Playing to Focus: A Systematic Review of Reveal-and-React Board and Card Games for Executive Function Development in Children

Research Findings: Early elementary school is a crucial time for the development of executive functions, but less is known about the impact of parent-child narratives on executive function development in children of this age group. This study aims to investigate the influence of parental scaffolding styles in parent-child co-constructed narratives in the development of transitional kindergartners’ executive function. The sample comprised 35 Hispanic and non-Hispanic parent-child dyads, who were video recorded discussing a past experience at home. Video recordings were transcribed and coded for parental scaffolding strategies. Through principal component analysis, three scaffolding styles were identified: elaborative, eliciting, and echoing. Children’s executive function was measured using the pencil tap task. Hierarchical linear regression analysis revealed that parents’ echoing scaffolding style was positively and significantly associated with children’s executive function outcomes, after controlling for child expressive language, maternal education, and parent dominant narrative languages. Practice or Policy: These findings highlight that the way parents scaffold their children’s narratives can have a positive impact on their development of executive function. It also emphasizes the need for educators and practitioners to recognize the role of parent-child language interactions in supporting children’s cognitive development, and to collaborate with families to promote positive developmental outcomes.

Prenatal exposure to polycyclic aromatic hydrocarbons and executive functions at school age: Results from a combined cohort study

Association of Sedentary Time and Physical Activity With Executive Function Among Children.

Objectives: This review assesses how daily exposure to Information and Communication Technologies (ICTs) affects executive functions in children and adolescents and explores the roles of parents in mitigating potential negative impacts on cognitive development and emotional regulation. Methods: Following PRISMA guidelines, a systematic search was conducted from 2022 to 2024 using PubMed, Scopus, and Cochrane Library. The study criteria included cohort studies, randomized controlled trials (RCTs), quasi-RCTs, and systematic reviews. Data extraction and risk-of-bias assessments were performed using ROBIS and ROBINS-E tools. Due to the heterogeneity of the results, a narrative synthesis was carried out. Results: Ten studies were included for analysis, comprising a total of 231,117 children from nine countries on three continents. Most studies indicated that excessive ICT exposure negatively affects executive functions, particularly working memory, inhibitory control, cognitive flexibility, and attention. Adverse effects were linked to increased screen time, poor sleep quality, and multitasking. However, two studies found no significant association, highlighting the influence of contextual factors like socioeconomic status, parental mediation, and screen content type. Shared ICT use with parents or siblings appeared to reduce negative effects. Conclusions: Excessive ICT exposure is associated with impaired executive function development in children and adolescents. Parental supervision and structured ICT use may mitigate risks. Future research should investigate moderating factors, such as socioeconomic status and ICT content, to develop guidelines for healthy digital engagement in youth.

BackgroundExecutive functions (EF) are core cognitive processes that support self-regulation, learning, and behavioral flexibility in childhood. Structured physical activity (PA) programs implemented in school settings have been proposed as a means to enhance EF, but previous findings are inconsistent due to variations in intervention design, cognitive demands, and measurement strategies. This review offers an updated synthesis by focusing exclusively on school-based interventions in primary school children and including studies with neurophysiological outcomes.MethodsA systematic search was conducted in PubMed, SCOPUS, Web of Science, and EBSCO for studies published between January 2015 and March 2025. Eligible studies were randomized or cluster-randomized trials evaluating structured PA programs targeting EF in children aged 6–12 years. Methodological quality was assessed using a custom checklist aligned with Cochrane ROB-2 criteria. Due to heterogeneity in intervention formats and outcome measures, a narrative synthesis was conducted.ResultsTen studies met the inclusion criteria (total N ≈ 2,400). Short, cognitively engaging exercise sessions, such as rhythm-based activities or task-switching drills, were frequently associated with immediate improvements in inhibitory control. Longer-term interventions delivered over several weeks showed more robust and consistent benefits, particularly for inhibitory control and working memory. Positive effects were reported in 6 of 8 studies assessing inhibition, 5 of 6 on working memory, and 3 of 4 on cognitive flexibility. Some studies using fNIRS and EEG reported changes in prefrontal activation, suggesting potential functional enhancement. However, overall methodological quality was moderate, with common limitations in blinding and protocol transparency.ConclusionSchool-based physical activity can support EF development in children, especially when interventions are sustained and cognitively demanding. Effects are strongest for inhibition and working memory, while gains in cognitive flexibility appear less consistent and may require greater novelty and task variability. Future trials should refine intervention parameters, apply standardized EF assessments, and explore individual variability to guide evidence-based educational applications.Systematic review registrationCRD420251084225, https://www.crd.york.ac.uk/PROSPERO/view/CRD420251084225.

