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Mindfulness apps for kids

In this installment of “Let's Get Technical,” our panel of


experts review three apps for children.

By Nicole Owings-Fonner, MA

April 2020

Can a mobile app help children develop the skills they need to become more resilient, increase
their well-being or bring calm to their lives? Our panel of experts review three apps for children
that claim to do just that.
For each app, we provide guidance on several background factors practitioners should consider
when selecting mobile apps for children. Next our panel of psychologists rates and reviews three
top apps for children: Breathe, Think, Do with Sesame; Smiling Mind; and Mindful Powers.
*The following mobile apps are not billed as a mental health apps nor are they designed to be
used for symptom reduction.

Review Ratings
Breathe, READ
REVIEW
5
★★★★★
Think, Do 5
★★★★★
with
Sesame
Review Ratings
Smiling READ
REVIEW
5
★★★★★
Mind 5
★★★★★

Review Ratings
Mindful READ
REVIEW
4
★★★★☆
Powers 3
★★★☆☆

Many apps collect data and aggregate it for, among


other things, use by researchers. Before
incorporating an app in treatment, psychologists
may want to consult with their attorney or
malpractice carrier’s legal consultation service and
implement any recommended informed consent
strategies to permit the data sharing aspects of these
apps under the Health Insurance Portability and
Accountability Act (HIPAA).
—Kevin D. Arnold, PhD, ABPP

Breathe, Think, Do with Sesame


Breathe, Think, Do with Sesame is a free interactive app for
children ages 2 to 5 and their parents that aims to help children
build resilience through practicing problem-solving skills. The app
teaches a three-step method: “Take a deep breath, think about
what to do next, and give the solution a try.” Using touch screen
technology, children are encouraged to help a friendly monster take
deep breaths, think of plans and try them out to get through a
challenging situation. The app also provides tips and strategies for
parents on patience, overcoming mistakes and more, as well as
curriculum guides, songs and videos.

Overall Review Ratings

5 5
★★★★★ ★★★★★
—JoAnna Romero Cartaya, PhD —Charmain F. Jackman, PhD

Background Ratings

PRIVACY/SECURITY
4 ★★★★☆
Features an easy to understand but potentially out-of-date privacy policy. The app does
not require users to submit any personal data and does not use any behavioral
advertising. Anonymous usage tracking is conducted to perform analytics and improve
the app. Users do not need to set up an account to use the app.

EVIDENCE BASE FOR THE APP


4 ★★★★☆
A compared intervention study of the Little Children, Big Challenges: Resilience project
that included the Breathe, Think, Do with Sesame strategy, but not the app itself, found a
variety of positive growth in children’s emotional and social functioning such as
increases in children’s ability to resolve conflicts constructively, persevere and identify
and manage emotions.
USER FEEDBACK
4 ★★★★☆
Around 1,200 reviews averaging 4/5 stars. When it functions well, it gets high ratings.
The biggest complaints are that the app can freeze and that its audio stops working. An
update was published in November 2019 purporting to address these issues.

Panelist Ratings and Comments — JoAnna


Romero Cartaya, PhD
Breathe, Think, Do with Sesame is a well-done, inviting, colorfully animated free
interactive application which engages young children and their parents/caregivers
to learn adaptive coping strategies through a mindfulness approach to increase
resiliency and socioemotional wellness. In practice, I recommend asking
parents/caregivers to use it with their child daily for 3 to 5 minutes to begin
teaching and learning the strategy and then encourage using the mindfulness
approach in real time with a challenging situation for their child together either
with the app or using the approach together, or even with a stuffed animal.
—JoAnna Romero Cartaya, PhD

PURPOSE
5 ★★★★★
This interactive app does a great job in assisting children to build resiliency by engaging
in a mindfulness exercise and active problem-solving when they encounter challenging
situations and/or emotions. It also offers the opportunity for caregivers to provide
supportive statements and help identify emotions and teaches children to ask for help
when needed from a responsive adult.

APPROPRIATENESS OF CONTENT
5 ★★★★★
Content within the app is geared to ages 2 through 8 and provides examples of common
challenging situations that children encounter within this age range. It is part of the Little
Children, Big Challenges initiative and included researchers and educators with a vision
to assist children in building resiliency and social emotional development.

CULTURAL RESPONSIVENESS
4 ★★★★☆
The gender of the monster and family members are ambiguous to appeal to various
cultural and diverse backgrounds. However, there are no examples of children who have
disabilities or assistive devices. The app is available in Spanish and English.

