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Interrelations of EFs with Emotional,
Social, and Physical Well-Being: How
Can We Help more Children Thrive?
Adele Diamond, PhD, FRSC
Canada Research Chair Professor of
Developmental Cognitive Neuroscience
University of British Columbia (UBC)
I am happy to give the conference
organizers a PDF of my slides.
You don’t have to worry about
writing down what’s on the slides.
Why text is on the slides.
‘Executive Functions’
refers to a family of
mental processes needed
whenever going ‘on automatic’
or relying on instinct or intuition
would NOT be a good idea
1. Inhibitory
Control
2. Working
Memory
3. Cognitive
Flexibility
The
3 core
Executive
Functions
Focused
Attention
or
Selective
Attention
Inhibitory control
at the level of
attention:
Inhibitory control
at the level
of behavior:
FOCUSED ATTENTION
• Screening out distractions
which enables us to
be able to concen-
trate and stay focused
Being able to concentrate
on what someone is
saying on the phone
when someone else is talking
to you in the room
Being able to hone in on
the one thing you need to see
in a sea of distraction
Because we are able to selectively
attend, we can miss important
things because we were selectively
attending for other things
People were asked to count the number of
photos in a newspaper.
Some people finished in a few seconds; others
took minutes.
It was not that some were faster counters.
The secret lay on Page 2 where in huge block
letters it said:
STOP COUNTING! THERE ARE 43
PHOTOGRAPHS IN THIS PAPER.
Many people missed that enormous headline.
They were so focused on counting the
photos they hadn’t notice it.
We need to balance
selective attention
with
cognitive flexibility
Kindergarten &
First Grade
teachers love
making their
classrooms look
beautiful by
decorating the
walls with lots
of lovely posters
and pictures.
It turns out that decorating the walls makes
it harder for young children to concentrate
on their schoolwork; they get distracted.
Fisher et al. (2014) showed that young
children are better able to pay attention, and
learn more, when the walls are more bare.
Fisher et al. (2014). Psychological Science
vol 25, p. 1362-1370
On the other hand, we can under-
estimate how capable young
children can be.
Next you’ll see 3-year-old display-
ing truly outstanding perseverance
& focused attention (despite lots of
distraction all around him)
www.devcogneuro.com/
videos/PinkTower1.wmv
Be Patient
Give children time to figure
things out on their own.
Don’t intervene too early to
help out.
We adults tend to want to DO
for children
but LESS IS MORE
When a child is struggling, our
natural first inclination is to want to
get in there and help out.
But if you solve the problem, you
are the strong, heroic one and the
child is the weak and needy one.
Have faith in the child’s abilities
and intellect.
There’s Inhibitory
control at the level
of attention:
Inhibitory control
at the level
of behavior:
Self-Control
or
Response
Inhibition
• wait your turn, raise your hand, don’t grab another child’s
toy, don’t eat sweets before dinner, don’t pee in your pants
(1) Self-control: resisting temptations, not
acting impulsively, think before you act:
Self-control:
Examples of when you need
SELF-CONTROL
• resist hurting someone just because that
person hurt you (cycle of ‘tit for tat’)
• WAIT: don’t blurt out the 1st thing that
comes to mind
• WAIT: resist acting in the heat of the moment
• WAIT: resist jumping to a conclusion of what
something meant or why it was done
and
• to have the discipline and perseverance…
to resist the many temptations to quit and
not finish what you started
to continue to work even though the
reward may be a long time in coming
(delaying gratification)
requires Self-Control
Without inhibitory control we’d
be at the mercy of impulses,
old habits of thought or action,
and stimuli in the environment
that pull us this way or that.
Self-control saves us from putting our foot in
our mouth or making a social faux pas.
Think of all the trouble you’d get in if you
…told your boss what you really thought of
him or her,
..grabbed whatever you wanted without
asking or paying, or
..did other socially inappropriate or hurtful
things. If we want to change,
if we want to mend our ways,
we need self-control.
Helping children develop
rudimentary self-control and
scaffolding that
opens up possibilities for the
BEST education.
Children can work on their own or in
pairs or small groups -- without
constant supervision -- and without
chaos.
Teachers can then give each child
individual attention -- observing,
seeing what a child needs to help
him or her progress.
• Each child can work on what most
interests him or her.
• All children can work at their own
pace – some progressing faster on
this, others on that. There’s no
problem with children in the same
class working at different levels.
• And the teacher can give each child
individualized instruction.
Children with better inhibitory control
(i.e., children who were more persistent,
less impulsive,
& had better attention regulation)
as adults 30 years later have:
better health
higher incomes and better jobs
fewer run-ins with the law
a better quality of life (happier)
than their peers who as young children
had worse inhibitory control,
controlling for IQ, gender, social class, & home
lives & family circumstances growing up
across diverse measures of self control.
That’s based on a study of 1,000 children
born in the same city in the same year
followed for 32 years with a 96% retention
rate.
by Terrie Moffitt et al. (2011)
Proceedings of the Nat’l Academy of Sci.
