Submitted:
26 January 2025
Posted:
29 January 2025
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Abstract
Keywords:
1. Introduction
1.1. Conceptualization of Executive Functions
1.2. Executive Function Alterations: Children at Psychosocial Risk
1.3. Executive Function Interventions: The Novel Scope of EF Training + Metacognition
1.4. Objectives
2. Materials and Methods
2.1. Participants
2.2. Assessments
- Questionnaire for parents created ad hoc: The questionnaire was used to collect participant data related to the inclusion criteria, filled out by the child’s legal guardian.
- Five Digit Test (FDT) (Sedó, 2007): This test provides measures of inhibition and flexibility. In the inhibition subscale, participants must count the numbers in a box instead of reading them. In the flexibility subscale, participants must change their strategy (from counting the numbers in a box to reading the numbers in it). The boxes in which the strategy is changed are marked by a blue frame. The Spearman-Brown coefficient for this test ranges from .92 to .95.
- WM sub-index of the Wechsler Intelligence Scale (WISC-V): We used the Spanish adaptation of the WISC-V for children (2014), focusing on the WM index subtests: (1) Digits, which involves repeating digits in direct, reverse, and ascending order; (2) Drawing Span, requiring participants to recall and order drawings after brief exposure; and (3) Letters and Numbers, in which participants repeat numbers in ascending order and letters alphabetically after hearing a mixed series. The Spanish adaptation for children WISC-V (2014) was applied.
- Reynold’s Brief Intelligence Test (RIST): RIST (Reynolds and Kamphaus, 2013) is a screening intelligence test that contains two subscales: Riddles, to assess verbal intelligence, and Categories, to assess non-verbal intelligence. The sum of both subscales determines an intelligence index (M = 100; SD = 15). The reliability for this test, based on Cronbach’s alpha, is .91.
- Behavior Rating Inventory of Executive Function (BRIEF-2) (Gioia et al., 2015): This standardized test for youth aged 5 to 18 focuses on assessing EF with two versions, for teachers and parents. It is a Likert-type assessment in which the parent/guardian responds regarding frequency to a series of questions. Three main indices comprise the different clinical scales: Behavioral regulation index, Emotional regulation index, and Cognitive regulation index. The Global index of executive function is made up of all three. It provides various scores related to EF, such as inhibition, flexibility, self-control, WM, and cognitive regulation. Higher scores indicate problems or difficulties (T, typical scale M = 50, SD = 10). This study used the Spanish adaptation (Gioia et al., 2017). This test has high reliability (based on Cronbach’s alpha M = .86).
