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.
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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.CrossRefGoogle 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.CrossRefPubMedGoogle Scholar
Barkley, R. A. (2002). Major life activity and health outcomes associated with attention-deficit/hyperactivity disorder. Journal of Clinical Psychiatry, 63, 10–15.PubMedGoogle 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.CrossRefGoogle Scholar
Birdee, G. S., Yeh, G. Y., Wayne, P. M., Philips, R. S., Davis, R. B., & Gardiner, P. (2009). Clinical application of yoga for the pediatric population: a systematic review. Academic Pediatrics, 9(4), 212–220.CrossRefPubMedPubMedCentralGoogle 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. (2009). Introduction to meta-analysis. West Sussex: John Wiley & Sons.CrossRefGoogle Scholar
Borenstein, M., Hedges, L., Higgins, J., & Rothstein, H. (2010). A basic introduction to fixed-effect and random-effects models for meta-analysis. Research Synthesis Methods, 1, 97–111.CrossRefPubMedGoogle Scholar
Büssing, A., Michaelsen, A., Khalsa, S. B. S., Telles, S., & Sherman, K. J. (2012). Effects of yoga on mental and physical health:a short summary of reviews. Evidence-Based Complementary and Alternative Medicine, 2012, 165410.PubMedPubMedCentralGoogle 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.CrossRefGoogle 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.CrossRefGoogle Scholar
Chacko, A., Newcorn, J. H., Feirsen, N., & Uderman, J. Z. (2010). Improving medication adherence in chronic pediatric health conditions: a focus on ADHD in youth. Current Pharmaceutical Design, 16(22), 2416–2423.CrossRefPubMedGoogle Scholar
Coatsworth, J. D., et al. (2010). Changing parent’s mindfulness, child management skills and relationship quality with their youth: results from a randomized pilot intervention trial. Journal of Child and Family Studies, 19(2), 203–217.CrossRefPubMedGoogle Scholar
Cohen, J. (1988). Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Erlbaum.Google Scholar
Evans, S., Ling, M., Hill, B., Rinehart, N., Austin, D., & Sciberras, E. (2017a). Systematic review of meditation-based interventions for children with ADHD. European Child and Adolescent Psychiatry.https://doi.org/10.1007/s00787-017-1008-9.
Evans, S. W., Owens, J. S., Wymbs, B. T., & Ray, A. R. (2017b). Evidence-based psychosocial treatments for children and adolescents with attention deficit/hyperactivity disorder. Journal of Child and Adolescent Psychology.https://doi.org/10.1080/15374416.2017.1390757.
Galantino, M. L., Galbavy, R., & Quinn, L. (2008). Therapeutic effects of yoga for children: a systematic review of the literature. Pediatric Physical Therapy, 20(1), 66–80.CrossRefPubMedGoogle Scholar
Garg, A. X., Hackman, D., & Tonelli, M. (2008). Systematic review and meta-analysis: when one study is just not enough. Clinical Journal of the American Society of Nephrology, 3, 253–260.CrossRefPubMedGoogle 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.CrossRefGoogle 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.CrossRefGoogle 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.CrossRefGoogle 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.CrossRefGoogle Scholar
Hedges, L. V., & Olkin, I. (1985). Statistical methods for meta-analysis. New York, NY: Academic Press.Google Scholar
Higgins, J. P., et al. (2011). The Cochrane collaboration’s tool for assessing risk of bias in randomised trials. British Medical Journal, 343, d5928.CrossRefPubMedGoogle 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
Jarrett, M. A. (2013). Treatment of comorbid attention-deficit/ hyperactivity disorder and anxiety in children: processes of change. Psychological Assessment, 25, 545–555.CrossRefPubMedGoogle Scholar
Jensen, P. S., & Kenny, D. T. (2004). The effects of yoga on the attention and behavior of boys with attention-deficit/hyperactivity disorder (ADHD). Journal of Attention Disorders, 7(4), 205–216.CrossRefPubMedGoogle Scholar