A study of 500 fraternal twin pairs
found that the twin with poorer
inhibitory control at age 5,
was more likely than his/her sibling to
• smoke,
• perform poorly in school
• engage in antisocial behavior
at age 12, though each twin pair grew
up together. (Wong et al., 2010)
Working
Memory
Holding
information
in mind
to work or
play with it
Working memory is critical for
making sense of anything that
unfolds over time, for that always
requires holding in mind what
happened earlier and relating
that to what is happening now.
• Mental math calculations
• Reflect on the past or consider an
imagined future
• Understanding cause and effect
• Remembering multi-step
instructions & executing them
in the correct order
• Re-ordering or updating the
elements held in mind
Working Memory is essential for
REASONING and for
PROBLEM-SOLVING
for those require holding ideas and
information in mind and playing
with them, relating one to another,
re-ordering priorities, and more
Working memory and inhibitory control
each independently predict both
math & reading competence
from the earliest grades thru university
often better than does IQ.
(Alloway & Alloway, 2010; Bull & Scerif, 2001; Dumontheil
& Klingberg, 2012; Gathercole et al., 2004; McClelland &
Cameron, 2011; Nicholson, 2007; Passolunghi et al., 2007;
St Clair-Thompson & Gathercole, 2006; Savage et al.,
2006; Swanson, 2014)
EFs need to be
continually challenged
to see improvements -
not just used, but
challenged.
I predict that a great way
to improve children’s
focused attention &
working memory is simply
to tell them stories.
I predict that a great way
to improve children’s
focused attention &
working memory is simply
to tell them stories.
Storytelling
should be a terrific way
to challenge and improve
Working Memory
(both telling and listening)
I’m a huge fan of Storytelling
Storytelling requires and invites your
rapt attention for extended periods
(sustained, focused attention), and
working memory to hold in mind all
that’s happened so far, different
characters’ identities,
story details and to
relate that to the new
info being revealed –
without visual aids
(like pictures on the page !
A researcher (Gallets, 2005) randomly
assigned children in Kindergarten &
Grade 1 to storytelling or story-
reading -- 2x a week for 12 weeks.
Vocabulary and recall improved more
in the children assigned to
STORYTELLING than in children
assigned to story-reading.
Vocabulary assessed at
age 3 strongly predicts
reading comprehension
at 9-10 years of age.
Hart and Risley (1995). Meaningful
Differences(see also Hoff, 2002, 2003, 2013; Rowe et al., 2013;
Pancsofar & Vernon-Feagans, 2010)
The more interaction, the more
conversation between the story-
reader or storyteller & the children,
the more actively engaged the
children are, the more their
vocabulary improves.
Maybe one reason for Gallets’ results is that when you are reading to, or with, a child you are looking down at the page at least part of the time.
But when you are telling a story you are looking directly at the children & interacting more.
The conversation (the human interaction) that takes
place in the context of reading seems to benefit
language development, literacy, & brain maturation
even more than the reading itself.
The critical variable is the # of conversational turns
taken. It is talking *with* the child, listening to &
responding, not talking to or at the child, that drives
the effect.
Children who have experienced more
conversational turns
show greater activation in the language
region in prefrontal cortex (Broca’s Area).
That explains almost 50% of the relation
between early language exposure and later
language skills.
Romeo, Leonard, Robinson, West, Mackey, Rowe, & Gabrieli (2018)
Beyond the 30-Million-Word Gap: Children’s Conversational Exposure
Is Associated With Language-Related Brain Function.
Psychological Science, 29, 700-710.
Walsh, B.A., & Blewitt, P. (2006). The effect of questioning style during storybook reading on novel vocabulary acquisition of preschoolers. Early Childhood Education J., 33, 273-278.
Sénéchal, M., Thomas, E., & Monker, J. (1995). Individual differences in 4-year-old children's acquisition of vocabulary during storybook reading. J. of Ed. Psychology, 87, 218-229.
Kertoy, M.K. (1994). Adult interactive strategies and the spontaneous comments of preschoolers during joint storybook readings. Journal of Research in Childhood Education, 9, 58-67.
The conversation that takes place in the context of reading
seems to have more benefit than the reading itself.
That builds on a lot of earlier work
showing similar results:
While Story-readingis wonderful
I predict that
Storytellingshould improve
attention and working memory more
because it taxes them more
Cognitive
Flexibility
involves
being able to
..see an issue from
different perspectives
..think about something
in a whole new way
(“thinking outside the
box”)
..seamlessly adjust to
change or unexpected
situations
In what way is a carrot like a cucumber?
In what way is a carrot like an orange?
In what way is a carrot like a potato?
In what way is a carrot like an apple?
Cognitive Flexibility also includes
having the FLEXIBILITY…
• …to take advantage of a sudden
opportunity (serendipity)
• …to get to your desired goal despite
unexpected obstacles seeming to
block the way
• …to admit you were wrong when you
xxget more information
When one door closes, another
door opens;
but we often look so long and so
regretfully upon the closed door,
that we do not see the ones which
open for us.
