Preschool program shown to improve key cognitive functions (including working memory and control of attention and action)

Wednesday, November 28, 2007

An innovative curriculum, called "Tools of the Mind" (Tools, for short), holds hope for:
• improving academic achievement of children from poor families
• reducing the achievement gap between children from poorer versus wealthier homes and
• reducing the number of diagnoses of attention deficit hyperactivity disorder (ADHD),
according to University of British Columbia (UBC) neuroscientist and Professor in the Dept. of Psychiatry, Adele Diamond, Ph.D., an expert on the development of cognitive functions that depend on prefrontal cortex (called 'executive functions'), and lead author on an article to appear in Science this week:

Preschool Program Improves Cognitive Control
Adele Diamond, W. Steven Barnett, Jessica Thomas, Sarah Munro
30 November 2007, Science, vol. 317

This research evaluated for the first time the effect on executive functions of the Tools preschool curriculum. The Tools curriculum uses intentional dramatic play, visual aids, and peer interaction during reading and math to teach children important cognitive and social-emotional skills. Such executive function skills include resisting distraction, giving a more considered response instead of your first impulse, working with information you are holding in mind, and the mental flexibility to think "outside the box."

The Tools program was developed over the past 12 years by U.S. educational psychologists, Deborah Leong, Ph.D., and Elena Bodrova, Ph.D. It has been used in several U.S. states. The Tools curriculum is based on Vygotsky and Luria's insights into executive functions and their development. Its value in improving executive functions has not been determined until now.

"Executive functions are critical for success in school and life. These skills are rarely taught, but they can be, even to preschoolers. It could make a huge difference, especially for disadvantaged children," says Diamond who holds a Canada Research Chair in Developmental Cognitive Neuroscience, is a member of UBC's Brain Research Centre, the Child and Adolescent Psychiatry Department at BC Children's Hospital, and the Neuroscience graduate and Cognitive Science undergraduate programs at UBC.

COGNTIVE CONTROL CAN BE IMPROVED IN PRESCHOOLERS -- AT MINIMAL EXPENSE
Some have felt preschool too early to try to improve executive function skills, "This research shows that executive functions can indeed be improved in preschoolers, and it can done without fancy equipment, by regular teachers in regular public school classrooms," say the authors.

No computers or other technical equipment were used. No more individualized attention was required than occurs in a regular classroom. No specialists. The materials used were simple, inexpensive, and readily available.

At-risk 5-year-old children in Tools showed markedly better executive function performance compared with closely-matched peers. Being in the Tools curriculum accounted for more variance in executive functions than did age or gender, and remained significant even after taking into age and gender.

IMPROVING COGNITIVE CONTROL IMPROVES ACADEMIC PERFFORMANCE
"Previous research has shown that executive function skills (especially inhibitory control of attention and action) are stronger predictors of academic performance than is IQ," says Diamond.

It was on the most demanding executive function conditions in the present study that children in Tools shone most compared to their peers. The most demanding executive function conditions also correlated most highly with independently-acquired, objective measures of academic performance. Indeed, superior academic performance has been found for Tools programs with other children and teachers, in other schools and states and with different comparison conditions.

These results are consistent with the strong impressions of teachers and administrators where both new curricula were introduced in the same school. After one year, so convinced were educators in that school that Tools children were doing substantially better than other children that they halted the experiment there and switched over all classrooms in their school to Tools.

The widening achievement gap between the economically advantaged and disadvantaged might result from a negative feedback loop beginning with poor initial executive functions. Interventions that improve executive functions early should reduce that achievement gap.

Children from lower-income families enter school with disproportionately poor executive function skills. They fall progressively farther behind academically each school year.

"Those two facts are related and correctible," says Diamond, "Helping at-risk children improve their executive function skills early might be critical to closing the achievement gap and reducing societal inequalities."

