Improve Lung Function in Children with Duchenne Muscular Dystrophy with Physiotherapy and Yoga

Improve Lung Function in Children with Duchenne Muscular Dystrophy with Physiotherapy and Yoga

 

By John M. de Castro, Ph.D.

 

It’s not just about the physical movement, although that can really benefit people. Yoga is more about the inner experience than the outer experience. For people who have disabilities, I focus on deep breathing and meditation. Even when a pose requires the use of muscles impacted by neuromuscular disease, I tell my students they can close their eyes and visualize the body part that won’t move the way they think it should.” – Chelsea Singer

 

Muscular dystrophy is a relatively rare inherited disease that damages and weakens muscles over time due to the lack of a protein called dystrophin, which is necessary for normal muscle function. The absence of this protein can cause problems with walking, swallowing, and muscle coordination. Eventually sufferers lose the ability to walk and require a wheelchair. Muscular dystrophy can occur at any age, but most diagnoses occur in childhood. Duchenne muscular dystrophy is the most common form in children occurring in 1 out of 3,500 births. The symptoms include trouble walking and standing, breathing difficulties, swallowing problems, and lung and heart weakness.

 

There is no cure for Duchenne muscular dystrophy. Drugs and surgery are used to slow progression and relieve symptoms. Respiratory problems are often treated with physiotherapy. Yoga practice has been shown to improve pulmonary function. It is not known, however, if yoga practice in addition to physiotherapy can help improve pulmonary function in children with Duchenne muscular dystrophy in children.

 

In today’s Research News article “Effect of Yoga and Physiotherapy on Pulmonary Functions in Children with Duchenne Muscular Dystrophy – A Comparative Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191220/ ) Dhargave and colleagues recruited boys 5-10 years old who were diagnosed with Duchenne muscular dystrophy and randomly assigned them to receive daily physiotherapy or the combination of physiotherapy plus yoga for 1 year. Physiotherapy occurred at home for 45 minutes twice a day in the morning and afternoon. The yoga group received physiotherapy in the morning and 45 minutes of yoga in the afternoon, including postures and breathing exercises. They were measure before and after training and every 3 months during the year of training for pulmonary function.

 

They found that in comparison to baseline both groups had significant improvements in pulmonary function over the year of training including improvements in vital capacity, peak expiratory flow rate, maximum voluntary ventilation, and tidal volume during maximum voluntary ventilation. Hence, replacing one daily physiotherapy session with yoga produced equivalent improvements in pulmonary function to 2 daily physiotherapy sessions. Both of the programs increased the respiratory muscle strength, maintained the resilience of lung tissue, and improved the lung capacities. Hence, yoga practice can be employed to supplement physiotherapy in the treatment of children diagnosed with Duchenne muscular dystrophy.

 

So, improve lung function in children with Duchenne muscular dystrophy with physiotherapy and yoga.

 

Although there is no cure, yoga can help to ease the symptoms of Muscular Dystrophy and improve quality of life. Yoga’s gentle movements in combination with pranayama (breathing techniques) can improve muscle tone and reduce pain, increasing the flow of oxygen, nutrients, and energy through the body, and enabling the more efficient expulsion of toxins.” – YogaClicks

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Dhargave, P., Nalini, A., Nagarathna, R., Sendhilkumar, R., James, T. T., Raju, T. R., & Sathyaprabha, T. N. (2021). Effect of Yoga and Physiotherapy on Pulmonary Functions in Children with Duchenne Muscular Dystrophy – A Comparative Study. International journal of yoga, 14(2), 133–140. https://doi.org/10.4103/ijoy.IJOY_49_20

 

Abstract

Context:

Abnormal respiratory function is known to be detectable almost as soon as it can be measured reliably. Studies have identified the effect of respiratory muscle training as well as breathing exercises in improving pulmonary functions in children with Duchenne muscular dystrophy (DMD).

Aims:

This study aims to identify the add-on effect of yoga over physiotherapy on pulmonary functions in children with DMD.

Settings and Design:

One hundred and twenty-four patients with DMD were randomized to two groups. Group I received home-based physiotherapy and Group II received physiotherapy along with yoga intervention.

Materials and Methods:

Pulmonary function test (PFT) was assessed before the intervention (baseline data) and at regular intervals of 3 months for a period of 1 year.

Statistical Analysis Used:

Normality was assessed using Shapiro–Wilk normality test. The baseline data were analyzed using Mann–Whitney U-test to identify the homogeneity. Repeated measures analysis of variance was used to assess significant changes in study parameters during the assessment of every 3 months, both within and between the two groups of patients.

Results:

A total of 88 participants completed all the 5 assessments, with a mean age of 7.9 ± 1.5 years. PFT parameters such as forced vital capacity (FVC), peak expiratory flow rate, maximum voluntary ventilation (MVV), and tidal volume during maximum voluntary ventilation (MVt) demonstrated significant improvements in Group I. In Group II, FVC and MVt significantly improved from baseline up to 1 year, whereas MVV improved from baseline up to 9 months. Tidal volume did not show any changes in both the groups.

Conclusions:

The findings suggest that introduction of yoga with physiotherapy intervention at an early age can be considered as one of the therapeutic strategies in improving pulmonary functions in patients with DMD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191220/

Improve Cognitive Ability in Elementary School Children with Mindfulness

Improve Cognitive Ability in Elementary School Children with Mindfulness

 

By John M. de Castro, Ph.D.

 

mindfulness [has been linked] to two core social-emotional skills: self-regulation and self-awareness. Skills in these areas teach students not only how to recognize their thoughts, emotions, and actions, but also how to react to them in positive ways.” – Waterford.org

 

Childhood is a miraculous period during which the child is dynamically absorbing information from every aspect of its environment. This is particularly evident during the elementary school years. Mindfulness training in school has been shown to have very positive effects. These include improvements in the academic, cognitive, psychological, emotional and social domains. Importantly, mindfulness training in school appears to improve attentional ability which is fundamental to success in all aspects of academic performance. But there have been few studies comparing the effects of mindfulness training to other types of training for elementary schoolchildren.