- Alexander Graham Bell
An example of poor
cognitive flexibility:
If there’s a problem that we haven’t
been able to solve, can you ‘think
outside the box’ to…
…conceive of the problem, frame the
problem, in a new way?
… come up with a completely different
way of attacking it?
If you always do
what you always did,
you’ll always get
what you always got.
- Einstein
For example,
What unusual uses can you
think of for a TABLE?
Can you creatively see the
same thing from different
perspectives?
You could hide under it.
Turned it on its side to protect you
from things hurled at you (like
rotten tomatoes or snowballs).
Turn it upside down to play
horseshoes.
Use it as a percussion instrument.
Cut it up for firewood.
How can we stop ourselves from get
really upset when a child misbehaves?
What we usually get upset about is the
intent we think is behind an action.
We can use Cognitive Flexibility to re-
frame:
A child might be acting in the most awful
manner because he’s been terribly hurt and
is afraid of being hurt again, so he may push
you away before you have a chance to reject
him or may test you to see if are really
someone he can feel safe with.
If we see the behavior as coming
from hurt, we can react completely
differently.
The 3 core Executive Functions are:
• Inhibitory Control
• Working Memory
• Cognitive Flexibility
Higher-order Executive Functions are:
• Problem-solving
• Reasoning
• Planning
The 3 core Executive Functions are:
• Inhibitory Control
• Working Memory
• Cognitive Flexibility
Higher-order Executive Functions are:
• Problem-solving
• Reasoning
• Planning
= Fluid Intelligence
Executive Functions
depend on Prefrontal
Cortex and the other
neural regions with
which it is
interconnected.
Prefrontal
Cortex
Prefrontal
cortex is the
newest area
of the brain
and the most
vulnerable.
Prefrontal
Cortex
Frontal Cortex
If you’re
• sad or stressed
• lonely or
• not physically fit
Prefrontal Cortex and Executive
Functions are the first to suffer,
and suffer THE MOST.
Conversely, we show better
Executive Functions when we’re
• happy
• feel socially supported, &
• we’re healthy & physically fit
Hirt et al. 2008
J. of Personality
& Social Psych.
vol. 94, 214-230.
Yang, Yang &
Isen. 2013
Cognition and
Emotion.
vol 27, 474-482.
We have better
executive
functions
when we’re not
feeling sad or
depressed.
Desseilles et al., 2009
von Hecker & Meiser, 2005
Yang, Yang, & Isen, 2013
When we’re sad we have worse
working memory and
selective attention.
When we’re happy we have
better working memory and
selective attention.Gable & Harmon-Jones, 2008
Yang, Yang, & Isen, 2013
THE most heavily researched predictor of
creativity in social psychology is mood.
The most robust finding is that
a happy mood leads to greater creativity
(specifically greater cognitive flexibility)
(Ashby et al. 1999)
It enables people to work more flexibly
(Murray et al. 1990) & to see potential
relatedness among unusual & atypical
members of categories (Isen et al. 1985,1987).
Hirt et al. 2008: 214
When we are lucky enough to
work on something we
thoroughly enjoy,
there’s no clear distinction
between ‘work’ and ‘play.’
Are these
young people
working or playing?
Are these budding
musicians working
or playing?
Research shows
we learn more and get more
done, when we’re happy.
Passionate Enthusiasm
as a driver
of benefits
Greater benefits if
an activity is
deeply personally
meaningful
The majority of aerobic
exercise interventions
have NOT improved
memory or
executive functions.
(no suggestion of benefits in 59% of 34 studies)
Results are even
worse for
Resistance Training
(no suggestion of benefits
in 78% of 9 studies)
suggestion of benefits =
greater improvement OR
better post-test
performance
on just
50% of EF measures
Yet
People who are more physically
active and have better aerobic
fitness have better EFs.
That’s true for kids: Scudder et al., 2014
Hillman, Castelli, & Buck 2005
and for older adults: Boucard et al., 2012
Voelcker-Rehage, Godde, & Staudinger, 2010
That’s a seeming contradiction:
People who are more physically active &
physically fit have better EFs
but
Aerobic interventions
do little to improve EFs
Maybe it has to do with this:
Many people who maintain
better fitness do so by
participating in activities
to which they are
deeply committed.
These activities are a
major source of JOY
for them.
People who freely choose to do physical
activities probably enjoy them more than
people who are randomly assigned to them.
A fundamental problem with RCTs
is that people randomized to do something
usually do not have the same commitment
to it as people who chose to do it.
Even aerobic exercise interventions
with cognitive & motor skill challenges
Even aerobic exercise interventions
with cognitive & motor skill challenges
have generally asked participants
to do exercises drawn from a sport
out of context,
without ever playing the sport
Even aerobic exercise interventions
with cognitive & motor skill challenges
have generally asked participants
to do exercises drawn from a sport
out of context,
without ever playing the sport
(such as practicing dribbling a basketball but
never playing basketball).
