Almost 10% of school-aged children experience emotional and behavioral problems that are serious enough to require professional attention (Kauffman, 2005).  According to the U.S. Department of Education (2012) more than 420,000 school-aged students between the ages of 3 and 21 qualify for special education services under the category of emotional or behavioral disability (EBD).  Eighty-one percent of those students participate in some portion of general education classes in public schools while receiving behavior supports and academic accommodations.
   
     Educational settings use several different types of research-based interventions such as, positive reinforcement, token economies, positive behavior supports (PBS), functional behavioral assessments (FBA), social skills instruction, and self-management training to increase a student with EBD’s behavioral, social, and academic success.  However, the National Longitudinal Transition Study-2 (U.S. Department of Education [DOE], 2011; Institute of Educational Sciences [IES], 2011; NLTS2 Data Brief, 2004) indicate that students with EBD still have a difficult time performing successfully in school and post-school environments.  According to the National Longitudinal Transition Study-2 (DOE, 2011; IES, 2011; NLTS2 Data Brief, 2004) 25% of students with EBD have low social skills as compared to their peers in the general education population, almost 75% have been suspended or expelled at least once, and 14% are more likely to receive Ds or Fs on their report card as compared to all students with disabilities.  It is also reported that less than half of students with EBD have received a high school degree or GED, and over 40% have dropped out of school (DOE, 2011).   
   
     Bradley, Doolittle, and Bartolotta (2008) summarized from the National Longitudinal Transition Study-2 that early intervention and prevention programs show promise for improving student behavior; however, students with EBD are at risk of becoming resistant to behavior, social, and academic interventions as they move through the school system.  Furthermore, school systems aim to reduce negative school behaviors, but they have a difficult time identifying effective and feasible programs to implement on a broad scale in the classroom or school environment that will bring about the change they desire (Everett, Kann, & McReynolds, 1997).  One approach to the growing problem of school-related conduct and behavior problems with students with EBD may be to provide training in stress reduction (Meiklejohn, et al., 2012; Barnes, Bauza, & Treiber, 2003). 
   
     Over the past thirty-years, a form of stress reduction through the use of meditation called Mindfulness-Based Stress Reduction (MBSR) has been researched by the medical and health care community to document its many positive effects patients experience.  For example, a clinical study showed a reduction in anxiety and depression in patients who engaged in a MBSR program (Miller, Fletcher, & Kabat-Zinn, 1995).  Another study showed positive results in 174 adult patients who engaged in a MBSR program in reducing stress-related problems, anxiety, and chronic pain (Carmody & Baer, 2008).  Reibel, Greeson, Brainard, and Rosenzweig (2001) reported a 44% reduction of anxiety and 34% reduction of depression in 136 heterogeneous adult patients.  In an MBSR study related to school-age children, Barnes, Bauza, and Treiber (2001) used a meditation program based on MBSR techniques with inner-city African-American adolescents between the ages of 15 to 18-years old and found lower rates in absenteeism and school suspensions in the population of students engaged in the meditation program.  A meta-analysis conducted by Grossman et al. (2004) concluded that mindfulness interventions are effective, which lead the researchers to believe that “mindfulness training may be an intervention with potential for helping many learn to deal with chronic disease and stress” (2004, p. 40).
   
     In 2005, the Garrison Institute released the Garrison Institute Report on Contemplation and Education, a survey of contemplative practices used in K-12 educational settings.  This report defines contemplation practices as meditation practices that are not related to religious organizations.  The report organized programs into two categories: contemplative programs or contemplative techniques.  In defining a contemplative program, the Garrison Report based its definition on the structure of the MBSR program.  A contemplative program specifically emphasizes mindfulness and improving a students’ capacity for self-awareness.  Contemplative techniques use methods (not related to a program) that include teaching students how to pay better attention to the task at hand. 
   
     The Garrison Report (2005) asserts that the MBSR model is appropriate for educational settings by stating, “whereas pain and stress can be symptomatic of disease, trauma or other health-related causes, academic failure and anti-social behaviors at school often indicate systemic problems within the school community” (p. 7).  The Center for Mindfulness at the University of Massachusetts Medical School “believes that students, teachers and other members of the school community can benefit from mindfulness and other contemplative techniques in an effort to become more responsive and less reactive, more focused and less distracted, more calm and less stressed” (Garrison Institute, 2005, p. 7-8). 

