Journal of Child and Family Studies (2020) 29:82–93

https://doi.org/10.1007/s10826-019-01582-7

ORIGINAL PAPER

The Feasibility and Effectiveness of Mindful Yoga for Preschoolers

Exposed to High Levels of Trauma
1
Rachel A. Razza ●
Rachel Uveges Linsner1 Dessa Bergen-Cico2 Emily Carlson3 Staceyann Reid1
● ● ●

Published online: 21 September 2019

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Abstract
Objectives Although mindfulness-based interventions with children have been increasingly used as a strategy to promote
social-emotional learning, the exploration of these practices among preschoolers in limited. This pilot study examined the
feasibility and effectiveness of an 8-week mindful yoga program for preschoolers living in communities with high levels of
trauma. Of particular interest was whether participation in the intervention was associated with gains in children’s self-
regulation of attention and behavior. A related objective was to examine the acceptability and need for trauma-informed
professional development for teaching staff.
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Methods Five classrooms (n = 89 children) were randomly assigned to the intervention and control conditions; three
classrooms participated during the fall and two classrooms served as wait-list controls who received the intervention in the
spring.
Results Analyses revealed significant increases in children’s behavioral and attention regulation during the time that they
participated in the intervention. An unexpected potentially influential finding was the high prevalence of posttraumatic stress
among staff; the majority of staff experienced were above the threshold for civilian PTSD.
Conclusions Mindful yoga may be a promising strategy to promote behavioral regulation and attention regulation among
economically disadvantaged preschoolers. Staff may also benefit from trauma-informed practices given their high rate of
exposure to traumatic events and above-average levels of PTSD.
Keywords Mindfulness Yoga At-risk Preschoolers Trauma
● ● ● ●

Early childhood trauma is a mounting public health con-
cern, as approximately 25% of children in the United States
either witness or experience a traumatic event before the age
of 4 years (Briggs-Gowan et al. 2010; National Center for
Mental Health Promotion and Youth Violence Prevention
2012). Unfortunately, these rates are even higher among
ethnic minority children and those who live in dis-
advantaged neighborhoods (Finkelhor et al. 2013; Sacks
and Murphey 2018). For example, in a study of Head Start
* Rachel A. Razza
rrazza@syr.edu
1
Department of Human Development and Family Science,
Syracuse University, 144D White Hall, Syracuse, NY 13244, USA
2
Department of Public Health, Syracuse University, 144D White
Hall, Syracuse, NY 13244, USA
3
Department of Social Work, Syracuse University, 144D White
Hall, Syracuse, NY 13244, USA
families, 78% of preschoolers and 66% of parents reported
exposure to at least one incident of community violence
(Shahinfar et al. 2000).
Children exposed to trauma in the home or community
can be neurologically and psychologically affected in ways
that negatively impact cognitive function, emotional reg-
ulation, and increase their risks for depression, anxiety, and
substance abuse (Greenberg 2006; Kim and Cicchetti 2010;
Mejia et al. 2006). Relatedly, these children are at increased
risk for deficits in academic achievement and social com-
petence (see Chu and Lieberman 2010, for a review).
Research conducted within the community where the pre-
sent study was implemented, found significant associations
between community gun violence, academic failure, and
school suspensions among children in elementary schools
within high gun shot areas indicating that community vio-
lence negatively impacts cognitive and behavioral factors
pertinent to educational attainment (Bergen-Cico et al.
2018). Thus, there is growing interest in developing effec-
tive school-based primary prevention programs for children
Journal of Child and Family Studies (2020) 29:82–93
that cultivate habits of mind and behavior to foster resi-
lience, health, and well-being in the face of everyday
adversity (Shonkoff et al. 2009). Self-regulation is one key
protective factor highlighted by extant prevention research,
as it represents a critical asset for healthy development and
school success (Blair and Diamond 2008; McClelland et al.
2013; Moffitt et al. 2011).
Self-regulation refers to the ability to monitor and control
our attention, emotion, and behavior to fit situational
demands and includes a suite of specific skills that support
learning and social interaction, including focused attention
and inhibitory control (Blair and Dennis 2010; Rothbart and
Bates 2006). Extant literature suggests that early self-
regulatory skills serve as the foundation for children’s
behavioral and academic competence, and thus serve as an
important target of intervention, particularly during early
childhood when children are acquiring these foundational
skills (Blair and Razza 2007; Greenberg 2006; McClelland
et al. 2018). Promoting self-regulation is particularly critical
among disadvantaged children, as they routinely exhibit
dysregulation, and subsequently experience higher levels of
problem behavior and lower levels of academic achievement
(Blair and Raver 2012; Buckner et al. 2009; Hackman and
Farah 2009). One strategy for enhancing self-regulation that
is rooted in, and reflective of, a trauma-informed approach
are mindfulness-based practices in early childhood education
(Holmes et al. 2015; McConnico et al. 2016).
