Virtual Reality Mindfulness for Children’s Hearts

In a recent study published in Applied Psychophysiology and Biofeedback, Olarza and colleagues introduced “Virtual EMO‑Mind,” a short virtual reality–based mindfulness programme designed to support emotion regulation in primary school children. Working with 127 pupils aged 9–12 years, they explored how immersive, guided mindfulness experiences might shift both heart physiology and everyday emotional skills.

This work represents new emerging research with novel insights at the intersection of mindfulness, psychophysiology, and educational practice. It speaks to a familiar clinical and classroom reality: many children struggle to manage big feelings, pay attention, and recover from stress, yet traditional mindfulness exercises can feel abstract, boring, or simply too difficult at that age.

Here, virtual reality acts like a playful doorway into serious self-regulation training. Children are transported into immersive seasonal landscapes and calming natural scenes while their heart rate variability (HRV) is quietly monitored in the background. HRV is a moment-to-moment measure of variation between heartbeats, and a powerful biomarker of how flexibly the autonomic nervous system is responding to stress and recovery demands.

This is also a natural bridge to the broader worlds of biofeedback and neurofeedback. In simple terms, biofeedback uses sensors on the body (for example, heart, breathing, or muscle tension) to give real-time information that helps people practice regulating their physiology. Neurofeedback is a specialised form of biofeedback that focuses on brain activity, typically measured with EEG sensors on the scalp, to train the brain’s self-regulation capacities.

Although the Virtual EMO‑Mind study did not provide active feedback to the children, it sits very close to biofeedback territory: psychophysiological signals are measured, interpreted, and used to evaluate change over repeated mind–body training sessions.

Methods

The Virtual EMO‑Mind programme was implemented in two primary schools in the Basque Country with 127 students from Years 5 and 6 (ages 9–12). Children with significant neurodevelopmental, behavioural, or language difficulties were excluded to keep the group relatively homogeneous in terms of classroom functioning.

After school leaders agreed to participate and parents gave informed consent, classes were organised into small groups of three pupils. These mini-groups stayed constant across the intervention, helping to create a sense of safety and familiarity. Sessions took place once a week over four weeks, during school hours, in a quiet, dimly lit room equipped with three computers, VR headsets, headphones, and a HeartMath EmWave sensor.

Each VR session lasted around 15 minutes and represented one season of the year: spring, summer, autumn, and winter. Children were guided through immersive scenes such as a tranquil forest, Egyptian desert landscapes, Chinese cultural environments, and snowy polar views. Natural sounds, wide panoramas, and an audio mindfulness guide were combined to keep attention anchored while inviting relaxation and present-moment awareness.

While the children were “inside” these virtual worlds, their heart activity was recorded using the HeartMath EmWave Pro system, which uses a small photoplethysmographic sensor clipped to the earlobe. The device calculates inter-beat intervals and transmits data to software that estimates HRV patterns. In this study, three main physiological indices were extracted for each of the four sessions:

• High-frequency (HF) power, reflecting parasympathetic (vagal) activity in the 0.15–0.40 Hz band.

• Low-frequency (LF) power, in the 0.04–0.15 Hz band.

• A coherence score, expressing how smooth, sine-wave-like, and organised the heart rhythm pattern was around the resonance frequency (~0.1 Hz).

Raw data were cleaned and analysed using Kubios HRV Scientific, which automatically detects artefacts (for example, movement or signal loss) and corrects outlying RR intervals through interpolation. Standard detrending was applied to remove slow drifts, and spectral analysis was performed using Fast Fourier Transform to obtain HF and LF power in normalised units.

Emotional skills were assessed using two validated questionnaires before the programme began and after it ended. The Short Trait Meta-Mood Scale (TMMS) captured three aspects of emotional functioning: emotional attention (noticing feelings), emotional clarity (understanding what one feels), and emotional repair (ability to shift or recover from difficult emotions). The Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA) was used in its suppression subscale, focusing on the tendency to hold emotions in rather than express them.

Statistically, the authors used repeated-measures models to track changes in HRV across the four sessions, paired t-tests for pre–post emotional changes, and ANCOVAs to explore whether outcomes differed between boys and girls or between Year 5 and Year 6 pupils. When they found significant differences by year group, they followed up with session-by-session mixed ANOVAs to pinpoint where trajectories diverged.

