Mindfulness-Based ADHD Treatment for Children: a Feasibility Study (MBAT-C)
Attention-Deficit/Hyperactivity Disorder (ADHD) affects 11% of children and leads to adverse outcomes. Medications, while often effective in reducing certain ADHD symptoms, have many disadvantages, including misuse and side effects. Behavioral interventions do not have these adverse effects, but they are not as effective. Mindfulness is a candidate intervention for ADHD in elementary school children, but has not been systematically and rigorously studied.
This study will evaluate the feasibility and acceptability of Mindfulness-Based ADHD Treatment for Children (MBAT-C). MBAT-C is designed for children at precisely the age when ADHD-relevant neurocognitive systems are developing and clinical symptoms begin to appear. Forty-five children from the New Haven, CT area, ages 7-13, will be recruited to participate in this randomized-controlled feasibility trial that will compare MBAT-C, medication, and a combined intervention.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Attention-Deficit/Hyperactivity Disorder (ADHD) affects 11% of American children. ADHD is a source of considerable psychosocial, educational, and neurocognitive impairment. It is co-morbid with multiple psychiatric disorders and poses an economic burden. Pharmacotherapy is often the first-line treatment for children with ADHD, but such medications are associated with adverse effects, including insomnia, loss of appetite, headaches, stomachaches, tics, moodiness, and irritability. Further, concerns about substance misuse and diversion, as well as parental preference, can limit the use and utility of medications. These limitations underscore the urgency of developing behavioral interventions that do not pose such concerns. At this time, however, behavioral treatments for ADHD are generally less effective than pharmacotherapy, emphasizing the need for better non-pharmacologic interventions.
Mindfulness-defined here as nonjudgmentally paying attention to the present moment-is a promising behavioral approach to ADHD treatment, as evidence suggests that mindfulness improves attention in both healthy adults, and those with ADHD. Mindfulness also improves neurocognitive outcomes in children and adolescents, including executive function and attention, suggesting that mindfulness may be an effective treatment for ADHD in young persons.
This is a feasibility study of a novel intervention: Mindfulness-Based ADHD Treatment for Children (MBAT-C). MBAT-C is derived from Mindfulness-Based Stress Reduction (MBSR), a well-known and extensively-studied mindfulness intervention. Unlike all other mindfulness-based interventions, however, MBAT-C is tailored to the needs, abilities, and vulnerabilities of children with ADHD through the use of age-appropriate class length, homework assignments, contemplative practices, and discussion topics. Specifically, MBAT-C includes 16 twice-weekly 30-minute sessions over 8 weeks. Each session includes two brief meditations, discussion, an exercise, and homework.
In this study, 45 children ages 7-13 with ADHD will be randomized into one of three treatment groups: MBAT-C, medication (MED), or a combined intervention (COM).
The aims of the study are as follows:
Aim 1: Evaluate feasibility of MBAT-C
Aim 2. Measure within-group change from pre- to post-treatment on ADHD-relevant outcomes.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Early Phase 1
Contacts and Locations
Study Contact
Study Contact
- Name: David C Saunders, MD, PhD
- Phone Number: 9144096807
- Email: david.saunders@yale.edu
Study Locations
-
-
Connecticut
-
New Haven, Connecticut, United States, 06510
- Clinical & Affective Neuroscience Lab
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion criteria:
- child of any sex/gender ages 7-13;
- fulfills the Diagnostic Statistical Manual -5 criteria for ADHD (inattentive, hyperactive, or combined);
- speaks English;
- understands the assent form and provides informed assent;
- has parents who understand the consent form and provide informed consent;
- can commit to the full length of the protocol;
- is willing to undergo a wash-out period if already on ADHD medications;
- is willing to be randomized to treatment condition.
Exclusion criteria include:
- physical conditions that may preclude participation;
- any conditions contraindicated for ADHD medications, or potential participants taking monoamine-oxidase inhibitors;
- pregnancy.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Mindfulness-Based ADHD Treatment for Children
|
MBAT-C is derived from Mindfulness-Based Stress Reduction (MBSR), a well-known and extensively-studied mindfulness intervention.
Unlike all other mindfulness-based interventions, however, MBAT-C is tailored to the needs, abilities, and vulnerabilities of children with ADHD through the use of age-appropriate class length, homework assignments, contemplative practices, and discussion topics.
|
|
Active Comparator: Medication
|
Participants will receive gold-standard, non-experimental medication. This treatment arm relies on a step-by-step approach that is designed to mimic pharmacologic treatment-as-usual in the community. The treatment algorithm is as follows:
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|
Active Comparator: Combined (MBAT-C + medication)
|
MBAT-C is derived from Mindfulness-Based Stress Reduction (MBSR), a well-known and extensively-studied mindfulness intervention.
Unlike all other mindfulness-based interventions, however, MBAT-C is tailored to the needs, abilities, and vulnerabilities of children with ADHD through the use of age-appropriate class length, homework assignments, contemplative practices, and discussion topics.
