Development of Executive Functioning in School-Age Tunisian Children

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Development of executive functioning in school-age Tunisian children
Article in Child Neuropsychology · July 2015

DOI: 10.1080/09297049.2015.1058349 · Source: PubMed
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Development of executive functioning in school-

age Tunisian children
Tarek Bellaj, Imen Salhi, Didier Le Gall & Arnaud Roy
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of executive functioning in school-age Tunisian children, Child Neuropsychology, DOI:
10.1080/09297049.2015.1058349
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Child Neuropsychology, 2015
http://dx.doi.org/10.1080/09297049.2015.1058349
Development of executive functioning in school-age

Tunisian children
Tarek Bellaj1,3, Imen Salhi2, Didier Le Gall3, and Arnaud Roy3,4

1
Psychology Program, Department of Social Sciences, College of Arts and Science, Qatar
University, Doha, Qatar
Downloaded by [Qatar University] at 23:25 11 November 2015
2
Faculty of Human and Social Sciences of Tunis, Tunis University, Tunisia
3
Psychology Laboratory of Pays de la Loire, EA4638, LUNAM, University of Angers,
France
4
Learning Disabilities Reference Center, Nantes University Hospital, France
Research regarding executive functioning (EF) in children rarely focuses on populations in African or
Middle-Eastern Arabic-speaking countries. The current study used a cross-sectional design to examine the
developmental trajectories of school-age Tunisian children in three domains of executive control (inhibi-
tion of prepotent responses, cognitive flexibility, and working memory) as well as their mutual interactions
and the effects of gender and parents’ education level. Inhibitory processes, cognitive flexibility, and
working memory were assessed using the Stroop test, a version of the Hayling test adapted for children,
simple and alternating tasks of verbal fluency, and verbal and visuospatial span tasks (forward and
backward spans). The study population included 120 7- to 12-year-old Tunisian children (60 girls, 60
boys) who were grouped and matched for age, gender, and parents’ education level. The results revealed
an overall effect of age on executive performance, whereas gender and parents’ education level showed
non-significant effects. In addition, executive indices were significantly associated with fluid intelligence
level. Partial correlation analyses (controlled for age) found significant links between indices that assessed
the same executive process, except for inhibitory processes; the temporal indices for inhibitory processes
showed relative independence. The correlations between indices that assessed distinct executive processes
were weaker (but significant). Overall, the results suggest that executive components in school-age
Tunisian children operate according to relatively homogeneous developmental trajectories, marked by
peaks of maturity that differ according to the assessed index. A transcultural approach to EF is discussed in
terms of the unity and diversity of its components.
Keywords: Executive functioning; Development; Neuropsychology; Culture.
During development, children express a growing capacity to control their thoughts and
actions (Diamond, 2002). This improvement of control capacities is associated with
significant changes in the neuroanatomy and functioning of the brain, which takes the
Many thanks to all the girls and boys and their families for their participation in the study. As well, we
express appreciation to Tunisian and Angevin neuropsychological teams for their assistance in collecting, rating,
and analyzing the data and to all who made the mutual constructive collaboration always possible.
No potential conflict of interest was reported by the authors.
Address correspondence to Arnaud Roy, Université d’Angers, Faculté des Lettres, Langues et Sciences
Humaines, 11, boulevard Lavoisier, 49045 Angers Cedex 01 France. E-mail: arnaud.roy@univ-angers.fr
© 2015 Taylor & Francis

2 T. BELLAJ ET AL.
form of an increase in neuronal networks and brain volume (Dempster, 1992; Raz, 2000),
especially in prefrontal areas (Adleman et al., 2002; Schroeter, Zysset, Wahl, & Von
Cramon, 2004). The prefrontal cortex is known to play a crucial role in the planning,
organization, and cognitive-behavioral regulation of tasks (Best, Miller, & Jones, 2009;
Luria, 1966), which corresponds to executive functioning (EF). EF includes a variety of
cognitive processes involved in problem-solving skills (Levin et al., 1991), planning
(Shallice, 1982), task initiation (Burgess & Shallice, 1996), mental flexibility (reactive
and spontaneous; Eslinger & Grattan, 1993), and inhibition (Denckla, 1996). All of these
processes are activated when it is necessary to face new or difficult situations in which
routine actions become insufficient (Meulemans, 2006).
