Combining Physical and Cognitive Training To Improve Kindergarten Children's Executive Functions.

Contemporary Educational Psychology 63 (2020) 101908
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Contemporary Educational Psychology

journal homepage: www.elsevier.com/locate/cedpsych
Combining physical and cognitive training to improve kindergarten T

children’s executive functions: A cluster randomized controlled trial
Mirko Schmidta, , Myrto F. Mavilidib, Annina Singhc, Chris Englertd
⁎
a
Institute of Sport Science, University of Bern, Bremgartenstrasse 145, 3012 Bern, Switzerland
b
Early Start, School of Education, University of Wollongong, 2522 Keiraville, Australia
c
Department of Psychology, Zurich University of Teacher Education, Lagerstrasse 2, 8090 Zurich, Switzerland
d
Institute of Sports Sciences, Goethe University Frankfurt, Ginnheimer Landstraße 39, 60487 Frankfurt am Main, Germany
ARTICLE INFO ABSTRACT
Keywords: Considering the convincing evidence that executive functions predict academic achievement significantly,
Cognition strategies to foster executive functions in the early school years are highly requested. Besides traditional cog
Physical activity nitive training, combined physical and cognitive interventions are intended to be a feasible way of enhancing
Chronic exercise both children’s daily physical activity and executive functions. The purpose of the present study was therefore to
Accelerometer
test the effectiveness of a six-week combined physical-cognitive intervention, and to compare it to both a se
Mental effort
School
dentary cognitive intervention and a waitlist control group. Using a between-subjects experimental design, 189
children aged between four and six years (M = 5.34, SD = 0.59) were recruited from 14 kindergarten classes,
which were randomly assigned to one of three experimental conditions: (a) combined physical and cognitive
training, (b) sedentary cognitive training or (c) waitlist control group. Before and after the interventions, all
three core executive functions of updating, inhibition and shifting were measured. Physical activity was ob
jectively measured using accelerometers during one intervention session. Linear mixed models revealed that
children from both the combined physical-cognitive and the sedentary cognitive intervention improved their
updating performance compared to the children of the control group. Inhibition and shifting remained un
affected by both interventions. With respect to children’s daily physical activity, linear mixed models showed
that only the combined physical-cognitive intervention could significantly increase the amount of step counts.
The results underline the feasibility of combined physical-cognitive interventions to enhance children’s daily
physical activity and their cognitive performance.
1. Introduction to be negatively associated with a wide range of school-related beha

vioral problems (Blair & Diamond, 2008; Espy, Sheffield, Wiebe, Clark,
The ability to initialize, control and organize goal-directed behavior & Moehr, 2011; Friedman et al., 2007). Considering the relevance of
is essential for every human being in modern society. Three core cog EFs for children’s daily behavior and performance at school, the ques
nitive control processes that are necessary for such goal-directed be tion of how these cognitive processes can be enhanced arises.
havior are generally referred to as executive functions (EFs; Miyake
et al., 2000). These include the ability to hold information in mind and 1.1. Direct and indirect cognitive trainings to improve EFs
process it (updating), inhibit prepotent or automatic responses and deal
with interfering distractors (inhibition), and to change perspectives or Various types of interventions have been proposed to foster EFs in
react and adapt to changing tasks and demands of the environment children (Diamond & Lee, 2011), including computer-based trainings,
(shifting). EFs have been shown to predict school readiness in young educational programs and physical activities (Diamond, 2015; Karbach
children (Blair & Diamond, 2008; Roebers et al., 2014), and are con & Unger, 2014; Mackey, Hill, Stone, & Bunge, 2011; Tomporowski &
sistently reported to robustly predict academic achievement to a large Pesce, 2019). Despite the ongoing debate on the effectiveness and the
extent (Bull, Espy, & Wiebe, 2008; Schmidt et al., 2017; Viterbori, Usai, transfer of training effects (Kassai, Futo, Demetrovics, & Takacs, 2019;
Traverso, & de Franchis, 2015). Additionally, they have also been found Melby-Lervag & Hulme, 2013; Morrison & Chein, 2011), there seems to
Corresponding author.
⁎
E-mail addresses: [email protected] (M. Schmidt), [email protected] (M.F. Mavilidi), [email protected] (A. Singh),
[email protected] (C. Englert).
https://doi.org/10.1016/j.cedpsych.2020.101908
Available online 11 August 2020

0361-476X/ © 2020 Elsevier Inc. All rights reserved.
M. Schmidt, et al. Contemporary Educational Psychology 63 (2020) 101908
be convincing evidence that EFs can be enhanced if interventions are 1.2. Physical activity to improve EFs
designed to be constantly challenging, playful, and enjoyable (Diamond
& Ling, 2016; Takacs & Kassai, 2019). Many school-based interventions, As indicated by the conclusions drawn in several systematic reviews
which can be classified into direct or indirect trainings, have been de and meta-analyses (Álvarez-Bueno et al., 2017; De Greeff et al., 2016;
veloped and evaluated in recent years (Otero, Barker, & Naglieri, 2014; Hillman & Biggan, 2017), physical activity is a promising approach to
Scionti, Cavallero, Zogmaister, & Marzocchi, 2020). improve children’s EFs, whereby in exercise and cognition research
On the one hand, direct trainings are typically conceptualized to there is a clear distinction between the effects of acute and chronic
target one single EF, for instance computerized working memory physical activity on cognitive functioning (Best, 2010). Whereas acute
training (Klingberg, Forssberg, & Westerberg, 2002), which specifically physical activity denotes single bouts of physical activity provoking
stimulates working memory. For example, in a sample of 101 four year instant changes in cognitive functioning, chronic physical activity in
old children, Bergman Nutley et al. (2011) tested the effects of a cludes multiple sessions or habitual physical activity, provoking cog
computerized working memory training (15 min/day for 25 days) on nitive changes evident in the long term (Pesce, 2012). Depending on the
different working memory and problem solving measures. They found disciplinarity as well as the temporal perspective, the effects of physical
improvements on several trained and non-trained working memory activity on cognition are explained by different underlying mechanisms
tests, but not on problem solving tests. By way of example, this study (Mavilidi et al., 2018).
shows that direct trainings are generally capable to evoke larger im From a physiological perspective, multiple mechanisms are pro
provements within the specific domain, but mostly fail in producing far posed to contribute to the effects of acute physical activity on cognition
transfer effects (see also Melby-Lervag & Hulme, 2013). (Pontifex et al., 2019). Research using acute bouts of physical activity
On the other hand, indirect trainings are mostly designed to target have shown modulated event-related potentials (Hillman, Kamijo, &
multiple EFs through a broader range of activities that can be easily Scudder, 2011; Khan & Hillman, 2014) and an increased functional
embedded in the preschool curriculum, such as, for example, Tools of connectivity of brain networks (Weng et al., 2017). These neurophy
the Mind (Bodrova & Leong, 2007); a one-two-year intervention based siological changes are, in turn, thought to lead to altered psychological
on 40 EF-promoting activities. Assigning children from low-income states, such as increased arousal, making a larger pool of attentional
families to either a “Tools” group or an active control group covering resources available and therefore facilitating performance in sub
the same academic content without addressing EFs, Diamond, Barnett, sequent cognitively effortful tasks (Audiffren, Tomporowski, &
Thomas, and Munro (2007) found that children receiving “Tools” out Zagrodnik, 2009). From a psychological perspective, there is another
performed their counterparts of the control group, especially in the explanation for cognitive improvements induced by acute and chronic
most demanding EF tasks. Even though indirect interventions mostly physical activity, elaborated by the cognitive stimulation hypothesis.
lead to smaller effect sizes than direct trainings, they seem to be capable The assumption of the cognitive stimulation hypothesis is that non-
of producing substantial transfer effects (Diamond & Ling, 2016). In automated and cognitively challenging physical activity activates the
addition, a recent meta-analysis has shown that indirect trainings which same brain regions that are used to control higher-order cognitive
target core EFs implicitly, for example by means of constantly chal processes (Best, 2010; Pesce, 2012; Tomporowski, McCullick,
lenging and playful games, are “similarly or more effective, and these Pendleton, & Pesce, 2015). Thus, enhanced cognitive performance after
activities are more enjoyable and can be more easily embedded in a single bout of (acute) physical activity is explained by a specific pre-
children’s everyday activities” (Takacs & Kassai, 2019, p. 1). activation of those exact cognitive processes, which are then used in a
In recent years, researchers have developed interventions that subsequent cognitive task (Budde et al., 2008). For the effects of chronic
combine the advantages from both direct and indirect trainings. To physical activity, it is assumed that the repeated addressing of EF
enhance the effectiveness and the ecological validity for the school processes through designed physical activities leads to a long-term
setting, these interventions are generally characterized by activities change of only those EFs, which are specifically addressed by the
that are designed to target specific core EFs (as in direct trainings), but training (Herold, Hamacher, Schega, & Müller, 2018). This con
by applying a game-centered and group-based approach (as in indirect ceptualization of transfer as a limited phenomenon is not novel, going
trainings). For example, Röthlisberger, Neuenschwander, Cimeli, back to Thorndike and Woodworth (1901). Its revival was brought
Michel, and Roebers (2011) evaluated the effects of an intervention about and developed further in modern transfer theories, such as the
specifically targeting the three core EFs in preschool and early primary primitive elements theory of cognitive skills (Taatgen, 2013). According
school children (6-year-old). After completing their program, which to these theories, and considering meta-analytical evidence showing
consisted of cognitively challenging games over a duration of six weeks, only near-, but not far-transfer effects among children’s EFs (Kassai
typically developing children in the intervention group improved their et al., 2019), physical activities should be designed in a way that trig
interference control regarding their response accuracy to a stronger gers the same EFs that one intends to improve. This supposition of
degree than the children in the control group. Using the same inter shared cognitive processes is based on both theoretical and neuroima
vention material, but adapting the difficulty level to suit the age group ging literature.
of 10–12-year old school children, Benzing et al. (2018) found larger In theoretical frameworks, overlapping conceptualizations of motor
improvements in updating and shifting performance of children in the and cognitive control become apparent: In the cognitive literature,
experimental group, compared to the waiting control. For this, an in cognitive control, executive control or executive functioning describes
tervention was used which trained their EFs by means of group-based cognitive processes involving monitoring, planning, sequencing and
card and board games, completed twice a week for 30 min each. adapting ongoing operations (Best & Miller, 2010; Miyake et al., 2000).
Another longitudinal study evaluating the effects of a chronic In the literature on motor behavior and development, the term motor
training intervention in 5-year-old children reported similar results control is used to describe motor planning, organizing, monitoring,
(Traverso, Viterbori, & Usai, 2015), where they employed a comparable motor-coordinative adjustment as well as cross-modal integration, ra
game-based intervention using low-cost material, consisting of 12 ses ther than motor power or motor speed. Similar to the cognitive domain,
sions over the period of one month. Results revealed an improvement in motor control is needed under high demands of speed and accuracy
all three core EFs in children of the training group, compared to chil (Schmidt & Lee, 2011). From these definitions it is obvious that motor
dren in the control group. When the same intervention was adminis control involves EFs (Diamond, 2000; Roebers & Kauer, 2009), for ex
tered by regular teachers instead of a trained psychologist (to verify its ample, updating of task requirements enabling forward planning in a
ecological validity), only the inhibition scores improved over time dance choreography, inhibition of frequently used movements (pre
(Traverso, Viterbori, & Usai, 2019). All these studies, however, com potent responses) in anti-imitation games, or shifting the focus of at
pared their intervention to a control group without specific treatment. tention in sports with fast changing situations (Tomporowski et al.,
2
2015). challenging chronic physical activity can be achieved in kindergarten

