Improving executive function in childhood: evaluation of a training intervention for 5-year-old children

The effectiveness of a mindfulness-based intervention on improving executive functions and reducing the symptoms of attention deficit hyperactivity disorder in young children

The aim was to investigate the effectiveness of a mindfulness-based intervention on improving executive functions and reducing the symptoms of attention deficit hyperactivity disorder in young children. This study employed a quantitative approach using a quasi-experimental, pretest and post-test and follow up design. 56 children between 5 and 7 years of age(M = 6.9, SD= 1.7) with ADHD or with symptoms of inattention and hyperactivity are being recruited to participate in the mindfulness-based intervention. To determine whether there are any significant differences between the two independent (unrelated) groups on executive functions and symptoms of attention deficit hyperactivity disorder, pre-post-follow up test and multiple comparisons are used. Pretest assessments were conducted for both the control and training groups. Following the pretest, a four-weeks of training commenced for the intervention group only. T-test results for the differences in post- test mean scores between the two groups in EF and in ADHD symptoms showed that the training group outperformed the control group. There were statistical differences in EF and in ADHD symptoms between pre and post measures in favor of post test, and between pre and follow up measures in favor of follow up test, but no statistical differences between post and follow up test. This study demonstrates that it is possible to enhance EF skills using mindfulness-based intervention in which young with ADHD are engaged in a series of group play based activities.

Cognitive correlates of math abilities in autism spectrum disorder

The purpose of the current study was to investigate the contribution of different cognitive processes to specific math abilities in students with autism spectrum disorder (ASD) and typically developing (TD) students. The study involved a group of students with ASD without intellectual disabilities (n = 26) and a group with TD students (n = 52). The two groups aged from six to 20 years old and were matched for age, sex ratio and visuospatial reasoning. To assess math abilities, four math tasks were administered: arithmetic facts, mental calculation, mathematical inferences and math problem solving. Concerning cognitive processes, participants were tested on vocabulary, verbal working memory, visuospatial working memory, response inhibition and interference control. The group with ASD showed lower scores on all specific math measures than the TD group; cognitive processes differently contributed to diverse math abilities, and vocabulary and verbal working memory were stronger associated to specific math abilities in the group with ASD than in the TD group. The current results suggest that students with ASD had lower math abilities that are generalized to different math tasks. Implications for research and clinical assessment and intervention were discussed.

A Novel Battery to Assess "Cool" and "Hot" Executive Functions: Sensitivity to Age Differences in Middle Childhood

The main goal of the current work was to assess the age sensitivity of a novel battery of cool and hot Executive Function (EF) tasks developed for the middle childhood period: the Executive Brain Battery (EBB). To this end, we carried out a first study in which the EBB was administered to six age groups ranging from 6 to 11. Additionally, in a second study, we compared children at the end of middle childhood (age 11 years) and adult performance in the EBB. Results showed that tasks included in the EBB were suitable for all age groups, with more age-related changes being found in cool than hot EF tasks. Moreover, at the end of middle childhood, children reach an adult-like performance in most of these cool and hot tasks. The present findings extend previous research suggesting that cool and hot EFs exhibit different patterns of age-related growth in middle childhood. Additionally, the EEB could become a useful tool for research on EFs during middle childhood that could be adapted for a wide range of populations.

Training kindergarten children on learning from their mistakes

This study investigated whether feedback on their errors and speed improves kindergarten children's performance in an executive function (EF) task. Children from Switzerland (N = 213, 49% female, Mage = 6.4 years) were tested in the Hearts and Flowers task pre- and post-training and trained either on a variant of this task with (n = 71) or without feedback (n = 72), or on a control learning task (n = 70). The feedback group performed more efficiently than the no-feedback group during the intervention and partially also in the post-test. Both EF training groups performed more efficiently than the control group in the post-test. These results suggest that kindergarten children detect and monitor their errors and even get better at it given the opportunity to practice. Moreover, they benefit additionally from external feedback. Integrating feedback into computerized cognitive training (and learning apps) could be a potential avenue for interventions in school settings.

Recreational gymnastics exercise of moderate intensity enhances executive function in Chinese preschoolers: A randomized controlled trial

The current study aimed to investigate the impact of recreational gymnastics on executive function in Chinese preschoolers, with a focus on gymnastics potential to enhance core components of executive function. A total of 63 preschool children who received full-time education were randomly assigned to either an intervention group (N = 31, mean age = 66.27 months, SD = 3.12 months) or a control group (N = 32, mean age = 66.79 months, SD = 3.34 months). The intervention group engaged in recreational gymnastics for 60 min, three times a week for 12 weeks. Meanwhile, the control group continued with their typical outdoor activities at kindergarten and did not participate in any organized sports. The intervention program was primarily conducted through group play and was facilitated by teachers who underwent standardized training. Various simple and complex tasks were utilized to evaluate delay gratification (Snack delay and Wrapped gift), inhibitory control (Stop signal task and Circle drawing task), working memory (Letter memory task and Keep track task), and cognitive flexibility (Go/No-Go task and Dots task). The analysis of covariance revealed that the children who participated in the intervention outperformed the control group on most simple and complex executive function tasks. Specifically, these children demonstrated an enhanced ability to regulate persistent responses, process and update information, and manage high cognitive conflict. The findings of this investigation lend support to the hypothesis that moderate-intensity recreational gymnastics is an efficacious means of enhancing executive function in early childhood. Future research should employ a larger sample size, incorporate a long-term follow-up design, and utilize a multi-method approach to further substantiate the impact of moderate-intensity gymnastics on the executive function of young children, as well as to investigate its underlying mechanism and generalizability.

PROTOCOL: Key characteristics of effective preschool-based interventions to promote self-regulation: A systematic review and meta-analysis

This is the protocol for a Cochrane Review. The objectives are as follows: The aim of this systematic review is to advance our understanding of the key characteristics of effective preschool-based interventions designed to foster self-regulation. To accomplish this, the review addresses the following questions: 1. What types of preschool-based interventions have been developed to promote self-regulation? 2. What is the average effect of these preschool-based interventions on self-regulation, focusing on four key constructs: integrative effortful control, integrative executive function, self-regulation, and self-regulated learning? 3. What characteristics-such as Resource Allocation, Activity Type, and Instruction Method-could potentially contribute to the effects of preschool-based interventions in promoting self-regulation?

The effect of tDCS on inhibitory control and its transfer effect on sustained attention in children with autism spectrum disorder: An fNIRS study

BACKGROUND

Individuals with autism spectrum disorder (ASD) have inhibitory control deficits. The combination of transcranial direct current stimulation (tDCS) and inhibitory control training produces good transfer effects and improves neuroplasticity. However, no studies have explored whether applying tDCS over the dlPFC improves inhibitory control and produces transfer effects in children with ASD.

OBJECTIVE

To explore whether multisession tDCS could enhance inhibitory control training (response inhibition), near-transfer (interference control) and far-transfer effects (sustained attention; stability of attention) in children with ASD and the generalizability of training effects in daily life and the class, as reflected by behavioral performance and neural activity measured by functional near-infrared spectroscopy (fNIRS).

