Effortless Attention Trainings: The Intersection of Attention and Mental Health in Children and Teenagers

Abstract

This chapter presents several effortless attention trainings—mindfulness, yoga, qigong, nature exposure and more especially, autogenic meditation—which not only improve attention but also facilitate stress reduction and emotional regulation. Cultivating serene attention is a relevant strategy to promote mental health and well-being in children and teenagers. Fostering serene attention plays a fundamental role in shaping life experience because part of the individual’s identity and knowledge is founded on what they pay attention to—their conscious experience—. By training children and teenagers to focus and direct their attention from a calm state of mind, we allow them to mould their own conscious experiences, laying the foundation for a balanced and fulfilling life.

1. Introduction

Attention is the interface of consciousness, and its education is a relevant aspect in the adaptation and mental health of the individual [1, 2]. Childhood and adolescence constitute a sensitive period for shaping its capacity [3, 4]. Science has generally assumed that attention training requires effort [5]. However, there is a set of effective approaches that train attention in a more effortless way and also show a positive impact on the emotional and behavioural sphere [1, 6].

It is well known that attention and emotion interact [7, 8, 9], suggesting that those who train their attention optimally can lay the foundation for a proper emotional management and a calmer lifestyle. This is not a trivial matter. In the twenty-first century, the rise of technology offers new generations a world of opportunities, such as the Internet, artificial intelligence and online omnipresence, although these opportunities come with potential dangers. Much of children’s leisure time is spent between screens that constantly compete for their attentional resources. At the same time, today’s society encourages a fast pace of life, which results in stressful school and extracurricular agendas, all against a worrying backdrop of serious ecological problems, wars and in some cases, violence at school and the family. Consequently, young people often exhaust their energy with little time to connect with themselves and cultivate a calm and conscious way of being.

When analysing the mental states of children and adolescents, it is pertinent to consider ‘mind-wandering’, a common phenomenon that involves the involuntary shift of attention from the immediate external context or any specific task to self-generated thoughts unrelated to the ongoing activity [10]. It is estimated that mind-wandering accounts for between 25 and 50% of mental activity during waking hours [11, 12]. This suggests that the typical state of the mind is not being present-focused. Such a tendency to wander is associated with the Default Mode Network (DMN), negative affect, reduced psychological well-being and diminished learning capacity, although some studies have also related it to creativity [11, 13, 14, 15, 16].

In this regard, the sum of attentional states throughout life will reflect a trait or a way of being. An idea that William James himself reflected in the following way: ‘The faculty of voluntarily bringing back a wandering attention, over and over again, is the very root of judgment, character, and will’ ([17], p. 424). The education of attention is the key that opens the floodgate of the cognitive process and constitutes the seed of character in interaction with temperament. In individual counselling or training groups, we present this idea to children and adolescents with the following statement: ‘You are what you pay attention to, even when you are not aware that you are paying attention’. Therefore, we propose to train this ability to improve cognitive performance, to react with equanimity to the flow of thoughts wandering through the mind and to improve self-control.

As can be seen, educating attention is a relevant issue and is postulated as a preventive mental health measure. The following sections outline the nature of attention and how to train it from the perspective of effortless attention training, presenting its key methods and preliminary evidence supporting its efficacy.

2. What is attention?

Since the dawn of scientific psychology, many definitions and theoretical models of attention have been put forward. William James, in 1890, outlined a pioneering definition, stating: ‘Everyone knows what attention is. It is the taking possession by the mind, in clear and vivid form, of one out of what seem several simultaneously possible objects or trains of thought. Focalization, concentration, of consciousness are of their essence. It implies withdrawal from some things in order to deal effectively with others and is a condition which has a real opposite in the confused, dazed, scatterbrained state which in French is called distraction, and Zerstreutheit in German’ ([17], pp. 403–404).

Today, the understanding of attention as a limited resource that requires selection and is intrinsically linked to consciousness continues to prevail. However, although the term is ubiquitous in everyday language, the ongoing scientific debate reveals discrepancies. Some argue that the concept of attention is elusive and that no one really knows what attention is [18, 19, 20]. This interpretation underlines the inherent complexity of its definition and makes it difficult to encapsulate it from a monolithic perspective. In contrast, the current contemporary alternative approaches the understanding of attention from a modular and multifaceted perspective. In this context, Rueda defines attention as: ‘The optimal state of activation that allows the individual to select the stimulation he receives through his senses in order to process the most relevant information with priority and efficiency, and thus be able to voluntarily and consciously control his behaviour´ ([21], p. 20). This definition highlights three essential functions: activation, selection, and executive control. (1) Therefore, to achieve attentional efficiency, an optimal activation level is crucial, a concept supported by the Yerkes-Dobson law [22], which shows that performance improves with moderate activation levels. (2) Because humans receive an infinite number of stimuli and have many thoughts running through their minds, it is necessary to select what to pay attention to. This selection process can be exogenous, bottom-up, reacting to external stimuli or endogenous, top-down, based on intention [23]. (3) Finally, executive attention also known as control attention regulates endogenous attention persistence, distractor inhibition, and self-regulation of behaviour. This function is closely linked to consciousness.

The intellectual journey of attention has seen the emergence of several theoretical models. During the first half of the twentieth century, the behaviourist paradigm conceived attention from stimulus control of observable behaviour [24]. Attentional models of classical conditioning were formulated in the second half of the century with the arrival of the cognitive paradigm [25, 26]. In the field of human attention were postulated models of functioning as selection or filter systems, whether rigid [27], attenuated [28], delayed [29] or flexible [30]. The markedly structural character of these proposals, and the emphasis on processing from data and other constraints, gave rise to a resource-centred conception of attention, conceiving it as a mental effort that can be distributed across tasks [5, 31, 32]. However, these theories lacked explanations for adaptability in attentional demand, encapsulating it as fixed, and could not account for the effect of practice, so automaticity models emerged in response [33]. The predominantly passive nature of these models gave way to control models [34], emphasising the active nature of attention. Finally, the emergence of cognitive neuroscience is making it possible to study the neuroanatomical structures involved in the functions of attention.

