Impact of COVID-19 Pandemic on the Development of Children’s Executive Functions: Implications for School-Based Interventions

The pandemic of COVID-19 has had a significant impact on children’s lives. Worldwide, there has been evidence of a decline in children's mental health, well-being, and quality of life. Few studies, however, have reported the pandemic's impact on children's cognitive functioning. Executive Functions (EFs) are a set of high-order cognitive functions involved in behavior and emotions self-regulation. EFs are powerful predictors of school performance, child’s well-being and health. During crisis and disaster, EFs are critical resources to cope with unusual and complex situations, and to find novel solutions to problems. Because of EFs’ extensive growth, there are many time periods during which experience has the greatest effect on brain development. Therefore, EFs are among the cognitive systems that are most vulnerable to environmental stress. As a result, children's emotional distress has been related to concentration and memory problems, difficulties managing impulses and emotions, and difficulties in planning ahead. Recent research has found executive dysfunction in children and adolescents during pandemic. Adopting an ecological contextual model, this study aimed to identify factors associated to pandemic that may affect children's performance and development of EFs, as well as, to propose a set of evidence-based strategies for teachers to assist children manage stress and promote EFs during crisis. Peer-reviewed academic articles, books, and web resources published between 2010 and 2023 were chosen for review in this study. As a result, child stress, family stress, school closure, changes in child-teacher interactions, and unhealthy habits are highlighted as potential factors influencing child EF development. In response to the Sustainable Development Goals agenda, a set of strategies was developed that may be easily included into the school curriculum. Creating school-based interventions to develop students' EFs is one approach to improve children's crisis-response resources.

The COVID-19 pandemic has caused crisis and significant changes in people's lives. It resulted in significant morbidity and mortality rates among the global population, as well as increasing risk factors for healthy growth and development in children.

Families have experienced economic and social challenges, which have generated crisis and emotional stress in both adults and children. Numerous stressors associated with the pandemic have been identified, including: fear of illness, loss of family members or friends, quarantine, loneliness, social isolation, job loss, financial instability, exposure to news about the severity of the virus and the high rate of infections, the uncertainty about the length of the lockdown, the requirements of social distancing, and the unwanted changes in daily life [1-4].

The COVID-19 pandemic continues to present many problematic consequences for society, and it has been predicted that recovery from these consequences will take years. Prolonged psychological stress can negatively affect physical and psychological health, well-being and quality of life. Consequently, it is urgent to assist the most vulnerable populations, such as children and adolescent.

Beyond the immediate stress and suffering, youth are at the greatest risk during catastrophes [5]. Although the coronavirus tends to produce less physical pathology in children than in adults, special consideration must be paid to the implications and long-term effects on children's growth and development.

During COVID pandemic, children have experienced significant changes in their daily routines and activities, as well as long periods of confinement and social isolation. Facing pandemic, children have experienced a broad of reactions, including emotional distress, attention difficulties, behavioral changes, sleep disturbances, physical symptoms and fears [6-11]. Systematic review studies have reported that anxiety, depression, loneliness, stress, and tension are the most commonly seen symptoms in children and adolescents during COVID-19 which have negatively impacted children’s mental health [12-15]. On the other hand, school closures and distant education have resulted in academic delay and school dropout [9,16,17]. Similarly, prolonged confinement has limited children's peer relationships and participation in group activities, which may have an impact on children's socio-emotional, cognitive, and linguistic development trajectories [6,18-20].

Regarding cognitive development, it has been observed that the SARS-CoV-2 infection can affect the functioning of the nervous system (CNS). Although SARS-COV-2 predominantly affects the respiratory system, it has effects on multiple organ systems, including the CNS [21]. Between 36-84% of cases present neurological symptoms [22]. Among the neurological symptoms associated with COVID-19, mild symptoms have been identified: loss of smell and taste, headaches, fluctuating consciousness, dizziness, muscle weakness, dysexecutive syndrome. More serious symptoms have included: polyneuropathy, myositis, encephalitis, thrombosis and stroke [1, 22-24]. If the virus enters the CNS, it has the potential to cause neuropsychiatric and neurological complications [1,23,24]. This may include loss of inhibitory control, apparent unconcern, loss of normal fear and anxiety, and social disinhibition [25]. Cognitively, impacts might be expected on inhibitory control systems, executive functions and memory [22].

Although children have been the least affected by SARS-CoV-2, some studies report neurological effects in newborns infected by the virus such as irritability, difficulty feeding and hypotonia [22]. One of the most common complications is preterm birth. Some studies have documented intergenerational transmission through the mother, and others speculate the possibility that COVID can be transmitted by the father [22]. Maternal infection could lead to neurodevelopmental changes in the fetus and increase neuropsychiatric incidence rates. Based on these preliminary results, there is an urgent need to analyze the longitudinal effects of COVID-19 on brain function, behavior and cognition.

However, in children, the presence of chronic psychological stress is one of the most powerful ways in which the consequences of the pandemic can affect their neurocognitive functioning and perhaps slow down or alter their development. Stress affects the immune system, hormonal system and can raise the risk of neuro-inflammation, increasing the possibility of damaging the CNS and altering cognitive functioning [1,26]. In line with this approach, there have been reports of an increase in attention and memory problems, increased irritability and alterations in Executive Functions (EFs) in children and adolescents [6,9-11,27].

Executive Functions (EFs) are a set of high-order cognitive functions involved in behavior and emotions self-regulation. EFs are powerful predictors child’s well-being and health. During crisis and disaster, EFs are required to self-regulate behavior, adjust to changes, and solve problems. Nevertheless, EFs are among the cognitive systems that are most vulnerable to environmental stress [28]. As a result, children's emotional distress has been related to concentration and memory problems, difficulties managing impulses and emotions, and difficulties in planning and in organizational skills. Scare studies have reported the pandemic effect on children EFs, therefore, it is important to analyze how children EFs has been affected by COVID pandemic.

In accordance with the Sustainable Development Goals (SDGs), children's rights to equality, health, education, and well-being are top on the agenda list. As a result, it is critical to take immediate steps to aid children and adolescents in order to mitigate the impact of the pandemic's consequences on their overall development. In line with this agenda, the goals of this study are to: 1) to identify factors associated with the pandemic wich may impact on children's performance and development of EFs, and 2) to propose a set of evidence-based strategies for teachers to assist children manage stress and promote EFs during crisis.

A theoretical design [29] was used to address the study problem: to identify factors associated with the COVID-19 pandemic that may have affected the development of children EFs. To address the problem under study, the contextual ecological model of human development [30] was adopted, focusing on micro and mesosystem factors. Consequently, a review and integration of peer-reviewed academic publications, books and web resources, published between 2010 and 2023, was carried out on the following topics: pandemic’s impact on children's mental health and family functioning, parental stress, child stress, homeschooling, restriction of social interactions, confinement, change in teacher-child interactions, changes in teaching-learning processes, increase in unhealthy habits in children.

Given that family and school are the contexts that most influence children development, implicactions for school-based interventions are presented. It is proposed a set of strategies and activites that are easily integrated in the school curriculum in order to help children lower stress and strengthen their EFs in crisis situations. To develop these strategies, peer-reviewed academic publications, books and web resources, published between 2010 and 2023, on the following topics were reviewed and integrated: school sensitive-trauma interventions, SBFC crisis interventions, programs aimed to strengthen children EFs in sociovulnerable contexs, school-based interventions to promote children self-regulation.

EFs play a critical role in cognitive, social and emotional development of children, and predict many life outcomes [31,32]. Executive Functions (EFs) describe a set of high-order cognitive abilities that control behaviors, emotions, and cognitions necessary to achieve goals, solve problems, and provide adaptive responses to novel or complex situations [31]. EFs enable the ability to act with purpose and in a self-regulating manner in the various contexts of social interaction [32,33].