EASE OF USE
4 ★★★★☆
The app is easy to navigate and straight forward. Children and adults can record their
voices saying phrases that are then used within the app. No other customization is
available.

FUNCTIONALITY
5 ★★★★★
Breathe, Think, Do with Sesame needs a strong Wi-Fi connection to download; however,
once downloaded the app will work well without internet and all content from the
resource library also works well without an internet connection.

Panelist Ratings and Comments — Charmain F.


Jackman, PhD
The Breathe, Think, Do with Sesame app provides an easy way for caregivers
and teachers to teach breathing and problem-solving skills to young children.
Even though it is designed for children up to age 5, my 7-year-old child enjoyed
the app very much. The app and additional resources are great resources for
caregivers. The app has five scenarios that deal with an issue that would frustrate
and anger a pre-school child. Each scenario has three possible solutions, which
gives a total of 15 solutions. I worry that children may become bored with the app
quickly. So, parents will want to think about ways to combine the app with the additional
resources to extend interest in the app.
—Charmain F. Jackman, PhD

PURPOSE
4 ★★★★☆
The Breathe, Think, Do Sesame app was designed to build resilience in young children
by teaching them, along with their parents, how to calm down and solve everyday
problems that come up. The three-step strategy/intervention requires children and
parents to work together to practice. If caregivers are consistent in teaching and
reinforcing the skills when the computer is not available, I think that it can build those
skills for children.

APPROPRIATENESS OF CONTENT
5 ★★★★★
The content is child-friendly and engaging. It provides clear and interactive ways for
children to practice breathing and to think of solutions to typical problems they face,
such as taking turns or fears at bedtime. The curriculum is well researched, developed
by experts in several fields such as child development, psychology and social work. The
strength of the app is in the supplemental resources, including curricula, videos and
songs.

CULTURAL RESPONSIVENESS
4 ★★★★☆
The app is available in English and Spanish. No closed captions are available. The main
character is a monster who uses he/him/his pronouns. The videos show children from a
range of cultural backgrounds.

EASE OF USE
5 ★★★★★
The app developers understand this age group well. The verbal instructions are clear,
and it is easy to navigate particularly for children who are digital natives. It can be fun for
children and caregivers to record their voices for the app and then hear them played
back when the monster is thinking of a solution.

FUNCTIONALITY
5 ★★★★★
The app works well and there were no technical difficulties.

Smiling Mind
Smiling Mind is an Australian nonprofit offering mindfulness and
meditation programs for all ages. To achieve their purpose —
equipping young people with the integral skills they need to thrive
in life — the organization offers free comprehensive programs
geared specifically toward different populations, including adults,
youth, family, classroom and workplace individuals and groups.
Their program can be used as an app or from a computer. While
they do have a couple of modules for children age 3 and older, a
wider variety of options is available for those over age 7. The
application is based on empirical research from multiple disciplines
and provides information, learning, tools, and content to engage in
a daily mindful practice.

Overall Review Ratings

5 5
★★★★★ ★★★★★
—JoAnna Romero Cartaya, PhD —Mary O'Leary Wiley, PhD, ABPP

Background Ratings
PRIVACY/SECURITY
4 ★★★★☆
This app features an updated privacy policy that describes common usage tracking to
personalize services and to perform analytics for app improvement and marketing.
Users must create an account to use the app. The app notifies users when personal
data is collected and there are opt-out procedures.

EVIDENCE BASE FOR THE APP


4 ★★★★☆
The app was developed with input from peer-reviewed journals from multiple disciplines
including medicine and psychology. The evidence-based guidelines of their programing
and curriculum and internal research report is available online and from the app.
Research with schools to evaluate the interventions across age ranges is ongoing.
However, no specific research on the app alone could be found.

USER FEEDBACK
4 ★★★★☆
Around 3,000 reviews in the United States averaging 4.3/5 stars. Most users are very
pleased with this app. Reviewers describing issues with log in and other functions were
contacted by the Smiling Mind support team and a fix seems to have been rolled out in
January 2020 addressing most of the reported function issues.