Several developmental studies devoted to EF in early childhood have revealed perfor-
mance patterns close to the behavior of patients with frontal lesions (for example, Anderson,
Anderson, & Lajoie, 1996; Lehto, Juujärvi, Kooistra, & Pulkkinen, 2003; Welsh, Pennington,
& Groisser, 1991). This observation is in agreement with data that show an early and
prolonged maturation of the prefrontal cortex and its involvement in the progressive devel-
opment of EF (Diamond, 2002). However, the relations between the developmental trajec-
tories of hypothetically different executive components and performance on the traditional
tasks aimed at assessing them are still debated, in particular because of the problem of the
“task impurity” of EF, which interferes with the fractionation of these high-level processes
(Hughes & Graham, 2002; Kline, 1998; Miyake et al., 2000). Indeed, single indicators for a
given construct (e.g., working memory) can rarely, if ever, be viewed as a pure measure of that
construct. Most measures are contaminated by random and systematic error (see Kline, 1998).
The task impurity problem is highly relevant to EF research, as the manifestation of EF
components invariably involves other non-executive processes (e.g., Miyake et al., 2000).
Neuropsychology recognizes that EF consists of separate but interrelated compo-
nents. This approach to EF, which is simultaneously unitary and pluralist, claims that one
or several common mechanisms underlie all executive processes (Miyake et al., 2000).
Researchers that study pediatric populations agree with this conception (Anderson,
Anderson, Northam, Jacobs, & Catroppa, 2001; Asato, Sweeney, & Luna, 2006; Bull &
Scerif, 2001; Hughes, 1998; Lehto et al., 2003). Empirical studies based on the admin-
istration of a battery of executive tasks have shown weak correlations between different
tasks and found many distinct factors by means of exploratory and confirmatory factor
analysis (Anderson et al., 2001; Brocki & Bohlin, 2004; Klenberg, Korkman, & Lahti-
Nuuttila, 2001; Lehto, 1996; Lehto et al., 2003; Levin et al., 1991; Senn, Espy, &
Kaufmann, 2004; Sevino, 1998; Welsh et al., 1991). The fractionation of EF has also
been supported by other empirical studies that identified differential developmental curves
according to EF at pre-school (Hughes, 1998; Senn et al., 2004) and school ages
(Huizinga, Dolan, & Van Der Molen, 2006; Lehto et al., 2003) as well as in adulthood
(Fisk & Sharp, 2004; Miyake et al., 2000; Zelazo, Craik, & Booth, 2004).
Moreover, the results of brain-imaging studies have argued for multifactorial and
unitary conceptions of EF by showing that different prefrontal areas are differentially
activated by a variety of executive tasks, including dorsolateral and ventromedial areas
(Olson & Luciana, 2008) as well as the anterior cingulate cortex (Best et al., 2009).
Finally, the different levels of involvement of components of the executive architecture in
certain clinical pathologies, such as attention deficit hyperactivity disorder (ADHD),
confirms the supposed independence of EF (Barkley, 1997; Shallice et al., 2002).
The inhibition of prepotent responses, cognitive flexibility, and working memory
constitute the three main components that are often postulated to reflect the functional
EXECUTIVE FUNCTION IN TUNISIAN CHILDREN 3
architecture of the cognitive aspect of EF in adults (Miyake et al., 2000) and in children
(Brocki & Bohlin, 2004; Lehto et al., 2003). For the inhibition of prepotent responses, a
significant developmental progression has been observed in young people through the use
of multiple paradigms, such as the day-night task and the knock-tap task (Balamore &
Wozniak, 1984; Diamond, 2002; Gerstadt, Hong, & Diamond, 1994; Klenberg et al.,
2001; Williams, Ponesse, Schachar, Logan, & Tannock, 1999). Many studies conducted in
school-age children have shown a prolonged improvement of inhibition capacities with
age using the Stroop test (Armengol, 2002; Comalli, Wapner, & Werner, 1962; Koenig,
1989; MacLeod, 1991; Sevino, 1998) and the Hayling task (Shallice et al., 2002).
Cognitive flexibility abilities have been shown to follow the same progression for both
the verbal and figural modalities of spontaneous shifting (Arán-Filippetti & Allegri, 2011;
Brocki & Bohlin, 2004; Hurks et al., 2010; Kavé, 2006; Kavé, Kigel, & Kochva, 2008;
Koren, Kofman, & Berger, 2005; Lehto et al., 2003; Levin et al., 1991; Riva, Nichelli, &
Devoti, 2000; Sevino, 1998; Tallberg, Carlsson, & Lieberman, 2011; Welsh et al., 1991).
