Children born preterm present a high incidence of language development delay and motor difficulties. However, the association between these two developmental dimensions has been scarcely studied. Thus, the aim of this study was to determine the association between motor abilities (gross and fine) and language development (vocabulary size), in a sample of children born very preterm and extremely preterm in Chile. We conducted a comparative cross-sectional study in a sample of 38 very preterm and extremely preterm children from a pediatric hospital in Chile, compared with 42 term-born children from a kindergarten. Children were evaluated at 2 years of corrected age (preterm) or 2 years of chronological age (term-born), using standardized instruments. The association between language development and motor development was evaluated using generalized additive models. Our results show that there is a significant positive association between vocabulary size and gross motor development in preterm children up to a vocabulary size 200 words, but no association in term-born children. These results provide preliminary evidence for a relationship between motor skill scores and language development at small vocabulary sizes in very preterm and extremely preterm children, which future studies should expand into a multi-center design.
Children who are deaf or hard hearing (DHH) demonstrate difficulties with working memory (WM), which is associated with language, literacy and academic skills. This feasibility study investigated WM, language and literacy skills and the relationship among them in children who are DHH and whether a low-frequency dosage of Cogmed working memory training (CWMT) program leads to improved performance in WM (trained) and in language (untrained) tasks. Twenty-one children, aged 6-16 years who used hearing aids and/or cochlear implants participated in the assessment study. A battery of 14 subtests spanning cognitive, language, and literacy domains was administered to all children. Ten children participated in approximately 40 sessions of CWMT program, administered two-three times per week at their school. Results showed below-average performance by some children on verbal WM, language, and reading comprehension, with demonstrated strengths in word reading skills. Verbal WM showed significant positive associations with language and literacy variables whereas visual WM did not. Following intervention, children demonstrated significant improvements in WM and in recalling sentences task. Results demonstrated feasibility of administering a low-frequency dosage of CWMT program in public schools and provided preliminary evidence for short-term improvement in WM and far transfer of intervention effects.
Children born after threatened preterm labor (TPL) are at increased risk for executive function (EF) difficulties, even when born at term. However, EF development in this population remains understudied, particularly regarding the role of gestational age and early psychosocial adversity. Prenatal stress (e.g., maternal anxiety at TPL diagnosis and trauma history) and postnatal environmental factors may contribute to variability in EF outcomes. In this prospective cohort study with a 6-year follow-up, EF was assessed at ages 2 and 6 using the Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P). The sample included 180 mother-child dyads: 120 children born after TPL (full-term n = 27, late-preterm n = 56, very-preterm n = 37) and 60 full-term controls. Bayesian mixed-effects models were used to examine associations between EF outcomes and gestational age group, time, and relevant prenatal and postnatal factors, including child sex, parental education, maternal trauma history, and maternal anxiety. The models showed a group × time interaction for global EF scores. At age 2, all TPL groups showed higher EF difficulty scores compared with controls, with the largest differences observed in the very-preterm group. Between ages 2 and 6, EF scores decreased in TPL groups relative to controls, indicating a greater reduction in EF difficulties over time, although patterns varied across EF domains. Higher maternal anxiety (prenatal and postnatal), greater maternal trauma exposure, and lower parental education were associated with higher EF difficulty scores, whereas female sex was associated with lower scores. Children born after TPL show early EF vulnerabilities across gestational ages, including those born at term. EF outcomes change across early childhood and are associated with both biological and environmental factors. These findings support the importance of early monitoring of children exposed to prenatal complications and highlight the role of perinatal maternal mental health and family context in early executive function development.
