Assessment and Development of Executive Function (EF) During Childhood

TLDR

Executive function in children and adolescents is defined by attentional control, cognitive flexibility, goal setting, and information processing, and its assessment is complicated by developmental changes and associated impairments. The paper proposes a developmental model of EF integrating these four domains and calls for longitudinal neuroimaging studies to confirm and extend this model. The authors discuss traditional EF measures, their interpretive challenges, ecological validity, and present adjunct methods to achieve a more comprehensive and valid assessment. Developmental mapping shows attentional control emerges in infancy and develops rapidly in early childhood, while cognitive flexibility, goal setting, and information processing mature between ages 7–9 and are largely mature by age 12, with executive control emerging after a transitional period at the start of adolescence.

Abstract

This review paper outlines the issues associated with the assessment of executive function (EF) in children and adolescents, and describes the developmental profile of executive processes across childhood. At the outset, EF is defined, and cognitive and behavioral impairments associated with executive dysfunction (EDF) are described. A developmental model of EF is proposed incorporating four discrete but inter-related executive domains (attentional control, cognitive flexibility, goal setting, and information processing) which operate in an integrative manner to enable "executive control". Characteristics that constitute traditional EF measures are discussed, as are the problems associated with test interpretation. The ecological validity of EF tests and neuropsychological assessment procedures are examined, and adjunct methods of measurement are presented to enable a more comprehensive and valid assessment of EF. Based on developmental and normative studies, the maturation of executive domains is mapped. Attentional control appears to emerge in infancy and develop rapidly in early childhood. In contrast, cognitive flexibility, goal setting, and information processing experience a critical period of development between 7 and 9 years of age, and are relatively mature by 12 years of age. A transitional period is thought to occur at the beginning of adolescence, and shortly after "executive control" is likely to emerge. In order to confirm our current understanding of EF development and further enhance our understanding of brain-behavior relationships, longitudinal studies incorporating structural and functional neuroimaging are required.