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The Effects of a Stress Management Intervention in Elementary School Children

Denise A. Bothe, MD, Josephine B. Grignon, MEd, Karen N. Olness, MD

Journal of Developmental & Behavioral Pediatrics, Vol. 35, No. 1, January 2014

For a PDF version of the complete paper, click here.


Objective: This preliminary study tests the effectiveness of an elementary school-based stress management technique on anxiety symptoms and heart rate variability (HRV) in children. Methods: In this controlled prospective longitudinal study, children in third-grade classroom participated in a teacher-led daily 10-minute stress management intervention for 4 months. The control class teacher read from a children’s book for 10 minutes daily. A standardized anxiety scale and HRV (using computer biofeedback program) were measured before the 4-month intervention, immediately after, and 1 year later. Results: The intervention class showed significant improvement from baseline to the immediate post-intervention period in total anxiety (N 5 14, F 5 12.95, p 5 .002), with 1-year follow-up scores maintaining improvement (N 5 13, F 5 5.88, p 5 .025). The intervention class had small improvement in HRV using the biofeedback program in the immediate post-intervention period, with significant improvement at 1-year follow-up (N 5 13, F 5 10.61, p 5 .005). The control class showed no improvements. Qualitatively, children reported that the intervention was helpful during stressful times at school and at home, even after the study period. Conclusion: An elementary school-based short daily stress management intervention can decrease symptoms of anxiety, and improve HRV, a measure of relaxation. Ultimately, these children found this skill continued to help them cope better with everyday stressors.