No abstract

Children with ADHD are often non-compliant with parental instructions. Various methods have been used to reduce problem behaviors in these children, with medication and manipulation of behavioral contingencies being the most prevalent. An objection often raised by parents is that these management strategies require them to impose external control on the children which not only results in the children not learning self-control strategies, but also does not enhance positive interactions between them and their parents. Studies have shown that providing mindfulness training to parents, without a focus on reducing problem behaviors, can enhance positive interactions with their children and increase their satisfaction with parenting. We were interested to see what effects giving mindfulness training to two mothers, and subsequently to their children, would have on compliance by the children. Using a multiple baseline across mothers and children design, we found that giving a mother mindfulness training enhanced compliance by her child. When the children were subsequently given similar training, compliance increased even more markedly, and was maintained during follow-up. The mothers reported associated increases in satisfaction with the interactions with their children and happiness with parenting. We suspect that the mindfulness training produces personal transformations, both in parents and children, rather than teaching strategies for changing behavior.

Background The use of physical restraints has generated immense controversy in the delivery of services to individuals with intellectual disabilities. The current zeitgeist is that effective positive approaches obviate the need for using physical restraints. In a multiple baseline design, we sought to assess how training staff members in mindfulness affected their use of physical restraints for aggressive and destructive behaviours of individuals with intellectual disabilities. Methods Twenty-three members of staff working in four group homes participated in a 12-week mindfulnesstraining programme. Objective data were collected on the number of incidents, staff observations of incidents, staff verbal redirections, restraints used, Stat medications administered, staff injuries and peer injuries. Data were collected during baseline, mindfulness training and mindfulness practice phases. ResultsAs mindfulness training progressed, the use of restraints decreased, with almost no use being recorded by the end of the study. Any use of physical restraints was correlated with new admissions and on-call staff who had not received training in mindfulness. Stat medications administered also decreased and staff and peer injuries were close to zero levels during the latter stages of mindfulness practice. Conclusions Data from this initial study suggest that staff training in mindfulness is potentially beneficial to both staff and the individuals with intellectual disabilities, particularly in reducing the use of physical restraints and Stat medication for aggressive and destructive behaviours.

The effects of a mindfulness-based procedure, called Meditation on the Soles of the Feet, were evaluated as a cognitive-behavioral intervention for physical aggression in 6 offenders with mild intellectual disabilities. They were taught a simple meditation technique that required them to shift their attention and awareness from the precursors of aggression to the soles of their feet, a neutral point on their body. Results showed that physical and verbal aggression decreased substantially, no Stat medication or physical restraint was required, and there were no staff or peer injuries. Benefit-cost analysis of lost days of work and cost of medical and rehabilitation because of injury caused by these individuals in both the 12 months prior to and following mindfulness-based training showed a 95.7% reduction in costs. This study suggests that this procedure may be a clinically effective and cost-effective method of enabling adult offenders with intellectual disabilities to control their aggression.

Individuals with Prader-Willi syndrome have hyperphagia, a characteristic eating disorder defined by a marked delay in the satiety response when compared to controls. This eating disorder has been particularly difficult to control. The authors taught and evaluated effectiveness of regular exercise alone, regular exercise plus healthy eating, and mindfulness-based strategies combined with exercise and healthy eating to an adolescent with this syndrome. Mindfulness-based strategies included mindful eating, visualizing and labeling hunger, and rapidly shifting attention away from hunger by engaging in Meditation on the Soles of the Feet. On average, when compared to baseline levels, there were decreases in weight with regular exercise and exercise plus healthy eating, but the most consistent and sustained changes were evidenced when mindfulness training was added to exercise and healthy eating. The adolescent continued using the mindfulness health wellness program and further reduced his weight during the 3-year follow-up period.