More direct evidence for this theoretical assumption of shared in children using a shorter and thus more feasible intervention. Despite
formation processes in both motor and cognitive control stems from the explicit call for more research, in which the “right” control group is
neuroscience literature. Neuroimaging studies indicate that for the carefully chosen (Singh et al., 2019), studies of combined interventions
mastery of executive function tasks (involving executive control of at using both cognitive and physical demands in kindergarten children are
tention and working memory) and motor-coordinative tasks (empha still lacking in research.
sizing speed and accuracy of motor responses), the prefrontal cortex
and the cerebellum are primarily activated (Diamond, 2000; Serrien, 1.4. The current study
Ivry, & Swinnen, 2007). In sum, EFs are involved not only in mastery of
complex cognitive tasks, but also in certain motor tasks. In the current study, therefore, we wanted to examine the influence
of a combined physical-cognitive intervention on the three core EFs in
1.3. Empirical evidence on the effects of acute and chronic physical activity kindergarten children. Since both direct cognitive trainings and phy
sical activity programs are considered advantageous in promoting EFs
Against this theoretical and neuroscientific overlap between action in young children (Diamond & Ling, 2016), in the present study, we
and cognition, researchers have started to recognize the importance of expected a stronger positive effect of our indirect training when adding
qualitative characteristics when specifically designing physical activity physical activity on top of the cognitive intervention. Given the over
interventions to improve EFs (Pesce & Ben-Soussan, 2016; Pesce, 2012). lapping processes inherent in motor performance and EFs (Oberer,
Considering, for example, the idea that various physical activities may Gashaj, & Roebers, 2018; Roebers et al., 2014; Schmidt et al., 2017),
not only differ in their intensity, duration, and frequency, but also, for and that previous research has found positive effects of a combined
example, in their cognitive challenges, necessitating EFs to master them intervention with both cognitive engagement and physical activity
(Vazou, Pesce, Lakes, & Smiley-Oyen, 2019). Although a recent review compared to pure aerobic exercise in primary school children (Egger
suggested that interventions integrating cognitive and motor compo et al., 2019; Schmidt et al., 2015), we hypothesize that a combined
nents may offer enhanced cognitive and learning benefits in children physical-cognitive intervention will benefit kindergarten children’s EFs
(Mavilidi et al., 2018), findings from acute studies explicitly testing the more than a sedentary cognitive training and an active control condi
cognitive stimulation hypothesis remain equivocal (Paschen, Lehmann, tion. To test these hypotheses, an intervention with both cognitively
Kehne, & Baumeister, 2019). Some studies have revealed positive ef demanding and physically engaging games (gross motor activities) was
fects on cognitive performance in favor of the cognitively challenging developed and compared against an intervention with equal amounts of
condition (Benzing, Heinks, Eggenberger, & Schmidt, 2016; Budde cognitive challenge but limited physically engaging games (fine motor
et al., 2008; Jäger, Schmidt, Conzelmann, & Roebers, 2014; Pesce, activities), both carried out in kindergarten classes over a period of six
Crova, Cereatti, Casella, & Bellucci, 2009; Schmidt, Benzing, & Kamer, weeks. Since the most recent meta-analyses investigating both the ef
2016), some have found no difference (Best, 2012; Jäger, Schmidt, fects of chronic physical activity (Xue, Yang, & Huang, 2019) and
Conzelmann, & Roebers, 2015), and others have even reported detri cognitive training interventions (Kassai et al., 2019) on EFs among
mental effects compared to physical activity without cognitive chal children and adolescents did not detect the duration as a significant
lenges (Egger, Conzelmann, & Schmidt, 2018; Gallotta et al., 2012, moderator, we had to derive the optimal duration from those studies
2015). that examined the most similar interventions. Whereas the reviewed
When it comes to chronic physical activity interventions, there is indirect cognitive trainings with positive effects on children’s EFs lasted
tentative evidence that cognitively engaging aerobic exercise requiring between four (Traverso et al., 2015, 2019) and six weeks (Benzing
strategic behaviors, complex motor coordination and adaptation to et al., 2018; Röthlisberger et al., 2011), the trainings with cognitively
changing tasks benefit children’s EFs more than non-engaging simple challenging physical activities lasted between six weeks (Schmidt et al.,
and repetitive activities (Chang, Tsai, Chen, & Hung, 2013; Egger, 2015) and six months (Pesce et al., 2016), with decreased im
Benzing, Conzelmann, & Schmidt, 2019; Koutsandreou, Wegner, plementation fidelity after 10 weeks of intervention time (Egger et al.,
Niemann, & Budde, 2016; Pesce et al., 2016; Schmidt, Jäger, Egger, 2019). Thus, to compare our results with those of previous studies and
Roebers, & Conzelmann, 2015; Van der Niet et al., 2016). For example, to ensure high implementation fidelity (Carroll et al., 2007), a time
in primary school children aged between 10 and 12 years, Schmidt period of six weeks was chosen. A waiting control group with ongoing
et al. (2015) compared a pure aerobic exercise intervention in physical curricular classes was used as a control condition.
education, a team game intervention combining both physical and
cognitive demands, and an active control group. Positive effects were 2. Method
found for children’s shifting performance when using high cognitive
engagement within a physical activity, compared to pure aerobic ac 2.1. Overview
tivities with low cognitive engagement. This underscores the im
portance of cognitive demands within applied physical activities to Two 6-week interventions with diverging levels of physical activity
boost EFs in older children. However, the study did not include a pure were conducted in the classroom and compared to a waiting control
cognitive intervention, which in turn only allows the conclusion that group with respect to their effects on kindergarten children’s EFs.
combining physical activity with cognitive challenges is more effective Classes in the physical-cognitive condition carried out a gross motor
in promoting EFs than a pure aerobic exercise intervention. game program with both high physical and cognitive demands. Classes
To overcome this shortcoming and to replicate these findings in in the cognitive condition went through a similar fine motor game
younger children aged between 7 and 9 years, Egger et al. (2019) program with low physical, but high cognitive demands. Classes in the
conducted a 20-week classroom-based physical activity program, with waiting control group followed the regular school curriculum and re
either high physical exertion and high cognitive engagement (combo ceived all intervention contents following posttest. Altogether, 14
group), high physical exertion and low cognitive engagement (aerobic classes were randomly assigned to one of these three experimental
group), or low physical exertion and high cognitive engagement (cog conditions. The teachers were informed about the basic aims of the
nition group). Results showed that only the combo group displayed en study but were blinded with respect to the specific study hypotheses.
hanced shifting performance. The authors, however, also reported that All kindergarten classes were recruited in the cantons of Bern,
the implementation fidelity decreased after the first 10 weeks, with Lucerne and Zurich (Switzerland). The Institutional Review Board of
teachers testifying the challenges of such long-lasting interventions. the Faculty of Human Sciences at the University of Bern approved
Thus, the question arises of whether the same effects of cognitively ethical consent for the study protocol, which adhered to the latest
3
version of the declaration of Helsinki. The parents/legal guardians of all 2.4. Experimental conditions
participating children signed an informed consent form. All children