Three core EFs have been identified: inhibitory control, working memory and cognitive flexibility. During the developmental process, these three basic executive functions mature, differentiate and enable the development of more complex ones, such as planning, organization, metacognition, monitoring, fluency and decision-making [31,34]. These functions act in an interrelated way, enabling flexible, propositive and self-regulated behavior.

Executive functions emerge in early childhood and present a protracted development that continues into adulthood [35,36]. This development is associated with the late maturation of a set of neural networks coordinated by the prefrontal cortex [37].

The extensive development of the neural networks that make up cognitive control creates several sensitive periods, in which the plasticity of the brain is increased and the brain is more susceptible to the environmental experience [38]. It has been documented that environments that promote healthy child development can help children to strengthen their EFs [28]. However, EFs can be negatively affected both by stressful environments and by the lack of quality and proactive interactions with adult caregivers. Consequently, gains in children's executive abilities should be interpreted as resulting from the delicate and sustained interaction between brain maturation and the influence of the environment.

Based on these reports, the neurosciences have attempted to specify the factors that mediate the impact of the environment on children's cognitive development. During the last two decades, environmental factors that model the EF development have been studied, identifying factors from the family, school, and community. For family, they are rearing practices [39,40], cognitive stimulation [41], parenting stress [28], parental education level [28,42] and caregiving [43]. For school, they are classroom management, classroom climate, resources for learning [44], teacher modelling and scaffolding of EFs [45,46], and peer relationships [47]. For community, they are cultural norms, ethical values and social practices [48,49].

Children who show a greater capacity for self-regulation are better able to regulate their emotions, establish positive relationships with peers and adults, tolerate frustrations, expect rewards, adjust their behavior to the demands of the context, be more creative, be flexible, and present a better school performance. EFs are considered critical for school readiness, future academic performance, and successful learning [50].

These achievements in childhood predict better health, better quality of life, greater academic success, better employment status and a lower incidence of conduct problems, in adolescence and adulthood [31,51]. From there, the importance of identifying the factors that shape EFs development arises, in order to estimate how the consequences of COVID pandemic may affect it.

Child anxiety, stress and depression have been associated with executive dysfunctions [6,9-11,27]. In the face of a crisis, it is probable that attentional and memory problems occur. Similarly, anxiety and fear can impair strategic planning skills and cognitive flexibility, making it difficult to find novel solutions to problems.

From April 2020 to October 2021, a study examined parents' perceptions of the presence of anxiety, sleep disorders, and executive dysfunction in 953 Spanish children and adolescents. The main results showed that the rates of anxiety, sleeping habits, and executive functioning impairments in children and adolescents appear to have deteriorated over time [27]. In terms of EFs, results revealed a decline in global executive functioning as well as deteroration in emotional regulation, cognitive flexibility, and planning and organizational skills [27]. Other authors have reported a worsening in executive and academic functioning during the COVID-19 confinement period, which is consistent with these findings [20,52-54]. A longitudinal study discovered that the COVID-19 has a direct effect on children's executive performance. Children's organizational skills declined during the lockdown, but they struggled with strategic planning skills afterward [55]. The quarantine process has also been connected to problems with self-control, discipline, and hyperactivity in youngsters [56].

Few studies have analyzed factors associated with the pandemic that may impair child EFs. A research study found that state anxiety explained the decline in children and teenage executive functioning during pandemic [27]. More research is needed. According to an ecological contextual model of child cognitive development [30,57], several pandemic-related factors that can impair children's executive functioning and potentially interfere with their development trajectory are presented (Figure 1).

Figure 1: COVID-19 related factors that can impair children's EFs performance and development.

Child stress

EFs constitute one of the cognitive processes most vulnerable to stress [28,58]. Poverty studies have documented that the presence of chronic stress in children is associated with neurodevelopmental disorders (i.e. hippocampus and amygdala reduction), higher incidence of mental illnesses, poor school performance, memory problems, inattention and behavior problems [26,58-60]. Similarly, when children face a disaster, such as the COVID pandemic, they may experience a broad range of stress reactions. It has been documented that child emotional distress is linked with attention problems, memory failures, difficulties in managing impulses and emotions, and difficulties planning ahead and setting goals [6,7,9-11]. Psychological reactions to a pandemic appear to be acute, and long-term emotional consequences can be observed. Therefore, chronic stress and trait anxiety may impair executive functions performance and slow their developmental trajectory. Recent studies have found positive and moderate associations between anxiety, depression, sleep disturbance, and executive dysfunctions in children during pandemic [20,27].

Family stress

Stressors that COVID-19 brings to families, such as health concerns, financial difficulties, job loss, lockdown and challenges of homeschooling, have generated a significant increase in parental stress [61,62]. Parental stress decreases the involvement, the sensitivity to the needs of the children, resulting in a lower quality of parental care [63,64]. Parents with high levels of stress are less predisposed to interact and communicate with their children, which negatively affects the development of child cognitive and emotional self-regulation abilities. Likewise, the presence of stress in parents has been linked to the use of punitive and inconsistent parenting strategies, greater neglect, greater frequency of family conflicts, and family violence, all of which promotes emotional and behavioral problems in children [28,64,65]. There have been reports of increase in child maltreatment during the periods of self-isolation, quarantine and lockdowns [64,66]. Nevertheless, the impact of the pandemic in the family context varies, depending on contextual stressors that family members experience, and the family`s internal and external resources to cope with them.

It’s important to highligth some positive family and child experiencies during lockdown. Some studies have reported positive experiences among families during the confinament. A research study found that low-income families spent most of their time together engaging in mealtime activities, and this time was associated with pleasant interactions between parents and children [67]. Another study surveyed Turkish and Chinese parents about their positive experiences with their children while in quarantine. More than half of parents rated activities such as playing, cooking, drawing, reading, watching films/TV, singing, and physical exercise as enjoyable during quarantine [68]. Portuguese and Brazilian parents observed gains in proximal relationships with their children, between couples, and among family members [69]. An intercultural study research [70] done in five cultures described parental features during the first COVID lockdown (March-May 2020). The key finding revealed that love expression was the most prominent parenting behavior, demonstrating its importance in panerthood regardless of culture [70]. In conclusion, these research illustrate certain families' ability to modify family dynamics to crisis. As a result, positive parenting amid a crisis is an excellent resource for enhancing children's socioemotional and cognitive development. Being calm, sympathetic, supportive, and finding alternative solutions to situations model autoregulatory competence to youngsters. As a result, certain parenting behaviors may encourage the development of EF in children.

Closures of schools

Prolonged school closure and remote learning has had a significant impact on children's school learning trajectories, and has expanded the academic gap between the most and least favored children [9,16,71]. Recent research has made predictions about the impact that the COVID-19 pandemic has had on children's learning trajectories. Kuhfeld M, et al. [16] estimated that children have achieved 63% to 68% gains in reading, and 37% to 50% gains in math, compared to a typical year of schooling. Another study found that second graders in the first 200 days of the 2020-2021 school year had poorer oral fluency gain compared to prepandemic years [72]. However, those estimates will vary significantly if other factors are included in the predictive model, such as differential access to parent and teacher supports for learning during the school closure months, health issues related to the virus, and access to technology and remote instruction. Likewise, homeschooling has posed responsibilities and challenges for parents, who have had to create a structured environment for learning, organize a daily routine and schedule of activities for children, in order to provide children with academic and emotional support [73-75]. The ability of the family to overcome these challenges and the parental involvement in learning tasks have been affected by multiple factors, such as: internet access, available parent's time for homeschooling, parent's educational resources and knowledge, and home environmental conditions. According to one study, children who received more need-oriented help from their parents developed their math skills more favorably throughout the lockdown [76].

Schooling is an experience that affects many aspects of child development, including the development of EFs. The literature reports that the schooling experience is a factor that contributes to the promotion of EFs [77,78]. Recent research has documented bidirectional relationships between EFs and reading, writing, and math skills, indicating a mutual influence between both processes [79]. Furthermore, it has been documented that children who learn school content and skills more quickly are more willing to participate in increasingly demanding academic activities, which stimulate the development of EFs [78]. In sum, children's gains in school learning will lead to improvements in their self-regulation abilities. Therefore, the loss of months of schooling can negatively affect the development of children’s self-regulation abilities.