 

In today’s Research News article “Mindfulness-Based Versus Story Reading Intervention in Public Elementary Schools: Effects on Executive Functions and Emotional Health.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.576311/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1679696_a0P58000000G0YfEAK_Psycho_20210713_arts_A ) Milaré and colleagues recruited 2 classrooms of children 8-9 years of age. One class received an 8-week mindfulness training that met twice a week for 30 minutes. The instructions were on awareness, generosity, and heartfulness. The other class received 8 weeks of story reading that met twice a week for 15 minutes. The stories were targeted to moral and emotional issues appropriate for children. They were measured before and after training for stress, anxiety, depression, positive and negative emotions, and executive functions including attention.

 

They found that in comparison to baseline both groups had significant improvements in executive functions including attention, processing speed, and controlled attention. On the other hand, the story reading but not mindfulness group had decreases in depression and negative emotions.

 

It should be noted that there wasn’t a control condition, so improvements from baseline might have been due to a number of confounding factors including practice effects, expectancy effects, experimenter bias etc. In addition, there wasn’t random assignment of the children to condition. But in adults it is well established that mindfulness training produces improvements in executive functions including attention. This is not surprising as mindfulness training involves focusing attention which is important for cognitive performance. The present study suggests that these benefits also accrue to 8-9 year-old children. Improving cognitive skills particularly attention in children is important and may well lead to improved academic performance.

 

It is interesting that targeted story reading produced similar cognitive benefits and also some emotional improvements. This may be due to the fact that the stories included emotional issues pertinent to children while the mindfulness training did not include mindfulness of emotions. This suggests that the mindfulness program could be improved by including paying attention to emotions.

 

So, improve cognitive ability in elementary school children with mindfulness.

 

Students . . . have been spending anywhere from 10 to 12 minutes per day on mindfulness exercises. But classes appear to be gaining more instruction time as a result because there are fewer outbursts and disruptions.” – Emily DeRuy

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Milaré CAR, Kozasa EH, Lacerda S, Barrichello C, Tobo PR and Horta ALD (2021) Mindfulness-Based Versus Story Reading Intervention in Public Elementary Schools: Effects on Executive Functions and Emotional Health. Front. Psychol. 12:576311. doi: 10.3389/fpsyg.2021.576311

 

Introduction: In this study we compared the effects of a mindfulness-based intervention (MBI) with a story reading intervention (SI) on the executive functions and psychological profile of children in two different public schools in São Paulo, Brazil.

Methods: In this controlled clinical trial, 207 children aged 8 to 9 years old responded to the Five-Digit Test (FDT), stress levels, depression, anxiety, positive and negative affect, at baseline (T0) and 8 weeks later (T1). From T0 to T1, school 1 participated in MBI classes and school 2 in IS classes.

Results: In school 1 (MBI), children improved their scores on all tests except reading (errors) and counting (errors) compared with school 2. No differences were observed between groups in terms of emotional health.

Conclusion: It is feasible to implement MBI or SI in Brazilian public schools. Students in the MBI group presented broader effects in executive functions, while students in the SI group showed a trend toward reduced negative affect and depression symptoms.

Highlights

This study contributes to the scientific evidence of the positive effects of Mindfulness and Story reading on executive functions and emotional well-being in children. Neither intervention had significant effects on depression, anxiety, stress, positive, and negative affect (although Story reading showed a trend in reducing negative affect and depression), while the Mindfulness-Based Intervention had relatively broader effects on executive functions.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.576311/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1679696_a0P58000000G0YfEAK_Psycho_20210713_arts_A

 

Mindfulness Improves Thinking in Children and Youths with Attention Deficit Hyperactivity Disorder (ADHD)

Mindfulness Improves Thinking in Children and Youths with Attention Deficit Hyperactivity Disorder (ADHD)

 

By John M. de Castro, Ph.D.

 

“studies indicate that people with ADHD can meditate successfully, and that meditation may have benefits for some of the behaviors associated with ADHD.” – Corey Whelan

 

Attention Deficit Hyperactivity Disorder (ADHD) is most commonly found in children, but for about half it persists into adulthood. It’s estimated that about 5% of the adult population has ADHD. Hence, this is a very large problem that can produce inattention, impulsivity, hyperactivity, and emotional issues, and reduce quality of life. The most common treatment is drugs, like methylphenidate, Ritalin, which helps reducing symptoms in about 30% of the people with ADHD. Unfortunately, the effectiveness of the drugs appears to be markedly reduced after the first year. In addition, the drugs often have troublesome side effects, can be addictive, and can readily be abused. So, drugs, at present, do not appear to be a good solution, only affecting some, only for a short time, and with unwanted side effects.

 

There are indications that mindfulness practices may be an effective treatment for ADHD. It makes sense that it should be, as the skills and abilities strengthened by mindfulness practices training are identical to those that are defective in ADHD,  attentionimpulse controlexecutive functionemotion control, and mood improvement. In addition, unlike drugs, they are relatively safe interventions that have minimal troublesome side effects.

 

In today’s Research News article “The Differential Impact of Acute Exercise and Mindfulness Meditation on Executive Functioning and Psycho-Emotional Well-Being in Children and Youth With ADHD.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.660845/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1665889_a0P58000000G0YfEAK_Psycho_20210623_arts_A ) Bigelow and colleagues recruited children aged 10-14 years who were diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). They completed 3 sessions in random order of 10 minutes of either aerobic cycling, mindfulness meditation, or magazine reading. They were measured before and after each session and 10 minutes later for inhibitory control, short-term memory, task switching, mood, and self-efficacy.

