May 11, 2018
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Self-regulation interventions improve behavioral outcomes of children, teens

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Numerous interventions focused on improving self-regulation in children and teenagers exist, with published studies demonstrating the highlights of incorporating curriculum-based, personal skills and exercised-based programs, according to a review published in JAMA Pediatrics.

“There is growing evidence that self-regulation plays an important foundational role in development and maintenance of physical health and well-being in childhood and across the life span,” Anuja Pandey, MD, from the University College London Great Ormond Street Institute of Child Health, London, and colleagues wrote. “Greater self-regulation has been associated with positive outcomes on a range of attributes, including school readiness, academic achievement, healthy behavior, physical health and mental health.”

“Conversely, poor self-regulation has been linked to adverse outcomes, such as health risk behaviors, psychiatric disorders, substance dependence, crime and unemployment,” the researchers continued.

To review and perform a meta-analysis of researched interventions related to self-regulation in children and adolescents between the ages of 0 and 19 years, the researchers searched databases, including PsycINFO, PubMed, EMBASE, CINAHL Plus, ERIC, British Education Index, Child Development and Adolescent Studies and CENTRAL. All studies in the review reported on data from randomized trials or randomized clinical trials, assessed universal interventions that improve self-regulation and encompassed outcomes of children concerning their self-regulation skills.

Of the 14,369 screened records, Pandey and colleagues recognized 147 full-text reviews and 49 studies. These published items included data on 50 self-regulation interventions, and the researcher conducted a narrative review and meta-analysis to describe results.

Pandey and colleagues identified 17 cluster randomized trials and 32 randomized clinical trials that met review criteria. The 49 published works included 23,098 participants between the ages of 2 and 17 years (median age, 6.0 years), and each work examined the efficacy of self-regulation interventions. Over three-quarters of the works included demonstrated steady improvement in self-regulation for curriculum-based interventions (76%). Half of yoga and mindfulness interventions demonstrated this outcome, and 56% of family-based programs showed positive improvements.

Additionally, the researchers observed that 67% of exercised-based interventions improved self-regulation, and improvements were noticed in 66% of studies that examined social and personal skills interventions. Of the 50 studies reviewed, 66% positively impacted participants.

When the Pandey and colleagues conducted a meta-analysis to inspect the effects of interventions on self-regulation task performance scores, they observed a positive result, with a pooled effect size of 0.42 (95% CI, 0.32-0.53). Distal outcomes were reported in 24 studies, which included 29 outcomes. Enhancements in academic achievement (85%) and substance abuse were noticed in this review. Furthermore, all studies related to self-regulation improved conduct disorders (n = 3), social skills (n = 2), depression (n = 2), behavioral problems (n = 2) and school suspensions (n = 1).

Two studies reported no effect on academic achievement of children included in those studies. One study was related to substance abuse, and the other study concerned psychological well-being.

“The findings of this review would be useful for policymakers, educators and health professionals focusing on prevention as self-regulation attracts more attention as an intervention target,” Pandey and colleagues wrote. “The findings can be a useful aid when designing self-regulation interventions, with a range of effective intervention strategy options available.”

“Also, some interventions brought more improvements in self-regulation measures of those with lower baseline scores,” the researchers added. “Such interventions can be particularly useful when limited resources are available and there is need to design interventions for the most vulnerable children and adolescents.” – by Katherine Bortz

Disclosures: The authors report no relevant financial disclosures.