Increase attention, concentration and school performance

Reproduced from: Peper, E., Harvey, R., & Rosegard, E. (2024). Increase attention, concentration and school performance with posture feedback. Biofeedback, 52(2), 48-52. https://doi.org/10.5298/1081-5937-52.02.07

When I sit with good posture on my computer, I am significantly more engaged in what I’m doing. When I slouch on my computer I tend to procrastinate, go on my phone, and get distracted so it ends up taking much longer to do my work when my posture is bad.…I have ADHD and I struggle a lot with my mind wandering when I should be paying attention. Having good posture really helps me to lock in and focus.—22 year old male student.

Over the past two decades, there has been a significant increase in the prevalence of attention-deficit/hyperactivity disorder (ADHD), anxiety, and depression. ADHD rates have increased from 6% in 1997 to approximately 10% in 2018 (CDC, 2022). The rates of anxiety among 18–25 year-olds have also increased from 7.97% in 2008 to 14.66% in 2018 (Goodwin et al., 2020). Students are more distracted, stressed and exhausted (Hanscom, 2022; Hoyt et al., 2021). The more students are distracted, the lower their academic achievement (Feng et al., 2019). In our recent class survey of more than 100 junior and senior college students on the first day of class, 54% reported that they were tired and dreading the day when they woke up. When you are tired and stressed it is difficult to focus attention and have clarity of thought. Their self-report is similar to the mental health trends in the United States by age group in 2008–2019. Mental health of young people has significantly deteriorated over the last 15 years (Braghieri et al., 2021/2023).

The increase in psychological distress is most prevalent in people ages 18–29 and who were brought up with the cellphone (the iPhone was introduced in 2007) and social media. Now when students enter a class, they tend to sit down, look down at their cellphone while slouching, and they do not make contact with most other students unless instructed or reminded by the instructor. When instructed to talk to another student for less than 5 minutes (e.g., share something positive that happened to you this week), 93% of the students reported an increase in subjective energy and alertness (Peper, 2024).

As a group, students are social media and cell phone natives and thus have many distractions and stimuli to which they continuously respond. It is not surprising that the average attention span has decreased from 150 seconds in 2004 to 44 seconds in 2021 (Mark, 2023). More importantly, they now tend to sit in a slouched collapsed position, which facilitates access to hopeless, helpless, powerless and defeated thoughts and memories (Tsai et al., 2016; Peper et al., 2017) and reduces cognitive performance when performing mental math (Peper et al., 2018). Sitting slouched and looking down also reduces peripheral awareness and increases shallow thoracic breathing—a breathing pattern that increases the risk of anxiety. Experience this yourself.

For a minute, look at your cellphone while intensely reading the text or searching social media in the following two positions: sitting straight up and looking straight ahead at your cell phone or slouching and looking down at your cell phone, as shown in Figure 1. Most likely, your experience is similar to the findings from the classroom observational study in which half the students looked down and the other half looked straight ahead and then reversed their positions (Peper, unpublished). They then compared the subjective experience associated with the position. In the slouched position, most experienced a reduction in peripheral awareness and breathed more shallowly (see Figure 1).

Figure 1. Effect of slouching or looking straight ahead on vision and breathing.

The slouched position reduces social awareness and decreases awareness of  external stimuli as  illustrated in Steve Cutts’ superb animation, Mobile world (https://www.youtube.com/watch?v=wUW1wjlKvmY).

Given the constant stimulation, distractions and shortened attention span, it is more challenging to be calm and have clarity of mind when having to study or take an exam at school. As educators, we constantly explore ways to engage students and support their learning and especially share quick skills they can use to optimize performance (Peper& Wilson, 2021). In previous research, Harvey et al., 2020 showed that students who used posture feedback improved their health scores compared to the control group. The purpose of this paper is to share a 4-week class assignment by which numerous students reported an increase in attention, concentration, confidence, school performance and a decrease in stress.

Participants: 18 undergraduate students (7 males and 11 females, average age 22 [STDEV 2.2]) enrolled in an upper division class. As a report about an effort to improve the quality of a classroom activity, this report of findings was exempted from Institutional Review Board oversight.

Equipment: Wearable posture feedback device, UpRight Go 2, which the person wears on their neck and which provides vibratory feedback whenever they slouch, as shown in Figure 2. It is used in conjunction with the cellphone app that allows them to calibrate the feedback device.

Figure 2. Attachment of posture feedback device on neck or spine and the app to calibrate the device.