were explicitly asked before the first data collection session whether Children were instructed to participate in twelve games (see Tables
they wanted to participate, and informed that they could discontinue at 2 and 3) with increasing difficulty, specifically designed to target EFs
any time during the study. All data were treated confidentially. (Egger et al., 2018, 2019).1 There were four games to be played each
week. After three weeks, all games were repeated, since practice is
required to build up automatic motor and cognitive processes that can
2.2. Participants be inhibited or changed. The games were based on experimental tasks
used in the previous literature that quantify the individual differences
In total, 189 children (91 female) aged between four and six years in EFs (Carlson, 2005) and on action games specifically designed to
(M = 5.34, SD = 0.59) participated in the present study. Detailed foster children’s EFs (Tomporowski, McCullick, & Pesce, 2015). For
sample characteristics are shown in Table 1. There was some loss of example, an adapted version of the well-known imitation game Simon
data due to sick leave, technical problems, or refusal of participation. Says (Strommen, 1973) was used to address children’s inhibition, built
The percentage of pupils with incomplete values ranged between 1.1% upon a Go/No-Go paradigm requiring the playing child to respond to
for the inhibition task and 6.9% for the updating task. Since Little’s target stimuli but inhibit from responding to non-target stimuli. How
Missing Completely at Random test (Little & Rubin, 2002) identified no ever, considering the task-impurity problem (Miyake & Friedman,
systematic pattern in the missing data, χ2 (149) = 241.35, p > .999, 2012) indicating that EFs interact with each other, each game was in
the missing values were imputed using the expectation–maximization tended to tap multiple EFs.
(EM) algorithm. Separate ANOVAs showed that there were no sig To increase the chance of reaching children’s optimal challenge
nificant differences between the three experimental conditions with point (Pesce et al., 2013), each game was designed with three incre
respect to age, F(2, 186) = 0.60, p = .549, ηp2 = 0.006, weight, F(2, mental levels of difficulty. In the first 3 weeks, the games were in
186) = 1.63, p = .199, ηp2 = 0.017, height, F(2, 186) = 0.69, troduced by the teacher and played at a lower difficulty level. From the
p = .505, ηp2 = 0.007, and BMI, F(2, 186) = 1.03, p = .358, fourth week on, depending on the teacher’s judgment of the children’s
ηp2 = 0.011. A chi-square test indicated that the gender distribution did understanding, the difficulty level was raised to adapt to the children’s
not differ between the three groups, χ2(2) = 5.34, p = .068, Cramer’s skills. And by doing this, to constantly maintain high cognitive de
V = 0.169. mands. The level of difficulty was increased by a) adding more items to
Considering a previous study that tested the effects of a chronic be remembered and/or manipulated in short-term storage (updating),
physical-cognitive intervention on all three core EFs with participants introducing new rules, which necessitate responding in a way that
of a comparable age (Egger et al., 2019), an a priori power analysis conflicts with an older rule or a dominant behavior (inhibition), and b)
using G*Power 3 (Faul, Erdfelder, Lang, & Buchner, 2007) was per including multiple rule sets to fluently switch between (shifting). All
formed with power (1 – beta error probability) = 0.80, alpha error games were child-friendly and suitable for kindergarten classrooms. To
probability = 0.05, effect size f = 0.25, numerator df = 3, number of enhance children’s motivation and make them more age-appropriate,
groups = 3, and number of covariates = 1, resulting in an optimal the games were adapted to the frame story of Edi the lizard.
sample size of 179. Physical-cognitive condition. The physical-cognitive training
program consisted of twelve games targeting the three core EFs; up
dating, inhibition, and shifting, whereas the main focus was distributed
2.3. Materials and procedure equally over the duration of the intervention (Table 2). The games were
conceptualized to require gross motor movements, which in turn should
The two interventions were carried out by the regular school tea increase physical activity. For example, in week 6, the imitation game
chers in their classroom, during the morning classes between 9 am and Lizard Edi says (adapted from Strommen, 1973) was played. On the first
12 pm. Prior to the study, teachers completed a half-day training pro level, children had to perform various gross motor movements (e.g.
gram instructing them in the basic principles, aims and purposes of the jumping up, turning quickly in circles), but only when the command of
intervention program, demonstrating the specific contents with the the teacher was prefaced with “Lizard Edi says”. Otherwise, the chil
special teaching materials. Over a period of six weeks, four 15 min dren had to stand still. Then, on the next difficulty level, the task was
sessions per week were carried out in the group setting, whereby the changed in so far, that the children had to carry out the “opposite” of
entire intervention was intended to cover 24 sessions. To test im the commanded movement (e.g. instead of turning quickly, turning
plementation compliance (Dane & Schneider, 1998), teachers had to slow in circles). At the highest level, the commanded movements were
report the number of sessions carried out effectively. With a range only given to a predefined group of children (e.g. only the girls). The
between 20 and 24, they reported to have implemented M = 23.20 children had to update the new information, quickly find solutions for
(SD = 0.84) sessions in the physical-cognitive group and M = 21.80 the “opposite” movement and inhibit the movements depending on the
(SD = 1.10) sessions in the cognitive group, indicating high compliance verbal command.
with the training. Cognitive condition. The cognitive training program consisted of
At pretest, children’s weight and height were measured while chil the same or similar twelve games, also targeting the three core EFs
dren’s age and gender were received from the teachers. As primary (Table 3). In contrast to the physical-cognitive training, the games re
outcome variables, updating, inhibition, and shifting were assessed quired low physical activity, since they were based on fine motor
individually with the help of three standardized cognitive tests adapted movements and cognitive demands. However, there were also four
for computer use. The testing took place in in a quiet room at both games to play each week. As in the physical-cognitive training, all the
pretest and posttest by two investigators, who were blinded with re games were included in the lizard frame story and the level of difficulty
spect to the conditions. They gave general instructions whilst the was raised constantly after the first three weeks. Also in week 6, the
children were encouraged to work quietly but to ask questions about game Lizard Edi says (adapted from Strommen, 1973) was played in the
the test whenever something was unclear. The sequence of the con cognitive condition. While sitting on a chair, the children had to per
ducted tasks within cognitive assessment was counterbalanced within form various fine motor movement (e.g. closing the fist, clapping the
classes and the complete testing lasted about 15 min per child.
Following posttest, children of all participating classes also received a
small lizard toy in return for their participation. 1
For replication or dissemination, all the teaching materials and audio files
can be obtained from the corresponding author.
4
Table 1
Means (and standard deviations) for the background, the manipulation check and the dependent variables in the three experimental conditions.
Physical-cognitive Group (n = 75) Cognitive Group (n = 52) Control Group (n = 62)
Sample characteristics
Age (years) 5.39 (0.58) 5.35 (0.62) 5.28 (0.58)
Gender distribution (male/female) 34/41 34/18 30/32
Weight (kg) 20.86 (3.62) 20.26 (3.20) 19.87 (2.74)
Height (m) 1.15 (0.06) 1.14 (0.06) 1.14 (0.06)
BMI (kg·m−2) 15.66 (1.98) 15.40 (1.56) 15.25 (1.38)
Manipulation check variable

