Brain development and

executive function

Setyo Handryastuti
Neurology Division
FKUI-RS Cipto Mangunkusumo
 Outline

• Brain development in early life

• Brain structure and function
• Executive functions
Brain Development – early life

Adapted from Silbereis et al., 2016

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Brain Development – early life

• Children’s brains are significantly different

from the adult brain as the organization and
properties of brain structures change with
age1

• The early brain develops with a level of

plasticity; this facilitates both adaptive
changes, representing potential opportunity,
and malformations, reflecting potential
vulnerability2
1Vân Phan et al., 2018, 2Gao et al 2017
Influencing Factors
Environmental factors Total White and Gray Matter (stunting status)
• Socioeconomic status (SES) not malnourished
• Social mobility n=18 (age 73d +/- 8d)

• Nutrition malnourished
n=9 (age 82d +/- 11d)
• Social interactions
• Stress
• Ubranisation
• Pollution

Source: worldbank.org/en/publication/WDR 2018, using data from Nelson and others (2017). Data at http://bit.do/WDR2018-Fig_S2-1.

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Myelination
Myelination is a key part of neurodevelopment1,2

• Wrapping of nerve fibers (axons) with lipid-rich sheath

• Ensures fast, efficient & synchronized communication
between cells and networks
• Protects the neuron
• Matures alongside cognitive and behavioural development

1Silberis 2016; 2Deoni et al 2011

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Myelination & Cognition
Clinical studies demonstrate the link between myelination and cognition, including:

• general cognitive ability1

• language2 & reading3

• working memory4

• processing speed5

• sensory reactivity6

1Schmithorst et al., 2005; Deoni et al., 2015; 2Büchel et al., 2004; O'Muircheartaigh et al., 2013; 3Nagy et al., 2004; Beaulieu et al., 2005; 4Nagy et al., 2004; Short et al.,
2013; 5Turken et al., 2008; Bartzokis et al., 2010; Lu et al., 2013; 6Weinstein et al., 2014

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Development of EFs – related to other cognitive skills
• Children are not born with EFs skills, but
with the ability to develop them1

• EF draw on other, earlier developing

cognitive skills

• Generally cognitive development proceeds

from sensory, motor and early language
activity to social interaction and finally
higher order cognition and executive
functions2

1 https://developingchild.harvard.edu/science/key-concepts/executive-function;2Dajani et al 2015

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 What is Executive function ?

• EF skills cover 3 important sets of functions.

• Working memory
– Short-term memory storage that we use to manipulate
information that is necessary to find solutions to problems
• Cognitive flexibility
– Necessary for us to be able to take different perspectives,
modify our strategies in problem-solving or decision-
making and think creatively
• Self-control or Impulse-control
– Necessary to retain our focus, remove distractions, resist
temptations, control impulsiveness, respond and act with
calm and consideration

Miyake, et all.2000.Cognitive Psychology

Diamond, et all.2013.Ann Rev of Psychology
 What is Executive function ?
• Basic for learning and development.
• Brain functions :
– Focus, plan and organize our behavior.
– Things we do, learn from experience, embrace different perspectives,
and pursue and achieve our goals.
• Executive functions are important for kids to handle many
different situations in life: family, friends, on a playground or
in school.
• The basis of creative thinking, innovativeness, good
organization and time management, growth or goal-oriented
mindset, emotional intelligence and effective communication.
• By helping your child develop them, you are helping them
succeed in life. Miyake, et all.2000.Cognitive Psychology
Diamond, et all.2013.Ann Rev of Psychology
 Where is the executive function ?

• Exchange of information across high-level areas of the brain.

• Needs to experience challenges, to learn and grow.
• Continuously expose our kids to various growth-promoting
experiences, especially in the first 2 years of live due to
increased brain plasticity
Miyake, et all.2000.Cognitive Psychology
Diamond, et all.2013.Ann Rev of Psychology
 When does the Executive develop?
Simple Simple goal- Objects and Ability to Can solve Simple rule
coordination of directed labels control problems learning, can
memory and behavior connected attention or involving two- avoid
action (words, focus step solutions perseveration
vocabulary)

Birth 6 mos 9 mos 12 mos 18 mos 24 mos 36 mos

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Slide from Prof John Colombo, PhD
Factors influencing the development of EFs1-4

• Neural maturation • Factors disrupting brain architecture

• Schooling & education • Negative stress
• Language • Neglect & violence
• Social environment & connections
• Positive relationships with adults
• Physical & mental activity
• Practice
• Creative play

1 https://developingchild.harvard.edu/science/key-concepts/executive-function/; 2 Matsuda et al. 2017; 3 Baum et al. 2017; 4Best & Miller (2010)

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 Why is EF important ?

• Initiate: Beginning a task or activity.

Impact of difficulty: May have trouble getting started on homework
or independent tasks.
• Inhibit: Not acting on an impulse or stopping one’s own
inappropriate activity at the proper time.
Impact of difficulty: May have trouble stopping negative behavior or
acts without thinking.
• Shift: The ability to move from one situation, activity, or aspect of a
problem to another as the situation demands.
Impact of difficulty: Can get stuck on a topic or tends to perseverate
on ideas or actions.
• Plan: Anticipating future events, setting goals, and developing
appropriate steps ahead of time to carry out an activity.
Impact of difficulty: May start assignments at the last minute; does
not think ahead about possible problems.
 Why is EF important ?

• Organise: Establishing or maintaining order in an activity or place; carrying

out a task in a systematic manner.
Impact of difficulty: Often has a scattered or disorganised approach to
solving a problem; is easily overwhelmed by large tasks or assignments
and unsure where to begin.
• Self-monitor: Checking on one’s own actions during, or shortly after
finishing, the task or activity to ensure appropriate attainment of goal.
Impact of difficulty: Unlikely to check work for mistakes; is unaware of
own behavior and its impact on others.
• Working memory: Holding information in the mind for the purpose of
completing a specific and related task.
Impact of difficulty: Trouble remembering things, even for a few minutes;
when sent to get something, forgets what he or she is supposed to get.
• Emotional control: Modulating/controlling one’s own emotional response
appropriate to the situation or stressor.
Impact of difficulty: Is easily upset, explosive; small events trigger a big
emotional response.
 Activities to develop EF
in infants

Pok ame-ame Ciluk-ba

Petak umpet
mainan
 Activities to develop EF
in infants

Put things in Sensory

the box activities

Bermain jari
 Activities to develop EF
for Toddlers

Simple board Coloring and

games drawing

Simple task
 Activities to develop EF
for Toddlers

Pretend play Singing and

dancing

Puzzles
 Activities to develop EF
Kindergarten and preschool

crafts

Problem
solving task

Science for kids

 Activities to develop EF
Kindergarten and preschool

Role play
Stories

Animation
movies
Executive Function Tasks for Children
Problem-Solving Tasks

Goal: Move rings from the left peg to the right peg,
retaining size order shown.
Rule: A bigger ring may not be placed on top of a
smaller one

Slide from Prof John Colombo, PhD

 Key messages

• The first years of life are a rapid and dynamic period

of brain maturation, which is primarily focus on
connecting brain (myelination)
• The resulting connectivity is central to establishing
cognitive functions, such as EF.
• EF development and maturation is fundamental to
success in school life, as well as health and well-
being