METHODS

Twenty-eight autistic children were randomly assigned to either the true or sham tDCS group. The experimental group received bifrontal tDCS stimulation at 1.5 mA, administered for 15 min daily across eight consecutive days. tDCS was delivered during a computerized Go/No-go training task. Behavioral performance in terms of inhibitory control (Dog/Monkey and Day/Night Stroop tasks), sustained attention (Continuous Performance and Cancellation tests), prefrontal cortex (PFC) neural activity and inhibitory control and sustained attention in the class and at home were evaluated.

RESULTS

Training (response inhibition) and transfer effects (interference control; sustained attention) were significantly greater after receiving tDCS during the Go/No-go training task than after receiving sham tDCS. Changes in oxyhemoglobin (HbO) concentrations in the dlPFC and FPA associated with consistent conditions in the Day/Night Stroop and Continuous Performance test were observed after applying tDCS during the inhibitory control training task. Notably, transfer effects can be generalized to classroom environments.

CONCLUSION

Inhibitory control training combined with tDCS may be a promising, safe, and effective method for improving inhibitory control and sustained attention in children with ASD.

Influence of rhythmic-movement activity intervention on hot executive function of 5- to 6-year-old children

Hot Executive Function (hot EF) refers to cognitive process involved in high emotion or motivation, and the operation of this function is related to the activities of the ventromedial prefrontal lobe and orbitofrontal lobe. Meanwhile, rhythmic-movement activity is a musical activity in which one expresses and feels music with one's own body movements which involves cognitive abilities such as adjusting and understanding emotions among children. To explore how rhythmic-movement activity with rewards influences the development of hot EF in children of 5-6 years old, the organization principles of rhythmic-movement activity with rewards intervention on hot EF were designed, and 62 children of 5-6 years old in a kindergarten in Yantai of China were selected as research participants (M = 5.80 years old, SD = 0.37 years old) for pre-test and post-test experimental design. The experimental group received rhythmic-movement activity with rewards three times a week for 6 weeks, while the control group did not. The gift delay task and the children's gambling task were used to measure two sub-components of hot EF before and after the intervention, and the results show that rhythmic-movement activity with rewards has a significant effect on gratification delay and affective decision-making ability of children. Finally, the effects and enlightenment of rhythmic-movement activity with rewards on hot EF are discussed.

Executive functions in children with specific learning disorders: Shedding light on a complex profile through teleassessment

Executive Functions (EFs) are high-order cognitive processes relevant to learning and adaptation and frequently impaired in children with specific learning disorders (SLDs). This study aimed to investigate EFs in children with SLD and explore the role of specific EF-related subprocesses, such as stimuli processing and processing speed. Fifty-seven SLD and 114 typically developing (TD) children, matched for gender and age, completed four tasks measuring response inhibition, interference control, shifting, and updating on a web-based teleassessment platform. The results show that SLD children performed lower in all EF tasks than TD children, regardless of stimulus type and condition. Mediation analyses suggested that differences between the SLD and TD groups are mediated by EF-related subprocesses, offering an interpretative model of EF deficits in children with SLD.

Executive Functions Training for 7- to 10-Year-Old Students With Mathematics Difficulty: Instant Effects and 6-Month Sustained Effects

Executive function (EF) training has shown promise for remedying general EF deficiencies faced by students with mathematics difficulty (MD) and for improving their performance. However, latest research also suggests that the instant and sustained effects of EF training remain inconsistent. In this study, 32 Chinese students with MD, age 7 to 10 years, were recruited and randomly divided into two groups: the training group (n = 16, 25 training sessions) and the control group (n = 16). Both groups took a pretest, a posttest, and a follow-up test (after 6 months) on EF, fluid intelligence, and mathematics skills. In the posttest, the training group's performance significantly improved in 2-back, number shifting, letter shifting, calculation fluency, and mathematics problem-solving tasks, but not in Stroop, Flanker, 1-back, numerical operations, and colored progressive matrices tasks. In the follow-up test after 6 months, the effects of training only on the 2-back and letter shifting tasks were sustained. The effect on the numerical operations task appeared; however, the effects on number shifting, calculation fluency, and mathematics problem-solving tasks disappeared. The results of this study show that EF training has instant effects of improving EF and mathematics skills of students with MD, and 6-month sustained effects on some of the improved skills. However, for fluid intelligence, the effects may be very limited.

Differential effects of mindfulness meditation and cognitive training on cool and hot inhibitory control in children and adolescents

Inhibitory control (IC) can occur either in a neutral context (cool) or in social contexts involving emotions (hot). Cool and hot IC have specific developmental trajectories; cool IC develops linearly from childhood to adulthood, whereas hot IC follows a quadratic trajectory. Some activities can improve the IC, such as cognitive training (CT) and mindfulness meditation (MM). The aim of our study was to compare the effects of 5 weeks of computerized MM versus CT on IC performance in 66 children (9-10 years old) and 63 adolescents (16-17 years old) by specifically analyzing cool and hot dimensions in the same participants and from a developmental perspective. We fit a linear mixed-effect model on the Stroop interference score with time (pretest vs. posttest) and type of conflict (cool vs. hot) as within-participant factors and intervention group (CT vs. MM) and age group (child vs. adolescent) as between-participant factors. The findings revealed that children but not adolescents benefitted from interventions. More specifically, CT improved cool IC but not hot IC, whereas MM practice improved hot IC but not cool IC. This study supports the benefits of MM at a young age. Theoretical issues linking MM programs to emotional competence grounded in hot IC skills are considered in academic settings.

Executive functioning in preschoolers with 22q11.2 deletion syndrome and the impact of congenital heart defects

BACKGROUND

Executive functioning (EF) is an umbrella term for various cognitive functions that play a role in monitoring and planning to effectuate goal-directed behavior. The 22q11.2 deletion syndrome (22q11DS), the most common microdeletion syndrome, is associated with a multitude of both somatic and cognitive symptoms, including EF impairments in school-age and adolescence. However, results vary across different EF domains and studies with preschool children are scarce. As EF is critically associated with later psychopathology and adaptive functioning, our first aim was to study EF in preschool children with 22q11DS. Our second aim was to explore the effect of a congenital heart defects (CHD) on EF abilities, as CHD are common in 22q11DS and have been implicated in EF impairment in individuals with CHD without a syndromic origin.

METHODS

All children with 22q11DS (n = 44) and typically developing (TD) children (n = 81) were 3.0 to 6.5 years old and participated in a larger prospective study. We administered tasks measuring visual selective attention, visual working memory, and a task gauging broad EF abilities. The presence of CHD was determined by a pediatric cardiologist based on medical records.

RESULTS

Analyses showed that children with 22q11DS were outperformed by TD peers on the selective attention task and the working memory task. As many children were unable to complete the broad EF task, we did not run statistical analyses, but provide a qualitative description of the results. There were no differences in EF abilities between children with 22q11DS with and without CHDs.

