The findings of a meta-analysis in JAMA Pediatrics suggest that a variety of interventions are effective in improving self-regulation skills in children and adolescents.
Self-regulation is the concept of controlling one’s own emotions, behaviors, and focus. The cognitive processes behind these skills, such as ability to direct attention and think flexibly, are commonly referred to as “executive functions.”
The authors of the systematic review identified 32 randomized clinical trials and 17 cluster randomized trials that included 23,098 participants aged 2 to 17 years (median age 6 years, mean 462 patients per study). All studies were in English and reported outcomes on self-regulation.
The studies were grouped by intervention type, including curriculum-based interventions (such as roleplay and circle time games), family-based interventions, yoga and mindfulness, exercise, and social and personal skills training. The latter tended to report larger effect sizes, perhaps because of their focus on more specific skills. Among 50 trials, 33 reported positive outcomes.
The outcomes evaluated included academic success, conduct problems, substance use, number of school suspensions, mental health, and behavioral problems. The authors noted that improvements in academic success might make self-regulation interventions particularly helpful to children from low-income backgrounds, who made up 34.3% of the participants in the review.
One limitation the study faced was considerable heterogeneity (I²=77.0%). A meta-analysis of intervention type did not help investigators identify the source of this heterogeneity, but subgroup analysis pointed to the reporting method (parent, teacher, or self) as a source. Restricting the analysis to studies that used performance testing reduced the I² score to 39.3%.
“The findings of this review would be useful for policy makers, educators, and health professionals focusing on prevention as [self-regulation] attracts more attention as an intervention target,” the authors said. “The findings can be a useful aid when designing [self-regulation] interventions, with a range of effective intervention strategy options available.”
Pandey A, Hale D, Das S, Goddings A-L, Blakemore S-J, Vine RM. Effectiveness of universal self-regulation-based interventions in children and adolescents: a systematic review and meta-analysis [published online April 16, 2018]. JAMA Pediatr. doi:10.1001/jamapediatrics.2018.0232