 

They found that in comparison to baseline and the magazine reading control condition only mindfulness meditation produced an increase in inhibitory control, short-term memory, and task switching. The improvement in inhibitory control and short-term memory were still present 10 minutes later. On the other hand, in comparison to baseline and the magazine reading control condition only aerobic exercise produced an improvement in mood and self-efficacy.

 

These results suggest that brief mindfulness meditation produces short-term improvements in executive function (thinking) in children with Attention Deficit Hyperactivity Disorder (ADHD) while aerobic exercise produces mood improvements in these children. These are acute effects of brief interventions and do not demonstrate lasting effects. But previous research has shown that mindfulness training produces lasting improvements in ADHD and executive function and that yoga practice, a form of exercise and mindfulness practice also produces lasting improvements in ADHD and executive function.

 

Hence, it appears that mindfulness training and exercise are both beneficial for children with Attention Deficit Hyperactivity Disorder (ADHD) but they appear to affect different types of ADHD symptoms with mindfulness meditation improving executive function and exercise improving emotions. This suggests that a combined program or meditation and exercise may be particularly beneficial for children with ADHD. It remains for future research to examine this intriguing possibility.

 

So, mindfulness improves thinking in children and youths with Attention Deficit Hyperactivity Disorder (ADHD)

 

 

Medication and therapy are good ways to manage your ADHD symptoms. But they’re not your only options. Research now shows that mindfulness meditation — where you actively observe your moment-to-moment thoughts and feelings- — may also be a good way to calm your mind and improve your focus.” – WebMD

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Bigelow H, Gottlieb MD, Ogrodnik M, Graham JD and Fenesi B (2021) The Differential Impact of Acute Exercise and Mindfulness Meditation on Executive Functioning and Psycho-Emotional Well-Being in Children and Youth With ADHD. Front. Psychol. 12:660845. doi: 10.3389/fpsyg.2021.660845

 

This study investigated how acute exercise and mindfulness meditation impacts executive functioning and psycho-emotional well-being in 16 children and youth with ADHD aged 10–14 (male = 11; White = 80%). Participants completed three interventions: 10 min of exercise, 10 min of mindfulness meditation, and 10 min of reading (control). Before and after each intervention, executive functioning (inhibitory control, working memory, task-switching) and psycho-emotional well-being (mood, self-efficacy) were assessed. Mindfulness meditation increased performance on all executive functioning tasks whereas the other interventions did not (d = 0.55–0.86). Exercise enhanced positive mood and self-efficacy whereas the other interventions did not (d = 0.22–0.35). This work provides preliminary evidence for how acute exercise and mindfulness meditation can support differential aspects of executive and psycho-emotional functioning among children and youth with ADHD.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.660845/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1665889_a0P58000000G0YfEAK_Psycho_20210623_arts_A

 

Yoga Improves Pregnancy and Childbirth Outcomes

Yoga Improves Pregnancy and Childbirth Outcomes

 

By John M. de Castro, Ph.D.

 

“Much like other types of childbirth-preparation classes, prenatal yoga is a multifaceted approach to exercise that encourages stretching, mental centering and focused breathing. Research suggests that prenatal yoga is safe and can have many benefits for pregnant women and their babies.” – Mayo Clinic

 

The period of pregnancy is a time of intense physiological and psychological change. The psychological health of pregnant women has consequences for fetal development, birthing, and consequently, child outcomes. Depression during pregnancy is associated with premature delivery and low birth weight. Childbirth fear is associated with “low childbirth self-efficacy, greater use of pain medication during labor, more unwanted obstetric interventions in labor, as well as increased risk of postpartum depression.” Hence, it is clear that there is a need for methods to treat childbirth fear, depression, and anxiety during pregnancy. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. Yoga has been shown to relieve maternal anxiety and depression during pregnancy. So, it would make sense to study the effects of yoga during pregnancy.

 

In today’s Research News article “The effect of yoga on the delivery and neonatal outcomes in nulliparous pregnant women in Iran: a clinical trial study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8091762/ )  Yekefallah and colleagues recruited women during their first pregnancy in their 26th-28th week and randomly assigned them to a no-treatment control condition or to receive 10 weeks of twice a week 75-minute Hatha yoga classes. They completed demographic information and body size and information was recorded about the pregnancy, childbirth, and neonatal outcome (Apgar score).

 

They found that the yoga group was significantly less likely to have labor induced, have a preterm delivery, had a significantly shorter labor duration, and had significantly lower episiotomy rupture grades. In addition, the children of the yoga group had significantly higher birthweights, were born at a later gestational age, and had significantly higher Apgar scores.

 

The results clearly demonstrate that yoga practice during a first pregnancy improves the pregnancy, delivery, and neonatal outcomes. It should be noted, however, that the comparison group did not receive any treatment. So, it is not clear if the benefits were due to practicing yoga or if they would have been produced by any gentle exercise. Nevertheless, the study found evidence that practicing yoga during pregnancy is of great benefit to the mother and the infant.

 

So, yoga improves pregnancy and childbirth outcomes.

 

The combination of length and strength in the pelvic floor creates muscles with great integrity to support a baby in addition to all of the organs that rest on it. These strong muscles in conjunction with the gluteus medius are called upon during the second stage of labor (pushing) and are responsible for helping the bones of the pelvis come back together after delivery.“ – Karly Treacy

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Yekefallah, L., Namdar, P., Dehghankar, L., Golestaneh, F., Taheri, S., & Mohammadkhaniha, F. (2021). The effect of yoga on the delivery and neonatal outcomes in nulliparous pregnant women in Iran: a clinical trial study. BMC pregnancy and childbirth, 21(1), 351. https://doi.org/10.1186/s12884-021-03794-6

 

Abstract

Background

Yoga can reduce the risk of preterm delivery, cesarean section (CS), and fetal death. The aim of the present study was to investigate the effects of Yoga on pregnancy, delivery, and neonatal outcomes.

