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Indian Journal of Health and Wellbeing © 2014 Indian Association of Health,

2014, 5(10), 1165-1172 Research and Welfare ISSN-p-2229-5356,e-2321-3698

Effect of mindfulness therapy on attention deficit among adolescents

with symptoms of attention deficit disorder
Soamya and Sandeep Singh
Department of Applied Psychology, Guru Jambheshwar University of Science & Technology, Hisar, Haryana

Attention-deficit/hyperactivity disorder is a complex disorder with diverse challenges arising at each new phase of a
child's developmental span. The clinical presentation of ADHD consists of inattention, hyperactivity and
impulsivity. The American Psychiatric Association 2013 documented ADHD as “impairing disorder”. There is a
growing body of research on the effectiveness of mindfulness for children and adolescents with psychopathology
reported by Black et al. (2009); Burke (2010). Jon Kabat Zinn (2003) described mindfulness as the awareness that
emerges through paying attention on purpose, in the present moment, and nonjudgmental to the unfolding of
experiences moment by moment. The rationale for using a mindfulness therapy with ADHD is built on several
levels of potential impact, that the mindfulness based therapy focuses on the ability to enhance, control attention and
to reduce automatic responses Teasdale et al. (1995). The present study was conducted to investigate the effect of six
months mindfulness therapy on attention deficit of adolescents manifesting symptoms of ADHD. Sample: The
target sample of the study comprises of 33 adolescent with the age group of 13 to 16 years of private schools. The
sample in the present study was assessed for attention deficit by different measures. The D2 Attention by
Brickenkamp and Zillmer (1998) was administered to measure sustained and focuses attention. The symptom of
inattention was measured by Conner's 3 parent rating scale by Conners (2008) and further attention again was
assessed with Brown's ADD Scales by Brown (2001). The outcome of the present study was analyzed by applying
paired t- test on [pair 1 (baseline and middle phase), pair 2 (middle and post) and pair 3 (baseline & post)]. The
finding of the present study indicates the considerable improvement on the alertness, attention, concentration and
focus. The practice of mindfulness based therapy strengthens the ability to sustain and monitor the attention. The
outcome of the present study is also consistent with the findings of Heeren and Philippot (2011); Semple (2010), that
the mindfulness therapy enhances performance on the executive functioning such as attention, working memory
and cognitive control. The evidence suggesting the potential benefits of mindfulness interventions with adolescents
manifesting symptoms of attention deficits.

Keywords: ADHD, ADD and mindfulness therapy

Attention-Deficit Hyperactivity Disorder is operationally defined as ADHD is found to be one of the most common neuropsychiatric
“a persistent pattern of inattention and/or hyperactivity-impulsivity disorder in childhood and which is often persist into a adulthood.
that is more frequently displayed and more severe the effects of than ADD without hyperactivity has been defined with its most central
is typically observed in individuals at a comparable level of feature of inattentiveness. Other associated behaviors observed are
development” DSM-IV-TR (2000). ADHD defined as "Persistent excessive daydreaming, “spacy” appearance, cognitive
pattern of inattention and/or hyperactivity-impulsivity that interferes sluggishness, hypoactivity, lethargy, excessive confusion or mental
with functioning or development" beginning in childhood, and “fogginess,” and apparent problems of memory retrieval.
present across more than one setting American Psychiatric Inattention manifests itself as an inability to sustain attention in
Association, DSM V (2013). Hyperkinetic Disorder defined by ICD tasks, to follow instructions and rules for the same duration as their
10 as a persistent and severe impairment of psychological peers (Barkley, 1997a; Biederman, 2005). These individuals tend to
development, characterised by 'a combination of overactive, poorly reflect substantial degrees of anxiety, be socially inept, shy, or have
modulated behaviour with marked inattention and lack of persistent diminished social involvement. They are rarely aggressive,
task involvement; and pervasiveness, over situations and persistence oppositional, or impulsive. The children with ADD tend to doubt
over time of these behavioural characteristics'. ADHD is categorized their confidence despite the fact that they are capable of being doing
in the DSM-IV, 2000 as an “externalizing disorder” further added by that task. And its repercussion leads to a high degree of avoidance
Bogels, Hoogstad, Van Dun, De Schutter and Restifo (2008) that and procrastination. ADD children and adolescents not only get
behaviour of ADHD children is manifested outwardly rather than easily distracted with the external environment but by the stream of
their internal thoughts and feelings. The American Psychiatric thoughts in their mind. Children and adolescents with ADD
Association (2013) documented ADHD as “impairing disorder”. The manifests the problems with concentration, distractibility, shifts
DSM-5 now lists ADHD under the heading of “Neurodevelopment from one activity to another, are disorganized, forgetful and have a
Disorders” rather than under “Diagnoses in Infancy, Childhood, or mind that easily wanders (Wenar & Kerig, 2005).
Adolescence. Barkley (1998) and Wendera (2000) documented that Inattention is a markedly core criterion in the diagnosis of ADHD
as reported by American Psychiatric Association (2000); Jarrett and
Correspondence should be sent to Soamya Ollendick, (2008); Reddy and Hale (2007). Children with inattention
Department of Applied Psychology, Guru Jambheshwar symptomatic of ADHD are usually described as disorganized,
University of Science & Technology, Hisar, Haryana distracted and forgetful when compared to other children of the