This study aims to examine psychopathological factors associated with Cognitive Disengagement Syndrome (CDS) in preterm school-aged children, while controlling for the potential confounding effects of inattention, emotional problems, and peer difficulties. A comparative cross-sectional design was utilized with 181 children (89 preterm, 92 full-term). Assessment tools included the Turgay DSM-IV-Based Screening Scale, the Barkley Child Attention Scale, and the Strengths and Difficulties Questionnaire (SDQ). Group differences were analyzed using t-tests. A univariate ANCOVA was conducted to assess the effect of prematurity on CDS symptom scores after adjusting for birth weight, age, gender, and psychopathological covariates. The preterm group had significantly lower birth weight and gestational age (p < .001). While no significant difference was found in raw CDS symptom scores between groups (p = .603), preterm children scored significantly higher on the SDQ Peer Problems subscale (p = .002). The ANCOVA model revealed that prematurity status was not independently associated with CDS severity after adjusting for covariates (p = .432). Instead, ADHD-inattention (p < .001), emotional problems (p = .001), and peer problems (p = .004) emerged as significant predictors of CDS severity. Prematurity status is not an independent risk factor for CDS in school-aged children. The variance in CDS severity is primarily accounted for by co-occurring psychopathological vulnerabilities, particularly inattention and internalizing social challenges. Clinical evaluations of preterm children should prioritize screening for these associated factors to better manage the risk of cognitive disengagement.
Preterm birth is a common neurodevelopmental condition that can have lasting impacts on cognition, including attention and working memory. Interventions that strengthen these skills in early childhood could support school readiness. Dino Island is a tablet-based intervention that combines process-specific practice of attention and working memory skills with a compensatory component that teaches metacognitive skills to scaffold learning. In this pilot study, we evaluated the feasibility of parent-delivered Dino Island in young children born preterm (N = 10), alongside a control group who played educational games (N = 12). Both groups were instructed to play 2-3 times per week for approximately 20 minutes over a 12-week period. Attention and working memory on untrained tasks were assessed before and after completing the intervention. Parents provided fidelity data through tracking sheets and participated in exit interviews to offer feedback and identify barriers and facilitators. We found that the Dino Island program was successfully delivered by parents with high fidelity. Attrition was higher in the Dino Island group, likely reflecting the challenges of delivering cognitive remediation in home settings. Comparison of attention and working memory scores on untrained tasks pre- and post- showed practice effects but no specific benefit of Dino Island. However, parent reports suggested behavioral improvements specific to the Dino Island group, noting far-transfer effects where children applied metacognitive strategies in other contexts. Overall, this work shows feasibility and tolerability of Dino Island in young children born preterm. Future research should examine its potential impact on school readiness and longer-term academic outcomes in this population.
Cognitive Disengagement Syndrome (CDS) is an attentional construct characterized by excessive daydreaming, mental fogginess, and slowed behavior. This study examined CDS/SCT symptoms and their association with learning difficulties in children with epilepsy. In this cross-sectional case-control study, 400 children aged 6-16 years (200 with epilepsy, 200 healthy controls) were assessed using the WISC-R, Turgay DSM-IV Scale, Barkley Child Attention Survey, and Specific Learning Difficulty Symptom Scale. Children with epilepsy demonstrated significantly higher CDS scores than controls (18.28 ± 5.47 vs. 16.36 ± 5.34; p < 0.001; g = 0.36) and lower IQ scores (95.0 ± 7.9 vs. 97.0 ± 6.1; p = 0.004; g = 0.29). CDS symptoms correlated significantly with learning difficulties (r = 0.65), inattention (r = 0.52), and hyperactivity/impulsivity (r = -0.37). In multiple regression analysis (epilepsy group, n = 200), CDS (β = 0.52), inattention (β = 0.42), hyperactivity/impulsivity (β = 0.11), and polytherapy (β = 0.09) independently predicted learning difficulties (R2 = 0.89); epilepsy duration was not significant (p = 0.055). CDS symptoms independently associated with learning difficulties in pediatric epilepsy beyond ADHD-related symptoms. Routine CDS screening should be considered in children with epilepsy presenting with academic concerns.
Children's language development starts in utero, with language-relevant brain areas starting to develop and differentiate during the second trimester of pregnancy. Postnatal development in language-relevant brain areas such as the inferior frontal gyrus (IFG) and superior temporal gyrus (STG) has been shown to be related to language skills. In this study, as part of the Cambridge Human Imaging and Longitudinal Development (CHILD) project, prenatal structural characteristics of the IFG and STG (30th - 33rd GW) and their association with English children's language skills, obtained longitudinally at two postnatal assessment points (n = 24 and n = 25) was examined. Prenatal bilateral STG volume was found to be associated with expressive vocabulary 2-3 years after birth (M = 139.1 weeks), as measured by the Communicative Development Inventory (CDI). These results highlight the relevance of prenatal brain development for language acquisition after birth. SUMMARY: Postnatal structural characteristics of neural language network, including IFG and STG, are known to be related to language skills in children and adults Structural characteristics of IFG and STG were assessed prenatally in this study and related to language outcomes in early childhood Bilateral STG volume at birth predicts vocabulary scores 2-3 years later Findings support the importance of prenatal brain development for postnatal language acquisition.