Steps per minute 47.75 (15.64) 12.69 (9.25) 15.06 (14.21)
Enjoyment 3.83 (0.52) 3.81 (0.56) .
Dependent variables
Pretest Updating (accuracy)a 15.41 (4.48) 14.25 (6.35) 16.15 (5.24)
Pretest Inhibition (accuracy)a 0.76 (0.20) 0.78 (0.23) 0.76 (0.24)
Pretest Inhibition (RT)b 2059 (1047) 2503 (1251) 1913 (972)
Pretest Shifting (accuracy)a 12.12 (7.12) 12.48 (6.04) 13.90 (6.51)
Posttest Updating (accuracy)a 17.49 (4.33) 17.33 (5.92) 16.36 (4.78)

Posttest Inhibition (accuracy)a 0.84 (0.16) 0.83 (0.20) 0.83 (0.14)
Posttest Inhibition (RT)b 1649 (554) 2131 (950) 1529 (525)
Posttest Shifting (accuracy)a 14.63 (5.77) 14.77 (5.99) 15.37 (5.89)
Note. BMI = body mass index, RT = reaction time. aAccuracy corresponds to the number of correct responses. bReaction time is given in milliseconds.
hand), but only when the command of the teacher preceded with “Li Even though this scale has not been validated, using thumbs up pictures
zard Edi says”. Otherwise the children had to sit still without moving appeared to lead to comparable results as using smileys (Toepoel,
their hands. On the second level, children were asked to carry out the Vermeeren, & Metin, 2019).
“opposite” of the commanded fine motor movement (e.g. instead of
closing the fist, spreading the fingers). On the highest level, a rule was 2.6. Cognitive assessment
added in which the commanded movements were only given to a de
fined group of children (e.g. only the girls). To measure EFs, three standardized cognitive tests were used and
Control condition. The control condition consisted of an active adapted for computer use with identical instructions and stimulus
waiting-list group. Teachers of this condition were asked to continue to material using OpenSesame (Mathôt, Schreij, & Theeuwes, 2012). The
teach according to the curricular requirements and were informed that sequence of the conducted tasks within the cognitive assessment was
they will receive the resources of both trainings after the posttest. counterbalanced and lasted about 15 min per child.
Updating was measured with the computerized pictorial updating
2.5. Manipulation check variables task, which is an adapted n-back task (Jäger et al., 2014; Lee, Ng, Bull,
Pe, & Ho, 2011). A series of animals were subsequently shown on the
To compare the three experimental conditions regarding their computer screen for one second each, and the children were instructed
physical activity, the LightMove 3 activity sensor, a lightweight (26 g) to memorize the last three animals they saw. However, the children
and small (62.3 × 38.6 × 11.5 mm) monitor, was used (movisens were not informed beforehand how many animals they would see,
GmbH, Karlsruhe, Germany). The LightMove 3 is a three-axial accel meaning that they had to update their memory constantly. After four
eration sensor with a measurement range of ± 8 g and a sampling rate practice trials, the children worked on eight trials in a randomized
of 64 Hz. Despite its capability to additionally measure barometric order, and in each trial, they were asked to name the last three animals
pressure, temperature, and ambient light sensor, only physical activity they had seen before the experimenter interrupted them. The total
parameters were processed in the present study. Reliability and validity number of correct answers was used as the dependent measure. Evi
of the device has been proven by Anastasopoulou et al. (2014), using dence for the acceptable reliability and construct validity of the pic
indirect calorimetry as reference measure for activity energy ex torial n-back task has been proven, with an internal consistency score of
penditure. The assessment of objective physical activity took place on Cronbach’s alpha = 0.87 in a sample of 6 year old children (Lee et al.,
one morning within the period of one intervention session. In order to 2012) and with correlations of r = 0.41 between the n-back and the
ensure a high generalizability of the results, the data collection was listening recall memory task in a sample of 151 elementary school
distributed over the entire intervention phase. As recommended by children (Lee et al., 2011).
Johansson, Larisch, Marcus, and Hagströmer (2016), the acceleration Inhibition was measured with the Stroop-like day-night task for
sensor was attached to the child’s wrist and objectively measured steps children that lasted three minutes (Gerstadt, Hong, & Diamond, 1994).
based on body acceleration data were derived. Daily step counts were This task was found to be reliable in EEG measures (Wolfe & Bell,
reported to be valid for physical activity levels in preschoolers (Pagels, 2004), and to be sensitive in preschool ages (Diamond & Taylor, 1996).
Boldemann, & Raustorp, 2011) and step counts based on accelerometers In this task, either a picture of a moon or sun was presented centrally on
were found to be reliable to measure physical activity in preschool the screen. The task required the children to answer with “day” when
children (De Craemer et al., 2015). Hence, steps per minute during the presented a moon-card, and to answer with “night” when shown a sun-
time of the intervention game were used as the manipulation check card. Participants were told to answer as fast and as correct as possible.
variable. In the control condition, a matched time window was ran Following four practice trials to check the correct understanding of the
domly chosen from the available data. instruction, all children were presented 16 cards at a given, pseudor
To test if the children receiving the physical-cognitive and the andom order. Both the child’s response accuracy and the reaction time
cognitive training enjoyed the intervention to the same extent, their were recorded. The first verbal response was rated on the log sheet,
enjoyment was measured using a single-item question: “How much did whereas the reaction time was assessed by pressing the spacebar of the
you enjoy the games with Edi the lizard?”. The questions had to be laptop used for the cognitive testing. Following Gerstadt et al. (1994),
answered by pointing on a pictorial thumbs up 4-point Likert scale. individual percentage of correct responses and reaction time were used
5
Table 2
Summary of the twelve games in the physical-cognitive condition in carried out order.
Game Description EF involvement
One Lizard, two lizards Children need to stop an ongoing movement (e.g. hopping, turning, Inhibit prepotent motor reactions, adapt to rule changes, remember
dancing) in a specific way (e.g. sit down quickly, freeze, stand on one leg) different rules and motor actions, update the last stopping position, find
when the song is paused unexpectedly. The specific position to stop is new solutions for a different stopping position
given by a verbal or visual command. To increase the level of difficulty,
the children are only allowed to perform a commanded stopping position
that is different to the previous position. Children are challenged to find
and immediately execute a creative new stopping position.
Billy Billy Buh Children perform a predefined movement (i.e. response, such as a crouch Remember different motor actions, coordinate a motor reaction with a
or jump), whenever they hear the verbal signal ‘Billy Billy Buh’ (i.e. verbal command, inhibit prepotent responses, adapt to rule changes
stimulus). After some practice stimulus–response bindings are exchanged,
and an additional rule is added where children have to inhibit the
movement when the verbal signal ‘Buh’ is omitted (‘Billy Billy’).
Lizard song Adjust different gross motor movements (e.g. crawling, kicking) in Adjust to the rhythm of the music, inhibit prepotent motor responses,
response to changing music tempo. As an additional rule, children inhibit adapt to rule changes
the movement when the music is paused unexpectedly.
Wild farm Children are moving around in the classroom and imitate an assigned Deal with interfering distractors (animal noises and movements from
animal (movement and/or noise). The task is to find the corresponding others), inhibit prepotent motor and acoustic response
animal within the other children. Animal roles and conditions
(movements and/or noises) are exchanged every round.
Parking meter Children run around the classroom while listening to a song. Whenever Remember stimulus–response bindings, connect and re-connect a specific
they hear a predefined word (i.e. stimulus), they interrupt their running motor response with a verbal stimulus, adapt to rule changes, inhibit
and immediately perform an assigned gross motor movement (i.e. prepotent motor responses
response), such as a crouch or jump. After some practice to learn these
stimulus–response bindings, they are exchanged.
The strict farmer Execute predefined motor tasks (e.g. turning around, jumping jack) Remember an ascribed animal role, inhibit prepotent motor responses,
according to a verbal command and depending on predefined animal adapt to rule changes
roles. After some practice, a visual stimulus (green and red card) is added,
meaning one should only perform the commanded movement when the
green card is shown. After some time, assignment of the animal role is
exchanged.
Story with movements Recall an assigned animal role and perform a predefined fast movement Remember an ascribed animal role, connect and re-connect a specific
pattern (i.e. a response, such as jump on a chair and climb down) in motor response with a verbal stimulus, adapt to rule changes
response to some predefined terms (i.e. stimulus) in a story. After some
practice to learn these stimulus–response bindings, they are exchanged.
Lizard dance Children imitate a movement shown on a card (e.g. jumping jack, bounce Remember the sequence of cards and motor actions, inhibit prepotent
back and forth), but only if the card shown before was different. Children motor responses, connect and re-connect a specific motor response with a
are challenged to quickly execute a different movement. After some visual stimulus, adapt to rule changes
practice, a visual stimulus (lizard on the movement card) is added, where
one is required to perform a certain predefined gross motor movement
which is not shown on the card.
On the wall Whenever a predefined lyric (i.e. stimulus) is sung in the song, children Connect a specific motor reaction with a verbal command, remember
interrupt fast walking and perform a certain gross motor movement (i.e. a different motor actions, inhibit prepotent motor reactions
response, such as frog hop, lie down or get up quickly). The action should
be inhibited when the specific lyric is skipped in the song.