We are less motivated to
master arbitrary skills
abstracted from their
practical, real world use.
Participants are more likely to be
emotionally invested in a sport than in
decontextualized drills.
Emotional investment may be key to
whether an activity, even if it
challenges EFs, actually improves them.
We learn something best when we
need it for something we want to do,
when it is relevant.
We never evolved to learn for
learning’s sake.
If EFs are demanded only for
arbitrary, de-contextualized
purposes (as in computerized WM
WM
If EFs are demanded only for
arbitrary, de-contextualized
purposes (as in computerized WM
training or learning a sports skills,
but never playing the sport),
EF improvements are
small and narrow.
We enjoy the training more & are more invested
in it if it is meaningful / related to real life.
I predict that training people on a real-world
activity, e.g., a sport, will be more meaningful to
them, & engender more emotional commitment,
and therefore will more successful in improving
EFs than training them on isolated skills
abstracted from that sport (decontextualized).
Ishihara et al. (2017)
The Beneficial Effects of Game-based
Exercise Using Age-appropriate Tennis
Lessons on the Executive Functions of
6- to 12-year-old Children
Neuroscience Letters
Evaluated the effects of
2 different ways of teaching tennis
• technique-based approach (TBA)
• a game-based approach
(PLAY+STAY [P+S])
vs. watching TV
on the EFs of 6-12 year olds in Japan
The Beneficial Effects of Game-based Exercise Using Age-appropriate Tennis
Lessons on the Executive Functions of 6- to 12-year-old Children
Ishihara et al. (2017) Neuroscience Letters, 642, 97-101
Stroop Task
Performance
Improving aerobic capacity per se, or
improving particular cognitive skills
isolated from their use in an activity,
is less likely to improve EFs
than touching the hearts and minds of
people, as a commitment to a
holistic, coherent activity (e.g., soccer
or dance) can do.
I propose that whether someone is
emotionally invested in an activity that
trains EFs is key to whether that activity
will improve EFs
and how much joy a person derives
from an activity that challenges EFs will
predict how much EFs improve.
The distinction between
‘academic’
& ‘enrichment’
activities is arbitrary
Critical executive function skills
like reasoning, problem-solving,
self-control, working memory, &
cognitive flexibility can all be
Critical executive function skills
like reasoning, problem-solving,
self-control, working memory, &
cognitive flexibility can all be
taught thru wilderness survival,
theatre, martial arts, dance,
sports, carpentry, music-making,
auto mechanics, circus, or play.
Why not have children do
activities they love?
If those challenge EFs, they
should improve them more than
boring classes.
And many children
LOVE doing these
things.
and these
See VIDEO at:
www.ted.com/talks/gever_tulley_s_tinkering_school_in_action?language=en
Many children love
doing these activities
and these
The arts (such
as music and
dance) have
so many
benefits and
teach children
so much.
These activities require:
• planning
• cognitive flexibility to respond to
unexpected reactions or difficulties
• perseverance, even in the face of
setbacks or initial failure
• creative problem-solving
Indeed, ALL the executive functions!
Also…
if you love what you are
doing,
you will devote lots of time
and effort to it.
It’s the hours of practice,
pushing yourself
to keep improving,
that drives the benefits.
Ericsson: 10,000 hrs of practice
Ericsson, K.A., Nandagopal, K., & Roring, R.W. (2009).
Toward a science of exceptional achievement: Attaining superior
performance through deliberate practice.
Annals of New York Academy of Sciences, 1172, 199-217.
Amy Arnsten,
1998
The biology of
being frazzled
Science
Our brains work
better when we
are not
in a stressed
emotional state.
That is particularly true
for prefrontal cortex
and executive functions.
Stress impairs Executive Functions
and can cause anyone
to look as if
he or she has an EF impairment
(like ADHD)
when that’s not the case.
You may have noticed that
when you’re stressed
you can’t think as clearly
or exercise as good self-control.
Here are some of the
neurobiological reasons
for why that’s the case.
Stress and Prefrontal Cortex
(Roth et al., 1988)
Even mild stress increases DA release in
PFC - but not elsewhere in the brain
Sánchez MM, Young LJ, Plotsky PM, Insel TR
(2000)
Distribution of Corticosteroid Receptors
in the Rhesus Brain.
J Neurosci, 20, 4657-4568
In humans (& primates in general)
Prefrontal Cortex has
more receptors for CORTISOL
than any other area in the brain.
A few weeks of stress in preparation for a
major exam disrupts communication
between PFC and other brain regions.
(including parietal cortex, anterior cingulate cortex,
the insula, and the cerebellum)
Liston et al. (2009) PNAS
If you’re stressed,
you can’t do your
best in school
or at work.
If you’re stressed,
you can’t be the
parent or
teacher you
want to be.
If you’re stressed,
your children will pick on it.
It will cause them to feel
stressed.
And if they’re stressed, their
EFs will suffer & therefore
their school performance will
suffer.
