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Activities and Programs That Improve Children’s Executive Functions

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Executive functions (EFs; e.g., reasoning, working memory, and self-control) can be improved. Good news indeed, since EFs are critical for school and job success and for mental and physical health. Various activities appear to improve children’s EFs. The best evidence exists for computer-based training, traditional martial arts, and two school curricula. Weaker evidence, though strong enough to pass peer review, exists for aerobics, yoga, mindfulness, and other school curricula. Here I address what can be learned from the research thus far, including that EFs need to be progressively challenged as children improve and that repeated practice is key. Children devote time and effort to activities they love; therefore, EF interventions might use children’s motivation to advantage. Focusing narrowly on EFs or aerobic activity alone appears not to be as efficacious in improving EFs as also addressing children’s emotional, social, and character development (as do martial arts, yoga, and curricula shown to improve EFs). Children with poorer EFs benefit more from training; hence, training might provide them an opportunity to “catch up” with their peers and not be left behind. Remaining questions include how long benefits of EF training last and who benefits most from which activities.
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Current Directions in Psychological
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21(5) 335 –341
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Diverse activities have been reported in research papers pub-
lished in peer-reviewed journals to improve children’s execu-
tive functions (EFs). These activities include computer-based
training, certain school curricula, and training in aerobics, tra-
ditional martial arts, yoga, or mindfulness (for a review, see
Diamond & Lee, 2011). In this paper, I address what can be
learned from these many studies.
First, What Are EFs?
EFs are a family of control functions needed when you have to
concentrate and think, when acting on your initial impulse
might be ill-advised. These functions depend on a neural cir-
cuit in which the prefrontal cortex plays a prominent role
(Anderson, Jacobs, & Anderson, 2008; Bialystok & Craik,
2005). There is general agreement that there are three core
EFs: inhibition (also called “inhibitory control”), working
memory, and cognitive flexibility (e.g., Miyake et al., 2000).
These form the foundation for higher-order EFs, such as
reasoning, problem solving, and planning (Christoff, Ream,
Geddes, & Gabrieli, 2003; Collins & Koechlin, 2012; Lunt
et al., 2012).
Inhibition is important for (a) controlling one’s behavior—
for example, by overriding habitual responses, exerting self-
control (i.e., resisting temptations, such as the temptation to
overeat or to respond impulsively rather than giving a more
considered response), and exercising discipline (e.g., resisting
the temptation to not complete a task); (b) controlling
one’s attention (selective or focused); and (c) controlling one’s
emotions so as not to act inappropriately (an aspect of self-
regulation). In a longitudinal study in which 1,000 children
born in the same city in the same year were followed for 32
years, Moffitt et al. (2011; Moffitt, 2012) found that children
whose inhibition was worse (i.e., they had less persistence,
more impulsivity, and poorer attention regulation) between the
ages of 3 and 11 grew up to have worse health, earn less
money, be less happy, and commit more crimes 30 years later
than did those who had better inhibitory control as children,
controlling for IQ, gender, social class, and home and family
circumstances during childhood. Moffitt et al. (2011) con-
cluded that because the effects of inhibitory control follow a
linear gradient, “interventions that achieve even small
improvements in [inhibitory control]1 for individuals could
shift the entire distribution of outcomes in a salutary direction
Corresponding Author:
Adele Diamond, Department of Psychiatry, University of British Columbia,
2255 Wesbrook Mall, Vancouver, BC V6T 2A1, Canada
E-mail: adele.diamond@ubc.ca
Activities and Programs That Improve
Children’s Executive Functions
Adele Diamond
Depar tment of Psychiatry, University of British Columbia
Abstract
Executive functions (EFs; e.g., reasoning, working memory, and self-control) can be improved. Good news indeed, since EFs
are critical for school and job success and for mental and physical health. Various activities appear to improve children’s EFs.