Changes in teacher-child interactions

Distance education has established new educational practices, in which the interactions between children and their teachers have changed dramatically. Teaching instances have been reduced, communication has been affected by connectivity problems, and learning mediation has become a challenge for teachers [17,80]. On the other hand, it has been documented an increase in teacher’s stress and a decrease in teacher’s well-being associated with COVID-19 pandemic [81]. Stress and well-being influence the quality of teacher-child interactions and teachers’ delivery of emotional and instructional support [81]. The quality of teaching is one of the most important school variables influencing children achievement [82]. It has also been established that exposure to teachers and educational activities is crucial for children's learning. Teachers with higher job commitment, executive functioning, classroom instruction, and organizational quality dedicate more time to remote teaching and teaching-related tasks during lockdown [83]. Therefore, it is estimated that the reduction of interactions between teachers and children is a factor that will negatively impact learning, and child cognitive and social-emotional development. The teacher has a critical role as a mediator of the cognitive development of children, especially of the EFs [45,46,84]. Two ways have been identified by which teachers promote the development of children's EFs: one, implicit, from modeling the use of EFs in daily school activities; and, the other, explicit, through scaffolding the development of the children's self-regulatory capacities [45,46]. Therefore, distance education, which has restricted collaborative interactions between children and teachers, is another avenue that may have affected the development of children's self-regulation capacities.

Limits to social interactions

Children have been the most affected by lockdown measures, and the resulting restriction limits to interactions. Children develop in everyday interaction with important others, such as peers [85]. Peer bonds nurture children emotionally, and help them to create friendships, engage in leisure activities, group games, learn social skills, and learn how groups work [18]. Children’s active engagement with peers serves as a rich resource for their cognitive, emotional, and social development [18,86]. In everyday interaction with peers, children put their EFs into play by regulating their emotions, practicing attentive listening, solving interpersonal problems, and being flexible by taking the other's point of view. Likewise, when they participate in group activities, children must adjust their behavior to the rules of the activity, wait their turn, memorize instructions, and solve problems, among many other actions. Therefore, restricted social contact is another avenue that can impact the development of EFs.

Unhealthy habits

A significant increase in the use of screens, a reduction in outdoor activities, a reduction in physical activity, an increase in unhealthy eating habits has been observed, which has been associated with weight gain, boredom, increased stress and alterations in sleep [11,87-90]. These factors impact cognitive performance, with greater problems focusing and sustaining attention, memory problems and alterations in child EFs.

Impact of the pandemic on the macro and exosystem

The COVID-19 pandemic forced governments to take measures to prevent the spread of the virus, including: mandatory confinement and school closures. The least developed countries had to prolong the application of these measures due to a lack of health and economic resources to face the pandemic [1-4]. Consequently, the pandemic generated more devastating consequences in the countries with the highest poverty rates, accentuating their social and economic inequalities. The loss of jobs, financial instability and prolonged confinement significantly affected families, generating stress and crisis. On the other hand, the daily exposure of news about mortality rates, about the rapid proliferation of the virus and the lack of appropriate therapeutic approaches, generated fear and insecurity [1-4]. These are some of the macro and exosystem factors that must be analyzed to understand their impact on the comprehensive development of children.

In sum, these are some factors associated with the pandemic that may affect the development of EFs. However, it is important to note that the impact of these factors will vary depending on various aspects, such as the internal and external resources of children, family resilience, the academic, cognitive and emotional support that children receive to cope with the pandemic.

Returning to face-to-face classes poses numerous challenges for teachers, who will encounter greater variability in learning [16]. Added to these challenges is the need to provide academic, social and emotional support to children.

Teachers are in an excellent position to help children after disasters as they are significant adults in children’s lives; they are familiar with developmental processes; and, they are likely to notice emotional and behavioral changes, academic difficulties, and functional impairment in their students [8]. They are critical in recognizing the signs of traumatic stress, promoting resilience and helping children to manage reactions to stress.

Though, teachers need guidance and additional coping strategies for assisting children to overcome pandemic’s emotional distress. School-Based Family Counseling (SBFC) is an excellent framework and approach for helping teachers to implement crisis interventions. SBFC crisis intervention refers to remedial interventions that focus on creating a responsive trauma-learning environment, in order to helping children, succeed academically, and personally through mental health approaches [91]. Therefore, SBFC practitioners collaborate with teachers in designing and applying coping strategies to help children manage stress and foster well-being.

Another excellent approach is neurosciences school-based interventions [31,32,45,46,92], which has been aplied to streghten EFs in children living in sociovulnerable contexts. Worldwive evidence has documented that EFs can be trained, and its gains are associated with better school performance, and with an increase in children social and emotial resources to face sociovulnerable living conditions. Teachers play a key role in those interventions, because the cognitive strategies are embedding into school curricula, and teachers are trained to apply them.

According those frameworks, a set of evidence-based approaches and strategies for teachers to help children lowering stress and promote EFs during the COVID-19 pandemic, have been selected. Those strategies have been chosen from: peer-reviewed academic publications, books and web resources, published between 2010 and 2021: For lowering children sress: [8,26,89,93-99] and for promoting children EFs [100-108]. As a result, a collection of techniques was created that can easily be embedded into the school curriculum, while also encouraging cooperation between teachers, and between teachers and families.

Identifying children’s symptoms of stress

The first step in applying stress management strategies is to assess stress levels of a student group. For identifying child stress, a teacher should use children prior knowledge to identify changes in their behavior associated with stress trauma, and identify child risk factors –isolation, domestic violence, episodes of depression. Some children may be more vulnerable than others to a disaster and need further intervention during crisis. Teachers can create a checklist of stress symptoms, and use it to guide their observation of children's behavior in the classroom and follow up signs of children's stress, to verify their magnitude and duration over time.

Creating a structured and predictable learning environment

Exposure to the pandemic creates feelings of unpredictability and uncertainty. That is why it is important to create a school environment that allows children to regain a sense of stability and foresight. Teachers may help children by:

• Creating a school routine: Assist children in the use of the school agenda and calendar, so that they organize and plan their daily and weekly activities. It is important to create rituals to start and end the class, to regain a sense of foresight. For example, teachers may share with children one grateful moment, give a positive message or practice a mindful activity before or after checking assignments.
• Maintaining clear and fluid communication: Children should feel that they can communicate with their teachers with ease. Also, it is important to provide information as clearly as possible, and in children-manageable amounts. Using visual schematics, images, and reminders to make it easier for children to get information.
• Being flexible: Adapt the tasks and assessments. Address academic and behavioral issues with empathy and support. During crisis, children can feel assignments are more overwhelming. Present instructions in smaller bites when necessary, and encourage children to ask clarifying questions.
• Communicating the school’s emergency response plan: Children may not want to go to school for fear of contracting COVID-19 disease, and infecting their loved ones. Children may feel insecure and worry about not knowing if the health situation may worsen and how this will affect their daily lives. That is why teachers have to communicate to children and their families that the school has a plan to handle the changes associated with pandemic evolution.
• Strengthening relationships: Restricted contact with loved ones and other people is one of the greatest stressors for human beings. That’s why it is important to: 1) let children know that they can discuss their concerns and fears with teachers, counselors or parents; 2) provide moments when children can enjoy the company of their peers; 3) consider putting children together in small groups to work on projects or activities; and 4) encourage children to connect with their friends and loved ones. Peer interactions play a critical role in fostering socio-emotional and cognitive development. Therefore, a teacher can use groups interaction to propose child activities to foster EFs, such as: creating a plan to reach a goal; exercising the ability to put oneself in the others’ shoes to understand their perspective; taking turns to talk; and, establishing rules for regulating emotions and behaviors.
• Fostering regulation of emotions: Emotions are a way of reacting to situations, so it is important to recognize them in order to be able to control them later. Therefore, teachers may promote and value self-expression through different channels. Encourage children to express themselves by art, such as drawing a picture about how their day is going or role-playing the most important thing that happened to them that day. Also, teachers can teach children techniques to control their emotions: counting 10 to 1 before saying or doing something, using deep breathing, focusing their attention on an object to calm down.
• Using mindfulness and relaxation techniques: Using these effective methods can help children to relax and cope with tension, anxiety or fear. Using a three-minute mindfulness exercise at the beginning of the school day or when children are tired or restless, help them to regain calm and improve their attention performance.
• Promoting healthy habits: Help children identify and practice healthy habits, such as: balanced diet, sleep hygiene, exercise and contact with nature. Include in school activities a walk in the park, an outdoor activity, introducing the practice of mindfulness in contact with nature. Take time out of your class to help children establish a healthy daily routine, in which they can balance their schedules for study, rest, exercise, eating, and sleep. Talk to their parents or caregivers about the importance of maintaining a routine and suggest activities that parents can share with their children: go for a walk in the park, watch a movie, share a board game or go biking.