Results

Across the four VR mindfulness sessions, children showed a clear physiological shift. High-frequency (HF) power increased significantly from the first session to subsequent sessions, indicating stronger parasympathetic (vagal) activity and a heart rhythm profile more compatible with rest, recovery, and emotional flexibility. Low-frequency (LF) power decreased over the same period. The most notable changes in both HF and LF occurred between Session 1 and Session 2, and then stabilised: by Sessions 3 and 4, HF remained higher and LF remained lower than at baseline.

Physiological coherence followed a slightly different time course. Coherence remained relatively unchanged between the first and second session, then rose sharply in Session 3 and increased further in Session 4. By the end of the programme, children were spending a much larger proportion of session time in a highly coherent state, where the heart rhythm forms a smooth, regular pattern associated with calm focus and efficient autonomic regulation.

Because the interpretation of LF power as a pure marker of sympathetic activity is controversial, the authors rightly cautioned against over-claiming that the LF reduction necessarily reflected “less” sympathetic drive. Still, taken together, the increase in HF and the rise in coherence strongly support the idea that the VR mindfulness training nudged the autonomic nervous system toward better-regulated, more parasympathetically-supported states.

On the psychological side, emotional clarity and emotional repair improved significantly from pre- to post-programme with small-to-moderate effect sizes. Children reported being more able to make sense of their feelings and more capable of shifting out of negative moods or re-establishing a more balanced state. Emotional attention showed a non-significant trend toward improvement, and the suppression tendency measured by the ERQ-CA did not change reliably.

Interestingly, results did not differ between boys and girls—both seemed to benefit in similar ways in this relatively short programme. However, year-group analyses revealed a consistent pattern: younger pupils in Year 5 showed larger gains in HF and LF across sessions and higher post-intervention scores in emotional attention and clarity than their Year 6 peers. Session-by-session analyses confirmed that Year 5 children were ahead particularly in Sessions 2 and 3, suggesting that younger children may be especially responsive, at least in the short term, to this type of VR-based emotional training.

Discussion

Taken as a whole, Virtual EMO‑Mind offers a compelling snapshot of what can happen when immersive technology is harnessed to support children’s self-regulation rather than merely entertain them. In only four weekly 15‑minute sessions, pupils showed measurable improvements in HRV patterns and reported feeling more able to understand and repair their emotions. The study does not claim dramatic clinical change, but the direction of the shifts is consistent and encouraging.

From a physiological standpoint, the increase in HF power and in heart rhythm coherence suggests stronger vagal engagement and more flexible autonomic tuning. High HRV is often described as a kind of “reserve” for dealing with life’s surprises: when the heart can speed up and slow down in a well-coordinated way, children tend to cope better with stress, regulate behaviour more effectively, and show better social adjustment. The fact that these changes emerged so quickly—primarily after the first two sessions—and then stabilised is especially interesting for school-based programmes, where time is precious and interventions must fit inside real timetables.

Emotionally, the gains in clarity and repair echo a central aim of both mindfulness and biofeedback approaches: not to erase difficult feelings, but to help children name them, understand them, and recover more smoothly. Feeling sad or angry is not the problem; getting stuck there without tools is. By pairing calm, structured VR experiences with guided awareness, this programme seems to give children just enough scaffolding to begin noticing and reshaping their inner landscape.

The absence of gender differences is also clinically useful. Many mindfulness studies in adolescents find that girls engage more and benefit more, especially in terms of anxiety and self-compassion. Here, in late childhood, boys and girls moved in broadly similar directions, suggesting that this kind of playful, visually rich format may bridge some of the usual engagement gaps.

The age pattern is perhaps the most intriguing part of the story. Contrary to expectations that older children—with more mature executive functions—would benefit more, it was the younger Year 5 pupils who showed the stronger physiological and emotional gains. One plausible interpretation is that 9–10‑year‑olds may still be in a particularly plastic phase for emotional learning, more open to new practices and less weighed down by accumulated academic stress or social pressure. Their nervous systems might simply be more willing to “try on” new patterns of breathing, attention, and feeling.

For everyday practice in schools or clinics, several themes stand out:

• Short, structured mind–body practices embedded in engaging formats can shift HRV and emotional skills without needing long, intensive programmes.