However, the age of maturity with respect to verbal fluency is debated (Anderson et al.,
2001; Kavé et al., 2008; Klenberg et al., 2001; Riva et al., 2000; Sauzéon, Lestage,
Raboutet, N’Kaoua, & Claverie, 2004; Sevino, 1998; Welsh et al., 1991), and the
dissociation of progressive profiles according to the suggested division, semantic or
phonemic (Klenberg et al., 2001; Levin et al., 1991), is difficult to check because some
studies did not distinguish between the two conditions (Brocki & Bohlin, 2004; Lehto
et al., 2003) or they focused on only one method (Anderson et al., 2001; John &
Rajashekhar, 2014; Sevino, 1998; Welsh et al., 1991). Verbal fluency development has
been studied in different languages, including French (Sauzéon et al., 2004), Italian (Riva
et al., 2000), Swedish (Tallberg et al., 2011), Hebrew (Kavé et al., 2008), Dutch (Hurks
et al., 2010), Spanish (Arán-Filippetti & Allegri, 2011), and Malayalam (John &
Rajashekhar, 2014). However, few studies have been performed in the Arabic language.
For working memory, development continues until adolescence for both verbal and
visuospatial components (Best et al., 2009; Dempster, 1992; Gathercole, Pickering,
Ambridge, & Wearing, 2004; Hale, Bronik, & Fry, 1997; Klingberg, Forssberg, &
Westerberg, 2002; Luciana, Conklin, Hooper, & Yarger, 2005; Nagy, Westerberg, &
Klingberg, 2004; Scherf, Sweeney, & Luna, 2006). For example, Gathercole et al.
(2004) found a linear increase in performance from age 4 to age 15 for a battery of
working memory tasks of varying complexity (except for a visual patterns task, for which
performance leveled off around age 11). Luciana et al. (2005) examined non-verbal
working memory tasks of varying complexity, ranging from a non-complex task (face
recognition) to a complex task (spatial self-ordered search). As predicted, the age-related
changes in performance depended on the complexity of the particular task. For ages 9 to
20, there were no performance differences on the simple face recognition task; in contrast,
there were steady improvements on the most difficult self-ordered search task until age 16.
Thus, it is important to consider the complexity of the task when extrapolating a general
trajectory of working memory development.
Although developmental studies performed to date have shown that different
aspects of EF develop in line with the progress of childhood, the developmental curves
differed from one study to another. These differences probably result from the large
variety of methodological choices and because the socio-demographic variables that
may act as determining factors are not always considered or give rise to conflicting
data, making it difficult to generalize the results. In addition to the influence of age,
studies have also reported the influence of other demographic variables, such as gender
4 T. BELLAJ ET AL.
(Becker, Isaac, & Hynd, 1987; Berlin & Bohlin, 2002; Klenberg et al., 2001), intelligence
(Ardila, Pineda, & Rosselli, 2000; Arffa, 2007; Arffa, Lovell, Podell, & Goldberg, 1998;
Baron, 2003; Mahone et al., 2002), type of education (Ratcliff et al., 1998), socioeco-
nomic level (Arán-Filippetti & Richaud De Minzi, 2012) and bilingualism (Pena, Bedore,
& Zlatic-Giunta, 2002), with some reporting no effect or a weak effect (Armengol, 2002;
Brocki & Bohlin, 2004; Welsh et al., 1991). For example, the very few studies that have
investigated the effect of gender have reported contradictory results. Welsh et al. (1991)
did not find a significant gender-related effect on various executive measures in a
developmental study of 100 normal children between 3 and 12 years of age. In contrast,
Brocki and Bohlin (2004) suggested that gender-related disparities would be higher
beyond 12 years of age. Likewise, similar results were found in studies analyzing the
effect of gender on changes in performance on specific executive tasks in pediatric
populations from countries with different languages and cultures. Armengol (2002)
evaluated 349 Spanish-speaking children, aged 6 years and 6 months to 12 years and
11 months, who were attending two different Mexican institutions (public and private)
using a Spanish version of the Stroop test. The results showed an improvement in
performance based on the time index score and number of errors. However, the gender
differences were not found to be significant.