Among the emerging neuroscientific models [23, 35, 36], the neurocognitive approach outlined by Posner and Petersen [37] is noteworthy. This model articulates the existence of three attentional networks: alertness, orienting and executive, interconnected, but with neuroanatomical and functional independence. The model has been reconfigured by incorporating additional subnetworks to the orienting and executive attention networks, to incorporate new evidence [38]. The alertness network is predominantly located in the right hemisphere, includes regions of the frontal and parietal cortex and is associated with the reticular system, particularly the locus coeruleus, with norepinephrine as its main neurotransmitter [39]. The orientation network is responsible for selection and prioritisation. While the original model argued for the importance of the pulvinar nucleus and superior colliculus [37], subsequent neuroimaging studies highlighted the relevance of the parietal and frontal regions of the cortex [38]. Two subnetworks are identified within this network: the dorsal frontoparietal, linked to endogenous orienting, and the ventral frontoparietal, associated with exogenous orienting [23]. Acetylcholine acts as its main neurotransmitter. The executive network responsible for voluntary control, inhibition, and planning extends predominantly through the dorsolateral prefrontal cortex, the dorsomedial prefrontal cortex, and the anterior cingulate cortex (ACC) [40]. The CCA shows functional specialisation in its dorsal and ventral divisions: the dorsal is activated in conflict situations devoid of emotional content, while the ventral responds to emotional conflict processes. The CCA is highly interconnected with different brain regions, with evidence pointing to the existence of two essential neural circuits that perform specific but coordinated functions: the cingulo-opercular network, responsible for processing goals and executing behaviours, and the frontoparietal network, responsible for selecting and adapting responses at any given moment [41, 42]. In the dynamics of the executive network, dopamine is the predominant neurotransmitter. This network is related to self-regulation or self-control, reflecting the ability to regulate one’s emotions, cognitions and behaviours [6, 38, 43]. Within the framework of self-regulation, it is relevant to highlight the conceptual parallelism between executive attention and what the cognitive literature defines as Executive Functions (EFs). These functions, intrinsically associated with the dynamics of the executive network, encompass critical domains such as cognitive flexibility and inhibitory control. According to landmark studies in the field [44, 45], these domains comprise two of the three fundamental pillars of executive functions, the third being working memory.

Finally, it is important to note that attention is the result of a complex biological and ecological interaction. Comparative studies with monozygotic and dizygotic twins suggest a significant relationship between genetic heritability and the executive network and to a more subtle degree with the alertness network [46]. In regard to executive attention, through specific inhibitory control tasks, polymorphic variations in specific genes, such as DRD4 and DAT [47], as well as SLC6A3 and COMT [48, 49], have been shown to play a role in modulating dopamine levels in the prefrontal cortex. Likewise, a polymorphism in the CHRNA4 gene, involved in the modulation of cholinergic receptors, has been associated with selective visual attention [50]. Among environmental conditions, some studies indicate that socioeconomic status influences alertness and executive attention [51] and the performance of executive attention and other cognitive processes [52]. In parallel, factors such as parenting and attachment style also seem to play a relevant role. In this sense, as revealed by a longitudinal study, sensitivity to children’s needs in the first years of life, but above all, a maternal educational style that promotes autonomy correlates with better performance in executive attention and EFs [53]. It is worth recalling the overlap between attention and most EFs. A meta-analysis of the influence of parental behaviour on the EFs of children aged zero to eight years revealed details of interest. Specifically, there is a stable relationship between positive behaviours such as sensitivity or warmth and negative behaviours such as control or detachment. In contrast, parental cognitive behaviours such as autonomy support are moderated by children’s age, showing a stronger effect size in younger children [54].

The set of findings described suggests the neuroplasticity of attention. Indeed, attention is not a fixed entity, but is susceptible to malleability. A direct intervention in this capacity constitutes attentional training. In the following, traditional attentional training is explained succinctly and, in more detail, a set of emerging attentional trainings that require a lower level of attentional effort.

3. Attention trainings

Meta-analysis studies on attention training have confirmed its efficacy, showing a medium effect size. It has been shown that, although it is possible to train attention at any age, childhood and adolescence are particularly sensitive periods, representing a clear window of opportunity [3, 4]. The meta-analyses mentioned above index studies are based on the effort or cognitive control paradigm. Identifying attention with effort has established itself as the dominant current in the field. An essential reference for this topic is Kahneman’s seminal work, entitled ‘Attention and Effort’ [5], which has been widely cited and has had a notable influence on the configuration of attentional training. These trainings usually use computer programs to train a specific attentional skill, where the subject, through continuous practice in increasing difficulty and with high cognitive effort, improves the trained ability [55, 56]. Effortful training engages the sympathetic nervous system and the frontoparietal network [6] with the disadvantage of inducing mental fatigue, due to the metabolic increase [5] needed to counteract mind-wandering and sustain cognitive effort.

The biunivocal identification between attention and effort, as postulated by Kahneman, is a widely accepted idea, not only in the cognitive academic tradition but also resonates in popular conception. However, Bruya and Tang have presented a critical discussion highlighting the shortcomings and biases of this approach [57]. They argue that the notion of effort is not clearly defined in Kahneman’s work. Furthermore, they explain that Kahneman conceives of effort/attention as a particular case of sympathetic dominance of the autonomic nervous system leading to increased metabolic activity in the brain. However, current evidence questions the direct equivalence between attention and effort, indicating that attention is not necessarily linked to the consumption of metabolic resources directly, but to the priming of those resources. This preparation, under sympathetic dominance, may be perceived as effort. It is also noted that attention can also be exercised in a state of parasympathetic dominance. This is the case of less effortful or attentional state training [6, 58, 59, 60]. The particularity of this, it promotes a balanced attentional state between mental fatigue and mind-wandering, which constitutes an optimal relationship between the level of effort and attentional performance [59]. Some theoretical bases underlying this approach are found in the Yerkes-Dodson law [22] and attention restoration theory [61, 62]. It is relevant to note that these practices are not explicitly configured to train attention, but are oriented towards psychophysical well-being, and yet they improve the efficiency of attention. This training framework encompasses experiences such as exposure to nature and various meditation practices, including mindfulness, yoga, Qigong or autogenic meditation. These forms of experience promote a soft and flexible attentional state that favours emotional and behavioural self-regulation. The neurophysiological state that unfolds in addition to parasympathetic predominance involves the synergistic cooperation of the central and autonomic nervous systems [60] and involves specific brain regions such as the anterior and posterior cingulate cortex, insula or striatum [6]. A distinctive aspect is that these practices show both a stress reduction response and a non-stressful attentional state.

