School Based Mindfulness Interventions Within a Response to Intervention Framework

School-Based Mindfulness
Interventions within a
Response to Intervention
Framework
Alexandra Bluell, BA,
SSP (Specialist in School Psychology)

2
The information and concepts contained in this document are the proprietary property of Sodexo.
As such, they cannot be reproduced or utilized without permission. ©2015
ACADEMIC AND SOCIAL-EMOTIONAL LEARNING STANDARDS
Public education is continually evolving to best meet the
academic and social-emotional needs of an increasingly
diverse student population. A major driving force for
this change is the No Child Left Behind Act (2001), which
holds schools and teachers accountable for student
performance on standardized tests in reading, math,
and science.1
In order to academically prepare students
for these high-stakes tests, 43 states have adopted
the Common Core Standards.* These standards hold
students to a high level of performance in language
arts and math that is designed to prepare them for
career and college readiness.2
While the Common
Core Standards provide a universal framework for
academic standards across the United States, there is
no comparable measure for social-emotional learning
standards despite the fact that approximately one in
five children and adolescents either currently experience
or will experience mental health issues that warrant
intervention.3
These types of issues include both
internalizing conditions such as anxiety and depression
and externalizing conditions such as Attention
Deficit Hyperactivity Disorder, Conduct Disorder,
and Oppositional Defiant Disorder.3
These disorders
present a wide variety of challenges and adverse side
effects for individuals who suffer from them. Some
of these negative side effects include lower academic
achievement4,5,6,7
, higher school dropout rates4,6
, and
negative peer relationships.4,5,6,7
Figure 1: Negative Outcomes Associated with Clinically Significant Internalizing and Externalizing Conditions
* All red terms are defined in the Glossary on page 8.
INTERNALIZING
CONDITIONS
Anxiety
Depression
COMORBIDITY
OF DISORDERS
EXTERNALIZING
CONDITIONS
Attention Deﬁcit
Hyperactivity Disorder
Conduct Disorder
Oppositional Deﬁant
Disorder
NEGATIVE OUTCOMES
ê Academic Achievement
é Dropout Rates
ê Peer Relationships

3
While one in five children or adolescents will at some point suffer from a condition requiring intervention, many will
not seek out or receive the necessary treatment for various reasons. Schools have the potential to help intervene and
potentially prevent some of these issues by promoting social-emotional learning standards. Social-emotional learning
(SEL) emphasizes development of several critical skills that are often impaired in students with internalizing and
externalizing disorders, including self-awareness, self-management, responsible decision making, social awareness,
and relationship skills.8
In addition, these skills have documented relationships to academic achievement as well as to
a number of other positive outcomes. For example, a meta-analysis of roughly 270,000 students from kindergarten
to high school found statistically significant effect sizes indicating that students who received a universal curriculum
emphasizing one or more SEL skill had improved SEL skills, more positive attitudes towards self and others, used more
positive social behaviors, experienced higher academic performance, had fewer conduct problems, and less emotional
distress than controls.9

4
While this example highlights the importance of universal SEL curriculum, current trends in education as well as federal
legislation such as the Individuals with Disabilities Education Improvement Act (2004)10
emphasize a continuum of
intervention intensity. This service delivery model is known as Response to Intervention (RtI), and it underscores the
importance of early intervention and prevention. The RtI service delivery model categorizes evidence-based general
education interventions into three tiers of intensity. Tier 1, or universal interventions, target the entire student
population and include the general curriculum. Students identified as at-risk for academic or social-emotional concerns
should receive Tier 2 interventions that are targeted at areas of concern and delivered in a small group format. Finally,
those students with the most severe academic or behavioral deficits should receive intensive and individualized Tier 3
services which can be provided in a small group setting or individually.11
Figure 2: Response to Intervention Tiers
Target: Students with severe
academic or behavioral problems
(5% of all students)
Delivery: Small groups or Individually
Target: All students (80% of student
needs should ideally be met here)
Delivery: General curriculum or
universal programs
Target: Students at-risk for academic
or social-emotional-behavioral
concerns (15% of all students)
Delivery: Small Groups
TIER
THREE
TIER
TWO
TIER
ONE