same age. Parents and teachers often report the child's inability to Linehan, 2004; Kabat-Zinn, 1990).
follow instructions, distractible and daydreamer, and switch from Marchetta, Hurks, De Sonneville, Krabbendam and Jolles, 2008
one activity to another without completing the previous one. reported that attention is a multi-factorial construct that includes
Research using measures of attention corroborate these reports three aspects: focused attention, divided attention and sustained
(Barkley,1997a). ADD without hyperactivity is called as slow attention. Focused attention is the ability to attend to relevant
cognitive speed or slow thinking speed as if the information is information while ignoring irrelevant stimuli (Marchetta et al.,
slowly moving through the brain like sludge. 2008). Divided attention is the ability to direct attention across all
Children with ADHD have demonstrated deficits in sustained stimulus elements of the relevant signal which assist in the process
attention and shifting attention as compared to their peers on of decision-making (Kalff et al., 2005). Sustained attention is the
Continuous Performance Test (Conners, 2004; Gordon, 1983; ability to maintain vigilance over time (Posner & Petersen, 1990).
Rosvold, Mirsky, Sarason, Bransome, & Beck, 1956). In support to Mindfulness training encompasses all types of attention Bishop et
the previous research the study done by Barkley et al., 1992; (Fischer, al. (2004) emphasized that the mindfulness therapy has the potential
Barkley, Smallish, & Fletcher, 2005) studied across multiple samples to enhance the capacity for sustained, switching attention, and
of youth with ADHD and demonstrated on the CPT the elevated rates regulation of elaborative processing however (Schmertz, Anderson
of omission which indicates non-response to a target; sustained & Robins, 2009) reported that sustained attention is considered as
attention, vigilance and commission which indicates response to a the basic aspect of mindfulness practice, in which alertness and
non-target; sustained attention, response inhibition errors. awareness is required to maintain focus on present experience.
Zylowska et al. (2007) reported that ADHD has varied etiological (Lazar et al., 2005) found that the experienced mindfulness
components and is influenced by multiple genetic and environmental practioners have displayed greater cortical thickening in areas of the
factors. Children with the inattentive type have difficulties mostly right prefrontal cortex and right anterior insula that are considered to
with sustaining attention. be linked to sustained attention and awareness.
Whalen and Henker (1998) said that the pills do not teach skills ADD is often marked by impairments in attentional processes
required to cope up with symptoms of ADHD. Further supported by whereas mindfulness by its nature involves a practice of working
(Zylowska et al., 2007) reported that some people are not responsive with one's attention and awareness. Further Raz and Buhle (2006)
of pharmacological treatment, experience intolerable side effects research work suggests that mindfulness may be associated with the
and refuses to use it for health concerns. Mindfulness therapy is a three primary attention networks: alerting attention, orienting
promising new approach to treat the symptoms of ADHD. (Smalley, attention, and executing attention. Alerting attention is
Loo, Sigi Hale, Shrestha, & McGough, 2009) documented that the characterized by a steady uninterrupted attention to one's experience
mindfulness approach has a history of over 2500 year in Eastern and sustained, orienting attention is ability to effectively scan and