The aim of this study was to determine performances in executive functions in preschool children and the relationship with children's age and their receptive and expressive language skills. The study was conducted in four public kindergartens in Baltim that approved the research. The study was conducted on three age groups: 3 (3 years, 0 months - 3 years, 11 months), 4 (4 years, 0 months - 4 years, 11 months), and 5 (5 years, 0 months - 5 years, 11 months). A total of 160 children were included, 83 girls and 77 boys. The Mann-Whitney U test was also applied to analyze gender differences. The relationships between executive function tasks and the Arabic receptive and expressive language skills test were analyzed using the Spearman rank correlation test. A significance level of .05 was used in all analyses. Findings from the Night/Day Task indicate no significant age-related performance increase related to this task. When the relationship between Language Test scores and executive function tasks was examined, it was found that NDT had no relationship with receptive and expressive language scores.
The preschool stage is a critical period for children's emotional regulation ability and cognitive function development. This study adopted a cluster randomized controlled trial design, selecting 120 4-6-year-old preschool children in Tianjin, who were randomly divided by class into an experimental group (n = 60) and a control group (n = 60). The experimental group received a 12-week traditional culture picture book intervention (twice a week), while the control group received regular kindergarten teaching without special picture book intervention. Both groups received equal class time and teacher attention to avoid confounding effects. The results showed that after the intervention, the experimental group performed significantly better than the control group in all indicators of emotional regulation ability and cognitive functions (all p < 0.001). Repeated-measures ANOVA revealed significant main effects of time, group, and time×group interaction (all p < 0.001). Pearson correlation analysis indicated a significant positive linear correlation between emotional regulation ability and cognitive functions (r = 0.426-0.578, p < 0.01). All results were reported with Cohen's d effect sizes and 95% confidence intervals, and Bonferroni correction was applied for multiple testing. In conclusion, traditional culture picture book intervention can significantly improve preschool children's emotional regulation ability and promote their cognitive function development, which can be incorporated into regular kindergarten teaching as an effective local intervention carrier. The correlation only demonstrates an association rather than a causal relationship between emotional regulation and cognitive functions.
Positive childhood experiences (PCEs) have been linked to adolescent health, but less is known about their association with executive function or the unique contributions of specific PCEs. This study aimed to examine the association between individual PCEs and adolescent executive function and to explore whether these associations differed by maltreatment experiences. This cross-sectional study included 4,789 high school students (Mage: 14.0 years, 53.9% boys) in Guangzhou, China. Adolescents self-reported their PCEs, executive function, and maltreatment experiences using the Benevolent Childhood Experiences Scale, the Adolescent Executive Function Scale, and the Adverse Childhood Experiences International Questionnaire, respectively. Structural equation modeling was applied to estimate the association of individual PCEs with latent executive function domains. Multiple-group structural equation modeling was used to examine whether the associations differed by maltreatment experiences. Three latent executive function domains were identified, including inhibitory control, cognitive flexibility, and working memory. Among the individual PCEs, positive self-perception, a predictable home routine, and enjoyment of school showed the largest standardized coefficients across all executive function domains. In multiple-group structural equation modeling analyses, none of the structural paths from PCEs to executive function domains significantly differed between adolescents with and without maltreatment experiences, indicating comparable associations across maltreatment subgroups. Our findings revealed complex associations between PCEs and adolescent executive function, underscoring the importance of promoting multifaceted PCEs across self, family, and school contexts to support cognitive development for all adolescents, regardless of their maltreatment experiences. Nevertheless, future randomized controlled trials are warranted to confirm these conclusions. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
The aim was to investigate the predictive effect of executive function on learning quality, early language ability, and mathematical ability in preschool children aged 4-6 in Sultanate Oman. A cross-sectional mediation model in which learning quality mediated the relationship between executive function and early mathematical and language abilities was used. Five kindergartens were selected from Oman. One small, one medium, and one large class were randomly selected from each kindergarten, for a total of 15 classes. In each class, teachers selected 10-20 children with average performance, totaling 270 children, of whom 140 were girls (51.8%). There were 130 boys (48.2%). This study yielded the following findings: (1) executive function has a significant positive predictive effect on learning quality and early-stage language and mathematical abilities; and (2) learning quality plays a partial mediating role in the relationship between executive function and early-stage mathematical abilities, but has no mediating role in the relationship between executive function and early-stage language abilities.