RELAX
Imperfect ≠ Worthless
Don’t be so hard on
yourself when you
make a mistake.
Many children are so
terrified of making a mistake
they’re afraid to try
anything new.
We need to let them know
it’s okay to make mistakes.
Everyone makes mistakes,
even us.
The only way to completely
avoid mistakes is to stay with
what you already know,
to stop growing.
Anyone who has never
made a mistake has never
tried anything new.
- Albert Einstein
Children can’t relax if they’re
worried you might embarass them.
They can’t relax if they feel a lot of
pressure to always succeed
and never mess up.
Another major source of
stress for many children
is feeling that they’re not
smart enough.
It’s important to
communicate loud and
clear the faith and
expectation that each
child will succeed (find
his way).
Children
need to
believe in
themselves.
When a toddler falls while
trying to walk, we would never
say ….
“You get a ‘D’ in walking today;”
it would never occur to us.
Instead we say, “Don’t worry;
I’m sure you’re going to be able
to do this.”
How different is that from what
children hear all to often in schools
these days, which is: “You get a D”
instead of “There’s no question
you are going to be able to do this.
And we, together, are going to
figure out a way to make that
happen.”
Our expectations for how a
person will do have a HUGE
effect on how that person
does do.
(the Pygmalion Effect)
“Treat people as if they were
what they ought to be and
you help them become what
they are capable of being.”
– Johann W. van Goethe
Too often, our expectations for
children with disabilities or
from disadvantaged back-
grounds are too low.
Sadly, society often pre-judges ex-
cons and ex-addicts and suspects
that they have really not changed.
Those expectations make it harder to
change and harder to sustain change.
Better to
always be
open to the
possibility
that ANY
child might
go on to do
amazing
things.
Hope is a socially supported vision.
It’s hard to hold on to it if there’s no one
else who shares the vision with you.
Parents, teachers, & clinicians need to
make it absolutely clear that they share
that vision.
With HOPE in the
POSSIBILITY of SUCCESS,
can come the COURAGE
NOT TO GIVE UP
Just one person believing in
you (believing in your
potential to change and
grow) can make all the
difference.
Adele Diamond, A. & Ling, D.
(forthcoming) “Fundamental Questions Surrounding Efforts
to Improve Executive Functions”
Largest, most comprehensive review to date:
First review to look at all the different methods
tried for improving EFs
and at all ages (children thru the elderly).
Over a 100 more studies than included in
Diamond and Ling (2016). Almost 200 in all.
(2019, in press)
A relatively understudied approach –
Mindfulness Practices Involving
Movement (other than yoga)
(including t’ai chi, taekwondo, Chinese mind-
body practices, & Quadrato motor training)
show BY FAR the BEST results
for improving EFs.
Across all 4
metrics,
Mindful M’v’t
Practices have
the very best
results.
Far better than
even the 2nd
best for any
metric.
Every single
study of MMP
(100%) have
found at least
suggestive
evidence of
EF benefits
– NOT true
for any other
approach.
Markedly
better results
than for other
physical
activities
without a
mindfulness
component
0
20
40
60
80
100
53%
Pe
rce
nt
of
Stu
die
s
ResistanceTraining
Aerobic Exercise with minimal EF
demands
Aerobic Exercise w/ EF & motorskill demands
50%
31%
22%
Percentage of Studies finding even Suggestive Evidence
of Physical Activity Benefiting any EFs (including reasoning)
Mindful Practices involving Movement
(other than yoga)
100%
Markedly
better results
than for other
physical
activities
without a
mindfulness
component
&
markedly
better than for
mindfulness
practices
primarily done
seated.
0
20
40
60
80
100
Pe
rce
nt
of
Stu
die
s
61%
Sitting Mindfulness
Practices
Percentage of Studies finding even Suggestive Evidence that a Mindfulness Activity Benefits Executive Functions
Mindful Practices involving Movement
(other than yoga)
100%
Caveat:
There are only 8 studies, and only
2 or 3 of any particular practice.
Often initial results look promising
but then do not hold up.
Decidedly
mixed
results for
YOGA
To the extent that Mindful Practices
improve executive functions that
may be because they reduce stress,
To the extent that Mindful Practices
improve executive functions that
may be because they reduce stress,
and perhaps they improve EFs to the
extent that they reduce stress.
That Mindful Movement Practices reduce
stress has been demonstrated repeatedly.
Wang et al. (2014). The effects of tai chi on depression, anxiety, and psychological well-
being: A systematic review and meta-analysis. International Journal of Behavioral
Medicine, 21(4), 605-617.
Wang et al. (2014) Managing stress and anxiety through qigong exercise in healthy
adults: A systematic review and meta-analysis of randomized controlled trials. BMC
Complementary and Alternative Medicine.
Chan et al. (2014). Qigong exercise alleviates fatigue, anxiety, and depressive symptoms,
improves sleep quality, and shortens sleep latency in persons with chronic fatigue
syndrome-like illness. Evidence-Based Complementary and Alternative Medicine, 1-10.
