A school-based program that aims to increase executive function in preschoolers through training in mindfulness and reflection delivered by teachers in the regular classroom setting.
Blueprints: Inconclusive Evidence
Philip David Zelazo
Institute of Child Development, University of Minnesota
The Mindfulness + Reflection program teaches mindfulness and reflection skills to preschoolers from low-income families in order to improve their executive function and provide practice in reflection for goal-oriented problem solving. The program is implemented through 30 sessions over a time period of six weeks by trained preschool classroom teachers. Children are pulled out of their normal classroom activities to participate in the intervention program in small groups (8-12 children).
Mindfulness skills taught by the program target children's ability to calm down, regulate stress, sustain attention, and become aware of the moment, and include belly breathing and body scanning. The reflection training, which takes the form of three executive function-challenging games, aims to help children recognize when they should act deliberately rather than on autopilot. This reflection program is adapted from the intervention Ready? Set. Go! Teachers who implement the program adjust the level of challenge of the activities to match students' ability levels.
Zelazo et al. (2018) reported that in comparison to the control condition, children in the intervention condition showed significantly:
Zelazo et al. (2018) evaluated the program in a randomized controlled trial of 218 preschool students from two schools serving low-income families in two cities in the United States. Students were randomly assigned within schools to receive the Mindfulness + Reflection program, a literacy training program, or business as usual. Executive functions, literacy, theory of mind, and child behavior were measured at baseline (within two weeks prior to the start of the six-week program), posttest (in the two weeks immediately following the six-week program), and four to six weeks after the posttest.
Source: Washington State Institute for Public Policy
All benefit-cost ratios are the most recent estimates published by The Washington State Institute for Public Policy for Blueprint programs implemented in Washington State. These ratios are based on a) meta-analysis estimates of effect size and b) monetized benefits and calculated costs for programs as delivered in the State of Washington. Caution is recommended in applying these estimates of the benefit-cost ratio to any other state or local area. They are provided as an illustration of the benefit-cost ratio found in one specific state. When feasible, local costs and monetized benefits should be used to calculate expected local benefit-cost ratios. The formula for this calculation can be found on the WSIPP website.
Philip David ZelazoInstitute of Child Development, University of MinnesotaMinneapolis, MN USAzelazo@umn.edu
A school-based program that aims to increase executive function in preschoolers through training in mindfulness and reflection delivered by teachers in the regular classroom setting.
The program targets preschoolers from low-income families.
Zelazo et al. (2018) tested the program in a primarily minority sample.
Theory of mind, intelligence, coping skills
*Risk/Protective Factor was significantly impacted by the program
Mindfulness skills taught by the program target children's ability to calm down, regulate stress, sustain attention, and become aware of the moment, and include belly breathing and body scanning. The reflection training, which takes the form of three executive function-challenging games, aims to help children recognize when they should act deliberately rather than on autopilot. This reflection program is adapted from the intervention Ready? Set. Go! Teachers who implement the program adjust the level of challenge of the activities to match students' ability levels.
Executive function predicts success in school on both cognitive and social outcomes. Children of lower socioeconomic statuses have lower executive function, so an intervention to develop executive function can be especially impactful in that population. According to the Iterative Reprocessing model, reflection can help develop executive function. Mindfulness has been shown to improve executive function as well.
Zelazo et al. (2018) evaluated the program in a randomized controlled trial of 218 preschool students from two schools serving low-income families in two cities in the United States. Students were randomly assigned within schools to receive the Mindfulness + Reflection program, a literacy training program, or business as usual. Executive functions, literacy, theory of mind, and child behavior were measured at baseline (within two weeks prior to the start of the six-week program), posttest (in the two weeks immediately following the six-week program), and four to six weeks after the posttest.
Zelazo et al. (2018) reported that children in the intervention condition showed significantly greater improvements in overall executive function compared to a business-as-usual control group at the four-week follow-up.
Zelazo et al. (2018) reported that in comparison to the control condition, children in the intervention condition showed significantly:
Zelazo et al. (2018) did not test for mediation.
Zelazo et al. (2018) did not report effect sizes.
Zelazo et al. (2018) can be generalized to preschoolers from low-income families in urban regions of the United States.
Zelazo et al. (2018) had the following limitations:
The literacy program used as a comparison, entitled Opening the World of Learning (OWL) Building Blocks Pre-Kindergarten Program, is written up in the Blueprints database. Update on 8/16/18: S1 (Zelazo et al., 2018) going to the board in September, 2018.
Blueprints: Inconclusive Evidence
Evaluation Methodology
Design:
Recruitment: Children were recruited from two preschools that serve low-income families: one school in Houston, Texas and one school in Washington, DC. Parents of preschoolers at these schools were provided with written information about the study and received a passive (opt-out) consent form.
Four local teachers (two in each city) were recruited to deliver the two active intervention programs, Mindfulness + Reflection (n=2 teachers) and Literacy (n=2 teachers). Teachers also completed two survey questionnaires for each child at each time point, and were compensated with a $10 gift card for each report. Parents were invited to fill out a Family Information Questionnaire, presumably to assess sociodemographic characteristics, for a $10 gift card, though only 29% of families in Houston and 74% of families in Washington DC returned the questionnaire.
Assignment: Children were randomly assigned within each school to receive the Mindfulness + Reflection intervention program, a literacy intervention program entitled Opening the World of Learning (OWL) Building Blocks Pre-Kindergarten program, or a control condition. The purpose of the literacy control program was to provide a comparison group for the Mindfulness + Reflection program that controlled for the effect of a small-group pullout program. At the school in Houston, the control condition consisted of no programming other than business-as-usual. At the Washington, DC school, the control condition consisted of a Second Step social-emotional learning intervention. The initial randomized sample included 218 children.