Fruit and vegetable Children are sitting in a circle and get assigned a fruit or vegetable role. In Remember an ascribed role, react quickly to a verbal command, adapt to
dance response to a verbal command (e.g. “all bananas”, “all apples”), children rule changes
change seats quickly. After practice, further verbal commands are added
and roles are exchanged.
Lizard Edi says Perform the commanded gross motor movement (e.g. turn quickly in Connect a specific motor reaction with a verbal command, inhibit
circles), but only when the command is prefaced with “Lizard Edi says…”. prepotent motor reactions, adapt to rule changes, find solution for the
After some practice, the children carry out the “opposite” of the “opposite” movement
commanded movement (e.g. instead of turning quickly, turning slow in
circles). After some practice, the commanded movements are only given
to a group of children (e.g. only the girls).
Grass, Grasshopper Execute a predefined gross motor action (i.e. a response, such as fast frog Remember different motor actions, connect and re-connect a motor
hops or a two-legged jump), when a specific song passage (i.e. stimulus) is reaction with a verbal command, adapt to rule changes
played. After some practice to learn these stimulus–response bindings,
they are exchanged.
as dependent variables for inhibitory control. Evidence for the accep depicting a rabbit had to be sorted on one stack and all cards depicting
table reliability and construct validity of the Stroop-like day-night task boats on another stack; order counterbalanced). In the post-switch
has been proven, with test–retest reliability of r = 0.84 in a sample of phase, the instructions changed as the children had to sort the same
4–5 year old children tested two weeks apart (Thorell & Wåhlstedt, types of cards according to the respective other dimension (i.e. if they
2006) and with correlations of r = 0.44 between the Stroop-like day- had to sort the cards according to their color in the pre-switch phase,
night and the grass-snow task in a sample of 107 preschool children they now had to sort the cards according to their shape in the post-
(Carlson & Moses, 2001). switch phase). Each phase started with two practice trials and was
Shifting was measured with the Dimensional Change Card Sort followed by six trials. The rules were repeated on each trial. After the
(DCCS; Zelazo, 2006). In the pre-switch phase, the children were asked post-switch phase, children proceeded to the border version containing
to sort a series of bivalent test cards (e.g., blue boats, red rabbits) ac the same target cards as the previous two phases, plus so-called border
cording to their color (e.g., all blue cards had to be sorted on one stack test cards which were identical to the other target cards with the only
and all red cards on another stack) or their shape (e.g., all cards difference being that they had a black border around them. The
6
Table 3
Summary of the twelve games in the cognitive condition in carried out order.
Game Description EF involvement
The cheeky lizard child Children are sitting on chairs in a circle. One child is hiding an object Inhibit revealing emotions, adapt to rule changes, remember
behind his back, while the others are pretending to hide it as well. The goal different rules
is to avoid eye contact and control facial expression, so that the seeker can’t
find the object. To increase the level of difficulty, rule changes are added
(e.g. increase number of objects, pass the object behind the back).
Poor black cat Children are sitting on chairs and refrain from laughing while a child meows Remember predefined sentences, inhibit emotions, find distraction
like a cat and pulls a funny face. Different rule changes are added (e.g. speak strategy, adapt to rule changes
a predefined sentence without laughing, increased distraction by other
children).
Lizard song Adjust different fine motor movements (e.g. fidget with fingers, fists Remember different fine motor actions, adjust to the rhythm of the
rotating in a circle) in response to changing music tempo. As an additional music, inhibit prepotent fine motor responses, adapt to rule change
rule, children inhibit the movement when the music is paused unexpectedly.
Listen up! While sitting on chairs, half of the group imitate animal noises shown on Remember different animals and rules, inhibit prepotent acoustic
cards, whilst the other group’s task is to find the corresponding animal only response, adapt to rule changes
by hearing the imitated noises. Roles and animal cards are exchanged every
round. As an additional rule, children inhibit the animal noises when a
lizard is shown on the card.
Parking meter Children are sitting on chairs and execute an enduring fine motor action Remember different fine motor actions, inhibit prepotent fine motor
(e.g. riding a steering wheel with hands) while listening to a song. responses, connect and re-connect a specific fine motor response with
Whenever they hear a predefined word (i.e. stimulus), they interrupt their a verbal stimulus, adapt to rule changes
action and immediately perform a certain fine motor movement (i.e.
response), such as drawing a circle in the air with fingers. After some
practice to learn these stimulus–response bindings, they are exchanged.
Secret language While sitting on chairs, children execute a sequence of hand motions (e.g. Remember sequences of hand motions, inhibit prepotent fine motor
clap, fingers snip) after a visual command. The length and difficulty of the responses
sequence increases every round.
Story with movements Recall an assigned animal role and perform a predefined movement pattern Remember an assigned animal role, connect and re-connect a specific
(i.e. a response, such as clap your hands), in response to used terms (i.e. fine motor response with a verbal stimulus, adapt to rule changes
stimulus) in a story. After some practice to learn these stimulus–response
bindings, they are exchanged.
Fruit salad Fruits and vegetable cards are shown to the children while they’re sitting on Remember sequences of cards, inhibit prepotent responses, connect
chairs. The task is to name the fruit/vegetable shown on the card, but only if and re-connect a specific response with a visual stimulus, adapt to
the card shown before it was different. Children are challenged to name a rule changes
different fruit. After some practice, a visual stimulus (lizard on the fruit/
vegetable-card) is added, meaning they need to say a certain predefined
word instead of the fruit/vegetable shown on the card.
On the wall While sitting on a chair, perform a predefined fine motor action (i.e. a Connect a specific fine motor reaction with a verbal command,
response, such as clap your hands or put hands on top of each other), remember different fine motor actions, inhibit prepotent motor
whenever a specific lyric (i.e. stimulus) is sung in the song. reactions
The action should be inhibited, when the specific lyric is skipped in the
song.
Kim’s game with animal Children are sitting in a circle while memorizing different animals on cards. Remember cards, inhibit prepotent responses, adapt to rule changes
card After, they try to find the missing animal card that was taken out, recalling
the correct name. As an additional rule, it is only allowed to imitate the
animal noise instead of naming it. Animal cards are exchanged every round.
Lizard Edi says Perform the commanded fine motor movement (e.g. close fist), but only Connect a specific fine motor reaction with a verbal command,
when the command is prefaced with “Lizard Edi says…”. After some inhibit prepotent motor reactions, adapt to rule changes, find
practice, the children carry out the “opposite” of the commanded movement solutions for the “opposite” hand movement
(e.g. instead of close fist, spread fingers). After practice, the commanded
movements are only given to a group of children (e.g. only the girls).
Three Chinamen with a Practice the song Three Chinamen with a double bass. After practice, sing the Remember lyrics, inhibit prepotent responses, connect a reaction
double bass song with different vocals in response to a verbal command. As an with a verbal or visual command, adapt to rule changes
additional rule, a visual signal for the different vocals (green, red and
yellow card) is added instead of the verbal command.
children were instructed to sort the cards according to their shape if clustered within their classes, multilevel analyses were conducted
they had a black border, and to otherwise sort them according to their (using the linear mixed-effects models procedure of the IBM SPSS
color. The border version started with a practice trial and was followed software; SPSS 26.0). A two-level structure was applied, with children
by 12 trials. Again, the rules were repeated on each trial. Performance (n = 189) at the first level, and class (n = 14) at the second level. In the
in the DCCS was measured as the total number of correctly solved trials. model of the manipulation check analysis, group was treated as fixed
Evidence for the acceptable reliability and construct validity of the effect and class as random effect. In all the models of the main analyses,
DCCS border version has been proven, with same-day test–retest re time, group and the group-by-time interaction were treated as fixed
liability of ICC = 0.90 in a sample of 4.5 year old children (Beck, effects and class as random effect. These models of the main analyses
Schaefer, Pang, & Carlson, 2011) and with correlations of r = 0.53 were specified accordingly to adjust for potential baseline imbalances
between the DCCS and the head-toes-knees-shoulders task in a sample (Twisk et al., 2018). Since repeated measures designs result in corre
of 151 kindergarten children (McClelland et al., 2014). lated error terms within a subject, a block diagonal matrix was chosen,
where each block is a first-order autoregressive (AR1) covariance ma
trix. Besides being recommended for repeatedly measured variables, in
2.7. Statistical analyses which the correlation between the measurements decrease with in
creasing lag (Littell, Pendergast, & Natarajan, 2000), this choice also led
To account for the hierarchical data structure with children being
7
Table 4
Results of the multilevel models with experimental condition as the independent variable and steps per minute as well as the core executive functions as dependent
variables.
Random Effects
Level Effect Parameter Estimate Standard Error Wald Z p 95% C.I.
Lower Upper
Steps per minute

