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How does mindfulness modulate self-regulation in pre-adolescent children? An integrative neurocognitive review

Authors:

Abstract

Pre-adolescence is a key developmental period in which complex intrinsic volitional methods of self-regulation are acquired as a result of rapid maturation within the brain networks underlying the self-regulatory processes of attention control and emotion regulation. Fostering adaptive self-regulation skills during this stage of development has strong implications for physical health, emotional and socio-economic outcomes during adulthood. There is a growing interest in mindfulness-based programmes for pre-adolescents with initial findings suggesting self-regulation improvements, however, neurodevelopmental studies on mindfulness with pre-adolescents are scarce. This analytical review outlines an integrative neuro-developmental approach, which combines self-report and behavioural assessments with event related brain potentials (ERPs) to provide systemic multilevel understanding of the neurocognitive mechanisms of mindfulness in pre-adolescence. We specifically focus on the N2, error related negativity (ERN), error positivity (Pe), P3a, P3b and late positive potential (LPP) ERP components as indexes of mindfulness related modulations in non-volitional bottom-up self-regulatory processes (salience detection, stimulus driven orienting and mind wandering) and volitional top-down self-regulatory processes (endogenous orienting and executive attention).
Neuroscience
and
Biobehavioral
Reviews
74
(2017)
163–184
Contents lists available at ScienceDirect
Neuroscience
and
Biobehavioral
Reviews
journal homepage: www.elsevier.com/locate/neubiorev
How
does
mindfulness
modulate
self-regulation
in
pre-adolescent
children?
An
integrative
neurocognitive
review
Rebekah
Jane
Kaunhoven,
Dusana
Dorjee
School
of
Psychology,
Bangor
University,
Brigantia
Building,
Bangor,
Gwynedd,
Wales,
LL57
2AS,
UK
a
r
t
i
c
l
e
i
n
f
o
Article
history:
Received
29
June
2016
Received
in
revised
form
20
November
2016
Accepted
6
January
2017
Available
online
17
January
2017
Keywords:
Mindfulness
Self-regulation
Pre-adolescents
Event-related
potential
Emotion
regulation
Attention
control
Mechanisms
Development
Neuroscience
Neurocognitive
Theory
Children
a
b
s
t
r
a
c
t
Pre-adolescence
is
a
key
developmental
period
in
which
complex
intrinsic
volitional
methods
of
self-
regulation
are
acquired
as
a
result
of
rapid
maturation
within
the
brain
networks
underlying
the
self-regulatory
processes
of
attention
control
and
emotion
regulation.
Fostering
adaptive
self-regulation
skills
during
this
stage
of
development
has
strong
implications
for
physical
health,
emotional
and
socio-
economic
outcomes
during
adulthood.
There
is
a
growing
interest
in
mindfulness-based
programmes
for
pre-adolescents
with
initial
findings
suggesting
self-regulation
improvements,
however,
neurode-
velopmental
studies
on
mindfulness
with
pre-adolescents
are
scarce.
This
analytical
review
outlines
an
integrative
neuro-developmental
approach,
which
combines
self-report
and
behavioural
assess-
ments
with
event
related
brain
potentials
(ERPs)
to
provide
a
systemic
multilevel
understanding
of
the
neurocognitive
mechanisms
of
mindfulness
in
pre-adolescence.
We
specifically
focus
on
the
N2,
error
related
negativity
(ERN),
error
positivity
(Pe),
P3a,
P3b
and
late
positive
potential
(LPP)
ERP
com-
ponents
as
indexes
of
mindfulness
related
modulations
in
non-volitional
bottom-up
self-regulatory
processes
(salience
detection,
stimulus
driven
orienting
and
mind
wandering)
and
volitional
top-down
self-regulatory
processes
(endogenous
orienting
and
executive
attention).
Crown
Copyright
©
2017
Published
by
Elsevier
Ltd.
This
is
an
open
access
article
under
the
CC
BY
license
(http://creativecommons.org/licenses/by/4.0/).
Contents
1.
Introduction
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164
2.
Mindfulness
training
for
pre-adolescents
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165
3.
An
integrative
neurodevelopmental
framework
for
research
on
mindfulness
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166
4.
Possible
modulation
of
neurocognitive
self-regulation
by
mindfulness
practice
in
pre-adolescence
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166
4.1.
Bottom-up
and
top-down
self-regulatory
processes
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166
4.2.
Self-regulation
development
during
pre-adolescence
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170
4.3.