traditions however it is relatively new form of treatment in Western selecting situational appropriate information i.e. disengaged and
psychology. The mindfulness based techniques have origin in reengaged, and lastly the executive attention pertains to a conscious
Buddhist meditation however increasingly been used in the examination of one's reactions (inhibiting an automatic response of
treatment into mental health (Schmertz, 2006). According to Kabat- in order to attend to a less automatic response (Fan, McCandliss,
Zinn (2003), Mindfulness is 'the awareness that emerges through Sommer, Raz, & Posner, 2002) and responses to environmental
paying attention on purpose, in the present moment, and non- events (Raz & Buhle, 2006; Robertson & Garavan, 2004). Siegel
judgmentally to the unfolding of experience, moment to moment'. In (2007) also depicted that mindfulness awareness practices (MAP) is
support to this (Schmertz, 2006) added that this definition focuses on associated with improved neural pathways and brain activation in
the three components: the regulation of attention, a focus on the the prefrontal cortex, further improving self regulation and
present experience and a nonjudgmental attitude. (Kabat-Zinn, awareness.
1990; Segal et al., 2002) put forward that mindfulness has two Research evidences revealed that the mindfulness training is
consistent features i.e. the attention and awareness. Further suggested to enhance alerting and orienting attention. Jha et al.
supported by (Brown & Ryan, 2003) described that the mindfulness (2007) further reported that the participants who participated in 8
is considered as a state of consciousness which inculcate enhanced weeks of MBSR training without any meditation experience
self awareness and attention of the present reality or current activity demonstrated an increased ability to orient their attention to the
with core feature of being open, receptive, and non-judgmental. In present moment. In support to previous research Tang et al., 2007
discussing the application of mindfulness to ADHD, the focus is on also reported that five days integrative meditation training including
“mindful awareness” as meta awareness (Teasdale et al., 2000) a mindfulness showed improved efficiency of executive attention as
quality of consciousness that has a regulatory function on the rest of compared to control group.
the one's experience and leads to improved cognitive-emotional and Zylowska, Ackerman, Yang, et al. (2008); Jha, Krompinger and
behavioral self-regulation (Brown & Ryan, 2003; & Creswell, Baime (2007) investigated the effects of a mindfulness meditation
2007).Mindful awareness could be seen as a specific quality of approach and which revealed significant cognitive changes,
attention and intention (Bishop et al., 2004; Brown & Ryan, 2003; particularly related to attentional processes such as alerting,
Shapiro, 1982) that leads to monitoring and modulation of cognition, orienting, conflict attention and attentional set-shifting. In another
emotion and behaviour resulting in improved awareness and controlled research study using the ANT, Attention Network Test
flexibility in responding. The processes involved in this regulatory it was observed that the mindfulness training builds on both
function have been diversely described including de-centering, de- concentrative (specific focus) and receptive (in the present
automatization (Teasdale, Segal, & Williams, 2003), exposure (Baer, moment experience) attention (Rueda, Fan, Mc Candliss,
2003), attention regulation to the present moment and adoption of Halparin, Gruber, Lercari, & Posner, 2004; Jha, Krompinger, &
open and accepting attitude (Bishop et al., 2004; Hayes, Follette, & Baime, 2007).
1167 Indian Journal of Health and Wellbeing 2014, 5(10), 1165-1172