Strategies to foster EFs

Learning to face a crisis such as the COVID-19 pandemic implies putting self-regulation capabilities into play. Hence, it is necessary to embed educational practices with specific activities that foster children's EFs.

Improving attention performance: Attention is one of the cognitive functions most affected by stress, and consequently, schoolchildren will experience difficulties in focusing and sustaining their attention. Therefore, the following are recommended:

• Observing the children attentional process to identify what captures their attention and what types of activities help them to stay focused longer:
• Varying the stimuli and teaching methods
• Providing clear instructions
• Shortening the duration of activities and introducing breaks and
• Encouraging self-assessment of attention.

Improving inhibitory control: The measures to contain the pandemic have imposed new action protocols in order to regulate activities within the school context. Children must learn new rules of behavior, and this can be a unique opportunity to promote inhibitory control. Measures could include:

• Placing posters, visual signs, reminders to facilitate the internalization of the new rules: the use the role-playing technique to exemplify the new norms of behavior and how children can play an active role in their compliance
• Fostering initiative: teachers are likely to encounter children with difficulty starting tasks, so it is recommended to use activities that increase their motivation: play a game at the beginning of class, do stretching activities, a special welcome greeting
• Carrying out activities that allow children to reflect on their behavior and emotions, -self-awareness, self-expression and self-control techniques can be used
• Using relaxation techniques.

Improving working memory: Working memory plays a critical role in learning and could be stimulated in the following ways:

• Starting a new topic updating content learned
• Practicing mental calculations
• Using comprehensive reading techniques, such as summarizing the main ideas of the text in a paragraph or making a diagram with the central ideas and
• Proposing playful activities, in which children must memorize multiple steps or actions to reach the goal.

Improving cognitive flexibility: Cognitive flexibility is an indicator of mental health and a valuable resource in dealing with changing situations:

• Modeling flexibility use in times of crisis by adapting tasks, activities and evaluation to changing circumstances
• Encouraging children to think of different approaches to problems
• Training perspective taking
• Using problem-solving techniques and
• Use brainstorming and roleplaying.

Improving planning and organization abilities: Provide strategies for organizing school activities, planning time, and selecting materials. Suggestions include:

• Creating a monthly or weekly school calendar that helps children visualize deadlines for homework and important school activities
• Assisting children in the use of the school planner and checking lists
• Using route maps to diagram for children the stages of the tasks to be carried out, making it easier to see the whole and its parts
• Encouraging children to carry out projects, with the teacher able to scaffold the children’s planning skills by: a) helping children to identify goals; b) dividing complex goals into sub-goals that are measurable, achievable, and specific; c) helping children identify the steps necessary to achieve the goal, manage time, and identify the materials needed for each step; d) helping them to foresee obstacles to reach goals and to identify the resources to overcome them; e) helping them to monitor progress in achieving the goal; and, f) graphing the steps to achieve a goal.

Finally, it is recommended that teachers take every opportunity to highlight the progress of children in the management of stress techniques and in improvements of EFs. In a crisis, teachers should help children treasure their good deeds and achievements. It is necessary to reinforce their value and their active role in the face of the pandemic. Also, it is recommended to create partnership between school and family in order to help children to cope with the pandemic. Maintaining a clear and fluid communication with parents, including parents in school activities, providing support to parents when struggle with homeschooling, and listening to parents when they feel overwhelmed, are some strategies to foster bounds between family and school.

Limitations and recommendations

The theoretical nature and bibliographic integration of this study is recognized, and future scholars are encouraged to do a systematic review study. It is acknowledged as a study constraint that only studies published in English, Spanish, and Portuguese were included, with no consideration given to others published in other languages. At the moment of conducting this study, it was observed that few studies report empirical data about difficulties in children EFs during pandemic, and even fewer point out reasons that could explain them. Therefore, it is recommended that researchers continue to investigate the influence of the pandemic on children's cognitive development and analyze studies on the subject that have been published globally.

Despite these limitations, this research discusses various contextual factors that may have mediated the pandemic's impact on EFs performance and development in children. Future longitudinal investigations are intended to put these potential explanatory pathways to the test. On the other hand, this study suggests implications for school-based interventions targeted at creating a sensitive trauma learning environment in order to mitigate the pandemic's impact on children's mental health and improve their cognitive functioning. It would be interesting to examine the efficacy of the recommended strategies to support children in crisis situations. It is also suggested that school-based interventions be developed to establish partnerships among family, school, and community in order to improve resources in the face of crisis and disasters.

The pandemic has had a significant impact on children's lives. The deterioration in the mental health, well-being and quality of life of children have been widely documented worldwide. However, few studies have reported the impact of the pandemic on the executive functioning of children. EFs are responsible for the self-regulation of behavior, cognitions and emotions, and are critical resources for facing novel and complex situations. From an ecological contextual model of cognitive development, this paper identifies contextual factors that may have mediated the impact of the pandemic on the performance and development of EFs in children. Given that family and school are crucial contexts that model children development, school-based interventions are proposed in order to support children during times of crisis.

Children’s ability to overcome challenges will depend on their internal resources and the support they obtain from their families and school. In the school context, the teacher plays a key role in identifying the symptoms of stress in children, in helping them manage stress, gain calm, promote resilience and strengthen their EFs. Therefore, it is necessary to train teachers in the application of evidence-based techniques and strategies aimed at strengthening child EFs and lowering stress. This challenge requires partnerships between mental health professionals, teachers, and families. It also requires listening to children's voices, stimulating their active participation and empowering them as agents of change.