Mindfulness-based practices, particularly mediation and
yoga, use movement, thinking, and breathing techniques to
increase attention, concentration, flexibility, and reduce stress
(Cook-Cottone 2017; Greenberg and Harris 2012). More
specifically, mindfulness is defined as “paying attention to
what’s happening in the present moment in the mind, body,
and external environment, with an attitude of curiosity and
kindness” (Mindfulness All-Party Parliamentary Group
[MAPP] 2015, p. 13). Thus, while there is variability across
exercises, a shared goal of mindfulness-based practice is to
enhance our attention to, and acceptance of, present moment
experiences (Bishop et al. 2004; Cook-Cottone 2017).
Mindfulness-based programs are increasingly popular among
school-aged children, and there is a growing body of evidence
to support their effectiveness in promoting the regulation of
emotions, attention, and behavior among children and youth
(Felver et al. 2016; Waters et al. 2015; Zenner et al. 2014).
Although fewer in number, the results of a recent review
suggest that mindfulness-based programs also hold promise
for young children, with benefits found in the domains of self-
regulation, social-emotional competence, and physical
development (Erwin and Robinson 2016).
Early childhood is viewed as an optimal time for redu-
cing self-regulatory deficits, as the underlying develop-
mental processes, including attention and executive
functions, are highly malleable during this sensitive period
83
(Blair and Raver 2015; Sanders et al. 2006; Shonkoff et al.
2009). The rapid growth in these skills across the preschool
years mirrors significant brain development, particularly in
the prefrontal cortex, an area associated with higher-order
thinking and behavior regulation (Diamond 2002; Mor-
iguchi and Hiraki 2011), and marks a critical turning point
in development (McClelland et al. 2018). Mindfulness
programs for preschoolers are particularly appealing
because they target these early self-regulatory processes that
contribute to both the cognitive and socioemotional
domains of school-readiness and thus have the potential to
significantly impact children’s developmental trajectories
(Diamond and Lee 2011; Thierry et al. 2016; Willis and
Dinehart 2014). Moreover, with an emphasis on refining
concentration or attention and strengthening impulse control
within a nonjudgmental framework, mindfulness interven-
tions may impact both the top-down (cognitive response
engaging the prefrontal cortex characterized by a measured
response) and bottom-up (stress/emotional reactivity to
sensory input driven by the amygdala) processes involved
in self-regulation (Gard et al. 2014; Ochsner et al. 2009;
Zelazo and Lyons 2012). Thus, these programs may be
particularly powerful for children with a history of chronic
stress or trauma, as they are at increased risk for deficits in
executive function (e.g., working memory, inhibitory con-
trol, attention flexibility), as well as compromised physio-
logical functioning (e.g., elevated cortisol levels, reduced
immune response) (Blair and Raver 2012; Evans and Kim
2013; Miller et al. 2011; Telles et al. 2012).
Yoga, defined as a set of practices that include physical
postures, breathing techniques, meditation, and relaxation
(Hagan and Nayar 2014), represents one mindfulness-based
technique that has been successfully adapted to be devel-
opmentally appropriate for young children (Cook-Cottone
2017; Kaiser-Greenland 2010; Roeser and Peck 2009). In
yoga, movements are enacted to strengthen, stretch and
relax the body, including the nervous and emotional sys-
tems, while breath is used to restore attention to the present
moment and balance to the body and mind (Cook-Cottone
2015; Khalsa 2004). The use of movement and somatic
experiences is common in early childhood education and
practices like yoga, that involve sensory-motor coordina-
tion, are thought to reinforce the brain-body connection and
neurological underpinnings of self-regulation (Diamond and
Lee 2011; Williams 2018). Moreover, these practices
facilitate embodied self-regulation, a concept delineated by
Cook-Cottone (2017) in her mindful and yogic self as an
effective learner (MY-SEL) model that delinates how
mindfulness practices and yoga contribute to student
engagement in the classroom. Specifically, embodied self-
regulation requires mindful awareness of our thoughts,
feelings, and, physical sensations and includes key pro-
cesses that support the mind-body-behavior connection
84
such as inquiry into our inner experiences and choice of our
actions (Cook-Cottone 2015, 2017). Consequently, yoga is
considered an important tool and educational strategy for
promoting social-emotional learning (SEL; Butzer et al.
2016; Cook-Cottone 2017).
The self-regulatory benefits of secular practice for older
children, including enhanced academic engagement and
psychological well-being, are supported by recent reviews of
yoga in the schools research (Khalsa and Butzer 2016;
Serwacki and Cook-Cottone 2012). As the reviews point
out, however, the findings are considered preliminary given
the low methodological quality (e.g., lack of randomized
control, limited follow-up data, self-report measures, follow-
up data) and limited intervention description among many of
the early studies. Moreover, most of the research on yoga
has focused on programs at the elementary-school level or
above. Thus, research on the feasibility and effectiveness of
yoga interventions among young children is still in its
infancy. There is evidence, however, that mindful yoga,
defined as mindfulness-based programs that include simple
breathing and yoga poses, can be effective in enhancing self-
regulation among preschool children (Adair and Bhaskaran
2010; Flook et al. 2015; Poehlmann-Tynan et al. 2016;
Razza et al. 2015). For example, meditation and simple yoga
postures integrated across the year by classroom teachers in
both Montessori (Adair and Bhaskaran 2010) and public
(Razza et al. 2015) preschools has been associated with
benefits in both attentional and behavioral regulation.
