Promoting Executive Functioning Skills in Children and Adolescents

Editor's Note: This text-based course is a transcript of the webinar, Promoting Executive Functioning Skills in Children and Adolescents, presented by Bryce Hella, PhD, Licensed Psychologist, Clinical Social Work.

Learning Outcomes

• After this course, participants will be able to describe executive functioning skills.
• After this course, participants will be able to explain the current state of research on EF interventions.
• After this course, participants will be able to identify and list several EF strategies with children.

Introduction

Great, thank you so much.  The limitation of the presentation is that this is an initial and broad overview of executive functioning in the pediatric population. It's not meant to be used to create a comprehensive treatment plan. The most common potential risk following the presentation could be attempting to make a treatment plan based on the information I provide.

What are Executive Functions

A good place to start discussing executive functions is what they are. Executive functions are brain functions similar to an air traffic control system. It's how we retain and work with information in our bodies and brains. It's higher-order processing, those things that make us human and differentiate us from animals. It allows us to filter distractions and switch mental gears.

Developmentally, executive functioning skills tend to emerge in preschool. But existing data suggests that they're not fully mature until about the early 20s for females and mid to late 20s for males. Executive functions are housed in the frontal lobe, the last part of the brain to develop, which is developing well into a person's 20s.

An interesting fact about executive functioning is that it's found to be more predictive of school success than IQ. The thought is it's not necessarily how smart you are that predicts how well you do in school, but it's how well you can inhibit the impulses to, for example, watch TV instead of study. How well do you keep your tasks organized and turn things in on time? Executive functions are important, particularly for academic success.

Executive Functioning Subtypes

There are many different subtypes of executive functions. Executive functioning is a broad term to describe many different kinds of mechanisms and behaviors that people engage in or don't engage in.

Inhibition

Inhibition is fairly self-explanatory. This is a person's ability to inhibit their impulses. A classic study on behavioral inhibition is the marshmallow test, where a researcher brings a young child into the lab, puts a marshmallow on their plate and says something like, "Please don't touch this marshmallow when I leave," or  "Right now you have one marshmallow. Don't eat it.  I'm going to leave, but if you can wait and not eat it, when I come back, you'll get two or three marshmallows." The study is great because children work hard to inhibit the impulse to eat the marshmallow.

Organizing and Planning

Organizing and planning are also pretty self-explanatory. How well do people keep organized? Can they organize their belongings? For children, is their backpack a mess? Is their bedroom a mess?

Planning is knowing, for example, that next week I have a partial day of school. I know next week is a final exam. That means my schedule has changed. I have tests that I need to study for. I have a final paper that I need to write.

Task Initiation

Task initiation is a fancy way of saying "getting started" with something. This would be the opposite of procrastination. For example, I have a project that I need to do. I can sit at my computer, but I don't get started. Instead, I check my email or go on social media. This is how well do you get started with a task.

Shifting

Shifting is an interesting skill. We see many children with issues with transitioning, having the ability to shift from a preferred task to a nonpreferred task. You might see a tantrum, for example. This is not only being able to shift behavior but also mental sets. For example, I'm working on a math problem and trying to use a strategy that works for similar math problems, but I'm getting stuck. A shifting mental set is being able to step outside of, "I've tried this problem-solving approach, I'm working hard at it, but it's not working. I need to try something different." They can shift from the initial mental set to something else.

Emotional Control

We don't necessarily think of emotions as being regulated by the prefrontal cortex. But being able to control one's emotions and not have a big emotional or behavioral reaction is considered a higher-order executive function.

Self-monitor and Modify

Self-monitor and modify is pretty similar to shifting. This is being able to say, "The last time that I studied for my biology test, I crammed it in the night before. I tried to do flashcards, but I got an 'F.' This time, I might need to try a different strategy." Maybe they could schedule times to study or use a different strategy besides flashcards.

Working Memory

Working memory is holding short bits of information in your head long enough to do something with it.  If I give you my phone number and you have to remember it long enough just to get it in your phone, that would be working memory. Another example is given a two-step direction or a three-step direction, can you remember all three of those steps?

Working memory is also important for students with copying notes from the board. If I have a short working memory and I can only remember a couple of words at a time, I'm going to be constantly looking up at the board and looking down to write. As a result, tasks can take a lot longer. 

Goal-directed Persistence

Goal-directed persistence is being able to see the long-term implications of your behavior. It's continuing a task even if you're not getting an immediate response, reaction, or gratification. You're able to persist and push through with your behavior.