1. Kempuraj D, Selvakumar GP, Ahmed ME, Raikwar SP, Thangavel R, Khan A, Zaheer SA, Iyer SS, Burton C, James D, Zaheer A. COVID-19, Mast Cells, Cytokine Storm, Psychological Stress, and Neuroinflammation. Neuroscientist. 2020 Oct-Dec;26(5-6):402-414. doi: 10.1177/1073858420941476. Epub 2020 Jul 18. PMID: 32684080.
2. Park CL, Russell BS, Fendrich M, Finkelstein-Fox L, Hutchison M, Becker J. Americans' COVID-19 Stress, Coping, and Adherence to CDC Guidelines. J Gen Intern Med. 2020 Aug;35(8):2296-2303. doi: 10.1007/s11606-020-05898-9. Epub 2020 May 29. PMID: 32472486; PMCID: PMC7259430.
3. Vinkers CH, van Amelsvoort T, Bisson JI, Branchi I, Cryan JF, Domschke K, Howes OD, Manchia M, Pinto L, de Quervain D, Schmidt MV, van der Wee NJA. Stress resilience during the coronavirus pandemic. Eur Neuropsychopharmacol. 2020 Jun;35:12-16. doi: 10.1016/j.euroneuro.2020.05.003. Epub 2020 May 11. PMID: 32446705. PMCID: PMC7211573.
4. Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, Ho RC. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health. 2020 Mar 6;17(5):1729. doi: 10.3390/ijerph17051729. PMID: 32155789. PMCID: PMC7084952.
5. Amjadi K. Exploring factors that influence children’s growth and development during a pandemic. Glob Pediatr Health. 2021 Aug 27;8:2333794X211042464. doi: 10.1177/2333794X211042464. PMCID: PMC8404674. PMID: 34471654.
6. Abdulah DM, Abdulla BMO, Liamputtong P. Psychological response of children to home confinement during COVID-19: A qualitative arts-based research. International Journal of Social Psychiatry. 2020;67(8):0020764020972431-9. doi: 10.1177/0020764020972439.
7. Giraudo S. How to identify when students are stressed. In: Disastershock Educators Collaboration Team, editors. Disastershock: How schools can cope with the emotional stress of a major disaster a manual for principals and teachers. San Francisco, USA: Institute for School-Based Family Counseling; 2021. p.19-23.
8. Korzeniowski C. Teaching strategies for reducing student stress. In: Disastershock Educators Collaboration Team, editors. Disastershock: How schools can cope with the emotional stress of a major disaster a manual for principals and teachers. San Francisco, USA: Institute for School-Based Family Counseling; 2021. p.24-30.
9. Sánchez Boris IM. Psychological impact of the COVID-19 in children and adolescents. Medisan. 2021;25(1):124-143.
10. Schwartz KD, Exner-Cortens D, McMorris CA, Makarenko C, Arnold P, Van Bavel M, Williams S, Canfield R. COVID-19 and student well-being: Stress and mental health during return-to-school. Can J Sch Psychol. 2021 Jun;36(2):166-185. doi: 10.1177/08295735211001653. Epub 2021 Mar 18. PMID: 34040284. PMCID: PMC8114331.
11. Williams ML, Morse BL, DeGraffenried W, McAuliffe DL. Addressing stress in high school students during the COVID-19 pandemic.  NASN Sch Nurse. 2021 Jul;36(4):226-232. doi: 10.1177/1942602X21993053. Epub 2021 Mar 17. PMID: 33729054.
12. Sayed MH, Hegazi MA, El-Baz MS, Alahmadi TS, Zubairi NA, Altuwiriqi MA, Saeedi FA, Atwah AF, Abdulhaq NM, Almurashi SH. COVID-19 related posttraumatic stress disorder in children and adolescents in Saudi Arabia. PLoS One. 2021 Aug 4;16(8):0255440. doi: 10.1371/journal.pone.0255440. eCollection 2021. PMID: 34347842. PMCID: PMC8336789.
13. Sharma M, Idele P, Manzini A, Aladro CP, Ipince A, Olsson G, Banati P, Anthony D. UNICEF Office of Research-Innocenti (Italy). Life in Lockdown: Child and adolescent mental health and well-being in the time of COVID-19. Florence, Italy: UNICEF Office of Research - Innocenti; 2021.
14. Theberath M, Bauer D, Chen W, Salinas M, Mohabbat4 AB, Yang J, Chon TY, Bauer BA, Wahner-Roedler DL. Effects of COVID-19 pandemic on mental health of children and adolescents: A systematic review of survey studies. SAGE Open Med. 2022 Mar 30;10:20503121221086712. doi: 10.1177/20503121221086712 PMCID: PMC8972920.PMID: 35371484.
15. Naff D, Williams S, Furman-Darby J, Yeung M. The mental health impacts of COVID-19 on PK-12 students: A systematic review of emerging literatura. AERA Open. 2022;8(1):1-40. doi: 10.1177/23328584221084722.
16. Kuhfeld M, Soland J, Tarasawa B, Johnson A, Ruzek E, Liu J. Projecting the potential impact of COVID-19 school closures on academic achievement. Educational Researcher. 2020;49(8):549-565. doi: 10.3102/0013189X2096591.
17. Peredo Videa R. Shall we go back to school? Analysis from educational psychology towards effects of COVID-19 pandemic. Revista de Psicologia. 2020;S42-56.
18. Cameron L, Tenenbaum HR. Lessons from developmental science to mitigate the effects of the COVID-19 restrictions on social development. Group Processes & Intergroup Relations. 2021;24(2):231-236. doi: 10.1177/1368430220984236.
19. Charney SA, Camarata SM, Chern A. Potential impact of the COVID-19 pandemic on communication and language skills in children. Otolaryngol Head Neck Sur. 2021 Jul; 165(1):1–2. doi: 10.1177/0194599820978247. Epub 2020 Dec 1. PMID: 33258739.
20. Lavigne-Cervan R, Costa-López B, Juárez-Ruiz de Mier R, Sánchez-Muñoz de León M, Real-Fernández M, Navarro-Soria I. Implications of the Online Teaching Model Derived from the COVID-19 Lockdown Situation for Anxiety and Executive Functioning in Spanish Children and Adolescents. Int J Environ Res Public Health. 2021 Oct 5;18(19):10456. doi: 10.3390/ijerph181910456. PMID: 34639755; PMCID: PMC8508010.
21. Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB , Krumholz  HM , Uriel N, Mehra MR, Elkind  MSV, Stone  GW, Schwartz A, Ho  DD, Bilezikian JP, Landry  DW. Extrapulmonary manifestations of COVID-19. Nat Med. 2020 Jul;26(7):1017-1032. doi: 10.1038/s41591-020-0968-3. Epub 2020 Jul 10. PMID: 32651579.
22. Pantelis C, Jayaram M, Hannan AJ, Wesselingh R, Nithianantharajah J, Wannan CM, Syeda WT, Choy KH, Zantomio D, Christopoulos A, Velakoulis D, O’Brien TJ. Neurological, neuropsychiatric and neurodevelopmental complications of COVID-19. Aust N Z J Psychiatry. 2021 Aug;55(8):750-762. doi: 10.1177/0004867420961472. Epub 2020 Oct 1. PMID: 32998512. PMCID: PMC8317235.
23. Helms J, Kremer S, Merdji H, Clere-Jeh R, Schenck M, Kummerlen C, Collange O, Boulay C, Fafi-Kremer S, Ohana M, Anheim M, Meziani F. Neurologic features in severe SARS-CoV-2 infection. N Eng J Med. 2020 Jun 4;382(23):2268-2270. doi: 10.1056/NEJMc2008597. Epub 2020 Apr 15. PMID: 32294339. PMCID: PMC7179967.
24. Tsivgoulis G, Palaiodimou L, Katsanos AH, Caso V, Köhrmann M, Molina C, Cordonnier C, Fischer U, Kelly P, Sharma VK, Chan AC, Zand R, Sarraj A, Schellinger PD, Voumvourakis KI, Grigoriadis N, Alexandrov AV, Tsiodras S. Neurological manifestations and implications of COVID-19 pandemic. Ther Adv Neurol Disord. 2020 Jun 9;13:1756286420932036. doi: 10.1177/1756286420932036. eCollection 2020. PMID: 32565914. PMCID: PMC7284455.
25. Rogers JP, Chesney E, Oliver D, Pollak TA, McGuire P, Fusar- Poli, P., Zandi MS, Lewis G, David AS. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry. 2020 Jul;7(7):611-27.doi: 10.1016/S2215-0366(20)30203-0. Epub 2020 May 18. PMID: 32437679. PMCID: PMC7234781.
