By: Lauren Halladay, Ph.D.
Pediatric Neuropsychologist, NESCA
Children with Attention Deficit-Hyperactivity Disorder (ADHD) often struggle to sustain attention, follow directions, and appropriately interact with peers when compared to children with typical development. Executive functioning challenges, including difficulties with self-regulation, are also common in individuals with ADHD. Executive functioning refers to the neuropsychological-based functions involved in the regulation of behavioral states and the organization of goal-directed behavior. This can present as difficulty breaking down goals into steps, planning, monitoring the effectiveness of an approach to a task, modulating one’s emotions, etc.
Currently, evidence-based treatment methods for managing ADHD symptomology include medication, behavioral interventions, or the combination of the two. In addition, one domain that has received increased attention from the scientific community over the past several years is the integration of mindfulness-based interventions (MBI) within treatment (Felver & Jennings, 2016).
Mindfulness is the ability to bring one’s attention to experiences occurring in the present moment, which can allow an individual to consider alternative ways to perceive and react to a situation (Singh et al., 2007). Many MBI curriculums include lessons on focusing one’s attention on the present moment, which can improve individuals’ self-regulation, executive functioning, concentration, and emotional-reactivity, while reducing aggressive behavior, social problems, and anxiety (Keng et al., 2011; Parker et al., 2014).
One such curriculum, originally developed for adults with Intellectual Disabilities and aggressive behaviors, is Soles of the Feet (SoF) (Singh et al., 2003). The purpose of this exercise is to shift the individual’s attention from a typically triggering situation to a neutral stimulus. The SoF intervention involves teaching an individual to recognize situations that trigger an emotional response in real life or through role-play scenarios. Next, the individual is guided through steps in the curriculum that consist of finding a neutral body posture, breathing naturally while thinking about the triggering event, and shifting attention to the soles of the feet. Then the individual is guided to be mindful of their feet on the ground. The goal is for the individual to end this process having appropriately responded to the situation without engaging in behavior that was contrary to expectations. Research suggests that engaging in this intervention significantly improved participants’ ability to regulate their aggressive and disruptive behaviors, and appropriately engage with others (Felver et al., 2013; Singh et al., 2007).
There are several mindfulness-based activities, such as progressive muscle relaxation and focusing on your five senses, that can be modified to support children’s attentional and emotional regulation. For some ideas, please consider visiting the American Psychological Association (APA)’s Magination Press website, where they offer several children’s book titles related to a variety of topics, including mindfulness.
References
Felver, J. C., Doerner, E., Jones, J., Kaye, N., & Merrell, K. M. (2013). Mindfulness in school psychology: Applications for intervention and research. Psychology in the Schools, 50, 531–547
Felver, J. C., Celis-DeHoyos, C., Tezanos, K., & Singh, N. N. (2016) A systematic review of mindfulness-based interventions for youth in school settings. Mindfulness. doi:10.1007/s12671-015-0389-4
Keng, S. L., Smoski, M. J., & Robins, C. J. (2011). Effects of mindfulness on psychological health: a review of empirical studies. Clinical Psychology Review, 31(6), 1041-56.
Parker, A. E., Kupersmidt, J. B., Mathis, E. T., Scull, T. M., & Sims, C. (2014). The impact of Mindfulness education on elementary school students: evaluation of the Master Mind program. Advances in School Mental Health Promotion, 7(3), 184-204. doi:10.1080/1754730x.2014.916497
Singh, N. N., Wahler, R. G., Winton, Adkins, A. D., Myers, R. E., & The Mindfulness Research Group. (2003). Soles of the feet: A mindfulness based self-control intervention for aggression by an individual with mild mental retardation and mental illness. Research in Developmental Disabilities, 24, 158–169.
Singh, N. N., Lancioni, G. E., Winton, A. S. W., Singh, J., Curtis, W. J., Wahler, R. G., & McAleavey, K. M. (2007). Mindful parenting decreases aggression and increases social behavior in children with developmental disabilities. Behavior Modification, 31(6), 749-771. doi:10.1177/0145445507300924
About Lauren Halladay, Ph.D.