These data are consistent with recent studies of Stroop test performance (Talarowska,
Florkowski, Chamielec, & Galecki, 2013) that did not find a significant gender-related
effect regardless of the age of the subjects. Riva et al. (2000) studied developmental changes
in verbal fluency as a function of age and gender in 160 Italian children, aged 5 years and
11 months to 11 years and 4 months. The results indicated a significant effect of age but no
gender effect. Other studies conducted in French, Dutch, Spanish, Hebrew and Indian
pediatric populations also found similar results for semantic and phonemic verbal fluency
tasks (Arán-Filippetti & Allegri, 2011; Hurks et al., 2010; John & Rajashekhar, 2014; Kavé
et al., 2008; Sauzéon et al., 2004). In addition, a significant effect of age and a non-
significant effect of gender have been highlighted in studies of working memory in pediatric
school-age populations (Brocki & Bohlin, 2004; Welsh et al., 1991). In contrast, working
with a sample of 52 subjects aged 7 to 15 years, Levin et al. (1991) showed higher
performance on semantic fluency tasks in girls compared with boys.
These results agree with those obtained in studies of the performance of populations
of normal school children and children with certain pathologies on tasks that assess
language skills and verbal fluency (Anderson et al., 2001; Ardila, Rosselli, Matute, &
Guajardo, 2005; Klenberg et al., 2001). Other studies, however, have found superior
performance for boys compared to girls of the same age (Capitani, Laiacona, &
Barbarotto, 1999; Halpern, 2000). Regarding inhibition tasks, Berlin and Bohlin (2002)
reported a higher level of inhibitory control in preschool girls compared to boys of the
same age. Carlson and Moses (2001) reported better performance for 3- to 4-year-old girls
compared to boys of the same age in tasks assessing inhibitory control. However, other
studies have reported the opposite results, such as Becker et al. (1987), who noted faster
reaction times on a Go/No-Go task for boys compared to girls. For working memory
tasks, the same contradictions have been noted. Some authors do not find significant
differences between boys and girls of the same age for working memory tasks, whereas
others have identified differences at specific ages, generally in favor of boys (Brocki &
Bohlin, 2004). In sum, the gender differences reported for executive performance are
inconsistent. In some studies girls were favored and in other studies boys were favored,
with many studies reporting a non-significant effect. The results seem to be highly
dependent on the nature of the task and the methods of analysis used (Brocki & Bohlin,
2004). For example, John and Rajashekhar (2014) have suggested that the conflicting
results regarding the effect of gender on verbal fluency performance could be linked to the
nature of the selected semantic category (e.g., animals and fruits and vegetable or
vehicles). For example, Capitani et al. (1999) reported a benefit in favor of boys compared
to girls of the same age for the semantic category “tools”, but this advantage favored girls
for the semantic category “fruits”. It should also be noted that the effect of the general
intellectual level of children on executive task performance was seldom taken into
account, even if there was a tendency to show that fluid intelligence is involved in several
domains of cognitive functioning.
However, even when the authors did consider the influence of this factor, incon-
sistencies in the data from one study to another still emerge. Welsh et al. (1991) did not
identify any significant correlations between IQ and all executive measures obtained for 6-
to 12-year-old children. Similar results have been previously noted by Golden (1978),
who found low correlations between IQ and executive measures related to motor plan-
ning. Boone, Ghaffarian, Lesser, and Hill-Gutierrez (1993) and Ardila et al. (2000)
obtained similar results for tasks assessing cognitive flexibility capabilities. In a study
of 6- to 16-year-old children with ADHD, Riccio et al. (1994) found significant correla-
tions between IQ (obtained via the Wechsler Intelligence Scale for Children-Revised
(WISC-R)) and the indices of the Wisconsin Card Sorting Test (WCST) in children
aged 9 years to 11 years and 11 months. However, in a study of 148 6- to 15-year-old
children of different intellectual levels (average, above average, gifted youth), Arffa
(2007) found significant correlations between IQ and certain executive tests (such as the
Stroop, verbal fluency, Rey Complex Figure, underlining and figure design tests).
Finally, very few studies have analyzed the effect of parents’ education level on the
development of children’s EF, and these studies have yielded contradictory results as well.
While some studies considered the effect of this factor on the performance of children on
executive tasks (Ardila et al., 2005; Klenberg et al., 2001), others have reported a
significant but non-predictive effect (Armengol, 2002).