To be successful takes creativity, flexibility, self-control, and discipline. Central to all those are executive functions, including mentally playing with ideas, giving a considered rather than an impulsive response, and staying focused. Diverse activities have been shown to improve children's executive functions: computerized training, noncomputerized games, aerobics, martial arts, yoga, mindfulness, and school curricula. All successful programs involve repeated practice and progressively increase the challenge to executive functions. Children with worse executive functions benefit most from these activities; thus, early executive-function training may avert widening achievement gaps later. To improve executive functions, focusing narrowly on them may not be as effective as also addressing emotional and social development (as do curricula that improve executive functions) and physical development (shown by positive effects of aerobics, martial arts, and yoga).

Executive functions are higher-order cognitive abilities that support decision-making, reasoning, planning, reflective processes, and abstract thinking. Recent work suggests that the development of these abilities in early life is, in part, socially mediated—that the emergence of executive functions across childhood is partially organized by children’s relationships with other individuals, and with relationships to caregivers in particular. Using the basic association between the development of executive functions and children’s relationships with caregivers as a starting point, this chapter seeks to better understand the broader association observed across many studies between one of the most clearly stressful contexts for parents—poverty—and executive function development in children. Specifically, this chapter considers the extent to which the immediate caregiving environments of children can be viewed as a mediator of the relation between the socioeconomic conditions of families and children’s executive function development. In doing so, this chapter also considers several aspects of the caregiving environment that may be influenced by the context of poverty (e.g., parents’ own stress processes and behaviors with children, the home learning environment, and parents’ own cognitive and biobehavioral regulation) that are also presumed to shape children’s neurocognitive growth. Future directions emphasize the need for more experimental work in this area of research, the need for more research that distinguishes specific parent stress processes related to children’s executive function development in the context of poverty, and the need to consider the larger socioecological contexts in which children and families are embedded to understand the etiology and development of family stress processes related to children’s emerging self-regulation.

BackgroundAutism and ADHD are heritable, co-occurrent, and associated with difficulties with executive functioning (cognitive and self-regulation skills which enable us to set and work toward goals). Executive function difficulties, and their negative impacts across cognitive, health and social domains, extend to individuals with first-degree relatives who are autistic or have ADHD, even if they do not meet thresholds for a clinical diagnosis themselves. Supporting executive function development in children with elevated autism traits, or a first-degree relative with autism or ADHD, addresses community priorities for early support to help achieve the best mental health, education and life outcomes.MethodsThis study will evaluate the feasibility and acceptability of a randomized controlled trial (RCT) of a parent-toddler programme entitled “Supporting Toddlers with a connection to autism or ADHD to develop strong Attention, Regulation and Thinking skills” (START). START is a neurodiversity-affirming programme, co-refined through extensive Patient and Public Involvement. Sixty parent-child dyads, in Oxford or Southampton (UK), will be randomized using Sealed Envelope by a researcher not involved in recruitment, delivery or outcome data collection to receive START or usual practice, on a 1:1 ratio. Children (20 months old) will be assessed using questionnaires completed by the parent (not blind to allocation) post-intervention (within 2 weeks of the end of the active intervention wave, when children are aged 27–31 months), and using parent questionnaires and a battery of executive function measures administered by researchers blind to allocation at baseline and follow-up (36 months old). START will be delivered in small groups to 30 parent-child dyads, in community settings.DiscussionWe will assess the feasibility of recruiting eligible participants to the study, the reliability of measures of implementation fidelity and degree of implementation fidelity achieved, the appropriateness of proposed outcome and mechanism measures, the acceptability of an RCT of the programme, parental adherence to the programme, logistics of programme delivery, and the acceptability of START, using mixed-method measures of engagement and satisfaction. Results will inform the design and implementation of a definitive RCT of START, and yield broader insights into the delivery and evaluation of complex early-years interventions in community settings.Trial registrationISRCTN registry ISRCTN99820028 https://doi.org/10.1186/ISRCTN99820028.