Panelist Ratings and Comments — JoAnna


Romero Cartaya, PhD
I would recommend this application to other psychologists given its applicability to
a wide range of users in terms of age and environments (e.g. school, workplace).
I like that it provides meditations that are developmentally appropriate — fun,
engaging and creative for young and school-aged children and teens on a wide
variety of topics and situations to keep users engaged. The app also provides
guides for parents and caregivers. The app is free, which makes it easier to
recommend to clients. Although aesthetically not as beautiful as some of the
meditation apps out there — it makes up for it and then some with the extremely well-developed,
thoughtful, creative and evidence-based content without the unnecessary or distracting frills. I
would ask clients (i.e. child, teen, and caregiver/parents) to use this app regularly to establish a
mediation practice (app recommends 10 minutes a day).
—JoAnna Romero Cartaya, PhD

PURPOSE
5 ★★★★★
Smiling Mind fulfills its vision to make mindfulness meditation available to everyone —
lifelong, across the world and without limits to socioeconomic status by providing free
meditations that are developmentally appropriate — fun, engaging, and creative. In
addition, the app provides guides for parents and caregivers as well as options for use
within schools and a selection of workplace meditations.

APPROPRIATENESS OF CONTENT
5 ★★★★★
The content is very appropriate for each age range and provides a variety of
mindfulness exercises and meditations for establishing a regular mindfulness meditation
practice. It was developed with specific input from empirically and peer reviewed
journals from multiple disciplines including medicine and psychology. Psychologists were
also highly involved in the development of the app as well as the curriculum and vision
for Smiling Mind.

CULTURAL RESPONSIVENESS
4 ★★★★☆
The application has considered multiple aspects of diversity and inclusion in their
programing for Australia and development of the application itself. It is currently
available in limited modules and sessions in multiple Australian Aboriginal languages.
There is no current research on the implementation of this application with U.S.
populations.

EASE OF USE
5 ★★★★★
The app is very easy to navigate with options to choose one program or many and to
jump between programs on mindfulness. Users can easily set a scheduled reminder as
well as mark items as favorites.

FUNCTIONALITY
5 ★★★★★
The app performs well. It does need internet initially to download the app and any
meditations to use when not connected to the internet.

Panelist Ratings and Comments — Mary


O'Leary Wiley, PhD, ABPP
I highly recommend Smiling Mind. It is a thorough, well designed mindfulness
meditation app that is amazingly adaptable to individuals, groups and families. It
also works effectively with different age ranges, and with individuals and groups. I
haven’t seen anything with this sophisticated curriculum for the classroom, from
preschool through senior high school and adult. I will be using this with clients!
—Mary O'Leary Wiley, PhD, ABPP

PURPOSE
5 ★★★★★
Smiling Mind is a mindfulness meditation app that includes a variety of resources
designed to assist people in dealing with the pressure, stress and challenges of daily
life. It is highly likely to do just that as the proposed interventions are very impressive
and are likely to result in positive outcomes related to mindfulness meditation as
evidenced in previous research on the topic.

APPROPRIATENESS OF CONTENT
5 ★★★★★
It is very clear that the developers are highly knowledgeable in developmental
psychology, mindfulness philosophy and mindfulness practice. The content is
exceptionally appropriate for the settings and age groups indicated in the program.

CULTURAL RESPONSIVENESS
★★★★☆
The audio recordings feature Australian accents and modules are available in three
indigenous languages. There do not appear to be specific programs addressing cultural
issues related to American populations beyond age (which is done very well). Gender
designation in the user profile does offer a non-binary option. Children or adults with
different ability levels could easily use modules designed for lower or higher age groups
in order to tailor the program to specific needs.

EASE OF USE
5 ★★★★★
Smiling Mind is clearly laid out and easy to navigate. The software works effectively, and
the audio material uploads quickly and smoothly. The only limitation to this program is
that there are so many wonderful modules and lessons geared toward different age
groups and settings that can be difficult to know where to start. This limitation is quickly
compensated for, however, by trying a few of the modules (for example, parent versus
adult).

FUNCTIONALITY
4 ★★★★☆
The app functions well, although internet service is required to access it. The program
tracks the number of minutes spent in each module, so it is easy for users to see what
they have done and what modules are remaining. It is easy to navigate between
modules, so adults can work on some themselves while still completing various modules
with children and family.

