Efficacy of Mandala Coloring Intervention on Executive Functioning and Emotional & Motivational Self-Regulation Among Children With Symptoms of Attention Deficit Hyperactivity Disorder

Introduction: Attention deficit hyperactivity disorder (ADHD) is the most common neuropsychiatric condition of childhood. There is a sizable subset of children with ADHD symptoms in whom early intervention can prevent their progression into fulminant ADHD. However, the therapeutic options for ADHD symptoms are limited. Mandala coloring is a form of art therapy that may be used in these children, but there is a dearth of literature regarding its efficacy. Method: This is a prospective cohort study on 120 children aged six to 10 years diagnosed with ADHD symptoms. The children were divided into two equal groups of intervention and control. Children in the intervention group were given mandala coloring intervention for 10 weeks duration. Pre-test and post-test values of executive functioning and emotional and motivational self-regulation (EMSRQ) were compared between the two groups by using SPSS 23 (IBM Corp., Armonk, NY). Results: The demographic data and baseline characteristics were comparable in both groups. Post-test values showed significant improvement across all parameters of executive functioning in the intervention group. However, the difference was not significant in EMSRQ. At follow-up, parents reported improvement in academic performance, concentration, and mindfully focusing on a single activity for a longer duration of time. Conclusion: The attention span and cognitive abilities of children at risk for ADHD may be improved with the relatively simple yet effective intervention technique of mandala coloring that can easily be administered by parents at home. Further research is needed to compare its efficacy with other treatment modalities.