5
A number of established curriculums exist to promote
SEL standards; however, best practices in education
indicate that schools should implement evidence-
based practices or interventions with extensive
research support demonstrating their efficacy. One
type of intervention with growing empirical support
is mindfulness which has been found to have positive
effects on self-regulation, attention, promoting positive
emotions, and improving math performance.12,13
This
white paper provides information on the current research
establishing the preliminary efficacy and effectiveness of
school-based mindfulness interventions, at each of the
three tiers in the RtI service delivery model.
WHAT ARE MINDFULNESS
INTERVENTIONS?
Mindfulness interventions represent a relatively new
field in the study of school-based interventions utilized
to promote positive SEL outcomes. Mindfulness itself
has been defined in numerous ways; however, most
definitions include emphasis on individuals’ awareness
of and focus on the present moment.14
Mindfulness can
also be considered a type of contemplative practice
sharing some similar central concepts as yoga and
meditation. For example, contemplative practices
encourage focused attention on one’s thoughts and
awareness of one’s body and environment.15
Recent
research has focused on adult outcomes of mindfulness
interventions; however, there is a growing body of
literature suggesting positive results of mindfulness
interventions for children and adolescents.
Contemplative practices not only focus on attention but
also on self-regulation skills which require students
to control or manage their thoughts, emotions, and
behaviors.16
Self-regulation skills are exceedingly
recognized as positively related to student’s later
academic success.17
In addition, contemplative practices
may also simultaneously focus on promoting physical
fitness by strengthening muscles or encouraging
movement. Research suggests that physical fitness itself
is associated not only with positive physical effects but
also with positive psychological outcomes including
reduced depressive and anxiety symptoms.18

6
CASE STUDIES
The following case studies demonstrate the flexibility,
utility, and acceptability of school-based mindfulness
interventions to address a wide variety of student needs
at each level of the Response to Intervention service
delivery model.
Tier 1 Interventions
Tier 1 practices, which include scientifically-based
general education curriculum, screening procedures
for all students to identify those at-risk for learning or
behavioral difficulties, and other evidence-based group
interventions implemented universally, are meant to
meet the needs of approximately 80% of the student
population at a school.19
The following case study
describes the feasibility, acceptability, and effectiveness
of a universal, preventative Mindfulness Education
program implemented by classroom teachers to improve
students’ social emotional competence.20
This study consisted of six experimental groups of
4th-7th grade students who received the Mindfulness
Education (ME) program daily in their regular classroom
setting (n=139) and six control groups who were on
a wait-list (n=107). ME is considered a universal and
preventive classroom curriculum designed to promote
social-emotional competence in all children. The ME
lessons were implemented by the classroom teachers
and consisted of at least 3 “mindful attention training”
sessions daily for a 10-week period of time. The ME
curriculum was developed into a user-friendly manual
to facilitate implementation ease and integrity. The
lessons focused on the development of the following four
skills related to mindfulness: (1) quieting thoughts in
the mind by focusing on one sound and one’s breathing,
(2) “mindful attention” to thoughts, feelings, and body,
(3) controlling negative thoughts, and (4) being aware
of one’s self and of others. These skills were selected as
targets of intervention due to hypothesized relationships
with increased self-regulation, positive emotions, and
use of goal setting.
The results of this study indicate some very promising
effects from the ME program. First, teachers valued
the program, as evidenced by their ratings of the
effectiveness of the program. Specifically, post
intervention, teachers were asked to rate how effective
the ME program was at helping their students
demonstrate social-emotional skills in the classroom.
On a scale of 1 (not at all) to 5 (significantly), the