A research conducted by Jha (2007), at the University of thorough assessment of attention deficit/hyperactivity disorder
Pennsylvania demonstrated that participants in an eight week (ADHD) and its most commonly associated problems and disorders
mindfulness program or one month meditation retreat showed in school-aged youth. The Conners 3P assesses behaviours and other
improvements in different facet of attention as compared to control concerns in children from the age of 618. The both full-length and
group. short versions are available. The Conner's 3 is a multi-informant
A collaborated study carried out by Maclean (2010), at Johns assessment with forms for parents, teachers, and youth. The short
Hopkins University, researchers at University of California Davis, version for Conner's parent rating scale consists of 43 items provides
and the meditation teacher and scholar Alan Wallace on a group of evaluation of the key areas of inattention, hyperactivity/impulsivity,
adults for intensive three-month meditation training. This training learning problems, executive functioning, aggression, and peer
involved five hours a day of meditation, it focuses on sustained relations. The parents were asked to respond about the adolescent
attention on the breath. After three months of practice participants behaviour during the last month and rating of behaviour was done
found to have enhanced sharpened visual perception and were more according frequency The parents were instructed to respond “0”, if
alert when paying attention to any stimuli. Further it may foster the the behaviour of the adolescents has been observed as NOT TRUE
ability of sustained attention. AT ALL. “1”, if the behaviour has been noticed JUST A LITTLE
Chiesa et al. (2011), concluded from the twenty three controlled TRUE. “2”, if the behaviour has been seen “PRETTY MUCH
mindfulness researches conducted in the 2010 review of literature TRUE” and “3”, if the behaviour found to be “VERY MUCH
that the initial phase of mindfulness practice showed significant TRUE”. The both test-retest reliability and internal consistency are
improvement in selective and executive attention and later phases very good for the Conner's 3 scales and indices. Internal consistency
indicated improvement in alert and sustained attention. coefficients for the total sample range from .77 to .97, and 2- to 4-
week test-retest reliability coefficients (Cronbach's alpha) range
Objective of the study from .71 to .98 (all correlations significant, p < .001), the inter-rater
To study the effect of mindfulness therapy on attention deficit of reliability coefficients range from .52 to .94. In the present study
adolescents manifesting symptoms of Attention Deficit Disorder. only subscale of Inattention has been used to assess the difficulty
level of attention deficit.
Hypothesis of the study Brown Attention Deficit Disorder Scales: The Brown ADD Scales
Mindfulness Therapy shall be effective in reducing attention deficit for Children and Adolescents was developed by Thomas E. Brown
of adolescents manifesting symptoms of Attention Deficit 2001 can be used for initial screening of children and adolescents
Disorder. suspected of having an Attention Deficit/Hyperactivity Disorder
and as a comprehensive diagnostic assessment tool in a battery of
Method assessment instruments. The scale address a variety of ADHD
Participants related cognitive impairments (executive function) and symptoms
beyond IV criteria. The Brown ADD scales for children are designed
The target sample of the study was adolescents with the age group of
for evaluating children in two age groups: age's 3-7years, and ages 8-
13 to 16 years who were regular students of private schools. The
12 years both parent and teacher version available in addition to this
sample of the present study comprises of 33 adolescents (obtained
for 8-12 years self report is also there. The Brown ADD Scales for
after the screening of 400 subjects). The baseline measures were
adolescents is having (collateral and self-report) for assessing
taken on attention of adolescents by administering the D2 Attention
individuals' ages 12-18 years. The Brown ADD Scales for
Scale, Conner's 3 parent rating scale and Brown ADD Scales. The
Adolescents include 40 items. In the present study involved two
screening of the sample was done with the help of respective tools
clusters i.e. attention and efforts. The scale offered likert type
used in the study. The primary mode of the sample selection was
frequency responses (0=never to 3=almost daily) to statements. For
observation by teachers and research investigator which was further
cluster of Brown ADD Scales for Adolescents, alpha coefficients for
followed by parental interview. The selected sample of adolescents
self ratings of adolescents and 12 years ranged from .70 to .89. The
was a group of adolescents manifesting symptoms of ADD.The
alpha coefficient for total scores of adolescents self rating ranged
selected sample was given treatment over a period of six months.
from.90 to.95. The test retest reliability for the total scores for the
Baseline Middle Phase Post Test non-clinical adolescents sample aged 12-18 years was reported as .87.
Prior to Treatment During treatment assessment Immediately after Cluster 2: Focusing, Sustaining, and shifting Attention to Tasks.
was carried out after three treatment i.e. six These items query a child's chronic problems in sustaining attention
months. months. and focus for tasks or in shifting attention as needed from one focus
to another. Some of the items relate to inattention in receptive
Instruments modes. Other items relate to vulnerability to distraction in more
D2 Attention Scale: The d2 Attention Scale developed by R. active modes (e.g., “is easily sidetracked” or “starts talking about
Brickenkamp & Eric A. Zillmer (1998) to measure selective and one topic and then interrupts self and switches to talking about
sustained attention. It is a paper pencil test. In this scale, the 14 test something else”).
lines with 47 charcters in each line are available. Each letter consists Cluster 3: Regulating Alertness, Sustaining Effort, and Processing
of a letter'd' or 'p' marked with one, two, three or four small dashes. Speed: This cluster includes behaviours such as insufficient
The subjects were instructed to put cross on the letter "d" with two regulation of alertness, insufficiently sustained effort, and problems
dashes above it or below it while ignoring the other all other with excessive slowness in processing information. Some items
characters. relate to apparent drowsiness or chronic lack of energy that may be
Conner's3 Parents Rating Scale: The Conner's 3 is scale is a interrupted as laziness.

