P2.Q327: An Online Mindfulness-Based Intervention for Children with Attention Deficit Hyperactivity Disorder: A Feasibility Study

Background: 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. Recognizing the need for more accessible treatment options, a flexible, online-based MBI in Spanish and English was developed. The objective of this study was to assess the application and feasibility of an 8-week, online MBI for children with ADHD. We hypothesize that by providing a flexible online program structure, enabling engagement at any time without fixed appointments and accessible from any location, participants would exhibit good adherence to the program as designed.

Methods: Study participants were recruited from two hospital-based developmental-behavioral pediatrics clinics. Inclusion criteria specified diagnosis of ADHD, 8-12 years of age, and no changes in ADHD medication during the study. During the first and eighth week, caregivers completed questionnaires, including the BRIEF-2. For six weeks, participants engaged in weekly pre-recorded mindfulness interventions. Interviews were completed with caregivers following the study engagement; their responses were analyzed for common themes regarding feedback for the program.

Results: 85 families consented to participate (77 English-, 8 Spanish- speaking). Of these, 20 families completed all portions of the study and 8 were completely adherent to the schedule. Of the 65 families that did not complete the program, 46 participants engaged in at least one MBI activity. Review of scores on the BRIEF-2 for the 20 participants who completed the program revealed that there were no statistically significant changes in executive functioning. Adherence rates were noted to drop substantially between Week Two and Three which coincided with a predetermined decrease in reminders from study personnel after Week Two. 39 families participated in follow up interviews which revealed that the most common barriers to adherence were related to time management and commitment difficulties.

Conclusion: Our study aimed to assess if a flexible online MBI is feasible as a therapeutic option for children with ADHD. Only 23% of participants completed the program, which is comparable to other online-based MBI treatments. The 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. Additionally, the low completion rate emphasizes the need for additional supports to assist in completing the program. This is further supported by the themes from the follow up interviews identifying busy schedules and difficulty committing to the program as major barriers to adherence. This information will be used to further adapt online MBIs to cater to these families’ needs. Furthermore, linguistic and cultural adaptations are underway to expand the mindfulness tools provided to children with ADHD.