Procedure: Students attended the 3-hour weekly class that explored autogenic training, somatic awareness, psychobiology of stress, the role of posture, and the psychophysiology of respiration. The lectures included short experiential practices demonstrating the body-mind connections such as imagining a lemon to increase salivation, the effect of slouched versus erect posture on evoking positive/empowering or hopeless/helpless/powerless/defeated thoughts, and the effect of sequential 70% exhalation for 30 seconds on increasing anxiety (Tsai et al., 2016; Peper et al., 2017).

Each week for 4 weeks the students were assigned a self-practice that they would implement daily at home and record their experiences. At the end of the week, they reviewed their own log and summarized their own observations (benefits, difficulties). During the next class session, they met in small groups of 5 to 6 students to discuss their experiences and extract common themes.

The 4-week curriculum was sequenced as follows:

Week 1

• Lecture on the benefits/harms of posture with experiential practices (effect of slouching vs erect on access to hopeless/helpless/powerless thoughts versus optimistic and empowering thoughts; posture and arm strength (Peper, 2022).
• Homework assignments:
• Watch the great Ted Talk and one of the most viewed by Amy Cuddy (2013), “Your body language shapes who you are.”
• Keep a detailed log to monitor situations where they slouched and identify situations that were associated with slouching.

Week 2

• Lecture on psychophysiology and class discussion in which students shared their experiences of slouching; namely, what were the triggers, how it affected them and what they could do to change.
• Demonstration, explanation, and how to use the posture feedback device, UpRight Go 2.
• Homework assignment: Wear UpRight Go 2 during the day, use it in different settings (studying, walking, work), and keep a log. When it vibrates (slouching) observe what was going on and change your behavior such as when tired>get rest or do exercise; when depressed>change internal language; ergonomic issues>change the environment, posture>give yourself lower back support.

 Week 3

• Class discussion on what to do when slouching is triggered by tiredness, negative and hopeless thoughts, ergonomics such as laptop placement and chair. Students meet in groups to share their experiences and what they did in response to the vibratory feedback.
• Homework assignment: Continue to wear the UpRight Go 2 during the day and keep a log.

Week 4

• Class discussion in groups of five students about their experiences of slouching, what to do and how it affects them.
• Homework assignment: Wear UpRight Go 2 during the day and keep a log. Submit a paper that describes their experience with the posture feedback from the UpRight Go 2 and fill out a short anonymous survey in which they rated their change in experience since using the posture feedback device on a scale from 3 (worse) to 0 (no change) to 3 (better) .

Results

All students reported that wearing the feedback device increased attention and concentration as shown in Figure 3.

Figure 3.

Amount of time using the UpRight Go 2:On the average the students used the device 4.8 days a week (STDEV 2.0) and 2.2 hours per day (STDEV 1.3).

Location of use:Although most students practiced sitting in front of their computer, they also reported using it while at work, playing pool or doing yoga and even while seeing a therapist.

Discussion

All the students reported that the posture feedback helped them to become more aware of slouching and when they then interrupted their slouching, they experienced an increase in energy and a decrease in stress. As a 21-year-old male student said: “I felt more engaged with whatever I was doing. I tend to … daydream and get distracted, but I experience much less of that when I sit with good posture.”          

Many reported that it helped identify their emotions when they were feeling overwhelmed. Then they could sit up, shift their perspective, and many reported a decrease in back and neck pain as well as a decrease in tiredness. When participants wear non-invasive wearables that provide accurate feedback, they are often surprised what triggers are associated with feedback or how their performance improves when they respond to the feedback signal by changing their thoughts and behavior. This posture self-awareness project should be embedded in strategies that optimize the learning state as described by Peper & Wilson (2021).

To the students’ surprise, they were often unaware that they started to slouch, nor were they aware of how much this slouching was connected to their emotions, mental state or external factors. For example, one student reported that he wore the device while being in a therapy session. All of a sudden, it vibrated. At that moment, he realized that he was becoming anxious, although he and therapist were unaware. He then shared what happened with the therapist, and that helped the therapeutic process.

The benefits may not only be due to posture change but that the students became aware and interrupted their habitual pattern. This process is similar to that described by Charles Stroebel (1985) when he taught patients the Quieting Reflect that reduced numerous somatic symptoms ranging from headaches to hypertension.

The posture feedback intervention is both simple and challenging since it requires the participants to wear the device, identify factors that trigger the slouching, and interrupt their automatic patterns by changing posture and behavior whenever they felt the vibratory feedback. The awareness gave them the opportunity to change posture and thoughts. By shifting to an upright posture, they experienced that they could concentrate more and have increased energy. As a 19-year-old female student wrote: “My breathing was better and sitting in an upright position gave me more energy when doing tasks.”