26. Berken JA, Heard-Garris N, Wakschlag LS. Guardians at the Gate: Early adversity, neurocognitive development, and the role of the pediatrician in the era of COVID-19. Front Pediatr. 2021 Apr 14; e9:665335. doi: 10.3389/fped.2021.665335. PMID: 33937157. PMCID: PMC8079717.
27. Navarro-Soria I, Costa-López B, Collado-Valero JA, de Mier RJ, Lavigne-Cervan R. Anxiety, sleep habits and executive function during the COVID-19 pandemic through parents' perception: a longitudinal study. Psicol Reflex Crit. 2023 Mar 29;36(1):8. doi: 10.1186/s41155-023-00251-5. PMID: 36988724; PMCID: PMC10050808.
28. Hackman DA, Farah MJ, Meaney MJ. Socioeconomic status and the brain: mechanistic insights from human and animal research. Nat Rev Neurosci. 2010 Sep 1; 11(9): 651–659. doi: 10.1038/nrn2897. PMCID: PMC2950073. NIHMSID: NIHMS234938. PMID: 20725096.
29. García-González JR, Sánchez-Sánchez PA. Theoretical design of research: Methodological instructions for the development of scientific research proposals and projects. Información Técnológica. 2020;31(6):159-170. doi: 10.4067/S0718-07642020000600159.
30. Bronfenbrenner U. Ecological Systems Theory. Vasta R, editor. In: Six Theories of Child Development: Revised Formulations and Current Issues. Bristol: Jessica Kingsley Publisher; 1992. p.187-249.
31. Diamond A. Executive functions. Annu Rev Psychol. 2013; 64(1):135-68. doi: 10.1146/annurev-psych-113011-143750. Epub 2012 Sep 27. PMID: 23020641. PMCID: PMC4084861.
32. Walk LM, Evers WF, Quante S, Hille K. Evaluation of a teacher training program to enhance executive functions in preschool children. PLoS One. 2018 May 24;13(5):0197454. doi: 10.1371/journal.pone.0197454. eCollection 2018. PMID: 29795603. PMCID: PMC5967750.
33. Blair C, Raver C. Closing the achievement gap through modification of neurocognitive and neuroendocrine function: results from a cluster randomized controlled trial of an innovative approach to the education of children in kindergarten. PLoS ONE. 2014; 9(11):112393. doi: 10.1371/journal.pone.0112393. PMID: 25389751. PMCID: PMC4229187.
34. Miyake A, Friedman NP, Emerson MJ, Witzki AH, Howerter A. (2000). The unity and diversity of executive functions and their contributions to complex “frontal lobe” tasks: A latent variable analysis. Cogn Psychol. 2000 Aug;41(1):49-100.doi: 10.1006/cogp.1999.0734. PMID: 10945922.
35. Hughes C. Changes and challenges in 20 years of research into the development of executive functions. Infant Child Dev. 2011;20(3):251-271. doi: 10.1002/icd.736 .
36. Korzeniowski C, Ison M, Difabio H. A summary of the developmental trajectory of executive functions from birth to adulthood. In: Gargiulo PA, Mesones-Arroyo HL, editors. Psychiatry and Neuroscience Update, Vol IV. Switzerland: Springer; 2021. p.459-473.
37. Fuster JM. The prefrontal cortex - An update: Time of the essence. Neuron. 2001 May;30(2):319-33. doi: 10.1016/s0896-6273(01)00285-9. PMID: 11394996.
38. Armstrong V, Brunet P, He C, Nishimura M, Poole, H. What is so critical? A commentary on the reexamination of critical periods. Developmental Psychobiology. 2006;48(4):326-331. doi: 10.1002/dev.20135.
39. Bernier A, Carlson SM, Deschênes M, Matte-Gagné C. Social factors in the development of early executive functioning: A closer look at the caregiving environment. Dev Sci. 2012 Jan; 15(1):12-24. doi: 10.1111/j.1467-7687.2011.01093.x. Epub 2011 Sep 29. PMID: 22251288.
40. Bibok MB, Carpendale JI, Müller U. Parental scaffolding and the development of executive function. In: Lewis C, Carpendale JI, editors. Social interaction and the development of executive function. New Dir Child Adolesc Dev. 2009. p.17-34. doi: 10.1002/cd.233. PMID: 19306272.
41. Hoff E. The specificity of environmental influence: Socioeconomic status affects early vocabulary development via maternal speech. Child Dev. 2003 Sep-Oct;74(5):1368-78. doi: 10.1111/1467-8624.00612. PMID: 14552403.
42. Ardila A, Rosselli M, Matute E, Guajardo S. The influence of the parents' educational level on the development of executive functions. Dev Neuropsychol. 2005;28(1):539-60. doi: 10.1207/s15326942dn2801_5. PMID: 15992255.
43. Spruijt AM, Dekker MC, Ziermans TB, Swaab H. Attentional control and executive functioning in school-aged children: Linking self-regulation and parenting strategies. J Exp Child Psychol. 2018 Feb;166:340-359. doi: 10.1016/j.jecp.2017.09.004. Epub 2017 Oct 9. PMID: 29024846.
44. Weiland C, Ulvestad K, Sachs J, Yoshikawa H. Associations between classroom quality and children's vocabulary and executive function skills in an urban public prekindergarten program. Early Childhood Research Quarterly. 2013;28(2):199-209. doi: 10.1016/j.ecresq.2012.12.002.
45. Bardack S, Obradović J. Observing teachers' displays and scaffolding of executive functioning in the classroom context. Journal of Applied Developmental Psychology. 2019;62(1):205-219. doi: 10.1016/j.appdev.2018.12.004.
46. Korinek L, deFur SH. Supporting student self-regulation to access the general education curriculum. Teaching Exceptional Children. 2016;48(5):232-242. doi: 10.1177/0040059915626134.
47. Vandenbrouck L, Spilt JL, Verschueren K, Baeyens D. The effects of peer rejection, parent and teacher support on working memory performance: An experimental approach in middle childhood. Learning and Individual Differences. 2018;67:12-21. doi: 10.1016/j.lindif.2018.06.007.
48. Lecuyer EA, Zhang, Y. An integrative review of ethnic and cultural variation in socialization and children's self-regulation. J Adv Nur. 2015 Apr 7;71(4):735-50. doi: 10.1111/jan.12526. Epub 2014 Sep 23. PMID: 25250509.
49. Moriguchi Y, Evans AD, Hiraki K, Itakura S, Lee K. Cultural differences in the development of cognitive shifting: East–West comparison. J Exp Child Psychol. 2012 Feb;111(2):156-63.doi: 10.1016/j.jecp.2011.09.001. Epub 2011 Oct 2. PMID: 21967676.
50. Nyroos M, Wiklund-Hörnqvist C, Löfgren K. Executive function skills and their importance in education: Swedish student teachers’ perceptions. Thinking Skill and Creativity. 2018;27:1-12. doi: 10.1016/j.tsc.2017.11.007.
51. Moffitt TE, Arseneault L, Belsky D, Dickson N, Hancox RJ, Harrington H, Houts R, Poulton R, Roberts BW, Ross S, Sears MR, Thomson WM, Caspi A. A gradient of childhood self-control predicts health, wealth, and public safety. Proc Natl Acad Sci U S A. 2011 Feb 15;108(7):2693-8. doi: 10.1073/pnas.1010076108. Epub 2011 Jan 24. PMID: 21262822; PMCID: PMC3041102.
52. Andrés ML, Galli JI, Del Valle M, Vernucci S, López-Morales H, Gelpi-Trudo R, Canet-Juric L. Parental Perceptions of Child and Adolescent Mental Health During the COVID-19 Pandemic in Argentina. Child Youth Care Forum. 2022;51(6):1195-1225. doi: 10.1007/s10566-021-09663-9. Epub 2022 Jan 27. PMID: 35103041; PMCID: PMC8791676.
