Abstract
Abstract
Objectives
Medication is the predominant treatment for childhood attention-deficit hyperactivity disorder (ADHD) but has side effects and limited longer-term effects. Mindfulness for children and their parents could be an alternative as it targets children’s core symptoms and supports parents. This study compared the effectiveness of a family mindfulness-based intervention to methylphenidate in children with ADHD.
Method
We conducted a randomised controlled trial (RCT) and a preference trial (PT) for families who refused randomisation. Mindfulness (“MYmind”) consisted of 2-months weekly group-based 1.5-hr mindfulness sessions for children and parallel mindful parenting for their parents, plus a follow-up session 2 months later. Medication concerned 4-months short-acting methylphenidate. Intention-to-treat (ITT) and per-protocol (PP) analyses were performed using multilevel modelling. Both parents and adolescents (not children) completed questionnaires on child ADHD pre-treatment, and at 2-, 4-, and 10-months follow-up, whereas teachers and blind observers completed these questionnaires at pre-treatment and 2-months follow-up only. Similarly, neuropsychological attention measures were administered pre-treatment and at 2-months follow-up only.
Results
In the RCT, 91 children with ADHD (Mage=11.29, range 9–18, 71% boys), 172 parents (91 mothers, 81 fathers), 81 teachers, and 85 observers participated, and in the PT, 29 children (Mage=11.57, 55% boys), 52 parents (28 mothers, 24 fathers), 24 teachers, and 26 observers. Medication was more effective than family mindfulness at 2 and 4 months on multi-informant questionnaires but not on objective (neuropsychological and blind observer) measures. Differences between treatments diminished at mid-term even though in the medication group treatment was continued after 2 months while the mindfulness training was already finished at 2 months. Differences between treatment groups disappeared at 10 months, but note that in the long-term, children from the mindfulness arm started taking medication and vice versa, so that we cannot be sure to what extent the long-term results are caused by mindfulness, medication, or its combination. Findings in the PT and according to PP analyses were similar. Note moreover that 1 in 4 children (26%) discontinued taking medication during the first 2 months versus almost no families (2%) discontinued mindfulness, suggesting that mindfulness was more easily accepted.
Conclusions
Overall, although mindfulness alone might not be sufficient for some families, family mindfulness training in general can be considered a non-pharmacological alternative or addition in the treatment of childhood ADHD.
Preregistration
https://onderzoekmetmensen.nl/nl/trial/22179, 11.10.2013.
Publisher
Springer Science and Business Media LLC
Subject
Applied Psychology,Developmental and Educational Psychology,Experimental and Cognitive Psychology,Health (social science),Social Psychology
Reference69 articles.
1. Achenbach, T. (1991). Integrative guide for the 1991 CBCL/4-18, YSR, and TRF profiles. University of Vermont.
2. American Academy of Child and Adolescent Psychiatry. (2007). Practice parameters for the assessment and treatment of children and adolescents with attention deficit hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 894–921. https://doi.org/10.1097/chi.0b013e318054e724
3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
4. Bachmann, C.J., Wijlaars, L.P., Kalverdijk, L.J., Burcu, M., Gloeske, G., Schuiling-Veninga, C.C.M., Hoffmann, F., Aagaard,L., & Zito, J.M. (2017). Trends in ADHD medication use in children and adolescents in five western countries, 2005–2012. European Neuropsychopharmacology, 27, 484-493. https://doi.org/10.1016/j.euroneuro.2017.03.002.
5. Bögels, S. M. (2020). MYmind Mindfulness Training voor Kinderen met ADHD en hun Ouders [MYmind mindfulness training for youth with ADHD and their parents]. LannooCampus.