Objective: To examine the development of executive functions, in preschool children with autism spectrum disorders (ASD), receiving early intensive behavioral training (EIBI). Method: Executive functions (EF) were assessed with The Behavior Rating Inventory of Executive Function – Preschool Version (BRIEF-P), by parents and preschool teachers at the time of diagnostic assessment and after 15 months of EIBI intervention. Ten children with ASD (M = 2.9 years, nine males) participated in the study. Reliable Change Index scores were computed for each of the participants in order to investigate any significant change in BRIEF-P T-scores. Results: Three children showed a significant improvement in EF, based on parent ratings. Four children showed a significant improvement in EF based on preschool teacher ratings. Conclusion: Findings indicating a reliable improvement in one third of preschool children with ASD receiving EIBI are encouraging but need to be replicated in larger scale controlled studies.

Children's ability to monitor subjective feelings of uncertainty (i.e., engage in uncertainty monitoring) is a central metacognitive skill. In the current study, we examined the development of uncertainty monitoring as well as its relations with vocabulary and executive function development in children (N=137, 52% female) from predominately White and Latinx/Hispanic backgrounds when they were 4-6years old and enrolled in a Head Start preschool and kindergarten between 2018 and 2019. We found that children's uncertainty monitoring improved during the kindergarten year. Children's executive function and vocabulary in preschool and vocabulary growth from preschool to kindergarten predicted uncertainty monitoring at the end of kindergarten, which sheds new light on potential mechanisms supporting children's metacognitive development.

Background and Aims Attention-deficit hyperactivity disorder (ADHD) can impair psychological, emotional, and cognitive processes. The present study aims to investigate the effect of beta neurofeedback on executive functions and problem-solving skills of elementary school male children with ADHD. Methods This is a quasi-experimental study with a pre-test/post-test/two-month follow-up design. The participants were 24 elementary school male children with ADHD referred to psychology and psychiatry clinics in Mashhad, Iran, in 2020. They were selected using a purposive sampling method and randomly divided into intervention and control groups. The children in the intervention group received beta neurofeedback at 30 sessions for 2.5 months. The data collection tools were Brock and Clinton’s ADHD questionnaire, the children’s problem-solving exploratory test of Johnson, and Coolidge et al.’s executive functions questionnaire. The data were analyzed using repeated measures ANOVA. Results The results showed that beta neurofeedback had significant effects on executive functions (F=33.42; Eta squared=0.60; P=0.0001) and problem-solving skills (F=29.81; Eta squared=0.57; P=0.0001). It led to significant improvement in the intervention group. Conclusion Beta neurofeedback can improve executive functions and problem-solving skills of children with ADHD through providing biological feedback and increasing awareness of mental and cognitive processes.

A. Diamond and K. Lee's review “Interventions shown to aid executive function development in children 4 to 12 years old” (special section on Investing Early in Education, 19 August, p. [959][1]) leaves the impression that martial arts training as usually delivered enhances executive functions.