3.1 Exposure to nature

Nature seems to exert a revitalising influence on human well-being and health. Strolling through green landscapes and forests immerses us in a fascinating setting, where the symbiosis of plants and fresh air creates an atmosphere of harmony and serenity. In tune with this, the blue surroundings, with their vast sea horizons and melodious waves, offer a sonorous and visual spectacle that facilitates a state of contemplation. These and many other possible experiences are not limited to mere pleasurable sensory experiences, but review studies suggest the restorative potential of nature on health and well-being, as well as on the cognitive domain of attention [63]. It is timely to reflect on the influence of the environment on children and young people. Under this consideration, having natural spaces in front of or in conjunction with urban and digital environments, which seem to be the trend of the twenty-first century, could have advantageous consequences on their development. In the case of attention, the Attention Restoration Theory (ART) [61] argues that contemporary urban life demands more and more endogenous or top-down attentional resources, which can result in attentional exhaustion. In contrast, natural environments deploy exogenous or bottom-up attention, less effortful, which helps the recovery of endogenous or executive attention [64, 65, 66]. This view is complemented by Stress Reduction Theory, which postulates that natural spaces attenuate physiological responses, favouring recovery from cognitive fatigue and optimising attentional performance [67, 68].

A systematic review comprising thirty-one meta-analysis studies identifies that twenty-one of them empirically support ART, based on three objective measures of attention [66]. In the adult population, research using an experimental paradigm of comparing urban and natural environments, such as forest walks, park walks and viewing natural landscapes, demonstrates the benefit of green spaces on both mood and attentional performance [69, 70]. This evidence has also been documented in people diagnosed with depression [71]. However, there are also cases where exposure to nature does not show efficacy. Specifically, a study using this same paradigm, but with the variant photographic exposure in a sample of healthy long-lived adults did not reveal positive effects, compared to a control group of young individuals. This finding suggests that age may moderate the efficacy of nature exposure [72].

Upon reviewing the empirical evidence for children and young people, a positive effect is also found, characterised by the following findings. One study shows that walking in a forest or a small to medium-sized park improves the level of well-being and selective and sustained attention in all conditions compared to the urban context baseline [73]. Another study focusing on a child population using the natural vs. urban walking paradigm assessed executive attention. The results reflected that while the performance of both groups was comparable, the natural walk group exhibited a more stable and faster response rate. An additional measure of the study was gaze fixation which was indexed by recording eye movements during walks in both conditions. The results showed that the natural walk group fixated their gaze more on their environment than the urban walk group. This finding could explain the attentional restoration effect attributed to nature [74]. Following this line of research, an additional study with children and adolescents aged eight to fifteen years examined the differential effects of the natural vs. urban environment on two types of attention, specifically, endogenous and exogenous. This study revealed a significant improvement exclusively in endogenous attention following exposure to the natural environment. These findings, therefore, provide empirical support for the ART hypothesis, which posits an exclusive enhancement in voluntary or endogenous attention following interaction with nature [75].

Broadening the spectrum of analysis on exposure to nature and in line with the underlying stress reduction theory for ART, both direct interaction with natural environments and simple observation from the classroom have been identified as reducing cortisol levels and heart rate [76, 77]. This evidence supports the notion that nature facilitates a less effortful attentional focus, and its effects appear to be interconnected with the modulation of the stress response. Furthermore, it is relevant to note that there appears to be a minimum age at which exposure to nature works. Such is the case of research using the urban nature walk paradigm, comparing attentional performance in a group of four- to five-year-old preschoolers versus a group of seven- to eight-year-old school children. The results support that only the nature-walking group of school children significantly improves attentional performance [78]. This finding, in conjunction with previous evidence found in older adults [72], indicates the need to continue to explore the peculiarities of each age range in order for exposure to nature to be effective.

It is worth noting that a recent systematic review analysing the impact of green spaces in the school context on cognitive functioning in children and adolescents supports the efficacy of these interventions on selective and sustained attention and working memory. In parallel, the review credits the underlying mechanisms of ART as reducing stress and decreasing cognitive fatigue, and supports the state of well-being facilitated by nature [79]. This evidence, although preliminary, suggests the desirability of establishing green educational contexts, taking advantage of the benefits that nature classrooms can offer for young people’s well-being and cognitive development. In line with these findings, one study found that the density of tree cover in the school environment is positively associated with the academic performance of adolescents. This finding reinforces the idea that not only general exposure to nature but also specific aspect of the natural environment, such as the presence of trees, can have a significant impact on young people’s cognitive and academic development [80].

On the other hand, it is worth mentioning that interaction with nature has shown efficacy not only in typically developing children and adolescents but also in those on the psychopathological spectrum. Circumscribing the details of studies to the specific area of attention, it has been found that nature shows therapeutic potential in children with attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD). A pioneering study evaluated the impact of different activities performed by a sample of children aged seven to twelve years diagnosed with ADD after school and on weekends. Parents took responsibility for indexing and reporting their children’s activities. This task included classifying the context of each activity into three categories: natural (e.g., fishing), unnatural (e.g., playing video games) and ambiguous (e.g., playing outside); in addition, they were to assess the children’s level of functioning in these activities. The results showed that activities performed in natural contexts, compared to those performed in non-natural or ambiguous contexts, significantly reduced ADD symptoms and facilitated better functioning of the children. Notably, the non-nature context elicited an inverse response, characterised by increased symptoms and poorer functioning. In addition, the study shows that the higher the density of green areas in the play space, the more ADD symptoms were reduced [81]. A study on the effects of 49 activities on children and young people between the ages of five and eighteen years, in this case, diagnosed with ADHD, is along the same lines. The study supports that outdoor green environments significantly reduce symptoms compared to other environments, even when the activities were comparable across environments. This effect was shown across all age groups, irrespective of gender, socio-economic status, symptom severity level and other individual and residential characteristics [82]. In line with previous research is another study that conducted a direct assessment of children diagnosed with ADHD using an objective attention test. The results show significant improvements in attention after a twenty-minute dose of nature walking compared to the same amount of walking time in other urban settings. It is noted in the study that the effect size found is comparable to that reported for methylphenidate, suggesting that nature is an accessible, ecological and cost-effective alternative for children with ADHD [83].

3.2 Meditation training

Defining meditation is not a trivial matter, due to the diversity of ancient practices that converge in this concept. In essence, meditation is a tool for a deep understanding of human beings in their relationship with themselves and their surrounding universe. This experiential learning comprises four dimensions: a path to wisdom, a technique, a state and a trait. The path to wisdom is forged in the doctrine imparted by the various schools with millennia-old roots, encompassing dogmas, spiritual or religious beliefs and ethical conduct that guides the meditator towards values such as compassion and responsibility. The technique constitutes the vehicle or set of specific exercises with the aim of achieving its purpose. Through the practice of this technique, an expanded state of consciousness is induced that gradually integrates the bodily, emotional, cognitive, social and spiritual spheres of ‘being’. This state is accompanied by multi-level neuropsychophysiological changes. The trait constitutes the transfer of the state—or, more precisely, set of states—and the accumulated experiential learning into everyday life.