Procedure effectiveness of the mindfulness therapy in enhancing attention,

concentration, focus and to reduce the distractibility. The
The present study on mindfulness therapeutic program for adolescents
assessment of the variables was done with the respective tools
was designed for six months and was implemented five days a week
used in the study. The data of the study was analyzed by applying
with each session of 45 minutes. The adolescents under mindfulness
descriptive statistics and paired t- test. The evidence suggests
therapeutic program were being assessed after every two months. The
that practice of mindfulness based therapy has the potential
mindfulness program inculcates both group and individual sessions.
benefits in strengthening the ability to sustain and monitor the
The introductory session was planned and carried out with the attention.
adolescents to get oriented with the whole purpose of the programme
and its guidelines. The certain ground rules were formed and written Table 1.1a Outcomes for the variable of D2 Attention (Descriptive
down on a sheet visible to the adolescents. The initial few sessions Statistics)
were designed for rapport building with adolescents and to make Variables Level N M SD SEM
them comfortable within the group setting. The initial sessions
created interest, curiosity and acceptability for ones and others D2 Attention Baseline 33 1.00 14.79 2.57
feelings. Further, the psycho education session was conducted with Middle 33 1.09 14.85 2.58
the adolescents manifesting symptoms of ADHD. The ambiance of Post 33 1.15 15.48 2.69
the group was child friendly, safe, open, accepting and appreciating Note: N- Number of Participants; M- Mean; SD- Standard Deviation; SEM-
to new ideas. The room selected for the intervention was stimulus Standard Error of Mean
free. The mindfulness therapy planned was according to appropriate
age and daily lives of the adolescents. Each adolescent received a 3.00 2.72
folder including practice worksheet, session summaries other than 2.50
this instruction related to mindful activities were given. The therapy
addresses the difficulties with attention, distractibility, restlessness, 2.00
concentration etc and focuses on enhancing the attention and
awareness of the present moment. The sessions designed as per the 1.1
requirement of the present group sample and also from the MAP's 1.00 1.00
programme for ADHD developed by Lidia Zylowska, MD,
psychiatrist. In the present study mindfulness therapy includes:
Session1-Psycho-education, Session2-Attention and the five senses, 0.00
Session3- Mindful Breathing, Mindful Eating, Session4- Baseline Middle Post
Mindfulness of sound, breath and body, Session5- Mindfulness of D2 Attention
body sensation and movement, Session6 Mindfulness of thoughts,
Session7- Mindfulness of Feelings, Session8-Mindful Listening and Figure 1.1 Graphical presentation of outcomes for the variable of
Speaking, Session9- Mindful Decisions and Actions, Session10- D2 Attention.
Mindfulness in daily life and other activities such as sense of
The D2 Attention scores indicated the reduction from the baseline
perception of time etc
(M=1.00, SD=14.79) to middle phase (M=1.09, SD=14.85) and
Results and discussion furthermore reported to have improvement at post-test (M=1.15,
The main objective of the present study was to investigate the