7
average teacher rating was 4.6, indicating a strong
belief that the ME program was effective at influencing
social-emotional skills. Similarly, teachers reported
implementing the core ME activities on average 87% of
the time over the course of the study, which is a high
implementation rate. These results indicate both the
feasibility and acceptability of implementing a universal
ME program in the classroom setting.
Additionally, students who participated in the ME
program reported significantly higher levels of optimism
post-study than students in the control group. Similarly,
pre-adolescents in the ME group reported higher levels
of self-concept following the intervention; however,
this effect was not found for older students included in
the study. Perhaps the most promising finding is that
teachers reported significantly higher levels of attention,
emotion-regulation, and social-emotional skill
competence for students in the classrooms that received
the ME program when compared to those students in the
control classrooms.
Summary of Outcomes for the Mindfulness Education (ME)
Program
Tier 1 Outcomes:
»» Students reported increased optimism
»» Pre-adolescents reported improved self-
concept
»» Teachers reported increased levels of attention,
emotion-regulation, and social-emotional
skills for their students
»» Teachers valued the program and
acknowledged the feasibility of universal
implementation
Those students whose needs are not met solely by
universal practices progress along the continuum to
targeted, Tier 2 interventions based on broad areas of
concern. Students receiving Tier 2 interventions continue
to receive the general curriculum in addition to more
targeted interventions. Tier 2 services are meant to
meet the needs of approximately 15% of students for
whom Tier 1 practices are insufficient to make adequate
academic or behavioral progress.19
Students in this
category may have deficits in specific academic areas,
difficulty sustaining attention in the classroom, or
poor work completion rates. The following case study
documents the effectiveness of a Mindfulness-Based
Kindness Curriculum on promoting prosocial behavior
and self-regulation skills in preschool children.16
In this study, 68 children were randomly assigned to
one of three intervention classrooms (n=30) or one of
four control classrooms (n=38). The students in the
intervention classrooms received two 20–30 minute
lessons over the course of 12 weeks from a trained
mindfulness instructor. The lessons incorporated
music, stories, and movement activities that promoted
prosocial behaviors (e.g., kindness, empathy, and
sharing) and self-regulation skills.
The results of the study indicated statistically
significant improvements in teacher ratings of self-
regulation skills and prosocial behaviors for students
who participated in the Mindfulness-Based Kindness
Curriculum as compared to the controls. Similarly,
students in the control group performed more selfishly
on a sticker-sharing task, as they kept more stickers

8
for themselves than students in the intervention group.
Students in the intervention group also earned higher
grades in the following areas: approaches to learning,
health and physical development, and social emotional
development. These grades were provided three months
after the end of the intervention, therefore they serve
as a type of follow-up measure indicating the program
continued to impact student performance even after
the end of implementation. Additionally, students in
the experimental group did not earn higher scores in
all areas assessed on the report card providing further
evidence that the intervention, at least partially, led to
increased grades. No statistically significant results for
improvements in self-regulation skills as measured by
executive functioning tasks (e.g., flanker task) were
found in this study; however, a positive trend (based
on effect sizes) for improved executive functioning
for students in the intervention group was noted. One
possible reason for the lack of statistical significance is
the small sample size of the study.
This study was implemented as a universal program,
such as those used in Tier 1; however, the results
indicated that those students who demonstrated the
greatest improvements were the individuals who began
with the lowest levels of self-regulation and social-
emotional competence. In other words, students likely
to benefit most from this type of intervention are those
who would likely be identified as at risk and in need of
Tier 2 services. The intervention described in this study
could easily be modified to be delivered in a smaller
group format for students identified as needing more
support than the universal curriculum alone can provide.
Summary of Outcomes for the Mindfulness-Based Kindness
Curriculum
Tier 2 Outcomes:
»» Teachers indicated increased self-
regulation skills and prosocial behaviors
for their students
»» Students who did not receive the
intervention demonstrated more selfish
behaviors on a sharing task
»» Students in the intervention earned
higher grades in several areas
»» The students most likely to benefit were
those who started with the lowest levels
of self-regulation and social-emotional
competence
The remaining 5% of students whose academic or
behavioral needs are not met through either Tier 1 or
Tier 2 services receive the most intensive, individualized
interventions based on specific areas of deficit.19
The
following case study demonstrates the preliminary
efficacy of a mindfulness-based cognitive therapy for
children (MBCT-C) targeted at reducing anxiety and
minimizing attention and behavioral problems.21
The study included children ages 9–13 who were
predominantly from families of low socioeconomic
status in an urban environment. The children were
referred to the study for displaying academic difficulties,
particularly in reading. The sample consisted of 25
children, 6 of whom entered with clinically significant
levels of anxiety and 5 of whom showed attention
problems consistent with Attention Deficit Hyperactivity
Disorder. The MBCT-C was delivered in a group format
with no more than 8 students in a group. The groups
met once a week for 90 minutes for a 12-week period.
The MBCT-C was developed by Semple and Lee as a
developmentally appropriate intervention based on a
MBCT used to treat adults with depressive symptoms.
MBCT-C actively engaged the participants by utilizing
games, activities, and various sensory activities.
These types of “mindful movement” activities were
incorporated into the study because of children’s
documented need for physical activity. The students also
had the opportunity to engage in mindful meditation for
shorter periods of time (i.e., 3–9 minutes). Parents were
invited to participate in the intervention by practicing
mindfulness practices at home and completing daily logs
of their child’s progress.