Mindful Powers
Mindful Powers is an app designed for children ages 7 to 10 to build social-emotional learning
through play. Through a series of interactive, voice-guided sessions (meditations) children learn
to master mindfulness so they calm their thoughts and improve focus. The app also has a focus
timer so children can set a specified amount of time to concentrate on a given task. Three of the
10 available sessions are free. The package of remaining sessions is $4.99.
Overall Review Ratings

4 3
★★★★☆ ★★★☆☆
—Charmain F. Jackman, PhD —Kevin D. Arnold, PhD, ABPP

Background Ratings
PRIVACY/SECURITY
3 ★★★☆☆
Features an easy to understand, up-to-date privacy policy. Users do not need to set up
an account. The app does not require users to submit any personal data; however, the
app uses tracking to perform analytics, improve the app and for research purposes. No
information on data security was provided.

EVIDENCE BASE FOR THE APP


3 ★★★☆☆
While there have been no academic studies of the app nor research on its capacity to
translate the outcomes of ACT and mindfulness strategies through technology, the
content is very true to mindfulness as found in treatment protocol such as Acceptance
and Commitment Therapy or the Unified Treatment Protocol.

USER FEEDBACK
4 ★★★★☆
Between 80 and 100 reviews in the United States averaging 4.1/5 stars. Most users are
very pleased with this app. The app developers regularly respond to user reviews to
assist with any reported issues.
Panelist Ratings and Comments — Charmain F.
Jackman, PhD
Mindful Powers is a well-designed app that provides accurate information about
mindfulness strategies for children, while also engaging them through play. I
especially liked that the app is able to detect whether a child is rushing or being
too rough and its ability to provide feedback to children to slow down or to be
more gentle. The app is based on Acceptance and Commitment Therapy and is
also grounded in mindfulness/stress reduction and child development. As a
result, I would definitely recommend it to other psychologists. I could easily see
myself using the app in-session with clients to teach and reinforce skills around breathing and
mindfulness. Designing an app that appeals to both children and caregivers is not an easy feat,
and I applaud Mindful Powers in their effort to think about parents. The major drawback is that
the app is only available in English.
—Charmain F. Jackman, PhD

PURPOSE
5 ★★★★★
Mindful Powers prides itself as a “kid-tested” product that teaches social-emotional
learning through the power of play. The intervention uses play to teach early elementary
and middle school children mindfulness strategies to bring calm to their lives. The way
that the app is designed, children can successfully learn skills to help with breathing,
mindfulness and focus.

APPROPRIATENESS OF CONTENT
4 ★★★★☆
The “lessons” provide clear and appropriate explanations of mindfulness and meditation
in language that is engaging and easy for children to understand. Some lessons are
long (i.e., 10 minutes) and, depending on the child’s age, an adult may need to
breakdown some of the concepts to ensure that a child fully understands them. The app
is based on Acceptance and Commitment Therapy and was developed in consultation
with a clinical psychologist.

CULTURAL RESPONSIVENESS
2 ★★☆☆☆
The app is only available in English. There is only one voice; while soothing, it may not
appeal to all listeners.

EASE OF USE
5 ★★★★★
The app is very easy to navigate. There are on-screen instructions that give feedback
when soothing the character. Other incentives help students stay interested. Users must
complete each lesson before unlocking the next lesson/level, which can keep up
curiosity and is consistent with many video games.
FUNCTIONALITY
5 ★★★★★
The app works well and did not exhibit any challenges. It does require the internet to
work.

Panelist Ratings and Comments — Kevin D.


Arnold, PhD, ABPP
Mindful Powers can be moderately recommended for children, perhaps a bit older
than the 7 to 10-year-old range, who are from socio-cultural groups that will
identify with the metaphors and language used in the narrations. However, there
are several caveats to that recommendation. As a psychologist working in a
pediatrician’s office, I would not use the app because of its:

Rigid requirement to matriculate through each lesson before the next skill is provided.
Repetitive use of the smoothing and petting functions for the app character before accessing
the lessons.
Lack of any replicated studies or adequate scientific evidence of its capacity to translate the
outcomes of Acceptance and Commitment Therapy and mindfulness strategies through
technology.

It is not clear that Mindful Powers provides any better, or even similar clinical outcomes to its
alternatives, such as the Unified Treatment Protocol designed for use with for children.
— Kevin D. Arnold, PhD, ABPP

PURPOSE
4 ★★★★☆
Mindful Powers intends to teach mindfulness skills employed in Acceptance and
Commitment Therapy to children, claiming that mindfulness can change brain functions,
reduce the size of the limbic system, and build more effective stress-management skills.
Producing the intended impacts likely depends on the consistent practice of the
exercises. Since no adjunctive, structured parent-implemented reward system is a part
of the program, a potential flaw is the need for practice to maximize benefits without
adequately building rewards for the sometimes long (over 10 minutes) lessons.

