Effektivität und Durchführbarkeit exekutive Funktionen zentrierender Interventionen im Kindergartenalter
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Philipps-Universität Marburg
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Externalizing disorders are among the most common mental disorders in childhood and adolescence. In many etiological models of externalizing disorders, executive dysfunctions are considered basic deficits. Training of executive core functions (working memory, inhibitory control and cognitive flexibility) in preschool age, in which brain development undergoes significant steps, can therefore be a promising starting point for prevention and intervention of externalizing disorders. Various approaches to train executive functions have been developed. However, a quantitative summary of the effectiveness of these approaches at preschool age has not yet been available. Therefore, a meta-analysis was conducted in Study 1 to close this research gap. In the literature search, k = 42 studies could be identified. Possible risks of bias were recorded. The effect sizes in terms of executive functions were d = .31 (cold inhibitory control), d = .46 (working memory), d = 44 (hot inhibitory control) and d = .42 (cognitive flexibility). Regarding externalizing symptoms, small (ADHD symptoms: d = .40) to medium (further externalizing symptoms: d = .59) were calculated. Interventions targeting multiple EFs and using scaffolding and metacognitive approaches showed large and statistically significant effects in this respect. Attention-directing Training showed the largest effect size regarding hot inhibitory control. In future research more well-controlled studies need to be conducted to further verify the results of this meta-analysis. Components of a cognitive training (CRIPS; Pauli-Pott, 2019) were evaluated in two studies. In study 2, a feasibility-study, the attractiveness and motivability of the Training for preschool children was qualitatively evaluated. For this purpose, 2-3 essential training sessions of CRIPS training were carried out in two day care centers. Subsequently, the participating n = 7 preschool children and n = 3 preschool teachers were interviewed with semi-structured interviews with regard to motivability and attractiveness. Most of the children showed motivation to further participate in the training and stated the training content as attractive. Some pieces of content were perceived as less attractive than others. Statements of the preschool teachers matched with the statements of the children. The elements of the training, which were said to be less attractive, should be revised based on the interviews in order to further increase the attractiveness and motivability of the training. In Study 3, first proofs of effectiveness of the CRIPS training in a pilot study were evaluated. It should be evaluated whether at least small effect sizes of the training can be detected in children with externalizing symptoms/disorders. In total, n = 14 children participated. At three recruitment points, eight of the twelve dates of the CRIPS training were carried out in a child and adolescent psychiatric day clinic. At each time of recruitment, pre- and post-measurements on working memory, hot and cold inhibitory control (neuropsychological tests) as well as a questionnaire rating by the care staff of the day clinic on externalizing symptoms were carried out. Effects could be found on working memory (d = 1.57) and cold inhibitory control (d = .31), whereas on hot inhibitory control, no effect were discernible. Other than expected, no effect could be found on externalizing symptoms. In addition, a small effect in favor of the control group did occur for behavior problems. This could have been on the one hand since only eight of twelve sessions were carried out, on the other hand due to the lack of blinded assessment of externalizing symptoms and the not detailed assessment of drug therapy. The question of effectiveness of CRIPS-Training on externalizing symptoms should be investigated in further studies. Within this dissertation a research gap was closed, in which a first quantitative comparison of executive function-centering intervention approaches in preschool age was carried out. Effective approaches could be identified. Based on these results a cognitive training was developed. Components of this training were evaluated in a feasibility- and a pilot-study.
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Created: 2023Issued: 2023-05-02Updated: 2023-05-02
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
Keywords
Exekutive Funktionen Kindergartenalter Vorschulalter ADHS Externalisierende Störungen Arbeitsgedächtnis InhibitionskontrolleExecutive functions Preschool age ADHD Externalizing disorders Working Memory Inhibitioncontrol Cognitive flexibility Feasibility
DFG-subjects
Kognitive Flexibilität
DDC-Numbers
610
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Mann, Christopher: Effektivität und Durchführbarkeit exekutive Funktionen zentrierender Interventionen im Kindergartenalter. : Philipps-Universität Marburg 2023-05-02. DOI: https://doi.org/10.17192/z2023.0332.