Moreover, the self-regulatory benefits of yoga are supported
in recent qualitative work investigating young children’s
experiences of yoga in the classroom. Specifically, emo-
tional regulation and cognitive function, along with physical
benefits, emerged as themes reflected in the narratives of
preschoolers in one study (Stapp and Wolff 2019). Another
theme that emerged in similar work was children’s auton-
omy and how somatic experiences promote awareness of
their inner and outer-selves and a sense of independence that
supports behavioral regulation (Buono 2019). Thus, it is
feeble that mindful yoga can be infused into classrooms via a
trauma-informed early education framework that addresses
the needs of the children and their teachers.
Early childhood educators experience multiple job stressors,
including inadequate compensation and resources, reduced
autonomy, and low confidence in managing children’s behavior
(Hall-Kenyon et al. 2014; Hammarberg and Hagekull 2002;
Leana et al. 2009). These challenges, particularly behavioral
management concerns, are exacerbated for preschool teachers
who serve children from disadvantaged neighborhoods (Fried-
man-Krauss et al. 2014b; Li-Grining et al. 2010; Zhai et al.
2011). Not surprisingly, these teachers report high levels of
emotional exhaustion and burnout (McGinty et al. 2008).
Moreover, a recent poll of Head Start teachers in Pennsylvania
found that they were at greater-risk of poor physical and mental
Journal of Child and Family Studies (2020) 29:82–93
health compared with the broader population, with 24% of the
sample meeting the criteria for depression (Whitaker et al.
2013). Unfortunately, these adverse outcomes also have nega-
tive implications for classroom quality, as high levels of teacher
stress and depressive symptoms are associated with lower
emotional climates and reduced social-emotional competence
among preschoolers (Friedman-Krauss et al. 2014a; Jennings
2015; Roberts et al. 2016). Collectively, these findings are
consistent with the Prosocial Classroom theoretical model
(Jennings and Greenberg 2009), which posits that classroom
quality is influenced by the bidirectional associations between
the teacher’s social-emotional competence and the child’s
social-emotional competence. Moreover, there is evidence that
mindfulness training for preschool teachers was associated with
decreased reports of challenging behaviors and negative social
interactions with peers and increased compliance among stu-
dents (Singh et al. 2013).
This pilot study extends the scope of successful
mindfulness-based interventions for young children by
infusing yoga into the daily physical/gross motor activities
for children in the center while also assessing the needs of
their teachers. The first aim was to examine the benefits of
an 8-week mindful yoga program for preschoolers’ self-
regulation. The evaluation used random assignment with
two intervention cohorts and included direct assessments of
attention and behavioral regulation at three time-points.
Based on previous research (Flook et al. 2015; Razza et al.
2015), we expected children in the intervention to demon-
strate significant gains in self-regulation. We also expected
children in the first cohort of the intervention to maintain
their self-regulatory skills at the 3-month post-test, although
this hypothesis was more tentative given the limited
research on the sustainability of self-regulatory gains within
the context of mindfulness-based interventions for children
(Poehlmann-Tynan et al. 2016; Thierry et al. 2016). A
second aim was to document the level of trauma and stress
among the teaching staff and examine the acceptability of
professional development workshops that focused on
trauma-informed practice and mindfulness-based stress
reduction. In line with prior work with Head Start teachers
(Friedman-Krauss et al. 2014b; Zhai et al. 2011), we
expected elevated levels of stress and trauma within this
sample. We also anticipated that teachers would find the
professional development workshops useful and indicate
interest in additional seminars.
Method
Participants
The study included 89 children aged 3 to 5 years (M = 4.1
years, SD = 0.37; 50% male) from five preschool
Journal of Child and Family Studies (2020) 29:82–93
classrooms within an urban Head Start center in a mid-sized
city in the northeastern region of the United States. The
center serves an ethnically diverse community of children
who were predominantly African American (74%) and
mixed-race (14.3%). Per the Federal regulations, at least
90% of families enrolled in Head Start must be at or below
130% of the federal poverty level, with priority given to
families at or below 100% of the federal poverty level
(http://www.benefits.gov/benefits/benefit-details/616). This
Head Start center serves a particularly disadvantaged
population, as one third of all city residents live below the
federal poverty level; among families with children under
age 18, 43% fall below the poverty level and 54% are
female-headed (United States Census Bureau 2016). The
high school graduation rate in the community studied here
is about 50% while 52% of their public schools have been
designated as failing by New York State (New York State
Education Department 2015.) Moreover, these children
reside in a city that had the highest per capita murder rate in
all of New York state in 2013; and the rate of posttraumatic
stress among citizens in the community where this study
was conducted is 51% (Lane et al. 2017).
Study participants also included 23 teaching staff who
attended at least one of the two professional development
workshops. The staff included eight head teachers, seven
teaching assistants, and eight teacher aides from the pre-
school classrooms. The staff was primarily female (91%
female, 9% male) between the ages of 26 and 40 years
(39%). The majority of the staff members were white (74%)
with the remaining staff members identifying as Black
(13%), Asian/Pacific Islander (9%), or Hispanic (4%).