The best evidence exists for computer-based training, traditional martial arts, and two school curricula. Weaker evidence,
though strong enough to pass peer review, exists for aerobics, yoga, mindfulness, and other school curricula. Here I address
what can be learned from the research thus far, including that EFs need to be progressively challenged as children improve
and that repeated practice is key. Children devote time and effort to activities they love; therefore, EF interventions might
use children’s motivation to advantage. Focusing narrowly on EFs or aerobic activity alone appears not to be as efficacious
in improving EFs as also addressing children’s emotional, social, and character development (as do martial arts, yoga, and
curricula shown to improve EFs). Children with poorer EFs benefit more from training; hence, training might provide them
an opportunity to “catch up” with their peers and not be left behind. Remaining questions include how long benefits of EF
training last and who benefits most from which activities.
Keywords
intervention, training, executive control, working memory, self-regulation, cognitive control, inhibition, self-control,
prefrontal cortex, aerobics, yoga, martial arts
336 Diamond
and yield large improvements in health, wealth, and crime rate
for a nation” (p. 2694).
Working memory refers to holding information in mind and
mentally working with it. It is crucial for making sense of any-
thing that unfolds over time, for that requires holding in mind
what happened earlier and relating it to what is happening
now. Therefore, working memory is necessary for making
sense of any linguistic information, whether read or heard. It is
also needed for mentally reordering items (e.g., reorganizing a
to-do list), understanding cause and effect, and mentally relat-
ing pieces of information to derive a general principle or see
novel relations among old ideas.
Cognitive flexibility refers to the ability to change perspec-
tives (e.g., to see something from another person’s point of
view), change the way you think about a problem (e.g., think
outside the box to attack a problem from a different angle),
and be flexible enough to adjust to changed demands or priori-
ties, admit you were wrong, and take advantage of sudden,
unexpected opportunities.
EFs are critical for success in school (Alloway & Alloway,
2010; Borella, Carretti, & Pelgrina, 2010; Duckworth &
Seligman, 2005; Gathercole, Pickering, Knight, & Stegmann,
2004), on the job (Bailey, 2007), in friendships (Rotenberg,
Michalik, Eisenberg, & Betts, 2008), and in marriage (Eakin
et al., 2004); for mental and physical health (Baler & Volkow,
2006; Miller, Barnes, & Beaver, 2011); and for quality of life
(J. C. Davis, Marra, Najafzadeh, & Lui-Ambrose, 2010).
Improving EFs early in life is important because EF problems
in early childhood predict EF problems years later (Friedman
et al., 2007; Moffitt et al., 2011), and early EF deficits often do
not disappear but can grow larger over time (O’Shaughnessy,
Lane, Gresham, & Beebe-Frankenberger, 2003; Riggs, Blair,
& Greenberg, 2003).
What Do We Know About Programs and
Strategies for Improving EFs in Young
Children?
Although all the studies that I discuss here passed peer review,
not all provide equally compelling evidence. The strongest
evidence for an activity improving children’s EFs exists for
Cogmed computer-based training for working memory and
reasoning (Bergman Nutley, 2011; Holmes, Gathercole, &
Dunning, 2009; Klingberg et al., 2005; Thorell, Lindqvist,
Bergman, Bohlin, & Klingberg, 2009), a combination of
computerized and interactive games (Mackey, Hill, Stone,
& Bunge, 2011), task-switching computer-based training
(Karbach & Kray, 2009), traditional tae kwon do (Lakes &
Hoyt, 2004), and two add-ons to school curricula: Promoting
Alternative Thinking Strategies (PATHS; Riggs, Greenberg,
Kusché, & Pentz, 2006) and the Chicago School Readiness
Project (CSRP; Raver et al., 2008, Raver et al., 2011).
All the studies above used random assignment, included an
active control group and pre- and post-intervention measures,
and found convincing evidence that training effects transferred
to more than one objective measure of EFs on which the chil-
dren had not been trained. Studies that have thus far looked at
the benefits to children’s EFs from aerobics (C. L. Davis et al.,
2011; Kamijo et al., 2011; Tuckman & Hinkle, 1986), mind-
fulness (Flook et al., 2010), yoga (Manjunath & Telles, 2001),
the Tools of the Mind early childhood curriculum (Diamond,
Barnett, Thomas, & Munro, 2007), and the Montessori cur-
riculum (Lillard & Else-Quest, 2006) have lacked one or more
of the above features.
In the next two sections, I discuss a few principles that hold
regardless of the program or intervention used.
General principles that apply to EF training
Those who most need improvement benefit the most.
