Measuring Executive Functions in Children from Low- and Middle-Income Countries

How RTI’s EF Touch platform helps to quantify crucial developmental skills

While there has been much recent research about how developmental changes in executive functions during early childhood contribute to children’s school readiness, most of this research has focused on children in high-income countries. A lot remains unknown about the impact of executive functions on the performance of children in low- and middle-income countries.

Executive functions are cognitive skills that facilitate problem solving, learning, and goal-directed activities. The word “skills,” rather than “abilities,” conveys the idea that executive function skills are malleable and can be improved. Executive- function skills are interesting because they are higher-order cognitive processes that act on other aspects of cognition; as such, they are often referred to as the “air-traffic-control system of the brain.”

A long-standing debate in the research literature involves which specific cognitive skills fall under the rubric of executive functions. In early childhood, there is a consensus that executive-function skills primarily consist of inhibitory control (the ability to override a dominant or habitual response), working memory (the ability to hold information in mind while processing or updating it), and cognitive flexibility (the ability to shift attention or strategy in the face of changing information).

Inhibitory control, working memory, and cognitive flexibility are three foundational executive-function skills that facilitate later cognitive development, including problem solving, decision making, and self-monitoring. Executive- function skills undergo rapid improvements in early childhood, which is why a lot of research focuses on this developmental period.

Improving Executive Function in Young Children

There are a number of areas of child development related to executive- function skills. For example, early language development, especially expressive language, is associated with improved executive-function skills in children. Moreover, multiple aspects of the early caregiving environment, especially the experience of consistent, contingent, and sensitive caregiving behaviors, are related to executive-function development.

In theory, efforts to enhance children’s early caregiving milieu should benefit their executive-function skills — but these supporting environments will benefit multiple aspects of cognitive and social development and are not specific to executive function. There is a growing body of literature on interventions that improve executive-function skills; these range from classroom curricula to adaptive computerized-training programs to physical activity. If there is a common ingredient among these programs, it is that executive-function skills benefit from repeated experiences that both engage these cognitive processes and make developmentally appropriate demands of children.

Using EF Touch to Measure Executive-Function Skills

EF Touch is a computerized battery of tasks that measures executive-function skills — including inhibitory control, working memory, and cognitive flexibility — in early childhood. We developed EF Touch with funding from the National Institute of Child Health and Human Development and, after an extensive period of task development and testing, the Institute of Educational Sciences in the United States Department of Education. RTI then made an internal investment to expand the functionality of Tangerine, an electronic data-collection program used for learning assessments and designed for laptops, tablets and smartphones, so we could administer EF Touch tasks using Tangerine-equipped tablets.

In our research, we emphasize the creation of a composite measure that indexes children’s performance across multiple tasks. The Bubbles task, which tests reaction time, serves as a control variable: bubbles appear on the screen and children are told to pop them as fast as they can. In Tangerine, we can record reaction time to the millisecond, and we find that kids who are faster at the Bubbles task actually do better on all measured executive-function tasks.

What is the relevance of executive function to broader learning outcomes? Recent research shows a correlation between age and improvement in executive function; if you don’t measure all tasks you can misattribute executive function to other developmental growth. It’s still unclear at how early a stage we can differentiate specific skills, which is why EF Touch focuses on a battery-wide score rather than scores on individual tasks.

Testing EF Touch in Developing Countries

We conducted a pilot test of EF Touch in May 2017, in what was primarily a proof- of-concept study. The goal of this work was to test the feasibility and usability of the Tangerine version of EF Touch, including a new data-collection platform (Android tablets versus Windows laptops), a new setting (Kenya, a developing country), and expanded language offerings (tasks were administered in either English or Swahili).

In general, Kenyan children enjoyed and were able to complete most of the EF Touch tasks, enumerators were satisfied with the quality of data collected, and individual differences in children’s performance was evident. Our results showed expected associations with age (older children outperformed younger children) and behavior (enumerator ratings of children’s attention-related behaviors were associated with improved task performance).  

Based on the success of this pilot test, our team elected to include a subset of the EF Touch tasks in Kenya’s Tayari Midline Assessment conducted in October 2017. Approximately 1,200 children in pre-primary classrooms were given the opportunity to complete EF Touch tasks. Once we analyze this data, we can begin to ask systematic questions about how performance on EF Touch tasks relates to children’s performance on more traditional measures of school readiness, including pre-academic achievement and social-emotional functioning.

Our data analysis promises to be one of the largest efforts to date to study issues of executive function in a developing-country context. In addition, we also plan to conduct formal psychometric tests of EF Touch, including testing whether the tasks work equally well (in a measurement sense) when administered in English and Swahili. This will ensure that any inferences we draw from our data are not artifacts of differences in test performance for children from different language backgrounds.

Charting the Future of EF Touch

Our immediate focus regarding EF Touch involves data analysis and analyzing the results from the Tayari program. However, we are actively seeking out opportunities to partner with other organizations and projects that have an interest in measuring executive-function skills in early childhood. We want to learn the best way to facilitate and support external partners in their use of these tasks, and as we think about new work and new applications, we also hope to connect to potential funders who have an interest in early childhood development and executive function.

Children in low- and middle-income countries have a unique set of experiences that, for better and for worse, likely influence the development of executive- function skills. Ultimately, early-childhood educators around the world are interested in knowing whether executive-function skills contribute to school success and, if so, whether it’s worth making an investment to improve these skills. We hope to continue to play a central role in answering those questions.