Class Intercept 97.69 39.35 2.48 .013 44.35 215.14
Enjoyment
Class Intercept 0.01 0.02 0.89 .373 0.00 0.12
Updating (accuracy)
Class Intercept 3.87 1.95 1.98 .048 1.44 10.41
Inhibition (accuracy)
Class Intercept 0.00 0.00 1.14 .253 0.00 0.00
Inhibition (RT)
Class Intercept 167504.07 80954.57 2.07 .039 64959.16 431926.98
Shifting (accuracy)
Class Intercept . . . . . .
Fixed Effects
Effect Parameter Estimate Standard Error Approx df t ratio p 95% C.I.
Lower Upper
Steps per minute

Physical-cognitive 31.92 6.88 13.35 4.64 < .0005 17.10 46.74
Cognitive −3.63 6.82 12.85 −0.53 .604 −18.40 11.13
Controla 0 0 . . . . .
Enjoyment
Physical-cognitive 0.00 0.11 14.92 0.03 .980 −0.24 0.24
Cognitivea 0 0 . . . . .
Updating (accuracy)
Time −0.22 0.64 363.68 −0.34 .732 −1.48 1.04
Cognitive 1.38 1.60 15.98 0.86 .401 −2.01 4.77
Time*physical-cognitive −1.87 0.86 363.68 −2.17 .032 −3.57 −0.17
Time*cognitive −2.86 0.94 363.68 −3.03 .003 −4.72 −1.00
Inhibition (accuracy)
Time −0.07 0.03 359.67 −2.11 .036 −0.14 −0.00
Cognitive 0.02 0.04 27.06 0.34 .734 −0.07 0.10
Time*physical-cognitive −0.01 0.04 359.67 −0.26 .796 −0.10 0.08
Time*cognitive 0.01 0.05 359.67 0.27 .791 −0.09 0.11
Inhibition (RT)
Time 383.91 143.96 364.01 2.67 .008 100.81 667.00
Cognitive 478.70 291.36 12.40 1.64 .125 −153.84 1111.25
Time*physical-cognitive 25.56 194.56 364.01 0.13 .896 −357.06 408.18
Time*cognitive −11.81 213.15 364.01 −0.06 .956 −430.97 407.36
Shifting (accuracy)
Time −1.47 1.12 378 −1.32 .189 −3.66 0.73
Physical-cognitive −0.75 1.07 378 −0.70 .485 −2.84 1.35
Cognitive −0.60 1.17 378 −0.52 .607 −2.90 1.70
Time*physical-cognitive −1.04 1.51 378 −0.69 .492 −4.00 1.93
Time*cognitive −0.82 1.65 378 −0.50 .620 −4.07 2.43
Note. aExcept for enjoyment, in all analyses, the control condition served as the reference group. Significant p-values (p < .05) are marked in bold.
to better model fit indices, using the Akaike information criterion (AIC), 3. Results
than applying the unstructured (UN) or the more “liberal” compound
symmetry (CS) covariance structure. 3.1. Manipulation check
To test whether the full model in which the class was included as a
random intercept, fitted the data significantly better than the “basic” The linear mixed model showed that there was a significant dif
model, a χ2 difference test was used with −2 Log-Likelihood as the ference between the experimental conditions in children’s step counts
information criterion. The model with the best fit was subsequently per minute, F(2, 13.93) = 17.73, p < .0005. Parameter estimates and
chosen. When the fixed effect of interest was significant, the control statistics are presented in Table 4. Post hoc comparisons revealed that
group used set as the reference group to test for between-group dif the physical-cognitive condition was more physically exerting than the
ferences. The pattern of results did not change when using one of the control condition, t(13.35) = 4.64, p < .0005. The cognitive condi
other two groups instead. The level of significance was set at p < .05 tion, however, did not differ from the control condition, t(12.85) = -
for all analyses. 0.53, p = .604.
As revealed by the linear mixed model including only the two
conditions receiving an intervention, the physical-cognitive and the
cognitive training did not elicit different enjoyment in the participating
8
children, F(1, 14.92) = 0.00, p = .980. and unfractionated form of EFs skills proceeding to a more integrated
model during the preschool years (Howard, Okely, & Ellis, 2015).
3.2. Main analyses Specifically, updating, inhibition, and shifting show a direct and in
terconnected relationship in the early years of life, while they are
Multiple χ2 difference tests revealed that the full model (including gradually turned into specific and discrete skills by the early years of
the class as second-level factor) fitted the data significantly better than primary school (Brydges, Fox, Reid, & Anderson, 2014; Howard et al.,
the intercepts-only model for updating, χ2 (2, N = 189) = 2302.59 – 2015). These separate functions have a similar performance and influ
2241.58 = 61.01, p < .05, and inhibition reaction time, χ2 (2, ence each other (Howard et al., 2015), but different structures may be
N = 189) = 6212.91 – 6146.86 = 66.05, p < .05, but not for in observed during preschool, primary school, and adolescent years (Best
hibition accuracy, χ2 (2, N = 189) = -168.08 – −164.45 = 3.63, & Miller, 2010). Hence, the developmental trajectory of EFs in the early
p > .05, and shifting, χ2 (2, N = 189) = 2454.05 – 2449.89 = 4.16, years commences with qualitative changes related to cognitive func
p > .05. tion, and concludes with more quantitative changes related to enhan
For updating, the linear mixed model showed that there was a sig cing these abilities (Best & Miller, 2010). The most significant amend
nificant group-by-time interaction, F(2, 363.68) = 4.87, p = .009. ments can occur between 5 and 8 years, until reaching a stable and
Parameter estimates and statistics are presented in Table 4. Post hoc stagnant period of early adulthood (Best, Miller, & Naglieri, 2011;
comparisons showed that the children from both the physical-cognitive, Huizinga, Dolan, & van der Molen, 2006). To this vein, inhibition and
t(363.68) = -2.17, p = .032, and the cognitive training, t(363.68) = - updating are fully developed earlier (Davidson, Amso, Anderson, &
3.03, p = .003, improved more in their updating performance than Diamond, 2006) and should be less easily affected compared to shifting;
those from the control group. the last EF to be fully developed, grounded on updating and inhibition
For inhibition, the linear mixed model revealed no significant (Diamond, 2013).
group-by-time interaction for both the reaction time score of inhibition, The current literature on cognitively challenging physical activity
F(2, 364.01) = 0.02, p = .982, and the accuracy score of inhibition, F and cognition has found selective effects, concluding that physical ac
(2, 359.67) = 0.14, p = .872. tivity interventions can improve EFs in children. However, EFs are not
For shifting, the model including the class at the second level has all changed in the same way. For instance, shifting seems to be easier to
not converged, due to the Hessian matrix not being positive definite. include in a physical activity task, as it entails a quick response between
Therefore, the reported results are based on the basic model. There was several tasks. Consequently, it may be more sensitive to positive
no significant group-by-time interaction for shifting, F(2, 378) = 0.25, changes through physical activity. A 6-month cognitively enriched
p = .777. physical education intervention revealed improved shifting perfor
mance in children aged 5–10 years (Pesce et al., 2013). Similarly,
4. Discussion shifting was boosted when 10–12 years children participated in a 6-
week program that involved high level of physical exertion and cog
In the present study, we tested the assumption that a six-week nitive engagement, compared to the aerobic exercise and control group
combined physical-cognitive training benefits kindergarten children’s (Schmidt et al., 2015), or when younger children of 7–9 years were
EFs more than a six-week sedentary cognitive training. We also as involved with cognitively engaging classroom-based physical activity
sumed that the EFs of children in both training groups would improve for 20-weeks (Egger et al., 2019). Overall, positive effects on shifting
more in comparison to a waiting control group. The results partially were found in chronic physical activity interventions. However, an
supported our assumptions, as updating improved significantly in the acute bout of classroom-based physical activity was found to impede
training groups compared to the waiting control group. However, there shifting performance in 7–9 year old children (Egger et al., 2018).
was no statistically significant improvement in inhibition and shifting. Regarding other EFs, inhibition and updating were improved when
These results suggest that playful group-based interventions (con overweight children (9–10 years) completed a 6-month physical edu
ceptualized as indirect trainings) are suitable to foster specific EFs, cation program, including cognitively demanding physical activity
regardless of with or without physical activity. Specifically, involving (Crova, Marchetti, Struzzolino, Forte, & Pesce, 2014). In the study of
kindergarten children in short (15 min) challenging tasks four times a Van der Niet et al. (2016), a 22-week cognitively demanding aerobic
week for a period of six weeks leads to better EF performance, espe intervention during recess also produced enhanced inhibition and up
cially in updating. From an applied perspective, the current findings dating performance compared to a passive control group in 8- to 12-
suggest that in order to promote EFs, it does not matter if the children year-olds. And in conducting an 8-week coordinative exercise inter
participate in a combined physical-cognitive training or in a sedentary vention with different exercise intensities in kindergarten children,
cognitive training, as long as they train their EFs. However, in order to Chang et al. (2013) found shorter reaction times and higher response
foster EFs and to add physical activity to kindergarten children’s school accuracy in the Eriksen flanker test measuring children’s inhibition.
day, the implementation of a combined physical-cognitive training These results align with results from reviews and meta-analyses showing
seems the most promising way, since this condition has induced sig that inhibition is the EF domain that is the easiest to be influenced by
nificantly more objectively measured step counts than the cognitive or physical activity, with positive effects found in children (Álvarez-Bueno
control condition. et al., 2017; Barenberg et al., 2011), as well as adults (Kramer,
Erickson, & Colcombe, 2006).
4.1. Effects of the combined physical-cognitive training Contrary to the beliefs that inhibition and shifting may be more
receptive to changes occurring through physical activity, the current
In the current study, kindergarten children’s core EFs (i.e., updating, study did not find differences in these dimensions. The timeframe used
inhibition, and shifting) were assessed, and selective effects were found in previous chronic cognitively challenging physical activity interven
only for updating in both the physical-cognitive and the cognitive condi tions that found positive effects varied between two (Chang et al.,
tion. This is a particularly interesting finding taking into account that 2013) and six months (Pesce et al., 2013), while one study had 6-weeks
updating has rarely been examined for this age group, with the effects (Schmidt et al., 2015). The population used in these studies was pri
of both acute and chronic physical activity on updating presenting in mary school children. Possibly, the duration of the intervention implies
conclusive results in child and adolescent samples (Barenberg, Berse, & that more time is needed for preschool children to provoke variations in