Children with the weakest EFs benefit the most from any EF
intervention or program (Flook et al., 2010; Karbach & Kray,
2009; Lakes & Hoyt, 2004). Hence, early EF training should
be an excellent candidate for leveling the playing field and
reducing social disparities in EFs, thus heading off social dis-
parities in academic achievement and health (O’Shaughnessy
et al., 2003). Because EFs predict school readiness (Blair &
Razza, 2007), later academic performance (Raver et al., 2011;
Li-Grining, Raver, & Pess, 2011), and mental and physical
health (Moffitt et al., 2011), if the early disparity in EFs is nar-
rowed, the disparity in school readiness and academic and
health outcomes should be narrowed as well.
Transfer effects from EF training are narrow. EF training
appears to transfer (i.e., produce benefits to performance of
tasks other than the task used in training), but transfer from
computer-based working memory and reasoning training
observed in studies thus far has been narrow. In children, train-
ing on working memory improves performance on untrained
working memory tasks, but it does not improve inhibition
(Thorell et al., 2009) and probably does not improve reasoning
or problem solving (Bergman Nutley et al., 2011; Thorell et al.,
2009; but see Klingberg et al., 2005). Training on reasoning
improves performance on untrained reasoning tasks but does
not improve working memory (Bergman Nutley et al., 2011)
or processing speed (Mackey et al., 2011). The effects of non-
verbal-reasoning training transfer to the same type of nonver-
bal reasoning but not to a different type of nonverbal reasoning
(Bergman Nutley et al., 2011). Bergman Nutley et al. (2011)
found that the effects of training on nonverbal working mem-
ory transferred to other measures of nonverbal working mem-
ory but not to a measure of verbal working memory.
EF gains resulting from training on task switching
(Karbach & Kray, 2009), traditional martial arts (Lakes &
Hoyt, 2004), and school curricula (Raver et al., 2011; Riggs
et al., 2006) are wider, perhaps because these programs address
EFs more globally. Thus, the transfer to particular EFs may be
just as narrow, but the programs address more EF components.
For example, the effects of training on task switching (which
Improving Children’s Executive Functions 337
arguably requires all three core EFs) were found to transfer not
only to an untrained task-switching task, but also to tests of
inhibition, verbal and nonverbal working memory, and reason-
ing (Karbach & Kray, 2009).
Children’s EFs should be challenged throughout training.
EF demands need to keep increasing as children’s EFs
improve, or few gains will be seen (Bergman Nutley et al.,
2011; Holmes et al., 2009; Klingberg et al., 2005). There may
be two reasons for this. First, if people don’t keep pushing
themselves to do better, they stop improving. Second, if the
difficulty of an activity doesn’t increase, it becomes boring,
and children lose interest. This has been a criticism of the con-
trol conditions in Cogmed studies.
Repeated practice is key. Whether EF gains are seen depends
on the amount of time children spend doggedly working on
these skills, pushing themselves to improve (Klingberg et al.,
2005). This is consistent with what Ericsson (e.g., Ericsson,
Nandagopal, & Roring, 2009) has found to be key for being
truly excellent at anything: hours and hours of practice trying
to master what is just beyond your current level of competence
and comfort (working in what Vygotsky, 1978, would call the
“zone of proximal development”). Similarly, school curricula
shown to improve EFs train and challenge children’s EFs
throughout the day, embedding practice in all activities (which
may also have the benefit of varying the content and kind of
EF practice) rather than in a single, isolated module (Diamond
et al., 2007; Lillard & Else-Quest, 2006; Riggs et al., 2006).
Whether EF gains are produced depends on how an
activity is done. For example, in a study with adolescent
juvenile delinquents (Trulson, 1986), some adolescents were
assigned to traditional tae kwon do, which emphasizes not only
physical conditioning but also character development and self-
control (e.g., waiting until your opponent attacks or is off bal-
ance and then taking advantage of that). Others were assigned
to “modern martial arts” (i.e., martial arts as a competitive
sport, emphasizing only the physical aspect, with no emphasis
on exercising self-control). Compared with the adolescents
who were trained in modern martial arts, those who were
trained in traditional tae kwon do showed less aggression and
anxiety and improved social ability and self-esteem. Those
trained in modern martial arts showed more juvenile delin-
quency and aggressiveness and decreased self-esteem and
social ability.