It is pertinent to underline that the rules of original or ‘pure’ meditation transcend the logic and reason dominant in Western thought, and, thus, for a long time, remained on the fringes of scientific knowledge. However, in its quest for understanding, science made its way towards its study. Thus, arose contemplative science: the scientific analysis of meditation which, from a secular perspective, examines the underlying basis for the functioning of meditative technique or practice and subjects the efficacy of these in clinical and non-clinical applications to empirical scrutiny. This view overcomes the pitfalls of religious and spiritual dogmas or beliefs inherent in the term ‘meditation’. Without entering into the profound debate whether it is possible or correct to detach the technique from its values or beliefs, it is undeniable that the emerging evidence provided by contemplative science supports its efficacy in both educational and mental health settings.

Contemplative science identifies two specific modes of attention that are exercised in the contemplative practice set: Focusing Attention Meditation (FAM) and Open Monitoring of attention (OM) [84, 85]. FAM is the ability to direct attention in a calm attitude in a selective and sustained manner towards a specific meditation object, such as the breath, a mantra, the beating of the heart or the flame of a candle. If a distraction occurs, it is prescribed to redirect the attention to the object of meditation. The peculiarity of FAM compared to the attentional focus of daily life is that, unlike the latter, which demands constant effort, FAM requires an initial effort, but with a relatively low dose of practice, this effort is significantly reduced. An illustrative example occurs when contemplating a campfire for one minute. The field of consciousness merges to such an extent with the object that what is called absorption occurs, drastically decreasing the activation of the sympathetic tone. This absorption and calming effect is well described in ancient practices such as samadhi [86] or samatha [87]. Nowadays, the set of meditative practices circumscribed to this ability is also called ‘concentration meditation’. FAM deploys stable monitoring, or a constant flow of processing of the meditative object, as opposed to distraction and mind-wandering, which appear to be the default mode of the human mind states, highly associated with unhappiness in adults, as well as in children and adolescents [11, 88, 89]. OM is conceptualised as a meta-attention skill. The meditator performs an attentional registration of the continuous flow of experience in an attitude of equanimity. In contrast to FAM, he or she does not have to focus on any particular aspect or content, but deploys open and global attention [85, 90]. Rather than anchoring to a stimulus and identifying with its content, as in FAM, this modality monitors the vast ocean of consciousness in an unbiased way, welcoming the waves or fluctuations of thoughts, sensations and emotions. This open monitoring, in its highest expression, allows us to reconnect with the wonder and awe of everyday experience, but also confronts us with the inescapable reality of human suffering. One practice that deploys this mode of attention is vipassana meditation [91]. Practices that fall under this domain of deep understanding are called ‘insight meditation’.

It is common for meditative protocols to begin with experiences that encompass FAM and evolve into OM, although it is possible for OM to emerge naturally. These meditative praxis produce states that transcend standard conditions of sensory consciousness and cognition. Such states have received multiple labels, such as altered, enhanced, exceptional or expanded [92, 93, 94, 95]. The term ‘expanded state of consciousness’ reflects a more accurate encapsulation of experience. In addition to changes in consciousness and cognition, meditation has an impact on the emotional sphere of the individual. Notably, a review analysing the efficacy of a range of attentional trainings on emotional regulation concludes that meditative practice emerges as the most effective option [96].

One of the prevailing practices in the psychotherapeutic landscape and in contemporary society is mindfulness. The origin of this term dates back to 1881 when W. Rhys Davids translated the Pali word ‘sati’ [97]. Mindfulness-based interventions involve the practice of FAM on the breath as the preferred anchor of concentration, and often evolve into OM. There are multiple empirically supported mindfulness-based programmes and therapies [98, 99]. Recent meta-analyses indicate that mindfulness is an effective training for improving attention, particularity, sustained and executive attention, albeit with a small effect size [100, 101].

When examining the role of mindfulness in the child and adolescent population, it is remarkable that it has a wide acceptance. There is no school or child and adolescent psychology clinic in the world that is unaware of its knowledge and probably its practice. Does it work? The evidence supports that it does, although it is not a magic bullet. Regarding its effects on attention, a recent systematic review notes that mindfulness-based training and other meditative practices improve children’s sustained attention or concentration to a greater extent than effortful cognitive training, for which no reliable improvement in attention is found. However, the review concludes that the level of evidence is preliminary [102].

When seeking to understand how mindfulness works, a pioneering study that addresses the intersection between mindfulness and the neuroscience of attention provides a clarifying answer. The research compares a mindfulness-based intervention with active control in terms of sustained attention in thirteen-year-old schoolchildren. In addition, the study looked at brain connectivity. Specifically, the relationship between the default mode network (DMN), linked to mental wandering, and the right dorsolateral prefrontal cortex (DLPFC), an epicentre of cognitive control, was recorded. The initial assessment showed that those students with better-sustained attention had a higher negative correlation between these two areas. After the intervention, the group that practised mindfulness improved their level of sustained attention and maintained this negative correlation. In contrast, the control group experienced a decrease in both sustained attention and the negative correlation between DMN and DLPFC. These results demonstrate that mindfulness-based training improves not only sustained attention but also influences how these critical brain regions interact with each other. Furthermore, the study is pioneering in crediting a causal connection between mindfulness training and both sustained attention and associated neural plasticity [103].

Importantly, mindfulness engages not only less effortful attention but is also linked to stress reduction. In concordance with this, a study analysed the efficacy of a mindfulness-based intervention versus a control group on selective and sustained attention and daily stress in adolescents. The results indicated a medium effect size for attention and a small effect size for stress [104]. Following this line of research, another mindfulness intervention of only six weeks examined attention and anxiety involving children aged six to thirteen years. Although the evidence of attentional improvement was subtle compared with the control, it is noteworthy that a decrease in trait anxiety was found. This latter finding denotes a stable and extensible change beyond the classroom in the children’s anxiety response [105].

