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Poster #202 - Applying the Science of Behavior Change to Promote Child Self-Regulation: Results from an Emotion-Regulation Intervention

Fri, March 22, 9:45 to 11:00am, Baltimore Convention Center, Floor: Level 1, Exhibit Hall B

Integrative Statement

Background. Self-regulation is a multifaceted construct that may shape various child health and developmental outcomes (Blair, 2008). From a science of behavior change perspective (Nielsen, 2018), it is critical to determine whether an intervention acts on hypothesized targets in order to understand how the intervention changes behavior. Mindfulness training was shown to improve emotion regulation (Tang, 2015) and subsequently increase hope about the future (Munoz, 2016). We examined whether a biofeedback/mindfulness-focused intervention altered two hypothesized self-regulation targets, Emotion Regulation (ER) and Future Orientation (FO) in children.
Method. Participants were 123 children (mean age=10.6 years (SD=0.57), range 9-12) from a longitudinal cohort of Head Start graduates. Children were randomly assigned to receive the Relaxing Rhythms (RR) intervention (n=49) or other activities that were similarly delivered at home with an interventionist (data not presented here).
RR Intervention. The intervention was delivered during 3 home visits across a 6-week period. The interventionist used a computer-based game (Journey to Wild Divine) to coach the child to control heart rate using sensors/guided diaphragmatic breathing, and taught the child to do relaxation activities at home using practice cards. Intervention fidelity was assessed by rating 29% of intervention videos (Cohen’s Kappa > 0.75 or ICC > 0.91 for all codes) on 23 items from 1 (did not meet expectations) to 3 (exceeded expectations). Intervention dosage was assessed by tracking how often children completed home practice.
ER Outcome. Child-reported ER was assessed using the Children’s Anger Management Scale (CAMS; Zeman, 2002), which generated Anger Dysregulated-Expression (3 items; α=0.61; e.g., slamming doors when angry) and Anger Coping subscales (4 items, α=0.69; e.g., keeping cool when angry).
FO Outcome. FO was measured based on child responses to a standardized interview about upcoming future events. Using language to verbalize future plans in a vivid and concrete manner is considered to reflect FO (Schacter et al., 2017). Children described two events and were prompted for details. Child language was reliably coded based on prior coding systems (Addis et al., 2008) for use of “internal,” future-oriented language characterized by descriptive detail and imagery (e.g., “At the county fair, I’ll see animals”), compared to “external,” generic speech that did not reference the event (e.g., “I hate broccoli;” Kappa > 0.78 for all codes).
Results.
Intervention Implementation. Fidelity was high across visits (Table 1). Children showed high engagement, practicing relaxation activities 18 days on average (SD=9, range 5-28; goal was 25 days).
Intervention Outcomes. Independent t-tests indicated intervention effects for anger dysregulation (post-test M=1.70, SD=0.51) compared to controls (M=1.82, SD=0.64); there was no significant impact on anger coping. Children receiving RR had a higher proportion of internal (M=0.71, SD=0.14) compared to external (M=0.27, SD=0.14) utterances, indicating better FO. Controls had a lower proportion of internal (M=0.69, SD=0.17) compared to external utterances (M=0.29, SD=0.17). Table 2 presents change scores, effect sizes, and p-values by group.
Discussion. The RR intervention may enhance self-regulation, specifically emotion regulation and future orientation in children. Future work will use mobile technologies to adapt and deliver RR to novel populations.

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