Table 1.1b Outcome for the Variable of Attention (Paired t values)

Paired Differences
95% Confidence
Interval Level of
the Difference
Mean Difference Std. Error of Lower Upper T df Sig. (2
Difference tailed)
Pair 1 -9.48 3.80 -17.24 1.72 -2.49 32 0.02
Pair 2 -6.33 3.80 -14.07 1.40 -1.66 32 0.11
Pair 3 -1.58 4.11 -24.19 -7.43 3.84 32 0.00
Note: Variable: D2 Attention, Pair 1- Baseline and Middle, Pair 2- Middle and Post Pair, 3- Baseline and Post

The paired t-test outcomes obtained from the (Pair 1-baseline and significant with a 95% confidence level ranging from -14.07 to 1.4.
middle) depicted in the Table No.1.1b, demonstrated the marked Finally if we look at the pair 3 (baseline with post-test), the
mean difference of the D2 attention reported to be -9.48[t (32) = - decreased mean difference of D2 attention recorded to be 1.33 which
2.49, p<.0001] with a 95% confidence level ranging from 17.24 to was highly considerable with a 95% confidence level ranging from -
1.72. The findings obtained at (pair 2- middle and post) reported 24.19 to -7.43 [t(32) = 3.84 and p<.0001]. The findings suggested
mean difference with -6.33 [t (19) = -1.66, p<.0001] and found to be that the level of attention has increased from baseline to post-test.
1169 Indian Journal of Health and Wellbeing 2014, 5(10), 1165-1172

Table 2.1a Outcome for Variable of Inattention (Descriptive Table 3.1a Outcome for Variable of Attention (Descriptive Statistics)
Variables Level N M SD SEM
Variables Level N M SD SEM
Attention Baseline 33 15.39 2.72 0.47
Inattention Baseline 33 9.42 1.27 .22 Middle 33 13.33 2.78 0.48
Middle 33 7.70 1.20 .20 Post 33 11.00 2.34 0.40
Post 33 6.36 1.19 .20 Note: N- Number of Participants; M- Mean; SD- Standard Deviation; SEM-
Note: N- Number of Participants; M- Mean; SD- Standard Deviation; SEM- Standard Error of Mean
Standard Error of Mean.
10.00 9.42
16.00 15.39
14.00 13.33
8.00 7.70
12.00 11.00
7.00 6.36
5.00 8.00

4.00 6.00

3.00 4.00

2.00 2.00

1.00 0.00
0.00 Baseline Middle Post
Baseline Middle Post
Inattention Figure 3.1 Graphical presentation of outcomes for the variable of
Figure 2.1: Graphical presentation of outcomes for the variable of
Inattention. The Attention scores indicated the reduction from the baseline
(M=15.39, SD= 2.72) to middle phase (M=13.33, SD=2.78) and
The outcome obtained from the results of inattention were recorded
furthermore reported to have improvement at post-test (M=11.00,
from the Conner's 3 Parent rating scale and reported to have decrease
SD= 2.34).
value from baseline (M=9.42, SD=1.27) to middle phase (M=7.70,
SD=1.2) and sustained the trend by further declining of scores at Table 3.1b Outcome for the Variable of Attention (Paired t values)
post-test (M=6.36, SD=1.19). Paired Differences