Mindfulness
training
and
self-regulatory
processes
in
pre-adolescents
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171
5.
ERP
measures
of
mindfulness
on
attention
and
emotion
processing.
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.172
5.1.
N2
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172
5.2.
Error
related
negativity
(ERN)
and
error
positivity
(Pe)
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173
5.3.
P3a
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5.4.
P3b
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5.5.
Late
positive
potential
(LPP)
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176
6.
Conclusions
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178
Conflict
of
interest.
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.178
Acknowledgements
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178
References
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178
Corresponding
author.
E-mail
addresses:
psp233@bangor.ac.uk
(R.J.
Kaunhoven),
d.dorjee@bangor.ac.uk
(D.
Dorjee).
http://dx.doi.org/10.1016/j.neubiorev.2017.01.007
0149-7634/Crown
Copyright
©
2017
Published
by
Elsevier
Ltd.
This
is
an
open
access
article
under
the
CC
BY
license
(http://creativecommons.org/licenses/by/4.0/).
164
R.J.
Kaunhoven,
D.
Dorjee
/
Neuroscience
and
Biobehavioral
Reviews
74
(2017)
163–184
1.
Introduction
Early
and
middle
childhood
has
been
highlighted
as
a
key
devel-
opmental
period
in
which
skills
in
self-regulation
are
fostered
(Berger
et
al.,
2007;
Fjell
et
al.,
2012;
Marsh
et
al.,
2009;
Posner
and
Rothbart,
2009).
Self-regulation
skills
facilitate
goal
oriented
behaviour
and
optimal
responding
to
emotionally
and
cognitively
demanding
stimuli
through
the
effective
regulation
of
cognitions,
feelings
and
behaviours
(Fjell
et
al.,
2012;
Posner
et
al.,
2007;
Zelazo
and
Lyons,
2012).
There
are
two
key
processes
of
self-
regulation:
attention
control
as
the
capacity
to
resolve
conflicts,
inhibit
processes
and
shift
the
focus
of
attention
(Muris
et
al.,
2007;
Rueda
et
al.,
2004a,
2005),
and
emotion
regulation,
the
ability
to
modify
how
emotions
are
experienced
and
expressed
(Gross
and
Thompson,
2007;
Lewis
and
Todd,
2007;
Thompson,
1994).
Self-regulation
has
a
pivotal
impact
on
developmental
outcomes
including
social
and
emotional
wellbeing
and
academic
functioning
(Blair
and
Razza,
2007;
Gross
and
John,
2003;
Liew,
2012;
Ursache
et
al.,
2012);
children
who
exhibit
ineffective
self-regulation
skills
are
at
increased
risk
of
physical
and
mental
health
disorders
as
adults
(Althoff
et
al.,
2010).
Indeed,
self-regulation
abilities
present
during
childhood
predict
adult
health
problems,
substance
depen-
dence,
socioeconomic
position
and
the
likelihood
of
committing
a
criminal
offence
in
adulthood
(Moffitt
et
al.,
2011).
Higher
levels
of
self-regulation
are
associated
with
enhanced
well-being
including
better
mental
health,
the
ability
to
maintain
effective
social
rela-
tionships
and
global
adaptive
functioning
in
home
and
school
life
(Buckner
et
al.,
2009;
Checa
et
al.,
2008;
Graziano
et
al.,
2007).
Effective
self-regulation
hinges
upon
an
optimal
balance
between
“bottom-up”
emotional
reactivity
(ventral
system;
involv-
ing
brain
regions
lower
down
the
neuroaxis
including
the
limbic
areas)
and
“top-down”
cognitive
and
attention
control
(dorsal
sys-
tem;
involving
brain
regions
higher
up
the
neuroaxis
including
the
prefrontal
cortex;
PFC;
Blair
and
Dennis,
2010;
Blair
and
Ursache,
2011;
Lewis
and
Todd,
2007;
Zelazo
and
Lyons,
2012).
Bottom-up
regulation
involves
unconscious,
non-volitional
processes
which
are
driven
by
the
salient
behaviourally
relevant
properties
of
stim-
uli
(i.e.
novel,
unexpected
or
emotionally
arousing;
Buschman
and
Miller,
2007;
Lewis
and
Todd,
2007).
