Executive Function Skills Research Articles

Early Childhood Screen Use Contexts and Cognitive and Psychosocial Outcomes

The multifaceted nature of screen use has been largely overlooked in favor of a simplistic unidimensional measure of overall screen time when evaluating the benefits and risks of screen use to early childhood development. To conduct a systematic review and meta-analysis to examine associations of screen use contexts in early childhood with cognitive and psychosocial outcomes. PsycINFO, Embase, MEDLINE Ovid, ProQuest, CINAHL, Web of Science, and Scopus were searched from inception to December 31, 2023. A total of 7441 studies were initially identified. Studies were included if they examined associations between a contextual factor of screen use among children aged 0 to 5.99 years and cognitive or psychosocial development. Observational, experimental, and randomized clinical trial study designs were included. All studies were independently screened in duplicate following PRISMA guidelines. Effect sizes of associations (r) from observational studies were pooled using random-effects 3-level meta-analyses. The remaining study designs were narratively synthesized. Screen use contexts included content (child directed and age inappropriate), type (program viewing and game or app use), co-use (or solo use), background television, caregiver screen use during child routines, and purpose. Outcomes were cognitive (executive functioning, language, and academic skills) or psychosocial (internalizing and externalizing behavior problems and socioemotional competence). Overall, 100 studies (176 742 participants) were included, and of these, 64 observational studies (pooled sample sizes ranging from 711 to 69 232) were included in meta-analyses. Program viewing (n = 14; k = 48; r, -0.16; 95% CI, -0.24 to -0.08) and background television (n = 8; k = 18; r, -0.10; 95% CI, -0.18 to -0.02) were negatively associated with cognitive outcomes, while program viewing (n = 6; k = 31; r, -0.04; 95% CI, -0.07 to -0.01), age-inappropriate content (n = 9; k = 36; r, -0.11; 95% CI, -0.17 to -0.04), and caregiver screen use during routines (n = 6; k = 14; r, -0.11; 95% CI, -0.20 to -0.03) were negatively associated with psychosocial outcomes. Co-use was positively associated with cognitive outcomes (n = 8; k = 28; r, 0.14; 95% CI, 0.03 to 0.25). Findings show small to moderate effect sizes that highlight the need to consider screen use contexts when making recommendations for families, clinicians, and educators beyond screen time limits; including encouraging intentional and productive screen use, age-appropriate content, and co-use with caregivers.

Impact & Experience of Directly Teaching About Executive Function to Second Graders on Their Understanding & Performance of Executive Function Skills

Abstract Date Presented 03/22/24 Executive function (EF) skills are essential for children, but we often support them around students and not actively with them. This mixed-methods study looked at the impact of a 3-week curriculum directly teaching second graders about EF skills. Primary Author and Speaker: Lisa Raymond-Tolan Contributing Authors: Theresa Arcidiacono, Cassandra Panzarino, Amber Vazquez, Cj Letterese, Jennifer Sigler, Kelly Farah Khadam-Hir

Multidimensionality of children’s foundational skills: an IRT-based validation of the NEPSY factorial structure

ABSTRACT Objective Measurement tools for children’s foundational skills provide important insights towards the developmental mechanisms of these domains. This study examines the structure of sensorimotor, visuospatial processing (VP), executive function (EF) skills and their interrelationship. The NEPSY is a widely-used neuropsychological instrument, but while validated at the domain-level through classical test theory approaches, no studies have conducted in-depth item-level analyses on its structural and psychometric properties. Method This study examined whether the designed structure of NEPSY is empirically supported by fitting unidimensional and multidimensional Item Response Theory models to item response data of early elementary students in the United States. A confirmatory factor analysis was also conducted to examine the factorial structure of the data. Results Results provide empirical support to the factorial structure of NEPSY, both at the domain level and within the VP sub-domain. The results show that VP and EF are separate constructs and subtests within the VP domain can further be modelled as interrelated but distinct factors – non-motor and motor-based processing. Conclusion Our specific results support the theoretical stance that VP consists of multiple component skills that are distinct because they require different neurological processes. This multidimensional NEPSY model shares some structural commonalities with the Cattell–Horn–Carroll model.