9
The results of the study indicated that participants
were reported to experience fewer attention problems
than the control group and that these improvements in
attention were maintained at a 3-month follow-up. Of
the six children who entered the study with clinically
significant levels of anxiety, there was a clinically
significant reduction in both anxiety and behavioral
problems. Due to the small sample size, future research
with larger samples, specifically of students with
severe anxiety or attention problems, is necessary to
provide more empirical support. Although limited by
the sample, the preliminary results indicate the efficacy
of mindfulness-based cognitive therapies in helping
children with anxiety and attention problems.
The application of this type of intensive and targeted
intervention to schools would likely involve breaking
down each of the 90-minute lessons into 20- to
30-minute sessions that could be delivered over the
course of a school week. As the results indicated, use
of MBCT-C may produce the best results for children
with clinically significant levels of attention disorders
or anxiety concerns prior to starting treatment. In other
words, the children who have not benefited from Tier 1
and Tier 2 services would be ideal candidates for this
type of targeted intervention.
Summary of Outcomes for Mindfulness-Based Cognitive Therapy
for Children (MBCT-C)
Tier 3 Outcomes:
»» Participants reported fewer attention
problems
»» Improvements in attention were
maintained at a 3-month follow-up
»» Students with the highest levels of
anxiety experienced clinically significant
reductions in anxiety and behavioral
problems
SUMMARY
The Common Core Standards highlight the importance of
high levels of academic achievement for today’s students.
While traditional teaching methods are essential for
meeting these standards, social-emotional learning
can also positively impact and support attainment of
academic goals when appropriately addressed. In fact,
there is a growing trend that acknowledges and values
the use of preventive and early intervention services to
help resolve students’ academic and social-emotional
concerns. Response to Intervention is a service delivery
model recognized by federal law as a means to address
student concerns prior to a referral to special education
services. The model involves the use of screening
measures that help identify at-risk and struggling
students, and then the provision of high-quality, research-
based interventions to address their needs.
Although a variety of methods to target and build
social-emotional competence is available, a growing
body of empirical research supports the effectiveness of
mindfulness-based interventions at improving attention,
self-regulation, and emotion-regulation among school
children. Activities included in these interventions not
only focus on mindful attention but also on movement
and therefore may promote physical fitness. Some
research even suggests that mindfulness interventions
can improve students’ academic outcomes, such as
their math grades. Mindfulness-based interventions are
relatively simple to implement, as evidenced by teacher
reports of acceptability and feasibility. Additionally,
they use resources already readily available at most
schools, saving time and money. Continued rigorous
and controlled studies will help to further substantiate
the current empirical evidence supporting school-
based mindfulness interventions for children; however,
the current findings are promising and reinforce the
important role that such programs can play in today’s
education system.

