Conclusions about interventions, programs, and approaches for improving executive functions that appear justified and those that, despite much hype, do not

Adele Diamond, Daphne S Ling, Adele Diamond, Daphne S Ling

Abstract

The 'Executive Functions' (EFs) of inhibitory control, working memory, and cognitive flexibility enable us to think before we act, resist temptations or impulsive reactions, stay focused, reason, problem-solve, flexibly adjust to changed demands or priorities, and see things from new and different perspectives. These skills are critical for success in all life's aspects and are sometimes more predictive than even IQ or socioeconomic status. Understandably, there is great interest in improving EFs. It's now clear they can be improved at any age through training and practice, much as physical exercise hones physical fitness. However, despite claims to the contrary, wide transfer does not seem to occur and 'mindless' aerobic exercise does little to improve EFs. Important questions remain: How much can EFs be improved (are benefits only superficial) and how long can benefits be sustained? What are the best methods for improving EFs? What about an approach accounts for its success? Do the answers to these differ by individual characteristics such as age or gender? Since stress, sadness, loneliness, or poor health impair EFs, and the reverse enhances EFs, we predict that besides directly train EFs, the most successful approaches for improving EFs will also address emotional, social, and physical needs.

Keywords: Aerobic exercise; Cognitive training; Loneliness; Prefrontal cortex; Stress; Working memory.

Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Figures

Fig. 1
Fig. 1
(a) Effect size estimates for main effects for Tools of the Mind versus the control group at the end of kindergarten in Blair and Raver (2014). (b) Effect size estimates for main effects for Tools of the Mind versus the control group at the end of kindergarten in high poverty schools in Blair and Raver (2014). Errors bars represent ± 1 standard error. Legend: RT = reaction time; RAN = Rapid automatic naming.
Fig. 2
Fig. 2
Results of the meta-analysis by Smith et al. (2010), showing that aerobic exercise produces little to no benefit for EFs. (a) Subjects had chronic obstructive pulmonary disease; (b) Subjects had depression; (c) Subjects had multiple sclerosis; (d) Subjects had hypertension. (e) Subjects had chronic fatigue syndrome.
Fig. 3
Fig. 3
Results from Kamijo et al. (2011) showing Pre- and Post-Intervention Percentage of Correct Responses on an EF measure (the Sternberg test) in children who did Aerobic Activities for 70 min 5 days a week for an entire school year versus Wait-list Controls. When all conditions were combined, and in the 3- and 5-Letters condition, the control subjects started out better and the aerobic group simply caught up; there was no significant difference in post-test scores. The only significant difference in post-test scores was on the trivially easy 1-Letter condition where controls got worse, perhaps because they were bored.
Fig. 4
Fig. 4
Results from Hillman et al. (2014) showing no difference in post-test performance. Intervention Group pretest score, Intervention Group post-test score, Wait-list Control Group pretest score, Wait-list Control Group post-test score.

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