Remote assessment of the association between early executive function and mathematics skills

AbstractExecutive function (EF) skills are consistently associated with global mathematics assessments. However, less is known about which specific mathematics skills invoke EF in early childhood. We adapted batteries of EF, numerical, and patterning tasks to be conducted via synchronous video conferencing with typically developing 4‐year‐old children (N = 115, 56.6% female, 85.2% White, non‐Hispanic, 7.8% Multiracial, 0.9% Hispanic, 0.9% Black, 1.7% American Indian/Alaska Native, 2.6% Asian and 0.9% missing) from primarily upper middle class households (maternal education range: some college to graduate or professional degree, mode = graduate or professional degree) in the United States. We found feasibility of remote adaptation varied greatly by task. Just over half of enrolled children (57.02%) completed all tasks and there were higher rates of missingness compared to an in‐person sample with a similar age range collected in schools. Nonetheless, working memory predicted various mathematics skills, including patterning, verbal counting, and number comparison, controlling for age and maternal education. Relations between cognitive flexibility and patterning varied across model specifications. Overall, these findings provide insight into the costs and benefits of remotely administered direct assessments of EF and mathematics in early childhood and add to the growing body of literature suggesting working memory plays an important role in several foundational early mathematics skills. Suggestions are offered for remote assessment with preschoolers.Highlights Executive function and mathematics tasks were adapted for remote use and associations among skill sets were examined. Remotely administered data collection sessions had higher rates of missingness than comparable in‐person studies. Findings replicate and extend prior work on the associations between working memory and patterning, verbal counting, and number comparison in a remote setting.

Cross-Sectional Study on the Effect of Bilingualism, Age, Gender, and Family Income on Executive Function Development in a Sample of Lebanese School-Aged Children

ABSTRACT This study investigates executive functions (EFs) and selected developmental factors in 120 children aged 6–11 years. By examining inhibition, working memory, and cognitive flexibility, the research evaluates the potential influences of age, gender, bilingualism, and family income on these EF skills. Tests adapted to Lebanese Arabic were used to assess EFs. Results indicate a linear development of inhibition, working memory, and flexibility with age. Gender differences were observed, affecting verbal and visuospatial working memory as well as flexibility. Bilingualism positively impacts EFs, with early bilinguals outperforming late bilinguals. Family income, however, shows no significant effect on EFs.

Strengthening Resilience: Parent Experiences in Developing their Children Executive Function Skills

Executive functions (EF) play a key role in child development. However, Thai parents’ knowledge and practice skills for their children’s EF are still limited. This study aimed to explore the lived experiences of Thai parents in developing their children’s EF skills in a semi-rural sociocultural context. The theme pattern was interpreted using the Heideggerian hermeneutic phenomenological approach, and the themes were reflected in Van Manen’s fundamental existential themes of the life world. As many as 16 parents were selected using the purposive sampling method. Semi-structured interviews were conducted. The results of this study revealed seven themes: 1) strong resilience, self-confidence, and responsibilities; 2) challenges in handling misbehaving family members and children with poor self-control; 3) living in a natural and peaceful environment; 4) staying away from terrible things; 5) practicing time management; 6) trying to use the mobile phone safely; and 7) organizing belongings and toys. In conclusion, nurses can help parents to increase their children’s EF skills by strengthening parents’ resilience, self-confidence, and responsibilities; supporting parents and co-parents to deal with terrible situations; time management; and preparing a safe, green, and natural environment for children to develop their EF skills.

Not EF skills but play with real toys prevents screen time tantrums in children.

