Belly Breathing for Kids

About this resource

Slow diaphragmatic breathing is one of the most widely taught relaxation skills in CBT programs for children, including Coping Cat and Cool Kids, and in anger management programs such as Coping Power. During the fight-or-flight response breathing becomes fast and shallow; deliberately slowing and deepening the breath, with a longer exhale, engages the parasympathetic system and gives the child something concrete to do while the body settles. For children the mechanics matter less than having a simple routine they can remember and a way of seeing that it is working, which is why this exercise uses a hand or a small toy resting on the belly.

This exercise is written for children aged roughly six to twelve and is suitable for both anxiety and anger. It teaches the child to breathe in through the nose so the belly rises, pause briefly, and breathe out slowly through the mouth so the belly falls, counting to keep the pace. It is presented as a skill to practise when calm, so that it is available when feelings are big. A parent section explains how to coach the breath without turning it into a battle.

The professional version adds guidance on the most common problems (children who breathe with their chest and shoulders, who hyperventilate by breathing too deeply, or who refuse to breathe when already upset), on pairing the exercise with a cue word, and on the important caveat that breathing is a coping skill, not a way of avoiding feared situations. In exposure work, breathing should not be used as a safety behaviour to prevent anxiety being felt.

How to use it

1. Teach the exercise when the child is calm. Demonstrate first, lying on the floor or sitting back in a chair with a hand or a small toy on the belly, and let the child watch it rise and fall.
2. Have the child try it for five or six breaths. Watch for chest and shoulder movement; if the belly is not moving, ask them to pretend they are slowly blowing up a balloon in their tummy. Keep the exhale longer than the inhale.
3. Agree a cue word or picture the child can use to remember the skill (for example 'balloon' or 'slow'). Practise saying the cue, then doing three breaths.
4. Ask the family to practise once a day for a week at a calm time, such as after school or before a story at bedtime, and to fill in the practice log. Regular practice when calm is what makes the skill usable when upset.
5. Once the child can do it reliably, coach the parent to prompt it early in a rising anger or anxiety episode, not at the peak. Make clear that breathing is for settling the body, and is not a reason to leave or avoid a brave-ladder step.

References

• Kendall, P. C., & Hedtke, K. A. (2006). Cognitive-Behavioral Therapy for Anxious Children: Therapist Manual (3rd ed.). Workbook Publishing.
• Lochman, J. E., Wells, K. C., & Lenhart, L. A. (2008). Coping Power: Child Group Program Facilitator Guide. Oxford University Press.
• Koeppen, A. S. (1974). Relaxation training for children. Elementary School Guidance and Counseling, 9(1), 14-21.