Outcome measures must test the limits of the children’s
EF abilities to see a benefit from training. In studies of EF-
enhancing activities, the largest differences between interven-
tion groups and controls are consistently found on the most
demanding EF tasks and task conditions. It is often only when
the limits of children’s EF skills are pushed that these differ-
ences emerge (C. L. Davis et al., 2011; Diamond et al., 2007;
Manjunath & Telles, 2001).
Activities reported by at least one published
research study to improve EFs
Computerized training. It is clear that working memory and
reasoning can be improved in children via computer-based
training and specially designed games. The most researched
approach for improving children’s EFs, and one repeatedly
found to be successful, is Cogmed computerized training.
When Cogmed training is on working memory, working mem-
ory improves even on untrained tasks (e.g., Klingberg et al.,
2005; Thorell et al., 2009). Two studies (Holmes et al., 2009,
Holmes et al., 2010) have found that gains in working memory
remained 6 months after training. Moreover, although no
immediate gains in math or reading were found after training,
gains in math were evident 6 months later (Holmes et al.,
2009). When Cogmed training is on reasoning, reasoning
improves. Mackey et al. (2011) found that reasoning training
using a combination of computerized and noncomputerized
games also improved reasoning, even on untrained tasks.
Although there is evidence that computer-based training
can improve children’s working memory and reasoning,
attempts thus far to improve 4- to 6-year-olds’ inhibitory con-
trol using computerized inhibitory-control games or training
have not been successful (Rueda, Rothbart, McCandliss,
Saccomanno, & Posner, 2005; Thorell et al., 2009). For exam-
ple, Rueda et al. (2005) found no EF improvements. Older
children (9-year-olds), however, who received computer-
based task-switching training improved in both task switching
and inhibition (Karbach & Kray, 2009). Other approaches
(e.g., school curricula) have improved inhibition in 4- to
6-year-olds. Thus, either computer-based training is not opti-
mal for training inhibitory control in children so young, or the
optimal computer-based approaches have not yet been studied.
No approach demonstrated to improve EFs in young children
has yet been shown to improve their ability to delay gratifica-
tion; however, that ability has only been measured in assess-
ments, not targeted during training (Lillard & Else-Quest,
2006; Raver et al., 2011).
Physical activity. Many studies have found that aerobic exer-
cise improves EFs, but all but three of them have involved
adults and/or examined the effects of only a single bout of
exercise. The three studies in which young children exercised
over an extended period did not find strong effects. (The earli-
est study, by Tuckman & Hinkle, 1986, found the strongest
effects; the most recent study, by Kamijo et al., 2011, found
the weakest).
Exercise alone may be less effective in improving chil-
dren’s EFs than activities that involve both exercise and char-
acter development (e.g., traditional martial arts) or activities
that involve both exercise and mindfulness (e.g., yoga). Lakes
and Hoyt (2004) randomly assigned children in kindergarten
through fifth grade (5- to 11-year-olds) by homeroom class to
take part in either traditional tae kwon do or standard physical
education. Students in the tae kwon do group improved more
338 Diamond
than students in the standard-physical-education group in
working memory and on all dimensions of inhibitory control
studied (e.g., cognitive inhibitory control, measured on a
distractible–focused continuum; discipline, measured on a
quitting–persevering continuum; and emotion regulation).
These effects generalized to multiple contexts and were found
on multiple measures.
In a pilot study of the effects of yoga (which involved phys-
ical training, relaxation, and sensory awareness) on children’s
EFs, 10- and 13-year-old girls were randomly assigned to
either yoga or physical training for 75 minutes a day, 7 days a
week for 1 month (Manjunath & Telles, 2001). Those who did
yoga improved more in planning and execution on the Tower
of London (a task that requires all three core EFs), especially
when task conditions were more difficult and complex, than
did controls.
