Executive Function Deficits Mediate Effects of Poverty on Academic Achievement: An Important Target for Interventions to Enhance Neurocognitive Development in At-Risk Children

Abstract

Background: Millions of children raised in unstable, impoverished or violent environments fall behind more fortunate peers in brain development, executive cognitive functions (EF), and academic achievement, general health and employment outcomes. It is important to empirically demonstrate the relation between environment-related compromised EF and compromised functional life outcomes in order to establish that interventions to enhance EF in high-risk children could mitigate life-long effects of adverse rearing environments. Methods: EF was assessed in 5717 children grades k-8 in 40 schools across the United States with web-based classroom-administered tests, and poverty level and academic achievement for each school drawn from US Department of Education data. A regression-based EF factor score was used to evaluate the degree of mediation by EF of the association between poverty and academic proficiency. Findings: EF and academic achievement were both related to school poverty (pearson r -.50 to - .65, p =.0009 to <.0001). Estimated indirect effects of poverty through effects on EF were both significant according to bootstrap results (reading: -0.26, 95% CI: -0.47, -0.07; math: -0.23, 95% CI: -0.44, -0.06 ). The effect of poverty, after controlling for EF, was significant, but diminished on both reading (-0.58 to -0.31) and math (-0.59 to -0.35) performance, indicating that the effects of poverty on reading and math proficiency were mediated via effects of poverty on EF. Interpretation: Effects of poverty on academic achievement are mediated by effects of poverty on EF, suggesting that interventions that enhance development of EF in children in impoverished and/or violent environments can mitigate damaging effects of these environments on neurocognitive and associated life and health outcomes. Without such interventions, a large number of young adults in troubled areas of the world will be ill-prepared for productive function in the 21st century world. Funding: Research was supported by C8 Sciences' operating budget. Declaration of Interest: Two of the authors, Professors Morris Bell and Bruce Wexler, have financial interest in the Yale start-up company C8 Sciences. A third author, Dr. Ahmet Esat Imal, is a part time employee of C8 Sciences. C8 Sciences has developed the assessments described in the paper, and an education intervention directed at improving cognitive skills and learning outcomes in children from poverty. The results presented in our manuscript support the value of the assessments done by C8 Sciences and the rationale for the C8 Sciences intervention. Because of this, Drs. Bell, Imal and Wexler could benefit financially from the publication of these findings. Pittman has no competing financial interest. Ethical Approval: The Yale Human Investigations Committee determined that individual consent was not needed.