The effects of a stress management intervention in elementary school children

J Dev Behav Pediatr. 2014 Jan;35(1):62-7. doi: 10.1097/DBP.0000000000000016.


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 postintervention period in total anxiety (N = 14, F = 12.95, p = .002), with 1-year follow-up scores maintaining improvement (N = 13, F = 5.88, p = .025). The intervention class had small improvement in HRV using the biofeedback program in the immediate postintervention period, with significant improvement at 1-year follow-up (N = 13, F = 10.61, p = .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.

Publication types

  • Controlled Clinical Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Anxiety / therapy*
  • Biofeedback, Psychology / methods*
  • Child
  • Child Behavior / psychology*
  • Female
  • Heart Rate / physiology*
  • Humans
  • Male
  • Pilot Projects
  • Prospective Studies
  • Stress, Psychological / therapy*
  • Treatment Outcome