APPROPRIATENESS OF CONTENT
3 ★★★☆☆
Mindful Powers was developed in consultation with a clinical psychologist and the
content is very true to mindfulness as found in treatment protocol such as Acceptance
and Commitment Therapy or the Unified Treatment Protocol. In contrast, there are likely
some questions about the appropriateness of the content for children ages 7 to 10 as
the language itself may exceed the developmental levels of those ages in some parts of
the lessons inside the app. Several of the non-oral prompts that appear as words on the
screen are negative and do not prompt users to alternative behaviors. Prompts like
those likely are not appropriate for young children, unless the intent is to reprimand
them.
CULTURAL RESPONSIVENESS
3 ★★★☆☆
The app’s use of a genderless creature, the Flibbertigibbet, and a cat as a metaphoric
representative of the listener, is likely to appeal to people from different cultural
backgrounds. It is only available in English. The vernacular and assumption of more
normative emotional experiences does not appear to contain sensitivity to children from
impoverished backgrounds or to those who have been exposed to Adverse Childhood
Experiences.

EASE OF USE
4 ★★★★☆
Overall, the app design makes it easy to use. One aspect that might be difficult for a
child is the need to perform two repetitive rubbing activities of the app’s character before
a user can access each lesson’s content. The need to do the exercise repeatedly
becomes more complicated depending on the app’s settings and the near-identical
design of the interactive exercise over repeated lessons could become less engaging, or
even frustrating.
The app’s requirement to complete the lessons in order without variation creates a
manualized feel to it and prevents the treating psychologist from being able to tailor it for
use.

FUNCTIONALITY
4 ★★★★☆
The programming of the app seems very well done through the Mindfulness 101 lessons
(the first 11 lessons). It performs well, and navigation within the app is only hampered by
its design to move through each lesson in order. When my iPhone was set to airplane
mode, it continued to function in mid-lesson, but not to the next lesson.

Background Ratings Key


(categories rated from 1-5, with 5 being the most positive score)

Privacy/Security If applicable, do the creators acknowledge that 1- HIPAA relevant


providers need to be HIPAA compliant? Is there a and ignored, no
privacy policy? Is data collected, stored, shared? Is privacy policy etc.; 5-
data de-identified? Can you opt out? Is there a Highest levels of
security policy? Data encryption? privacy and security
Evidence Base Is there any research support for the product? Is it 1- No research
peer-reviewed? Between-group design evidence; 5- Ample
experiments? Who provided the funding for the research evidence
research?
Cost and If it is free, how is it supported? Are there in app 1- Heavy
Business Model purchases? marketing/advertising;
5- Reasonably priced,
clear and easy to
navigate payment
options
User Feedback What are current user feedback/ratings? 1- Very negative
reviews; 5- Very
positive reviews

Psychologist Panel Review Ratings Key


(categories rated from 1-5, with 5 being the most positive score)

Purpose What is the proposed intervention or what does it claim to 1-Highly


do? Is it likely to do what it claims? unlikely; 5-
Highly likely
Appropriateness Is the content appropriate? Does the content match the 1- Very
of Content description and purpose? Were any clinical/psychology inappropriate;
experts involved in the development of the material? 5- Highly
appropriate
Cultural Did the app/software consider a variety/range of cultural 1- Very
Responsiveness factors (e.g., age, race, ethnicity, gender, gender identity, unresponsive;
sexual orientation, ability levels) in the development? Is the 5- very
app/software likely to appeal to people from different responsive
cultural backgrounds? Is it available in multiple languages?
Ease of Use Is it easy to navigate? Is it customizable? 1- Very
difficult; 5-
Very easy
Functionality Does it perform well? Does it need the internet to work? 1- Very poor;
Can you export/download your data? 5- Very well
Overall Rating Would you recommend this app to other psychologists? 1- Strongly do
How often would you use or ask a client to use this app? not
What is your overall rating of this app? recommend;
5- Strongly
recommend

Applications reviewed February 2020

This column discusses various software and applications available to psychologists for their
professional use. The views expressed in this column are the views of the authors and do not
reflect the views of the American Psychological Association (APA) or any of its divisions or sub-
units. All authors have no financial interests in the apps or software discussed. APA does not
recommend or endorse any practitioners, products, procedures, opinions or other information
that may be mentioned in this column; those who use these applications or products do so at
their own risk. Please send updates and feedback about apps to Communications Office Staff.

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