EF Example 

I like to use the example of holiday shopping at the mall. Although I think this is becoming an outdated example as people aren't shopping at malls for holidays as much as they used to. But, let's say you're given the task of doing holiday shopping at a shopping mall for ten members of your family, and you have to think through the steps you need to take to come home with ten presents for ten different people.

The executive functioning skills that are activated in this example are planning, organizing, and shifting attention.  For example, "I went to Bath and Body Works, and there's a long line there. I know that the mall is closing in two hours, and if I spend all my time in this line, I will probably not get the other stuff on my list done." 

Budgeting requires you to plan out how much you have left to spend. You need to remember all of the people that you need to buy things for versus having a list. If somebody has something specific on their list, and you can't find their size, or if the store is out of that item, you have to be flexible and shift your mindset to consider what else that person might like.  Also, finding a parking spot and remembering where you parked also requires executive functioning. 

All of these executive functions are activated during complex tasks such as shopping.  And some people might find this an unpleasant experience because it is a complex task involving many executive functioning skills. Even adults with weak executive functioning skills may find going to the mall to buy ten presents overwhelming.

EF and Childhood Disorders

Research suggests that there are several childhood disorders that have some implications for executive functioning deficits and difficulties.  The most common disorder that's characterized by executive functioning deficits is ADHD. Individuals with ADHD demonstrate delays in executive functioning skills, sometimes up to three to five years delay in school. A fourth grader with ADHD may be more like a first grader with their executive functioning skills.

Aside from ADHD, there are many other disorders that have implications and go hand-in-hand with executive functioning deficits. Children with learning disabilities oftentimes have executive functioning issues.  With autism spectrum disorder, it's not uncommon to see executive functioning deficits in emotional control and shifting. Being able to shift from preferred activities to other activities is a common executive functioning deficit with autism spectrum disorder.

Interestingly, depression and anxiety also have implications for executive functioning deficits, although we don't always think of those as disorders of the brain. The theory is that there are other more primitive parts of the brain that are activated when people have depression or anxiety. When those parts of the brain are activated, like the amygdala, it overrides the ability of the frontal lobe to be effective.

For example, my emotions are heightened if I have social anxiety and I'm sitting in the classroom terrified of getting called on because I don't want to be embarrassed in front of my class. I have a lot of adrenaline rushing through my body, and I feel my heart race, making it hard for me to do a working memory task where I have to remember something for a short time. So, depression and anxiety are surprisingly associated with executive functioning difficulties, and a lot of research suggests that.

Schizophrenia is not a common disorder for children and adolescents. The typical age of onset for schizophrenia is between 18-22 years old. So, child and adolescent onset of schizophrenia is very, very rare. But there are many studies that suggest people diagnosed with schizophrenia in the 18-21-year-old timeframe or later typically had some executive functioning deficits in childhood and adolescence.  When doing a comprehensive evaluation for early onset schizophrenia, executive functioning abilities are also typically evaluated.  That does not suggest that a child with executive functioning issues in childhood and adolescence will automatically develop schizophrenia. This is more retrospectively, in that you can look back and see that the groundwork was laid during childhood and adolescence. 

Finally, fetal alcohol spectrum disorders and traumatic brain injury (TBI) also have implications for executive functioning deficits.

How to Assess EF

There are two primary ways to assess and evaluate executive functioning deficits. The first is by questionnaire, and the second is by individually administered tests. The most common questionnaire in psychology is the Brief-2, which looks at many different executive functioning domains. There's a parent report, a teacher report, and a self-report version of the Brief-2 for older children. This questionnaire gives us a good sense of how the child is doing with their executive functioning skills in the real world.

There are several individually administered tests: 

• DKEFS 
• NEPSY-2 
• Comprehensive Trail Making Test
• Tower of London 
• Wisconsin Card Sort
• Test of Everyday Attention for Children

These are typically administered by a psychologist or somebody trained to give these types of tests, usually in the context of a comprehensive battery of other assessments.  One-on-one testing with a psychologist and the self-report, parent report, and teacher report questionnaires, oftentimes indicate how an individual's executive functioning skills translate into the real world.

EF Expectations by Age

Again, generally speaking, the frontal lobe and executive functions are the last part of the brain to develop. They develop throughout the course of childhood. What we expect to see in preschool is being able to run simple errands, do simple tasks, and can mostly inhibit behaviors like "don't touch," "don't run on the street," and "be safe."