- School performance: The numerical evaluations provided by the participant’s tutor in mathematics and language were used. Student’s academic performance ranges from 0 to 10.
2.3. Interventions
2.4. Data Analysis
3. Results
3.1. Variables Considered Near Transfer Assessed Individually
| Experimental group | Control group | ANOVA t1p-value |
Main effect (Time in each group) |
Main effect (Group/time/time*group) |
||
| WISC-V Working Memory Index | Pretest | 89.2 (4.69) | 88.1 (3.45) | .31 | Experimental: (χ2 = 52.7, p = <.001) Control: (χ2 = 5.02, p =.08) |
|
| Postest | 101.2(8.10) | 87.4 (2.34) | ||||
| Follow-up | 104.2 (7.53) | 88.8 (2.77) | ||||
| WISC-V Auditory Working Memory Index | Pretest | 95.0 (4.17) | 96.4 (5.36) | .27 | (F (1,58) = 60.75, p = <.001, η²p =.50) (F (1,58) = 4.46, p = <.014, η²p =.07) (F (1,58) = 85.55, p = <.001, η²p =.59) |
|
| Postest | 110.5 (7.39) | 96.4 (4.75) | ||||
| Follow-up | 114 (6.56) | 100 (4.45) | ||||
| FDT Inhibition | Pretest | 26.2 (8.43) | 26.3 (9.53) | .95 | (F (1,60) = 13.16, p = <.001, η²p =.18) (F (1,60) = .22, p = .81, η²p =.004) (F (1,60) = 14.96, p = <.001, η²p =.2) |
|
| Postest | 22.8 (5.96) | 31.2 (5.52) | ||||
| Follow-up | 22.9 (5.80) | 30.3 (4.49) | ||||
| Pretest | 35.0 (9.90) | 35.8 (9.44) | .75 | (F (1,60) = 11.14, p = .001, η²p =.16) (F (1,60) = .31, p = .73, η²p =.005) (F (1,60) = 9.56, p = <.001, η²p =.14) |
||
| FDT Flexibility | Postest | 30.3 (6.47) | 37.0 (6.14) | |||
| Follow-up | 29.4 (5.74) | 37.8 (6.07) | ||||
| Pretest | 33.8 (6.55) | 34.6 (5.29) | .62 | (F (1,58) = 5.80, p = .019, η²p =.08) (F(1,58) = 1.19, p = .31, η²p =.02) (F(1,58) = 5.59, p = .005, η²p =.08) |
||
| FDT Counting Time | Postest | 32.2 (4.91) | 35.0 (2.88) | |||
| Follow-up | 33.2 (5.20) | 37.8 (4.89) | ||||
| FDT Reading Time | Pretest | 28.0 (4.64) | 30.6 (5.32) | .04 | (F (1,60) = 13.22, p = <.001, η²p =.18) (F (1,60) = 1.45, p = .23, η²p =.02) (F (1,60) = 5.89, p = .018, η²p =.09) |
|
| Postest | 25.5 (3.78) | 28.3 (3.23) | ||||
| Follow-up | 25.2 (3.17) | 29.3 (3.43) | ||||
| Experimental group | Control group |
ANOVA t1p-value |
Main effect (Time in each group) |
Main effect (Group/time/time*group) |
|||
| WISC-V Working Memory Index | Pretest | 88.4 (2.92) | 87.3 (3.61) | .20 | Experimental: (χ2 = 55.9, p = <.001) Control: (χ2 = 12.7, p = .002) |
||
| Postest | 99.3 (4.28) | 89.2 (3.26) | |||||
| Follow-up | 102.7 (4.23) | 89.8 (4.15) | |||||
| WISC-V Auditory Working Memory Index | Pretest | 94.3 (5.07) | 95.2 (5.45) | .49 | (F (1,59) = 79.55, p = <.001, η²p =.58) (F (1,59) = 3.41, p = .036, η²p =.06) (F (1,59) = 80.16, p = <.001, η²p =.58) |
||
| Postest | 110.3 (4.88) | 97.6 (3.72) | |||||
| Follow-up | 114 (4.02) | 101 (4.66) | |||||
| FDT Inhibition | Pretest | 26.9 (8.37) | 25.4 (7.94) | .47 | (F (1,59) = 8.35, p = .005, η²p =.13) (F (1,59) = .77, p = 46, η²p =.01) (F (1,59) = 18.25, p = <.001, η²p =.24) |
||
