Abstract
Meditation-based interventions such as mindfulness and yoga are commonly practiced in the general community to improve mental and physical health. Parents, teachers and healthcare providers are also increasingly using such interventions with children. This review examines the use of meditation-based interventions in the treatment of children with Attention-Deficit Hyperactivity Disorder (ADHD). Electronic databases searched included PsycINFO, Medline, CINAHL, and AMED. Inclusion criteria involved children (aged to 18 years) diagnosed with ADHD, delivery of a meditation-based intervention to children and/or parents, and publication in a peer-reviewed journal. Studies were identified and coded using standard criteria, risk of bias was assessed using Risk of Bias in Non-randomised Studies- of interventions (ROBINS-I), and effect sizes were calculated. A total of 16 studies were identified (8 that included children in treatment, and 8 that included combined parent–child treatment). Results indicated that risk of bias was high across studies. At this stage, no definitive conclusions can be offered regarding the utility of meditation-based interventions for children with ADHD and/or their parents, since the methodological quality of the studies reviewed is low. Future well designed research is needed to establish the efficacy of meditation-based interventions, including commonly used practices such as mindfulness, before recommendations can be made for children with ADHD and their families.
Similar content being viewed by others
References
Tripp G, Wickens JR (2009) Neurobiology of ADHD. Neuropharmacology 57(7–8):579–589
De La Fuente A et al (2013) A review of attention-deficit/hyperactivity disorder from the perspective of brain networks. Front Hum Neurosci 7:192
Polanczyk GV et al (2014) ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis. Int J Epidemiol 43(2):434–442
Efron D et al (2014) Functional status in children with ADHD at age 6-8: a controlled community study. Pediatrics 134(4):e992–e1000
Sciberras E, Roos LE, Efron D (2009) Review of prospective longitudinal studies of children with ADHD: mental health, educational, and social outcomes. Curr Atten Disord Rep 1:171–177
Lee SS et al (2008) Few preschool boys and girls with ADHD are well-adjusted during adolescence. J Abnorm Child Psychol 36(3):373–383
Barbaresi WJ et al (2013) Mortality, ADHD, and psychosocial adversity in adults with childhood ADHD: a prospective study. Pediatrics 131(4):637–644
Dalsgaard S et al (2015) Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: a nationwide cohort study. Lancet 385(9983):2190–2196
Theule J et al (2013) Parenting stress in families of children with ADHD: a meta-analysis. J Emot Behav Disord 21:3–17
Deater-Deckard K (1998) Parenting stress. Yale University Press, New haven CT
Kazdin AE (1995) Child, parent and family dysfunction as predictors of outcome in cognitive-behavioral treatment of antisocial children. Behav Res Ther 33:271–281
Mash EJ, Johnston C (1990) Determinants of parenting stress. J Clinic Child Psychol 19:313–328
Theule J et al (2011) Predicting parenting stress in families of children with ADHD: parent and contextual factors. J Child Fam Stud 20:640–647
Bhide S, et al (2016) Association between parenting style and socio-emotional and academic functioning in children with and without ADHD: a community-based study. J Atten Disord 1–12
Chronis AM et al (2003) Psychopathology and substance abuse in parents of young children with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 42(12):1424–1432
Agha SS et al (2013) Are parental ADHD problems associated with a more severe clinical presentation and greater family adversity in children with ADHD? Eur Child Adolesc Psychiatry 22(6):369–377
Murray C, Johnston C (2006) Parenting in mothers with and without attention-deficit/hyperactivity disorder. J Abnorm Psychol 115(1):52–61
Weinstein CS, Apfel RJ, Weinstein SR (1998) Description of mothers with ADHD with children with ADHD. Psychiatry 61(1):12–19
Katzmann J, et al. (2016) Behavioral and nondirective guided self-help for parents of children with externalizing behavior: mediating mechanisms in a head-to-head comparison. J Abnorm Child Psychol 45(4):719–730
Johnston C et al (2002) Responsiveness in interactions of mothers and sons with ADHD: relations to maternal and child characteristics. J Abnorm Child Psychol 30(1):77–88
Miller-Lewis LR et al (2006) Early childhood externalising behaviour problems: child, parenting, and family-related predictors over time. J Abnorm Child Psychol 34(6):891–906
Anderson SB, Guthery AM (2015) Mindfulness-based psychoeducation for parents of children with attention-deficit/hyperactivity disorder: an applied clinical project. J Child Adolesc Psychiatr Nurs 28(1):43–49
Efron D, Davies S, Sciberras E (2013) Current Australian pediatric practice in the assessment and treatment of ADHD. Acad Pediatr 13(4):328–333
Langberg JM, Becker SP (2012) Does long-term medication use improve the academic outcomes of youth with attention-deficit/hyperactivity disorder? Clin Child Fam Psychol Rev 15(3):215–233
Graham J, Coghill D (2008) Adverse effects of pharmacotherapies for attention-deficit hyperactivity disorder: epidemiology, prevention and management. CNS Drugs 22(3):213–237
Sonuga-Barke EJ et al (2013) Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. Am J Psychiatry 170(3):275–289
Singh NN et al (2010) Mindfulness training for parents and their children with ADHD increases the children’s compliance. J Child Family Stud 19(2):157–166
McClintock CH, Lau E, Miller L (2016) Phenotypic dimensions of spirituality: implications for mental health in China, India, and the United States. Front Psychol 7:1600
Nash JD, Newberg A (2013) Toward a unifying taxonomy and definition for meditation. Front Psychol 4:806