Additional demands that are considered reasonable for kindergarten to second grade include being able to sit down and do homework for 20 minutes. In contrast, a preschooler might not be able to do that. On average, kindergarten through second-grade children can inhibit more complex behaviors, they can tidy a bedroom or a playroom but probably can't clean an entire house or bathroom. 

In third to fifth grade, children are typically able to run small errands, perform chores that take a little longer, spend an hour on homework, and plan simple projects like book reports. They can behave appropriately when a teacher is out of the classroom and plan for things that are days in advance.

Moving into middle school age, there are some additional reasonable expectations, such as performing chores around the home, including daily responsibilities and occasional tasks, babysitting younger siblings or other children for pay, using a system for organizing schoolwork, including assignment books, notebooks, etc. They can follow complex school schedules involving changing teachers and changing schedules, plan and carry out long-term projects, plan time, including after-school activities, homework, family responsibilities, and inhibit rule-breaking in the absence of visible authority.

EF Strategies

Next, I want to discuss executive functioning strategies by focusing on the research and describing different strategies that can be used with children and adolescents.

In general, the research on executive functioning interventions is very mixed. There are many different ways to try and improve executive functioning skills, and the approaches are ever-changing. 

• Computer-based EF training: There is a public market for computer-based executive functioning training, which is online training for simple executive functioning tasks such as improving working memory by remembering long strings of numbers or longer strings of information. The challenge with those types of programs is that they're highly expensive, not covered by insurance, and the research does not have much external validity. The research that's being done on those programs tends to be done in-house by the company, and there are limitations to that research. They will typically do a pretest of a working memory task, for example, and then a post-test of the same working memory task. Then the research will suggest that "Yes, there might be a few points gained in a working memory score when you're testing it the same way."  But that doesn't necessarily translate into improved working memory in the real world. So I always caution people who are thinking about doing some of that computer-based executive functioning training because there isn't much evidence supporting its use. 

A similar example is giving an IQ test and then training the individual on the items from that test.  We would expect their IQ score to improve.  But if that individual's grades don't improve and they don't know how to study better, is that a helpful change? 

• Physical activity: There is some research suggesting that any type of physical activity can have a small impact on executive functioning skills, particularly with emotion regulation, emotion control, and some inhibition.
• Mindfulness: Has a moderate effect on tasks, such as shifting and controlling emotions.
• Teaching "real life" executive functioning skills: There's some research to support that this is an effective and cost-effective strategy, as well. If you can implement real-life executive functioning skills training in a classroom or at home, that can translate into being able to study better, organize better, plan better, et cetera.  
• Neurofeedback and biofeedback: This strategy has mixed results regarding how well it impacts executive functioning skills.  Additionally, it tends to be expensive. It's not that they're ineffective. But there isn't strong data to suggest whether they're effective or ineffective.

Task Initiation

Let's discuss some specific strategies for task initiation.  Again, task initiation is being able to get started on something, such as sitting down, opening up a Word document, and starting to type out the first paragraph of a research paper. A quote that I like is, "If you're having trouble getting started, the first task is too big." You probably need to start with a smaller step.  If I need to write a research paper, it needs to include a reference portion, information from five sources, it needs to have an introduction, a body, and a conclusion.  It needs to be six pages, for example. We can make that task easier by breaking it into smaller chunks; maybe set small due dates for those chunks.  

I may be having a hard time getting started with the first paragraph, but I have three sources that I can read and put into my references. I can summarize and write the main points I want to cover in the paper. All of those smaller chunks are doing something to get started.

Another strategy for writing assignments is to provide some sentence starters, "The first paragraph sentence could start like this...," or, "This is how you could start your introduction...," or "Here are some sentence starters for the body of the paper...,"

Another task initiation strategy that works for adults, too, is setting aside 5-10 minutes to work on the paper. If, at 10 minutes, you're in a good flow and you can keep going, great. And I think, in general, that is what happens. You get started, do 10 minutes, and think, "I can do more." But if that doesn't happen, you still got some work done in 10 minutes or at least got started. 

For school-age and adolescent students, provide them with samples of a good quality finished product. For these students, the task may so daunting, and they don't know where to start because they don't know what the end is supposed to look like. Sharing samples of finished products can be helpful.