Limiting children's screen time has become a new parenting challenge. Due to the high attractiveness of media and digital devices, many children experience painful transitions in screen time to other activities. Screen time tantrums is a new concept that describes children's negative affect screen time limits. Knowing the factors that increase children's negative reactions will be helpful in parents and educators practice to prevent screen time tantrums or enrich children's nondigital activities, making them attractive alternatives to the media. Based on theoretical insights into the coping mechanisms of frustration and anger in preschool children, this study was aimed to explore the effects of executive functions skills, family activities, and children's play behavior with real toys on screen time tantrums. Sample included 654 caregiver-child pairs (M children age = 70.3 months, SD = 4.02). Results confirmed the hypothesis that play behavior with real toys is a stronger preventor of screen time tantrum than EF skills. The findings suggest that supporting play activity in preschool children might help them to avoid strong negative affects due to screen time limitation. The results of this study may be also considered as a support for the theoretical assumptions that play can be considered as a universal way of coping with frustration and anger in childhood.

Assessing the Language Abilities of Preterm-Born Children: An Examination of Standardized Testing and Language Sample Analysis.

To understand how best to assess the language abilities of preterm-born children, this study: (a) compared preterm- and term-born children's language skills using standardized testing and language sample analysis (LSA), (b) investigated how executive function skills and the language sampling context respectively affect standardized test and LSA scores, and (c) examined the pattern of associations between standardized test and LSA scores among preterm-/term-born groups. Twenty-five term-born and 23 preterm-born 2-year-old singletons were administered the language scales of the Bayley Scales of Infant and Toddler Development-Third Edition (receptive communication, expressive communication, language composite scores). Parent-child free-play recordings were used to quantify the (para)linguistic features of the children's speech. Executive function was measured via parent report. The preterm-born group obtained significantly lower scores than the term-born group on all Bayley language measures (though differences were not consistently observed when using cutoff scores). Few preterm-term differences in LSA measures were found. The preterm-term differences in Bayley scores were not explained by between-group differences in executive function. Some preterm-term differences in LSA scores were moderated by the language sampling context. The preterm- and term-born groups exhibited different patterns of Bayley-LSA correlations. Preterm language difficulties were more apparent on standardized test than LSA scores. Nonetheless, the Bayley-LSA correlations indicate that poor test performance (linked with preterm birth) is associated with functional communication difficulties. The discussion outlines the complementary utility of standardized tests and LSA while acknowledging the limited utility of cutoff scores and the confounding influence of the language sampling context. https://doi.org/10.23641/asha.26142661.

Executive Functions and Stuttering Severity in Persian Adults

Introduction: Fluent speech requires executive functions to identify, inhibit, and modify speech interruptions to continuously regulate the speech process. The current study aims to examine the executive functions in adults who stutter (AWS) and adults who do not stutter (AWNS). We also examined the relationship between executive functions and stuttering severity. Materials and Methods: This research is a cross-sectional descriptive-analytic study. The participants included 32 AWS (Mean±SD of age=28±6.79) divided into three groups of mild, moderate, and severe severity and 32 AWNS (Mean±SD of age=28.57±6.53). Selected tests from the Delis-Kaplan executive function system (D-KEFS) were used to assess executive function domains. Results: The results of this study showed that AWS performed significantly lower than AWNS in working memory (P=0.009), problem-solving and planning (P<0.001), verbal cognitive flexibility (shifting) (P<0.001), and verbal inhibitory control (P<0.001). The results also showed no difference between AWS and AWNS in non-verbal inhibition, shifting, and reasoning. Furthermore, a significant relationship was observed between stuttering severity and executive function domains. Conclusion: This study showed that executive function skills are affected in AWS and should be considered in the rehabilitation programs of AWS.