Ardila et al. (2005) conducted a study of 622 5- to 14-year-old children, who were
matched for age, gender and type of school attended (public and private) in order to
analyze the relationships between parental educational level and children’s performance
on executive tests (phonemic and semantic fluency, figural semantic and non-semantic
fluency). Most of the scores obtained were significantly correlated to parental educational
level, especially the verbal tests. Klenberg et al. (2001) studied the development of EF in
400 3- to 12-year-old Finnish children. The data from 10 subtests, which measured
impulse control and the inhibition of irrelevant responses, auditory and visual attention,
visual search, planning, and verbal and visual fluency, were included. Significant relations
between gender and development and between parental education and development were
found for several of the subtests. Hoff (2003a, 2003b) has argued that parents with a high
level of education offer their children a more intellectually and verbally stimulating
environment (Ganzach, 2000; Teachman, 1987; White, 1982). Armengol (2002) used a
multiple regression analysis on Stroop data from Mexican school-age children and found
that the educational level of the father and the mother explained 3% of the variance of the
results.
The study of the universality and specificity of cognitive processes via emic or etic
approaches is important for a better understanding of human cognition. Yet, hardly any
studies of EF have been conducted among African or Middle Eastern Arabic-speaking
6 T. BELLAJ ET AL.
populations. A search of the major academic databases (PsychINFO, Elsevier, ERIC,

Medline, Psycharticles and PubMed) conducted on 21 March 2015 using the words
“Children”, “Arabic” and “Executive functions” returned four publications. the first was
a clinical study that did not give any developmental benchmark because it involved
Schistosoma mansoni infection in three samples of 40 9- to 12-year-old children (Nazel,
El-Morshedy, Farghaly, Shatat, & Barakat, 1999). The second and third studies investi-
gated the effect of bilingualism on EF using, among other tests, the Stroop test, phonemic
fluency tasks, the Trail Making Test (Abdelgafar & Moawad, 2014), and category fluency
tasks (Soliman, 2014). Both studies did not give any descriptive data of the children’s
performance on any of the tests used. The fourth study compared the development of
attentional processes in Syrian and German children using a computerized battery called
KITAP, the Test of Attentional Performance for Children (Sobeh & Spijkers, 2013).
Although EF was not studied per se, some of the attentional processes examined in this
study overlap with EF. However, the tests used were computer-based and the obtained
data cannot be easily compared to classic EF tools such as the Stroop, Hayling, and Trail
Making tests as well as the WCST and fluency tasks. Moreover, this battery was used
without any research regarding the feasibility of its use with Syrian children and without
any cultural adaptation of its European culture-based scenarios (Sad and the Happy Ghost,
The Owls, The Witches’ Parade, The Ghosts’ Ball, etc.). Non-verbal tests are as culturally
biased as verbal tests, and non-verbal stimuli are not necessarily “culture-free” (De Mattos
Pimenta Parente & Lecours, 1988). The authors did not even mention the language in
which the test was administered or describe any effort of item translation.
Therefore, there is a strong need to expand research to include such sociocultural
contexts, which may allow the analysis of the role of cultural factors in the development
of EF. Therefore, the main aim of this study was to examine the developmental trends of
the three basic components of EF, namely inhibition of prepotent responses, cognitive
flexibility, and working memory among a sample of 7- to 12-year-old Tunisian children
using traditional neuropsychological tasks and a cross-sectional design. The secondary
objectives included assessment of the potential effects of two demographic factors (gender
and parents’ education level) and of the effect of general intellectual level on the
development of EF. A developmental study of EF in the Tunisian sociocultural context
has the advantage of compensating for the lack of normative data.
We expected (1) an improvement of executive control abilities in the different
assessed domains between the ages of 7 and 12 years. We expected progress in inhibition,
flexibility, and working memory skills to be evident in the Stroop and Hayling tasks,
verbal fluency (semantic, phonemic, and alternating), and verbal and visuospatial spans,
respectively (Brocki & Bohlin, 2004; Lehto et al., 2003; Sevino, 1998). Given the more-
or-less established influence of the demographic factors (gender and parents’ education
level) on the executive control abilities of school-age children, we also expected (2) a
significant effect of parents’ education level (Ardila et al., 2005) and a non-significant
effect of gender on executive performance (Ardila et al., 2005; Brocki & Bohlin, 2004;
Welsh et al., 1991). Moreover, we expected (3) the fluid intelligence level (measured with
the Raven Matrices test) to be significantly correlated to performance on the different
executive tasks (Arffa, 2007; Blair, 2006). Finally (4), we expected to find weak but
significant correlations between the different executive indices (after age adjustment), in
agreement with studies that consider EF as a set of distinct yet interrelated components
(Lehto et al., 2003; Miyake et al., 2000).