Table 2.1b Outcome for Variable of Inattention (paired t values) 95% Confidence
Interval Level of
Paired Differences
the Difference
95% Confidence
Mean Std. Lower Upper T df Sig. (2
Interval Level of
Difference Error of tailed)
the Difference
Mean Std. Lower Upper T df Sig. (2
Pair 1 2.06 0.09 1.86 2.25 21.30 32 0.00
Difference Error of tailed)
Pair 2 2.33 0.14 2.03 2.63 15.69 32 0.00
Pair 3 4.39 0.17 4.02 4.75 24.53 32 0.00
Pair 1 1.69 0.32 1.04 2.34 5.32 32 0.00
Note: Variable: Attention
Pair 2 1.36 0.31 0.72 2.00 4.35 32 0.00
Pair 3 3.06 0.27 2.50 3.62 11.12 32 0.00 Pair 1- Baseline and Middle
Pair 2- Middle and Post
Note: Variable: Inattention Pair 1- Baseline and Middle,
Pair 3- Baseline and Post
Pair 2- Middle and Post, Pair 3- Baseline and Post
The paired t-test outcomes obtained from the (Pair 1-baseline and
The paired t- test outcomes obtained from the Pair 1(baseline and middle) depicted in the Table No. 3.1b, demonstrated the marked
middle) depicted in Table No.2.1b, revealed the mean difference of mean difference of the attention level was 2.06[t (32) =21.3,
inattention was 1.69 [t(32)=5.32, p<.0001] with a 95% confidence p<.0001] with a 95% confidence level ranging from 1.86 to 2.25.
level ranging from 1.04 to 2.34. The findings obtained at (pair 2- middle and post) reported mean
The findings obtained at Pair 2(middle and post) reported the difference with 2.33[t (19) =15.69, p<.0001] and found to be
mean difference of 1.36 [t (32) =4.35, p<.0001] with a 95% significant with a 95% confidence level ranging from 2.03 to 2.63.
confidence level ranging from 2.00 to 4.35. At the end of the finally if we look at the pair 3 (baseline with post-test), the decrease
mindfulness programme the inattention level was significantly mean difference of attention recorded to be 4.39 which was highly
reduced as reflected at Pair 3(baseline and post) with the mean considerable with a 95% confidence level ranging from 4.02 to 4.75
difference of 3.06 [t (32) = 11.12, p<.0001] with a 95% confidence [t(32)=24.53 and p<.0001]. The findings suggested the less level of
level ranging from 2.50 to 3.62. attention deficit among participants.