CONCLUSION

To our knowledge, this is the first study measuring EF in a relatively large sample of young children with 22q11DS. Our results show that EF impairments are already present in early childhood in children with 22q11DS. In line with previous studies with older children with 22q11DS, CHDs do not appear to have an effect on EF performance. These findings might have important implications for early intervention and support the improvement of prognostic accuracy.

Atypical development of social and nonsocial working memory capacity among preschoolers with autism spectrum disorders

Individuals with autism spectrum disorders (ASD) have shown impaired performance in canonical and nonsocial working memory (WM). However, no study has investigated social WM and its early development. Using biological motion stimuli, our study assessed the development of social and nonsocial WM capacity among children with or without ASD across the age span between 4 and 6 (N = 150). While typically developing (TD) children show a rapid development from age 5 to 6, children with ASD showed a delayed development for both social and nonsocial WM capacity, reaching a significant group difference at age 6. Furthermore, we found a negative correlation between social (but not nonsocial) WM capacity and the severity of autistic symptoms among children with ASD. In contrast, there is a positive correlation between both types of WM capacity and intelligence among TD children but not among children with ASD. Our findings thus indicate that individuals with ASD miss the rapid development of WM capacity in early childhood and, particularly, their delayed social WM development might contribute to core symptoms that critically depend on social information processing.

Prenatal organophosphorus pesticide exposure and executive function in preschool-aged children in the Norwegian Mother, Father and Child Cohort Study (MoBa)

INTRODUCTION

Prenatal exposure to organophosphorus pesticides (OPPs) has been associated with neurodevelopmental deficits in children, however evidence linking OPPs with specific cognitive mechanisms, such as executive function (EF), is limited.

OBJECTIVE

This study aims to evaluate the association between prenatal exposure to OPPs with multiple measures of EF in preschool-aged children, while considering the role of variant alleles in OPP metabolism genes.

METHODS

We included 262 children with preschool attention-deficit/hyperactivity disorder (ADHD), and 78 typically developing children, from the Preschool ADHD substudy of the Norwegian, Mother, Father, and Child Cohort Study. Participants who gave birth between 2004 and 2008 were invited to participate in an on-site clinical assessment when the child was approximately 3.5 years; measurements of EF included parent and teacher rating on Behavior Rating Inventory of Executive Function-Preschool (BRIEF-P), and three performance-based assessments. We measured OPP metabolites in maternal urines collected at ∼17 weeks' gestation to calculate total dimethyl- (ΣDMP) and diethyl phosphate (ΣDEP) metabolite concentrations. We estimated multivariable adjusted β's and 95% confidence intervals (CIs) corresponding to a change in z-score per unit increase in log-ΣDMP/DEP. We further characterized gene-OPP interactions for maternal variants in PON1 (Q192R, M55L), CYP1A2 (1548T > C), CYP1A1 (IntG > A) and CYP2A6 (-47A > C).

RESULTS

Prenatal OPP metabolite concentrations were associated with worse parent and teacher ratings of emotional control, inhibition, and working memory. A one log-∑DMP increase was associated with poorer teacher ratings of EF on the BRIEF-P (e.g. emotional control domain: β = 0.55, 95% CI: 0.35, 0.74), when weighted to account for sampling procedures. We found less consistent associations with performance-based EF assessments. We found some evidence of modification for PON1 Q192R and CYP2A6 -47A > C. Association with other variants were inconsistent.

CONCLUSIONS

Biomarkers of prenatal OPP exposure were associated with more adverse teacher and parent ratings of EF in preschool-aged children.

Effectiveness of a process-based executive function intervention on arithmetic knowledge of children with Developmental Dyscalculia

BACKGROUND

Arithmetic knowledge has long been known as an essential factor for educational and vocational success.

AIMS

This study aims to explore the effectiveness of a process-based Executive Function (EF) intervention program on the improvement of components of arithmetic.

METHODS AND PROCEDURE

A goal-directed sampling method was applied in this study. Participants were assigned into active control and experimental groups. Semi-experimental design with pre-test, post-test and follow-up was utilized in this research. Participants were included in this study based on their WISC-IV and Key-Math test performance. 30 male students aged 8-10 years with a formal diagnosis of Developmental Dyscalculia (DD), selected from a learning disability center in Ahvaz, Iran, participated in the study. The pre-test took 1 month, the intervention including 17 sessions, took two months and the post-test took 1 month. All the students' arithmetic knowledge were tested in pre-test, post-test, and 3 months after post-test to test the longevity of the intervention effects. Repeated measure Univariate Analysis of Variance was conducted in this study.

OUTCOMES AND RESULTS

The results indicate that the students who attended the intervention, outperformed control group in the components of factual and procedural arithmetic in post-test and follow-up, however; the performance of two groups in conceptual knowledge was not different. This study contributes to the emerging evidence that EF intervention may improve factual and procedural arithmetic knowledge in children with DD.

CONCLUSIONS AND IMPLICATIONS

Process-based EF interventions can improve arithmetic knowledge of students with DD, which can contribute to the literature of this area WHAT THIS PAPER ADDS?: The current research helps cognitive science to present a more meticulous theoretical and conceptual pattern for EF components and math, using process-based EF intervention programs with arithmetic content. Furthermore, this research allows for specification of cognitive fundamentals of arithmetic development and understanding the mechanisms underlying the transfer effect of EF intervention to math. The findings of this research can contribute to evidence-based EF intervention studies and help educational psychologists in preparation of appropriate curricula based on the fundamental components of arithmetic development in preschool and primary school.

On the Relation between the Development of Working Memory Updating and Working Memory Capacity in Preschoolers

This study aims at investigating the relationship between working memory updating and working memory capacity in preschool children. A sample of 176 preschoolers (36–74 months) was administered a working memory updating task (Magic House) along with three working memory capacity tests that specifically measure their core attentional component (M capacity, as defined in the theory of constructive operators): Backward Word Span, Mr. Cucumber, and Direction Following Task. Correlational analyses and cross-classification prediction analyses were performed. Updating and capacity were significantly correlated, although the correlations were not high when age was partialled out. Capacity increased with age, and mediated the relation between age and updating. More importantly, cross-classification prediction analysis revealed that high updating scores with low M capacity, and low updating scores with relatively high M capacity, are possible events; the only combination ruled out was a low updating score with precocious development of M capacity. These facts demonstrate that updating skills in preschoolers depends on M capacity but does not coincide with it. Therefore, in cognitive developmental theories, the constructs of working memory updating and capacity should be distinguished, and on practical grounds, different tests should be used to measure them.

A multidimensional evaluation of the benefits of an ecologically realistic training based on pretend play for preschoolers' cognitive control and self-regulation: From behavior to the underlying theta neuro-oscillatory activity

To what extent can cognitive control, self-regulation, and the underlying midfrontal theta oscillatory activity of preschool children be modified by an ecologically realistic training based on pretend play? To answer this question, 70 children aged 4-6 years (37 boys) were assigned to a training group or a control group using a pairing randomization procedure. Children were administered 20 play sessions over 10 weeks. Benefits were evaluated with a pre-post design. The intervention helped children to engage more in self-regulation within the training activities. However, the intervention did not promote self-regulation outside of the training context, nor did it influence cognitive control and theta activity. These results provide a better understanding of the limitations of an ecologically realistic approach to cognitive control training.