53. Hanno EC, Fritz LS, Jones SM, Lesaux NK. School Learning Format and Children's Behavioral Health During the COVID-19 Pandemic. JAMA Pediatr. 2022 Apr 1;176(4):410-411. doi: 10.1001/jamapediatrics.2021.5698. PMID: 35006261; PMCID: PMC8749689.
54. Polizzi C, Burgio S, Lavanco G, Alesi M. Parental distress and perception of children’s executive functioning after the first COVID-19 lockdown in Italy. J Clin Med. 2021 Set 15;10(18):4170. doi: 10.3390/jcm10184170. PMCID: PMC8471124. PMID: 34575279 .
55. Moh’d AS, Hasan M. Well-being, psychological distress, family environment and executive functions during and after the first wave lockdown of COVID-19 in Jordan: A longitudinal study. Journal of Positive Psychology and Wellbeing. 2021;5(4):1022-1037.
56. Di Giorgio E, Di Riso D, Mioni G, Cellini N. The interplay between mothers’ and children behavioral and psychological factors during COVID-19: An Italian study. Eur Child Adolesc Psychiatry. 2021 Sep;30(9):1401-1412. doi: 10.1007/s00787-020-01631-3. Epub 2020 Aug 31. PMID: 32865654. PMCID: PMC7456665.
57. Korzeniowski C. An ecological-contextual model of the development of executive functions: Identifying target areas for its promotion in children in socially-disadvantaged contexts. In: Deb S, Gerrard B, editors. Handbook of Health and Well-being: Challenges, Strategies and Future Trends. Singapore: Springer Nature; 2022. p.455-476.
58. Noble KG, Farah MJ. Neurocognitive consequences of socioeconomic disparities: the intersection of cognitive neuroscience and public health. Dev Sci. 2013 Sep;16(5):639-40. doi: 10.1111/desc.12076. Epub 2013 Jun 25. PMID: 24033569.
59. Kishiyama MM, Boyce WT, Jiménez AM, Perry LM, Knight RT. Socioeconomic disparities affect prefrontal function in children. J Cog Neurosci, 2009 Jun;21(6):1106-15.doi: 10.1162/jocn.2009.21101. PMID: 18752394.
60. Lupien SJ, King S, Meaney MJ, McEwen BS. Can poverty get under your skin? Basal cortisol levels and cognitive function in children from low and high socioeconomic status. Dev Psychopathol. 2001 Summer;13(3):653-76.doi: 10.1017/s0954579401003133. PMID: 11523853.
61. 61.Park JH, Park JY, Jin KS. What did COVID-19 change? The impact of COVID-19 on Korean parents' and children's daily lives and stress. Child Psychiatry Hum Dev. 2022 Feb;53(1):172-82. doi: 10.1007/s10578-021-01262-y. Epub 2021 Oct 1. PMID: 34596821. PMCID: PMC8485309.
62. Russell BS, Tomkunas A J, Hutchison M, Tambling RR, Horton AL. The protective role of parent resilience on mental health and the parent–child relationship during COVID-19. Child Psychiatry Hum Dev. 2022 Feb;53(1):183-96. doi: 10.1007/s10578-021-01243-1. Epub 2021 Sep 17. PMID: 34533667. PMCID: PMC8447807.
63. Blair C, Granger DA, Willoughby M, Mills-Koonce R, Cox M, Greenberg MT, Kivlighan KT, Fortunato CK, FLP Investigators. Salivary cortisol mediates effects of poverty and parenting on executive functions in early childhood. Child Dev. 2011;82(6):1970–84. Doi: 10.1111/j.1467-8624.2011.01643.x. Epub 2011 Oct 25. PMID: 22026915.
64. Wu Q, Xu Y. Parenting stress and risk of child maltreatment during the COVID-19 pandemic: A family stress theory- informed perspective. Dev Child Welf. 2020 Oct 20;2516103220967937. PMCID: PMC7576334.
65. Fitzpatrick C, McKinnon RD, Blair C, Willoughby M. Do preschool executive function skills explain the school readiness gap between advantaged and disadvantaged children? Learning and Instruction. 2014;30:25-31. doi: 10.1016/j.learninstruc.2013.11.003.
66. Cuartas J. Heightened risk of child maltreatment amid the COVID-19 pandemic can exacerbate mental health problems for the next generation. Psychol Trauma. 2020 Aug;12(S1):S195-S196. doi: 10.1037/tra0000597. Epub 2020 May 28. PMID: 32463282.
67. Cohen SR, Wishard-Guerra A, Molgaard MR, Miguel J. Social class and emotional well-being: Lessons from a daily diary study of families engaged in virtual elementary school during COVID-19. AERA Open. 2022;8(1):1-14. doi: 10.1177/23328584221095854.
68. Toran M, Ramazan S, Xu Y, Sahin-Sak IT, Yu Y. Parents and children during the COVID-19 quarantine process: Experiences from Turkey and China. Journal of Early Childhood Research. 2021;19(1):21-39. doi: 10.1177/1476718X20977.
69. Magalhães L, Nascimento C, Antunes AP, Martins S, Mattar Yunes MA, Almeida A. Perception of impressive experiences during the confinement on portuguese and brazilian families: A qualitative study.  New Trends in Qualitative Research. 2021;9:172-180. doi: 10.36367/ntqr.9.2021.172-180.
70. Aram D, Asaf M, Karabanov GM, Ziv M, Sonnenschein S, Stites M, Shtereva K, López-Escribano C. Beneficial Parenting According to the “Parenting Pentagon Model”: A Cross-Cultural Study During a Pandemic. In: Pattnaik J, Renck Jalongo M, editors. The impact of COVID-19 on early childhood education and care. Educating the Young Child. Cham: Springer; 2022. doi: 10.1007/978-3-030-96977-6_112022.
71. Salas G, Santander P, Precht A, Scholten H, Moretti R, López-López W. COVID-19: Psychosocial impact at school in Chile. Inequalities and challenges for Latin America. Avances en Psicología Latinoamericana. 2020;38(2):4-20. doi: 10.12804/revistas.urosario.edu.co/apl/a.9404.
72. Domingue BW, Dell M, Lang D, Silverman R, Yeatman J, Hough H. The effect of covid on oral reading fluency during the 2020-2021 academic year. AERA Open. 2022;8(1):1-12. doi: 10.1177/23328584221120254.
73. Davis CR, Grooms J, Ortega A, Rubalcaba JAA, Vargas E. Distance Learning and Parental Mental Health During COVID-19. Educational Researcher. 2021;50(1):61-64. doi: 10.3102/0013189X20978806.
74. Weaver JL, Swank JM. Parents’ lived experiences with the COVID-19 pandemic. Fam J Alex Va. 2020 Nov 10: 1066480720969194. doi: 10.1177/1066480720969194. PMCID: PMC7657952.
75. Yung-Chi Chen C, Byrne E, Vélez T. Impact of the 2020 pandemic of COVID-19 on families with school-aged children in the United States: Roles of income level and race. Journal of Family Issues. Journal of Family Issues. 2021;43(35). doi: 10.1177/0192513X21994153.
76. Gunzenhauser C, Enke S, Johann VE, Karbach J, Saalbach H. Parent and teacher support of elementary students’ remote learning during the COVID-19 pandemic in Germany. AERA Open. 2021;7(1):1-16.  doi: 10.1177/23328584211065710.
77. Burrage M, Ponitz C, McCready E, Shah P, Sims B, Jewkes A, Morrison F. Age and schooling related effects on executive functions in young children: A natural experiment. Child Neuropsychol. 2008;14(6):510-24. doi: 10.1080/09297040701756917. PMID: 18982508.
78. Wagner-Fuhs M, Nesbitt K, Farran D, Dong N. Longitudinal associations between executive functioning and academic skills across content areas. Dev Psychol. 2014 Jun;50(6):1698-709, doi: 10.1037/a0036633. Epub 2014 Apr 21. PMID: 24749550.
79. McKinnon R, Blair C. Bidirectional relations among executive function, teacher-child relationships, and early reading and math achievement: A cross-lagged panel analysis. Early Childhood Research Quarterly. 2019; 46(1):152-165. doi: 10.1016/j.ecresq.2018.03.011.