The field of meditation is vast and varied, ranging from techniques that require stillness to those that incorporate movement. Despite the popularity of mindfulness in its more static form, one cannot overlook dynamic practices such as Qigong. This form of meditation, rooted in the Chinese medical tradition, intertwines movement and breathing exercises, unfolding an expanded state of consciousness associated with the flow of qi or vital energy [106]. It has been shown that Qigong can mitigate stress [107, 108] and enhance attention. A study highlights this potential, in which a four-week Qigong programme significantly improved selective and sustained attention in adolescents compared to a sham Qigong placebo and a passive control [109].

In another vein, it is worth noting that the application of meditation extends its scope to child and adolescent psychopathology. In the field of attention-related disorder, it is crucial to describe the evidence in the field of ADHD. In this sense, systematic reviews indicate the efficacy of meditative practices, whether static such as mindfulness, or dynamic such as yoga or Tai Chi [110, 111, 112]. While the evidence may still be considered preliminary, it is remarkable that these interventions do not have the adverse side effects of conventional pharmacological therapy and, at the same time, promote an increase in well-being. Nevertheless, the ‘status quo’ in this second decade of the twenty-first century considers them as adjuvant therapy.

Further to this research topic, a study showed the benefits of a mindfulness intervention in female adolescents aged thirteen to sixteen with pronounced ADHD symptoms. Compared to a control group, the girls in the mindfulness group showed significant improvements in certain aspects of attention, such as resistance to interference (inhibition) and, to a lesser extent, attentional span, but not in others such as sustained attention. Crucially, after the intervention, only mindfulness participants showed a significant and large effect size increase in planning ability and emotional regulation in the facets of impulse control and emotional acceptance [113]. In concordance with the previous line of research, a study focusing on children aged seven to eleven years compared the effectiveness of a mindfulness-based intervention with an emotional education programme. The results showed significant improvements with a large effect size unique to participants in the mindfulness programme in the set of neuropsychological tests employed, including the assessment of sustained and executive attention. In addition, a significant reduction in ADHD symptoms was observed only in mindfulness programme participants [114].

Additionally, ADHD impacts not only the health of children and adolescents but also family dynamics. Therefore, interventions involving both children and parents are a crucial line of research. A study involving both parents and their adolescent children examined the efficacy of an eight-week mindfulness-based cognitive therapy (MBCT) programme. Comparisons between pre -and post-intervention assessments revealed a significant reduction in symptoms of inattention, learning disabilities and peer relationship problems, as measured by parental assessments on the Conners’ 3 scales. Results of assessments implemented with adolescents revealed significant improvement in family relationships and internalising symptoms, particularly depression and anxiety. In terms of parenting stress, a significant decrease was identified in parents, especially in social isolation and life restrictions. In the area of family functioning, although time effects were reported, detailed comparisons did not reveal significant changes. It is essential to underline the increase in mindfulness in parents after the intervention and its inverse correlation with parental stress. In a follow-up evaluation six weeks later, the persistence of these improvements was confirmed, with additional benefits emerging in parental stress reduction [115]. Consistent with these findings, a similar result was obtained in a study involving children and their parents. Specifically, the intervention facilitated a significant reduction in children’s ADHD symptoms as assessed by parents, which was not supported in the teachers’ assessment. Additionally, a significant reduction in parental stress and reactive behaviour was evident [116]. The set of findings suggests the desirability of involving the family in mindfulness-based interventions implemented with children and adolescents with ADHD.

Other emerging evidence of therapeutic efficacy for ADHD is found in yoga. Yoga is derived from a set of meditative practices rooted in the Veda tradition, which, according to its doctrine, facilitates holistic mind-body-spirit union [117]. Among the neurophysiological effects associated with its practice is a modulation of the breathing pattern, which slows down and becomes abdominal. At the same time, it induces low-frequency brain waves, with a predominance of alpha waves during meditation, transitioning to theta waves at the end [118]. In addition, a significant reduction in cortisol and adrenocorticotropic hormone (ACTH) levels has been found [119]. In this context of stress reduction, a theoretical model is proposed in which yoga, by reducing sympathetic tone and enhancing parasympathetic tone, favours efficient emotional regulation [120].

In parallel, under this activation reduction approach, yoga promotes an expanded state of consciousness. The state of consciousness is intimately linked to attention, which makes it possible to propose that the practice of yoga improves attentional efficiency. In order to explore possible effective therapeutic alternatives for ADHD, a randomised controlled trial was conducted, contrasting yoga training with neurofeedback training, and also incorporating a wait-list control group. This study assessed sustained attention and attentional span in children diagnosed with ADHD, aged between seven and eleven years. The findings revealed that both alternatives produced a significant effect, with a large effect size on both attentional dimensions compared to the wait-list control [121]. The recommendation of yoga for children diagnosed with ADHD in school and out-of-school settings is the conclusion of a study crediting that the practice in ten-year-olds led to significant improvements in selective, sustained attention and resistance to distracting interference compared to a control group. These improvements were evident with medium to large effect sizes [122]. In a similar vein, another study in children aged six to eight years compares an eight-week yoga intervention with a control group. The results of the study show how the intervention significantly improves emotional regulation and ADHD symptoms in the experimental group compared to the control, which prevailed at the follow-up assessment [123].

In this chapter, we highlight the uniqueness and relevance of autogenic meditation. In contrast to other contemplative practices that have been adapted to fit into the Western worldview, this meditation emerges directly from the Western rational-scientific perspective. It is the legacy of Johannes Heinrich Schultz, a visionary German neuropsychiatrist, who in 1932 introduced the world to this methodology through his revelatory work ‘Das Autogene Training-Konzentrative Selbstentspannung’ (Autogenic Training-Concentrative Self-relaxation) [124]. Beyond presenting a secular meditative practice of a medical-scientific nature, this method lays the theoretical foundations for a new paradigm in twentieth-century psychotherapy, known as autogenic psychotherapy. In addition to standard and advanced autogenic meditation, autogenic psychotherapy includes a wide range of psychophysiologically oriented approaches. Unlike other medical or psychological forms of treatment, this therapeutic arsenal has the peculiarity of involving both mind and body simultaneously, with autogenic meditation as its core and starting point [125]. Clinical applications cover a broad spectrum, with particular relevance to stress disorders and psychosomatic conditions [125, 126, 127, 128, 129]. Non-clinical applications include the enhancement of well-being and psychophysical performance [126, 130].