Research Questions
   
     The aim of this research is to determine the effectiveness of meditation used by secondary students who receive special education services in a public school setting.  The researcher will ask the following questions:

1. After a student is taught how to use meditation, is there a statistically significant increase in his or her level of mindfulness awareness?
2. From the pre-test measurement to the post-test measurement is there a statistically significant change in the student's perceived stress levels and anxiety.
3. Do the English and math teachers of students with EBD who use meditation observe a statistically significant decrease in concentration problems and disruptive or aggressive behavior in the classroom, and an increase in positive social interactions from the beginning to the conclusion of the intervention?
4. Is there a statistically significant increase in the student's self-evaluation of his or her mood based on a check-in/check-out system for each meditation session?
5. Is there a statistically significant increase in time on-task for the students participating in the meditation intervention?

     Listed in Table 1 are the null hypothesis research questions with the associated instruments to measure the change in student's behavior.


Overview of Research Activities
   
     The meditation intervention is eight weeks long with a week prior and after the intervention to collect measurement data.  During those eight weeks the intervention will be conducted after school, twice a week for 45-minutes.  There will be approximately 10 students in the treatment group and 10 students in the control group. 

Design and Data Sources

     This study will employ a quantitative pretest-posttest randomized group study designed to assess the impact of meditation on secondary students who receive special education services.  The setting of the intervention will take place in a public school during an after-school program.  The independent variable throughout the study will be the meditation sessions.  The dependent variables will be the student's

• levels of mindfulness awareness as measured by the Child Acceptance and Mindfulness Measure (CAMM),
• perceived stress levels as measured by the Perceived Stress Scale (PSS),
• anxiety as measured by the Revised Children's Manifest Anxiety Scale, Short Form (MASC),
• concentration problems, aggressive and disruptive behavior, pro-social interactions observed in the classroom by an English and math teacher as measured by the Teacher Observation of Classroom Adaptation-Checklist (TOCA-C),
• the participant's self-evaluation of his or her mood as measured by a check-in/check-out system for each meditation session, and
• the student's time on-task during the intervention as measured by time-sampling. 

     These measures will be completed prior to, during, and after initiation of the intervention.  Listed in Table 2 are the eight sub-domains with the corresponding instrument, and the reliability and validity of these instruments. 
   
     All of the measurements will be collected throughout the duration of the study.  The dependent variables of mindfulness awareness, perceived stress, anxiety, and the teacher observation of the student's concentration, aggressive and disruptive behavior, and pro-social interactions will be collected one week prior to the start of the intervention (pre-intervention measure), week four (intervention measure), and one week after the intervention has concluded (post-intervention measure).  The dependent variables of the student's self-evaluation of his or her mood and time on-task during the meditation session will be measured at the beginning and end of each of the 16 meditation sessions during the 8-week intervention.  The independent variable for the study is the meditation intervention. 

     Figure 1 provides a visual representation of the design of the research study.

Setting
   
     The eight-week intervention will take place in a secondary public school in a suburban community in the Mid-Atlantic Region.  A classroom in the school will be utilized to provide adequate space and privacy for the participants to engage in the intervention.  The instruction of the meditation intervention will be conducted after school twice a week from 4:00 p.m. to 4:45 p.m. 

Participants
   
     Student participants will be selected to participate in the study using the following criteria.  The student participant must already be identified as currently receiving special education services under the classification of an emotional or behavioral disability, specific learning disability, or other health impairment with a current Individualized Education Program.  The ages of the participants will be between 14 and 22-years old, male and female, and with various ethnic backgrounds.  The participant’s home-life will vary greatly among the population.  Some participants may be involved in foster care, adopted, or are with a natural family member.  The financial status of the participants will range from being on welfare to financially stable. 

Materials
   
     The materials used for this research study will consist of an iPad, ten iPods, eleven sets of headphones, a meditation workbook, yoga mats, 30 $25 iTunes gift cards, a meditation compact disk, a video camera, a tripod, and stereo. 
   
     The iPad, a tablet computer that utilizes a touchscreen, will be used for the treatment and control group participants to use to report their mood as the check-in and check-out measurement when they attend the meditation intervention or data collection session.  The iPad will also be used by the researcher to assist in measuring the treatment participants' time on-task during each meditation session.
   
     An iPod (a portable music device), headphones, yoga mat, and workbook will be given to each treatment participant to use during each meditation intervention sessions.  The iPod, headphones, and yoga mat will be used by the participants to receive the meditation intervention for each session.  The workbook will be used at the conclusion of each meditation intervention session for the participant to journal his or her thoughts and experiences related to that session's meditation.  The treatment participants will collect and return the equipment each intervention session.  Each iPod, headphone, yoga mat, and workbook will be marked with the treatment participants designated number.  At the end of the treatment intervention the participants will be allowed to keep the iPod, headphones, and yoga mat as a stipend for their involvement in the research study.
   