80. Swadener BB, Peters L, Bentley DF, Diaz X, Bloch M. Child care and COVID-19: Precarious communities in distanced times. Global Studies of Childhood. 2020;10(4):313-326. doi: 10.1177/2043610620970552.
81. Souto-Manning M, Melvin, SA. Early childhood teachers of color in New York city: heightened stress, lower quality of life, declining health, and compromised sleep amidst COVID-19. Early Child Res Q. 2022;60:34-48. doi: 10.1016/j.ecresq.2021.11.005. Epub 2021 Nov 23. PMID: 34840418. PMCID: PMC8608653.
82. Organisation for Economic Co-operation and Development. Improving Schools in Sweden: An OECD Perspective. Paris, France: OECD; 2015.
83. Johnson AD, Schochet ON, Castle S, Horm D, Phillips DA. Predictors of first-grade teachers’ teaching-related time during COVID-19. AERA Open. 2022;8(1):1-14. doi: 10.1177/23328584211067798.
84. Keenan L, Conroy S, O'Sullivan A, Downes M. Executive functioning in the classroom: Primary school teachers’ experiences of neuropsychological issues and reports. Teaching and Teacher Education. 2019;86. doi: 10.1016/j.tate.2019.102912.
85. Vygotsky LS. Mind in Society: The development of higher psychological processes. Cambridge, MA: Harvard Univ Press; 1978. doi: 10.2307/j.ctvjf9vz4.
86. Moriguchi Y. The early development of executive function and its relation to social interaction: a brief review. Front Psychol. 2014 Apr 29;5:388. doi: 10.3389/fpsyg.2014.00388. PMCID: PMC4010730. PMID: 24808885.
87. Cellini N, Canale N, Mioni G, Costa S. Changes in sleep pattern, sense of time, and digital media use during COVID-19 lockdown in Italy. J Sleep Res. 2020 Aug;29(4):13074. doi: 10.1111/jsr.13074. Epub 2020 May 15. PMID: 32410272. PMCID: PMC7235482.
88. Chambonnière C, Fearnbach N, Pelissier L, Genin P, Fillon A, Boscaro A, Bonjean L, Bailly M, Siroux J, Guirado T, Thivel D, Duclos M. Adverse collateral effects of COVID-19 public health restrictions on physical fitness and cognitive performance in primary school children. Int J Environ Res Public Health. 2021 Oct 22; 18(21):11099. doi: 10.3390/ijerph182111099. PMID: 34769619. PMCID: PMC8583224.
89. Hunter MR, Gillespie BW, Chen SY. (2019). Urban nature experiences reduce stress in the context of daily life based on salivary biomarkers. Front Psychol. 2019;10:722. doi: 10.3389/fpsyg.2019.00722. PMCID: PMC6458297. PMID: 31019479.
90. Susilowati IH, Nugraha S, Alimoeso S, Hasiholan BP. Screen time for preschool children: learning from home during the COVID-19 pandemic. Glob Pediatr Health. 2021 May 15;8:2333794X211017836. doi: 10.1177/2333794X211017836. eCollection 2021. PMID: 34031645. PMCID: PMC8127788.
91. Gerrard BA, Soriano M. School-based family counseling: The revolutionary paradigm. In: Gerrard BA, Carter MJ, Ribera D, editors. School-based family counseling: A Interdisciplinary Practitioner’s Guide. New York: Routledge; 2020. p.1-15.
92. Rosen SM, Boyle JR, Cariss K, Forchelli GA. Changing how we think, changing how we learn: Scaffolding executive function processes for students with learning disabilities. Learning Disabilities: A Multidisciplinary Journal. 2014;20(4):165-176. doi: 10.18666/LDMJ-2014-V20-I4-6145.
93. Brymer M, Taylor M, Escudero P, Jacobs A, Kronenberg M, Macy R, Mock L, Payne L, Pynoos R, Vogel J. Psychological First Aid for schools: Field Operations Guide, 2nd ed. Los Angeles: National Child Traumatic Stress Network; 2012.
94. Cohen J, Goodman R, Kliethermes MD, Epstein, C. Helping children with traumatic separation or traumatic grief related to COVID-19. Los Angeles, CA, and Durham, NC: National Center for Child Traumatic Stress; 2020.
95. Gerrard B, Girault E, Appleton V, Giraudo S, Shaffer SL. Disastershock. How to cope with the emotional stress of a major disaster. San Francisco, USA: Institute for School-Based Family Counseling. 2020. p.53.
96. Goldman JH, Danna L, Maze JW, Pickens IB, Ake III GS. Trauma informed school strategies during COVID-19. Los Angeles, CA, and Durham, NC: National Center for Child Traumatic Stress. 2020.
97. Pfefferbaum B, Sweeton JL, Newman E, Varma V, Nitiéma P, Shaw JA, Chrisman AK, Noffsinger MA. Child disaster mental health interventions, part I. Disaster Health. 2014 Jan 2; 2(1): 46–57. doi: 10.4161/dish.27534. PMCID: PMC4407368. NIHMSID: NIHMS678920. PMID: 25914863.
98. Pfefferbaum B, Sweeton JL, Newman E, Varma V, Nitiéma P, Shaw JA, Chrisman AK, Noffsinger MA. Child disaster mental health interventions, part II. Disaster Health. 2014 Jan 2; 2(1):58–67. doi: 10.4161/dish.27535 PMCID: PMC4540222. NIHMSID: NIHMS678923. PMID: 26295009.
99. Rechtschaffen D. The way of Mindful Education: Cultivating well-being in teachers and students. US, New York: WW Norton & Co; 2014.
100. Andersen PN, Klausen ME, Skogli EW. Art of learning-an Art-Based Intervention aimed at improving children’s executive functions. Front Psychol. 2019;10:1769. doi: 10.3389/fpsyg.2019.01769. PMC6685039.
101. Hodgkinson T, Parks S. Teachers as air traffic controllers: Helping adolescents navigate the unfriendly skies of executive functioning. Clearing House: A Journal of Educational Strategies, Issues and Ideas. 2016;89(6):208-214. doi: 10.1080/00098655.2016.1214472.
102. Janz P, Dawe S, Wyllie M. Mindfulness-based program embedded within the existing curriculum improves executive functioning and behavior in young children: A waitlist controlled trial. Front Psychol. 2019 Sep;10: 2052. doi: 10.3389/fpsyg.2019.02052. PMCID: PMC6746974. PMID: 31551884.
103. Korzeniowski C, Ison M, Difabio H. Child cognitive stimulation programs: Various modalities of intervention in socially vulnerable contexts. In: Gargiulo PA, Mesones-Arroyo HL, editors. Psychiatry and Neuroscience Update, Vol II: Translation Approach. Switzerland: Springer; 2017. p.309-21. doi: 10.1007/978-3-319-53126-7_23.
104. Korzeniowski C, Ison M, Difabio H. Group cognitive intervention targeted to the strengthening of executive functions in children at social risk. Int J Psychol Res (Medellin). 2017 Jul-Dec;10(2):34-45.doi: 10.21500/20112084.2760. PMID: 32612763. PMCID: PMC7110154.
105. Korzeniowski C, Morelato G, Greco C, Monteoliva JM. Improving executive functions in elementary schoolchildren. European Journal of Psychology and Educational Research. 2020;3(1):59-73. doi: 10.12973/ejper.3.1.59.
106. Moraine P. The executive functions of the student. Improve attention, memory, organization and other functions to facilitate learning. Madrid: Narcea, S.A. de Ediciones; 2014.
107. Raver CC, Blair C, Li-Grining CP. Extending models of emotional self- regulation to classroom settings: Implications for professional development. In: Howes C, Hamre B, Pianta R. Effective early Childhood Professional Development: Improving teacher Practice and Child Outcomes. Baltimore, ML: Brookes Publishing; 2012. p.113-130.
108. Zelazo PD, Forston JL, Masten AS, Carlson SM. Mindfulness plus reflection training: Effects on executive function in early childhood. Front Psychol. 2018 Feb 26;9:208. doi: 10.3389/fpsyg.2018.00208. PMCID: PMC5834482. PMID: 29535661.a