Chronic stress predicts post-traumatic stress disorder symptoms via executive function deficits among urban American Indian children

Little is known about how chronic exposure to stress affects mental health among American Indian (AI) children. The current study aimed to fill this gap by exploring if hair cortisol concentration (HCC), an indicator of chronic stress, predicted post-traumatic stress disorder (PTSD) symptoms through deficits in executive function (EF) skills commonly referred to as inhibitory control, working memory, and cognitive flexibility. A total of 163 urban AI children between 8- and 15-years old participated in the study (92 girls, 56.4%; M_age = 11.19, SD = 1.98). Chronic stress was measured as the concentration of cortisol in children's hair. EF deficits and PTSD symptoms were reported by primary caregivers using the Behavior Rating Inventory of Executive Function and the Trauma Symptom Checklist for Young Children. The results demonstrated that higher HCC was indirectly associated with more PTSD symptoms through deficits in EF skills. Specifically, higher levels of HCC were related to more symptoms of PTSD arousal through impaired working memory, and more symptoms of PTSD avoidance and Intrusion through deficits in cognitive flexibility. The findings suggest interventions that reduce or buffer chronic stress, or that focus on improving EF skills, may promote not only cognitive development but also the mental health of AI children.

Cognitive training improves emotion regulation in Chinese preschool children

BACKGROUND

The ability to regulate emotion effectively plays a key role in child psychosocial development and mental health. The current study examines the effect of cognitive training for executive function on emotion regulation in Chinese preschool children, and further investigate the underlying mediating mechanisms.

METHODS

A cluster randomized control trial design with pre-test and post-test was conducted in 61 preschool children aged 3-6 years in China. The intervention group consisted of 30 children who received eight cognitive training sessions on executive function, while the control group consisted of 31 children who did not receive any psychological training. Children's executive function was measured individually via five laboratory tasks both in the pre-test and post-test. Adaptive and maladaptive emotion regulation strategies were coded in emotion-elicit contexts.

RESULTS

Intervention group outperformed control group in working memory and inhibitory control. Children in the intervention group exhibited increased use of adaptive emotion regulation strategies and decreased use of maladaptive emotion regulation strategies than children in the control group. Mediation analyses indicated that there were significantly indirect effects of Intervention Condition on the gain scores of adaptive and maladaptive emotion regulation strategies through the gain score of inhibitory control.

CONCLUSIONS

Executive function training effectively promotes working memory, inhibitory control and the use of adaptive emotion regulation strategies, and reduces the use of maladaptive emotion regulation strategies. In addition, executive function training improves the use of adaptive and maladaptive emotion regulation strategies through the enhancement of inhibitory control capacity.

Waiting for the better reward: Comparison of delay of gratification in young children across two cultures

Delay of gratification-a form of self-control-is the ability to forsake immediately available rewards in order to obtain larger-valued outcomes in future, which develops throughout the pre-school years. The majority of previous research in this area has been conducted with Western populations, therefore knowledge of Eastern children's performance is scarcer. Here, utilising on a recently published dataset of British children (n = 61), we further tested delay of gratification in 3 to 5-year-old Chinese children (n = 75) using Bramlett et al.'s (2012) delay choice paradigm. The paradigm was previously used in non-human primates and it featured a mechanized rotating tray that sequentially moves rewards within reach. Additionally, we administered 3 inhibitory control tasks and 1 standardised delay choice task to Chinese pre-schoolers (British children were not tested). We aimed to investigate the influence of culture, reward type and reward visibility on pre-schoolers' ability to delay gratification. We found significant age-related improvements in delay of gratification ability in both countries and children performed better when presented with rewards varying in quality than quantity. Consistent with previous cross-cultural literature, Chinese children showed better overall performance than their British peers when reward visibility was manipulated (though reward visibility itself had no significant effect on performance). There were significant correlations in Chinese children's performance in Bramlett et al.'s (2012) delay choice paradigm and performance in some (though not all tested) inhibitory control tasks. We discuss these results in relation to task demands and the broader social orientation of self-control. We concluded that the intuitive comparative assessment of self-control task taps into children's delay of gratification ability. Our results emphasize the importance of testing for socio-cultural influences on children's cognitive development.

Thinking inside the box: Mental manipulation of working memory contents in 3- to 7-year-old children

We developed a non-verbal task assessing updating and manipulation of working memory contents. 80 3- to 7-year-olds (47 girls; predominantly European White) were tested with a 4 × 4 grid containing 8 boxes (in the 4 centre cells and 4 outer corners). A sticker was hidden and children searched for it after a delay phase. In the updating trials, the grid was rotated during delays, in the manipulation trials, the grid was both occluded and rotated. Rewards were hidden in either the inner or outer boxes (between-subjects design). Performance was affected by age, rotation degree and hiding condition. Performance was better in outer boxes trials, where visual tracking was easier. Occluded inner trials added a substantial cognitive load (which increased with degree of rotation), resulting in children performing at chance level, suggesting that manipulation involving mental rotation is a distinct skill from tracking invisible object displacement, with a more protracted development.

Reducing Aggression by Developing Emotional and Inhibitory Control

The objective of this study is to measure the effectiveness of a program on improving inhibitory and emotional control among children. In addition, it is assessed whether the improvement of these skills has an effect on the reduction of aggressive behavior in pre-school children. The participants were 100 children, 50 belonging to the control group and 50 to the experimental group, aged between 5 and 6 years. Pre-intervention and post-intervention measures of inhibitory and emotional control (BRIEF-P) and aggression (BASC) were taken. A Generalized Linear Mixed Model analysis (GLMM) was performed and found that children in the experimental group scored higher on inhibitory and emotional control compared to their peers in the control group. In addition, these improvements have an effect on the decrease in aggressiveness. In conclusion, preventive research should have among its priorities the design of such program given their implications for psychosocial development.

Dialogic Reading to Empower Executive Functions in Preschoolers

Among the interventions recently developed to enhance Executive Functions (EFs) in preschoolers, Quincey Quokka’s Quest (QQQ) is an illustrated book proposing EF activities embedded within a shared reading framework (Howard et al., 2017). In the present study, the Italian version of QQQ (QQQ_IT) was tested in 20 typical developing 4–5 year old children. Standardized tests were used to assess EFs pre- and post- intervention. QQQ_IT was conducted once a week for 8 weeks in small groups. A positive trend was registered in QQQ_IT performances from the first to the last sessions and a significant improvement, in comparison to the control condition, was obtained in the Color and Form Game test. These results, supporting the feasibility of the QQQ_IT intervention and its efficacy in increasing shifting abilities, confirm the usefulness of ecological interventions to empower specific EF components in preschool contexts.