METHODS
Participants
A total of 120 Tunisian children, between 7 and 12 years of age, participated in
the study. All of the children were native Arabic speakers and were right-handed.
None were authentic bilinguals who efficiently learned any other language before the
age of 5. We made sure that all of the children were Arabic-dominant monolinguals
based on information collected using the Language Experience and Proﬁciency
Questionnaire (Marian, Blumenfeld, & Kaushanskaya, 2007). From each of the six
primary education levels, 10 girls and 10 boys were selected randomly as long as they
were healthy and not suffering from mental, sensory or motor disorders. None of the
children had learning difficulties or neurological or psychiatric disorders. This infor-
mation was gathered from interviews conducted with parents, teachers and educational
staff and by consulting school and medical records. The recruitment of children was
made in Habib Bourguiba’s public school, which is located in the northern suburbs of
Tunis and is attended mostly by the children of families belonging to the middle
socioeconomic class. Recruitment took place during the third quarter of the 2012
school year. Written parental consent and informed participant consent was obtained
prior to testing.
Among the 130 children who agreed to participate in the study, 5 quit the study
and 1 child was excluded because of suspected mental deficiency. In addition, 2 other
children were excluded because both parents were not Tunisian, and 2 others were
excluded from the study because of their medical record (1 child was diagnosed with
esotropia, another suffered from a behavioral disorder). The age groups were compar-
able in terms of the mother’s and father’s education level, respectively: F(5,
114) = 0.37, p = .867, ηρ2 = .0161; F(5, 114) = 1.38, p = .238, ηρ2 = .0569.
Intelligence, as measured by the Raven Matrices Test (Raven, Court, & Raven,
1985), evolved from one age to another, F(5, 108) = 6.55, p < .0001, ηρ2 = .2327,
but no significant difference was found between girls and boys, F(1, 108) = 0.58,
p = .4473, ηρ2 = .0053 and the Age × Gender interaction was not significant, F(5,
108) = 1.11, p = .3568, ηρ2 = .0491. Table 1 shows the demographic and psycho-
metric data for the study population.
Table 1 Demographic and Psychometric Data.
Education level 1st year 2nd year 3rd year 4th year 5th year 6th year Total
(n = 20) (n = 20) (n = 20) (n = 20) (n = 20) (n = 20) (n = 120)
M SD M SD M SD M SD M SD M SD M SD
Age (years) 7.02 0.34 7.87 0.47 8.89 0.28 9.83 0.34 10.89 0.35 12.03 0.22 9.42 1.76
Mother’s 14.1 3.49 13.4 2.93 14.7 3.43 14.4 2.23 14.05 3.53 14.35 3.61 14.14 3.28
education
(years)
Father’s 14.15 3.84 14.05 3.52 14.15 5.1 15.2 2.28 16.4 2.41 14.5 3.86 14.74 3.52
education
(years)
Raven Matrices 22.85 4.62 24.3 5.8 26.55 3.8 27.1 3.82 28.15 4.12 29.8 4.08 26.46 4.92
test (raw
score)
8 T. BELLAJ ET AL.
Measures
Tests evaluating EF are numerous, and there is no consensus regarding the relevance
of a specific instrument and the executive processes recruited by each test. Nevertheless,
we sought to categorize several executive tests on the basis of developmental and factor
analysis data from Lehto et al. (2003) and Miyake et al. (2000). We therefore chose to
assess inhibition, mental flexibility and working memory. For each of these functions, we
decided to rely on two different tasks.
Note that all tasks were administered in the local Tunisian Arabic dialect to control
biases related to understanding of the instructions and were the subject of adaptation and
validation studies using the Tunisian population (Romdhane, Bellaj, & Attia-Romdhane,
2008). Particular attention was paid to ensuring the equivalence of the construct (Bellaj,
2011). Compared to the original version, the changes did not affect the content of the
instructions, the principles of scoring or the administration procedure (Bellaj & Seron,
2014).
Considering the general concept of inhibition, which refers to different mechanisms
(Bjorklund & Harnishfeger, 1995; Zacks & Hasher, 1997), we opted for the Stroop test,
which evaluates the susceptibility to interference, and the Hayling test, which requires the
deletion of dominant responses. Based on Eslinger and Grattan’s (1993) dichotomy
between “spontaneous flexibility” and “reactive flexibility”, simple and alternate verbal
fluency tasks, respectively, were used. Finally, based on Baddeley and Hitch’s (1974)
working memory model, we analyzed the ability to passively store information using
verbal (forward digit span) and visuospatial (forward block-tapping test) tasks before
examining the ability to temporarily store and manipulate information via the backward
verbal digit span and the backward visuospatial block-tapping tests.
