Thursday, February 2, 2023

Executive function in children: why it matters and how to help

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Executive function refers to the skills that help us focus, plan, set priorities, achieve goals, self-regulate behaviors and emotions, adapt to new and unexpected situations, and ultimately to engage in abstract thinking and planning. Much like a principal conductor for an orchestra, the executive functions oversee and coordinate a multitude of cognitive, behavioral and emotional tasks.

Executive functions in childhood are, by default, difficult. This is because although our executive function skills begin to develop in the first year of life, they are not fully developed until early adulthood.

Executive function in children

As with other stages of development, there is some normal variability in when children reach stages of executive function. But some children experience greater than normal difficulties or delays with their executive function skills.

In some children, problems with executive function present as problems with impulse control, temper tantrums and difficulty regulating emotions. For others, the challenges of organizing school, managing time and memorizing instructions are more visible. Adolescents who struggle with executive function often struggle to achieve independence and to plan for the future.

Contrary to what we tend to think, executive functioning does not refer to a single ability, and executive functional skills do not develop in a linear progression. The main components of executive functions include inhibitory control (the ability to control impulses); working memory (a type of short-term memory that involves the temporary storage and manipulation of information); and cognitive flexibility, or change (the ability to switch between thinking about different topics). Each of these skills develops at different rates, with windows of growth and opportunities for intervention.

Executive function skills can be significantly enhanced or hindered by environmental factors such as early childhood stress, family structure, and educational opportunities. Fortunately, this means that these skills are extremely malleable and open to improvement. Evidence-based interventions have been rigorously studied and have shown that children’s executive functions can be enhanced through structured educational, neuropsychological, and socio-emotional programs.

Promising interventions: cognitive training, neurofeedback and physical activity

Interventions targeting executive functions in children have increased exponentially in recent years. There is evidence of some benefit, which may vary depending on the child’s cognitive characteristics (such as language, memory, or intellectual functioning), family functioning, and underlying medical or psychological conditions.

Perhaps the best-known interventions are those that use computer programs, such as Cogmed cognitive training, or neurofeedback, such as Mightier. These child-friendly interventions consist of relatively intensive training (for example, several sessions per week for five to 15 weeks) in specific executive functions, such as working memory or impulse control. There is consistent data supporting the use of these interventions. But critics wonder if these improvements are generalizing to support improved executive functions in everyday life.

There is strong evidence that some school programs improve executive function in young children, especially those who use a Spirit Tools approach. This pedagogical approach emphasizes the teaching of self-regulatory and socio-emotional skills through dramatic play and cooperative learning. In these classrooms, children learn skills such as succession, active listening and the development of creative problem-solving methods.

Interventions involving physical activity (such as aerobic exercises or yoga practice), as well as organized sports activities (such as soccer or basketball) and martial arts promote the development of executive skills, as they force children to keep in mind rules and strategies, to adapt flexibly to the actions of others and to monitor their own performance and behavior. Physical activity is also essential for circulating blood (and therefore oxygen) to the brain and for emotional well-being, which in turn are essential for the development of children’s executive functions.

Promising intervention: mindfulness

As we learn more about what improves executive functions, we also realize that stress is something that “freezes” children’s ability to apply executive functions appropriately. Chronic stress and anxiety, often due to family, school or health problems, is one of the main risk factors for executive dysfunction throughout life, particularly in children, for whom executive functions that help us manage stress are not yet ripe. .

To tackle both stress reduction and improved executive functions, mindfulness training seems to be an ideal candidate. Mindfulness training involves the practice of drawing one’s attention to the present moment, to what we are doing and what we are feeling, without judgment. Mindfulness interventions have been increasingly adapted to children of all ages through simple exercises of breathing, body scanning, gratitude and kindness to oneself and others. The emerging data is promising, showing that children who participate in mindfulness programs exhibit less anxiety, greater ability to concentrate and remember, and better deal with difficult emotions.

Take home message

There is certainly no one-size-fits-all intervention to improve executive functions in children. Typically developing children and children with neurodevelopmental disorders such as ADHD, autism spectrum disorders, or learning disabilities may respond very differently to each of these interventions. Not all are achievable or even appropriate for some children and families.

The best approach is one that takes into account the strengths and vulnerabilities of each child, as well as the needs and functioning of each family. For example, giving too intense computer training to an already anxious and stressed child may not be the most appropriate option, as it would reduce the time they might have to relax, exercise and possibly practice resilience. emotional.

Finally, whatever the intervention, parent-child relationships are essential. It is the constant support from parents and family, the shared experiences, and the time spent together enjoying daily activities like reading books, cooking or dancing that help strengthen children’s self-regulatory skills. They are without doubt the most effective and enduring foundations of executive function.


Executive functional skills

Interventions demonstrated to promote the development of executive functions in children aged 4 to 12 years. Science, August 19, 2011.

Randomized controlled trial of working memory intervention in congenital heart disease. The Journal of Pediatrics, December 2020.

Cognitive training / neurofeedback

Adaptive training leads to lasting improvement in poor working memory in children. Development science, July 2009.

Computerized working memory training in children with ADHD – a randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, February 2005.

Improving neurodevelopmental outcomes in children with congenital heart disease: protocol for a randomized controlled trial of working memory training. BMJ open, February 19, 2019.

“RAGE-Control”: a game to develop emotional strength. Health Games Journal, February 2013.


Mindfulness-based program integrated into existing program improves functioning and management behavior in young children: a wait-list controlled trial. Frontiers in Psychology, September 10, 2019.

Linking Mindfulness and Executive Function in Children. Child psychology and clinical psychiatry, April 2020.

The post office Executive function in children: why it matters and how to help appeared first on Harvard Health Blog.


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