Google Scholar
- Rajwan, E., Chacko, A., & Moeller, M. (2012). Non-pharmacological intervention for preschool ADHD: state of the evidence and implications for practice. Professional Psychology: Research and Practice, 43, 520–526.Google Scholar
- Schonert-Reichl, K. A., Oberle, E., Lawlor, M. S., Abbott, D., Thomson, K., Oberlander, T. F., & Diamond, A. (2015). Enhancing cognitive and social–emotional development through a simple-to-administer mindfulness-based school program for elementary school children: a randomized controlled trial. Developmental Psychology, 51(1), 52–66.PubMedPubMedCentralGoogle Scholar
- Slavin, R., & Smith, D. (2009). The relationship between sample sizes and effect sizes in systematic reviews in education. Educational Evaluation and Policy Analysis, 31(4), 500–506.Google Scholar
- Singh, N. N., Lancioni, G. E., Karazsia, B. T., Felver, J. C., Myers, R. E., & Nugent, K. (2015). Effects of samatha meditation on active academic engagement and math performance of students with attention deficit/hyperactivity disorder. Mindfulness, 7(1), 68–75.Google Scholar
- Singh, N. N., Singh, A. N., Lancioni, G. E., Singh, J., Winton, A. S., & Adkins, A. D. (2010). Mindfulness training for parents and their children with ADHD increases the children’s compliance. Journal of Child and Family Studies, 19(2), 157–166.Google Scholar
- Sonuga-Barke, E., Bitsakou, P., & Thompson, M. (2010). Beyond the dual pathway model: evidence for the dissociation of timing, inhibitory, and delay-related impairments in attention-deficit/hyperactivity disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 49(4), 345–355.Google Scholar
- Sterne, J. A., et al. (2016). A cochrane risk of bias assessment tool: for non-randomized studies of interventions. BMJ, 355; i4919.Google Scholar
- Tang, Y., Tang, R., Jiang, C., & Posner, M. (2014). Short-term meditation intervention improves self-regulation and academic performance. Journal of Child and Adolescent Behaviour. https://doi.org/10.4172/2375-4494.1000154.
- Vysniauske, R., Verburgh, L., Oosterlaan, J., & Molendijk, M.L. (2016). The effects of physical exercise on functional outcomes in the treatment of ADHD. Journal of Attention Disorders. https://doi.org/10.1177/1087054715627489.
- Zylowska, L. (2012). The mindfulness prescription for adult ADHD. Boston: Trumpeter.Google Scholar