Do Executive Function Interventions Improve Children's Everyday Executive Functioning? A Systematic Review and Three-Level Meta-Analysis of Behavioral Report Measures

Executive function (EF) interventions are widely used to promote children's cognitive and behavioral development. However, previous meta-analyses on EF intervention outcomes have relied exclusively on laboratory-based performance tasks, leaving unclear whether intervention effects generalize to children's everyday functioning. The present systematic review and three-level meta-analysis synthesized evidence from studies using behavioral report measures of EF, including questionnaires and rating scales completed by parents, teachers, children, or researchers. Seven electronic databases were systematically searched following PRISMA guidelines. Nineteen studies met the inclusion criteria, contributing 83 effect sizes from 2,142 typically developing children. A three-level random-effects meta-analysis was conducted to account for the dependency among multiple outcomes reported within studies. Overall, EF interventions produced a small but statistically significant improvement in everyday executive functioning (g = 0.17, 95% CI [0.03, 0.32]). Moderator analyses suggested larger effects for EF-specific curricula than for other intervention approaches, although these findings should be interpreted cautiously because of the limited number of studies within intervention categories. The review also revealed important gaps in the literature: behavioral report outcomes remain substantially underrepresented relative to laboratory measures, nearly 80% of studies relied on the Behavior Rating Inventory of Executive Function (BRIEF), and almost half of the evidence originated from the United States. These findings provide the first quantitative evidence that EF interventions can produce modest improvements in children's everyday executive functioning while highlighting the need for more diverse behavioral measures, greater replication of intervention programs, and increased attention to ecologically valid outcomes when evaluating intervention effectiveness.