| Postest | 22.9 (4.06) | 30.2 (6.20) | |||||
| Follow-up | 23.7 (5.04) | 30.1 (5.55) | |||||
| FDT Flexibility | Pretest | 37.5 (9.55) | 36.7 (10.7) | .76 | (F (1,59) = 14.42, p = <.001, η²p =.19) (F (1,59) = .41, p = .662, η²p =.007) (F (1,59) = 9.6, p = <.001, η²p =.14) |
||
| Postest | 29.7 (5.90) | 38.4 (5.28) | |||||
| Follow-up | 30.3 (5.80) | 38.4 (5.82) | |||||
| FDT Counting Time | Pretest | 35.3 (6.19) | 36.0 (8.29) | .72 | (F (1,59) = 1.74, p = .192, η²p =.03) (F (1,59) = 1.31, p = .27, η²p =.02) (F (1,59) = 6.94, p = .001, η²p =.11) |
||
| Postest | 33.7 (5.47) | 36.0 (8.26) | |||||
| Follow-up | 33.5 (5.16) | 38.1 (6.49) | |||||
| FDT Reading Time | Pretest | 30.2 (6.75) | 32.0 (6.68) | .3 | Experimental: (χ2 =25.5, p = <.001) Control: (χ2 = 11.3, p = .004) |
||
| Postest | 25.3 (3.11) | 28.8 (6.38) | |||||
| Follow-up | 23.8 (2.67) | 30.1 (5.82) | |||||

- WISC-V Working Memory Index
- WISC-V Auditory Working Memory Index
- FDT Inhibition
- FDT Flexibility
- FDT Counting Time (Processing Speed)
- FDT Reading Time (Processing Speed)
3.2. Variables Considered Transfer in Participants’ Daily Lives Were Assessed Through Parent Questionnaires
| Experimental group | Control group | ANOVA t1p-value |
Main effect (Time in each group) |
Main effect (Group/time/time*group) |
||
| BRIEF-2 Inhibition | Pretest | 13.3 (2.57) | 15.2 (3.25) | .03 | (F (1,43) = 2.64, p = .11, η²p =.59) (F (1,43) = .01, p = .92, η²p =.00) (F (1,43) =.02, p = .87, η²p =.001) |
|
| Postest | 12.5 (1.81) | 13.9 (3.03) | ||||
| Follow-up | 13.3 (1.70) | 15.0(2.68) | ||||
| BRIEF-2 Flexibility | Pretest | 11.2 (2.35) | 12.4 (2.50) | .11 | Experimental: χ2 = 1.25, p =.53 Control: χ2 = .438, p = .80 |
|
| Postest | 10.1 (2.05) | 12.8 (2.80) | ||||
| Follow-up | 10.3 (1.81) | 13.0 (3.05) | ||||
| BRIEF-2 Working Memory | Pretest | 14.2 (2.71) | 15.5 (2.22) | .32 | (F (1,43) = 8.84, p = .005, η²p =.17) (F (1,43) = .021, p = .98, η²p =.001) (F (1,43) = 1.43, p = .25, η²p =.033) |
|
| Postest | 13.7 (2.40) | 14.8 (3.84) | ||||
| Follow-up | 12.4 (1.34) | 15.0 (2.71) | ||||
| BRIEF-2 Metacognition Index | Pretest | 62.5 (10.09) | 67.6 (9.62) | .09 | (F (1,43) = 7.50, p = .009, η²p =1.52) (F (1,43) = .37, p = .7, η²p =.009) (F (1,43) = 1.55, p = .22, η²p =.04) |
|
| Postest | 61.8 (11.7) | 66.9 (14.5) | ||||
| Follow-up | 57.1 (6.86) | 67.6 (11.20) | ||||
| BRIEF-2 Global Index of Executive Function | Pretest | 101 (15.9) | 107 (25.6) | .36 | Experimental: (χ2 =11.9, p =.003) Control: (χ2 =.67, p =.72) |
|
| Postest | 97.2 (14.2) | 109.0 (20.9) | ||||
| Follow-up | 93.4 (9.55) | 111.0 (17.70) |
| Psychosocial risk experimental group (PRE) | Psychosocial risk control group (PRC) | ANOVA t1p-value |
Main effect (Time in each group) |
Main effect (Group/time/time*group) |
||
| BRIEF-2 Inhibition | Pretest | 15.1 (6.23) | 14.3 (3.50) | .59 | Experimental: (χ2 = 4.10, p =.13) Control: (χ2 = 6.74, p = .03) |