The term ‘autogenic’, meaning self-generated, refers to two key therapeutic aspects. From a neuropsychophysiological point of view, it refers to the self-induced transition to the autogenic state that stimulates homeostatic, restorative and self-normalising self-regulatory processes [125]. From the locus of the control point of view, it emphasises the active role of the individual in his or her own training or treatment. Autogenic meditation comprises six exercises, formulas, or dual meditation anchors meticulously designed to access a specific expanded state of consciousness that activates self-regulatory technical keys not normally accessible to the non-practitioner. The exercises are: 1. Weight. 2. Warmth. 3. Cardiac regulation. 4. Breathing regulation. 5. Solar plexus regulation and 6. Fresh forehead. For a detailed explanation of the method, a protocol of autogenic group meditation, adapted for children and adolescents, is freely available [131]. In order to gain a better understanding of autogenic meditation, it is also recommended to read the work of González de Rivera [132].

It is essential to recognise that there are currently two predominant interpretations of the autogenic method: the autosuggestive and the meditative approaches. This is unsurprising, as both are the fundamental antecedents. These perspectives are relevant and effective. However, from its origin, the method is deeply anchored in meditative practice. For illustrative purposes and without entering into an interesting debate, two quotations from its creator are enough to support the tendency we are presenting here. Schultz affirmed: ‘There is an approximation and even coincidence between many aspects of the mystical and millenary tradition of Buddhism and the scientific-organismic attitude represented by autogenic training’ ([130], p. 213). He further emphasised that: ‘We have repeatedly pointed out that our technique does not consist of measures of a suggestive nature, and that it consists primarily of an exercise of concentration. There is in no way a forced relationship between autosuggestion and autogenic training’ ([130], p. 206). It is imperative to understand that while both approaches are valid, they involve different perspectives and instructions, which may result in variations in efficacy and effects. This issue is especially relevant in the education or training of attention at hand, where results may diverge.

Almost a century after the origin of autogenic training through concentrative relaxation, a contemporary explanation of the standard training, framed as autogenic meditation, is presented. It is important to note that under the original labels of ‘passive concentration and passive acceptance’, the practice of autogenic meditation involves the two attentional skills elucidated in current contemplative science: Focused Attention Meditation (FAM) and Open Monitoring of attention (OM) [2]. Autogenic meditation facilitates an expanded state of consciousness by exercising FAM or ‘passive concentration’ on six specific formulas or dual meditation objects. The uniqueness of FAM in autogenic meditation is that it combines in a single meditative act a meditation object that is simultaneously mental and bodily. The practitioner activates FAM by using subvocal repetition of the corresponding formula (e.g., my heart beats) while focusing attention on the mental meditation object (the idiosyncratic representation of the beating heart). Simultaneously, the practitioner focuses attention on the concurrent physiological-somatic sensations (heartbeat), the bodily object of meditation.

This process of conscious interaction allows a harmonious bridge between mind and body, integrating two perspectives of the same experience, the mental representations and their bodily correlates. Two information processing pathways converge: a semantic pathway that gives access to psychological or personal meaning and a somatic pathway that gives access to spatial information, the body schema and the proprioception of the internal physiology. This sign is unique, to the authors’ knowledge, there is no dual meditation in six anchors. As practitioners hone their FAM skill on these synchronous dual objects, an Open Monitoring of attention (OM) capability surfaces. This favours a non-reactive meta-attention or an equanimous, ‘passive acceptance’ of the phenomena occurring in the field of consciousness, paving the way for meta-consciousness. It is interesting how this practice that begins with a dual perspective progressively leads to a unified state of consciousness. The meditator in his or her mind-body conscious attentional space transcends from a dual state to a non-dual state in harmony. Through autogenic meditation, the practitioner blurs and overcomes the intangible boundaries between mind and body, bringing about an awakening to the autogenic self. This is the essence of autogenic experiential learning. The autogenic meditation learning process is presented in Table 1.

Dual synchronous meditative attentional focusing
Formulas: mind-body integration exercises	Mental meditation object representation	Body meditation object awareness
I. Weight	My arm-arms-neck-legs-body (is-are) heavy	Body mass
II. Warmth	My arm-arms-neck-legs-body (is-are) warm	Body temperature
III. Heart	My heart beats	Heartbeats
IV. Breathing	My breathing is	Respiratory flow
V. Solar plexus	My abdomen is pleasantly warm	Surrounding area of abdominal organs
VI. Forehead	My forehead is pleasantly fresh, and my mind is lucid	Frontal cephalic region

Table 1.

Autogenic meditation learning process.

The representation of the mental meditation object is idiosyncratic and may be acoustic or visual, among other modalities. The body meditation object involves physiological-somatic awareness. Note 1: In addition to the dual meditative attentional focus (DMAF), as the process progresses, open monitoring of attention (OM) begins to develop progressively, which is usually noticeable from formula VI onwards. Note 2: In combination with each formula, the rest formula can be introduced: “I am calm”, which represents a cross-sectional value of calm during meditation training. The recommended ratio is 6:1, i.e., six repetitions of the corresponding formula to one repetition of the rest formula.

Although the autogenic state is predominantly calm and pleasant and often confers a pronounced sense of egosyntonic peace, it possesses a singular phenomenon termed: ‘discharge’. This allows the release of physical or psychological tensions. Such therapeutic effect is elicited by the self-regulating homeostatic processes activated by the brain during the autogenic state. Manifestations can range from muscle twitching, eyelid vibration, lacrimation and release of somatosensory or cognitive experiences, among others. These experiences, which are almost always neutralised naturally, are a sign of progression. Furthermore, if necessary, as the creator of autogenic therapy, Luhte, taught, an opportunity for psychotherapy arises from it by means of specific methods, which must inevitably be dealt with by a specialised psychologist or psychiatrist [125, 133, 134].

Once the autogenic meditation has been presented, it is relevant to frame it within the context of ‘state training’ or effortless attention training. These trainings develop a non-stressful attention state of parasympathetic dominance, facilitating an optimal level of attentional effort [6, 58, 59, 60]. The autogenic state has been defined in terms of ‘relaxed alertness’ [135], which simultaneously indicates a state of relaxation and optimal cognitive performance.