     The iTunes gift cards will be used as a stipend to the control group participants and English and Math teachers for completing pre-, mid-, and post-measurement surveys for the research study.
   
     The researcher will create and record an eight-track meditation compact disk to use for the meditation intervention.  The eight tracks on the meditation compact disk will be loaded on to each treatment participant's iPod to be used during the meditation sessions.  Only eight meditations will be recorded on the compact disk because each meditation will be used twice during the 16 different meditation sessions. 
   
     A video camera and tripod will be used to record each treatment session to measure fidelity of treatment. 
   
     The stereo will be used to play quiet meditation music as the treatment group participants enter the classroom.  This is to set the mood and tone of the upcoming meditation intervention session.

Group Selection
   
     The researcher will complete a Human Subjects Review Board application for George Mason University and the participating school district, Loudoun County Public Schools, to obtain permission to conduct the meditation intervention.  Once approval has been granted, the researcher will send home an invitation letter at two different times to all qualifying students receiving special education services at the participating school.  Students who are receiving special education services for a specific learning disability (SLD), emotional or behavioral disability (EBD), or a other health impairment (OHI) are considered qualifying students.  The letters mailed home will ask the parents and qualifying students to attend one of three information sessions to explain the purpose of the research study and the meditation intervention.  Through these information sessions, the researcher will solicit student participation and collect assent and parent informed consent forms.  As the researcher receives signed assent and consent forms for participation in the intervention, each participant will be assigned a random number.  The researcher will randomly select numbers associated with the participants to place them in the treatment group or control group.  The participants will be informed that they will be volunteering for an after-school program if they are selected as part of the treatment group.  Each group, treatment and control, will have approximately ten participants each.  The low number of participants chosen for the intervention is similar to a traditional meditation class and a self-contained classroom in a secondary school setting. 
   
     Treatment group.  The randomly selected treatment group of eight to ten students who receive special education services will participate in the eight-week meditation intervention, which is the independent variable for the research study.  The researcher will provide instruction to the participants how to meditate.  This will consist of learning how to sit or lay quietly, control his or her breathing, how to focus on one event at a time, and how not respond to internal or external distractions. 
   
     Comparison group.  The randomly selected comparison group of eight to ten students who receive special education services for SLD, EBD, or OHI will receive no treatment during the eight-week intervention cycle. 

Intervention

     Once the control and treatment groups have been established, each group will meet at separate times to complete three of the pre-intervention measurements.  The three measurements the participants will complete will be the CAMM, PSS, and the MASC.  For the fourth pre-intervention measurement, an English teacher and a math teacher for each of the participants in the treatment and control groups will each complete a TOCA-C assessment, resulting in two different teacher in-school measurements.  These four assessments will provide a baseline measurement for the dependent variables of mindfulness awareness, perceived stress, anxiety, concentration, aggressive and disruptive behavior, and pro-social interactions.  The dependent measurement variables will be repeated at week four (mid-intervention measurement), and one week after the conclusion of the intervention (post-intervention measurement).  The data will be evaluated to determine if there is a change in the six dependent variables.
   
     Intervention:  treatment group participation.  Starting on week one, the intervention will be taught to the treatment group during an after-school program twice a week for forty-five minutes over a period of eight weeks.  The participants will report to the same classroom each Monday and Wednesday (or Tuesday and Thursday, depending on the school's schedule) between 3:50 p.m. and 4:05 p.m.  When the participant arrives he or she will use an iPad to provide a check-in on how he or she is feeling emotionally at that moment.  The check-in will be based on a ten-point scale similar to the Pain Management Scale.  The participant will then collect his or her designated iPod, headphones, workbook, and yoga mat to use during the intervention.  Each participant's equipment will be designated with the same number that was assigned to him or her at the beginning of the study.  The participants will have the option of sitting in a desk, at a table, or on the floor during each intervention session. 
   
     Starting at 4:05 p.m. the researcher will provide a brief introduction to the day's meditation lesson and check for questions.  Then at approximately 4:15 p.m., the researcher will prompt the participants to turn on their iPods, put on their headphones, and play the corresponding meditation track for that day's lesson. 
   