Sixty-five percent of the staff members were employed at
the center for five years or less. The majority of staff
completed a postsecondary degree, including an Associate’s
degree (13%), a Bachelor’s degree (30%), or a Master’s
degree (13%). The remaining staff either completed high
school (or equivalent; 21%) or some college (21%).
Procedure
Parents of the five preschool classrooms in the center were
notified about both the mindful yoga program and the
opportunity to participate in its evaluation via packets
mailed directly to their homes from the Head Start center.
Given that the mindful yoga program was considered part of
the center’s preschool curriculum, parental informed con-
sent was not required for children to participate in the yoga
program. Initially, families were recruited via active par-
ental consent. Given the low recruitment rate at T1 (44%),
at the request of the Head Start Center, the process was
changed to passive parental concent. This procedural
change was approved by the University’s IRB. There were
no instances of parental refusal for children to participate in
85
the program or in its evaluation; children provided verbal
consent at the time of each assessment.
The five preschool classrooms were randomly assigned
to the intervention or wait-list control condition. Three
classrooms participated in the intervention in the fall; two
classrooms served as the wait-list control and received the
intervention the following spring. Thus, two rounds of
the mindful yoga intervention were administered across the
school year. All children were individually assessed three
times (fall, winter, spring) across the school year. The child
assessments were conducted by trained research assistants
in a quiet area inside the classroom, or in the hall directly
outside the classroom. The battery of assessments are
described in detail in the measures section and included two
tasks tapping self-regulation that were administered in a
fixed order to maximize interest and minimize bias related
to variation in administration, as is typical in individual
difference designs (Carlson et al. 2004; Clark et al. 2013).
The self-regulation battery took approximately 20 min to
complete and children received a sticker after each session.
The families also received a child yoga book after the
completion of the study as an incentive.
The teaching staff were informed of the professional
development workshops via the Center Director and a letter
distributed by the researchers. Staff who attended either
session were eligible to participate in the research study and
complete a teacher survey. Informed consent was obtained
at the workshops; there were no refusals to participate. The
survey included a demographic questionnaire and two self-
report measures tapping trauma and stress. It was admi-
nistered at the start of the workshop and took approximately
15 min to complete. Teachers received a gift card for their
participation. Participants also completed a satisfaction
survey following each of the two workshops.
Mindful yoga intervention
The mindful yoga program was delivered by a certified
child yoga instructor who visited the center twice a week for
8-weeks. The sessions were conducted in the center’s
gymnasium and delivered to each classroom independently.
The yoga instructor taught three consecutive classes in the
fall and two in the spring. The mindful yoga program was
reflective of the YogaKids curriculum that treats yoga as a
medium for learning and integrates movement with other
elements including music, anatomy, language, and ecology
(Wenig 2003). Each 25-minute session began with a cen-
tering activity (e.g., feather breathing, mindful listening to
the singing bowl), progressed through a set of child-
centered yoga poses (e.g., downward dog, cat/cow), and
concluded with a brief relaxation activity (e.g., deep-belly
breathing with a ball, lying on the back and watching a
rubber duck rise and fall on their bellies). The same lesson
86
plan was used for all of the classes, but thematic content
differed slightly between the fall and spring cohorts, given
the integration of relevant events (e.g., holidays, seasons).
The instructor incorporated music, books, and props (e.g.,
stuffed animals, rainbow scarves) into all of the classes.
Teacher professional development
Teachers and teaching staff attended the yoga sessions and
participated to their comfort level. They also attended one
of two, two-hour child-yoga workshops led by the chil-
dren’s yoga instructor. The intent of these workshops was to
connect with the teachers in the intervention classrooms
prior to the start of the program. The instructor discussed
the benefits of children’s yoga, particularly within the
context of trauma, and led the teachers through a brief class
that mirrored the child session. She also modeled simple
breathing techniques that could be integrated into their
classrooms. Two trauma-informed workshops for preschool
teaching staff were conducted at the center during a two-
hour time reserved for professional development. In the first
seminar, a certified mindfulness instructor presented an
experiential mindfulness-based stress reduction (MBSR)
workshop. The purpose of this workshop was to introduce
teachers to mindfulness techniques (e.g., breath meditation,
body scan) that they could use for self-care and well-being.
In the second seminar, a licensed marriage and family
therapist presented strategies for treating complex trauma
using the Collaborative Change Model (CCM; Barrett and
Stone Fish 2014). More specifically, the therapist educated
the staff on the effects of trauma and provided tools to help
cope with symptoms of trauma that decrease hope and
resilience. The intent of this session was to increase the
teachers’ knowledge of trauma-informed practice and pro-
mote its application in their professional lives.
Measures
Assessments of children’s self-regulation
Children’s self-regulation was assessed via a two tasks. The
Head Toes Knees and Shoulders task (HTKS; Ponitz et al.
2009) measures children’s behavioral regulation using a
structured observation that requires children to perform the
opposite of a dominant response (i.e., touch their heads
when the interviewer says “touch your toes”) to four dif-
ferent oral commands. The measure has demonstrated both
construct and predictive validity in diverse samples (Dun-
can et al. 2017; McClelland et al. 2014; Wanless et al.
