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Comparative efficacy of executive function interventions for Chinese children with neurodevelopmental disorders: A
Yannan Zhao1, Bei Deng1, Xiang Li2
1School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Insights
Executive function interventions show modest but significant improvements in Chinese children's working memory, inhibitory control, and cognitive flexibility. These findings support non-pharmacological cognitive strategies for neurodevelopmental disorders.
Area of Science:
- Neuroscience
- Developmental Psychology
- Clinical Psychology
Background:
- Executive function (EF) deficits are central to neurodevelopmental disorders like ADHD and ASD.
- EF interventions offer potential for primary prevention and adjunct rehabilitation in children.
- Understanding the efficacy of EF interventions in diverse populations is crucial for clinical translation.
Purpose of the Study:
- To systematically evaluate evidence-based executive function interventions in Chinese children.
- To assess intervention effects on working memory, inhibitory control, and cognitive flexibility.
- To explore the clinical translation potential of these interventions.
Main Methods:
- A systematic search of randomized controlled trials (RCTs) on EF interventions in Chinese children was conducted across multiple databases.
- Two independent reviewers screened literature, extracted data, and assessed study bias.
- Network meta-analysis (NMA) was performed using RevMan 5.4 and R software.
Main Results:
- Fifty-two RCTs involving 2,986 children (ages 3-12) met the inclusion criteria.
- Network meta-analyses revealed significant, domain-specific improvements across all three core EF components.
- Treatment 2 most enhanced working memory (SMD=0.073), while Treatment 3 maximized inhibitory control (SMD=0.093) and cognitive flexibility (SMD=0.097).
Conclusions:
- Structured EF interventions yield statistically significant, albeit modest, effects in Chinese children.
- Findings preliminarily support non-pharmacological cognitive interventions for public health and rehabilitation.
- Further large-scale, long-term validation is necessary before widespread implementation in clinical and educational settings.
Background:
Executive function (EF) deficits are core features of neurodevelopmental disorders such as attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Executive function interventions for preschool and school-age children could serve as an important primary prevention and adjunct rehabilitation strategy.
Objective:
To systematically evaluate the efficacy of evidence-based executive function interventions on working memory, inhibitory control, and cognitive flexibility in Chinese children and to explore their potential for clinical translation.
Methods:
Randomized controlled trials (RCTs) on executive function interventions in Chinese children were searched from PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang, and VIP databases from inception to October 1, 2025. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Network meta-analysis (NMA) was performed using RevMan 5.4 software, and NMA was conducted using R software with the netmeta package.
Results:
Fifty-two RCTs enrolling 2,986 Chinese children (3-12 years) met inclusion criteria. Network meta-analyses demonstrated significant, domain-specific improvements in all three core executive-function components. Working memory was most enhanced by Treatment 2 (SMD = 0.073, 95% CI = 0.037-0.109), whereas inhibitory control and cognitive flexibility were both maximized by Treatment 3 (IC: SMD = 0.093, 95% CI = 0.071-0.115; CF: SMD = 0.097, 95% CI = 0.069-0.126).
Conclusion:
Current evidence indicates that structured executive function interventions have statistically significant but modest effects on Chinese children. These findings offer preliminary support for considering non-pharmacological cognitive interventions in preventive public health strategies and rehabilitation programs for neurodevelopmental disorders in children, with further large-scale, long-term validation needed before widespread implementation. These findings offer preliminary support for integrating non-pharmacological cognitive interventions into preventive public health strategies and clinical rehabilitation programs for children with neurodevelopmental disorders, with further large-scale, long-term validation required prior to their widespread implementation in clinical and educational settings.
Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/, identifier CRD420251266663.
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