Does mindfulness training work for young people?

A meta-analysis published in Journal of Child Psychology and Psychiatry aims to establish the efficacy of mindfulness-based interventions (MBIs) for children.

Darren Dunning and colleagues carried out a systematic literature search of randomised controlled trials (RCTs) of MBIs conducted up to October 2017. Thirty-three studies (3,666 children, ages 18 years or younger) were included in the meta-analysis, with outcome measures categorised into cognitive, behavioural, and emotional. In addition, a separate meta-analysis was completed for 17 RCTs (1,762 children) that had an active control condition (ie, something else that might be expected to benefit participants, but did not include mindfulness).

Across all RCTs, the researchers found small positive effects of MBIs, compared with control groups, for all measures (overall effect size = +0.19). In particular, MBIs led to greater improvements for mindfulness (effect size = +0.24), executive functions (effect size = +0.30), and attention (effect size = +0.13). However, for the RCTs with active control groups, children who completed an MBI improved significantly more than those in the active control groups on outcomes of mindfulness (effect size = +0.42), depression (effect size = +0.47), and anxiety/stress (effect size = +0.18) only.

Source: Research review: The effects of mindfulness‐based interventions on cognition and mental health in children and adolescents – a meta‐analysis of randomized controlled trials (October 2018), The Journal of Child Psychology and Psychiatry doi:10.1111/jcpp.12980

Are the youngest in class more likely to be diagnosed with ADHD?

Findings from a study published in the Journal of Child Psychology and Psychiatry suggest that children who are the youngest in their classroom are more likely to be diagnosed with attention deficit hyperactivity disorder (ADHD) than their older classmates.

Martin Whitely and colleagues conducted a systematic review of 22 studies that examined the relationship between a child’s age relative to their classmates and their chances of being diagnosed with, or medicated for, ADHD. Seventeen studies (with a total of more than 14 million children) found that it was more common for the youngest children in a school year to be diagnosed as ADHD than their older classmates. This effect was found for both countries that have a high diagnosis rate, like the US, Canada and Iceland, and countries where diagnosis is less common, like Finland and Sweden.

The researchers suggest that some teachers may be mistaking normal age-related immaturity of the youngest children in their class for ADHD, and that these findings highlight the importance of being aware of the impact of relative age and give the youngest children in class the extra time they may need to mature.

Source: Attention deficit hyperactivity disorder late birthdate effect common in both high and low prescribing international jurisdictions: systematic review (October 2018), The Journal of Child Psychology and Psychiatry doi:10.1111/jcpp.12991

Outcomes of a single-session intervention for teenage anxiety and depression

A study published in The Journal of Child Psychology and Psychiatry examines whether a half-hour, self-administered, single-session intervention (SSI) teaching growth mindset can reduce depression and anxiety and strengthen perceived control in high-risk teenagers.

Teenagers (aged 12–15) and their parents completed separate baseline questionnaires about the young person’s anxiety and depressive symptoms, which were then repeated over a nine-month follow-up period. Teenagers also reported on their perceived behavioural control. The teenagers were then randomised to receive either a 30-minute computer-guided intervention teaching growth mindset (the belief that personality is malleable), or a supportive therapy control.

Compared to the control group, teenagers who received the SSI had greater improvements in parent-reported depression (effect size = +0.60) and anxiety (+0.28), as well as self-reported depression (+0.32) and perceived behavioural control (+0.29) from baseline to nine-month follow-up. The effects of the intervention on self-reported anxiety were +0.36.

The report concludes that the findings suggest a promising, scalable SSI for reducing anxiety and depression in high-risk teenagers.

Source: A single-session growth mindset intervention for adolescent anxiety and depression: 9-month outcomes of a randomized trial (September 2017), The Journal of Child Psychology and Psychiatry

Evaluation of a parent-delivered early language enrichment programme

A study, published in The Journal of Child Psychology and Psychiatry, evaluates the effectiveness of a parent-delivered language programme on pre-school children’s language and emerging reading skills.

Kelly Burgoyne and colleagues conducted a randomised controlled trial with 208 pre-school children (mean age 3 years, 1 month) and their parents living in socially diverse areas of the UK. Children and parents received either an oral language programme or an active control programme targeting motor skills. Parents delivered the 20-minute sessions to their child at home every day over 30 weeks. Children were assessed at pre-test, post-test, and 6 months after post-test on measures of language and motor skills. Early literacy skills (letter-sound knowledge, phoneme awareness and regular and irregular word reading) were assessed at 6 months after post-test only, as children were non-readers at pre- and post-test.

Children who received the language programme made larger gains in language skills (effect size = +0.21) and narrative skills (effect size = +0.36) at post-test than those children who received the active control programme, and these results were maintained six months later. Improvements were also seen in letter-sound knowledge (effect size = +0.42) and regular word reading (effect size = +0.35). No evidence was found that the control programme improved motor skills.

Source: Evaluation of a parent-delivered early language enrichment programme: evidence from a randomised controlled trial (September 2017), Journal of Child Psychology and Psychiatry. doi:10.1111/jcpp.12819

Evaluation of an early language intervention

A randomised controlled trial, conducted by Silke Fricke and colleagues, looked at the effect of an oral language intervention and compared the extent to which a 30-week programme beginning in nursery and continuing for 20 weeks in Reception was more effective than delivering a 20-week programme starting in Reception.

Children from 34 nurseries in the UK were randomly allocated to a 30-week intervention (n= 132), a 20-week intervention (n=133), or an untreated waiting control group (n=129). Allocation was minimized for gender, age and verbal skills. The children in the 30-week intervention group received the Nuffield Early Language Intervention programme for 10 weeks in nursery and continued for 20 weeks in Reception. The 20-week intervention group received only the final 20 weeks of the intervention, beginning when they entered primary school. The control group received their usual schooling.

Children in both the 20- and 30-week programme intervention groups showed greater improvement in oral language skills on measures including the CELF Expressive Vocabulary and CELF Sentence Structure subtests, and the Information Score from the Renfrew Action Picture Test, compared to children in the control group (effect size for the 20-week programme = +0.21; effect size for the 30-week programme = +0.30). However, there was no evidence to suggest that either programme improved early literacy or reading comprehension skills.

Source: The efficacy of early language intervention in mainstream school settings: a randomized controlled trial (October 2017), Journal of Child Psychology and Psychiatry, 58. doi:10.1111/jcpp.12737

Children with ADHD more likely to have language problems

Children with Attention-Deficient Hyperactivity Disorder (ADHD) can have trouble with hyperactivity, impulsivity, inattention and distractibility, all of which can affect language and communication and can lead to low academic performance and antisocial behavior. A systematic review published in the Journal of Child Psychology and Psychiatry seeks to establish the types of language problems children with ADHD experience in order to inform future research into how these language problems contribute to long-term outcomes for children with ADHD.

Hannah Korrel and colleagues examined the last 35 years of ADHD research and identified 21 studies using 17 language measures, which included more than 2,000 participants (ADHD children = 1,209; non-ADHD children  = 1,101) for inclusion in the systematic review.

The study found that children with ADHD had poorer performance than non-ADHD children on 11 of the 12 measures of overall language (effect size = 1.09). Children with ADHD also had poorer performance on measures of expressive, receptive and pragmatic language compared with non-ADHD children.

Source: Research Review: Language problems in children with Attention-Deficit Hyperactivity Disorder – a systematic meta-analytic review (2017), Journal of Child Psychology and Psychiatry Volume 58, Issue 6