Jeter, P. E., Slutsky, J., Singh, N., & Khalsa, S. B. (2015). Yoga as a therapeutic intervention: a bibliometric analysis of published research studies from 1967 to 2013. The Journal of Alternative and Complementary Medicine, 21(10), 586–592.CrossRefPubMedGoogle 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.CrossRefPubMedGoogle Scholar
Lippold, M. A., et al. (2015). Understanding how mindfuln parenting may be linked to mother-adolescent communication. Journal of Youth and Adolescence, 44(9), 1663–1667.CrossRefPubMedPubMedCentralGoogle Scholar
Loe, I. M., & Feldman, H. M. (2007). Academic and educational outcomes of children with ADHD. Journal of Pediatric Psychology, 32(6), 643–654.CrossRefPubMedGoogle Scholar
Luu, K., & Hall, P. A. (2016). Hatha yoga and executive function: a systematic review. The Journal of Alternative and Complementary Medicine, 22(2), 125–133.CrossRefPubMedGoogle 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
Mullane, J. C., Corkum, P. V., Klein, R. M., McLaughlin, E. N., & Lawrence, M. A. (2011). Alerting, orienting, and executive attention in children with ADHD. Journal of Attention Disorders, 15(4), 310–320.CrossRefPubMedGoogle 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.CrossRefGoogle Scholar
Neudecker, C., Mewes, N., Reimers, A. K., & Woll, A. (2015). Exercise interventions in children and adolescents with ADHD: a systematic review. Journal of Attention Disorders. https://doi.org/10.1177/1087054715584053.Google Scholar
Overgaard, K. R., Aasa, H., Torgersen, S., & Zeiner, P. (2016). Co-occurrence of ADHD and anxiety in preschool children. Journal of Attention Disorders, 20(7), 573–580.CrossRefPubMedGoogle Scholar
Pascoe, M. C., & Bauer, I. E. (2015). A systematic review of randomized control trials on the effects of yoga on stress measures and mood. Journal of Psychiatric Research, 68, 270–282.CrossRefPubMedGoogle 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
Raggi, V. L., & Chronis, A. M. (2006). Interventions to address the academic impairment of children and adolescents with ADHD. Clinical Child and Family Psychology Review, 9(2), 85–111.CrossRefPubMedGoogle 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.CrossRefGoogle Scholar
Rajwan, E., Chacko, A., Wymbs, B. T., & Wymbs, F. A. (2014). Evaluating clinically significant change in parent and child functioning: comparison of traditional and enhanced behavioral parent training. Journal of Abnormal Child Psychology, 42, 1407–1412.CrossRefPubMedGoogle 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.CrossRefPubMedPubMedCentralGoogle 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.CrossRefGoogle Scholar
Steeger, C. M., Gondoli, D. M., Gibson, B. S., & Morissey, R. A. (2016). Combined cognitive and parent training interventions for adolescents with ADHD and their mothers: a randomized controlled trial. Child Neuropsychology, 22(4), 394–419.CrossRefPubMedGoogle 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.CrossRefGoogle 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.CrossRefGoogle 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.
Tsai, M., & Chou, W. (2016). Attentional orienting and executive control are affected by different types of meditation practice. Consciousness and Cognition, 46, 110–126.CrossRefPubMedGoogle Scholar
Van der Oord, S., Bögels, S. M., & Peijnenburg, D. (2012). The effectiveness of mindfulness training for children with ADHD and mindful parenting for their parents. Journal of Child and Family Studies, 21(1), 139–147.CrossRefPubMedGoogle Scholar
Van de Weijer-Bergsma, E., Formsma, A. R., de Bruin, E. I., & Bögels, S. M. (2012). The effectiveness of mindfulness training on behavioral problems and attentional functioning in adolescents with ADHD. Journal of Child and Family Studies, 21(5), 775–787.CrossRefPubMedGoogle Scholar
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
Zylowska, L., Ackerman, D. L., Yang, M. H., Futrell, J. L., Horton, N. L., Hale, T. S., & Smalley, S. L. (2008). Mindfulness meditation training in adults and adolescents with ADHD a feasibility study. Journal of Attention Disorders, 11(6), 737–746.CrossRefPubMedGoogle Scholar