Inhibitory control deficits have been implicated in developmental dyscalculia (DD), yet specific relationships between inhibition and arithmetic domains remain unclear. This study investigated inhibitory control in children with DD across nine arithmetic domains. Sixty-four children aged 9-11 years (32 with DD, 32 typically developing) completed the Stroop Color-Word Interference Test and a comprehensive arithmetic battery assessing quantity comparison, arithmetic operations, counting dots, subitizing, quantity estimation, number positioning, reverse verbal counting, number reading, and problem solving. Children with DD demonstrated significantly poorer inhibitory control, with longer completion times (M = 101.16 vs. 71.25 seconds) and more interference errors (d = 1.18, r = .41, both p < .001). Correlation analyses revealed a notable dissociation: controlled processing tasks showed strong negative correlations with Stroop performance (r = -.43 to -.55, p < .001), while automatic processing tasks showed positive correlations (r = +.27 to +.44, p < .05). These patterns remained significant after controlling for age. Children with DD may require differentiated interventions depending on whether difficulties stem from weak controlled processing or disrupted automatic processing. Results support dual-process theories and highlight need for domain-specific assessment and intervention.
This study aimed to investigate the associations of maternal epilepsy and prenatal antiepileptic drug (AED) exposure with neurodevelopmental outcomes in preschool-aged children, with a particular focus on adaptive functioning, emotional and behavioral problems, and autism spectrum disorder (ASD). This retrospective, case-control study included 53 children aged 2-6 years born to mothers with epilepsy and 53 age- and sex-matched controls whose mothers had no history of epilepsy or other chronic illness. Developmental outcomes and emotional problems were assessed using the Vineland Adaptive Behavior Scales-II (VABS-II), the Strengths and Difficulties Questionnaire (SDQ), and the Autism Behavior Checklist. Linear regression analysis showed that prenatal AED exposure was significantly associated with lower total VABS-II scores (R2 = 0.201, p = .040). Within the AED-exposed subgroup, higher standardized AED doses were negatively correlated with total VABS-II scores (r = -.425, p = .021). Hyperactivity/inattention and peer relationship problems were significantly higher in both AED-exposed and non-exposed epilepsy groups compared with controls (p < .05). Three cases of ASD were identified, all in the AED-exposed group. Maternal epilepsy and prenatal AED exposure may be associated with differences in adaptive functioning and behavioral outcomes in preschool-aged children. These findings should be interpreted cautiously given the observational design and potential residual confounding.
Evidence on written language assessment remains limited in Persian-speaking children, particularly in clinical populations such as children with cleft lip and/or palate (CL/P), who may present with higher-order language difficulties. This study aimed to develop and validate the Persian Written Language Assessment Profile (PWLAP). A sequential mixed-methods design was used. In Phase I, the PWLAP was developed through literature review, expert interviews, and a two-round Delphi process involving 14 specialists. In Phase II, the profile was administered to 184 Persian-speaking students in grades 3-6 (128 typically developing (TD) and 56 with CL/P). Written language was evaluated using lexical measures (total number of words, number of different words, and type-token ratio) and morphosyntactic indices (T-unit measures, clause production, clausal complexity, and morphosyntactic errors). Strong expert consensus supported the content validity of the PWLAP. The PWALP successfully differentiated students with CL/P from TD peers across lexical and morphosyntactic measures (p < 0.05), supporting construct validity. Reliability analyses demonstrated excellent inter- and intra-rater reliability (ICC ≥ 0.95). The PWLAP is a valid and reliable tool for assessing written language in Persian-speaking students and may be useful in assessment of written language in children with CL/P.