Bottom-up
self-regulatory
processes
can
be
externally
directed,
i.e.
the
rapid
detection
and
re-orientation
of
attention
resources
to
salient
stimuli
within
the
environment
(Buschman
and
Miller,
2007;
Corbetta
and
Shulman,
2002)
or
internally
directed,
i.e.
the
automatic
orientation
of
atten-
tion
away
from
a
goal
towards
task
irrelevant
internal
thoughts
(mind
wandering;
Smallwood
and
Schooler,
2006).
Top-down
reg-
ulation
involves
the
conscious,
volitional
goal
oriented
regulation
of
cognitions
and
emotions
(Corbetta
and
Shulman,
2002;
Lewis
and
Todd,
2007).
Endogenous
orienting
is
a
top-down
process
which
involves
the
orienting
of
attention
towards
goal
relevant
stim-
uli
(Corbetta
and
Shulman,
2002).
Top-down
executive
attention
abilities
include
conflict
monitoring
and
resolution
the
detec-
tion
of
behaviour
which
is
incongruent
to
a
goal,
the
resulting
modification
of
behaviour
to
align
it
with
a
goal
and
the
inhibi-
tion
of
goal-irrelevant
stimuli
(Berger
et
al.,
2007;
González
et
al.,
2001;
Mezzacappa,
2004;
Posner
and
Rothbart,
2007;
Rueda
et
al.,
2005).
The
connection
between
top-down
and
bottom-up
neu-
ral
systems
is
mediated
by
the
anterior
cingulate
cortex
(ACC);
the
dorsal
caudal
ACC
increases
attention
control
when
conflicts
between
competing
stimuli
are
detected
and
the
ventral
rostral
ACC
assesses
the
emotional
salience
of
a
stimulus
to
aid
the
for-
mation
of
regulatory
responses
(Bush
et
al.,
2000;
Dennis,
2010;
Yeung
et
al.,
2004).
Inefficient
interactions
between
these
neural
systems
are
associated
with
psychopathological
disorders
such
as
anxiety,
depression,
aggression
and
impulsivity
(Lewis
et
al.,
2008;
Pagliaccio
et
al.,
2014).
During
pre-adolescence
the
brain
networks
underlying
self-
regulation
undergo
considerable
maturation
(Berger
et
al.,
2007;
Posner
et
al.,
2007).
Bottom-up
self-regulatory
processes
develop
earlier
in
childhood
than
top-down
self-regulatory
processes
due
to
the
protracted
development
of
the
PFC
(Lewis
and
Todd,
2007;
McRae
et
al.,
2012;
Qin
et
al.,
2012).
Accordingly,
the
self-regulatory
strategies
employed
by
children
are
often
more
short
term
and
inflexible
compared
with
adults
(Decicco
et
al.,
2012;
Rothbart
et
al.,
2011).
During
pre-adolescence
considerable
maturational
brain
changes
occur
including
synaptic
pruning
of
ineffective
local
neural
connections
and
neuronal
myelination
of
longer
range
neu-
ral
connections
(Kelly
et
al.,
2009;
Stevens,
2009).
This
enables
the
top-down
regulatory
regions
of
the
PFC
and
the
bottom-up
sen-
sory
areas
of
the
parietal
cortex
to
become
increasingly
connected
(Fair
et
al.,
2007;
Kelly
et
al.,
2009;
Rothbart
et
al.,
2011;
Stevens,
2009),
facilitating
the
ability
to
employ
complex,
long
term
strate-
gic
methods
of
self-regulation
(Rothbart
et
al.,
2011).
These
maturational
developments
are
strongly
shaped
by
child-
hood
experiences
(Blair
and
Diamond,
2008;
Evans
and
Kim,
2013;
Fonagy
and
Target,
2002).
For
instance,
exposure
to
cumu-
lative
environmental
stressors,
such
as
being
raised
in
socially
and
emotionally
deprived
home
environments,
can
heighten
stress
reactivity
through
impairing
the
stress
regulatory
response
for-
mulated
by
the
hypothalamic-adrenal
stress
axis
(Blair,
2010;
Evans
and
Kim,
2013;
Fonagy
and
Target,
2002).
This
increased
sensitivity
to
stress
can
have
a
maladaptive
impact
on
develop-
ment
within
brain
regions
underlying
top-down
self-regulation
including
reduced
efficiency
of
the
executive
attention
network
(Kishiyama
et
al.,
2009;
Kolb
et
al.,
2012;
Loman
et
al.,
2013;
McDermott
et
al.,
2012)
and
over
activation
of
the
amygdala
(Arnsten,
2009;
Noble
et
al.,
2012;
Tottenham
et
al.,
2010).
