July 13, 2021 -- Meditation, yoga, breathing exercises, and other mindfulness activities can help children with attention deficit hyperactivity disorder, but it's not just the kids who benefit.

When families of children with ADHD complete a mindfulness program together, a new study suggests, children and parents can profit, with potential boosts to self-control, self-compassion, and psychological symptoms.

The findings do not suggest children should ditch medication in favor of focusing on the present moment. Instead, the study adds to growing evidence that mindfulness can be a helpful tool along with other strategies for children and adults with ADHD, says John Mitchell, PhD, a psychologist at Duke Universitywho was not involved with the new study. Mindfulness might help families ease stress and improve quality of life.

"We talk about ADHD because one person has that diagnosis, but we don't live in bubbles," he says. "We’re all interconnected and impact one another. And having treatments that acknowledge that and measuring that in the scientific literature is pretty important."

Mindfulness training, which has its roots in Eastern traditions, generally aims to teach people how to be present in the moment and let go of judgment. Over the last couple of decades, researchers working on depression and other conditions have gathered evidence that practicing mindfulness can help in a variety of ways, including with the self-regulation of attention and emotions. It didn’t take long for those findings to draw interest from researchers who study ADHD, Mitchell says.

Research on mindfulness for ADHD started with adults, and results have been encouraging, Mitchell says. People who complete a mindfulness program tend to show some improvement in focus, impulsivity, and hyperactivity, studies show. In one small pilot study, Mitchell and colleagues reported improvements in symptoms and executive function in adults with ADHD.

Studies with children have lagged behind, but recent work has been promising. When looking at data from a number of studies, researchers have found small reductions in inattentiveness, hyperactivity, and impulsivity in young people with ADHD. Several randomized controlled trials have also shown a reduction in symptoms as rated by parents and teachers.

Greater Understanding, Acceptance

In related research, there was a noticed reduction in stress among parents who get mindfulness training that teaches them to listen with their full attention, accept and develop compassion for themselves and their children, and regulate themselves within the relationship with their kids.

Still, first-line treatment for kids with ADHD usually includes a combination of medication, cognitive behavioral therapy, and education, even though those strategies don’t always work well for everyone, says Corina Greven, PhD, a psychologist at Radboud University Medical Centre and Karakter Child and Adolescent Psychiatry in the Netherlands.

Despite suggestive results, the data on mindfulness remains murky, in part because early studies that looked at mindfulness training for children with ADHD have been small. Few trials of mindfulness treatment for ADHD, Greven says, have included parents.

To fill in some of the gaps, Greven and colleagues conducted a trial with 103 families who had a child with ADHD between ages 8 and 16. Half of the families were randomly assigned simply to continue care as usual, which included medication for most.

The other half continued their usual care and also took part in a program called MYMind, which used mindfulness-based cognitive therapy for children and mindful parenting training for parents.

Families attended 90-minute group sessions once a week for 8 weeks, with an extra session 2 months later. The mindfulness group also completed homework every day that took about 30 to 45 minutes for parents and 15 minutes for children. Homework included workbooks and guided meditations.

In the short term, the team reported, children who received the mindfulness intervention showed small improvements in ADHD symptoms, anxiety, autistic symptoms, and problems falling asleep. One in 3 children who received mindfulness training improved on measures of self-control, Greven adds, compared with just 1 in 10 who got only their usual care.

Benefits were larger and longer-lasting for parents. Compared with parents who didn’t get mindfulness training, those assigned to the mindfulness group improved in self-control, self-compassion, depression, anxiety, stress, well-being, and their own ADHD symptoms. Given a large genetic component to the disorder, it is common for parents of children with ADHD to have a diagnosis or ADHD symptoms as well. In addition, Greven says, families who completed the mindfulness-based intervention reported improvements in their relationships as well as acceptance of ADHD.

A New Therapy?

The findings suggest new potential treatment options for children with ADHD, and for their parents, Greven says, as well as a need to study the condition more broadly. "Although parents of children with ADHD often have elevated parenting stress, anxiety, or their own ADHD symptoms, usual interventions for children with ADHD do not typically target parental mental health," she says. "As researchers, we need to go broader than just looking at whether an intervention reduces symptoms and include additional outcomes that families find important."

It will take more research to find out who is most likely to benefit from mindfulness training and how long those benefits last, but the new study is a useful starting point, experts say.

"Mindfulness training had potentially short-term and long-term beneficial effects to children with ADHD and their parents," says Samuel Wong, MD, director of the JC School of Public Health and Primary Care at the Chinese University of Hong Kong. He says mindfulness is more likely to become an add-on than a replacement for other kinds of therapies.

“Clinicians may consider combining or adding family-based mindfulness training with current practice for children with ADHD who have residual symptoms with their current treatment," he says.

Mindfulness training may help with issues beyond the classic symptoms that come with ADHD, Mitchell says, helping make family life better overall, even when some features of the disorder don’t budge much.

"With this study in particular, we see that we have some pretty promising effects that that there may be something that will be beneficial above and beyond the core 18 DSM symptoms," he says. "This is an important study, because it's going to be a basis for the continuing evolution of the scientific research on this topic. It’s something to feel excited about."

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Sources

Journal of Attention Disorders: “Mindfulness for Children With ADHD and Mindful Parenting (MindChamp): A Qualitative Study on Feasibility and Effects,” “A Comparison of Mindfulness-Based Group Training and Skills Group Training in Adults With ADHD: An Open Study,” “A Pilot Trial of Mindfulness Meditation Training for Attention-Deficit/Hyperactivity Disorder in Adulthood: Impact on Core Symptoms, Executive Functioning, and Emotion Dysregulation,” “The Effect of Mindfulness Interventions for Parents on Parenting Stress and Youth Psychological Outcomes: A Systematic Review and Meta-Analysis.”

John Mitchell, PhD, psychologist, Duke University, Durham, NC.

Frontiers in Psychology: “Mindfulness and Emotion Regulation: Insights from Neurobiological, Psychological, and Clinical Studies.”

Corina Greven, PhD, psychologist, Radboud University Medical Centre and Karakter Child and Adolescent Psychiatry, the Netherlands.

The Journal of Child Psychology Psychiatry: “A randomised controlled trial (MindChamp) of a mindfulness-based intervention for children with ADHD and their parents.”

Samuel Wong, MD, director, JC School of Public Health and Primary Care, Chinese University of Hong Kong.

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