This study aimed to investigate the effectiveness of the Cogmed computer-assisted cognitive rehabilitation program and training for reading in improving reading skills in children with linguistic dyslexia. A randomized, controlled clinical trial was used. Thirty children with linguistic dyslexia were assigned to experimental group (n = 15) or control group (n = 15). Two participants (one from each group) dropped out during the intervention, resulting in a final sample of 28 participants (n = 14 per group. The experimental group received 25 sessions of reading training and the Cogmed cognitive rehabilitation intervention, while the control group only received reading training. Data were collected using the NEMA Reading and Dyslexia Test, the Specific Learning Disorder Questionnaire, Raven's Progressive Matrices Test, and the Assessment of Persian Reading Ability. The findings indicated that the combined Cogmed and reading training intervention significantly improved multiple reading components, including low-frequency word reading (F = 56.34, p < 0.001, η2 = 0.68), high-frequency word reading (F = 29.62, p < 0.001, η2 = 0.53), word chains (F = 39.76, p = 0.001, η2 = 0.60), and word comprehension (F = 49.19, p = 0.001, η2 = 0.65). The combined Cogmed and reading training intervention produced statistically significant improvements across multiple reading subskills in children with linguistic dyslexia. These improvements remained stable over a one-month follow-up period, indicating short-to-medium-term durable cognitive and linguistic gains. Future research should examine long-term maintenance, test efficacy in other dyslexia subtypes, and utilize executive function (EFs) assessments along with neuroimaging techniques to explore the underlying mechanisms of change.
Children with Attention-Deficit/Hyperactivity Disorder (ADHD) frequently show deficits in Executive Functions (EFs), including inhibition, working memory, and cognitive flexibility. Digital games have recently been proposed as innovative tools to support EF development in this population. This randomized controlled trial investigated the effectiveness of The Incredible Adventures of Apollo and Rosetta in Space, a digital game designed to enhance executive functioning, in children aged 8-11 years with ADHD. Thirty-four participants were randomly assigned to an experimental group (n = 17), which played the game three times per week for three months, or to a control group (n = 17) that received no intervention. Neuropsychological tasks assessing inhibition, working memory, and cognitive flexibility, along with parent-reported questionnaires on ADHD symptoms and EF-related difficulties, were administered before and after the intervention. No significant group × time interactions emerged. However, exploratory effect size analyses revealed small-to-moderate directional improvements in the experimental group, particularly in cognitive flexibility, with modest gains in working memory and stable inhibition performance. Parent reports were consistent with these patterns, showing small improvements in attention in the experimental group and worsening EF-related behaviors in the control group. Although preliminary, these findings suggest that the game may be associated with meaningful patterns of change in abstract cognitive flexibility and working memory in children with ADHD, warranting further investigation into their generalization to daily functioning in larger samples. Trial registration: ClinicalTrials.gov ID NCT06881719.
This randomized, placebo-controlled trial investigated the cognitive effects of three phosphatidylserine (PS) formulations, with or without docosahexaenoic acid (DHA), in children aged 10-14 years diagnosed with attention-deficit/hyperactivity disorder (ADHD) or presenting with clinically significant subthreshold ADHD symptoms. Forty-five medication-naïve children meeting DSM-5 criteria for ADHD or exhibiting subthreshold symptoms confirmed by standardized parent-teacher rating scales (Turgay/Conners) and clinical evaluation were randomized in a 1:1:1:1 ratio to receive placebo, PS Capsule (100 mg PS + 17.78 mg DHA), PS Sachet (117.78 mg PS without DHA), or PS Plus Capsule (150 mg PS + 26.67 mg DHA) for eight weeks. Cognitive performance was assessed at baseline and post-intervention using the MOXO continuous performance test and the Stroop test. Significant between-group differences were observed across MOXO and Stroop outcomes. The PS Plus group showed the greatest improvements in attention, impulsivity, and hyperactivity, along with the largest reductions in reaction time. The placebo, Capsule, and Sachet groups demonstrated smaller and generally comparable changes. Stroop error rates and correction counts decreased significantly only in the PS Plus group, suggesting enhanced inhibitory control and cognitive flexibility. Higher-dose phosphatidylserine combined with DHA (PS Plus) yielded superior cognitive benefits compared with placebo and lower-dose formulations.