|
| Postest | 13.3 (3.22) | 15.5 (3.68) | ||||
| Follow-up | 13.5 (2.73) | 16.5 (3.64) | ||||
| BRIEF-2 Flexibility | Pretest | 13.5 (6.54) | 11.9 (3.17) | .28 | Experimental: (χ2 = 4.88, p = .08) Control: (χ2 = 10.2, p = .006) |
|
| Postest | 11.0 (2.96) | 13.4 (3.15) | ||||
| Follow-up | 10.7 (2.54) | 13.8 (2.85) | ||||
| BRIEF-2 Working Memory | Pretest | 16.5 (7.15) | 15.4 (2.63) | .45 | Experimental: (χ2 = 18.0, p = <.001) Control: (χ2 = 2.04, p = .36) |
|
| Postest | 14.5 (3.54) | 17.0 (3.55) | ||||
| Follow-up | 12.8 (2.94) | 16.0 (3.81) | ||||
| BRIEF-2 Metacognition Index | Pretest | 63.1 (10.86) | 64.8 (11.16) | .58 | (F (1,46) = 9.78, p = .003, η²p = .17) (F (1,46) = 1.63, p = .202, η²p = .033) (F (1,46) = 9.52, p = <.001, η²p = .17) |
|
| Postest | 61.3 (11.9) | 73.0 (13.9) | ||||
| Follow-up | 57.5 (9.70) | 71.6 (14.12) | ||||
| BRIEF-2 Global Index of ExecutiveFunction | Pretest | 102 (19.4) | 106 (19.3) | .53 | (F (1,46) = 9.93, p = .003, η²p = .17) (F (1,46) =1.28, p = .282, η²p = .026) (F (1,46) = 9.34, p = <.001, η²p = .16) |
|
| Postest | 99.1 (19.1) | 118.6 (22.2) | ||||
| Follow-up | 94.7 (15.93) | 118.0 (22.62) |
- BRIEF-2 Inhibition
- BRIEF-2 Flexibility
- BRIEF-2 Working Memory
- BRIEF-2 Metacognition Index
- BRIEF-2 Global Index of Executive Function
3.3. Variables Considered Far Transfer (Not Directly Trained)
| Experimental group | Control group | ANOVA t1p-value |
Main effect (Time in each group) |
Main effect (Group/time/time*group) |
||
| RIST Intelligence Index | Pretest | 91.1 (4.76) | 90.7 (3.70) | .66 | Experimental: (χ2 = 32.1, p = <.001) Control: (χ2 = 1.1, p = <.57) |
|
| Postest | 94.3 (5.06) | 90.8 (3.17) | ||||
| Follow-up | 96.2 (5.36) | 90.0 (2.62) | ||||
| Spanish Language academic performance | Pretest Postest Follow-up |
6.58 (1.52) 7.45 (1.39) 7.29 (1.49) |
6.74 (2.18) 6.31 (1.53) 7.19 (1.71) |
.74 | (F (1,60) = 1.66, p = .020, η²p = .03) (F (1,60) = 2.41, p = .094, η²p = .04) (F (1,60) = 17.08, p = <.001, η²p = .22) |
|
| Mathematics academic performance | Pretest | 6.16 (1.55) | 6.26 (2.16) | .84 | (F (1,60) = 1.2, p = .28, η²p = .02) (F (1,60) = .78, p = .46, η²p = .013) (F (1,60) = 9.57, p = <.001, η²p = .14) |
|
| Postest | 7.00 (1.13) | 6.06 (1.58) | ||||
| Follow-up | 7.03 (1.60) | 6.84 (1.89) | ||||
| BRIEF-2 Emotional Control | Pretest | 14.1 (2.97) | 14.7 (2.66) | .51 | (F (1,43) = 10.47, p = .002, η²p= .20) (F (1,43) = .18, p = .83, η²p= .004) (F (1,43) = 3.97, p = <.023, η²p= .09) |
|
| Postest | 12.7 (1.39) | 15.4 (2.84) | ||||
| Follow-up | 12.7 (1.60) | 15.5 (2.92) | ||||
| BRIEF-2 Behavioral Regulation Index | Pretest | 38.6 (6.60) | 43.0 (6.47) | .03 | (F (1,43) = 10.34, p = .003, η²p =.20) (F (1,43) = 1.12, p = .29, η²p =.03) (F (1,43) = .01, p = .93, η²p =.00) |
|
| Postest | 35.4 (3.38) | 42.1 (7.47) | ||||
| Follow-up | 36.3 (3.51) | 43.5 (7.29) |