Bilderbeck et al. (2013). Participation in a 10-week course of yoga improves
behavioural control and decreases psychological distress in a prison population. Journal of
Psychiatric Research, 47, 1438-1445.
Gothe et al. (2016). Yoga practice improves executive function by attenuating stress
levels. Biological Psychiatry, 121, 109-116.
Purohit & Pradhan. (2017). Effect of yoga program on executive functions of adolescents
dwelling in an orphan home: A randomized controlled study. Journal of Traditional and
Complementary Medicine, 7(1), 99-105.
But Meditation, too, has been shown to
reduce stress, and it is far less
successful at improving EFs.
Blanck et al. (2018) Effects of mindfulness exercises as stand-alone intervention on symptoms of anxiety and depression: Systematic review and meta-analysis.
Behaviour Research and Therapy.
Chi et al. (2018) Effects of mindfulness-based stress reduction on depression in
adolescents and young adults: A systematic review and meta-analysis.
Frontiers in Psychology.
Hazlett-Stevens et al. (2018) Mindfulness-based stress reduction and mindfulness-based cognitive therapy with older adults: A qualitative review of randomized
controlled outcome research. Clinical Gerontology.
Heckenberg et al. (2018) Do workplace-based mindfulness meditation programs improve physiological indices of stress? A systematic review and meta-analysis.
Journal of Psychosomatic Research.
Khoury et al. (2015) Mindfulness-based stress reduction for healthy individuals:
A meta-analysis. Journal of Psychosomatic Research.
Pascoe et al. (2017) Mindfulness mediates the physiological markers of
stress: Systematic review and meta-analysis. J. of Psychiatric Research.
Pets can reduce stress
Pets can teach us about
patience, gentleness, &
never holding a grudge.
The presence of a dog in the classroom
reduces stress and helps children
perform better.
Gee, N. R., Church, M. T., & Altobelli, C. L. (2010). Preschoolers make
fewer errors on an object categorization task in the presence of a dog.
Anthrozoös, 23, 223-230.
Gee, N. R., Crist, E. N., & Carr, D. N. (2010). Preschool children require
fewer instructional prompts to perform a memory task in the presence of
a dog. Anthrozoös, 23, 173-184.
Gee, N. R., Harris, S. L., & Johnson, K. L. (2007). The role of therapy dogs
in speed and accuracy to complete motor skills tasks for preschool
children. Anthrozoös, 20, 375-386.
Beetz, A., Julius, H., Turner, D., & Kotrschal, K. (2012). Effects of social support by
a dog on stress modulation in male children with insecure attachment. Frontiers in Psychology, 3.
Beetz, A., Kotrschal, K., Turner, D. C., Hediger, K., Uvnäs-Moberg, K., & Julius, H.
(2011). The effect of a real dog, toy dog and friendly person on insecurely attached
children during a stressful task: An exploratory study. Anthrozoös, 24, 349-368.
Bringing a Dog to Work Reduces Stress
Barker et al. (March 2012) International Journal of Workplace Health Management
Employees’ dogs reduce stress in the work-
place and make the job more satisfying for
those with whom the dogs come in contact.
Perceived stress is lower on days when a dog
is at work.
Being out in Nature
relieves stress
Loneliness:
Human Nature and
the Need for Social
Connection
2008
a book by
John Cacioppo
& William Patrick
Our brains work
better when
we are not
feeling lonely
or socially
isolated.
That is particularly true
for prefrontal cortex
and executive functions.
We are fundamentally social.
We need to belong.
We need to fit in & be liked.
Children who are lonely or
ostracized have more
difficulty learning.
People who feel lonely, or are
focusing on anticipating being
alone, show worse EFs than
people who feel, or anticipate
feeling, more socially supported.
Baumeister et al., 2002
Tangney et al. , 2004
Twenge et al., 2002
Campbell et al. (2006) gave subjects
a survey when they came in the lab
that included questions like “Do you feel
socially supported? Do they feel lonely?”
They found that prefrontal cortex
functioned less efficiently
in those who felt lonely or isolated.
Being socially excluded activates
the same brain network as that
for physical pain and the more
social pain you feel, the more
that network is activated.
Naomi Eisenberger et al. (2003) Science
What people need most
from us is
to feel loved,
respected,
and valued.
What matters most in Early
Childhood Education?
Not the # of children
Not the caregiver:children ratio
Not having the best materials
but the caring relationship between
the adults and the children
As international studies show (e.g.,
Melhuish, 1990 a & b)
Relationship matters more than
..instructional style
..subject matter knowledge
..adult :child ratio
..having the best equipment
hands down.
The same is true for
clinicians
Dr. Jerome Frank conducted a study compar-
ing many different forms of psychotherapy.