"Rates of students dropping out of school or getting expelled, teacher burnout, crime, drug addiction, and diagnoses of ADHD and conduct disorder can be reduced if children are helped early in life to improve their executive function skills," according to the authors.

"The recent explosion in diagnoses of ADHD may be due, in part, to some children never learning to exercise attentional control and self-discipline. Some children are strongly biologically predisposed to hyperactivity; training in self-regulation alone would not be sufficient for them. Some children, however, probably get misdiagnosed with ADHD when what they need is to be helped to acquire skills in self-regulation. Hence, we propose that early executive function (EF) training may be able to reduce the incidence of ADHD diagnoses," says Diamond, lead author of the Science article.

PREVENTION IS MORE EFFECTIVE AND LESS COSTLY THAN LATER TREATMENT
Most current interventions addressing executive functions target the consequences of poor self-control rather than seeking prevention at an early age, as does Tools.

"Early intervention (heading off problems before they develop) costs far less and achieves far better results than trying to correct problems once they have developed," says Diamond.

Co-author, and National Institute for Early Education Research (NIEER) Director, Steven Barnett, Ph.D., notes that "benefit-cost analyses have found that the longer term economic impacts of improving executive functions are quite large compared to the benefits of improving academic test scores alone, because executive functions leads to the avoidance of risky behaviors like smoking, teen pregnancy, and crime."

PLAY IS ONE OF THE BEST WAYS TO IMPLEMENT CURRICULAR GOALS
"Though preschool teachers are under pressure to limit play and spend more time on instruction, mature social pretend play in preschool may be more critical for academic success than preschool academic instruction," says Diamond, the lead author of a paper coming out in Science on Friday.

The results of this study support the value of mature, intentional make-believe play (an important component of Tools) for the development of executive functions. Consider that during role-playing you have to hold in mind your role and the roles that others are playing (working memory), you need to inhibit acting out of character (inhibitory control), and you need to flexibly adjust to whatever twists and turns the evolving plot might take (cognitive flexibility).

MENTAL EXERCISE HAS BENEFITS MUCH AS DOES PHYSICAL EXERCISE
"If throughout the school-day executive functions are supported and progressively challenged, benefits generalize and transfer to new activities. Daily EF 'exercise' appears to enhance and accelerate executive function development much as physical exercise improves our bodies," according to Diamond.

The Tools curriculum was refined over many years by educational psychologists, Leong and Bodrova. Initially they tried it as an add-on to existing curricula. Children improved on what they practiced in that module, but the benefit did not transfer. Only when executive functions were challenged and supported by activities throughout the day did gains generalize to new contexts.

Study Details & Background:

The research team, which included investigators from UBC and NIEER at Rutgers University in the US, evaluated 147 five-year-olds in a low-income, urban school district in the Northeast.

The researchers compared the Tools curriculum to another curriculum -- that covered the same academic content but did not address executive function development -- in preschool classrooms. The conditions and study participants here were well-matched and differed only in the exposure of one group to activities to improve cognitive control.

Importantly, both programs were instituted at the same time, had identical resources (the same instructional materials, even furniture), identical supports and training resources for the teachers, and covered the same academic content. They differed only in that Tools included procedures to support, improve, and challenge executive functions embedded in activities from reading and math through play), whereas the other curriculum did not do anything to explicitly improve executive functions.

Another important aspect of the research design is that all children and teachers in were randomly assigned to curricula. Both curricula were taught by teachers with equivalent levels of education and years of teaching experience. The children in both curricula were from the same neighborhood and ethnic group, and from families with very similar levels of income and parental education. The only difference between the groups was in the curriculum that was taught.

The cognitive control functions dependent on prefrontal cortex are called 'executive functions' (EFs).

