This systematic review and meta-analysis examined the impact of Mindfulness-based interventions (MBIs), specifically excluding yoga-only programs, on executive function in typically developing youth aged 3 to 18 years. The study encompassed N = 1,560 participants within educational settings, utilizing direct behavioural or computerised outcomes to measure executive function. The authors synthesized data to assess whether these interventions yield measurable improvements in cognitive control and related skills.
The primary analysis revealed a pooled effect size of Hedges' g = 0.365 with a 95% CI 0.264 to 0.465 and a p < .00001, indicating a small but statistically significant improvement. These effects were consistent across school-age and preschool populations, with Hedges' g = 0.389 and Hedges' g = 0.318 respectively. Furthermore, effects remained consistent across domains including inhibitory control, working memory, and cognitive flexibility, supported by a p_between = .60.
Subgroup analyses indicated the effect was robust, with Hedges' g = 0.361 for low-risk-of-bias studies and Hedges' g = 0.354 after trim and fill adjustment. The 95% PI 0.252 to 0.477 was entirely positive. However, no significant dose response relationship was observed (p = .79). Limitations included inconsistent construct definitions, pooling of heterogeneous outcome measures, and a single downgrade for risk of bias in the GRADE assessment. Adverse events, discontinuations, and tolerability were not reported.
The authors conclude that MBIs appear to produce a small, statistically significant improvement in executive function in youth aged 3 to 18 years, with moderate certainty of evidence per the GRADE framework. While emerging mediation evidence suggests EF improvement may serve as an important pathway through which MBI supports emotion regulation, this requires replication. Practitioners should interpret these findings cautiously given the heterogeneity of outcome measures and the moderate certainty rating.
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Background: Mindfulness based interventions (MBIs) have been increasingly adopted in educational settings to support cognitive development in youth. Executive function, encompassing inhibitory control, working memory, and cognitive flexibility, is a plausible target of MBI given its reliance on attention regulation. However, prior reviews have yielded mixed conclusions, partly due to inconsistent construct definitions and the pooling of heterogeneous outcome measures. Objectives: To (1) estimate the pooled effect of MBI on EF in youth aged 3 to 18 years using only construct validated, direct EF measures, (2) examine potential moderators including age group, EF domain, and risk of bias, and (3) test dose response relationships via meta regression on intervention duration. Methods: We searched PubMed, PsycINFO, CINAHL, Scopus, and Web of Science from inception to March 2026, supplemented by reference list searches from two existing systematic reviews and a scoping review. Only English-language publications were eligible. Eligible studies were randomised controlled trials (RCTs) or quasi-RCTs of MBI (excluding "yoga only" interventions) in typically developing youth, with at least one direct behavioural or computerised EF outcome. Risk of bias was assessed using Cochrane RoB 2. Hedges' g was computed for each study, and pooled using a random effects model. Subgroup analyses by age group, EF domain, and risk of bias were conducted, alongside "leave one out" sensitivity analyses, Egger's regression test, "trim and fill", and meta regression on intervention duration. Evidence certainty was rated using GRADE. Results: Thirteen RCTs (nine school age, four preschool; total N = 1,560) met inclusion criteria. The pooled effect was g = 0.365 (95% CI 0.264 to 0.465; p < .00001), with negligible heterogeneity (I2 = 0.0%; Q = 6.76, p = .87). Effects were consistent across age groups (school age g = 0.389; preschool g = 0.318) and EF domains (inhibitory control, working memory, cognitive flexibility; pbetween = .60). Meta regression on intervention duration (4 to 20 weeks) was in significant (p = .79). The effect was robust in "leave one out" analyses, in the low "risk of bias" subgroup (g = 0.361; k = 8), and after "trim and fill" adjustment (g = 0.354). The 95% prediction interval (0.252 to 0.477) was entirely positive. GRADE certainty was rated MODERATE, downgraded once for risk of bias. Conclusions: MBIs appear to produce a small, statistically significant improvement in EF in youth aged 3 to 18 years, with moderate certainty of evidence per the GRADE framework. The effect is consistent across preschool and school age samples and across EF domains, with no significant dose response relationship within the 4 to 20 week range studied. Emerging mediation evidence suggests that EF improvement may serve as an important pathway through which MBI supports emotion regulation, though this requires replication. Further large scale RCTs with active control conditions and longitudinal followup are warranted. Keywords: mindfulness, executive function, children, adolescents, meta-analysis, systematic review, inhibitory control, working memory, cognitive flexibility
