Effects of Mindfulness Training on the Psychological Well-being of Preschoolers
Phase: NA
Conditions: Mindfulness-based Intervention for Preschoolers
Sponsor: The University of Hong Kong

 
 
Study Protocol 
 
 
Project Title: 
Effects of Mindfulness Training on the Psychological Well-being of Preschoolers 
 
NCT Number: NCT05058365 
Document Date: July 30, 2021 
 
 
 

Effects of Mindfulness Training on the Psychological Well-being of Preschoolers 
 
Study Objective 
The current study wants to accomplish the following aims. 
(1) To evaluate MiSP dots curriculum in improving preschoolers’ attention, empathy and 
prosocial behaviour evaluated by behavioural tasks 
Attention, empathy, and prosocial behaviour are primary outcomes expected from the dots 
curriculum. 
(2) To evaluate MiSP dots curriculum in improving parent- and teacher-reported attention, 
emotion regulation, conduct and prosocial behaviour 
Apart from the children’s assessment, we also test whether the training leads to significant 
changes in attention, emotion regulation, conduct and prosocial behaviour observable by both 
parents and teachers. 
 
Background and Significance 
The Hong Kong Jockey Club Charities Trust has earmarked $27 million to fund a three-year 
program entitled “Peace and Awareness: Mindful School Culture Project” (PandA) to promote 
mindful school culture in Hong Kong. The practice of mindfulness helps students regulate their 
emotions and be more resilient to challenges. It also helps teachers cope with stress skillfully and 
schools develop a positive culture that enhances mental health of all the stakeholders in schools. 
The interest in mindfulness had greatly increased in the last two decades as indicated by its 
search volume (Google Trend, n.d.). The effectiveness of mindfulness training on mental health 
and well-being outcome has been supported by empirical evidence obtained from different 
populations (Ref.). Meta-analysis revealed that mindfulness training in schools to be effective in 
late adolescence (age 15-18) and middle childhood (age 6-10) while no significant effect was 
found in early adolescence (age 11-14) (Carsley, Khoury & Heath, 2017).  
Early childhood is critical period of brain development in which neural connections are 
reshaping, i.e. neural plasticity (Brown & Jernigan, 2012). However, there is only few studies 
evaluating mindfulness training in this period with randomized control trial (RCT) design (Ref.). 
The present study will add to the few studies evaluating the effect of mindfulness training on 
preschoolers’ social-emotional development, including attention, emotion regulation, empathy, 
prosocial behaviour and conduct. 
 
Participants 

Target Participants: The participants are recruited from a Hong Kong kindergarten. The 
kindergarten locates in the Central and Western District of Hong Kong Island and provides 
childcare service to children aged 2-6. Informed consent is provided by the school principal 
agreeing the study to be held in the whole grade of K3. 
Recruitment and enrolment: A circular is distributed to the parents of the whole K3 to introduce 
the study details and collect their informed consent. There is no specific inclusion or exclusion 
criteria for subject enrolment.  
 
Research Design and Methods 
The study uses a randomized control trial design with two arms – experimental group and 
waitlist control group.  
Randomization: Each participant is given a random number ranged from 0 to 1 generated by 
Microsoft Excel RAND() function. The participant list is sorted according to the random number 
and split half into two groups. The group with the larger random number will be experimental 
group and the group with the smaller random number will be waitlist control group.  
Mindfulness Training: The experimental group receives the dots curriculum named dots 
designed for preschool children aged between 3 and 6 by Mindfulness in School Project (MiSP) 
in UK. The curriculum consists of 30 sessions split into 3 set of 10 sessions. The dots curriculum 
is base around three themes – Awareness, Connections, and Emotion – and each dots session 
teach a distinct mindfulness skill or concept, e.g. anchoring/grounding/being present, awareness 
of others/world, emotion recognition, and self-regulation.  
The students will take the course in their classrooms. The course is taught by a certified teacher 
who has been trained to teach the dots curriculum by the MiSP. The students in the experimental 
group will take the course in the first semester of 2021/22 academic year whereas the students in 
the waitlist control group will take the course in the second semester. The course spans for 15 
weeks with 15-minute lessons twice a week.  
Child Measures: Data will be collected from all the participants at two time points: Before the 
course is started (T1); after the course is completed (T2).  
The Conners Kiddie Continuous Performance Test 2nd Edition TM (K-CPT 2). K-CPT 2 is an 
assessment of attention problem in children aged from 4 to 7. The children are presented with a 
series of pictures and are required to press the key every time they see the pictures except when 
the picture is a soccer ball. The performance of the students is standardized against the norm and 
generate nine T-scores: d-prime, omissions, commissions, perseverations, hit reaction time 
(HRT), hit reaction time standard deviation (HRT SD), variability, HRT block change, HRT 
inter-stimulus interval change (HRT ISI). For this study, we take the mean T-scores of the eight 
T-scores (except HRT) as an indicator of the intervention.  
Scenario Test. Two sets of scenario test are created to measure the changes in children’s empathy 
and prosocial behaviours. Each set contains four scenarios depicting a child (i.e. the protagonist) 

in an emotional situation (e.g. celebrating birthday, being chase by a dog). The children are 
asked to guess the feeling of protagonists after hearing the scenarios to test their empathy. 
Children are given two points if they can correctly recognize the emotion; one point is given if 
they can recognize the emotion after follow-up or can recognize the valence of the emotion (i.e. 
positive or negative); zero point is given if they gives incorrect answer or are unable to respond.   
Then the children are asked what action they would take if they were the protagonist or if they 
see the protagonist in front of them. Two points are given to socially appropriate behaviour (e.g. 
helping, comforting, seeking help); one point is given if the children are able to answer after 
follow-up; zero point is given if they gives socially inappropriate response (e.g. shouting, 
fighting, laughing at the protagonist) or are unable to respond. 
Parent- and Teacher-reported Measures: Data will also be collected from the parents and teachers 
at T1 and T2. Parents are asked to fill in a questionnaire asking about their children in the last 
one month. The head teachers of the class are asked to rate individual children in both the 
experimental and waitlist control group. 
Modified version of Strength and Difficulty Questionnaire (SDQ). We modified the 
hyperactivity, emotion problem, prosocial behaviour and conduct problem subscales of SDQ 
(Goodman, 1997) to capture the positive aspects of each dimension. Three new items are 
generated for each dimension and the subscales are renamed as attention, emotion regulation, 
prosocial behaviour, and conduct.  
Statistical Analysis Plan 
Seperated analyses of covariance (ANCOVA) will be conducted to compare the post-
intervention score of our measures with baseline score as the covariate (O’Connell et al., 2017). 
Post-hoc comparison between baseline and post-course score will be conducted for each 
treatment arm.