Methods

This was a clinical trial study and using the random sampling without replacement 70 pregnant women entered Hatha Yoga and control groups according to the color of the ball they took from a bag containing two balls (blue or red). The data collection tool was a questionnaire pregnancy, delivery, and neonatal outcomes. The intervention in this study included pregnancy Hatha Yoga exercises that first session of pregnancy Yoga started from the 26th week and samples attended the last session in the 37th week. They exercised Yoga twice a week (each session lasting 75 min) in a Yoga specialized sports club. The control group received the routine prenatal care that all pregnant women receive.

Results

The results showed that yoga reduced the induction of labor, the episiotomy rupture, duration of labor, also had a significant effect on normal birth weight and delivery at the appropriate gestational age. There were significant differences between the first and second Apgar scores of the infants.

Conclusion

The results of the present study showed that Yoga can improve the outcomes of pregnancy and childbirth. They can be used as part of the care protocol along with childbirth preparation classes to reduce the complications of pregnancy and childbirth.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8091762/

 

Improve Cognition and Performance in 3rd Grade Children with Mindfulness

Improve Cognition and Performance in 3rd Grade Children with Mindfulness

 

By John M. de Castro, Ph.D.

 

The Collaborative for Academic, Social, and Emotional Learning (CASEL) has linked mindfulness to two core social-emotional skills: self-regulation and self-awareness. Skills in these areas teach students not only how to recognize their thoughts, emotions, and actions, but also how to react to them in positive ways.” – Waterford.org

 

Childhood is a miraculous period during which the child is dynamically absorbing information from every aspect of its environment. This is particularly evident during the elementary school years. Mindfulness training in school has been shown to have very positive effects. These include improvements in the academic, cognitive, psychological, and social domains. Training early in childhood has the potential of jump-starting the child’s academic performance.

 

In today’s Research News article “Promoting Third Graders’ Executive Functions and Literacy: A Pilot Study Examining the Benefits of Mindfulness vs. Relaxation Training.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.643794/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1645362_69_Psycho_20210525_arts_A )  Cordeiro and colleagues recruited 3rd grade students and randomly assigned them to receive 2 30-minute sessions per week for 8 weeks of either mindfulness training or progressive muscle relaxation training. They were measured before and after training for non-verbal intelligence, short-term memory, inhibitory control, and cognitive flexibility, teacher ratings of the child’s short-term memory, inhibitory control, and cognitive flexibility, handwriting fluency, spelling, essay quality, and school grades.

 

They found that for children low in executive function, relaxation training produced significantly greater improvement in executive function while students high in executive function, mindfulness training produced significantly greater improvement in executive function. Further, in children high in cognitive flexibility mindfulness training produced significantly greater improvement in cognitive flexibility. Finally, they found that mindfulness training produced significantly greater improvements in handwriting fluency and school grades than relaxation training.

 

The results were not as straightforward as one might like but still are interesting. They suggest that mindfulness training of 3rd grade students produces cognitive improvements in the students with the greatest cognitive ability to start with and significantly greater improvements in grades and handwriting fluency in all students. It should be noted that there was no follow-up beyond the end of training, so it is not known if the benefits of mindfulness training persist longer than immediately after training.

 

It has been demonstrated in previous research that mindfulness training produces improvement in cognition and school performance. The results of the present study suggest that mindfulness training is beneficial for young children in the 3rd grade improving their thinking ability and school performance. Early interventions in children’s lives and school performance have the potential of producing greater achievements as the child progresses through school. It remains for future research to determine the long-term effects of early mindfulness training.

 

So, improve cognition and performance in 3rd grade children with mindfulness.

 

Mindfulness applies to nearly every part of life. It includes everything from mindful commuting, to being mindful of what we eat (and how it smells and tastes) to being mindful of opportunities to sneak in some physical activity – or rest – during our busy days. And for adults, a good place to start learning the art of mindfulness is from these third graders!” – Health Partners

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Cordeiro C, Magalhães S, Rocha R, Mesquita A, Olive T, Castro SL and Limpo T (2021) Promoting Third Graders’ Executive Functions and Literacy: A Pilot Study Examining the Benefits of Mindfulness vs. Relaxation Training. Front. Psychol. 12:643794. doi: 10.3389/fpsyg.2021.643794

 

Research suggested that developing mindfulness skills in children improves proximal outcomes, such as attention and executive functions, as well as distal outcomes, such as academic achievement. Despite empirical evidence supporting this claim, research on the benefits of mindfulness training in child populations is scarce, with some mixed findings in the field. Here, we aimed to fill in this gap, by examining the effects of a mindfulness training on third graders’ proximal and distal outcomes, namely, attention and executive functions (viz., inhibitory control, working memory, and cognitive flexibility) as well as literacy-related achievement (viz., handwriting fluency, text quality, Portuguese grades). These outcomes were measured with behavioral tasks and teacher ratings. Sixty-six Portuguese children were randomly allocated to an experimental group receiving mindfulness training (n = 29) or an active control group receiving relaxation training (n = 37). Both training programs were implemented by psychologists in two 30-min weekly sessions for 8 weeks. All students were assessed before and after the interventions. Three main findings are noteworthy: (a) mindfulness training enhanced teacher-rated cognitive flexibility and a performance-based composite score of executive functions among children with higher pretest scores; (b) relaxation training improved performance-based cognitive flexibility and the composite score of executive functions among children with lower pretest scores; (c) children receiving mindfulness training had higher handwriting fluency and better grades in Portuguese than those receiving relaxation training. These findings provide preliminary evidence on the benefits of mindfulness training in educational settings and highlight the moderating role of baseline performance on those benefits.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.643794/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1645362_69_Psycho_20210525_arts_A

 

Improve Elementary School Children Behavior with Mindfulness

Improve Elementary School Children Behavior with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Research shows that mindfulness skills improve memory, organizational skills, reading and math scores, all while giving kids the tools they need to handle toxic stress.” – Michelle Kinder

 

Elementary school environments have a huge effect on development. They are also excellent times to teach children the skills to adaptively negotiate its environment. Mindfulness training in school, at all levels has been shown to have very positive effects. These include academic, cognitive, psychological, and social domains. Importantly, mindfulness training in school appears to improve the student’s self-concept. It also improves attentional ability and reduces stress, which are keys to successful learning in school. Since, what occurs in the early years of school can have such a profound, long-term effect on the child it is important to further study the impact of mindfulness training on elementary school children.

