39 Safety, feasibility, child, and parent perceptions following biofeedback and breathing practices in children with attention deficit hyperactivity disorder: The healing minds study

Objectives/Goals: Attention deficit hyperactivity disorder (ADHD) affects 5.9% of youth worldwide and is associated with mental health disorders. In adults, HeartMath biofeedback improves ADHD, emotional regulation, and anxiety. Breathing practices promote similar outcomes. Our goal was to examine the synergistic effect of these therapies in children with ADHD. Methods/Study Population: A 10-week, 2-arm randomized controlled clinical trial was conducted in a rural health care clinic to examine the safety, feasibility, preliminary efficacy, and self-reported child and parent perceptions of a biofeedback plus breathing practices intervention (Healing Minds) in a pediatric population (n=12; M=5; F=7; 11.6 ±3.6 years). Children were randomized to waiting list placebo (P) or treatment (T) intervention Weekly biofeedback (HeartMath) and breathing exercises (Qi gong, belly, box, and alternate nostril) by trained medical staff. Symptoms and severity of ADHD (Vanderbilt; Conners), Screen for Child Anxiety-Related Disorders, Child 6=P) into the clinical trial. Nine completed the study T (N=4); P (N=5). One moderate, unrelated adverse event was reported. Treatment attendance rates varied 90% (2), 70% (1), 60% (1), and 30% (1). Children self-reported reduced panic attacks, improved sleep, and feelings of self-control. Parents perceived a calmer home with fewer meltdowns, less overwhelming events, and expressed satisfaction with biofeedback, Qi gong, and belly breathing, but not box and alternate nostril breathing. Questionnaires were perceived as burdensome, and placebo waiting list delays were unacceptable to parents. School-related scheduling challenges and missing assessment data limited study implementation. Small sample sizes limited statistical power and the evaluation of outcomes. Discussion/Significance of Impact: Healing Minds shows promise as a beneficial adjunct to clinical care in rural children with ADHD. The program was shown to be safe and feasible. Children and parents self-reported beneficial effects. Future studies should include a patient-centered study design, focused breathing techniques, fewer assessments, and improved school coordination.