Organization: Papers

Keeping papers organized is often a big issue for students and adults too.  Papers from school are stuffed into backpacks, desks, and lockers.  And there's really no perfect method for organizing them.  To see if a method works, you need to pick one and stick with it. For children, it can be helpful to have daily check-ins. During that daily check-in, a teacher or other staff member can check to see if all papers are filed in the correct section, and there are no loose papers in the backpack. If that's not the case, the adult oversees or sits with the child as they reach that goal or do that for the day.

There could be weekly or bi-weekly check-ins to review the student's folder to see what needs to be finished, what needs to be thrown away, what needs to go in a different location, what things need to be saved, et cetera.

Planning and Time Management

There are some general recommendations for people who have executive functioning deficits, particularly as they start to have more organizational responsibilities.  Having a planner is highly recommended by the end of elementary school and in middle school and high school. I often see that people are resistant to planners. But with smartphones and technology, there are electronic planners. There are also planners and calendars available through their school operating systems or on a Chromebook that they have through the school. Even using paper and a pencil to handwrite lists and notes is helpful. 

Ask what the student's preference is to increase buy-in.  And explain, "I know it's annoying. I know it's daunting. But it's going to help you get better grades. It will help you turn in the work you're completing. You're not turning it in because you didn't write it down, or you didn't organize it or put it in the right spot."

Also, a planner should always be open and out during homework time.  It's an integral part of their homework and looking at their schedule, what they have coming up for the week, and if they wrote everything down. It can also be a good idea to have them write in the planner if there is no homework in a particular class or in general.  A lot of times, students come home with nothing in their planner, and they will say, "Oh, I don't have any homework." Having the student write "none" or "no homework" can help clarify if nothing written in the planner means that it just didn't get written down or there is truly no homework.

Also, have the student use checkmarks to cross things off and indicate that something is complete.  Have a teacher sign off on the planner to ensure they wrote everything down appropriately. And set goals with the child or teen to participate cooperatively in the nightly check-ins.

Time Management: Studying and Long-term Projects

I work with many adolescents on time management for studying and long-term projects.  I want to teach them how to spend their time doing the things that get the most bang for their buck and not worrying quite as much about the little things. 

For example, it's generally helpful to have checklists for studying. There is a particular checklist, or "menu," for studying that discusses different studying strategies.  The first is "passive strategies," which should be used sparingly because they are not very effective.  These are strategies such as rereading what you read, rereading your notes, highlighting, rewriting notes, reading or watching SparkNotes. Those are considered to be more passive strategies for studying. It is better to use "active strategies" such as making a study guide, making flashcards, creating a concept map, organizing notes, completing a review packet without checking over the answers, and attending a review session or a study group.

Then there are "active strategies with feedback," which are sort of the gold standard studying strategies and include quizzing myself with study guides and flashcards, taking practice tests AND checking the answers to see what I got right and wrong.  Research suggests that if we get immediate feedback on the things we get wrong, and go back and figure out the actual answer, then we're going to remember that and put it into our long-term memory better. Redoing tests or homework, having someone quiz me, completing a review packet with checking answers, and meeting one-on-one with a teacher to get feedback about what you understand or don't understand are all active strategies with feedback. 

Have a list of studying options. For example, what are they going to prioritize for this particular test? Have the student set out a calendar of what they will do four days before the test, three days before the test, two days, and one day before the test. There is data to support that cramming for a test the day before doesn't help to learn the information and perform as well on a test versus spreading it out over the course of four days.

Also, in regard to time management and planning, have students set aside chunks of time for their obligations. For example, if I'm in school from 8:00-3:00, that's an obligation. Then, from 4:00-5:00, I have soccer practice. There's an open space between school and soccer practice, but there might be some drive time. There's a drive home and a drive to soccer practice. So, the time between school and soccer practice is only about 30 minutes. However, I might also need to change my clothes and have a snack, etc., during that time.  We can help them visualize how much time there is for their obligations and put those things on their calendar. Then, they can see how much open time there is for other activities they want to do.  Having students block out time for their obligations in a planner can show them that they only have, for example, four hours Monday-Friday to study for their math test.  That can be very helpful. 

Encouraging individuals to work backward on a calendar can also be helpful. For example, if I know my paper is due on December 15th and today is November 15, I can work backward and decide that the rough draft needs to be done by December 13-14th. If the rough draft needs to be done by December 13-14th, then all of my research needs to be done the week before, which is December 8th.  The idea is to help students realize that even though December 15th seems like a long time, there are a lot of pieces that need to be done well before that deadline, and they can't wait until the day before to start the paper. 