He concluded:
Regardless of which form of psychotherapy,
the most successful clinical outcomes were
achieved by….
those who cared deeply about their patients
and were able to communicate
that caring to their patients
The best body of work on the
relative effectiveness of different
forms of psychotherapy
Bruce Wampold’s 2001 book:
The Great Psychotherapy Debate:
Models, Methods, and Findings
He concluded:
the client-therapist relationship
trumps slavish adherence to
technique hands down.
Across all types of psychotherapy,
nothing predicts a good outcome as
reliably as the patient’s experience of the
therapist as being warm, caring, and
genuine, and, thus, the patient’s experience
of being seen, understood and [heard].
Review of Saffran & Muran by Diana Fosha,
2003, pp. 30-32
Caring
Relationship
as a major
driver of benefits
CogMed® is the computerized
method for training working
memory (WM) with the most and
the strongest evidence.
Could results for Cogmed be
better than for other computerized
approaches because, unlike those
other approaches, Cogmed
includes a 1-on-1 in-person
mentoring component with a
supportive, encouraging adult?
de Jong et al. found that the
mentoring may account for more
of the benefits of CogMed than
what’s on the computer.
de Jong et al. (2014)
The 2 times Cogmed has been compared
to other programs with significant
trainer-trainee interaction,
special math training (Gray et al., 2012) &
Pay Attention in Class (van der Donk et al., 2015),
EF benefits did not differ.
Given how different these programs
were (Cogmed, Math training, & Pay
Attention), could they have
produced comparable results
because of the increased adult
attention rather than the content
of the programs per se?
Results for non-computerized
cognitive training have been
better than for most
computerized training
(comparable to Cogmed).
Could that be because of
more human interaction with
the instructor when the
training is non-computerized?
Results for
promising School Programs
are BETTER than for
computerized and
non-computerized cognitive
training.
Attention Academy, CSRP, MindUP, Montessori, PATHs & Tools of the Mind
Results for all EFs Assessed: Far, as well as Near, EF Transfer
School Programs (preK – Grade 4)
- show the best results for improving
inhibitory control of any approach
- far better than any computerized
approach at any age
- far better than anything other
approach with young children
- too little study of WM benefits
That’s important because…
Inhibitory control is the
EF most predictive of
long-term outcomes.
For ex., children with better inhibitory control
(i.e., children who were more persistent,
less impulsive,
& had better attention regulation)
as adults 30 years later have:
better health
higher incomes and better jobs
fewer run-ins with the law
a better quality of life (happier)
than others who had worse inhibitory
control as young children (Moffitt et al., 2011)
A supportive mentor, who:
genuinely cares about each participant
firmly believes in the program and the
ability of trainees to succeed, and
helps build self-confidence & self-
esteem
can be absolutely critical to a program’s
success
Early Life Stress can cause
Accelerated Telomere Shortening
Review:
Price, Kao, Burgers, Carpenter, & Tyrka
2013
Telomeres and Early-life Stress:
An Overview
Biological Psychiatry
Jan 1; 73(1): 15-23
A telomere is the protective tip at the end of a
chromosome that caps and protects the chromosomefrom deterioration.
Elizabeth Blackburn gives this analogy: Think of
telomeres as like the plastic tips that cap your
shoelaces to prevent fraying. Telomeres stabilize the
ends of chromosomes, allowing cells to divide while
holding the important genetic material intact.
A cell dies when its telomere gets too short.
Thus telomeres determine the lifespan of cells.
If telomeres get too short, the cell can also
malfunction, e.g., causing inflammation or
triggering the development of tumors.
no exposure
> 2 exposures
adverse early
life events
differ-
ence in
telo-
mere
length
differ-
ence in
telo-
mere
length
Shalev…
Puterman, Lin,
Blackburn, &
Epel, 2013
Maternal sensitivity & warmth
can completely override the
effect of early adversity
on telomere length
Maternal Responsiveness Virtually Erases
the Effect of Early-life Risk on Telomere Length
Asok et al.
(2013)
Asok, A., Bernard, K., Roth, T. L., Rosen, J.
B., & Dozier, M.
(2013)
Parental Responsiveness Moderates the
Association Between Early-life Stress and
Reduced Telomere Length.
Development and Psychopathology
25 (3), pages 577–585
Parental nurturance (terrific
mothering, responsive parenting)
largely wipes out the effects of
stressful events & differences by SES
in academic and health outcomes.
Hackman et al. (2013) PlosOne
Bronfenbrenner & Morris (2006), chap.
14 in Handbk of Child Psychol. (eds.
Damon & Lerner)
The single greatest mitigating factor
to early adversity or trauma is
terrific mothering – responsive
parenting by a caring, warm adult.
I don’t think that has to come from
the child’s mother or even a relative.
Childhood maltreatment usually puts
people at elevated risk for PTSD as
adults.
However…
The association between
childhood maltreatment
and adulthood PTSD symptoms
is not significant for adults who have
even fleeting memories of benevolent
caregiving experiences.
Narayan, A. J., Ippen, C. G., Harris, W. W., & Lieberman, A. F. (2017).