Urdu Translation & Validation of Executive Skills Questionnaire-Revised: A Self-Report Tool of Executive Functioning

Executive functions (EF) include skills such as working memory, inhibition and cognitive flexibility that are required for efficient functioning in all disciplines of life, be it personal, educational or professional. The assessment of EF skills using task-based instruments or self-report forms is a debatable topic in research arena. The current study focused on translation and psychometric analysis of a comprehensive yet short and freely available tool of EF skills; Executive Skills Questionnaire-Revised (Strait et al., 2019) in Urdu language. The study followed a rigorous tool translation procedure including forward and back translation. Data was collected from 294 undergraduate students; both boys (n=142) and girls (n=152) aged 18-21 years (M= 19.2, SD=0.98) enrolled in various public sector higher educational institutes of Lahore, Pakistan. Data collection was followed by analysis which included use of descriptive statistics to analyze demographic characteristics and calculation of Cronbach’s alpha of sub-scales to determine internal consistency. Item total correlation was then calculated. Analysis further included Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). Results revealed the internal consistency of all sub-scales in acceptable range having Cronbach alpha value ranging from 0.72-0.80. CFA confirmed the 5-factor structure of the translated tool similar to the original tool. All fit indices were found to be excellent. Results revealed the ESQ-R Urdu as a valid and reliable tool to assess EF skills in student population.

Understanding social cognition in children with cerebral palsy: exploring the relationship with executive functions and the intervention outcomes in a randomized controlled trial

Children with Cerebral Palsy (CP) experience Social Cognition (SC) difficulties, which could be related to executive functioning. While motor interventions are common, there is limited knowledge about the impact of cognitive interventions on SC in this population. This study examined the relationship between SC and Executive Function (EF) skills and the effectiveness of an EF intervention that included some SC tasks for improving SC in children with CP. SC and EF domains were assessed in 60 participants with CP (30 females; 8–12 years). The relationship between SC and EF baseline scores was analyzed by bivariate correlations and contingency tables. Participants were matched by age, sex, motor ability, and intelligence quotient and randomized into intervention or control groups. The intervention group underwent a 12-week home-based computerized EF intervention. Analysis of covariance was used to examine differences in SC components between groups at post-intervention and 9 months after. Significant positive correlations were found between the SC and EF scores. The frequencies of impaired and average scores in SC were distributed similarly to the impaired and average scores in EFs. The intervention group showed significant improvements in Affect Recognition performance post-intervention, which were maintained at the follow-up assessment, with a moderate effect size. Long-term improvements in Theory of Mind were observed 9 months after.Conclusions: This study highlights the association between SC and EFs. A home-based computerized cognitive intervention program improves SC in children with CP. Including SC tasks in EF interventions may lead to positive short- and long-term effects for children with CP.Clinical trial registration: NCT04025749 retrospectively registered on 19 July 2019.What Is Known:• Executive functions and social cognition are associated with social and community participation in people with cerebral palsy.• A home-based computerized cognitive intervention can improve the executive functioning of children with cerebral palsy.What Is New:• Social cognition performance is related to core and higher-order executive functions.• A home-based computerized executive function intervention, including social cognition tasks, has positive short- and long-term effects on social cognition skills in children with cerebral palsy.

An examination of an inclusive French immersion program and preschoolers' executive functioning skills

AbstractThis exploratory study examines the relationship between executive functioning (EF) skills and the development of first (L1) and second language (L2) skills of preschool students. The participants of this study are enrolled in a French immersion program offered at an inclusion school combining students with disabilities (special needs) and those without (typically developing). All students were assessed for L1, L2, and EF skills. The findings of this study indicate L1 and L2 development in both receptive and expressive skills. Furthermore, EF skills served as a predictor of L2 expressive and receptive language skills. The findings of this study align with prior research showing a relationship between language skills and EF while also providing support for the inclusion of special needs students in immersion programs. Implications of findings suggest additional research is needed on the role of EF skills in L2 development and revisiting requirements for entry into language programs.

Putting Together the Pieces of Effective Instruction

Following the instructional methods of structured literacy is not entirely different from jigsaw puzzle assembly. The author reflects on similarities between effective literacy instruction and experiences assembling jigsaw puzzles. Both involve sequential, cumulative instruction; varying levels of explicit instruction; and assessment. Motivation, engagement, executive function skills, and strategy use play important parts as well.