The Stroop Test

We used the Modern Standard Arabic version of the Stroop test (Bellaj, Bouaziz, &
Bouaziz, 1995), which requires the child to inhibit the automatic reading process in favor
of a less automatic naming process. The task includes three conditions, and each condition
has a card containing 100 items randomly presented in a 10 × 10 matrix on a landscape-
oriented A4 sheet. Time to completion for each of the three conditions was used as the
dependent variable. From the first card, called the “Word” condition, the child read aloud
a list of color names (red, green and blue) printed in black type; in the second condition,
the “Color” condition, the child was asked to name the color of a series of dots; and in the
third, the “Color/Word” condition, the color names were printed in a discordantly colored
ink (e.g., the word “red” printed in blue), the child was asked to name the color of the
printed words while inhibiting the automatic tendency to read the word. For each condi-
tion, the completion time and the number of two types of errors (errors corrected
spontaneously and those that were not) were recorded. A handheld stopwatch was used
to record the time to completion for each condition. This was the time that elapsed
between the response to the first and last items in the list (the time was recorded in
seconds). An interference score was calculated using the formula: Color / Word − Color.
In this study, Stroop’s original measure of interference and inhibition is obtained by
calculating a difference score based on subtracting the time it took to name the colors
from the interference condition. Assuming an additive information-processing model,
Golden (1978) developed “a predicted color-word score” based on the assumption that
subjects first read the word and then named the color. On the basis of a factor analysis of
the various scores suggested as measures of “pure interference”, Golden found that the
best measure was represented by either Color / Word (CW) − predicted (W) or by CW −
C. In our study, we chose to use the latter formula based on the assumption that color
identification and word reading can be processed in parallel rather than sequentially, with
word reading occurring faster than color identification (MacLeod, 1991; Posner, 1978).
The Junior Hayling Test

The Junior Hayling test (Shallice et al., 2002) consists of two parts, A and B. Each
part has 10 sentences in which the final word is omitted. In both parts, the response is
highly activated by context and there is a particularly high probability of one specific
response. In part A (initiation), the word completing the sentences has to fit appropriately
at the end of the sentence. In part B (inhibition), the child has to complete the sentence
using a word that makes no sense at all within the context of the sentence, a word
unrelated to the sentence in every way. If the child provided an answer that gave meaning
to the phrase, this was indicated to him, and the task instructions were repeated. If the
latency exceeded 60 seconds, we passed on to the next sentence, and a response latency of
60 seconds was recorded.
In both parts, the response time (in seconds) and the produced word were recorded.
For the response time, we calculated what Shallice called the “Additional Thinking Time”
(ATT) as the difference between the latencies in parts A and B (B − A). For the produced
words, each response in part B was scored according to its semantic relatedness to its
stimulus sentence. One point was given if the child produced a word that was simply
semantically related to the stimulus sentence, and a three-point penalty was applied for a
word that was a straightforward completion of the sentence. If the word produced was not
connected to the sentence, zero points were given (the error score could vary between a
total of zero to thirty points). The sum is what Shallice called the “error score”. The
Arabic version of the Junior Hayling test was not a simple translation of the items
proposed by Burgess and Shallice (1997) but was developed based on empirical local
data (Bellaj, 1999). In this sense, the content of 50 children’s sentences were selected and
tested with a group of 30 6- to 12-year-old children. This pre-experimentation led to the
selection of sentences in which the probability of giving the appropriate last word was
over 90%. The individual phrases were randomly distributed over the two parts of the test
so that the average frequency of missing words and the average length were equivalent in
both parts of the test. Each of the two parts of the test included 10 sentences, and 4 more
sentences were added to serve as a familiarization trial.