 

In today’s Research News article “Effects of a School-Based Mindfulness Program for Young Children.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8046640/ )  Sciutto and colleagues recruited kindergarten through 3rd grade children aged 5 to 9 years. They were assigned to either receive an 8-week 16 session mindfulness program or to a 4-week delay before the mindfulness program. The teachers rated the children’s behavior for emotional symptoms, conduct problems, hyperactivity, peer problems, prosocial behavior, and student engagement. Teacher engagement was also measured.

 

During the 4-week delay period there were no significant changes in the children’s behavior. But over the 8-week mindfulness training period there was a significant increase in prosocial behaviors and decrease in externalizing behaviors. This was true for all classes except kindergarten. They also found that the higher the levels of teacher engagement and student engagement, the higher the levels of prosocial behaviors and the lower the levels of externalizing behaviors.

 

These are interesting results that suggest that mindfulness training in elementary school children improves their behaviors. Prosocial behaviors including sharing, helping, and cooperating were improved. In fact, the mindfulness program specifically included training in mindful prosocial behavior. So, it was not surprising that these behaviors were improved. Externalizing behaviors including hyperactivity and conduct problems were also improved. Since, these behaviors interfere with instruction and student learning, it would be expected that their reduction would contribute to overall learning, although this was not measured.

 

In addition, the engagement in the program of teachers and students appears to be very important for the benefits to accrue. Hence, strides should be taken to insure engagement. Overall, the results indicate that the mindfulness program is beneficial for the children and the learning environment. It would be interesting to explore whether these effects are transitory or improve student behavior as they progress through the years.

 

So, improve elementary school children behavior with mindfulness.

 

For children, mindfulness can offer relief from whatever difficulties they might be encountering in life. It also gives them the beauty of being in the present moment.” – Annika Harris

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Sciutto, M. J., Veres, D. A., Marinstein, T. L., Bailey, B. F., & Cehelyk, S. K. (2021). Effects of a School-Based Mindfulness Program for Young Children. Journal of Child and Family Studies, 1–12. Advance online publication. https://doi.org/10.1007/s10826-021-01955-x

 

Abstract

Schools are an attractive setting for implementation of mindfulness-based programs because mindfulness practices, by their very nature, align with a wide range of core educational goals. The present study investigated the effects of an 8-week (16 session) school-based mindfulness program for young children across 8 classrooms (K through 2) using a quasi-experimental delayed-intervention control group design. Results indicated that the mindfulness program was associated with significant improvements in teacher ratings of externalizing and prosocial behaviors. Program outcomes were not associated with child sex or race/ethnicity, but did vary by grade. Descriptive analyses suggest that outcomes tended to be more positive in classrooms with higher levels of teacher and student engagement. Results of the present study add to the growing knowledge base on the positive effects of school-based mindfulness programs and point to a need for more rigorous inquiry into the extent to which students and teachers are engaged with mindfulness programs both during the program itself and in their day to day functioning.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8046640/

 

Mindfulness’ Association with Well-Being is Diminished by Adverse Childhood Experiences

Mindfulness’ Association with Well-Being is Diminished by Adverse Childhood Experiences

 

By John M. de Castro, Ph.D.

 

“mindfulness instruction may mitigate the negative effects of stress and trauma related to adverse childhood exposures, improving short- and long-term outcomes, and potentially reducing poor health outcomes in adulthood.” – Robin Ortiz

 

Childhood trauma can leave in its wake symptoms which can haunt the victims for the rest of their lives. These include persistent recurrent re-experiencing of the traumatic event, including flashbacks and nightmares, loss of interest in life, detachment from other people, increased anxiety and emotional arousal, including outbursts of anger, difficulty concentration, and jumpiness, startling easily. Unfortunately, childhood maltreatment can continue to affect mental and physical health throughout the individual’s life. How individuals cope with childhood maltreatment helps determine the effects of the maltreatment on their mental health.

 

It has been found that experiencing the feelings and thoughts produced by trauma completely allows for better coping. This can be provided by mindfulness. Indeed, mindfulness has been found to be effective for relieving trauma symptoms. But it is not known how mindfulness interacts with adverse childhood experiences to impact psychological well-being later on.

 

In today’s Research News article “Adverse Childhood Experiences and Psychological Well-Being in Chinese College Students: Mediation Effect of Mindfulness.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7915366/ ) Huang and colleagues recruited college juniors and seniors online and had them complete measures of psychological well-being, mindfulness, and adverse childhood experiences (“including abuse (psychological, physical, or sexual), neglect, household challenges such as violence perpetrated against mother and cohabitation with individuals who use substances or have mental illness or incarceration history, from the first 18 years of life”.)

 

They found that the students for the most part experienced low levels of adverse childhood experiences with an average of 0.69 experiences. They found that the higher the levels of mindfulness the greater the levels of psychological well-being and the lower the levels of adverse childhood experiences. In addition, the higher the levels of adverse childhood experiences, the lower the levels of psychological well-being. A mediation analysis revealed that adverse childhood experiences were associated with reduced levels of psychological well-being directly and also indirectly by being associated with lower levels of mindfulness, lowering their ability to improve psychological well-being.