• HRV monitoring—even without real-time feedback to the child—gives an objective window into how the nervous system is responding, helping adults refine dosage, pacing, and environment.

• Younger children may be especially good candidates for early, preventive interventions that build emotional literacy and physiological flexibility before problems fully crystallise.

This study also invites comparison with more explicit biofeedback and neurofeedback approaches. HRV biofeedback typically involves teaching paced breathing at or near the individual’s resonance frequency, with real-time visual feedback on coherence. Neurofeedback uses EEG-based metrics (for example, training sensorimotor rhythm or alpha power) to shape brain activity patterns associated with calm attention, impulse control, or emotional regulation. Here, Virtual EMO‑Mind stops just short of that: HRV is monitored and analysed offline, but not fed back moment-to-moment.

Clinically, one could imagine building on this foundation by layering in simple HRV biofeedback elements—such as live coherence displays or game-like breathing guides—within the same VR scenes. For children with anxiety, irritability, or attentional challenges, EEG neurofeedback protocols could be added outside of VR sessions, targeting, for instance, sensorimotor rhythm (SMR) over central sites for behavioural inhibition, or enhancing alpha over posterior sites to support relaxation and anxiety reduction.

Of course, several limitations temper the conclusions. There was no control group, so we cannot fully rule out practice effects, maturation, or general classroom influences. The intervention was brief and there was no follow-up, so we do not know how durable these changes are. HRV was assessed only in the frequency domain and without additional time-domain metrics like mean RR or RMSSD that would have strengthened inferences about sympathetic–parasympathetic balance. And the sample did not include children with higher support needs, so generalisation to neurodivergent or clinically complex populations remains an open question.

Even so, Virtual EMO‑Mind demonstrates that VR is much more than a distraction tool: it can be an immersive container for teaching children to inhabit their bodies differently. For practitioners interested in biofeedback and neurofeedback, it offers a blueprint for integrating heart-based measures into school settings and opens the door to richer, multi-modal self-regulation programmes.

Brendan’s perspective

When I read this paper, I picture a classroom full of kids who have just come in from recess: flushed cheeks, half-finished conversations, a bit of chaos still buzzing around their nervous systems. Now imagine that, once a week, three of them step into headsets and suddenly find themselves standing in a quiet forest, or watching snow drift over the Arctic, while their hearts slowly learn a new rhythm. That’s essentially what Virtual EMO‑Mind is doing.

From a neurofeedback and biofeedback standpoint, I see three key opportunities: using HRV as a bridge into body-based awareness, using EEG neurofeedback to deepen the gains in self-regulation, and using VR strategically as a motivation amplifier rather than just a shiny toy.

First, HRV as a bridge. HeartMath-style coherence work has been integrated into many school programmes already, and for good reason: it’s simple, non-invasive, and children can quickly grasp the idea that "my breathing and feelings change how my heart beats." In practice, I always start children (and most adults) with HRV biofeedback before introducing EEG. We might use a finger or earlobe sensor to track coherence while they breathe at a comfortable, slightly slower pace—often around 6 breaths per minute—paired with images or stories that feel safe and interesting.

In a protocol inspired by this study, I’d be tempted to keep the four-session VR structure but add explicit HRV feedback. For example, during the spring forest scene, the child could see a small element of the environment—the brightness of fireflies, the movement of leaves—respond to their heart coherence in real time. The technical backend is straightforward: the EmWave or another HRV device streams coherence scores to the VR app, which translates them into subtle environmental changes. The child isn’t "chasing points" as in a video game; they’re noticing that when they breathe slowly and bring up a pleasant or grateful feeling, the world around them settles too.

Where does EEG neurofeedback come in? Once a child has tasted that sense of "I can influence what my body is doing," we can extend that to the brain. For children who primarily struggle with emotional reactivity and impulsivity, I would consider central SMR training—say at C3 or C4, sometimes Cz—reinforcing 12–15 Hz while inhibiting excess theta (4–7 Hz) and high beta (22–30 Hz). The aim is a quieter motor system and a smoother transition between rest and action, which complements the heart-based work on vagal tone.