Some
consequences
which
have
been
documented
include
an
increased
vulnerability
to
internalising
and
externalising
psychopathologi-
cal
disorders
(Blair
and
Raver,
2012;
Davidson
and
McEwen,
2012;
Gunnar
and
Fisher,
2006;
Leve
et
al.,
2005),
heightened
negativity
biases
(Pollak
et
al.,
1997),
a
reduced
ability
to
effectively
cogni-
tively
reappraise
situations
(Kim
et
al.,
2013),
and
impairments
in
response
inhibition
(Evans
and
Kim,
2013).
However,
bolstering
self-regulation
skills
during
childhood
may
potentially
ameliorate
adverse
outcomes
during
adulthood
(Durlak
et
al.,
2011;
Greenberg
et
al.,
2003;
Greenberg
et
al.,
2001).
Hence
not
surprisingly,
pro-
motion
of
self-regulation
during
childhood
is
high
on
educational
policy
agendas
(e.g.
in
the
United
Kingdom:
Connolly
et
al.,
2011;
Department
of
Education
Northern
Ireland,
2007;
Hyland,
2014;
Public
Health
England,
2015;
The
Scottish
Government,
2013;
Welsh
Assembly
Government,
2010).
Initial
evidence
suggests
that
mindfulness
training
can
improve
well-being
and
nurture
a
wide
range
of
effective
self-regulatory
skills
in
pre-adolescents
with
and
without
clinical
disorders
(Harnett
and
Dawe,
2012;
Meiklejohn
et
al.,
2012;
Schonert-Reichl
et
al.,
2015;
Tang
et
al.,
2012).
Mindfulness
is,
within
the
Buddhist
context
where
it
originated,
often
described
as
a
technique
or
a
neutral
mental
faculty
supporting
the
development
of
introspec-
tive
awareness
and
attention
stability
(Dorjee,
2010;
Thera,
1962).
The
construct
of
mindfulness
seems
more
encompassing
within
the
secular
context
(Kabat-Zinn,
2003)
where
it
is
described
as
an
awareness
of
experiences
arising
in
the
present
moment
whilst
attending
to
them
in
an
open
and
accepting
way
without
judgement
or
evaluation
(Bishop
et
al.,
2004a;
Shapiro
et
al.,
2006).
Secular
conceptualisations
of
mindfulness
are
adopted
in
the
majority
of
mindfulness-based
interventions
with
pre-adolescents.
Mindful-
ness
is
conceptualised
as
both
a
state
and
trait,
and
accordingly,
levels
of
mindfulness
can
vary
both
between
and
within
individuals
(Brown
and
Ryan,
2003;
Cahn
and
Polich,
2006).
State
mindfulness
is
a
mind-set
which
occurs
during
mindfulness
meditation
and
fluc-
tuates
over
time;
trait
mindfulness
is
a
relatively
stable
disposition
R.J.
Kaunhoven,
D.
Dorjee
/
Neuroscience
and
Biobehavioral
Reviews
74
(2017)
163–184
165
which
is
present
outside
of
actual
meditation
practice
(Brown
and
Ryan,
2003;
Cahn
and
Polich,
2006).
To
date,
schools
have
been
the
most
frequent
setting
for
studies
investigating
the
impact
of
mindfulness
training
in
pre-adolescents
aged
between
7
and
12
years
(Black
et
al.,
2009;
Burke,
2010;
Felver
et
al.,
2016;
Felver
and
Jennings,
2016;
Harnett
and
Dawe,
2012;
Zenner
et
al.,
2014);
16
studies
have
been
conducted
within
a
class-
room
setting
(for
a
full
review
of
these
studies
see
Felver
et
al.,
2016;
Felver
and
Jennings,
2016).
A
recent
meta-analysis
of
24
school
based
mindfulness
studies
conducted
across
both
pre-adolescent
and
adolescent
years
reported
large
effect
sizes
on
measures
of
cognitive
performance
and
small
to
medium
effect
sizes
on
stress
reduction
and
resilience
(Zenner
et
al.,
2014).
Interestingly,
a
study
with
pre-adolescents
found
that
the
largest
improvements
in
exec-
utive
functions
after
mindfulness
training
were
found
in
children
who
initially
had
the
poorest
skills
(Flook
et
al.,
2010).
This
is
important
because
physical
and
psychological
outcomes
during
adulthood
are
better
than
expected
for
those
children
who
show
self-regulatory
improvements
over
the
course
of
development
(Moffitt
et
al.,
2011).