 

These findings are correlational and as such conclusions regarding causation cannot be conclusively drawn. But previous controlled research has demonstrated that mindfulness improves psychological well-being, and lowers the symptoms of trauma, and that trauma diminishes well-being. So the present findings likely also represent causal linkages. Hence, the results suggest that mindfulness is good for the psychological well-being of college students but mindfulness is diminished by adverse childhood experiences and these experiences also directly decrease the students’ well-being.

 

Trauma during the early years of life can have a negative impact on the individual for the rest of their lives. The fact that mindfulness can mitigate these effects is heartening. It suggests the mindfulness training should be routinely implemented for individuals who experienced trauma in their formative years.

 

So, mindfulness’ association with well-being is diminished by adverse childhood experiences.

 

mindfulness training may enable those experiencing post-traumatic stress to be better able to inhibit or reduce the pernicious cycle of negative thoughts, feelings, and memories that accompany traumatic stress.” – B. Grace Bullock

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are a also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Huang, C. C., Tan, Y., Cheung, S. P., & Hu, H. (2021). Adverse Childhood Experiences and Psychological Well-Being in Chinese College Students: Mediation Effect of Mindfulness. International journal of environmental research and public health, 18(4), 1636. https://doi.org/10.3390/ijerph18041636

 

Abstract

Literature on the antecedents of psychological well-being (PWB) has found that adverse childhood experiences (ACEs) and mindfulness are associated with PWB; less is known, however, about the role of mindfulness, a type of emotional and self-regulation, in the pathway between ACEs and PWB. This study used data from 1871 college students across China to examine the relation between ACEs and PWB, and whether the relation was mediated by mindfulness. The findings from structural equation modelling indicate a statistically significant negative association between ACEs and PWB, while mindfulness was strongly and positively associated with PWB. The effect of ACEs on PWB was reduced once mindfulness was controlled for in the analysis. This provides evidence that mindfulness was able to partially mediate the effects of negative life experiences on psychological well-being. This calls for mindfulness interventions targeted toward students with a history of ACEs to buffer the effects of ACEs on PWB.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7915366/

 

Improve Physical and Mental Well-Being with Mindfulness Meditation-Based Interventions

Improve Physical and Mental Well-Being with Mindfulness Meditation-Based Interventions

 

By John M. de Castro, Ph.D.

 

“mindfulness meditation is related to improved mental health across a variety of disorders, including different anxiety disorders, depression, eating disorders, substance abuse, and chronic pain symptom reduction.” – Jennifer Wolkin

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of mental and physical illnesses. It appears to be beneficial across ages, from children to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity. The breadth and depth of benefits is unprecedented. There is no other treatment or practice that has been shown to come anyway near the range of mindfulness’ positive benefits.

 

Over the last few decades, a vast amount of research has been published on the benefits of mindfulness practices on the mental and physical health of the practitioners. Many reviews, summarizations, and meta-analyses have been performed of these studies. So, it makes sense to step back and summarize what these meta-analyses have found.

 

In today’s Research News article “The empirical status of mindfulness-based interventions: A systematic review of 44 meta-analyses of randomized controlled trials.” (See summary below or view the full text of the study at: https://centerhealthyminds.org/assets/files-publications/Goldberg-the-empirical-status.pdf ) Goldberg and colleagues review, summarize, and perform a meta-analysis of previous meta-analyses of published randomized controlled studies on benefits of sustained meditation practices on mental and physical well-being. They identified 44 published meta-analyses, representing 336 randomized controlled trials, which included a total of 30,483 participants.

 

They report that the meta-analyses of published randomized controlled trials found that sustained mindfulness meditation practices in comparison to passive, no treatment, controls had a very wide range of beneficial effects across a wide range of participants from children to the elderly, over a variety of programs from Mindfulness-Based Stress Reduction (MBSR) to mobile health, over a variety of psychological issues from anxiety to psychoses, and over a wide range of diseases from chronic pain to cancer. These effects were present immediately post treatment and at later follow-ups (an average of 7 months after treatment).

 

Comparison of these mindfulness meditation practices to active control conditions such as attentional controls to evidence-based treatments, resulted in reduced effect sizes and many were non-significant. Mindfulness meditation practices had significantly superior effects than active controls for adults, children, employees, and health care professionals/trainees but not for students. They were superior for psychiatric disorders, substance use, smoking, and depression but not for physical health conditions, pain, weight/eating-related conditions, cancer, or anxiety. They were superior for stress, and psychiatric symptoms but not for sleep, physical health symptoms, objective measures, or physiological measures.

 

These findings are essentially summaries of summaries and are based upon a wide variety of different researchers, methodologies, cultures, and time frames. Yet, the results are fairly consistent. In comparison to doing nothing, passive controls, mindfulness meditation practices are very beneficial for a wide range of physical and psychological issues over a wide range of ages. But these practices when compared to other types of treatments, are less effective and at times not superior. Nevertheless, this meta-analysis of meta-analyses paints a clear picture of the wide-ranging efficacy of mindfulness meditation practices for the relief of physical and psychological issues. These results verify the unprecedented depth and breadth of benefits of mindfulness meditation practices.

 

So, improve physical and mental well-being with mindfulness meditation-based interventions.