School curricula. The two curricula empirically shown to
improve children’s EFs—Montessori (Lillard & Else-Quest,
2006) and Tools of the Mind (inspired by Vygotsky, 1978;
Diamond et al., 2007)—share a number of features in common
(Diamond & Lee, 2011). They both (a) help children exercise
their EFs and constantly challenge them to do so at higher lev-
els; (b) reduce stress in the classroom; (c) rarely embarrass a
child; (d) cultivate children’s joy, pride, and self-confidence;
(e) take an active and hands-on approach to learning; (f) easily
accommodate children progressing at different rates; (g) em -
phasize character development as well as academic develop-
ment; (h) emphasize oral language; (i) engage children in
teaching one another; and (j) foster social skills and bonding.
Many of these characteristics are also true of the two programs
designed to complement school curricula that have been
shown to improve EFs: PATHS (Riggs et al., 2006) and CSRP
(Raver et al., 2011). Disadvantaged preschool children ran-
domly assigned to a CSRP Head Start class showed better EFs
than did controls at the end of that preschool year; moreover,
they continued to perform better than controls in math and
reading for the next 3 years, and those academic gains were
mediated almost entirely through improved EFs (Li-Grining
et al., 2011).
Both Tools of the Mind and CSRP are meant to be used
only with children aged 3 to 6. None of the four programs
shown to improve EFs have reported EF benefits in children
older than 9 years of age. Thus, the effects of school curri-
cula have been studied so far only in very young children.
The school programs and their assessment have concentrated
heavily on inhibitory control. A randomized control trial of
Tools of the Mind is currently underway (Farran & Wilson,
2011). This study is particularly noteworthy because of
its impeccable research design and the meticulous way in
which it is being conducted. The first year of data collection
failed to show a benefit from Tools of the Mind, but that may
have been because of floor and ceiling effects of the EF
measures.
Conclusions and Future Directions
Clearly, EFs can be improved in children, even in those as
young as 4 or 5 years of age, without specialists and even
without computers. To improve EFs, focusing narrowly on
them may be less effective than also addressing emotional and
social development (as do curricula shown to improve EFs)
and/or physical fitness (as do aerobics, martial arts, and yoga).
I hypothesize that the programs that will most successfully
improve EFs are those that challenge EFs continually and also
bring children joy and pride, give them a feeling of social
inclusion and belonging, and help their bodies to be strong, fit,
and healthy (Diamond, in press). Figure 1 illustrates this
hypothesized model.
No one has yet looked at the available data to see what,
other than amount of practice and baseline EFs, distinguishes
children who benefit from EF interventions from children who
do not. We know little about whether the benefits of EF inter-
ventions last and, if so, how long they last, in which domains,
and what factors affect how long they last. Only one study
(C. L. Davis et al., 2011) has systematically varied dosage
(i.e., how much time was devoted to the activity at each indi-
vidual session) or frequency. We know little about how the
optimal dose, frequency, or duration of an intervention might
vary as a function of a child’s age or the type of activity. Which
kind of program helps children most at which age? Research
to date has suggested that Cogmed and martial arts might work
best for children 8 years of age and older, whereas the efficacy
of school curricula in improving EFs has been demonstrated
(and studied) only in very young children and primarily for
inhibitory control.
It is likely that many activities not yet studied might
improve children’s EFs (e.g., theater, orchestra, choir, caring
for an animal, filmmaking, basketball, street soccer, rowing
crew, rock climbing, and more). Who might benefit most from
which activity? Which activities produce the most long-lasting
benefits, and why? Given the drawbacks of randomized con-
trol trials and that they are not always feasible, what other
research approaches might work well for investigating the
efficacy of various activities for improving children’s EFs?
Whether EF gains are seen depends on the way in which an
activity is done and the amount of time one spends doing it,
pushing oneself to do better. It’s the discipline, the practice,
that produces the benefits. The most important element of a
program might be that it involves an activity children love, so
they will devote intensive time and effort to it. An enthusiastic,
charismatic adult can often engender that passionate interest in
children. Improving EFs and thus school and job success is
serious business, yet there is no reason one needs to be grim
though working hard on important matters; one can be joyful
even while working hard. Indeed, research has shown that
people are more creative and have more energy for their work
if they are passionate about it (e.g., Hirt, Devers, & McCrea,
2008). Why not harness children’s passionate interests in the
Improving Children’s Executive Functions 339
service of the children’s positive development and academic
success?