This research aimed to analyze the extent to which executive functions (EF) predict changes in Science academic performance (SAP) of primary school students, based on student self-reports and parental perceptions of their children's executive functioning. Students attending primary school in Medina, Saudi Arabia was selected. A non-probability convenience sample was drawn. This sample consisted of 200 children from 3 schools. The present study corresponds to a non-experimental, quantitative design, with a descriptive-correlational scope. Descriptive analyses were performed, and the mean, standard deviation, and minimum and maximum values of the variables of interest were calculated. For inferential analyses, a correlation analysis was first conducted using Pearson's correlation coefficient to examine the existence of significant correlations between the variables. The results showed that EF related to planning (PL) and working memory (WM), according to the perceptions of the students and their parents, can explain Science academic performance (SAP). The results provide evidence regarding the potential importance of using self-reports and parental reports of cognitive abilities in analyzing the relationship between executive functioning (EF) and Science academic performance (SAP), and in studying the influence of socioeconomic context on SAP in primary school students. These results regarding EF can inform interventions or policies concerning school performance in academic achievement.
Executive functioning challenges, including difficulties with flexible thinking, goal setting and planning, are common among neurodivergent children, especially those identified with autism and/or attention-deficit/hyperactivity disorder. Executive functioning problems are linked to poorer academic achievement and are exacerbated by poverty. Importantly, executive functioning is responsive to intervention. This pragmatic study compared the effectiveness of two school-based executive functioning interventions for children with autism and/or attention-deficit/hyperactivity disorder in Title 1 (low-income-serving) school settings to improve accessibility of effective interventions. 148 children (82% male) in 3rd-5th grades were cluster-randomized by school (N = 24) to receive Unstuck and On Target (Unstuck), a cognitive-behavioral program, or Parents and Teachers Supporting Students, a behavior-management program considered best practice for children with attention-deficit/hyperactivity disorder. Both programs targeted executive functioning, were matched for dosage, and were delivered in small groups by school staff, with parent and teacher training to support generalization. The sample (attention-deficit/hyperactivity disorder N = 98; autism N = 50) was ethnically and socioeconomically diverse. The primary outcome was executive functioning behaviors assessed through masked classroom observations. Secondary outcomes were masked executive functioning tasks, and a parent report measure. Treatment fidelity, acceptability, potential moderation of family income, age, and cognitive functioning were assessed. Both interventions were implemented with high fidelity and were well-liked by children and parents, with Unstuck receiving higher acceptability ratings. Child executive functioning improved across both interventions and on all outcomes. There was limited moderation by income, and outcomes improved following intervention, even after accounting for income. School staff can effectively deliver both Unstuck and Parents and Teachers Supporting Students in low-income community schools to improve executive functioning. These accessible, low-cost options address income-based health disparities by providing an alternative to clinic-based care. The interventions show promise for broader applications in schools. Community Based Intervention for Children with ADHD and ASD; clinicaltrials.gov (NCT03003286) 9/13/2014.
This study aims to provide a comprehensive, longitudinal perspective on the evolution of executive functions (EF) in early childhood by examining scientific trends and conceptual transformations from 1997 to 2025. A bibliometric analysis was conducted on 530 peer-reviewed articles indexed in Social Sciences Citation Index (SSCI), Emerging Sources Citation Index (ESCI), and Science Citation Index Expanded (SCI Expanded), retrieved from the Web of Science (WoS) Core Collection. To enhance transparency and reproducibility, a rigorous screening process is detailed through a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. The field's conceptual structure was revealed through co-occurrence and clustering analyses, resulting in four major thematic clusters: (a) Skills and Early Learning, emphasizing school readiness and academic processes; (b) Family Influences, covering socioeconomic factors and parenting practices; (c) Behavioral Dimension, focusing on EF-related difficulties and standardized assessment tools; and (d) Experimental and Intervention-Based Studies, representing program evaluations and mechanism-oriented approaches. Trend analyses demonstrate a notable increase in EF research particularly after 2015, accompanied by a shift from deficit-oriented perspectives toward more ecological, developmental, and intervention-focused approaches. The visualized maps generated in this study illustrate both the dynamic intellectual growth of the field and the conceptual transitions that have shaped EF research in early childhood over nearly three decades.