Neurophysiological changes accompanying the autogenic state include a reduction in heart rate, vagal tone and salivary amylase levels [136, 137], regulation of blood pressure [138] and an increase in muscle distension and peripheral vasodilatation [130, 139]. A reduction in reticulo-cortical and thalamo-cortical activity is also observed, as well as immediate changes in structures connected to the reticular formation, such as the hypothalamus, cerebellum and limbic system, among others [139]. Regarding the brain wave pattern, EEGs show a predominance of theta and alpha waves [140]. Furthermore, research has identified a synchronisation between cardiac coherence and alpha waves during the autogenic state, indicating a harmonisation between the heart and brain [141, 142]. Overall, the evidence shows a state of self-regulation involving synergistic cooperation between the autonomic and central nervous systems [2]. Regarding the autonomic nervous system, this complementary and reciprocal cooperation is predominantly manifested as an increase in parasympathetic activation and a decrease in sympathetic activation [143, 144, 145]. It is noteworthy to underline that autogenic meditation goes beyond relaxation, as it allows the exercise of voluntary control of involuntary functions of the autonomic nervous system.

The neurophysiological profile, characteristic of the autogenic state, decreases stress reactivity and facilitates an optimal level of response [144]. In agreement with this assessment, the renowned endocrinologist Hans Selye pointed out in the foreword of the manual: ‘Introductory Workshop on Autogenic Therapy Methods’ that autogenic meditation unfolds a response diametrically opposed to that provoked by stress [146], underlining its relevance for holistic well-being. This has been corroborated in meta-analysis studies and systematic reviews on the efficacy of autogenic meditation in regulating stress and anxiety in both clinical and non-clinical populations [126, 127, 128]. In addition, this research also highlights its potential for well-being [126], depressive symptomatology and increasing cardiac variability [127].

It is evident that the autogenic state achieved through a serene attention education based on FAM and OM skills fully coincides with that delineated for less effortful attentional training. However, despite theoretical postulations in specialised manuals for children and adult populations suggesting attentional improvement [130, 147], empirical research in this area remains limited.

One of the pioneering research studies in the field involves five experiments in different age cohorts [148]. The first study focused on schoolchildren between the ages of eight and ten. Subsequent studies, from the second to the fourth, included young university students with average ages between twenty-two and twenty-three years. Finally, the fifth study focused on older adults, with an average age of seventy-two years. The first experiment compared a group assigned to a single guided session based on some autogenic FAM anchors (weight, warmth, breath and calm) of ten minutes with another group with a silent break of equivalent duration. Subjects were tested pre- and immediately after the experiment finished on their attentional span, verbal fluency and general intelligence. Results indicated significant improvements with a large effect size in attentional span and verbal fluency, but no improvement in general intelligence in the guided meditation group and no significant change in the control. The second experiment, similar in design to the first, replaced the intelligence test with a measure of selective and sustained attention or concentration. The results showed a similar pattern to the previous experiment, with significant changes and large, though slightly attenuated, effect sizes. In addition, concentration improved significantly, with a quasi-large effect size. The third experiment also focused on university students but had a variation in design, as half of the participants had at least six months of experience in autogenic meditation. The same test battery was used as in the previous experiment, comparing efficacy with a control condition that rested for ten minutes. The results showed significant changes with large effect sizes on all measures exclusive to the autogenic meditation group. Notably, Cohen’s d nearly doubled in magnitude from the previous experiment. The fourth experiment, which also involved university students and used the same test battery, had the peculiarity that, although all participants had experience in autogenic meditation, some were asked to practise just before the final assessment, and others were asked to listen to their favourite music selected beforehand. It is relevant to note that in the initial assessment, all participants obtained high scores compared to their normative groups. The results of the trial showed a significant improvement with large effect sizes in attentional span and concentration only for the group that practised autogenic meditation. This was not the case for verbal fluency; although the improvement was not significant in either group, it was better in the music rest group. Finally, the fifth experiment replicated the previous trial in older adults skilled in autogenic meditation and used relaxing music in the control condition. Although baseline scores on all tests were lower compared to undergraduates, those who meditated showed significant improvements in attentional span and concentration, with a medium effect size. In summary, the five experiments presented here show remarkable attentional change at different developmental stages due to autogenic meditation, highlighting childhood and youth as sensitive periods of attentional plasticity.

The following are several studies that, although they do not use an objective test of attention, require optimal attentional performance and have a transfer to academic performance. Following this line of research, the impact of autogenic meditation on the correction of spelling errors was examined. The trial included 399 schoolchildren with an average age of eleven years. The experimental task consisted of a classroom dictation followed by a correction phase. Those pupils who had been trained in abbreviated autogenic meditation (focusing on the first two formulas) practised meditation for four minutes. Simultaneously, the students in the control group rested with their eyes closed. At the end of this period, both groups had the opportunity to review and correct their dictations. This procedure was repeated on three different occasions during the course. The findings revealed that the autogenic meditation group showed significant improvements in error correction and obtained higher scores compared to the control group. Conversely, the control group also showed significantly fewer correct corrections and more incorrect revisions, with their academic performance worsening after the possibility of correction [149].

Expanding upon the previous line of research, a study analysed the efficacy of autogenic meditation in schoolchildren with reading disabilities. The efficacy of a specific intervention programme for this problem was compared with another programme that included an autogenic meditation module in addition to the programme. The duration of the interventions was one year. The findings highlighted that the participants in the combined programme showed a significant reduction in reading and writing errors, as well as in anxiety, neuroticism and increased extroversion compared to the standard intervention. The study attributes the efficacy to the increased concentration and decreased anxiety acquired with autogenic meditation [150].

More specifically, aligned with the central topic of this chapter—Effortless attention trainings and its intersection with mental health—the authors of this work and their team conducted a recent randomised controlled trial entitled: ‘Autogenic meditation: a framework for promoting mental health and attention regulation in children’ [2]. The uniqueness of this study lies in its multifaceted and comprehensive approach, investigating not only attention but also state and trait anxiety, and a screening of mental health. The study compared the efficacy of a 12-week autogenic meditation training programme with two controls, one active based on reading training and value orientation with equivalent duration and implementation, and one passive, wait-list condition. The findings were revealing. Following the interventions, participants in the meditation programme raised their selective and sustained attention prominently, manifesting significant changes with large effect sizes. Moreover, not only their state anxiety was significantly reduced, but also their trait anxiety, and in both cases with large effect sizes. These findings suggest in the first case that attention is exercised with a lower level of arousal, facilitating an optimal degree of effort, and in the second case it indicates that this capacity for anxiety regulation extends its reach to different situations of daily life, where children respond less reactively to life events, generating an upward state-trait spiral of calmness that promotes a disposition to be calm and attend serenely. The research also shows in mental health screening that meditators increased their ability to self-regulate emotionally, manage behavioural problems and regulate peer problems, as well as hyperactive-inattentive spectrum symptoms. All these significant changes were shown with large effect sizes. In contrast, controls showed no significant effects.

