Effects of Yoga on Attention, Impulsivity, and Hyperactivity in Preschool-Aged Children with Attention-Deficit Hyperactivity Disorder Symptoms

Abstract

Objective: Behavioral therapies are first-line for preschoolers with attention-deficit hyperactivity disorder (ADHD). Studies support yoga for school-aged children with ADHD; this study evaluated yoga in preschoolers on parent- and teacher-rated attention/challenging behaviors, attentional control (Kinder Test of Attentional Performance [KiTAP]), and heart rate variability (HRV).

Methods: This randomized waitlist-controlled trial tested a 6-week yoga intervention in preschoolers with ≥4 ADHD symptoms on the ADHD Rating Scale-IV Preschool Version. Group 1 (n = 12) practiced yoga first; Group 2 (n = 11) practiced yoga second. We collected data at 4 time points: baseline, T1 (6 weeks), T2 (12 weeks), and follow-up (3 months after T2).

Results: At baseline, there were no significant differences between groups. At T1, Group 1 had faster reaction times on the KiTAP go/no-go task (p = 0.01, 95% confidence interval [CI], -371.1 to -59.1, d = -1.7), fewer distractibility errors of omission (p = 0.009, 95% CI, -14.2 to -2.3, d = -1.5), and more commission errors (p = 0.02, 95% CI, 1.4-14.8, d = 1.3) than Group 2. Children in Group 1 with more severe symptoms at baseline showed improvement at T1 versus control on parent-rated Strengths and Difficulties Questionnaire hyperactivity inattention (β = -2.1, p = 0.04, 95% CI, -4.0 to -0.1) and inattention on the ADHD Rating Scale (β = -4.4, p = 0.02, 95% CI, -7.9 to -0.9). HRV measures did not differ between groups.

Conclusion: Yoga was associated with modest improvements on an objective measure of attention (KiTAP) and selective improvements on parent ratings.

Figure 1

Participant flowchart of the study depicting both the number of children included in each group over the course of the study as well as the sample sizes (n) available for analysis of each outcome measure: parent (p) and teacher (t) rating scales, KiTAP subtests, and heart rate variability (HRV).

Figure 2

Parent reported behaviors on the Inattention sub-scale of the (A) ADHD Rating Scale IV Preschool version and (B) Hyperactivity/Inattention sub-scale of the Strengths and Difficulties Scales at baseline and Time 1.

Figure 3

KiTAP performance at Time 1 (post-intervention for Group 1) significantly or marginally differed on numerous tests. For symmetry, Go/No-Go errors of omission were omitted from this figure; differences between groups on this task outcome were far from significant, p = .894. Note: ^†p < .10, *p < .05, **p < .01, ns = nonsignificant.