A
recent
analytical
review
of
adult
imaging
literature
high-
lighted
enhancement
in
self-regulation
as
the
main
mechanism
of
change
with
mindfulness
training
(Tang
et
al.,
2015).
It
has
been
proposed
that
the
extent
to
which
mindfulness
training
modu-
lates
top-down
and
bottom-up
regulatory
processes
depends
on
the
amount
of
mindfulness
experience,
with
initial
changes
first
observed
for
top-down
regulatory
abilities
followed
by
bottom-
up
modulations
after
extensive
mindfulness
experience
(Chiesa
et
al.,
2013).
In
comparison
to
mindfulness
research
with
adults,
investigation
of
the
neurocognitive
self-regulatory
mechanisms
of
change
underlying
the
effects
of
mindfulness
in
pre-adolescents
greatly
lags
behind
and
there
is
no
developmentally
specific
theo-
retical
framework
to
guide
further
systematic
investigation
of
how
mindfulness
training
modifies
self-regulation
in
children.
This
review
aims
to
contribute
to
the
theoretical
foundations
of
neurodevelopmental
research
on
mindfulness
training
by
exam-
ining
possible
neurocognitive
mechanisms
of
change
in
attention
control
and
emotion
regulation
of
pre-adolescents
aged
between
7
and
12
years.
The
review
will
primarily
focus
on
stable
trait
shifts
in
attention
control
and
emotion
regulation
resulting
from
mindfulness
training
with
pre-adolescents.
Studies
investigating
brief
inductions
of
mindfulness
associated
with
state
effects
will
only
be
discussed
where
trait-related
research
on
mindfulness
is
limited.
In
what
follows,
we
will
first
summarise
the
current
mind-
fulness
training
programmes
for
pre-adolescents.
We
will
then
discuss
the
importance
of
adopting
an
integrative
neurodevelop-
mental
approach
in
research
on
mindfulness
with
pre-adolescents;
this
involves
the
integration
of
self-report,
behavioural
and
neural
assessments.
We
will
then
outline
the
brain
networks
underlying
self-regulation
processes
in
pre-adolescents
and
review
current
findings
on
the
impact
of
mindfulness
training
on
these.
Finally,
we
will
highlight
the
advantages
of
using
event-related
potential
methodology
to
study
the
neurocognitive
impact
of
mindfulness
training
on
self-regulation
processes
in
pre-adolescents
(for
a
review
of
the
neuropsychological
impact
of
mindfulness
with
ado-
lescents
see
Sanger
and
Dorjee,
2015).
2.
Mindfulness
training
for
pre-adolescents
An
array
of
mindfulness
training
programmes
has
been
inves-
tigated
in
studies
with
pre-adolescents
aged
between
7
and
12
years
(Meiklejohn
et
al.,
2012;
Zoogman
et
al.,
2015).
These
include
the
Attention
Academy
program
(Napoli
et
al.,
2005),
Inner
Kids
program
(Flook
et
al.,
2010;
Greenland,
2010),
Integrative
con-
templative
pedagogy
(Britton
et
al.,
2014;
Roth,
2014),
Integrative
Body-Mind
Training
(IBMT;
Tang
et
al.,
2012;
Tang
and
Posner,
2009),
Mindful
Education
(ME)
(Schonert-Reichl
and
Lawlor,
2010),
Mindfulness-Based
Cognitive
Therapy
for
children
(MBCT-
C;
Semple
et
al.,
2010),
Mindful
Family
Stress
Reduction
(MFSR;
Felver
and
Tipsord,
2011;
Felver
et
al.,
2014a),
Mindful
Schools
(MS;
Black
and
Fernando,
2014;
Liehr
and
Diaz,
2010;
Mindful
Schools,
2012),
MindUP
(Hawn
Foundation,
2011;
Schonert-Reichl
et
al.,
2015),
Move-Into-Learning
(Klatt
et
al.,
2013),
Paws
b
(Mindfulness
in
Schools
Project,
2015;
Vickery
and
Dorjee,
2015),
Soles
of
the
Feet
(Felver
et
al.,
2014b;
Singh
et
al.,
2003),
Still
Quiet
Place
(Saltzman
and
Goldin,
2008),
and
a
yoga-based
mindfulness
cur-
riculum
(Mendelson
et
al.,
2010).