Toward a mechanistic understanding of the association between motor and executive function skill development in early childhood

Toward a mechanistic understanding of the association between motor and executive function skill development in early childhood

Socio-emotional behavior, learning, and the distinct contributions of Executive Functions in primary graders

Socio-emotional school behavior and learning are both fundamental aspects of children’s development influenced by cognitive control processes named Executive Functions (EF). Yet, research on school-age children has often focused on the relationship between EF and learning skills overlooking that of EF and school behavior, which has usually been examined among preschoolers. The current study investigated the contribution of EF in both school behavior and learning in school-age children. One hundred forty-six III–V graders were assessed using text comprehension and EF tasks and evaluated by teachers-rated inventories on behavioral difficulties and EF within the school context. The results suggested a different involvement of direct and indirect EF measures in the two domains considered: controlling for socioeconomic level and age, an EF direct measure, predicted reading comprehension whereas teacher-reported EF related to both behavior and text comprehension. The results contribute to defining the role of cognitive control processes on school behavior and learning in school-age children.

Educational robotics or unplugged coding activities in kindergartens?: Comparison of the effects on pre-school children's computational thinking and executive function skills

This study compares the effects of coding education with educational robot and unplugged coding activities on pre-school students' computational thinking and executive function skills. This study used a pre-test and post-test comparison group quasi-experimental design. The study was conducted in a public kindergarten with 48 pre-school students (24 educational robot- BeeBot® group and 24-unplugged coding group) aged 5-6. The TechCheck-K test was used to measure computational thinking skills, and Executive Functions Battery-Computerized Touch was used to measure executive function skills. The process started with pre-test applications and ended with post-tests after four weeks (16 different sessions) of the implementation in both groups. The study found a statistically significant difference between the computational thinking pre-test and post-test scores of pre-school students in both groups in favor of the post-test. It was determined that there was a statistically significant difference in favor of the educational robot group between the post-test scores of computational thinking skills. In addition, when the findings regarding executive functions were evaluated, there was a statistically significant difference between the pre-test and post-test scores of total executive function in favor of the post-test in both groups. However, it was observed that there was no statistically significant difference between the post-test scores of both groups in terms of total executive function skills scores. In addition, when the post-test scores of pre-school students in two groups were evaluated, it was determined that there was no significant difference in computational thinking and executive function skills according to gender. Consequently, it was determined that coding education with an educational robot was more effective for gaining computational thinking skills than unplugged coding activities for pre-school students. However, it was observed that there was no difference between the two groups in terms of the development of executive function skills in pre-school education.

School Readiness Predictors of Early Academic Achievement in Children Born Very Preterm.

This study examined associations of school readiness measures obtained before school entry with academic achievement at early school age in children born very preterm (VPT, gestational age ≤ 30 weeks) and children born full term (FT, GA ≥ 37 weeks). The sample included 38 children born VPT and 30 born FT recruited at age 4 years and followed to early school age. Measures of readiness included tests of global cognition, executive function, motor abilities, and preacademic skills, as well as caregiver behavior ratings. Tests of math, reading, and spelling were administered to assess school-age achievement. Analyses that controlled for socioeconomic status and accounted for inclusion of siblings compared the groups on the achievement tests and identified measures of readiness related to school-age achievement. Achievement difficulties were more pronounced in the VPT group and associated with problems in multiple readiness domains. Effect sizes for these associations were largest for measures of spatial ability, executive function, and preacademic skills. Some associations remained significant when controlling for global cognitive ability at age 4 years, and others were significant only for the VPT group. Findings suggest that deficits on tests in multiple readiness domains assessed before school entry in children born VPT or FT are associated with early school-age achievement. The most pronounced readiness deficits in the VPT group at age 4 years were also among those most closely associated with later difficulties in achievement. Further research is needed to refine assessment of school readiness in children born VPT.

Lower Independent Self-Care Readiness Persists over Time in Teens with Type 1 Diabetes and Executive Function Challenges.