Do cognitive interventions for preschoolers improve executive functions and reduce ADHD and externalizing symptoms? A meta-analysis of randomized controlled trials

Many interventions targeting executive function (EF) development in the preschool period, where malleability might be particularly high, have been created and evaluated. We conducted a meta-analysis of randomized controlled trials (RCTs) on the effects of these interventions on (a) EFs in preschool children from the general population as well as preschool children with (symptoms of) attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD), and (b) ADHD and ODD symptoms in preschool children with ADHD/ODD (symptoms). Literature search yielded 35 RCTs. Risk of bias of the individual studies was assessed. A random-effects model was used. Moderator effects were tested using mixed model analyses. The overall effects on EFs were: d = 0.46 (95% CI 0.30-0.61) for working memory (WM), d = 0.30 (95% CI 0.21-0.38) for inhibitory control (IC), d = 0.33 (95% CI - 0.04 to 0.71) for reward-related IC, and d = 0.47 (95% CI 0.28-0.66) for flexibility. In children with ADHD/ODD, mean effects were d = 0.64 (95% CI 0.31-0.96) for WM and d = 0.46 (95% CI 0.07-0.84) for IC. Studies on reward-related IC and FL were lacking. Effects on ODD and ADHD symptoms were d = 0.40 (95% CI - 0.23 to 1.03) and d = 0.28 (95% CI - 0.08 to 0.64), respectively. Interventions targeting multiple EFs and using interpersonal cognitive scaffolding approaches showed large and statistically significant effects on ADHD and ODD symptoms. In preschool children of the general population and in those with ADHD/ODD (symptoms), interventions led to an improvement of EF performance. In children with ADHD and ODD, cognitive scaffolding interventions were most effective in terms of reducing ADHD and ODD symptoms. However, more well-controlled studies need to be conducted before any firm conclusions can be drawn.

Cognitive flexibility training has direct and near transfer effects, but no far transfer effects, in preschoolers

The current project studied the direct, near transfer, and far transfer effects of cognitive flexibility training in two experiments with 117 3-year-olds. In both Experiments 1 and 2, children performed three Dimensional Change Card Sorting (DCCS) tasks in a pre-training/training/post-training design. The training consisted of giving corrective feedback in the training DCCS task. In Experiment 2, in addition, three other executive control tasks were administered during pre-training and post-training. Results showed a direct effect of feedback in the training DCCS task and transfer of this effect to the post-training DCCS task after 1 week with different sorting rules and different stimuli. These findings show that preschoolers learned to switch sorting rules in the context of the DCCS task, independent of the specific sorting rules, and that this effect is not transient. No support was found for transfer to the other executive control tasks. A possible explanation is that the feedback mainly improved rule switching, an ability that is specifically required for performing a cognitive flexibility task but not the other executive control tasks.

Altered Functional Connectivity in the Motor and Prefrontal Cortex for Children With Down's Syndrome: An fNIRS Study

Children with Down's syndrome (DS) might exhibit disrupted brain functional connectivity in the motor and prefrontal cortex. To inspect the alterations in brain activation and functional connectivity for children with DS, the functional near-infrared spectroscopy (fNIRS) method was applied to examine the brain activation difference in the motor and prefrontal cortex between the DS and typically developing (TD) groups during a fine motor task. In addition, small-world analysis based on graph theory was also carried out to characterize the topological organization of functional brain networks. Interestingly, behavior data demonstrated that the DS group showed significantly long reaction time and low accuracy as compared to the TD group (p < 0.05). More importantly, significantly reduced brain activations in the frontopolar area, the pre-motor, and the supplementary motor cortex (p < 0.05) were identified in the DS group compared with the TD group. Meanwhile, significantly high global efficiency (E g ) and short average path length (L p ) were also detected for the DS group. This pilot study illustrated that the disrupted connectivity of frontopolar area, pre-motor, and supplementary motor cortex might be one of the core mechanisms associated with motor and cognitive impairments for children with DS. Therefore, the combination of the fNIRS technique with functional network analysis may pave a new avenue for improving our understanding of the neural mechanisms of DS.

Empowering Executive Functions in 5- and 6-Year-Old Typically Developing Children Through Educational Robotics: An RCT Study

Educational Robotics (ER) is a new learning approach that is known mainly for its effects on scientific academic subjects such as science, technology, engineering, and mathematics. Recent studies indicate that ER can also affect cognitive development by improving critical reasoning and planning skills. This study aimed to quantify the ability of ER to empower Executive Functions (EF), including the ability to control, update, and program information, in 5- and 6-year-old children attending first grade, a crucial evolutionary window for the development of such abilities. A total of 187 typically developing children were enrolled and randomly allocated into two experimental conditions: A, for immediate ER training, and B, for waitlist. ER-Laboratories (ER-Lab) for small groups were organized at schools, using a child-friendly, bee-shaped robot called Bee-Bot^® (Campus Store). Activities were intensive, enjoyable, and progressively more challenging over the 20 twice-weekly sessions. Outcome measures, based on standardized tests, were used to quantify the effects of ER on EF. Compared to the control group, the ER-Lab group showed significantly better ability to actively manipulate information in short-term memory and suppress automatic responses in favor of goal-appropriate actions. This RCT study provides the first quantitative evidence of the positive effects of ER activities for improving working memory and inhibition in the early school years.

Is Cognitive Training Effective for Improving Executive Functions in Preschoolers? A Systematic Review and Meta-Analysis

In the present meta-analysis, we examined the effect of cognitive training on the Executive Functions (EFs) of preschool children (age range: 3–6 years). We selected a final set of 32 studies from 27 papers with a total sample of 123 effect sizes. We found an overall effect of cognitive training for improving EF (g = 0.352; k = 123; p < 0.001), without significant difference between near and far transfer effects on executive domains. No significant additional outcome effects were found for behavioral- and learning-related outcomes. Cognitive training programs for preschoolers are significantly more effective for developmentally at-risk children (ADHD or low socio-economic status) than for children with typical development and without risks. Other significant moderators were: individual vs. group sessions and length of training. The number of sessions and computerized vs. non-computerized training were not significant moderators. This is the first demonstration of cognitive training for transfer effects among different executive processes. We discuss this result in relationship to the lower level of modularization of EFs in younger children.

Improving Executive Functions at School in Children With Special Needs by Educational Robotics

Children with Special Needs represent a highly heterogeneous group in terms of neurofunctional, behavioral, and socio-cognitive characteristics, but they have in common a frequent impairment of Executive Functions. Educational Robotics is generally dedicated to study the effects of constructing and programming robots based on children's learning and academic achievement. Recently, we found that being engaged in progressively more challenging robot planning and monitoring (ER-Lab) promotes visual-spatial working memory and response inhibition in early childhood during typical development, and that an ER-Lab can be a feasible rehabilitative tool for children with Special Needs. The present study aimed to verify the efficacy of the ER-Lab on Executive Functions in children with Special Needs for the first time by using an RCT within their school environment. To pursue these aims, this study reports the results obtained in 42 first-grade children with Special Needs engaged in school Educational Robotics Laboratories (ER-Lab) to promote Executive Functions by means of enjoyable, intensive, and incrementally more challenging activities requiring them to program a bee-shaped robot called Bee-bot® (Campus Store). Several adaptations were done to meet different motor, cognitive, and social needs. All children were evaluated by means of standardized tests performed by each child before and at the end of the ER-Lab activities. Children with Special Needs had significantly improved inhibition skills, and children with attentional impairment had more benefits in their inhibition of motor responses tasks with respect to children with a language deficit. Results of the study and future perspectives on how ER-Lab programs could become a powerful tool in classrooms with children with special needs are discussed.