For a child whose main challenge is anxiety, constant worry, or difficulty winding down, I could, for example, train posterior alpha. A common starting point is to reward 9–12 Hz at POz, while again inhibiting fast beta. (Important note: alpha training is not always approriate in children, for a number of factors. Never apply a protocol "blind", without first running a qEEG and, as required, being properly supervised in it's interpretation toward protocol development.) Alpha here is less about "zoning out" and more about building a relaxed, open state in which the child can still stay engaged. If a person has trouble accessing calm even in the soothing VR environments, an alpha-enhancement protocol combined with HRV coherence training can create a kind of two-channel safety signal: the heart and the posterior cortex both learn that it is permissible to relax.

The magic is in individualisation. Some children come in already highly over-aroused; their EEG maps show elevated high beta, their HRV is compressed, and they live in a near-constant fight–flight state. Others look flat: low reactivity, blunted affect, and very low-frequency variability. A comprehensive assessment—ideally including a good quality qEEG, baseline HRV, and clinical history—helps decide whether we lean more heavily on SMR, alpha, or even specific frontal targets for emotion regulation (for example, theta, alpha or high beta inhibits at F3 and F4 when mood and motivation are central concerns).

I also see big value in combining these approaches with more traditional psychotherapeutic tools. Children don’t learn regulation from signals alone; they learn it in relationship. A VR–HRV–EEG protocol wrapped inside a supportive therapeutic relationship—where feelings are named, stories are told, and the child’s real-world struggles are linked back to what we see on the screen—tends to generalise more robustly. For instance, after a coherence-rich VR session, I might ask, "When else this week did your body feel a bit like that forest—steady, slow, safe?" Or after SMR training, "Did you notice any difference when you were trying to wait your turn or finish homework?"

The research design in Virtual EMO‑Mind is, understandably, a compromise with school reality: four short sessions, no control group, and limited follow-up. In clinical practice, we usually have the opposite pattern: far more sessions (20, 30, sometimes 40 or more for EEG neurofeedback), tailored adjustments each week, and nuanced outcome tracking, but no randomisation or blinding. That’s why it’s so important not to treat short trial results as ceilings. A child who shows measurable HRV and emotional benefits after four VR sessions is telling us, "I respond to this type of input." With more sessions, more individualised parameters, and ongoing coaching, those early shifts can become the new normal rather than a temporary state.

Finally, I want to highlight how this kind of work can serve children beyond the typical classroom. The study excluded kids with autism, major behavioural disorders, or high support needs, likely to keep procedures clean and logistically manageable. In real-world practice, those are often exactly the kids we see. My hunch—grounded in broader HRV and neurofeedback research—is that many of them could benefit even more from gentle, gamified mind–body training, provided it is carefully paced and highly individualised. Short, visually rich VR segments could be interspersed with very concrete, sensor-based feedback and lots of regulation co-practiced with adults.

In short, Virtual EMO‑Mind points toward a future where "screen time" isn’t automatically the enemy of mental health. When paired with HRV and EEG neurofeedback, VR can become a training ground in which children learn, in their bones and synapses, that calm focus is not an accident—it’s a skill they can practice, own, and carry back into the noisy, beautiful chaos of real life.

Conclusion

Virtual EMO‑Mind offers a thoughtful proof-of-concept: when you combine immersive virtual reality with brief, structured mindfulness sessions in the school setting, children’s hearts and emotional skills both start to move in a healthier direction. In only four weeks, HF power and heart rhythm coherence improved, while emotional clarity and emotional repair became stronger, particularly for younger pupils on the cusp of adolescence.

Although the study’s design leaves room for more rigorous future trials—adding control groups, longer follow-up, and richer physiological indices—it already supports a practical, hopeful message. Schools and clinicians can integrate short, engaging, body-based practices into everyday routines, using HRV and, potentially, EEG feedback to track and enhance the impact.

For children who are still learning how to ride the waves of their own feelings, VR-based mindfulness and psychophysiological training may become a valuable part of the toolkit. The take-home message is simple: even small doses of well-designed, embodied practice can help young nervous systems discover a steadier, more resilient rhythm.

Reference

Olarza, A., Soroa, G., Aritzeta, A., & Mindeguia, R. (2025). Virtual EMO‑Mind: Exploring the benefits of virtual mindfulness for heart rate variability and emotional skills in young students. Applied Psychophysiology and Biofeedback. Advance online publication. https://doi.org/10.1007/s10484-025-09759-1