Krisanaprakornkit T, et al (2010) Meditation therapies for attention-deficit/hyperactivity disorder (ADHD) Cochrane Database of Systematic Reviews. Cochrane (6):CD006507
Bögels SM, de Bruin EI, van der Oord S (2013) Mindfulness-based interventions in child and adolescent psychopathology, in Cognitive behaviour therapy for children and families. In: Graham P, et al. (eds), 3rd edn, Cambridge University Press, New York, p 371-384
Barkley RA (1997) Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychol Bull 121(1):65–94
Moffitt TE et al (2011) A gradient of childhood self-control predicts health, wealth, and public safety. Proc Natl Acad Sci USA 108(7):2693–2698
Smalley SL et al (2009) Mindfulness and attention deficit hyperactivity disorder. J Clin Psychol 65(10):1087–1098
Beltran M et al (2016) Yoga-based psychotherapy groups for boys exposed to Trauma in urban settings. Altern Ther Health Med 22(1):39–46
Khalsa SB, Butzer B (2016) Yoga in school settings: a research review. Ann N Y Acad Sci 1373(1):45–55
Bogels S, Restifo K (2015) Mindful parenting: A guide for mental health practitioners. WW Norton & Co., New York
Coatsworth JD et al (2010) Changing parent’s mindfulness, child management skills and relationship quality with their youth: results from a randomized pilot intervention trial. J Child Fam Stud 19(2):203–217
Lippold MA et al (2015) Understanding how mindful parenting may be linked to mother-adolescent communication. J Youth Adolesc 44(9):1663–1673
Reuben JD et al (2016) Warm parenting and effortful control in toddlerhood: independent and interactive predictors of school-age externalizing behavior. J Abnorm Child Psychol 44(6):1083–1096
Khoury B et al (2013) Mindfulness-based therapy: a comprehensive meta-analysis. Clin Psychol Rev 33(6):763–771
Cairncross M, Miller CJ (2016) The effectiveness of mindfulness-based therapies for ADHD: a meta-analytic review. J Atten Disord. doi:10.1177/1087054715625301
Mitchell JT, et al (2013) A pilot trial of mindfulness meditation training for ADHD in adulthood: impact on core symptoms, executive functioning, and emotion dysregulation. J Atten Disord. doi:10.1177/1087054713513328
Sterne JA, Higgins JP, ReevesBC (2014) A cochrane risk of bias assessment tool: for non-randomized studies of interventions (ACROBAT-NRSI), version 1.0.0
Higgins JP et al (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 343:d5928
Hedges L, Olkin I (1985) Statistical models for meta-analysis. Academic Press, New York
Hariprasad VR et al (2013) Feasibility and efficacy of yoga as an add-on intervention in attention deficit-hyperactivity disorder: an exploratory study. Indian J Psychiatry. 55:S379–S384
Harrison LJ, 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
Haydicky J et al (2015) Evaluation of MBCT for adolescents with ADHD and their parents: impact on individual and family functioning. J Child Family Stud 24(1):76–94
van de Weijer-Bergsma E et al (2012) The effectiveness of mindfulness training on behavioral problems and attentional functioning in adolescents with ADHD. J Child Fam Stud 21(5):775–787
van der Oord S, Bögels SM, Peijnenburg D (2012) The effectiveness of mindfulness training for children with ADHD and mindful parenting for their parents. J Child Fam Stud 21(1):139–147
Zhang D, et al (2016) Mindfulness-based intervention for Chinese children with ADHD and their parents: a pilot mixed-method study. Mindfulness. doi:10.1007/s12671-016-0660-3
Abadi MS, Madgaonkar J, Venkatesan S (2008) Effect of yoga on children with attention deficit/hyperactivity disorder. Psychological Studies 53(2):154–159
Jensen PS, Kenny DT (2004) The effects of yoga on the attention and behavior of boys with Attention-Deficit/hyperactivity Disorder (ADHD). J Atten Disord 7(4):205–216
Mehta S, et al (2011) Multimodal behavior program for ADHD incorporating yoga and implemented by high school volunteers: a pilot study. ISRN Pediatrics. p 5p–5p
Mehta S, et al (2012) Peer-mediated multimodal intervention program for the treatment of children with ADHD in India: one-year followup. ISRN Pediatrics. p 1–7
Murrell AR et al (2015) Acting out to ACTing on: a preliminary investigation in youth with ADHD and co-morbid disorders. J Child Fam Stud 24(7):2174–2181
Singh NN et al (2016) Effects of Samatha meditation on active academic engagement and math performance of students with attention deficit/hyperactivity disorder. Mindfulness 7(1):68–75
Haydicky J et al (2012) Evaluation of a mindfulness-based intervention for adolescents with learning disabilities and co-occurring ADHD and anxiety. Mindfulness 3(2):151–164
Carboni JA, Roach AT, Fredrick LD (2013) Impact of mindfulness training on the behavior of elementary students with attention-deficit/hyperactive disorder. Res Human Dev 10(3):234–251
Waschbusch DA et al (2009) Are there placebo effects in the medication treatment of children with attention-deficit hyperactivity disorder? J Dev Behav Pediatr 30(2):158–168
Author information
Authors and Affiliations
Contributions
Authors Evans and Sciberras designed the study. Authors Evans, Ling and Hill conducted literature searches and undertook the analyses. Author Evans wrote the first draft of the manuscript and all authors contributed to and have approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
All authors declare that they have no conflicts of interest.
Funding sources
Funding for this study was provided by a Deakin University Central Research Grants Scheme.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Evans, S., Ling, M., Hill, B. et al. Systematic review of meditation-based interventions for children with ADHD. Eur Child Adolesc Psychiatry 27, 9–27 (2018). https://doi.org/10.1007/s00787-017-1008-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00787-017-1008-9