Efficacy of a computer-based cognitive training program to enhance planning skills in 5 to 7-year-old normally-developing children

We designed and evaluated the efficacy of a computer-based cognitive training program (Executive Function Enhancement Program [EFEP]) to stimulate executive functions through enhancing planning in normally-developing children. A total of 111 Colombian children participated in the study. Fifty-nine (53%) of the children were assigned to the experimental condition (application of the EFEP program) with two levels of planning performance, and fifty-two (47%) to the waiting list control condition with the same two levels of planning. The training program was applied three times a week over six weeks, with post-intervention assessment two weeks after the end of training. A follow-up assessment was carried out three months later. Results showed that the intervention program was particularly effective in the children with lower pre-intervention performance in planning, demonstrating that the program is an efficient therapeutic instrument for enhancing the executive function of planning in children between 5 and 7 years old.

Improvement of Planning Skills in Children With Autism Spectrum Disorder After an Educational Intervention: A Study From a Mixed Methods Approach

The literature confirms that individuals with autism spectrum disorder (ASD) have planning deficits. However, few interventions have targeted these deficits. The aims of this study were to: (1) show that the mixed methods approach can be useful in studying planning skills of children with ASD during and after an educational intervention; (2) assess whether the planning skills of two groups of children with ASD improved during the intervention and if this progress was maintained 1 month after completing the intervention. The groups were formed depending on each child’s severity level (SL) of ASD according to DSM-5: SL1 (requiring support) and SL2 (requiring substantial support). Each group was composed of four children. In the framework of mixed methods, we used observational methodology, which is considered as mixed methods in itself because it integrates qualitative and quantitative elements. A nomothetic/follow-up/multidimensional observational design was used. Planning skills manifested by children during the intervention were codified, as well as the scaffolding behaviors provided by the educational specialist. These skills and behaviors were also coded in one session, which took place 1 month after the intervention. Coded data of each group were submitted to prospective and retrospective lag sequential analysis. This informed of the sequential structure of planning skills performed by children in interaction with the educational specialist at the beginning and at the end of the intervention, as well as 1 month later after the intervention. The comparison of the patterns obtained in these three temporal moments allowed us to know the improvement of the two groups in the use of planning skills. Results showed that both groups improved their autonomous use of planning skills. However, SL1 group used successfully and autonomously complex planning skills, while SL2 group were unable to achieve this gain. SL2 group progressed in autonomy, but only using basic planning skills. Both groups can further improve their use of planning skills; therefore, the intervention should be adjusted to their characteristics and temporarily extended. These findings contribute to the, as yet, little studied field of intervention and assessment of planning skills in children with ASD using a mixed methods approach.

Coding in Primary Grades Boosts Children's Executive Functions

Several programs have been developed worldwide to improve children’s executive functions (EFs). Yet, the role played in EF development by learning activities embedded in the school curriculum has received scarce attention. With two studies, we recently tested the effects of computational thinking (CT) and coding—a new element of the primary school curriculum—on the development of children’s EFs. CT stimulates the ability to define a clear and orderly sequence of simple and well-specified steps to solve a complex problem. We conjecture that CT skills are associated to such EF processes as response inhibition and planning. In a first between-group cluster-randomized controlled trial, we tested the effects of 1-month coding activities on 76 first graders’ planning and response inhibition against those of 1-month standard STEM activities of a control group. In a second study, we tested the effects of 1-month coding activities of 17 second graders in two ways: within group (longitudinally), against 7 months of standard activities experienced by the same children (experimental group); and between groups, in comparison to the effects of standard STEM activities in a control group of 19 second graders. The results of the two studies show significant benefits of learning to code: children exposed to coding improved significantly more in planning and inhibition tasks than control children did. The longitudinal data showed that improvements in planning and inhibition skills after 1 month of coding activities (eight lessons) were equivalent to or greater than the improvement attained after 7 months of standard activities. These findings support the hypothesis that learning CT via coding can significantly boost children’s spontaneous development of EFs.

Computer-Based Cognitive Training Improves Brain Functional Connectivity in the Attentional Networks: A Study With Primary School-Aged Children

We have shown that a computer-based program that trains schoolchildren in cognitive tasks that mainly tap working memory (WM), implemented by teachers and integrated into school routine, improved cognitive and academic skills compared with an active control group. Concretely, improvements were observed in inhibition skills, non-verbal IQ, mathematics and reading skills. Here, we focus on a subsample from the overarching study who volunteered to be scanned using a resting state fMRI protocol before and 6-month after training. This sample reproduced the aforementioned behavioral effects, and brain functional connectivity changes were observed within the attentional networks (ATN), linked to improvements in inhibitory control. Findings showed stronger relationships between inhibitory control scores and functional connectivity in a right middle frontal gyrus (MFG) cluster in trained children compared to children from the control group. Seed-based analyses revealed that connectivity between the r-MFG and homolateral parietal and superior temporal areas were more strongly related to inhibitory control in trained children compared to the control group. These findings highlight the relevance of computer-based cognitive training, integrated in real-life school environments, in boosting cognitive/academic performance and brain functional connectivity.

Effectiveness of an Executive Function Training in Italian Preschool Educational Services and Far Transfer Effects to Pre-academic Skills

In this study we examine the effectiveness and far transfer effects of a training that was found to be effective in promoting Executive Function (EF) in a sample of 5-year-old children (Traverso et al., 2015). By contrast with Traverso et al. (2015), the intervention was administered by regular teachers to verify its ecological validity. Far transfer was assessed by evaluating the training effects on pre-academic skills. 126 children attending the last year of Italian preschool educational services took part in the study (mainly 5-year-old children). Pre- and post-test assessments were conducted using a large EF and pre-academic skill task battery. The results indicate that the experimental group outperformed the control group in an interference suppression composite score. Moreover, significant far transfer effects to pre-academic skills in literacy domain were found. In addition, we found that the improvement in the pre academic skills (in both literacy and math domains) was mediated by the improvement in the interference suppression score. The results suggest the possibility that this intervention, which may be easily implemented in the context of educational services, can promote EF during the preschool period before entry to primary school.