Mindfulness
programmes
for
pre-adolescents
vary
in
format,
content
and
length,
for
instance,
programmes
range
from
3
to
12
min
daily
sessions
over
6
weeks
(Britton
et
al.,
2014)
to
45
min
fortnightly
sessions
over
24
weeks
(Napoli
et
al.,
2005).
The
experience
of
the
mindfulness
teacher
also
varies
greatly;
some
programmes
are
delivered
by
experienced
mindfulness
trainers
(Felver
et
al.,
2014a;
Flook
et
al.,
2010;
Klatt
et
al.,
2013;
Mendelson
et
al.,
2010)
whilst
others
are
delivered
by
school
teachers
with
different
levels
of
training
in
mindfulness
(Britton
et
al.,
2014;
Schonert-Reichl
and
Lawlor,
2010;
Schonert-Reichl
et
al.,
2015;
Vickery
and
Dorjee,
2015).
Overall,
a
meta-analysis
of
mindful-
ness
studies
with
youths
aged
between
6
and
18
years
found
that
the
clinical
nature
of
samples
and
types
of
outcome
measures
(not
mindfulness
training
format
or
other
variables)
were
the
only
aspect
of
the
studies’
design
which
significantly
moderated
the
effect
sizes
of
outcomes
(Zoogman
et
al.,
2015).
Many
mindfulness
programmes
for
pre-adolescents
include
practices
adapted
from
secular
standardised
mindfulness
courses
for
adults
including
mindfulness-based
stress
reduction
(MBSR;
Kabat-Zinn,
1990)
and
mindfulness-based
cognitive
therapy
(MBCT;
Segal
et
al.,
2002).
Both
of
these
programmes
have
a
strong
evidence
base
in
the
treatment
of
anxiety,
depression
and
well-
being
enhancement
in
adults
(Chiesa
and
Serretti,
2010;
Hofmann
et
al.,
2010;
Keng
et
al.,
2011).
In
programmes
with
pre-adolescents,
the
practices
are
adapted
to
be
age
appropriate,
for
example,
there
is
less
depth
of
inquiry
and
shorter
time
spent
in
mindfulness
med-
itation
(Meiklejohn
et
al.,
2012;
Thompson
and
Gauntlett-Gilbert,
2008;
Zelazo
and
Lyons,
2012).
This
is
due
to
developmental
dif-
ferences
in
the
ability
to
focus
and
sustain
attention
on
the
present
moment
(Mezzacappa,
2004;
Rueda
et
al.,
2004b)
and
the
capacity
for
metacognitive
awareness
of
mental
phenomena
(Davis
et
al.,
2011;
Dignath
and
Büttner,
2008;
Greenberg
and
Harris,
2012).
However,
similarly
to
MBSR
and
MBCT
(Kabat-Zinn,
1990;
Segal
et
al.,
2002),
mindfulness
courses
for
pre-adolescents
include
prac-
tices
which
train
aspects
of
self-regulation
including
attention
control
and
emotion
regulation.
Breath
awareness
practices
guide
attention
to
focus
on
a
stimulus
such
as
an
object
or
the
breath
to
anchor
attention
in
the
present
moment.
Learning
to
reen-
gage
attention
on
the
stimulus
after
recognising
that
attention
has
drifted
away
from
the
present
moment
towards
a
distraction
(a
habitual
process
called
mind
wandering),
is
another
skill
cultivated
during
practices
(Britton
et
al.,
2014;
Felver
et
al.,
2014a;
Flook
et
al.,
2010;
Mindfulness
in
Schools
Project,
2015;
Schonert-Reichl
et
al.,
2015;
Thompson
and
Gauntlett-Gilbert,
2008).
Mindfulness
pro-
grammes
also
often
include
practices
which
enhance
awareness
of
thoughts,
emotions
and
bodily
sensations
and
involve
observ-
ing
that
these
states
are
transient
and
change
over
time
(Flook
et
al.,
2010;
Mindfulness
in
Schools
Project,
2015;
Saltzman
and
Goldin,
2008),
as
well
as
practices
such
as
guided
visualisation
which
promote
an
attitude
of
kindness
and
compassion
to
the
self
and
others
(Flook
et
al.,
2010;
Mindfulness
in
Schools
Project,
2015;
Schonert-Reichl
et
al.,
2015).
This
suggests
that
despite
the
diverse
range
of
mindfulness
programmes
available
for
pre-adolescents,
166
R.J.
Kaunhoven,
D.
Dorjee
/
Neuroscience
and
Biobehavioral