Conclusion

We recommend that a 4-week home practice module that incorporates wearable posture feedback is offered to all students to enhance their well-being. With the posture feedback, participants can increase their awareness of slouching, identify situations that trigger slouch, and learn strategies to shift their posture, thoughts, emotions and external environment to optimize maintaining an empowered position. As a 20-year old male student reported, “The app helped me when I was feeling overwhelmed and then I would sit up. When I had it on, I did a lot of work. I was more concentrated.”

Explore the following blogs for more background and useful suggestions

References

Braghieri, L., Levy, R., & Makarin, A. (2023). Media and mental health (July 28, 2022). SSRN. (Original work published 2021). https://ssrn.com/abstract=3919760 or http://dx.doi.org/10.2139/ssrn.3919760

Centers for Disease Control and Prevention. (n.d.). ADHD through the years. Attention-Deficit / Hyperactivity Disorder (ADHD). Retrieved March 27, 2023, from https://www.cdc.gov/ncbddd/adhd/timeline.html

Cuddy, A. (2012) Your body language may shape who you are. TED Talk. Retrieved March 16, 2024 from https://www.youtube.com/watch?v=Ks-_Mh1QhMc

Feng, S., Wong, Y. K., Wong, L. Y., & Hossain, L. (2019). The internet and Facebook usage on academic distraction of college students, Computers & Education, 134, 41-49. https://doi.org/10.1016/j

Goodwin, R. D., Weinberger, A. H., Kim, J. H., Wu. M., & Galea, S. (2020). Trends in anxiety among adults in the United States, 2008–2018: Rapid increases among young adults. Journal of Psychiatric Research. 130, 441–446. https://doi.org/10.1016/j.jpsychires.2020.08.014

Hanscom, N. (2022). Students, staff notice higher levels of student distraction this school year, reflect on potential causes. Retrieved September 28, 2023, from https://dgnomega.org/13162/feature/students-staff-notice-higher-levels-of-student-distraction-this-school-year-reflect-on-potential-causes/

Harvey, R., Peper, E., Mason, L., & Joy, M. (2020). Effect of posture feedback training on health. Applied Psychophysiology and Biofeedback, 45(1), 59–65. https://doi.org/10.1007/s10484-020-09457-0

Hoyt, L. T., Cohen, A. K., Dull, B., Castro, E. M., & Yazdani, N. (2021). “Constant stress has become the new normal”: Stress and anxiety inequalities among U.S. college students in the time of COVID-19. Journal of Adolescent Health. 68(2), 270–276. https://doi.org/10.1016/j.jadohealth.2020.10.030

Mark, G. (2023). Attention span: A groundbreaking way to restore balance, happiness and productivity. Hanover Square Press.

Peper, E. (2022, March 4). A breath of fresh air: Breathing and posture to optimize health. [Conference presentation at the 2^nd Virtual Ergonomics Summit], Krista Burns, PhD. https://www.youtube.com/watch?v=PhV7Ulhs38s

Peper, E. (2024a). Change in energy and alertness after talking with each other versus looking at cellphone. Data collected from HH380 class fall 2023. Unpublished.

Peper, E. (2024b). Changes in vision and breathing when looking down or straight ahead at the cellphone. Data collected from HH380 class, Spring, 2024, San Francisco State University. Unpublished.

Peper, E., Harvey, R., Mason, L., & Lin, I.-M. (2018). Do better in math: How your body posture may change stereotype threat response. NeuroRegulation, 5(2), 67–74. http://dx.doi.org/10.15540/nr.5.2.67

Peper, E., Lin, I.-M., Harvey, R., & Perez, J. (2017). How posture affects memory recall and mood. Biofeedback.45(2), 36–41. https://doi.org/10.5298/1081-5937-45.2.01

Peper, E. & Wilson, V. (2021). Optimize the learning state: Techniques and habits. Biofeedback, 49(2), 46-49. https://doi.org/10.5298/1081-5937-49-2-04

Stroebel, C. F. (1985). QR: The Quieting Reflex. Berkley. https://www.amazon.com/Qr-Quieting-Charles-M-D-Stroebel/dp/0399126570

Tsai, H. Y., Peper, E., & Lin, I.-M.(2016). EEG patterns under positive/negative body postures and emotion recall tasks. NeuroRegulation, 3(1), 23–27. https://doi.org/10.15540/nr.3.1.23