Assessing Angels in the Nursery: A Pilot Study of Childhood Memories
of Benevolent Caregiving as Protective Influences. Infant Mental Health
Journal, 38(4), 461-474. doi:doi:10.1002/imhj.21653
Telomerase,an enzyme your body
makes,
can rescue telomeres
and re-grow them.
Can’t afford the latest gadgets
or the best equipment?
Not up on the latest books?
It doesn’t matter.
You are enough.
Your caring is more
important than your
knowledge or skill, material
possessions, or doing the
textbook-perfect thing.
Responsive parenting – listening
and taking turns in conversation
with your children – also aids
language development, literacy,
and maturation of brain regions
critical for language.
The conversation (the human interaction) that takes
place in the context of reading seems to have more
benefit than the reading itself.
The critical variable is the # of conversational turns
taken. It is talking *with* the child, listening to &
responding, not talking to or at the child, that
drives the effect.
It’s not just the relationship
between children and adults that
is critical…
The relationships among the
children are a major factor.
ALL school programs found to
improve EFs build community.
Norway’s Olympic Team won by far the most
medals in the 2018 Winter Olympics – though
Norway has only roughly 5 million people.
One of Norway’s Olympic Coaches
explained: “We think the biggest moti-
vation for the kids to do sports is that
they do it with their friends and have fun.”
We are not just intellects,
we have emotions
social needs
& bodies
The brain doesn’t recognize the
same sharp division between
cognitive and motor function that
we impose in our thinking.
The SAME or substantially
overlapping brain systems subserve
BOTH cognitive and motor function.
For example, an area of the brain
called the pre-SMA
is important for sequential tasks,
whether they are
sequential motor tasks or
sequential cognitive tasks.
Hanakawa et al., 2002
Motor development and
cognitive development appear
to be fundamentally intertwined.
Diamond, A. (2000)
Close Interrelation of
Motor Development and Cognitive
Development and of the Cerebellum and
Prefrontal Cortex
Child Development, 71, 44-56
Young children love to help with
adult tasks around the house.
These help develop fine and
gross motor skills and also train
the executive functions of focused
attention and concentration.
The different parts of the human
being are fundamentally
interrelated.
Each part (cognitive, spiritual,
social, emotional, & physical)
is affected by, and affects,
the others.
Diamond, 2007
The best and most
efficient way to foster
any one of those,
is probably to foster all
of them.
While training and
challenging EFs is needed
for them to improve…
that alone is probably
not enough to achieve
the best results.
It’s likely that indirectly supporting
them by lessening things that
impair them (like stress or loneliness)
and
enhancing things that support them
(like joy or physical vitality)
is needed for the best results.
We have to care about children’s
emotional
social &
physical well-being,
if we want them to be able to problem-solve,
exercise self-control, or display any of the
other Executive Functions.
If a child is stressed,
sad,
lonely,
or not physically fit
the very academic performance
a school is trying to improve
will take a hit.
Focusing exclusively on training cognition
(as mainstream education tends to do)
may not be the best, or most efficient, way
to improve cognition.
Addressing children’s social, emotional,
spiritual, and physical needs may be key to
whether they do well in school and in life.
Focusing exclusively on
treating physical health
(as Western medicine does)
is less efficient or effective
than a more holistic approach
that also addresses social
and emotional health.
Thank you for your attention
My thanks to the NIH (NIMH, NICHD, & NIDA), which has continuously funded our work since 1986, & to the Spencer Fdn, CFI, NSERC, & IES for recent support our work - and especially to all the members of my lab.
Passionate Enthusiasm
as a driver
of benefits
Greater benefits if
an activity is
deeply personally
meaningful
If EFs are demanded only for
arbitrary, de-contextualized
purposes (as in computerized
cognitive training or aerobic
exercise with skills drawn from
sports), EF improvements are
small and narrow.
We never evolved to learn for
learning’s sake.
Engaging in real-world activities
we care about may be critical.
The distinction between
‘academic’ and
‘enrichment’ activities
is arbitrary
Joy &
the Challenge of
Pushing One’s Limits
are better motivators
than Fear or Anxiety
Stress impairs EFs
and can cause anyone
to look as if
that person has an EF impairment
(like ADHD)
when that’s not the case.
Mindfulness Practices Involving
Movement
have shown
by far the best results for
improving executive functions
of all approaches tried thus far.
A caring
relationship
is a major
driver of benefits
A supportive mentor,
who fully believes in the program and
each participants’ ability to succeed
and who genuinely cares about
each participant
may be absolutely critical to a
program’s success.
Results for
School Programs
are BETTER than for
computerized training.
What children need most is
to feel loved,
respected,
and valued.
Your caring is more
important than your
knowledge or skill,
material things, or doing the
textbook-perfect thing.
YOU are enough
It’s not just the relationship
between children and adults,
camaraderie with one’s peers,
feeling a sense of belonging,
acceptance, and support
is key
Young people need
activities that touch their
hearts and minds,
inspire them, challenge
them to reach for the stars,
and build their self-
confidence and pride.
Thank you for your attention