Participants will receive gold-standard, non-experimental medication. This treatment arm relies on a step-by-step approach that is designed to mimic pharmacologic treatment-as-usual in the community. The treatment algorithm is as follows:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Recruitment
Time Frame: Completion of study (up to 30 months)
|
Total number of participants enrolled
|
Completion of study (up to 30 months)
|
|
Recruitment
Time Frame: Completion of study (up to 30 months)
|
Average time from screening to enrollment
|
Completion of study (up to 30 months)
|
|
Randomization
Time Frame: Completion of study (up to 30 months)
|
Percent of eligible screened participants who enroll and are randomized
|
Completion of study (up to 30 months)
|
|
Randomization
Time Frame: Completion of study (up to 30 months)
|
Percent of enrolled who attend at least one session
|
Completion of study (up to 30 months)
|
|
Attendance (MBAT-C Condition)
Time Frame: Post-Assessment (8-10 weeks)
|
Average number of minutes attended
|
Post-Assessment (8-10 weeks)
|
|
Attendance (Medication Condition)
Time Frame: Post-Assessment (8-10 weeks)
|
Average percent of scheduled medication visits attended
|
Post-Assessment (8-10 weeks)
|
|
Attendance (Combined Condition)
Time Frame: Post-Assessment (8-10 weeks)
|
Average percent of MBAT-C and medication visits attended
|
Post-Assessment (8-10 weeks)
|
|
Attendance (Combined Condition)
Time Frame: Post-Assessment (8-10 weeks)
|
Average number of minutes of MBAT-C attended
|
Post-Assessment (8-10 weeks)
|
|
Medication Adherence (for medication and combined conditions only)
Time Frame: Post-Assessment (8-10 weeks)
|
Average percent of prescribed doses taken
|
Post-Assessment (8-10 weeks)
|
|
Retention
Time Frame: Post-Assessment (8-10 weeks)
|
Percent of enrolled who attend >60% of study sessions
|
Post-Assessment (8-10 weeks)
|
|
Participation - Student Rated (for MBAT-C and combined conditions only)
Time Frame: Post-Assessment (8-10 weeks)
|
Average student ratings of participation of each MBAT-C session, as measured by the Research Assessment Package for Schools - Student (RAPS-SE); RAPS-SE is a 6 item measure with individual item scores ranging from 1 to 4; overall score is average of 3 individual items; higher scores indicate higher participation
|
Post-Assessment (8-10 weeks)
|
|
Participation - Teacher Rated (for MBAT-C and combined conditions only)
Time Frame: Post-Assessment (8-10 weeks)
|
Average teacher ratings of participation of each MBAT-C session, as measured by the Research Assessment Package for Schools - Teacher Engagement (RAPS-TE); RAPS-TE is a 3 item measure of participation with individual item scores ranging from 1 to 4; overall score is average of 3 individual items; higher scores indicate greater participation
|
Post-Assessment (8-10 weeks)
|
|
Homework Completion (for MBAT-C and combined conditions only)
Time Frame: Post-Assessment (8-10 weeks)
|
Average number of days per week practicing
|
Post-Assessment (8-10 weeks)
|
|
Homework Completion (for MBAT-C and combined conditions only)
Time Frame: Post-Assessment (8-10 weeks)
|
Average number of total minutes practiced
|
Post-Assessment (8-10 weeks)
|
|
Acceptability
Time Frame: Post-Assessment (8-10 weeks)
|
Average score on Acceptability of Intervention Measure (AIM); AIM is a 4 item measure of acceptability with individual item scores ranging from 1-4; overall score is sum of individual items; higher scores indicate higher acceptability
|
Post-Assessment (8-10 weeks)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
ADHD Symptoms
Time Frame: Post-Assessment (8-10 weeks)
|
Pre-assessment to post-assessment difference on ADHD Rating Scale (ADHD-RS); the ADHD-RS is an 18-item scale that assess core ADHD symptoms as reported by parents, with scores ranging from 0 to 54; higher scores indicate greater ADHD symptoms
|
Post-Assessment (8-10 weeks)
|
|
Total Problems
Time Frame: Post-Assessment (8-10 weeks)
|
Pre-assessment to post-assessment difference in the total score on the total problems subscale on the Child Behavior Checklist (CBCL), which is comprised of 98 questions; individual item scores range from 0 to 2; higher scores indicate higher amount of behavioral problems
|
Post-Assessment (8-10 weeks)
|
|
Externalizing Problems
Time Frame: Post-Assessment (8-10 weeks)
|
Pre-assessment to post-assessment difference in score on the externalizing problems subscale on the Child Behavior Checklist (CBCL), which is comprised of 33 questions; individual item scores range from 0 to 2; higher scores indicate higher amount of externalizing problems
|
Post-Assessment (8-10 weeks)
|
|
Attention
Time Frame: Post-Assessment (8-10 weeks)
|
Pre-assessment to post-assessment difference on Flanker Task performance, as assessed by accuracy
|
Post-Assessment (8-10 weeks)
|
|
Executive Function
Time Frame: Post-Assessment (8-10 weeks)
|
Pre-assessment to post-assessment difference on Hearts and Flowers Task, as assessed by accuracy
|
Post-Assessment (8-10 weeks)
|
|
Working Memory
Time Frame: Post-Assessment (8-10 weeks)
|
Pre-assessment to post-assessment difference in performance on the List Sorting Working Memory Task, as assessed by accuracy
|
Post-Assessment (8-10 weeks)
|
|
Mindfulness
Time Frame: Post-Assessment (8-10 weeks)
|
Pre-assessment to post-assessment difference in score on the Child and Adolescent Mindfulness Measure (CAMM); the CAMM is a 10-item measure of self-reported mindfulness; scores range from 0 to 40, with higher scores indicating higher mindfulness
|
Post-Assessment (8-10 weeks)
|
|
Overall Improvement
Time Frame: Post-Assessment (8-10 weeks)
|
Score on the Clinical Global Impression - Improvement (CGI-I) scale; the CGI-I is a 1 item measure of improvement from pre- to post-intervention, as assessed by a clinician; scores range from 0-7, with lower scores indicating greater improvement
|
Post-Assessment (8-10 weeks)
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Hedy Kober, PhD, Yale University
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2000020705
- 1R34AT009887-01A1 (U.S. NIH Grant/Contract)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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