2011). Internal reliability for the current sample was similar
to levels reported in previous research (α = 0.83 to 0.87).
The HTKS task includes three phases, each with 10 trials,
which become progressively more difficult. For each trial,
Journal of Child and Family Studies (2020) 29:82–93
the child received a score of 0 (incorrect), 1 (self-correct), or
2 (correct). Scores were summed across trials to reflect a
total correct response ranging from 0 to 60.
Children’s attention regulation was assessed using the
Attention Sustained task (AST) from the Leiter International
Performance Scale-Revised (Roid and Miller 1997). Chil-
dren were shown a picture of a variety of objects scattered
throughout a page. There was a target object at the top of
the page and children were asked to put a line through as
many of the objects matching the target as possible without
accidentally crossing out any other objects. Children’s
performance across four timed trials were averaged to yield
scores of attentional focus and inhibition. The adjusted total
correct score, which reflects the number of correct responses
(cross-outs of objects matching the target) minus the num-
ber of incorrect responses (cross-outs of objects not
matching the target), was used in analyses. The score was
standardized against a national norming sample with a mean
of 10 (SD = 3). The task has high internal reliability (α =
0.83) for young children and good test-retest reliability (r =
0.85) (Roid and Miller 1997).
Teacher survey
The Life Events Checklist for DSM-5 (LEC-5; Weathers
et al. 2013) is a self-report measure intended to screen for
potentially traumatic life events in an individual’s lifetime.
The list includes 16 events, such as a natural disaster (e.g.,
flood, hurricane, tornado, earthquake), that potentially
increase a person’s risk for personal distress or Post-
Traumatic Stress Disorder (PTSD). For each item, the
respondent indicated their level of exposure to the event on
a 5-point nominal scale (i.e., happened to me; witnessed it;
learned about it; not sure; does not apply) that allowed for
the selection of multiple levels of exposure to the same
event. The scale does not yield a composite score. For this
paper, the percentages of staff who experienced, witnessed,
or learned about the events were calculated to represent
levels of risk within the sample.
The PTSD Checklist (PCL—Civilian version; Weathers
et al. 1994) was used to assess the teachers’ self-report of
DMS-IV symptoms of PTSD. The 17-item measure asks
about the severity of symptoms over the last month in
relation to generic stressful experiences. For example,
respondents are asked to rate how much they are bothered
by problems (e.g., repeated, disturbing memories, thoughts,
or images of a stressful experience from the past), using a 5-
point Likert scale (1 = not at all; 2 = a little bit; 3 = mod-
erately, 4 = quite a bit; 5 = extremely). A total symptom
severity scores (range 17–85) was obtained by summing the
scores from each of the 17 items. The scale has demon-
strated both convergent and discriminant validity in non-
clinical samples (Conybeare et al. 2012). Suggested PLC
Journal of Child and Family Studies (2020) 29:82–93
Table 1 Summary of main
Measure Fall cohort
effects for repeated-measures
ANOVA models examining M (SD)
self-regulation
Behavioral regulation (HTKS)
Pretest 1.25 (3.34)
Post-test 6.30 (12.07)
Attention regulation (AST)
Pretest 7.31 (3.86)
Post-test 9.81 (3.47)
The fall intervention cohort participated in the program between T1 and T2; the spring cohort participated in
the program between T2 and T3. The F statistic represents the within-subject effect of time
HTKS Head Toes Knees Shoulder task, AST Attention Sustained task
cut-point scores within civilian settings are 30–35, where
the estimated prevalence of PTDS is 15% or below.
Data Analyses
Our original intent to compare change between the inter-
vention and wait-list control groups was limited given
issues with data collection. The revised analyses model the
change in time associated with participation in the inter-
vention (T1 and T2 scores for the fall intervention group;
T2 and T3 scores for the spring intervention group). Spe-
cifically, the effects of the program on children’s self-
regulation were examined using repeated-measures analysis
of variance (ANOVA) models. The within-subject variable
(time) had two levels (pre-test and post-test) and the
between-subjects variable reflected group (fall or spring).
The partial eta-squared statistic was used as an estimate of
effect size, with η2 = 0.02 suggesting a small effect, η2 =
0.09 signifying a moderate effect, and η2 = 0.25 represent-
ing a large effect (Cohen 1988). Additional analyses
included independent t-tests comparing the change scores
between the intervention and wait-list control group
between T1 and T2 (intervention effect) as well as com-
paring the pre-test score across both groups (T1 for the fall
intervention with T2 for the spring intervention). A paired-
sample t-test for the fall intervention group was also con-
ducted to test whether there was significant change in mean
scores during the follow-up period (T2 to T3). Teacher data
were analyzed via descriptive statistics representing demo-
graphic information, trauma, stress, and satisfaction with the
workshops.