Dr. Halladay conducts comprehensive evaluations of toddlers, preschoolers, and school-aged children with a wide range of developmental, behavioral, and emotional concerns. She particularly enjoys working with individuals with Autism Spectrum Disorder, Intellectual and Developmental Disabilities, and complex medical conditions. She has experience working in schools, as well as outpatient and inpatient hospital settings. She is passionate about optimizing outcomes for children with neurodevelopmental disabilities by providing evidence-based, family-oriented care.
If you are interested in booking an appointment for an evaluation with a Dr. Halladay or another NESCA neuropsychologist/clinician, please fill out and submit our online intake form.
NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region; and Brooklyn, New York (coaching services only) serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

research and academia for over 30 years. She is a national consultant and speaker on program design and the inclusion of children and adolescents with special needs, especially those diagnosed with Autism Spectrum Disorder (ASD). Prior to joining NESCA, Ms. Lucci was the Principal of the Partners Program/EDCO Collaborative and previously the Program Director and Director of Consultation at MGH/Aspire for 13 years, where she built child, teen and young adult programs and established the 3-Ss (self-awareness, social competency and stress management) as the programming backbone. She also served as director of the Autism Support Center. Ms. Lucci was previously an elementary classroom teacher, special educator, researcher, school psychologist, college professor and director of public schools, a private special education school and an education collaborative.
neuropsychologist who has been practicing for almost 20 years. In 1996, she jointly founded the Children’s Evaluation Center (CEC) in Newton, Massachusetts, serving as co-director there for almost ten years. During that time, CEC emerged as a leading regional center for the diagnosis and remediation of both learning disabilities and Autism Spectrum Disorders.
and academia for over 30 years. She is a national consultant and speaker on program design and the inclusion of children and adolescents with special needs, especially those diagnosed with Autism Spectrum Disorder (ASD). Prior to joining NESCA, Ms. Lucci was the Principal of the Partners Program/EDCO Collaborative and previously the Program Director and Director of Consultation at MGH/Aspire for 13 years, where she built child, teen and young adult programs and established the 3-Ss (self-awareness, social competency and stress management) as the programming backbone. She also served as director of the Autism Support Center. Ms. Lucci was previously an elementary classroom teacher, special educator, researcher, school psychologist, college professor and director of public schools, a private special education school and an education collaborative.
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Professional Psychology, with a concentration in Children, Adolescents and Families (CAF). She completed post-doctoral training in pediatric neuropsychology with an emphasis on treating children with developmental, intellectual, learning and executive functioning challenges. She also has extensive training psychological (projective) testing and has conducted individual and group therapies for children of all ages. Before joining NESCA, Dr. Kulis worked in private practices, clinics, and schools, conducting comprehensive assessments on children ranging from toddlers through young adults. In addition, Dr. Kulis has had the opportunity to consult with various school systems, conducting observations of programs, and providing in-service trainings for staff. Dr. Kulis currently conducts neuropsychological and psychological (projective) assessments for school-aged children through young adulthood. She regularly participates in transition assessments (focusing on the needs of adolescents as they emerge into adulthood) and has a special interest in working with complex learners that may also struggle with emotional challenges and psychiatric conditions. In addition to administering comprehensive and data-driven evaluations, Dr. Kulis regularly conducts school-based observations and participates in school meetings to help share her findings and consultation with a student’s TEAM.
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M.A. from Antioch New England in Applied Psychology. She also worked as an elementary school counselor and school psychologist for 15 years before embarking on her doctorate. During her doctorate, she did her pre-doctoral internship with RIT in Rochester, N.Y. where she worked with youth ages 5-17 who had experienced complex developmental trauma. Dr. Hess’s first post-doctoral fellowship was with The Counseling Center of New England where she provided psychotherapy and family therapy to children ages 5-18, their families and young adults. She also trained part-time with a pediatric neuropsychologist conducting neuropsychological evaluations. Currently, Dr. Hess is a second-year post-doctoral fellow in pediatric neuropsychological assessment, working with NESCA Londonderry’s
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