The Review “Interventions shown to aid executive function development in children 4 to 12 years old” by A. Diamond and K. Lee (special section on Investing Early in Education, 19 August, p. [959][1]) cited work that close examination shows to be weak. Some of the studies ([ 1 ][2], [ 2 ][3]) were randomized, but they failed to meet other criteria such as blinding of teachers and parents to pupils' treatment groups. Studies involving martial arts and physical exercise were particularly weak on isolation of variables. One study on martial arts training for children ([ 1 ][2]) compared a treatment group who wore special uniforms, meditated, bowed to their instructor, and were reminded of self-awareness and self-control, to a control group who continued with their ordinary physical education activities; these authors concluded that when some improvement on some scales occurred for the treatment group, the change was caused by the self-awareness and self-control messages, rather than by other ways the two groups differed. Another study ([ 2 ][3]) compared children who did “sport stacking,” a bimanual physical task, with a control group that did not experience any exciting new activity, and concluded that improvement on one of two reading measures was caused by the stacking task. ![Figure][4] CREDIT: STUART MONK/ISTOCKPHOTO.COM A relevant volume dealing with treatments for developmental disabilities ([ 3 ][5]) stressed the weakness of evidence for special education interventions and described some such conditions as “fad magnets.” Unfortunately, early educational interventions seem to be similarly weak in evidence. The stakes are high and the resources scarce in both cases. 1. [↵][6] 1. K. D. Lakes, 2. W. T. Hoyt , Appl. Dev. Psychol. 25, 283 (2004). [OpenUrl][7][CrossRef][8] 2. [↵][9] 1. T. A. Uhrich, 2. R. L. Swalm , Percept. Mot. Skills 104, 1935 (2007). [OpenUrl][10] 3. [↵][11] 1. J. W. Jacobson, 2. R. M. Foxx, 3. J. A. Mulick , Controversial Therapies for Developmental Disabilities (Erlbaum, Mahwah, NJ, 2005). [1]: /lookup/doi/10.1126/science.1204529 [2]: #ref-1 [3]: #ref-2 [4]: pending:yes [5]: #ref-3 [6]: #xref-ref-1-1 View reference 1 in text [7]: {openurl}?query=rft.jtitle%253DAppl.%2BDev.%2BPsychol.%26rft.volume%253D25%26rft.spage%253D283%26rft_id%253Dinfo%253Adoi%252F10.1016%252Fj.appdev.2004.04.002%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [8]: /lookup/external-ref?access_num=10.1016/j.appdev.2004.04.002&link_type=DOI [9]: #xref-ref-2-1 View reference 2 in text [10]: {openurl}?query=rft.jtitle%253DPercept.%2BMot.%2BSkills%26rft.volume%253D104%26rft.spage%253D1935%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [11]: #xref-ref-3-1 View reference 3 in text

To observe the effects of penetrating technique of scalp acupuncture on emotion, sleep and function development in children of autism spectrum disorder (ASD). A total of 60 SAD children aged 3 to 6 years were randomized in a control group (music education rehabilitation,n=30) and an observation group (penetrating technique of scalp acupuncture + music education rehabilitation,n=30). In the two groups, the treatment for 3 months was as 1 course, and 2 courses of treatment were required. Before and after treatment, the changes were observed in childhood autism rating scale (CARS), emotion regulation subscale (ER), children's sleep habits questionnaire (CSHQ) and children autism and psycho-educational profile for autistic and developmentally disabled children (C-PEP-3), separately. Compared with the scores before treatment, CARS score, the score of each subscale of CSHQ, e.g. bedtime resistance, sleep onset delay, irregular sleep duration, sleep anxiety, parasomnias and daytime sleepiness as well as the total score of CSHQ were all reduced in children of two groups (P<0.05); and the score of ER and C-PEP-3 were all increased (P<0.05) after 6 months' treatment. Compared with the control group, ER score was increased in 3 and 6 months after treatment (P<0.05), CARS score was reduced (P<0.05) and C-PEP-3 score was increased obviously (P<0.05) 6 months after treatment in the observation group; but the scores of the subscale for night waking and sleep disordered breathing did not changed noticeably (P > 0.05). Penetrating technique of scalp acupuncture improves the emotion and sleep disorder and promotes the function development in ASD children.

Executive functions (EF) and sensorimotor skills play a critical role in children's goal-directed behavior and school readiness. The aim of the current study is to provide new insights into the relationship between executive functions and sensorimotor development by considering the risks associated with learning difficulties. Therefore, we investigate the predictive role of EF and sensorimotor skills in the development of learning difficulties during preschool years. Ninety-five preschool children (5–7 years old) were tested, comparing the performance of children that are at risk of learning difficulties (n = 55) to the performance of typically developing children (n = 40). Participants completed a battery for the assessment of sensorimotor skills (i.e., Southern California Sensory Integration Test: postural imitation, body midline crossing, bilateral motor coordination, and standing balance with eyes open) and executive functions (i.e., inhibition, cognitive flexibility, and verbal working memory). Our results show that children at risk for learning difficulties exhibited more impairments on sensorimotor and EF measures (inhibition and verbal working memory) when compared with TD children. We ran three separate binary logistic regression analyses to assess the relative influence of EF and sensorimotor functions on predicting risk for learning difficulties. Our findings demonstrated that verbal working memory as EF function (odd ratio (OR) = 0.91, 95% CI 0.78-0.91, P = 0.05) and standing balance skills as a sensorimotor skill (odd ratio (OR) = 0.86, 95% CI 0.81-0.98, P = 0.01) were the strongest predictors of risk for learning difficulties. The findings point to the importance of supporting children's executive function development and promoting sensorimotor development, as both fundamentally influence school readiness.