Results
Although 89 children participated in the research, sample
size varied across time-points and outcomes. The following
number of children participated in the child assessments
over time: pre-test/T1 (n = 39), post-test/T2 (n = 81), and
87
Spring cohort
M (SD) N F p-value Partial η2
20 4.47 (11.41) 17
20 10.35 (15.10) 17 11.30 0.002 0.24
16 8.70 (3.25) 23
16 10.09 (2.84) 23 14.23 0.001 0.28
follow-up/T3 (n = 78); the notable increase at post-test was
a result of parent consent changing from active to passive
consent. Almost half (49.4%) of the children participated in
the post-test and follow up only; 32 children (36.0%) par-
ticipated at all three time-points. There was variation in
completion across the tasks due to unexpected events, such
as a fire drill or dismissal. Results from independent t-tests
indicate that the two groups did not differ significantly
across self-regulation measures at baseline T1. Similarly,
the mean pre-test scores for the fall intervention group did
not differ significantly from the mean pre-test scores for the
spring intervention group.
The effect of the intervention on children’s self-
regulation was examined via a series of repeated mea-
sures ANOVAs; the main effects are summarized in
Table 1. The model examining behavioral regulation
(HTKS) revealed a significant effect of time, F(1, 35) =
11.30, p < 0.05, partial η2 = 0.24. Post hoc tests using the
Bonferroni correction revealed that the intervention eli-
cited a significant increase (mean difference = 5.47, p <
0.01) in behavioral regulation from pre-test to post-test.
The interaction between time and group was not sig-
nificant, F(1, 35) = 0.10, ns, suggesting that the change
from pre-test to post-test was similar across the fall and
spring intervention cohorts. These patterns are reflected in
Fig. 1. Additional analyses examining change scores
between T1 and T2 only found that the fall intervention
cohort experienced significantly greater growth over that
time period compared with the waitlist control group,
t(22) = 2.32, p < 0.05. We also examined the change from
post-test (T2) to follow-up (T3) for the fall intervention
cohort using a paired-samples t-test. Although the scores
increased from post-test (M = 6.41, SD = 14.41) to
follow-up (M = 8.50, SD = 13.60), the change was not
significant, t(22) = 1.97, p = 0.06. Thus, behavioral reg-
ulation was responsive to the mindful yoga practice and
that the effects of the program were maintained across the
3-month follow-up period for the children in the fall
cohort.
88
Fig. 1 Change in behavioral regulation (HTKS) score by intervention
group. The fall cohort participated in the program from T1 to T2 and
the spring cohort group participated in the program from T2 to T3
A similar series of repeated measures ANOVA models
were conducted to examine change in attention regulation
(AST) over time. The model examining attention regulation
revealed a significant effect of time, F(1, 37) = 14. 23, p <
0.01, partial η2 = 0.28. Post hoc tests using the Bonferroni
correction revealed that the intervention elicited a sig-
nificant increase (mean difference = 1.95, p < 0.01) in
attention regulation from pre-test to post-test. The interac-
tion between time and group was not significant, F(1, 37) =
1.16, ns, indicating that the change from was similar across
the fall and spring groups (see Fig. 2). The changes scores
between T1 and T2 also suggest that the fall intervention
cohort experienced greater growth over that time period
compared with the waitlist control group, t(24) = 1.99, p =
0.06. The results of a paired samples t-test indicated positive
and significant change in attention regulation for partici-
pants in the fall intervention group from post-test (M =
9.31, SD = 3.66) to follow-up (M = 10.81, SD = 2.12), t =
2.65, p < 0.05. In sum, the intervention appeared to promote
attention regulation and continued growth was supported
during follow-up for the children in the fall cohort.
In total, 23 teachers or teaching staff completed the
teacher survey. The staff sample included eight head tea-
chers, seven teaching assistants, and eight teacher aides.
The staff was primarily female (91%) and between the ages
of 26 and 40 years (39%). The majority of the staff mem-
bers who participated in the trainings were White (74%)
with the remaining staff members identifying as Black
(13%), Asian/Pacific Islander (9%), or Hispanic (4%).
Sixty-five percent of the staff members were employed at
the center for five years or less. The majority (44%) of staff
members completed high school and/or had some college
experience; 30% received their Bachelor’s degree and 13%
earned a Master’s degree.
Almost all of the staff participants (95.7%) reported
experiencing multiple traumatic events on the TLEQ. The
Journal of Child and Family Studies (2020) 29:82–93
Fig. 2 Change in attention regulation (AST) score by intervention
group. The fall cohort participated in the program from T1 to T2 and
the spring cohort group participated in the program from T2 to T3
mean number of events experienced was 2.91 (SD = 2.25),
with a range of 0–9. Thirty-five percent experienced sexual
assault, 9% experienced physical assault, and 9% experi-
enced assault with a weapon. Ninety-one percent of the staff
participants had witnessed multiple traumatic events, with
22% witnessing physical assault, 22% witnessing assault
with a weapon, and 4% witnessing sexual assault. The mean
number of events witnessed was 2.30 (SD = 2.51), with a
range of 0 to 9 events. The mean score on the PCL was
34.38 (SD = 12.74). Fifty-seven percent of the staff mem-
bers scored higher than the 30 cut-point on the PCL, while
83% scored higher than a 35 on the PCL. The results from
independent t-tests indicated that trauma and stress among
teachers was similar across the intervention and control
classrooms.
