Protocol for a feasibility randomized control trial of the Supporting Toddlers with a connection to autism or ADHD to develop Strong Attention, Regulation, and Thinking skills (START) programme

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.

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

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.

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

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.

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.

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.

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.

Analog board and card games featuring reveal-and-react mechanics, characterized by immediate player responses to newly disclosed game elements, have emerged as promising tools for enhancing executive functions (EF), attention, memory, and problem-solving skills in children. This systematic review synthesizes findings from 13 studies, assessing the cognitive impact of reveal-and-react gameplay in participants aged 3–18, with particular emphasis on children aged ≤12 years. Results consistently indicate improvements across core EF domains such as inhibitory control, cognitive flexibility, and working memory. Notable games identified include Ghost Blitz, Dobble, Bee Alert, and Speed Cups, which provide structured yet engaging environments for cognitive training. The review underscores reveal-and-react mechanics as potent catalysts for developing rapid decision-making, attention control, and working memory updating. Moreover, these games hold significant educational and clinical potential, offering scalable, cost-effective interventions adaptable across diverse settings, including classrooms and therapeutic contexts. Despite limitations in study heterogeneity and longitudinal data scarcity, the collective evidence supports integrating these games into child-focused cognitive enhancement programs.

Background: There is growing evidence that individuals with Developmental Coordination Disorder (DCD) experience elevated internalising symptoms and executive function (EF) difficulties compared to their typically developing (TD) peers. Research also suggests that EFs are important for psychological wellbeing. Aims: This study aimed to explore whether adolescents with DCD experience greater levels of internalising symptoms and everyday EF difficulties than their TD peers. It also explored whether EF difficulties mediate the relationship between DCD status and internalising symptoms. Methods and procedures: Fourteen adolescents with a diagnosis of DCD and 29 TD adolescents (ages 12-15) participated. A cross-sectional survey was conducted to collect parent-reported EF difficulties and self-reported internalising symptoms. Outcomes and results: Self-reported internalising symptoms and parent-reported EF difficulties were significantly higher in the DCD group compared to the TD group. A bias-corrected, bootstrapped mediation analysis identified that the effect of DCD on internalising symptoms was mediated by parent-reported EF difficulties. Exploratory analyses identified that this indirect effect was greatest for symptoms of depression through behavioural regulation difficulties. Conclusions and implications: These findings support previous research indicating that adolescents with DCD experience greater levels of internalising symptoms and EF difficulties than their TD peers. This highlights the need for increased awareness, routine screening, and intervention for mental health and EF difficulties in people with DCD. The findings also highlight the potential benefits of targeting EF deficits in people with DCD to improve emotional wellbeing. However, larger scale, longitudinal research is needed.

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.

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

The aim of the study was to compare parent and teacher ratings of executive function and behavioral difficulties of kindergarten-age preterm and term children. Parents of 82 and kindergarten teachers of 105 preterm (<33 weeks’ gestation) children and parents of 49 and kindergarten teachers of 46 term four- to five-year-old children completed executive function (EF) and behavior questionnaires. The preterm children were rated to have more EF difficulties than the term children by parents and teachers. On the behavior scales, the preterm children were reported as having more attention control difficulties than the term group, but no other behavioral problems. The parents reported higher levels of EF and behavioral difficulties than the teachers when both child groups were combined. The overall interrater reliability between parents and teachers in terms of children being in the clinical vs. non-clinical range for EF and behavioral problems was low for the preterm and term groups. Conclusion: Based on this study, some young preterm children need EF supports when commencing kindergarten, and preterm children should be screened for EF difficulties. Noncongruent parent and teacher reporting nevertheless make it challenging to identify the preterm children most at need of such supports. Further studies are needed to determine the factors impacting on reporting patterns, and also the best combination of EF and behavior assessment tools.

Indigenous frameworks suggest environmental risk and protective factors for American Indian (AI) children's development can be understood in terms of connecting and disconnecting forces in five domains: spirituality, family, intergenerational ties, community, and environment/land. This study examined the prevalence of these forces among 156 urban AI parents and their children (mean age = 10.69, SD = 1.92) and investigated associations with child executive function (EF). Parents reported on three disconnecting forces (parent stressful life events, discrimination, and neighborhood risks) and two connecting forces (knowledge of tribal history and engagement with cultural beliefs and traditional practices). Parents rated children's EF using the Behavior Rating Inventory of Executive Function (BRIEF), and a subsample of children (n = 81) provided self-report EF data. Controlling for income and child age, connecting forces (parent engagement with cultural beliefs and traditional practices and knowledge of tribal history) were associated with higher parent-reported and child self-reported EF, while disconnecting forces (discrimination and neighborhood risk) were related to lower child EF. Findings highlight the protective role of cultural connectedness for urban AI children's cognitive development, and the importance of centering Indigenous theory in risk and resilience research with AI families.