     The meditation session will last approximately twenty-minutes, ending at 4:35 p.m.  The meditation session consist of a guided visualization exercise to instruct the participant how to regulate his or her breathing, focus his or her attention to the visualization exercise, and attempt to ignore internal and external distractions.  Between 4:35 p.m. and 4:40 p.m., the participant will be prompted by his or her iPod to complete a written or journaling exercise in his or her workbook.  From 4:40 p.m. to 4:50 p.m., the participant will return his or her equipment and use the iPad to check-out by rating how he or she feels emotionally at that moment.  The check-out will be based on a ten-point scale similar to the Pain Management Scale.  After the participant has completed the check-out measurement he or she will be allowed to leave.
   
     Through the use of the iPod, meditation exercise, and workbook, the researcher will instruct the treatment group participants to focus on how they can use what they learn from the meditation exercises to help them academically in his or her English class. 
   
     Dependent measurement data will be collected from the treatment group participants after school during the pre-intervention week, week four, and the post-intervention week.  During week four's second meditation intervention sessions, the meditation exercise will only be ten minutes long to allow the participants enough time to complete the three dependent measurements before 4:50 p.m.
   
     Intervention:  researcher participation during the meditation intervention sessions.  At 3:50 p.m. the research will turn on the video camera to start video recording the meditation intervention session.  The researcher will also turn on the quiet meditation music to set the mood and tone of the upcoming meditation intervention session in the classroom.  Between 3:50 p.m. and 4:05 p.m., the researcher will greet each treatment group participant and instruct him or her to check-in, gather his or her equipment, and get settled.  Between 4:05 p.m. and 4:15 p.m., the researcher will provide a brief introduction to the day's meditation lesson and check to see if the participants have any questions.  At 4:15 p.m. the researcher will identify which meditation session to use on the iPod the participants will listen to during the meditation session and prompt the participants to begin.  The researcher will turn-off the meditation music on the stereo.
   
     During the meditation exercise, 4:15 p.m. to 4:35 p.m., the researcher will sit in front of the treatment participants and plug a set of headphones into the iPad to start a recording to observe and measure each participant's time on-task during the meditation exercise.  The researcher will listen to a recording that prompts him or her every twenty seconds to scan the room of treatment participants and mark if the participant is on-task with the meditation exercise. 
   
     The definition of on-task with meditation is the participant is sitting or laying quietly with his or her eyes closed, comfortably breathing, body is relatively still (small itches or repositioning of sitting position is acceptable), headphones are on his or her ears, he or she are not talking or whispering, and there are no other electronics in the participant's personal space.  The definition of off-task with meditation is the participant is walking or moving around the room, eyes are open, he or she is snoring, body parts are fidgeting, headphones are not on his or her ears, he or she is whispering or talking, and there are other electronics in his or her personal space.
   
     Between 4:35 p.m. and 4:50 p.m., the researcher will prepare the iPad for the participants to check-out of the intervention session at 4:50 p.m.  The researcher will also instruct each participant to return his or her equipment.  The researcher will provide after-school bus passes to participants if needed.  At 4:50 p.m. the researcher will turn off the video camera and end the meditation intervention session.
   
     Intervention:  control group participation.  The control group participants will be asked to attend three after-school sessions to complete the dependent measurement assessments.  They will be asked to attend a 45-minute after-school session during the pre-intervention week, week four of the treatment cycle, and post-intervention week.  The control group and treatment groups will meet on different days during those three identified weeks to complete the measurements.  For example, if the treatment group is meeting on a Monday after school during the pre-intervention week, the control group will meet on a Tuesday after school. 
   
     The control group participants will report to the intervention classroom between 3:50 p.m. and 4:05 p.m.  During this time the control group participants will use an iPad to provide a check-in on how they are feeling emotionally at that moment.  The check-in will be based on a ten-point scale similar to the Pain Management Scale.  At 4:05 p.m. the researcher will distribute the dependent measurements to each control group participant based on the his or her assigned number at the beginning of the study.  The participant will have until 4:40 p.m. to complete the three dependent measures.  When the participant completes the three measurements he or she will return them to the researcher.  The participant will use the iPad to check-out of the session by rating how they feel emotionally at that moment.  The check-out will be based on a ten-point scale similar to the Pain Management Scale.  After the control group participant has completed the check-out measurement he or she will be allowed to leave.
   
     If a control group participant completes all three cycles of the dependent measurements he or she will receive a stipend of a $25 dollar iTunes gift card.
   