Goal-Directed Persistence

This is the idea of prioritizing your time when studying, working, et cetera. One strategy is to ensure that a study space that has been established for a child or adolescent has all the necessary supplies for homework. It can also be helpful for those who are visual to take a picture of what the study space looks like with all of their supplies. Then the student can compare the photo to their workspace before they get started and make sure they have everything that they need. 

Another strategy to help prioritize and work through tasks that people are less interested in is using the Covey Quadrant method. There are typically four work quadrants, with one quadrant for important and urgent tasks, one quadrant for tasks that are important but not urgent, one quadrant for urgent but not important, and a 4th quadrant for tasks that are not urgent and not important.  This method gives students a framework for deciding where their tasks and activities can be placed.  If a student can identify what a Q4 task is, then they know when they are supposed to be working on urgent and important tasks (Q1) and their important but not urgent tasks (Q2). They can prioritize their Q1 and Q2. People often operate in this urgent and important quadrant, "I have a test tomorrow. I have a paper due tomorrow. It's urgent, and I have to get it done. These are important things." They are operating in a crisis mode of, "I procrastinated, and now I have to do this thing. I HAVE to get it done."

The goal with the Covey Quadrant is to move tasks into Q2 (important but not urgent) so that most tasks that a person is doing are prioritized and are in that second quadrant. 

The third quadrant has tasks and activities that tend to take up a lot of time. They seem urgent because they're in our faces, but they're not important. Social media seems to capitalize on this "urgent, yet not important" with all the notifications you can get. We want to identify those types of tasks and add them to Q3. Then when I have something that I need to do that is Q2 or Q1, I can turn off my email or not open my social media. With children and adolescents, it can be very helpful to have them turn off their text messages, notifications, social media game requests, etc.  Make them inaccessible in their study space.  Have those be rewards for getting through the important tasks.

Self-Monitoring

Self-monitoring is recognizing how my behavior affects those around me and how my strategies help me get the output I want. For example, if I want to earn A's and B's for grades, how well does my strategy of cramming till the last minute work for me? We know that doesn't work for most students.  We need to teach them how to monitor that and be aware of how that works or doesn't work for them.

For younger children, this might look like building awareness of different things. "What do you think?" "What will we do if there's a long line at the store?" "What do you need to do first?" "What do you need to do next?"  This also prompts students to look at their visuals, schedules, and planners.  We want to bring their attention back to those strategies and have them use them, "What does your planner say about homework? Why don't you go get it out?" "What about that visual checklist that we have? Let's go through that," instead of a parent or teacher bringing attention to it and solving it.  We can say, "Let's look at the strategy that we've put in place to use. Let's see, we are using error checklists. This is a great strategy to use when you're done with your assignment." Maybe they completed all 30 math problems, but their handwriting is sloppy.  Ask them, "What does it look like to be done with your math? It means that I've looked through it, and there's a checklist. Is every single question answered? Check. Did I go through and double-check to see if the math makes sense? Check. Is my name on my paper? Check. Did I spell things correctly? Check." Using an actual checklist like that can be helpful.

Then, teach them to evaluate their own performance, "How well did you do?" "How well did that work for you?"  "What parts of the strategy did you like?" "What parts of it didn't work so well?" "Let's revise appropriately."

Working Memory

Working memory tasks, working memory interventions, as well as any general memory strategy, includes:

• Making sure that children are ready to hear important details before giving them instructions or directions.  For example, a classroom teacher will say, "Listen up, class, I'm going to tell you something important. I have important information." That prompts the students to be ready to listen and ready to learn. That helps them to not immediately forget what the teacher said.  is gonna help so that they don't forget it immediately.
• Repeat, rehearse, and review is self-explanatory.
• Attach meaning so the child can learn.  Provide a context, a story, or something familiar to them.  
• Mnemonics and crazy phrases to promote learning, such as remembering the names of the planets or the colors of the rainbow. 
• Recommended accommodations for memory weaknesses - There's not a lot of research to suggest that interventions for working memory have a lasting impact on a person's environment. Therefore, we will provide accommodations if a child has working memory difficulties. Some examples of accommodations include: 
  • Designated class note taker 
  • Recording lectures 
  • Access to teacher notes/presentations
  • Word banks
  • Visual checklists and to-do lists 
  • Post-it notes

Inhibition

When a child cannot inhibit behavior, it might be easy for them to, for example, hit their classmates to get their toy. That works. However, we need to teach a more pro-social strategy to inhibit the behavior, such as earning rewards. It will be harder for younger children to delay their gratification for very long.  A reward over the course of weeks or a month will probably be too long for a preschooler. 