10
GLOSSARY OF KEY TERMS
Social-Emotional Learning: emphasizes development
of several critical skills, including self-awareness, self-
management, responsible decision making, social
awareness, and relationship skills8
Common Core Standards: Career and college
readiness standards in the areas of English/Language
Arts and Mathematics for students in grades
kindergarten through 8th grade; students in high
school have grade-based standards for 9–10th and
11–12th grades
Anxiety: A broad type of psychological disorder that
is characterized by excessive fear or worry which can
lead to disturbances in behavior4
Depression: A psychological disorder in which an
individual suffers from symptoms such as depressed
mood (can be displayed as irritability in children
and adolescents), a loss of interest or pleasure
in activities, sleep problems, and/or feelings of
worthlessness for a marked period of time (at least
two weeks)5
Attention Deficit Hyperactivity Disorder (ADHD): A
childhood disorder that can persist into adolescence
and adulthood. The main symptoms include difficulty
focusing attention, impulsivity, and hyperactivity.
There are three subtypes: Predominantly hyperactive-
impulsive, Predominantly inattentive, and Combined
hyperactive-impulsive and inattentive6
Conduct Disorder: A disorder in which the basic
rights of others or age-appropriate societal norms
are violated which can be evidenced by a number of
behaviors including, aggression to people or animals,
destruction of property, deceitfulness or theft, and
serious violations of rules7
Oppositional Defiant Disorder: A disorder
characterized by angry/irritable mood,
argumentative/defiant behavior, or vindictiveness
that lasts for at least six months7
Effect Size: A statistical measure of the strength
of the relationship between two variables; it is a
standard measure that can be used across studies
Mindfulness Interventions: contemplative practices
(like yoga or meditation) which emphasis focused
attention and awareness of the present moment
Self-Regulation Skills: skills that enable students
to control or manage their thoughts, emotions, and
behaviors; often positively associated with later
academic achievement16
Social-Emotional Competence: Students’
demonstration of social-emotional learning
standards in the classroom environment
Self-Concept: an individual’s thoughts, perceptions,
and evaluations of themselves
Emotion-Regulation: The ability to identify and label
one’s emotions and the emotions of others and use
this knowledge to appropriately manage feelings
Prosocial Behavior: Behaviors that benefit others
based on social responsibility instead of the desire for
individual gain
Executive Functioning: An umbrella term for several
cognitive processes, including planning, focusing
attention on relevant information, using working
memory to complete tasks, and self-regulation
Flanker Task: Task that requires individuals to
selectively attend to a target stimulus while
simultaneously ignoring irrelevant stimuli
Example: Look in the direction the center arrow is
pointing:
èèèèè
ççèçç

11
REFERENCES
1. U.S. Department of Education. (2010). Laws & guidance: Elementary & secondary education. Retrieved from http://www2.
ed.gov/policy/elsec/leg/esea02/index.html
2. Common Core State Standards Initiative: Preparing America’s Students for College & Career. (2015). Frequently asked
questions. Retrieved from http://www.corestandards.org/about-the-standards/frequently-asked-questions/
3. National Institute of Mental Health. (2010) Any disorder among children. Retrieved from http://www.nimh.nih.gov/health/
statistics/prevalence/any-disorder-among-children.shtml
4. American Psychiatric Association. (2013). Anxiety disorders. In Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
Washington, D.C.: Author.
5. American Psychiatric Association. (2013). Depressive disorders. In Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
Washington, D.C.: Author.
6. American Psychiatric Association. (2013). Neurodevelopmental disorders. In Diagnostic and Statistical Manual of Mental
Disorders (5th ed.). Washington, D.C.: Author.
7. American Psychiatric Association. (2013). Disruptive, impulse-control, and conduct disorders. In Diagnostic and Statistical
Manual of Mental Disorders (5th ed.). Washington, D.C.: Author.
8. Collaborative for Academic, Social, and Emotional Learning. (2015). Social and emotional learning core competencies.
Retrieved from http://www.casel.org/social-and-emotional-learning/core-competencies
9. Durlak, J. A., Weissberg, R. P., Dymnicki, A. B., Taylor, R. D., & Schellinger, K. B. (2011). The impact of enhancing students’
social and emotional learning: A meta-analysis of school-based universal interventions. Child Development, 82, 405-432.
doi:10.1111/j.1467-8624.2010.01564.x
10. U.S. Department of Education. (2013). Building the legacy: IDEA 2004. Retrieved from http://idea.ed.gov/explore/view
11. RTI Action Network: A Program of the National Center for Learning Disabilities. (2014). What is RTI. Retrieved from http://
www.rtinetwork.org/learn/what/whatisrti
12. Collaborative for Academic, Social, and Emotional Learning. (2015). MindUP. Retrieved from http://www.casel.org/guide/
programs/mindup
13. Oaklander, M. (2015, January). Mindfulness exercises improve kids’ math scores. TIME Magazine. Retrieved from http://time.
com/3682311/mindfulness-math/
14. Marlatt, G. A. & Kristeller, J. L. (1999). Mindfulness and Meditation. In W.R. Miller (Ed.), Integrating spirituality into treatment
(67-84). Washington, D.C.: American Psychological Association.
15. Greenberg, M. T., & Harris, A. R. (2011). Nurturing mindfulness in children and youth: Current state of research. Child
Development Perspectives, 6, 161-166. doi: 10.1111/j.1750-8606.2011.00215.x
16. Flook, L., Goldberg, S. B., Pinger, L., & Davidson, R. J. (2015). Promoting prosocial behavior and self-regulatory skills in
preschool children through a mindfulness-based kindness curriculum. Developmental Psychology, 51, 44-51. doi: 10.1037/
a0038226
17. Chen, S. H., Main, A., Zhou, Q., Bunge, S. A., Lau, N., & Chu, K. (2014). Effortful control and early academic achievement of
Chinese American children in immigrant families. Early Childhood Research Quarterly, 30, 1-12. doi: x.doi.org/10.1016/j.
ecresq.2014.08.004
18. Floriani, V., & Kennedy, C. (2008). Promotion of physical activity in children. Current Opinion in Pediatrics, 20, 90-95. doi
10.1097/MOP.0b013e3282f3d9f9

