Exploring the Predictive Role of Early Executive Functions and Self-Regulation on Functional Outcome in Neurodevelopmental Disorders: A Systematic Review and Meta-analysis

Executive functions and self-regulation, which are the control processes relevant for learning and adaptation, are frequently impaired in neurodevelopmental disorders (NDDs). Research on the role of early executive functions and self-regulation in the diagnosis and developmental trajectories of NDDs has grown rapidly in recent years, necessitating a synthesis of the evidence strength and the methodologies used to investigate the relationship between executive functions/self-regulation and the functional profiles of NDDs. This systematic review and meta-analysis examined 32 studies that used longitudinal designs to investigate the relationship between executive functions and self-regulation in the first 6 years of life and NDDs symptoms from ages 3 to 18. Separate meta-analyses were conducted for the statistical methods used, as well as for ADHD and ASD diagnoses, types of executive function and self-regulation measures, and the developmental periods during which they were assessed. The results highlight a significant longitudinal association between early executive and self-regulation difficulties and later impairments in attention, socio-communication, and adaptive functioning in NDDs. The findings also support the predictive value of these early difficulties and the need to consider the methodological characteristics of the studies. Although these findings predominantly concern specific diagnostic categories, such as attention-deficit/hyperactivity disorder and autism spectrum disorder, they could have important implications for several conditions of atypical neurodevelopment, especially for the prevention of symptoms and associated psychopathological exacerbation. Given the methodological variability of the studies, the results of this review can also help in defining more appropriate tools and statistical methodologies for future research.