Executive Functions Can Be Improved in Preschoolers Through Systematic Playing in Educational Settings: Evidence From a Longitudinal Study

This study aimed to test the impact of play on the development of executive functions (EFs) in preschoolers. Thirty-two games were designed to be collectively played in groups by 70 children, in their regular classes. The games were specifically designed to promote the development of the three components of EFs: inhibition (behavioral or cognitive), working memory, and cognitive flexibility. The games focused on each function were of three types: playground games, expression games, and classroom games. Sixty 45 min play sessions were held on consecutive days for 3 months, always in the first period. The sessions were guided by two members of the research team, assisted by the four teachers of the participating classes. The intervention was carried out in two highly socially vulnerable schools in the city of Santiago de Chile. Four classes were studied in total: two experimental groups and two controls. The classes were selected using a questionnaire on teacher-student interaction quality and an age homogeneity criterion. EFs were evaluated using the Hearts and Flowers task at three points: before the intervention (T1), immediately after the end of the intervention (T2), and 8 months after the end of the intervention (T3). The results show a significant difference in the growth of EFs by comparing the experimental and control groups (p = 0.04) between T1 and T3. They also reveal a strong correlation between EFs measures at T1 and mathematics performance at T3. These results are discussed within the context of the guidelines proposed by Diamond and Ling (2016) and Barnett (2011) regarding what an EFs promotion program needs to be considered effective and high quality. The program presented in this study meets most of the requisites mentioned by the authors, which proves that following these guidelines guarantees a high probability of success.

Sustained Effect of Music Training on the Enhancement of Executive Function in Preschool Children

Musical training is an enrichment activity involving multiple senses, including auditory, visual, somatosensorial, attention, memory, and executive function (EF), all of which are related to cognition. This study examined whether musical training enhances EF in preschool children who had not undergone previous systematic music learning. This study also explored the after-effects 12 weeks after cessation of musical training. Participants were 61 preschool children from a university-affiliated kindergarten in North China. The experimental group underwent 12 weeks of integrated musical training (i.e., music theory, singing, dancing, and role-playing), while the control group performed typical daily classroom activities. The three components (inhibitory control, working memory, cognitive flexibility) of executive functions were evaluated using the Day/Night Stroop, Dimensional Change Card Sort, Dot Matrix Test, and Backward Digit Span Task. In Experiment 1, EFs were tested twice-before (T1) and after (T2) the music training. The results showed that children's EFs could be promoted by musical training. In addition, EFs were tested again 12 weeks later after the end of the intervention (T3) in Experiment 2. We discovered that integrated musical training demonstrated a sustained promotion effect.

Program for the Neuropsychological Stimulation of Cognition in Students: Impact, Effectiveness, and Transfer Effects on Student Cognitive Performance

Despite the crucial role played by the executive functions (EF) to cognitive, emotional, and social development of children before and during school years, little attention has been given to construct and analyze the efficacy of programs that intend to develop them. The program of neuropsychological stimulation of cognition in students: emphasis on EF, or PENcE (an acronym from its original name in Portuguese, Programa de Estimulação Neuropsicológica da Cognição em Escolares: ênfase nas Funções Executivas), is an early and preventive intervention program for school-aged children, and implemented at school three times a week for 5 months. The PENcE was structured in four modules, each focusing on a different executive component: organization and planning, inhibitory control, working memory, and cognitive flexibility. The objectives of this study were to verify the effectiveness of the PENcE among elementary school children and to investigate whether there are transfer effects to other executive, cognitive, and academic abilities. The sample consisted of 113 children attending 3rd or 4th grade at two public elementary schools. Eight classes participated in the study, divided into two groups: an experimental group (EG) (four classes; n = 64), which received the intervention, and a control group (CG) (four classes; n = 49), which continued their regular school activities. The EF and academic skills of both participant groups were evaluated before and after the intervention. The EG showed significantly greater improvements in inhibitory control, working memory, and abstract planning relative to the CG, with a small to medium effect size. There were transfer effects to other cognitive and academic abilities. These findings suggest the PENcE may be a useful method of improving EF and could benefit both school-aged children and education professionals.

The efficacy of a training that combines activities on working memory and metacognition: Transfer and maintenance effects in children with ADHD and typical development

Introduction: It has been demonstrated that children with attention deficit and hyperactivity disorder (ADHD) have impairments in working memory (WM), and particularly its visuospatial component, responsible for academic underachievement. Furthermore, children with ADHD have difficulty in metacognition, and consequently use inappropriate strategies to control attention and impulsive behavior. The aim of the present study was to devise a training that combined individual exercises on visuospatial WM and group metacognitive activities capable of helping children with ADHD to ameliorate their performance in executive functioning tasks, and to contain their inattentive and hyperactive/impulsive behavior. Method: A combined training that focused on visuospatial WM and metacognition was administered to 12 children with a diagnosis of ADHD and 15 typically-developing children. Tasks on executive functions and questionnaires for parents and teachers were administered before and at the end of the training, and one month after the post-test. Specific short- and long-term training gains and transfer effects were examined. Effects of the training on parents' and teachers' ratings were also considered. Results: Specific gains and transfer effects were found at the post-test and long-term assessments in both typically-developing children and those with ADHD. Parents' and teachers' ratings also indicated an improvement in the symptomatic behavior of children with ADHD. Conclusion: The results of this study have clinical and educational implications. A training that combines individual computerized visuospatial WM activities with metacognitive group reflection about useful strategies seems to produce promising results, helping children with ADHD to improve their executive functioning and behavioral problems.

Childhood Self-Control and Adolescent Obesity: Evidence from Longitudinal Data on a National Cohort

BACKGROUND

Whether self-control at school entry and changes in self-control in the early school years are predictive of BMI change and obesity onset over the next 8 years using longitudinal data on a nationally representative sample of US children.

METHODS

Data from the Early Childhood Longitudinal Study-Kindergarten Class 1998 were analyzed. The analysis sample included 7060 children with data from kindergarten (mean age = 6 years) until eighth grade (mean age = 14 years). Self-control was assessed using teacher-reported scales. Child BMI and obese status (BMI ≥95th percentile for age and gender) were computed from height and weight measurements. Weighted linear and logistic regression models were estimated, adjusting for child's cognitive ability and a rich set of child and family covariates.

RESULTS

High self-control in kindergarten was associated with lesser BMI increase (p < 0.05) and 43% lower odds (adjusted OR [AOR] = 0.57, 95% confidence interval [CI]: 0.38-0.86) of new onset obesity over the subsequent 8 years. The beneficial effect of high self-control in kindergarten emerged between fifth and eighth grade. Among children with low self-control in kindergarten, increase in self-control between kindergarten and fifth grade was associated with a 1.42 kg/m² (95% CI: -2.82 to -0.02) lesser increase in BMI and 66% lower odds of new obesity onset (AOR = 0.34; 95% CI: 0.14-0.83), between kindergarten and eighth grade.

CONCLUSIONS

Low self-control at school entry is an important risk factor for unhealthy BMI increase during the transition to adolescence. Increase in self-control in the early school years may prevent unhealthy BMI increase and obesity in adolescence.

Which tasks measure what? Reflections on executive function development and a commentary on Podjarny, Kamawar, and Andrews (2017)

This article provides a selective review of the literature on executive function development and related topics, focusing on the conceptual and terminological confusions that might hinder communication among researchers in the field. The distinctions between working memory and updating, and between shifting and flexibility, are discussed. Methodological problems, which have implications regarding whether a certain task can be considered a measure of a psychological construct, are also discussed. Research on preschoolers is examined with particular attention because it is a rapidly growing but controversial field that seems in particular need of greater conceptual clarity. As a specific touchstone case, we discuss whether the Multidimensional Card Selection Task (MCST) created by Podjarny, Kamawar, and Andrews (2017) should better be considered a measure of concurrent cognitive flexibility or working memory capacity. It is argued that connecting tasks to theoretical constructs is not warranted unless based on rigorous empirical testing of well-formulated models.