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19. RTI Action Network: A Program of the National Center for Learning Disabilities. (2014). Considering tier 3 within a response-
to-intervention model. Retrieved from http://www.rtinetwork.org/essential/tieredinstruction/tier3/consideringtier3
20. Schonert-Reichl, K. A., & Lawlor, M. S. (2010). The effects of a mindfulness-based education program on pre- and early
adolescents’ well-being and social emotional competence. Mindfulness, 3, 137-151.doi: 10.1007/s12671-010-0011-8
21. Semple, R. J., Lee, J., Rosa, D., & Miller, L. F. (2010). A randomized trial of mindfulness-based cognitive therapy for children:
Promoting mindful attention to enhance social-emotional resiliency in children. Journal of Child and Family Studies, 18, 218-
229. doi: 10.1007/s10826-009-9301-y
22. Common Core State Standards Initiative: Preparing America’s Students for College & Career. (2015). Read the standards.
Retrieved from http://www.corestandards.org/read-the-standards/
23. McLeod, S. A. (2008). Self concept. Retrieved from http://www.simplypsychology.org/self-concept.html
24. Learning to Breathe. (2015). Why is emotion regulation important? Retrieved from http://learning2breathe.org/about/purpose
25. Kidron, Y., & Fleischman, S. (2006, April). Research matters: promoting adolescents’ prosocial behavior. Teaching the Tweens,
63, 90-91.
26. Center on the Developing Child: Harvard University. (2015). Key concepts: Executive function. Retrieved from http://
developingchild.harvard.edu/key_concepts/executive_function/
27. National Institutes of Health Toolbox. (2012). NIH toolbox flanker inhibitory control and attention test. Retrieved from http://
www.nihtoolbox.org/WhatAndWhy/Cognition/Attention/Pages/NIH-Toolbox-Flanker-Inhibitory-Control-and-Attention-Test.aspx
Alexandra Bluell holds a Bachelor of Arts in Psychology
and Spanish from Bradley University. She was published
as the first author on an article in The Journal of
Development and Cognition for her work on her senior
honor’s thesis, which focused on executive functioning
in preschoolers. She recently completed a three year
graduate program at Illinois State University, earning a
Specialist degree in School Psychology. In Fall of 2015,
Alexandra will begin her career as a school psychologist
working for a district serving students from preschool
through 12th grade.
About the Author

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