Recommended Reading
Best, J. R. (2010). Effects of physical activity on children’s execu-
tive function: Contributions of experimental research on aerobic
exercise. Developmental Review, 30, 331–551. Provides a review
of the effects of physical exercise on EFs.
Chaddock, L., Pontifex, M. B., Hillman, C. H., & Kramer, A. F. (2011).
A review of the relation of aerobic fitness and physical activity
to brain structure and function in children. Journal of the Interna-
tional Neuropsychological Society, 17, 1–11. Provides a review of
the effects of physical exercise on EFs and on prefrontal cortex.
Diamond, A., & Lee, K. (2011). (See References). Provides a review
of a variety of approaches for improving EFs, with extensive
details on studies in supplementary tables.
Klingberg, T. (2010). Training and plasticity of working memory.
Trends in Cognitive Science, 14, 317–324. Provides a review
of the effects on EFs and on the brain of different attempts to
improve EFs.
Melby-Lervåg, M., & Hulme, C. (2012). Is working memory training
effective? A meta-analytic review. Developmental Psychology.
Advance online publication. doi: 10.1037/a0028228. Provides a
review of computerized working memory training.
Morrison, A. B., & Chein, J. M. (2011). Does working memory training
work? The promise and challenges of enhancing cognition by train-
ing working memory. Psychonomic Bulletin & Review, 18, 46–60.
Provides a review of computerized working memory training.
Declaration of Conflicting Interests
The author declared that she had no conflicts of interest with respect
to her authorship or the publication of this article.
Funding
The author gratefully acknowledges support from the National
Institute on Drug Abuse (Grant R01 DA019685) during the writing
of this paper.
Builds EFs:
Requires
Concentration,
Focus, Discipline,
Holding Complex
Sequences in
Working Memory,
and Quick,
Flexible
Adaptation to
Changed
Circumstances
Program
or
Intervention
Indirect Routes
Direct Route
Increases Feelings of
Social Belonging and
Support
Builds Confidence,
Pride, and Sense of
Self-Efficacy
Increases Joy
Reduced
Incidence and/or
Severity of EF
Disorders (e.g.,
ADHD,
Addictions, and
Conduct Disorder)
Improved
Academic
Outcomes and
School Success
Improves Physical
Fitness
Positive
Feedback
Loops
Positive
Feedback
Loops
Fig. 1. Prefrontal cortex and executive functions (EFs) are the first area of the brain and mental functions to
suffer, and suffer disproportionately, if you are sad (von Hecker & Meiser, 2005), stressed (Arnsten, 1998) , lonely
(Cacioppo & Patrick, 2008) , or not physically fit (Hillman, Erickson, & Kramer, 200 8). Unmet emotional, social, or
physical needs work against displaying good EFs. Conversely, when people are less stressed, happier, more physically
fit, and socially suppor ted, they can think more clearly and creatively and exercise better self- control and discipline
(i.e., display better EFs). Therefore, I hypothesize that programs that will most successfully improve children’s
EFs are those that require and directly challenge EFs and suppor t EFs indirectly by reducing children’s stress or
improving their ability to handle stress, increasing their joy, helping them feel that they belong and that others are
there for them, and improving their physical fitness.
340 Diamond
Note
1. The authors used the term “self-control” here, but what they
assessed was broader than just self-control and encompassed inhibi-
tory control more generally.
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... The executive functions encompass a set of control skills necessary to concentrate, think and act (Diamond, 2012). They are essential to successfully perform various everyday tasks and establish a connection between the individuals and the environment. ...
... Based on psychometric data, Miyake et al. (2000) proposed three core executive functions -working memory, inhibitory control and cognitive flexibility, which are the basis for the formation of complex executive functions such as reasoning, problem solving and planning (Diamond, 2012). This is the model with the most reports in the literature, as it has been widely accepted in neuropsychological studies. ...
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The collected papers from the most prestigious symposia in the field of child development provide scholars, students, and practitioners with access to the work of key researchers in human development. This volume focuses on changes in our understanding of cogisnitive control processes-constructs important to the field since Wundt and Freud. Our understanding of these constructs has advanced dramatically in recent years-both empirically and conceptually. This collection brings generalists and specialists alike up-to-date on this central process of human development and the implications for this new knowledge on school success and other areas.
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