Dutke, 2011). This selective effect can be discussed in light of devel these specific EFs. Alternatively, during the different stages of devel
opmental changes occurring in the EFs during childhood. opment, changes occurring in the working memory are more related to
Disentangling the development of EFs, an initially undifferentiated one component than another, or the brain activity pattern linked to one
9
component over the other may differ based on the age-related changes results in children being more physically active, attentive, and en
(Brahmbhatt, White, & Barch, 2010). thusiastic, and have higher learning scores compared to children in
sedentary control groups (Mavilidi, Okely, Chandler, Cliff, & Paas,
4.2. Effects of the cognitive training 2015; Mavilidi, Okely, Chandler, Domazet, & Paas, 2018; Mavilidi,
Okely, Chandler, & Paas, 2016, 2017; Mavilidi, Ruiter, et al., 2018;
Positive effects on updating were also shown in the cognitive con Toumpaniari, Loyens, Mavilidi, & Paas, 2015). Increases in children’s
dition. Further investigating the effects of mere cognitive training on physical activity levels and academic outcomes have also been found in
children’s EFs (with the absence of physical activity), multimodal ap primary school children (Donnelly et al., 2016), confirming the tenet
proaches (i.e., indirect training) have been found to be more effective that stealth interventions for promoting physical activity are highly
(Takacs & Kassai, 2019) than approaches including only one-dimension effective (Robinson, 2010).
(i.e., direct training) e.g. computerized working memory training Such interventions mostly promote moderate-to-vigorous physical
(Bergman Nutley et al., 2011; Klingberg et al., 2002). Interestingly, activity in children (Mavilidi et al., 2015, 2016, 2017; Mavilidi, Okely,
computer-based or school curricula activities can enhance EFs in chil et al., 2018; Mavilidi, Ruiter, et al., 2018). In order to elicit cognitive
dren as young as preschool (Diamond & Lee, 2011; Diamond & Ling, changes and promote children’s cognitive functions, acute bouts of
2016). For example, chronic trainings lasting 4 or 6 weeks have been moderate-to-vigorous physical activity are required with heart rates
found to improve all core EF skills in preschool children (Röthlisberger reaching 70–85% (Chang, Labban, Gapin, & Etnier, 2012). Regarding
et al., 2011; Traverso et al., 2015). In addition, improvements in up intensity, physical activity has improved EFs when the heart rate
dating and shifting were observed in 10–12 year old children after reaches up to 120 bpm in adolescents (Budde et al., 2008) and 160 bpm
6 weeks of cognitive training comprising card and board games in children aged 9–10 years (Best, 2012). In terms of duration, acute
(Benzing et al., 2018). These approaches incorporated adaptive, chal physical activity breaks lasting from 10 to 50 min have shown positive
lenging games with exposure to different and continuously changing effects on children’s attention (Budde et al., 2008; Gallotta et al., 2012,
situations for updating of information and adaptation to new situations 2015; Hill et al., 2010; Schmidt et al., 2016). Alternatively, physiolo
(Blair & Diamond, 2008; Diamond & Lee, 2011). Regarding inhibition, gical changes provoked by chronic physical activity have also been
the efficacy of interventions is more ambiguous, with few school pro found to positively affect children’s cognitive functioning (Drollette,
grams having found positive effects (Blair & Raver, 2014; Diamond Shishido, Pontifex, & Hillman, 2012). In this study, positive effects were
et al., 2007), and others including computerized training reporting null only found for updating. Future studies including higher intensity of
effects (Rueda, Rothbart, McCandliss, Saccomanno, & Posner, 2005; physical activity would more likely be able to show additional cognitive
Thorell, Lindqvist, Bergman Nutley, Bohlin, & Klingberg, 2009). benefits in the age group studied (i.e., kindergarten children).
Overall, the indirect trainings may elicit larger transfer effects and Nonetheless, physical activity recommendations worldwide suggest
smaller training gains (Takacs & Kassai, 2019). In contrast, direct that children from 5 years should spend at least 60 min of daily physical
trainings promote smaller transfer effects but larger training gains, with activity to ensure health outcomes (Australian Government Department
the majority of school-based interventions focusing only on one EF of Health (2017) ()2017, 2017; Canadian Society for Exercise
domain (Cardoso et al., 2018; Diamond & Lee, 2011; Otero et al., 2014). Physiology (2017) ()()2017, 2017, 2017; Centers for Disease Control
As such, the advantage of the present study lies on the fact that a and Prevention, 2016; Institute of Medicine, 2011; World Health
combination of both direct and indirect training was used. The physical- Organization (2018) ()()2018, 2018, 2018), while the recommended
cognitive and the cognitive condition targeted the three core EFs (i.e., time increases to 180 min of physical activity per day for younger ages
updating, inhibition, and shifting) along with self-regulations skills (0–5 years, Australian Government Department of Health (2017) ()
arising from attention to the tasks’ orders or rules, team collaboration, 2017, 2017; 1–4 years, Canadian Society for Exercise Physiology (2017)
emotion regulation, and in turn, successful game play. Consistent with ()()2017, 2017, 2017). Importantly, the Institute of Medicine (2011)
the study of Mackey et al. (2011), this study included both computer recommends that all childcare providers should offer preschool chil
ized and non-computerized training, showing that cognitive training dren with opportunities for physical activity throughout the day (i.e.,
can be modified and ameliorate children’s cognitive skills. Even if po moderate-to-vigorous physical activity for at least 15 min per hour
sitive effects in untrained computerized task performance in updating while children are in care), decreasing the time that children spend
were noted, it still remains unclear how the combination of different sitting or standing (i.e., limiting sitting or standing to no more than
elements of the tasks influenced transfer effects. The selective effect in 30 min at a time). Unfortunately, research has shown that preschool
updating, however, is meaningful, since updating can significantly children spend around 73% of their waking hours in sedentary behavior
predict math achievement (Bull & Lee, 2014; Bull & Scerif, 2001), in (Salmon, Tremblay, Marshall, & Hume, 2011), while 48.4% of their
contrast to shifting and inhibition being less conclusive. Thus, the time in childcare is spent sitting (Ellis et al., 2017). These behavioral
current study presents a unique contribution on fostering EFs in kin patterns are evident in children as young as 3–5 years, but also for
dergarten children, more precisely the core EF of updating, through a 5–8 year old’s (Jones, Hinkley, Okely, & Salmon, 2013).
cognitive and a combined physical-cognitive intervention. Considering the low levels of physical activity reported in childcares
In general, EFs are fundamental for physical and mental health, (Reilly, 2010), although in this study we were not able to infer re
cognition, psychological, emotional, and social development, as well as garding the intensity level, this intervention comes closer to the phy
academic success (Diamond, 2013). EFs are estimated to be even “more sical activity recommendations, offering both cognitive and physiolo
important for school readiness than intelligence quotient” (Diamond & gical benefits. This study, therefore, might be of practical relevance in
Lee, 2011, p. 959), with evidence showing that EFs have been asso the development of a low-cost intervention for the field of education.
ciated with early literacy and numeracy competence (Blair & Razza, Exploring the long-term effect on children’s academic achievement,
2007), which can be maintained during the first three years of motivation towards the school, and general mental health could be
schooling (Bull et al., 2008). worthwhile to investigate in future research.
Finally, results from the enjoyment scale showed no significant
4.3. Effects on children’s step counts and enjoyment differences among the two interventions, indicating that the interven
tions did not seem to differ in this potential confounding variable.
The combined physical-cognitive training has led to a higher Since, however, we did not measure enjoyment in the control condition,
amount of objectively measured step counts per minute than the cog we cannot rule out the possibility that the intervention effects were
nitive or control condition. The integration of movement experiences partly due to enhanced enjoyment or motivation. Intrinsic motivation,
into learning areas such as math or language in preschool children focusing on the enjoyment of the learning activity itself has been linked
10
to learning, creativity, and school achievement (Robinson et al., 2017; intervention studies on physical activity that target specific EFs and its
Ryan & Deci, 2000; Schmidt et al., 2019). It is also important to note the underlying mechanisms is indispensable (Singh et al., 2019).
importance of “play” during preschool years for children’s cognitive,
social and psychological development (Duncan & Tarulli, 2003). As Declaration of Competing Interest
Schwartzman (1978) noted: “Play is first of all assumed to be pleasur
able and enjoyable, to be characterized by freedom and spontaneity, The authors declare that they have no known competing financial
and to elicit active (as opposed to passive) engagement by players […] interests or personal relationships that could have appeared to influ
its motivations are said to be intrinsic as opposed to extrinsic” (p. 327). ence the work reported in this paper.
As such, age-appropriate activities tend to be game-based and have a
more playful and enjoyable character, while most tasks given to kin Acknowledgments
dergarten children inherently include the factor of enjoyment.
As pointed out by Diamond and Lee (2011, p. 963): “The best ap We would like to thank the participating teachers and students and
proaches to improving EFs and school outcomes will probably be those we also wish to acknowledge the help of our bachelor’s and master’s
that (a) engage students’ passionate interests, bringing them joy and students (Larissa Böhlen, Yannik Escher, and Maja Kelava) with col
pride, (b) address stresses in students’ lives, attempting to resolve ex lecting the data. Thanks are also due to Amie Wallman-Jones for her
ternal causes and strengthen calmer, healthier responses, (c) have stu last minute proofreading. This research was supported by the Swiss
dents vigorously exercise, and (d) give students a sense of belonging National Science Foundation (SNSF; grant number IZSEZ0_178014).
and social acceptance, in addition to giving students opportunities to
repeatedly practice EFs at progressively more-advanced levels.” References
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Combining Physical and Cognitive Training To Improve Kindergarten Children's Executive Functions.