As can be seen, beyond attention, or more precisely in connection with it, autogenic meditation aims to be a multilevel self-regulation strategy: emotional, cognitive, behavioural and neurophysiological. It is a law of life that young people face challenges, cope with change and deal with stressors of various kinds. An important question is whether autogenic meditation is effective when these difficulties overwhelm their resources and break their psychophysical equilibrium. In this context of distress, one study evaluated the efficacy of autogenic meditation as a single treatment in a sample of adolescents aged seventeen years on average with a diagnosis of adjustment disorder (F 43.2, in accordance with ICD 10) [151]. Specifically, the aim of this research was to determine the therapeutic efficacy of an autogenic meditation training programme through biophysical and biochemical indicators assessed at baseline, completion and six-month follow-up. Results indicated a significant reduction in arterial systolic and diastolic blood pressure, brachial pulse rate, cortisol and blood cholesterol levels after completion of the training, which were maintained at the six-month follow-up assessment. The findings suggest that autogenic meditation is a potential resource for reducing distress, recovery and coping with adaptive challenges. In short, it is a strategy that is not only exclusively promotive but also therapeutic for psychophysical health.

The capacity for emotional and behavioural self-regulation was also explored in an intervention based on autogenic meditation lasting only four hours compared to passive control. The selected sample consisted of children and adolescents aged six to fifteen years with mild or subclinical internalising and some externalising symptoms such as aggression, impulsivity and attention deficit. Following the intervention, a significant decrease in symptoms was observed in the group that practised autogenic meditation. Although the effect size was small, the research concludes that even a minimal four-hour dose of this meditation has broad-spectrum mental health benefits and recommends its implementation in primary care for children and adolescents with subclinical mental health symptoms [152].

It is important to know whether autogenic meditation promotes, alongside emotional regulation, changes in character that can contribute to a balanced and healthy development in young people. This was the purpose of research that scrutinised two mind-body integration techniques. Specifically, the study compared the efficacy of an autogenic meditation intervention and a mindfulness-based meditation intervention, both with an equivalent implementation of eight weeks. The sample consisted of healthy young people with an average age of seventeen years. The study evaluated three-character traits as outlined by Cloninger’s personality model—self-determination, cooperation and transcendence—and also incorporated a mental health screening. At the conclusion of the trainings, the results indicated a significant increase in the trait of self-determination only for the participants of the autogenic meditation programme. In addition, a significant increase in the trait of cooperativeness was observed for participants of both meditation practices. The mental health screening showed a significant increase in emotional self-regulation, which supported the efficacy of both meditation programmes. Emotional self-regulation, in turn, showed a correlation with cooperativeness [153]. What is most remarkable about the study is that there were changes in personality traits. That is, stable and consistent increases in self-determination, a trait linked to autonomy and trust exclusively in the autogenic meditation group. Also, cooperativeness, a trait that entails acceptance and compassion, improved for participants in both interventions.

The trait findings cited above, coupled with the observed increases in extroversion and reductions in neuroticism and trait anxiety [2, 150], suggest that autogenic meditation induces profound characterological modifications in an individual’s personality structure essential for fostering adaptability and strengthening mental health. In tandem with these traits, the emerging body of evidence found in the sphere of emotional, cognitive and behavioural self-regulation highlights autogenic meditation as a tool that empowers children and young people towards a calm and fulfilling life, where the meditator is a proactive architect of his or her own well-being and mental health.

In addition, it is worth noting that autogenic meditation is one of the most convenient and simplest forms of meditation practice. Its secular nature, the ergonomics of its posture, its sequential learning, the dual focus of concentration on six easily or naturally accessible synchronous meditative anchors, the short periods of practice, its immediate calming effect and most importantly, the fact that only oneself is needed, are reasons that position it as a highly recommended choice. Considering that it is inherently anchored and supported by a psychotherapy approach, it is not only recommended for children and young people but also for mental health professionals who may find in its clinical practice and application an effective tool and response to mental health problems, even more profound than the one addressed in this preliminary instance. While the findings presented are encouraging, and reveal that autogenic meditation has the potential to be a shining beacon on the vast horizon of mental health, research must continue and further studies are needed to establish more robust conclusions in both clinical and paraclinical contexts.

4. Conclusion

In this chapter, it is concluded that emerging evidence supports the capacity of less effortful attentional training to enhance attentional performance and its concurrent role in the sphere of emotional, cognitive and behavioural self-regulation among child and adolescent populations. As highlighted in the introduction, the statement ‘You are what you pay attention to’ remains pertinent. This allegory is a profound truth about identity and existence. In the act of attending, the individual selects not only what to perceive but also what to be. The sum of attentional states will configure the future identity. Therefore, every act of attention is an opportunity to mould who we will be tomorrow. Attention is intimately linked to all cognitive processes, emotions and behaviour. It is in how one pays attention that the virtue of exercising the conscious self resides, so rather than proposing mere training, one should consider talking about educating attention. Educating attention in a serene and conscious state of mind favours self-regulation in the present and, as James rightly pointed out, sculpts the seed of future character. The preliminary evidence presented in this chapter on attention, anxiety, stress, well-being and personality traits supports this position, although future research should explore this topic further.

Focusing on the present day, one must not end this chapter without reflecting on our contemporary twenty-first century, its circumstances and the fundamental role of child and youth mental health. The influence of digital environments, multi-stimulant devices, online omnipresence and multitasking as predominant lifestyles must be given attention and a watchful eye. In addition to the above, we must consider that we live in a volatile, changing, complex, ambiguous and not always friendly world, so methods that empower children and young people in serenity, psychophysical balance and daily stress management are undoubtedly welcome. The confluence between attention and health is a novel topic that transcends the cognitive approach towards an educational and psychotherapeutic approach. Exposure to nature and meditative practice invites reflection on the appropriateness of mind-body integration in the mental health landscape. Hence, understanding the person and, therefore, children and young people from a holistic perspective is a challenge in the realm of health and well-being. The appropriateness of these less effortful attention approaches in the areas of education, psychotherapy and mental health opens up a new opportunity for the full development of children and young people who are at a peak period of attentional plasticity. Ultimately, this chapter highlights the relevance of educating attention to promote a more fulfilling childhood and adolescence. In the twenty-first century context, it’s essential to emphasise that those who best educate their attention will be better prepared to face and successfully adapt to future challenges.

Conflict of interest

The authors declare no conflict of interest.