 

Practicing mindfulness exercises can have many possible benefits, including: reduced stress, anxiety and depression, less negative thinking and distraction, and improved mood,” -Mayo Clinic

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Goldberg, S. B., Riordan, K., Sun, S., & Davidson, R. J. (2021). The empirical status of mindfulness-based interventions: A systematic review of 44 meta-analyses of randomized controlled trials. Perspectives on Psychological Science 1–23, DOI: 10.1177/1745691620968771

 

Abstract

In response to questions regarding the scientific basis for mindfulness-based interventions (MBIs), we evaluated their empirical status by systematically reviewing meta-analyses of randomized controlled trials (RCTs). We searched six databases for effect sizes based on ≥4 trials that did not combine passive and active controls. Heterogeneity, moderators, tests of publication bias, risk of bias, and adverse effects were also extracted. Representative effect sizes based on the largest number of studies were identified across a wide range of populations, problems, interventions, comparisons, and outcomes (PICOS). A total of 160 effect sizes were reported in 44 meta-analyses (k=336 RCTs, N=30,483 participants). MBIs showed superiority to passive controls across most PICOS (ds=0.10-0.89). Effects were typically smaller and less often statistically significant when compared to active controls. MBIs were similar or superior to specific active controls and evidence-based treatments. Heterogeneity was typically moderate. Few consistent moderators were found. Results were generally robust to publication bias, although other important sources of bias were identified. Reporting of adverse effects was inconsistent. Statistical power may be lacking in meta-analyses, particularly for comparisons with active controls. As MBIs show promise across some PICOS, future RCTs and meta-analyses should build upon identified strengths and limitations of this literature.

https://centerhealthyminds.org/assets/files-publications/Goldberg-the-empirical-status.pdf

 

More Attentive Mother-Child Interactions are Associated with Mindfulness

More Attentive Mother-Child Interactions are Associated with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindful parenting means that you bring your conscious attention to what’s happening, instead of getting hijacked by your emotions. Mindfulness is about letting go of guilt and shame about the past and focusing on right now. It’s about accepting whatever is going on, rather than trying to change it or ignore it.” –  Jill Ceder

 

Raising children, parenting, is very rewarding. But it can also be challenging. Children test parents frequently. They test the boundaries of their freedom and the depth of parental love. They demand attention and seem to especially when parental attention is needed elsewhere. They don’t always conform to parental dictates or aspirations for their behavior. The challenges of parenting require that the parents be able to deal with stress, to regulate their own emotions, and to be sensitive and attentive their child. These skills are exactly those that are developed in mindfulness training. It improves the psychological and physiological responses to stress. It improves emotion regulation. It improves the ability to maintain attention and focus in the face of high levels of distraction.

 

Mindful parenting involves the parents having emotional awareness of themselves and compassion for the child and having the skills to pay full attention to the child in the present moment, to accept parenting non-judgmentally and be emotionally non-reactive to the child. Mindful parenting has been shown to have positive benefits for both the parents and the children. Hence, it is important to study the effects of the mother’s mindfulness on their interactions with their infants.

 

In today’s Research News article “Does Mothers’ Self-Reported Mindful Parenting Relate to the Observed Quality of Parenting Behavior and Mother-Child Interaction?” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7652703/ )  Potharst and colleagues recruited mothers with infants (0 to 24 months of age) and toddlers (24 to 48 months of age). The mothers completed measures of mindful parenting and were observed with their infants and toddlers for maternal sensitivity and acceptance. The mother’s speech while interacting with the child was categorized and mind related comments assessed and the mothers gaze during the interaction recorded.

 

They found that the higher the levels of mindful parenting the higher the levels of compassion for the child. They also found that the higher the levels of mindful listening with full attention the higher the levels of non-attuned mind related comments. Finally, they found that the higher the levels of mindful parenting, the higher the levels of mother’s gave upon the child’s face during interacting with the child.

 

These results are interesting but correlational, so caution must be exercised in concluding causation. The results do suggest that the mother’s levels of mindful parenting are related to their levels of compassion for the child and how the mothers interact with the child. In particular mindful parenting appears to be related to the amount of attention the mother provides the child. These better interactions between mother and child might predict better psychological well-being of the children are they grow. It will be interesting in the future to investigate whether training in mindful parenting will produce improvements in mother’s interactions with their children.

 

So, more attentive mother-child interactions are associated with mindfulness.

 

Mindfulness is also a potent tool for parents, especially when they’re feeling challenged by a child’s attitudes or behavior, and it’s easier to achieve than most people realize.” – Donna Matthews

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Potharst, E. S., Leyland, A., Colonnesi, C., Veringa, I. K., Salvadori, E. A., Jakschik, M., Bögels, S. M., & Zeegers, M. (2020). Does Mothers’ Self-Reported Mindful Parenting Relate to the Observed Quality of Parenting Behavior and Mother-Child Interaction?. Mindfulness, 1–13. Advance online publication. https://doi.org/10.1007/s12671-020-01533-0

 

Abstract

Objectives

Growing academic interest in mindful parenting (MP) requires a reliable and valid measure for use in research and clinical setting. Because MP concerns the way parents relate to, and nurture, their children, it is important to evaluate the associations between self-reported MP and observed parenting and parent-child interaction measures.

Methods

Seventy-three mothers who experience difficulties with their young children aged 0–48 months admitted for a Mindful with your baby/toddler training (63% in a mental health care and 27% in a preventative context) were included. Mothers completed the Interpersonal Mindfulness in Parenting scale (IM-P) and video-observations of parent-child interactions were coded for maternal sensitivity, acceptance, mind-mindedness, and emotional communication (EC).

Results

The IM-P total score was positively associated only with mothers’ gaze to the child (EC). IM-P subscale Listening with Full Attention negatively predicted non-attuned mind-mindedness, Compassion with the Child positively predicted maternal sensitivity and positive facial expression (EC), and Emotional Awareness of Self positively predicted mothers’ gaze to the child (EC) and dyadic synchrony of positive affect (EC).

