Pre-school program shown to improve key cognitive functions, self-control

November 29, 2007

An innovative curriculum for pre-schoolers may improve academic performance, reduce diagnoses of attention deficient hyperactivity disorder (ADHD), and close the achievement gap between children from poor families and those from wealthier homes, according to research led by a Vancouver neuroscientist who is an expert in the development of cognitive function.

University of British Columbia Psychiatry Prof. Adele Diamond, who is Canada Research Chair in Developmental Cognitive Neuroscience, led the first evaluation of a curriculum called Tools of the Mind (Tools), that focuses on executive functions (EFs) that depend on the prefrontal cortex area of the brain. Functions include resisting distraction, considering responses before speaking, mentally holding and using information, and mental flexibility to "think outside the box."

The program was developed over the last 12 years by U.S. educational psychologists Deborah Leong and Elena Bodrova and has been used in several U.S. states. Its value in improving EF has not been determined until now.

The study is published in this week's issue of Science.

"EFs are critical for success in school and life. The skills are rarely taught, but can be, even to preschoolers. It could make a huge difference, especially for disadvantaged children," says Diamond, who is a member of the Brain Research Centre at UBC Hospital; Vancouver Coastal Health Research Institute (VCHRI); the Child and Adolescent Psychiatry Dept. at BC Children's Hospital; the Child & Family Research Institute (CFRI); and the Human Early Learning Partnership (HELP) in Vancouver.

"The recent explosion in diagnoses of ADHD may be partly due to some children never learning to exercise attentional control and self-discipline," says Diamond. "Although some children are strongly biologically predisposed to hyperactivity and wouldn't benefit from training, others may be misdiagnosed because what they actually need are skills in self-regulation."

Previous research has shown that EFs are stronger predictors of academic performance than IQ, she adds.

Children from lower-income families may enter school with disproportionately poor EF skills and fall progressively farther behind in school each year - facts which Diamond says are related and correctible.

"Helping at-risk children improve EF skills early might be critical to closing the achievement gap. We showed EFs can be improved in preschoolers without fancy equipment and by regular teachers in regular public school classrooms."

Most interventions target consequences of poor self-control rather than seeking prevention at an early age, which is a hallmark of Tools. Previous attempts to improve children's EF have been costly and of limited success, say the researchers.

The research team, which includes investigators from the National Institute for Early Education Research at Rutgers University in New Jersey, evaluated 147 five-year-olds in a low-income, urban U.S. school district. Researchers compared Tools with a curriculum called balanced literacy (dBL) that covered the same academic content as Tools but without a focus on EF.

Both programs were new, instituted at the same time and used identical resources. Children and teachers in Tools and dBL were randomly assigned and teachers had equivalent levels of education and teaching experience. Children received either Tools or dBL for one to two years.

Evaluation involved two computerized tests that measured EF.

In the first test, children were told to respond to shapes (a heart and a flower), appearing one at a time on the left or right side of a computer screen, by pressing a right- or left-hand button. A heart symbol meant press the button on the same side as the shape appeared; the flower meant press the button on the opposite side. The exercise tested ability to hold abstract rules in the mind. Most children in Tools completed the test successfully, compared to fewer than one-third of children in dBL.

The second test presented one shape inside a different shape (e.g. a triangle and a circle) with instruction to focus on either the inside or outside shape and press corresponding right- or left-hand buttons. The test measured ability to focus attention, ignore the distraction of the non-relevant shape, and switch focus from inside to outside shapes. When children had to switch focus, children in dBL were correct on 65 per cent of the trials - not significantly better than chance. Children in Tools were correct on 84 per cent of the trials.

Tools encourages out-loud self-instruction and dramatic play. "Preschool teachers are under pressure to limit play and spend more time on instruction but social pretend play may be more critical to academic success," says Diamond.
Support for the study was provided by HELP and the National Institute on Drug Abuse (NIDA).

Attn: More information and a photo of Dr. Diamond can be found at

The Faculty of Medicine at UBC provides innovative programs in the health and life sciences, teaching students at the undergraduate, graduate and postgraduate levels, and generates more than $200 million in research funding each year.

The Brain Research Centre at Vancouver Hospital, a partnership between Vancouver Coastal Health Research Institute and UBC's Faculty of Medicine, has more than 200 investigators with broad, multi-disciplinary research expertise to advance knowledge of the brain and to explore new discoveries and technologies that have the potential to reduce the suffering and cost associated with disease and injuries of the brain.

VCHRI is the research body of Vancouver Coastal Health Authority. In academic partnership with UBC, the institute advances health research and innovation across B.C., Canada, and beyond. HELP, a research institute in UBC's Faculty of Graduate Studies, is a network of more than 200 faculty, researchers and graduate students from six B.C. universities.

BC Children's Hospital, an agency of the Provincial Health Services Authority, provides expert care for the province's most seriously ill or injured children, including newborns and adolescents. Children's is an academic health centre affiliated with the University of British Columbia, Simon Fraser University, and the Child & Family Research Institute. CFRI works in close partnership with UBC; BC Children's Hospital and Sunny Hill Health Centre for Children; BC Women's Hospital & Health Centre, agencies of the Provincial Health Services Authority, and the BC Children's Hospital Foundation. CFRI conducts discovery research to benefit the health of children and families and it is the largest research institute of its kind in Western Canada. NIDA is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world's research on the health aspects of drug abuse and addiction.

University of British Columbia

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