The feedback from staff on the workshops suggested that
they found the trainings relevant and were interested in
future opportunities. Sixty-one percent of the staff reported
having none-to-little prior experience with MBSR practices
and 63% reported having none-to-little prior training in
trauma-informed practice techniques. In terms of the MBSR
workshop, the majority of staff (66.7%) found the training
to be quite a bit or very relevant to their professional life;
50% indicated that they would use the MBSR practices that
they learned to address needs in their professional lives.
Similarly, the majority (66.7%) of staff were quite or very
satisfied with this training and reported that they would be
moderately or more interested in attending a future work-
shop on mindfulness-based practice. Fifty-two percent of
staff found the training on the CCM model to be at least
quite a bit relevant to their professional life and 63%
reported that they would use materials from the training to
address needs in their professional lives. Sixty-eight percent
of staff were satisfied with this training quite a bit and
68.5% said that they would attend a future workshops that
focused on trauma.
Journal of Child and Family Studies (2020) 29:82–93
Discussion
Overall, the results of this pilot study suggest that the
mindful yoga intervention was both feasible and effective
for Head Start preschoolers. The 8-week program was
easily integrated into the preschool curriculum and was
successfully implemented twice over the school year for
two independent cohorts of children in the same childcare
center. The findings suggest that the intervention promoted
behavioral regulation and attention regulation among eco-
nomically disadvantaged preschoolers. Moreover, the
trauma-informed professional development workshops were
well received by staff, the majority of whom experienced
multiple traumatic events and were above the civilian
threshold for PTSD.
The current study advanced our understanding of how
mindful yoga can promote self-regulatory skills among at-
risk children. As expected, both cohorts of children
demonstrated a significant increase in behavioral regulation
while participating in the intervention. Moreover, children
in the fall intervention group maintained their skill level
over the three-month follow-up. These findings are con-
sistent with the results of other mindfulness-based inter-
vention studies with young children that have demonstrated
benefits in behavioral regulation using the HTKS task
(Poehlmann-Tynan et al. 2016; Razza et al. 2015) and
support self-regulation as a mechanism through which
mindfulness influences early academic and social compe-
tence (Razza et al. 2015; Tang et al. 2012). Given that the
HTKS measure taps all three facets of executive function
(EF), future studies could include tasks from the NIH
Toolbox that tap individual components to gain insight into
the specific facets of EF that are targeted via mindfulness
during preschool.
Similarly, the mindful yoga intervention was associated
with change in preschoolers’ attention regulation, which is
also compatible with previous research detecting an effect
of mindfulness-based practice on young children’s focused
attention (Poehlmann-Tynan et al. 2016). Thus, during the
time that they were in the intervention, children experienced
an increase in their ability to sustain their attention, and
continued growth were reported for children in the fall
intervention group across the follow-up period. These pat-
terns are exciting and should be addressed via a more
comprehensive attention battery, such as the child version
of the Attention Network Task (ANT; Rueda et al. 2004).
The ANT taps the three individual networks of attention
(i.e., alerting or attentional readiness, orienting or selective
attention, and executive control or conflict attention), and
provides scores for each attentional component (Posner and
Peterson 1990). The adult literature suggests that mind-
fulness may initially improve the executive control network
as well as orienting, whereas changes in alerting may be
89
associated with later phases of practice (Chiesa et al. 2011).
Thus, similar to how we can learn more about the specificity
in the associations between mindfulness and EF, more
sophisticated measures would allow us to better identify the
attentional mechanisms supported by mindful yoga practice
in young children.
In addition to bringing mindful yoga to children, the
results of the present study also highlight the need for
mindfulness-based programming for the teachers who serve
and guide them. Notably, almost all of the staff (95.7%)
reported experiencing multiple traumatic events in their
lives. Moreover, there was a high prevalence of post-
traumatic stress (57% with a PCL > 30) in this sample of
teachers, which is consistent with previous literature citing
indices of poor mental health among Head Start teachers
compared to the general population (Whitaker et al. 2013;
Whitaker et al. 2014). Thus, exposure to trauma is clearly a
relevant risk factor for these teachers, which left unad-
dressed, may result in lower quality of teacher-child inter-
actions and reduced emotional climate (Friedman-Krauss
et al. 2014a; Jennings 2015). It is noteworthy that the 57%
rate of PTSD among the teachers is slightly higher, yet
similar to the rate among the community (51%) where this
study was conducted (Lane et al. 2017). Another study
found that the neighborhoods where the families of the
children attending the school in this study live have among
th highest rates of gun violence in the city (Bergen-Cico
et al. 2018). Together these factors illustrate the prevalence
of PTSD among the adults in these children’s lives and the
pervasive gun violence in the children’s neighborhoods.