| Experimental group | Control group | ANOVA t1p-value |
Main effect (Time in each group) |
Main effect (Group/time/time*group) |
||
| RIST Intelligence Index | Pretest | 89.8 (3.22) | 90.0 (3.53) | .23 | (F (1,59) = 20.53, p = <.001, η²p =.26) (F (1,59) = .44, p = .64, η²p =.01) (F (1,59) = 47.47, p = <.001, η²p =.45) |
|
| Postest | 94.2 (4.04) | 90.2 (2.68) | ||||
| Follow-up | 96.8 (3.54) | 90.5 (3.00) | ||||
| Spanish Language academic performance | Pretest | 5.50 (1.61) | 6.46 (1.14) | .01 | (F (1,59) = 74.22, p = <.001, η²p = .58) (F (1,59) = .26, p = .61, η²p = .005) (F (1,59) = 37.86, p = <.001, η²p = .41) |
|
| Postest | 7.20 (1.24) | 5.61 (1.28) | ||||
| Follow-up | 6.67 (1.60) | 6.39 (1.56) | ||||
| Mathematics academic performance | Pretest Postest Follow-up |
5.23 (1.65) 6.63 (1.35) 6.47 (1.74) |
5.89 (1.34) 5.32 (1.30) 5.90 (1.85) |
.10 | (F (1,59) = 1.65, p = .20, η²p = .03) (F (1,59) = 1.41, p = .25, η²p = .02) (F (1,59) = 24.12, p = <.001, η²p = .31) |
|
| BRIEF-2 Emotional Control | Pretest Postest Follow-up |
15.4 (5.55) 13.3 (3.07) 13.0 (2.68) |
14.6 (3.21) 16.6 (4.53) 16.3 (4.16) |
.54 | Experimental: (χ2 = 40.5, p=<.001) Control: (χ2 = 2.05, p = .36) |
|
| BRIEF-2 Behavioral Regulation Index | Pretest Postest Follow-up |
40.8 (5.61) 37.8 (8.14) 37.2 (6.97) |
41.0 (8.76) 45.6 (9.56) 46.4 (9.12) |
.12 | (F (1,46) = 8.12, p = .006, η²p = .15) (F (1,46) = 2.03, p = .14, η²p = .041) (F (1,46) = 9.97, p = <.001, η²p = .17) |

- RIST Intelligence Index
- Spanish Language Academic Performance
- Mathematics Academic Performance
- BRIEF-2 Emotional Control
- BRIEF-2 Behavioral Regulation Index
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
| EF | Executive Functions |
| WM | Working Memory |
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| RIST | Gender F/M | Age | ||
| Pretest | Typically-developing experimental group | 91.1 (4.76) | 14/17 | 133 (12.9) |
| Typically-developing control group | 90.7 (3.70) | 12/20 | 131 (6.96) | |
| Psychosocial risk experimental group | 89.8 (3.22) | 14/16 | 135 (8.76) | |
| Psychosocial risk control group | 90.8 (3.53) | 21/10 | 133 (10.3) | |
| F(3.120) | 0.69 (p = .057) |
1.13 (p = .34) |
||
| Postest | Typically-developing experimental group | 94.3 (5.06) | 14/17 | 136 (12.9) |
| Typically-developing control group | 90.8 (3.17) | 12/20 | 135 (6.96) | |
| Psychosocial risk experimental group | 94.2 (4.04) | 14/16 | 138 (8.75) | |
| F(3.120) | 10.1 (p = < .001) |
1.14 | ||
| Follow-up | Typically-developing experimental group | 96.2 (5.36) | 14/17 | 140 (12.9) |
| Typically-developing control group | 90.0 (2.62) | 12/20 | 138 (6.94) | |
| Psychosocial risk experimental group | 96.8 (3.54) | 14/16 | 142 (8.76) | |
| Psychosocial risk control group | 90.5 (3.00) | 21/10 | 90.5 (3.00) | |
| F(14.5) | 32.4 (p = < .001) |
1.13 | ||
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