     Intervention:  teacher participation.  For each treatment and control group participant an English and a math teacher will be asked to complete a Teacher Observation Checklist Assessment (TOCA-C) for each participant during the pre-intervention week, week four of the treatment cycle, and the post-intervention week.  This assessment will be conducted and collected during in-school hours.  Some English and math teachers may have to complete a TOCA-C assessment for more than one participant.  At this time there is no way to determine how many teacher participants will be involved in completing the TOCA-C measurements.  Each teacher participant, regardless of how many TOCA-C measurements they complete will receive a $25 dollar iTunes gift card. 

Fidelity of Treatment
   
     Prior to the measurement of fidelity of treatment the researcher will develop a checklist to measure if each data collection and meditation intervention session is conducted as outlined in the HSRB application.  The researcher will train a research assistant to use the checklist to measure the accuracy of each data collection and meditation intervention session with the treatment and control groups. 
  
     Every session, data collection or meditation intervention, with the treatment and control group will be video recorded and viewed by the researcher and research assistant to measure the fidelity of each session based on the checklist, to verify each session is being followed as planned.  If the researcher and research assistant disagree with the findings of checklist, they will review the video recording together and discuss the difference until a consensus is agreed upon.
   
     Lastly, the research assistant will review the video recordings of the intervention sessions.  Using the same iPad, the research assistant will record the treatment group participants time on-task based on the same on-task and off-task definition used by the researcher.  The research assistant and researcher will compare the each other's results to ensure accuracy.  If there is a discrepancy in data the researcher and the research assistant will review the video recordings and discuss the difference until a consensus is agreed upon.

Social Validity
   
     A week after the post-measurement data are collected the treatment group participants will be given a questionnaire in an envelope to measure the social validity of the intervention.  To ensure that feedback is confidential, the researchers will ask the participant to complete the social validity scale and seal it in the envelope before returning it to the researcher.  Statements on the questionnaire will be worded in a way that students agree or disagree with.  The statements will focus on ease of use, utility to participants, and effectiveness of increasing mindfulness awareness, reduction in stress, anxiety, aggressive and disruptive behaviors, and an increase in positive social interactions and concentration. 

Data Analysis
   
     The eight dependent variables will be assessed through four standardized measurement tools, a self-reporting tool about the participant's emotions, and time-sampling of the participant's time on-task during the meditation sessions.  The Statistical Package for Social Sciences (SPSS) Version 18.0 will be used to analyze the data.  The specific proposed data analysis procedure for each null hypothesis can be found in Table 3. 
   
     As an overview, each set of group data will include descriptive statistics, standard deviations, degrees of freedom, and independent sample t-test with Levene’s test for equal variances or dependent paired-sample t-test scores. 
    The data results will also be compared between the treatment and control groups to determine if there is a statistical significant decrease or increase in corresponding domains between groups for each null hypothesis.  The researcher will use the following data analysis procedures to determine the results of the dependent measures,

• one-factor analysis of variance (ANOVA) with the Tukey multiple range test,
• repeated-measures ANOVA,
• pearson r linear correlation and a multivariate analysis of variance (MANOVA) to determine if there is a difference among two or more groups based on a set of two or more dependent variables,
• analysis of variance with a covariate analysis (ANCOVA), with the mindfulness being the covariate,
• simple linear regression, and
• multiple regression with two or more predictors.

     More specifically, by having the participants complete the measurement assessments at three separate time periods the researcher will be able to implement a 2 (treatment vs. control group) X 3 (pretest, intervention, and posttest follow-up) mixed factorial repeated-measures analysis of variance (ANOVA) design.  More specifically, an independent sample t-test with Levene’s test for equal variances will be used to determine if students participating in the meditation intervention have a corresponding increase or decrease in dependent variable domains as compared to students in the control group.  A multiple regression from two or more predictors will be used to determine if mindfulness awareness varies by age, gender, or educational level.  Lastly, a chi-square analysis between two dependent variables will be used to determine the relationship between perceived stress and mindfulness.
     
     Specifically, for the TOCA-C data, the t values, degrees of freedom, and statistical significance of the three categories will be analyzed and compared between groups and across the pre, mid and post measurements of the study.  More specifically, a Pearson r linear correlation and a multivariate analysis of variance (MANOVA) will be used to determine if there is a difference between two or more groups based on a set of two or more dependent variables.  An analysis of variance (ANOVA) gain score and a repeated-measures ANOVA will be used to determine if there is a change in the three behaviors (concentration, disruptive behavior, and social interactions) as measured by the TOCA-C.  An exploratory factor analysis (EFA) along with principal factor methods will be used to verify the three basic constructs of the TOCA-C as reported in the Koth et al. (2009) study.  The specific data analysis related to each null hypothesis question can be found in Table 3.