Evaluation and training of Executive Functions in genocide survivors. The case of Yazidi children

Executive Functions (EFs) development is critically affected by stress and trauma, as well as the socioeconomic context in which children grow up (Welsh, Nix, Blair, Bierman, & Nelson, 2010, Journal of Educational Psychology, 102, 43-53). Research in this field is surprisingly lacking in relation to war contexts. This study represents a first attempt at addressing this topic by evaluating EFs in Yazidi children. The Yazidi community is an ethnic and religious minority living in Iraq. From August 2014 onwards, the Yazidi community has been the target of several atrocities perpetrated by ISIS and described as genocide by the international community at large. The University of Trieste, thanks to a program financed by the Friuli Venezia Giulia Region, developed a study aimed at (a) evaluating hot and cool EFs in children living in a war context and (b) developing a specific training method to enhance hot and cool EFs in Yazidi children of preschool age (N = 53). Data related to this group of children were compared with a sample of typically developing Italian children randomly assigned to either an EFs training group (N = 55) or a passive control group (N = 51). Results indicate different baselines in EFs in Yazidi and Italian samples and a significant effect of the program on both trained groups, especially in tasks measuring hot EFs. Data are discussed in terms of hot and cool EFs in children growing in adverse environments, as well as the evaluation of educational and developmental opportunities to prevent children who survived genocide from becoming a 'lost generation'. A video abstract of this article can be viewed at https://youtu.be/7t_08TbxR_8.

Effectiveness of Universal Self-regulation-Based Interventions in Children and Adolescents: A Systematic Review and Meta-analysis

Importance

Childhood and adolescence self-regulation (SR) is gaining importance as a target of intervention because of mounting evidence of its positive associations with health, social and educational outcomes.

Objective

To conduct a systematic review and meta-analysis of rigorously evaluated interventions to improve self-regulation in children and adolescents.

Data Sources

Keyword searches of the PsycINFO, PubMed, EMBASE, CINAHL Plus, ERIC, British Education Index, Child Development and Adolescent Studies, and CENTRAL were used to identify all studies published through July 2016.

Study Selection

To be eligible for this review, studies had to report cluster randomized trials or randomized clinical trials, evaluate universal interventions designed to improve self-regulation in children and adolescents aged 0 to 19 years, include outcomes associated with self-regulation skills, and be published in a peer-reviewed journal with the full text available in English.

Data Extraction and Synthesis

A total of 14 369 published records were screened, of which 147 were identified for full-text review and 49 studies reporting 50 interventions were included in the final review. Results were summarized by narrative review and meta-analysis.

Main Outcomes and Measures

Self-regulation outcomes in children and adolescents.

Results

This review identified 17 cluster randomized trials and 32 randomized clinical trials evaluating self-regulation interventions, which included a total of 23 098 participants ranging in age from 2 to 17 years (median age, 6.0 years). Consistent improvement in self-regulation was reported in 16 of 21 curriculum-based interventions (76%), 4 of the 8 mindfulness and yoga interventions (50%), 5 of 9 family-based programs (56%), 4 of 6 exercise-based programs (67%), and 4 of 6 social and personal skills interventions (67%), or a total of 33 of 50 interventions (66%). A meta-analysis evaluating associations of interventions with self-regulation task performance scores showed a positive effect of such interventions with pooled effect size of 0.42 (95% CI, 0.32-0.53). Only 24 studies reported data on distal outcomes (29 outcomes). Positive associations were reported in 11 of 13 studies (85%) on academic achievement, 4 of 5 studies on substance abuse (80%), and in all studies reporting on conduct disorders (n = 3), studies on social skills (n = 2), studies on depression (n = 2), studies on behavioral problems (n = 2), and study on school suspensions (n = 1). No effect was seen on 2 studies reporting on academic achievement, 1 study reporting on substance abuse, and 1 additional study reporting on psychological well-being.

Conclusions and Relevance

A wide range of interventions were successful in improving self-regulation in children and adolescents. There was improvement in distal academic, health, and behavioral outcomes in most intervention groups compared with controls.

Response Inhibition and Interference Suppression in Individuals With Down Syndrome Compared to Typically Developing Children

The present study aims to investigate inhibition in individuals with Down Syndrome compared to typically developing children with different inhibitory tasks tapping response inhibition and interference suppression. Previous studies that aimed to investigate inhibition in individuals with Down Syndrome reported contradictory results that are difficult to compare given the different types of inhibitory tasks used and the lack of reference to a theoretical model of inhibition that was tested in children (see Bunge et al., 2002; Gandolfi et al., 2014). Three groups took part in the study: 32 individuals with Down Syndrome (DS) with a mean age of 14 years and 4 months, 35 typically developing children 5 years of age (5TD), and 30 typically developing children 6 years of age (6TD). No difference emerged among the groups in fluid intelligence. Based on a confirmatory factor analysis, two different inhibition factors were identified (response inhibition and interference suppression), and two composite scores were calculated. An ANOVA was then executed with the composite inhibitory scores as dependent variables and group membership as the between-subject variable to explore the group differences in inhibition components. The 6TD group outperformed the 5TD group in both response inhibition and interference suppression component scores. No differences were found in both inhibition components between the DS group and 5TD. In contrast, the 6TD group outperformed the DS group in both response inhibition and in the interference suppression component's scores. Summarizing, our findings show that both response inhibition and interference suppression significantly increased during school transition and that individuals with DS showed a delay in both response inhibition and interference suppression components compared to typically developing 6-year-olds, but their performance was similar to typically developing 5-year-olds.

Computer-Based Training in Math and Working Memory Improves Cognitive Skills and Academic Achievement in Primary School Children: Behavioral Results

Student academic achievement has been positively related to further development outcomes, such as the attainment of higher educational, employment, and socioeconomic aspirations. Among all the academic competences, mathematics has been identified as an essential skill in the field of international leadership as well as for those seeking positions in disciplines related to science, technology, and engineering. Given its positive consequences, studies have designed trainings to enhance children's mathematical skills. Additionally, the ability to regulate and control actions and cognitions, i.e., executive functions (EF), has been associated with school success, which has resulted in a strong effort to develop EF training programs to improve students' EF and academic achievement. The present study examined the efficacy of a school computer-based training composed of two components, namely, working memory and mathematics tasks. Among the advantages of using a computer-based training program is the ease with which it can be implemented in school settings and the ease by which the difficulty of the tasks can be adapted to fit the child's ability level. To test the effects of the training, children's cognitive skills (EF and IQ) and their school achievement (math and language grades and abilities) were evaluated. The results revealed a significant improvement in cognitive skills, such as non-verbal IQ and inhibition, and better school performance in math and reading among the children who participated in the training compared to those children who did not. Most of the improvements were related to training on WM tasks. These findings confirmed the efficacy of a computer-based training that combined WM and mathematics activities as part of the school routines based on the training's impact on children's academic competences and cognitive skills.