Executive functions (EFs) include three core abilities: working memory, inhibitory control of attention and action, and cognitive flexibility.

working memory = holding information in mind and working with it (e.g., relating one idea to another, relating the beginning of a story to the end, doing mental arithmetic) or holding information in mind while working on something else (e.g., mentally holding onto information during an interruption or while you have to do something else first)
inhibitory control = controlling one's attention to resist distraction, controlling one's actions so you do what you should do rather than what might be your inclination, giving the considered response rather than one's first reaction
cognitive flexibility = being about to switch mental sets, to flexibly adapt to change.

The neurocognitive tasks used in the study:

In the first test, children were told to respond to shapes (a heart and a flower), appearing one at a time on the right or left of a computer screen, by pressing a right or left-hand button. If they saw a heart, they were to press the button on the same side as the stimulus. If they saw a flower, they were to press the button on the opposite side. This test required holding two abstract rules in mind ('press on the same or opposite side'), on each trial mentally translating the rule into "press right" or "press left," and inhibiting the tendency to press on the same side as the stimulus on "flower trials." When heart and flower trials were intermixed, children had to do all that plus flexibly switch between the two rules. Most children in Tools could show they could do that, but less than 1/3 of the children in dBL could demonstrate that they could flexibly switch between heart and flower trials.

The second test was a 'Flanker task' with one shape presented inside another (for example, a triangle inside a circle). The rules were "press right for triangle" and "press left for circle." To help children remember, a small triangle was placed atop its response button and at the bottom right of the computer screen. Similar memory aids were presented for the circle response. In the standard Flanker condition, children were told to focus on the inside shape, press the button for that shape, and ignore the outside shape. In the reverse Flanker condition, children were told to focus on the outsideshape, press the button for that shape, and ignore the inside shape. This test required that children remember where to focus their attention, inhibit attention to the distractor (the non-relevant shape), and flexibly switch from always focusing on the inside to always focusing on the outside. When they had to switch where they attended, children in dBL were correct on only 65 percent of the trials (not significantly better than chance) but children in Tools were correct on 84 percent of those trials.

Importantly, these tasks were different from anything any of the children had done before. Better performance by children in Tools shows that they were able to generalize and transfer their EF skills to new situations.

Adele Diamond holds a Canada Research Chair in Developmental Cognitive Neuroscience and is a Professor in the Psychiatry Department at the University of British Columbia & BC Children's Hospital. Prof. Diamond is one of the pioneers of the field of developmental cognitive neuroscience and one of the world's foremost experts on the development of the cognitive control functions dependent on prefrontal cortex. Her contact information is: adele.diamond@ubc.ca, 604-822-7220. For more information about Prof. Diamond see:
http://www.devcogneuro.com/People/AdeleDiamond.html & http://www.interprofessional.ubc.ca/bdl.html.

Co-authors on the paper are:

W. Steven Barnett, the Director of NIEER, National Institute for Early Education Research
Jessica Thomas, also at NIEER
& Sarah Munro, in Diamond's Developmental Cognitive Neuroscience Lab at UBC.

Support for the study was provided to Diamond by HELP (the Human Early Learning Partnership) and the National Institute on Drug Abuse (R01 DA19685).

None of the authors had any stake or involvement in either curriculum studied.

The developers of the Tools of the Mind curriculum are two educational psychologists, Drs. Deborah Leong and Elena Bodrova. Their contact information is:

* Deborah Leong, Professor Emerita, Psychology, and director of Tools of the Mind project, Center for Improving Early Learning, Metropolitan State College of Denver, Denver Colorado, leongdmscd.edu, 303-721-1313, or 303-279-5589, leongd@mscd.edu.

* Elena Bodrova, Senior Researcher at McRel in Aurora Colorado, ebodrova@mcrel.org.

For more on the Tools of the Mind curriculum, visit www.toolsofthemind.org.

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The National Institute for Early Education Research (www.nieer.org),a unit of the Graduate School of Education, Rutgers University, New Brunswick, NJ, supports early childhood education policy by providing objective, nonpartisan information based on research. NIEER is supported through grants from The Pew Charitable Trusts and others.