The high level of acceptance of the trauma-informed and
mindfulness-based professional development trainings
among this sample suggests that they may be particularly
posed to participate in, and benefit from, additional pro-
gramming to reduce stress and improve wellbeing. Future
replication with more diverse samples of educators is nee-
ded, however, to determine the generalizability of the tea-
chers’ perceptions of the acceptability of the professional
development. Other classroom-based interventions targeting
teachers’ job stressors, such as the Chicago School Readi-
ness Project (CSRP; Zhai et al. 2011), have been successful
in promoting teachers’ perceived job control and work-
related resources. Similarly, initiatives to enhance trauma-
informed practice among this population of teachers, such
as the Head Start Trauma Smart program (HSTS; Holmes
et al. 2015), are associated with enhanced emotional climate
and emotional support in classrooms. Thus, ideally, future
initiatives should include both teacher- and child-level
components aimed at reducing the impact of stress and
promoting resilience within the Head Start community. One
relevant and well-established intervention for teachers that
could be included in a comprehensive initiative is the
Cultivating Awareness and Resilience in Education (CARE;
90
Jennings 2016) program, which provides teachers with
training in emotion regulation, mindfulness and stress
management, and care and listening practices. Benefits of
CARE include reduced burnout and stress for teachers and a
more positive emotional climate for the classroom (Jennings
et al. 2017; Sharp and Jennings 2016).
Limitations and Future Research Directions
One limitation of the current study was the small analytic
sample. The substantial missing data, particularly at T1,
limited our analytic options. While we were able to detect
between-group differences in the change scores between the
intervention and wait-list control groups between T1 and
T2, the repeated measures ANOVAs used pooled data
across both intervention cohorts to model within-group
change. Thus, although the results reflect large effect sizes,
we cannot rule out change due to other factors, such as
maturation or emotional climate of the classroom (Raver
2012). Future studies with larger sample sizes and class-
room observations are needed to clarify the specific effect of
mindful yoga programs. Due to the small sample size, we
were also unable to examine potential moderators, such as
children’s initial levels of self-regulation, which have been
shown to be associated with the effectiveness of similar
interventions (Flook et al. 2010, 2015; Razza et al. 2015).
Another limitation was the restricted battery of self-
regulation tasks. Ideally, to elucidate the mechanisms
through which mindfulness promotes self-regulation, stu-
dies would include multiple tasks assessing specific aspects
of EF and attention, as well as biological markers of stress.
For example, a 10-week classroom-based yoga intervention
was associated with decreases in baseline cortisol levels
among second-grade students (Butzer et al. 2015). More-
over, the present study did not examine academic and
behavioral outcomes associated with mindfulness and self-
regulation, such as achievement and social-emotional
competence (Thierry et al. 2016). These data are impor-
tant for understanding how mindful yoga may influence the
academic or social-emotional trajectories of young children.
Additional concerns include the generalizability of the
findings and the sustainability of the effects of the inter-
vention. Specifically, although the intervention was repli-
cated across two cohorts of children, it was implemented by
a single child yoga instructor. Thus, it is possible that there
were characteristics of the instructor, such as personality or
experience teaching, that influenced the children’s engage-
ment in the program. Thus, future replications should
examine the fidelity and effectiveness of the mindful yoga
intervention across multiple instructors. Sustainability, of
both the practice and the effects, is also a concern, parti-
cularly for interventions implemented by personnel outside
the school system. Thus, options for transferring the
Journal of Child and Family Studies (2020) 29:82–93
practice to teachers over time should be explored. Possible
strategies include formal MBSR training or programs like
CARE, which help teachers build and sustain a personal
practice, as well as workshops and online resources that
share techniques for infusing child-based practices into their
classrooms. Indeed, there is evidence that even a few
minutes of mindful yoga a day can enhance self-regulation
and other positive outcomes among students (Adair and
Bhaskaran 2010; Bergen-Cico et al. 2015; Erwin and
Robinson 2016).
Finally, although our program did not include a parent
component, a comprehensive approach to addressing
trauma and stress in communities should target children,
families, and teachers. Prior studies have indicated that
mindfulness programs can improve the health and well-
being of both children and parents, particularly in popula-
tions subjected to trauma and/or stress (Coatsworth et al.
2010; Costello and Lawler 2014; Jee et al. 2015). Similarly,
there is evidence that family-based programs that focus on
attention training for children and parenting practices for
caregivers can influence the neural systems mediating
selective attention in lower SES preschool children and
decrease parenting stress within families (Neville et al.
2013). Thus, future work should explore multi-tiered
mindfulness-based intervention strategies that promote
resilience and enhance wellbeing across both home and
school settings.
Authors’ Contributions R.A.R. Designed and implemented the pro-
gram evaluation, assisted with data analyses, and wrote the paper. R.U.
L. served as a project manager and was responsible for scheduling data
collection, interviewing children, entering the data, and contributing to
data analysis. D.B.C. Collaborated on the design of the study, assisted
with measure preparation and IRB applications, contributed to the
analytic plan, and reviewed the manuscript and revisions. E.C.
Assisted with data collection and entry. S.R. Assisted with data
analyses.
Compliance with Ethical Standards
Conflict of Interest The authors declare that they have no conflict of
interest.
Ethical Approval All procedures performed in studies involving
human participants were in accordance with the ethical standards of
Syracuse University and with the 1964 Helsinki declaration and its
later amendments or comparable ethical standards. Approval for this
study was obtained from the Syracuse University Internal
Review Board.
Informed Consent Informed consent was obtained from all individual
participants included in the study. Parental consent included both
active and passive consent. All children provided verbal assent to
participate. Teachers provided active consent.
Publisher’s note Springer Nature remains neutral with regard to
jurisdictional claims in published maps and institutional affiliations.
Journal of Child and Family Studies (2020) 29:82–93
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