『Cover Story』A Comprehensive Interpretation of Executive Function in Children with Neurodevelopmental Disorders!

The cover of this issue of Nature Human Behaviour is “Executive function in children with neurodevelopmental conditions: a systematic review and meta-analysis” published by Professor Adam Guastella of the University of Sydney.

Volume 8 Issue 12, December 2024

Ayesha K. Sadozai, Carter Sun, Eleni A. Demetriou, Amit Lampit, Martha Munro, Nina Perry, Kelsie A. Boulton & Adam J. Guastella 

Research Background

Executive function (EF) delays are well-documented in pediatric neurodevelopmental disorders (NDCs). However, there is no consensus on whether EF delays represent a transdiagnostic feature of NDCs. To gain further understanding of the role of EF delays in NDCs, we conducted a systematic review and meta-analysis, synthesizing 180 studies that reported comparisons of two or more NDCs in terms of EF and explored differences between NDCs and the effects of moderators such as sex, age, publication year, DSM (Diagnostic and Statistical Manual of Mental Disorders) version, and assessment type.

The study included participants aged 18 or younger, assessed using established EF measures across seven domains: attention, fluency, set shifting, set switching, response inhibition, planning, and working memory.

Research Significance

Results showed that all NDCs showed moderate EF delays compared with controls (effect size g = 0.56, 95% confidence interval 0.49–0.63), confirming that EF delays are a transdiagnostic feature of neurodevelopmental delays. The study also found that comorbidity, DSM-5 criteria, and the use of informant measures increased the effect size of EF delay (g=0.72, 95% confidence interval 0.59–0.86).

Children with tic disorder (TD) had smaller EF delays, children with attention-deficit/hyperactivity disorder (ADHD) had larger delays in attention, response inhibition, planning, and working memory, and children with autism spectrum disorder (ASD) had larger delays in set switching. These findings help to better understand the EF differences between different NDCs.

Research Prospects

The results of this study support the transdiagnostic model of neurodevelopment and provide a basis for further scientific research on how EF delay affects brain circuits, symptom characteristics, and functional developmental sensitivity. Through methods such as neuroimaging and genetics, the relationship between EF delay and brain structure and function, as well as the impact of genetic variation on EF delay, will be studied. Develop interventions for EF delay and evaluate their effectiveness in improving symptoms and function in children with NDCs. Conduct long-term follow-up studies to understand the impact of EF delay on the long-term development and social adaptation of children with NDCs, as well as the long-term effects of interventions.

This study provides an important basis for understanding the role of EF delay in NDCs and provides direction for future research. Through in-depth research and effective intervention, it is expected that better support and treatment will be provided for children with NDCs.

Cover Design Process

• The cover design closely aligns with the theme of the paper. The maze pattern reflects the core topic of the study—executive function (EF) delays in neurodevelopmental disorders (NDCs). The maze symbolizes the complexity and uncertainty of NDCs, while the colorful boats and cartoon figures represent different types of NDCs and diverse research subjects.
• The cover features a pink and blue color scheme, creating a warm yet rational atmosphere. At the center, multiple boats navigate through a maze-like waterway, subtly metaphorizing the researchers’ journey in exploring the intricate landscape of NDCs.
• Overall, this Nature Human Behaviour cover design is both visually appealing and rich in symbolism. It closely ties to the paper’s theme, conveying a spirit of exploration, learning, and discovery. Through this design, readers can intuitively grasp the depth and breadth of the research, as well as the relentless efforts of researchers in the NDC field. Ultimately, the cover received high praise from both the professor and the journal’s editors, successfully making it to publication!