Assessments/Attrition: Direct behavioral assessments and teacher ratings of children's behavior were measured at baseline (within two weeks prior to the start of the program), at posttest (within two weeks following the completion of the six-week program), and at follow-up (four to six weeks after posttest). Child IQ was measured at pre-test only. For direct behavioral measures, final sample sizes at follow-up ranged from 185 to 216 (mean N = 202), and for teacher-report measures, final sample sizes ranged from 92 to 192 (mean N = 149). Overall, missing data rates for direct behavioral outcomes ranged from to 0.1% to 15% and missing data rates for outcomes from teacher observation ranged from 12% to 58%. The majority of missing data were from teacher reports at Time 2, which came at a busy time in the Spring term.
Sample:
The sample included low-income preschool children from one school in Houston, Texas and another school in Washington, DC. The school in Houston primarily served Hispanic and White children, with Hispanic participants comprising 97.4% of that sample and White participants comprising 55%. The school in Washington, DC served children who were primarily African American (100%). The overall sample was 53.7% female and the median income for families whose children participated in the study was $25,000-$50,000. The mean age of participants was 4.75 years (SD = 0.31).
Measures:
Measures included three executive function tasks (analyzed individually and as a combined composite), a theory of mind scale, a literacy test, and two teacher-reported behavior assessments (one with three subscales that were analyzed separately), yielding ten total outcomes for analysis. Direct behavioral assessments of children were conducted by trained assessors (n=3 per site), and teacher-reported child behaviors were completed by teachers who also delivered the intervention.
Executive function was measured from three established tasks: the Head-Toes-Knees-Shoulders task, the peg-tapping task, and the Minnesota Executive Function Scale, which was self-developed by the researchers in prior work but was reported to have test-retest reliability of 0.86 in another study. Data were missing from one or more EF tasks for 7% of participants, so composite EF scores were computed for each time point by averaging the proportion scores on each task for each individual. Correlations between the three tasks at baseline ranged from 0.11 to 0.40. Composite scores and scores on individual tasks were used for analysis.
Theory of mind was measured with the Theory of Mind scale. Literacy was measured with the Woodcock-Johnson III Letter-Word Identification subtest. Teachers completed behavior ratings using the Children's Behavior Questionnaire - Very Short Form and the Child Behavior Rating Scale. Three subscales of the Children's Behavior Questionnaire were reported to have α = 0.75, 0.72, and 0.74.
Intelligence was measured with the Stanford-Binet Early 5 only at pretest. Lastly, the Washington, DC school gave its children the Peabody Picture Vocabulary Test, the Devereaux Early Childhood Assessment test, the Test of Early Math Abilities, and the Strategic Teaching and Evaluation of Progress scale at posttest only.
Analysis:
The researchers used repeated measures ANOVAs to analyze condition differences in changes in outcome variables within individuals over time. They controlled for location due to differential attrition by study site by including a location variable in their models, but did not otherwise test or adjust for clustering of individuals within groups, schools, or sites. Changes in time across the three assessments were analyzed using linear models.
Intervention effects were tested overall across the three conditions in two degree of freedom tests comparing one condition against the average of the other two conditions. The contrasts included in those models were not clearly specified. Separate tests were also conducted with two sets of planned contrasts: one comparing just the intervention condition versus the passive control condition, and another comparing just the active control condition versus the passive control condition. The third contrast (intervention condition versus active control condition) was not reported.
Intent-to-Treat: It appears as though analyses included all subjects with complete data, though analysis Ns do not always match sample Ns. Missing data were treated as missing using pairwise deletion in correlations and listwise deletion in repeated measures ANOVAs.
Outcomes
Implementation Fidelity:
No quantitative information on implementation fidelity was provided.
Baseline Equivalence:
The researchers found no significant differences between the three groups on age, sex, intelligence, literacy, theory of mind, or executive function.
Differential Attrition:
Missing data on key outcome variables was significantly correlated with study location but no other study variables. Children in the DC sample were more likely than children in the Houston sample to be missing data from the Minnesota Executive Function Scale, the Children's Behavior Questionnaire, and the Child Behavior Rating scale at baseline; and from the peg-tapping task at follow-up. Children in the Houston sample were more likely than children in the DC sample to be missing data from the Letter/Word Knowledge task at posttest; and from the Theory of Mind Scale, the Minnesota Executive Function Scale, and the peg-tapping task at posttest. The researchers claim that the site differences "appeared to be due to logistical and staffing issues at the sites rather than differences in the children" but nonetheless included location as a factor in the main analyses.
Posttest:
For executive function, composite scores improved significantly for all children from baseline to follow-up, but there were no differences in those improvements between conditions in the models that compared all three conditions simultaneously. In the planned contrasts, children in the intervention condition significantly outperformed children in the passive control condition, whereas children in the active control condition did significantly outperform children in the passive control condition. (Comparisons between the intervention and active control conditions were not reported.) Follow-up tests revealed that this difference was not significant at post-test but was significant at follow-up. Results were similar when the three executive function tasks were analyzed individually.
No condition differences (overall or in planned contrasts) were found for any of the remaining outcomes examined, with the exception of teacher-reported effortful control, for which the active control condition was rated higher than the intervention and passive control conditions at all time points.
Long-Term:
Not examined.