According to the Centers for Disease Control (CDC), attention deficit hyperactivity disorder (ADHD) affects approximately 9.8% of children. 77% of these children receive either behavioral therapy and/or medication management. Mindfulness-based interventions (MBIs) are emerging as a potential adjunct treatment for individuals with ADHD. Considering post-pandemic gains in telehealth interventions, virtual or online-based treatments for ADHD have become increasingly desirable to widen access. This objective of this study was to assess the application and feasibility of an online MBI for children with ADHD.

Study participants were recruited from two hospital-based developmental-behavioral pediatrics clinics. Inclusion criteria specified diagnosis of ADHD, 8-12 years of age, English speaking, and no changes in ADHD medication during study timeline. Patients with comorbid neurological conditions were excluded. Caregivers of eligible participants completed baseline demographic questionnaires including the NICHQ Vanderbilt and BRIEF-2. Participants engaged in weekly pre-recorded mindfulness interventions for 6 weeks with a new topic each week. Topics included foundational mindfulness skills such as mindful breathing, present moment awareness, and mindful movement. Participants’ caregivers completed post-intervention questionnaires (NICHQ Vanderbilt and BRIEF-2) and an exit interview with study personnel. In total, the program lasted for 8 weeks.

Recruitment and participation began in October 2022 and was completed in June 2023. Of 411 interested families, 195 completed the screening, 104 were eligible for participation, and 77 families consented to participate. Baseline measures were completed by 69 and of those, 60 participants engaged in at least 1 video. From the 60, 18 families completed all components and 42 completed portions but not sufficient to be included in the final sample. Of the 18 families, 7 were fully adherent completing pre and post measures and following the order of videos per study protocol. The other 11 families completed all 6 videos but not in the order or time frames specified by the study protocol. Review of scores on the BRIEF-2 for the participants who completed pre and post measures (n = 18) revealed that there were no statistically significant changes in executive functioning. Group differences between the full and partial adherent groups were also not significant.

Our study aimed to assess if an online MBI is feasible as a therapeutic option for children with ADHD. While only a small percentage of participants completed the program (23%), these results suggest that the intervention did not yield statistically significant changes, underscoring the challenges of achieving measurable improvements in executive functioning through a brief online MBI, especially considering the limited sample size. Additionally, the low completion rate (23%) emphasizes the need for additional supports (i.e., more frequent reminders and check-ins with the study team) to assist families in completing the program. Future efforts will interview families who did not complete the study to review common themes and barriers contributing to treatment adherence. This information will be used to modify the intervention to make it more feasible for the next trial. Furthermore, linguistic and cultural adaptations are needed (and currently underway) to expand the mindfulness tools provided to children with ADHD.