Management of type 1 diabetes is complex and benefits from adequate executive function (EF) (planning, organization, problem-solving). Teens with diabetes and executive dysfunction may have challenges with acquisition of self-care skills. Over 18 months, parents of teens with type 1 diabetes aged 13-17 completed the Diabetes Family Responsibility Questionnaire (DFRQ) and Readiness for Independent Self-Care Questionnaire (RISQ) every 6 months. Parents assessed teen EF, completing the Behavior Rating Inventory of Executive Function (BRIEF). T-score ≥60 defined EF challenges. EF, demographic, and diabetes treatment variables predicted RISQ score over time using longitudinal mixed modeling with false discovery rate adjustment. There were 169 teen participants (54% male) aged 15.9±1.3 years, diabetes duration 8.4±3.7 years, and A1c 8.6±1.2%. About a third (31.4%) of teens had parent-reported BRIEF Global Executive Composite (GEC) scores ≥60. After adjusting for age, gender, and DFRQ, those with GEC <60 had RISQ score 4.1 points higher than those with GEC ≥60, p=0.016. Behavioral regulation index (BRI; adjusted for age, CGM use, DFRQ, and A1c) did not predict RISQ while metacognition index (MI; adjusted for age, gender, and DFRQ) did; those with MI <60 had RISQ score 5.3 points higher than those with MI ≥60, p<0.001. In all models, older teen age (p<0.05) and less parental involvement (p<0.001) predicted higher RISQ score. EF skills, especially metacognition, appear important for acquisition of self-care behaviors in teens with type 1 diabetes. Evaluating EF during adolescence may identify teens needing extra support during the transition process.

The Neural Correlates of Response Inhibition across the Transition from Infancy to Toddlerhood: An fNIRS study

Abstract The transition from late infancy into toddlerhood represents a fundamental period in early development. During this time, the prefrontal cortex (PFC) is undergoing structural and functional maturation processes that parallel the emergence and improvement of executive function skills, such as inhibitory control. Despite the importance of this developmental period, relatively little is known about the emergence and development of response inhibition, a form of inhibitory control, and the associated neural substrates across this key transition. Using functional near-infrared spectroscopy (fNIRS), an optical imaging technique suitable for imaging the developing brain, and an age-appropriate response inhibition task, we investigated the brain regions associated with response inhibition in 16-month-old toddlers. This pre-registered study extends our previous work with 10-month-old infants (Fiske et al., 2022) as it follows the same cohort of participants, now at 16-months of age. Whilst our previous work demonstrated that 10-month-old infants recruited right-lateralised regions of the PFC and parietal cortex when inhibition was required, the current study suggests that by 16-months, toddlers recruit the left superior parietal gyrus, the right inferior frontal gyrus, and bilateral regions of the dorsolateral PFC and orbital frontal cortex. Although there was no longitudinal change in response inhibition performance, more widespread, bilateral regions of the PFC were recruited during response inhibition at 16-months compared to 10 months. We acknowledge the need for replication of these results. Nevertheless, our findings suggest that the transition from infancy to toddlerhood may constitute an important period of reorganisation of the PFC that might support the development of early inhibitory control processes.

Age-Related Aspects of Sex Differences in Event-Related Brain Oscillatory Responses: A Turkish Study.

Earlier research has suggested gender differences in event-related potentials/oscillations (ERPs/EROs). Yet, the alteration in event-related oscillations (EROs) in the delta and theta frequency bands have not been explored between genders across the three age groups of adulthood, i.e., 18-50, 51-65, and >65 years. Data from 155 healthy elderly participants who underwent a neurological examination, comprehensive neuropsychological assessment (including attention, memory, executive function, language, and visuospatial skills), and magnetic resonance imaging (MRI) from past studies were used. The delta and theta ERO powers across the age groups and between genders were compared and correlational analyses among the ERO power, age, and neuropsychological tests were performed. The results indicated that females displayed higher theta ERO responses than males in the frontal, central, and parietal regions but not in the occipital location between 18 and 50 years of adulthood. The declining theta power of EROs in women reached that of men after the age of 50 while the theta ERO power was more stable across the age groups in men. Our results imply that the cohorts must be recruited at specified age ranges across genders, and clinical trials using neurophysiological biomarkers as an intervention endpoint should take gender into account in the future.