We can use "first, then" approaches and review situations we think might arise. For example, we know the child likes to take others' toys. What are we going to do the next time that happens?

Emotional Control

Here are a few strategies for managing and working on emotional control.  Teach children how to label their emotions, practice relaxation strategies, like deep breathing, teach mindfulness strategies, and positive imagery.

Sustained Attention

Tips and strategies to improve sustained attention include using timers (e.g., We need to do this for 10 minutes, or if that is too long, change it to 5 minutes.)  According to some emerging research, headphones and white noise can help tune out distractions and help with sustaining attention. Physical proximity can also help.  This is having a teacher or an adult physically nearby when a child needs to be sustaining attention and staying on task.

Motivating Children and Adolescents

Children and adolescents are not inherently interested in improving their executive functioning skills. So, it can be helpful to have a reward system which we've discussed previously.  The reward system should reward them for practicing different strategies and achieving positive outcomes for using those strategies. Meaning instead of rewarding the child for getting an 'A' on an assignment, reward them for using their error checklist or planner that was put in place.  We want to reinforce what that can control, which is not likely the grade.  What they can control is how much they study and how much effort they put into something. 

There are some frequent pitfalls to remember when setting up a reward strategy for children.

• Inconsistency - this is the death of any intervention
• Poor description of goals - if the goal is not clear
• Getting rewards without meeting goals - Giving the reward when the child didn't actually earn it
• The child doesn’t have skills to obtain goals - Setting up a goal that is not in line with his/her grade or developmental level
• Long time intervals - Younger children will need more immediate gratification (e.g., same day or in the moment)
• Adults not “paying” - The person who set the reward "owes" them their rewards because they didn't have it when it was promised. The child never received the reward.
• Rewards aren’t really rewarding - The children didn't choose the reward, or it's a reward that is not exciting to the child.
• Not trying long enough 

I have included research articles, books, and websites about executive functioning and executive functioning strategies that are user-friendly and can be used with children and adolescents. 

Books/Websites for EF Strategies

• Smart but Scattered and Smart but Scattered, for Teens by Peg Dawson and Richard Guare
• Promoting Executive Function in the Classroom, by Lynn Meltzer
• Understood.org
• Beyond Booksmart (web-based coaching)

References

Gagne, J. R., & Nwadinobi, O. K. (2018). Self-control interventions that benefit executive functioning and academic outcomes in early and middle childhood. Early Education & Development, 29(7), 971–987. 

Kassai, R., Futo, J., Demetrovics, Z., & Takacs, Z. K. (2019). A meta-analysis of the experimental evidence on the near- and far-transfer effects among children’s executive function skills. Psychological Bulletin, 145(2), 165. 

Pauli-Pott, U., Mann, C., & Becker, K. (2021). Do cognitive interventions for preschoolers improve executive functions and reduce ADHD and externalizing symptoms? A meta-analysis of randomized controlled trials. European Child & Adolescent Psychiatry, 30(10), 1503–1521. 

Piovesana, A., Ross, S., Lloyd, O., Whittingham, K., Ziviani, J., Ware, R. S., McKinlay, L., & Boyd, R. N. (2017). A randomised controlled trial of a web-based multi-modal therapy program to improve executive functioning in children and adolescents with acquired brain injury. Clinical Rehabilitation, 31(10), 1351–1363.

Riccio, C. A., & Gomes, H. (2013). Interventions for executive function deficits in Children and adolescents. Applied Neuropsychology: Child, 2(2), 133–140. 

Takacs, Z. K. (2019). The efficacy of different interventions to foster children’s executive function skills: A series of meta-analyses. Psychological Bulletin, 145(7).

Takacs, Z. K., & Kassai, R. (2019). The efficacy of different interventions to foster children’s executive function skills: A series of meta-analyses. Psychological Bulletin, 145(7), 653–697. 

Zelazo, P. D. (2020). Executive function and psychopathology: A neurodevelopmental perspective. Annual Review of Clinical Psychology, 16(1), 431–454.