Table 4.1a Outcome for Variable of Efforts (Descriptive Statistics) Discussion

Variables Level N M SD SEM The attention deficit is the main core feature of the ADHD and more
Efforts Baseline 33 18.24 5.11 .88 precisely it's is a deficit in attention regulation thus experience
Middle 33 16.15 5.00 .87 difficulties range from sustain attention, trouble with shift in
Post 33 13.57 4.05 .70 attention. Adolescents with ADD have difficulty in sustaining the
attention on the tasks that requires mental efforts or have difficulty in
Note: N- Number of Participants; M- Mean; SD- Standard Deviation; SEM-
Standard Error of Mean
initiating the task and during the tasks loose the track and get
distracted. The adolescents with Attention Deficit Disorder who
20.00 showed lower scores on D2 Attention Test have considerably
18.00 improvement by 15 % on the post-test measure Attention Test. The
16.15 Conner's 3 Parent Rating Scale and the scores on this indicated that
the participants have difficulty in concentration, get easily distracted
14.00 13.57 and makes careless mistakes while working on task. It also explains
12.00 the lower scores by -32.48*% as compared to baseline to post
measures. Further the Brown ADD Scales specifically on cluster of
Attention & Efforts revealed that the participants in the study
reported to have higher scores which indicated that the participants it
6.00 the present study have difficulty in focusing, sustaining, and shifting
4.00 attention to tasks. The participants also reported that their “mind
drifts when listening” or “gets so preoccupied with own thoughts on
imagination that whatever else is going on is unnoticed” further
0.00 demonstrated insufficient regulation of alertness, sustained effort,
Baseline Middle Post and problems associated with excessive slowness in processing
information. The adolescents with ADD in the study showed -
Figure 4.1 Graphical presentation of outcomes for the variable of 28.52*% & -25.60* % of improvement from the baseline to post test
Efforts. on the cluster of Attention and Efforts respectively. The skills deficit
The result obtained from the scores of efforts measured by the in ADD adolescents however found to be ingrained in mindfulness
Brown ADD Scales reported to be decrease in mean from the therapy which emphasizes on the enhancement and regulation of
baseline (M=18.24, SD=5.11) to middle phase (M=16.15, SD=5.00) attentional capacity. The main feature of mindfulness therapy
and further decline of scores were also found at pre-test (M= 13.57, focuses on bringing the attention to the present moment when mind
SD=4.05). wanders or get distracted then gently bringing back attention and
awareness to the present moment. This regular practice of mindful
Table 4.1b Outcome for the Variable of Efforts (Paired t values) exercises and mindful awareness in daily routine activities
Paired Differences strengthen the neural circuit of brain regions involved in regulating
attention, concentration, focus and reduces distractibility &
95% Confidence
restlessness. As hypothesized the adolescents with ADD exposed to
Interval Level of
mindfulness therapy have significant improvement as compared to
the Difference
baseline measures. Thus the findings suggest the efficacy of
Mean Std. Lower Upper t df Sig. (2 mindfulness therapy in enhancing attentional skills.
Difference Error of tailed) The mindful exercises in daily routine activities and formal
Difference mindfulness training conducted in the present study have assisted
Pair 1 2.09 0.46 1.15 3.03 04.53 32 0.00 the adolescents with ADD to monitor the attention and awareness
Pair 2 2.57 0.22 2.11 3.03 11.38 32 0.00 which usually gets entangled in the past or future. Zylowska et al.
Pair 3 4.66 0.46 3.72 5.60 10.10 32 0.00
(2007) also reported that when attention regulation during
meditation is mastered, open awareness is practiced to other aspects
Note: Variable: Efforts of attention. The practice of mindfulness ingrained the skill of re-
Pair 1- Baseline and Middle Footnote: (*) the minus % scores indicate improvement as compared
Pair 2- Middle and Post Pair 3- Baseline and Post to baseline and the post measures.
The paired t- test outcomes obtained from the Pair 1(baseline Directing the attention and thus distracting oneself from
and middle) depicted in Table No. 4.1b, revealed the mean irrelevant stimulus outside in the environment. The participants in
difference of efforts was 2.09 [t (32) =4.53, p<.0001] with a 95% the present study became more aware about one's attention and were
confidence level ranging from 1.15to 3.03. The findings able to keep track on attention. Adolescents reported that with the
obtained at Pair 2(middle and post) reported the mean difference mindfulness practice they are able to concentrate and focus in better
of 2.57 [t (32) =11.38, p<.0001] with a 95% confidence level way for longer period of time. The result obtained from the post
ranging from 2.11 to 3.03 At the end of the mindfulness programme intervention indicates that adolescents with ADHD have
the efforts level was significantly reduced as reflected at Pair considerably improved on the alertness, attention, concentration and
3(baseline and post) with the mean difference of 4.66[t (32) = focus. The therapist assisted the participants in the classroom setting
10.10, p<.0001] with a 95% confidence level ranging from 3.7 to to monitor attention when get distract by extraneous noises and other
5.6. factors. The practice of mindfulness based therapy strengthens the
1171 Indian Journal of Health and Wellbeing 2014, 5(10), 1165-1172

ability to sustain and monitor the attention. The findings of the Brickenkamp, R., & Zillmer, A. E. (1998). The D2 Test of Attention. Hogrefe & Huber
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