Conclusions

The current study provides support for the hypothesis that the IM-P total score is predictive of maternal actual attention for the child during a face-to-face interaction. When the IM-P is administered with the aim to gain understanding of different aspects of parenting behavior and the parent-child interaction, it is important not only to employ the IM-P total score but also to incorporate the individual IM-P subscales, as meaningful associations between IM-P subscales and observed parenting and parent-child interactions were found.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7652703/

 

Improve Children with Intellectual and Developmental Disabilities, their Caregivers, and the Agency with Mindfulness

Improve Children with Intellectual and Developmental Disabilities, their Caregivers, and the Agency with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness practices could be helpful for these caregivers because they encourage a nonjudgmental interpretation of their child’s situation, and increased acceptance of their reality.” – Emily Nauman

 

There is a tremendous demand for caregiving in the US. It is estimated that over 65 million (29% of the adult population) provides care to someone who is ill, disabled or aged, averaging 20 hours per week spent caring for their loved ones. This caregiving comes at a cost exacting a tremendous toll on caregivers’ health and well-being. Caregiving has been associated with increased levels of depression and anxiety as well as higher use of psychoactive medications, poorer self-reported physical health, compromised immune function, and increased mortality.

 

Caring for children with intellectual and developmental disabilities can be particularly difficult. Developmental disabilities are a group of conditions due to an impairment in physical, learning, language, or behavior areas. These conditions begin during the developmental period, may impact day-to-day functioning, and usually last throughout a person’s lifetime. Recent estimates in the United States show that about one in six, or about 15%, of children aged 3 through 17 years have a one or more developmental disabilities.

 

The challenges of caring for a child with intellectual and developmental disabilities require that the caregiver be able to deal with stress, to regulate their own emotions, and to be sensitive and attentive to the child. These skills are exactly those that are developed in mindfulness training. It improves the psychological and physiological responses to stress. It improves emotion regulation, it improves the ability to maintain attention and focus in the face of high levels of distraction, and can reduce burnout.

 

In today’s Research News article “Comparative Effectiveness of Caregiver Training in Mindfulness-Based Positive Behavior Support (MBPBS) and Positive Behavior Support (PBS) in a Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223775/) Singh and colleagues recruited caregivers from a home for children with intellectual and developmental disabilities. They were randomly assigned to receive either Mindfulness-Based Positive Behavior Support (MBPBS) of Positive Behavior Support (PBS).  The interventions were for 10 weeks and consisted of “an 8-h day on the first day of week 1 of training, followed by daily practice for 4 weeks. . .  a second part included five 8-h days (i.e., 40 h) during week 5, followed by daily practice for 4 weeks. . . and third part was again an 8-h day on the first day of week 10, followed by daily practice for the rest of the week.” During the next 30 weeks data were collected. The caregivers were measured before and after training for compassion satisfaction, compassion fatigue, perceived stress, professional quality of life, and meditation practice. The children’s behavior was rated for aggressive events, staff injury, and peer injury. The agency was evaluated for the use of physical restraints, emergency medication, staffing, and cost effectiveness.

 

They found that both interventions produced significantly increased compassion satisfaction, and decreased perceived and traumatic stress, and burnout for the caregivers. The Mindfulness-Based Positive Behavior Support (MBPBS) group, however, had significantly greater improvements than the Positive Behavior Support (PBS) group. Similar results were found for the children’s behavior with both treatments producing significant decreases with aggression, staff injuries, and peer injuries. Once again, the mindfulness group had significantly superior results. For the agency outcomes Mindfulness-Based Positive Behavior Support (MBPBS) produced significantly reduced use of physical restraints, emergency medication, and one-on-one staffing. In addition, the mindfulness treatment had significantly greater cost effectiveness.

 

These are very encouraging results that demonstrate that Mindfulness-Based Positive Behavior Support (MBPBS) is highly effective in improving the situation for staff, children, and the agency in an institution for children with intellectual and developmental disabilities. It increased

caregivers’ well-being and the children’s behavior, and decreased the strains on the agency. Amazingly, the mindfulness-based treatment was even more cost-effective.

 

So, improve children with intellectual and developmental disabilities, their caregivers, and the agency with mindfulness.

 

“the greater effects associated with mindfulness techniques may be due to “the immediacy of physiologic relaxation responses incurred in mindfulness practice, including strengthened attention to bodily sensations, and less reliance on rumination or other automatic emotions.” – Summer Allen

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Singh, N. N., Lancioni, G. E., Medvedev, O. N., Myers, R. E., Chan, J., McPherson, C. L., Jackman, M. M., & Kim, E. (2020). Comparative Effectiveness of Caregiver Training in Mindfulness-Based Positive Behavior Support (MBPBS) and Positive Behavior Support (PBS) in a Randomized Controlled Trial. Mindfulness, 11(1), 99–111. https://doi.org/10.1007/s12671-018-0895-2

 

Abstract

Caregivers of individuals with intellectual and developmental disabilities are often stressed due to the demands of the job, including the nature and severity of challenging behaviors of the clients, work conditions, degree of management support for the staff, and the demands of implementing some interventions under adverse conditions. Mindfulness-Based Positive Behavior Support (MBPBS) and PBS alone have been shown to be effective in assisting caregivers to better manage the challenging behaviors of clients with intellectual and developmental disabilities. The aim of the present study was to undertake a head-to-head assessment of the effectiveness of MBPBS and PBS alone in a 40-week randomized controlled trial. Of the 123 caregivers who met inclusion criteria, 60 were randomly assigned to MBPBS and 63 to PBS alone, with 59 completing the trial in the MBPBS condition and 57 in the PBS alone condition. Results showed both interventions to be effective, but the caregiver, client, and agency outcomes for MBPBS were uniformly superior to those of PBS alone condition. In addition, the MBPBS training was substantially more cost-effective than the PBS alone training. The present results add to the evidence base for the effectiveness of MBPBS and, if independently replicated, could provide an integrative health care approach in the field of intellectual and developmental disabilities.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223775/