Anil Chacko

Schools have made commendable efforts to incorporate yoga and mindfulness programs to address the wellbeing of students; however, research on the efficacy of school-based yoga and mindfulness programs is still in its infancy, particularly with school-aged students at risk of developing externalizing disorders. Much of the research has also focused on evaluating interventions implemented by researchers, rather than evaluating those implemented by the school and its staff. The aim of this pilot study was to evaluate Little Flower Yoga, a promising yoga and mindfulness program for children. The study sample consisted of girls, 5-7 years old (n = 14), from low-income, minority backgrounds with exposure to multiple risk factors, and who met a predetermined threshold based on well-validated measures of emotion regulation and attentional difficulties to assess the effects of the intervention on emotion regulation, attention, and executive functioning. Objective and multi-method measures were used to assess outcomes across four time points. Results of repeated measures ANOVA found medium effects on child’s emotional regulation (Partial η2 = 0.071), as well as small effects on child’s anger control (Partial η2 = 0.013), per teacher report. Results also showed large effects on improving child’s inhibitory control (Partial η2 = 0.244) on a computerized task, but no effects on child’s inattention and executive functioning. Additional analyses found that several participants experienced clinically meaningful change in executive functioning and emotion regulation. No significant changes were found at the 3-month follow-up. While the findings suggest that Little Flower Yoga shows promise as an approach to addressing emotion regulation and executive functioning difficulties in children, several limitations must be considered. The small sample size limits the generalizability of the results. Moreover, the study's reliance on teacher-reported measures introduces potential response bias, and the lack of long-term follow-up beyond three months limits understanding of the program’s sustained impact. Further investigations utilizing a larger, more diverse sample and robust experimental designs are warranted.

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent, chronic, and impairing mental health disorder of childhood. Decades of empirical research has established a strong evidence-based intervention armamentarium for ADHD; however, limitations exist in regards to efficacy and effectiveness of these interventions. We provide an overview of select evidence-based interventions for children and adolescents, highlighting potential approaches to further improving the efficacy and effectiveness of these interventions. We conclude with broader recommendations for interventions, including considerations to moderators and under-explored intervention target areas as well as avenues to improve access and availability of evidence-based interventions through leveraging underutilized workforces and leveraging technology.

Behavioral treatment, stimulants, and their combination are the recommended treatments for childhood attention-deficit/hyperactivity disorder (ADHD). The current study utilizes within-subjects manipulations of multiple doses of methylphenidate (placebo, 0.15, 0.30, and 0.60 mg/kg/dose t.i.d.) and intensities of behavioral modification (no, low, and high intensity) in the summer treatment program (STP) and home settings. Outcomes are evaluated in the home setting. Participants were 153 children (ages 5–12) diagnosed with ADHD. In alignment with experimental conditions implemented during the STP day, parents implemented behavioral modification levels in three-week intervals, child medication status varied daily, and the orders were randomized. Parents provided daily reports of child behavior, impairment, and symptoms and self-reported parenting stress and self-efficacy. At the end of the study, parents reported treatment preferences. Stimulant medication led to significant improvements across all outcome variables with higher doses resulting in greater improvement. Behavioral treatment significantly improved child individualized goal attainment, symptoms, and impairment in the home setting and parenting stress and self-efficacy. Effect sizes indicate that behavioral treatment combined with a low-medium dose (0.15 or 0.30 mg/kg/dose) of medication results in equivalent or superior outcomes compared to a higher dose (0.60 mg/kg/dose) of medication alone. This pattern was seen across outcomes. Parents overwhelmingly reported preferring treatment with a behavioral component as a first-choice treatment (99%). Results underscore the need to consider dosing as well as parent preference when utilizing combined treatment approaches. This study provides further evidence that combining behavioral treatment and stimulant medication may reduce the stimulant dose needed for beneficial effects.

Children with DBDs experience increased academic and social challenges. The MFG service delivery model, for families of youth with DBDs, was developed. This current study seeks to examine how the presence of ADHD moderates the outcomes for families who go through the MFG intervention. This analysis included families who were enrolled in the MFG intervention. Children were grouped by ADHD severity to examine how symptom severity moderates various behavioral outcomes. Results showed that several outcomes were moderated by ADHD severity. These results indicate that ADHD severity can have an impact on certain treatment outcomes, both positively and negatively.

Despite demonstrated effectiveness as a psychosocial intervention for youth diagnosed with attention-deficit/hyperactivity disorder (ADHD), behavioural parent training (BPT) remains inaccessible while disorder rates increase globally. Previously, Chacko and Scavenius found that the Caring in Chaos (CiC) BPT model leveraged the advantages of community health settings, resulting in improved child and parent outcomes, prompting a need to replicate these findings. This paper reports on the effects of the CiC BPT model on the previous waitlist, untreated sample from Chacko and Scavenius. Results confirm previous findings, demonstrating CiC BPT improves parenting behaviour, competence, stress, depressive symptoms, and child impairment.

This systematic review aimed to synthesize the research of peer mentor models for families involved in the child welfare system. Twelve studies were examined. Most interventions targeted birth parents to facilitate reunification and support the family, with outcomes being mainly favorable particularly for engagement in treatment and reunification outcomes. However, few studies employed rigorous research designs, suggesting several avenues for future practice and research such as advancing the rigor of the evidence and collaborating with peers to provide comprehensive services and enhance family outcomes.

News of a videogame that received FDA clearance to treat youth with attention-deficit hyperactivity disorder (ADHD) garnered a great deal of media attention and raised questions about the role of digital cognitive training programs for treatment. In order for clinicians and clients to understand this news for the purposes of making treatment decisions one must have an understanding of what it means for a treatment to be considered evidence-based and an understanding of what is required to obtain FDA clearance. Finally, in order to fully inform decisions about treatment, clinicians and parents must be able to consider the evidence supporting cognitive training programs in relation to other treatments available for children with ADHD. A review of these standards and the evidence supporting cognitive training in general, and the new videogame that received recent FDA clearance (EndeavorRX^TM) specifically, revealed an overall lack of support for this approach to treatment. There are multiple psychosocial and pharmacological treatment options with much more evidence supporting their effectiveness than any commercially available cognitive training program. The contrast between receiving FDA clearance without evidence of any observable benefits to the child is explained within a description of the FDA process for clearance and approval. Finally, these conclusions are described in the context of clinicians’ decisions regarding services offered and procedures for explaining this to families who may have seen the media attention related to FDA clearance.