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Contemporary Educational Psychology 63 (2020) 101908

Contents lists available at ScienceDirect

Contemporary Educational Psychology

Combining physical and cognitive training to improve kindergarten T

ARTICLE INFO ABSTRACT

1. Introduction to be negatively associated with a wide range of school-related beha

Available online 11 August 2020

2015). challenging chronic physical activity can be achieved in kindergarten

Manipulation check variable

Posttest Updating (accuracy)a 17.49 (4.33) 17.33 (5.92) 16.36 (4.78)

Steps per minute

Steps per minute

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Combining Physical and Cognitive Training To Improve Kindergarten Children's Executive Functions.

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Combining Physical and Cognitive Training To Improve Kindergarten Children's Executive Functions.

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Combining Physical and Cognitive Training To Improve Kindergarten Children's Executive Functions.

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Contemporary Educational Psychology 63 (2020) 101908

Contents lists available at ScienceDirect

Contemporary Educational Psychology

Combining physical and cognitive training to improve kindergarten T

ARTICLE INFO ABSTRACT

1. Introduction to be negatively associated with a wide range of school-related beha­

Available online 11 August 2020

2015). challenging chronic physical activity can be achieved in kindergarten

Manipulation check variable

Posttest Updating (accuracy)a 17.49 (4.33) 17.33 (5.92) 16.36 (4.78)

Steps per minute

Steps per minute

You might also like

1. Introduction to be negatively associated with a wide range of school-related beha