Simple and Alternating Verbal Fluency

In the verbal fluency tasks, the child was required to produce, within a fixed
amount of time (120 seconds), as many different words as possible according to
specific criteria, which included the exclusion of proper names and repetitions of the
same word with different morphosyntactic structures (according to Spreen & Strauss,
1998). We examined verbal fluency via three conditions: a simple semantic word
fluency task using the category “Animals”, a simple phonemic word fluency task
using the letter “M”, and an alternating word fluency task in which the child was
invited to alternate between phonemic and semantic criteria: “Clothing” and the letter
10 T. BELLAJ ET AL.
“H”. Note that the choice of categories and letters was tested in a pre-experiment to
determine average production rates in Tunisian populations; the letters “M”, “H” and
“K” were found to be the most frequently produced (Aguibi & Bouaziz, 1998). The
categories “Animals” and “Clothing” and the letters “M” and “H” were produced at
similar rates in Tunisian populations. They have also been widely used in previous
studies of children in different cultures and languages (Spanish: Arán-Filippetti &
Allegri, 2011; Italian: Riva et al., 2000; Dutch: Hurks et al., 2010; Finnish: Klenberg
et al., 2001; Hebrew: Kavé et al., 2008; Swedish: Tallberg et al., 2011; India,
Malayalam: John & Rajashekhar, 2014; and the letter “M” in Spanish: Ardila et al.,
2005; Matute, Rosselli, Ardila, & Morales, 2004; Nieto, Galtier, Barroso, & Espinosa,
2008). The instructions given to the children were adopted from Spreen and Strauss
(1998). For phonemic fluency, they were as follows:
I will say a letter of the alphabet. Then, I want you to give me as many words that
begin with that letter as quickly as you can in two minutes. For example, if I say “S”
“‫”ﺱ‬, you might give me “‫ ﺳﻠﻄﺔ‬,‫ ﺳﺎﺣﺔ‬,‫ﺳﺒﻮﺭﺓ‬. . .”. I do not want you to use words that are
proper names, such as “‫ ﺳﻮﺳﺔ‬,‫ ﺳﺎﻣﻲ‬or ‫”ﺳﻨﻴﺔ‬. Additionally, do not use the same word
with different endings, such as “eat” and “eating”. Any questions? (pause). Begin
when I say the letter. The first letter is “M”. Go ahead.
Timing began immediately.

For semantic fluency, the instructions were as follows: “I am going to tell you the
names of fruits: oranges, apples, bananas. Can you think of other fruits?”. After allowing
the child to name other things, and correcting him or her if he or she produced an incorrect
response, the task was explained once again. “Now, tell me the names of as many animals
as you can. Name them as quickly as possible in two minutes”.
For alternating fluency, the instructions were:
Say as many words, alternating a word beginning with . . . and a name of . . .,

avoiding words of the same family and proper names, and do this in two minutes.
For example, if I have to give words that alternate between a word beginning with
the letter “B” “‫ ”ﺏ‬and the name of a color, I will say “‫ﺃﺣﻤﺮ‬-‫ ﺑﺤﺮ‬،‫ﺑﺎﺏ—ﺃﺧﻀﺮ‬،. . .”. Can
you continue alternating between a word beginning with B and a color, as many as
you can?
After allowing the child to respond, and correcting him or her if he or she produced
an incorrect response, the task was explained once again:
Now, alternate between giving me a word beginning with the letter “H” and the names
of as many clothes as you can. Say them by switching back and forth between the
words starting with the letter “H” and the clothes as quickly as possible, for two
minutes.
The responses were recorded verbatim. The number of correct responses, repeti-
tions, and intrusions for each of these conditions were recorded. In the alternating fluency
task, we considered each time a child provided an additional word of the same type
(category or letter) to be perseveration. All of the subjects began with the simple task;
whether the phonemic or semantic fluency task was administered next was
counterbalanced between the groups. Then, we administered the alternating verbal fluency
task. A two-minute break was given between tasks.
Digit Span
This task is an adaptation of the WISC-R Digit Span subtest (Wechsler, 1996), with
seven levels containing three series of two to eight digits for each span. The examiner
reads the sequence of digits aloud at a rate of one digit per second. In the forward digit
span condition, the child is asked to immediately repeat the string of numbers in the order
in which they were heard, starting with the repetition of a two-digit series. The length of
each sequence of numbers is increased if the child responds correctly. The task was stops
when the child fails to correctly reproduce two of the three sequences of numbers at any
given length. In the backward condition, a different series of digits is presented, and the
child has to repeat the digits in reversed order. The forward digit condition is completed
prior to the backward digit condition. In each condition, the score is the highest number of
digits that was repeated correctly.
Corsi Block-Tapping Test

The Corsi (1972) block-tapping test was to assess visuospatial span and visuospatial
working memory. It utilizes a white wooden board (21 × 30 cm) in which nine identical
and spatially separated blue blocks are arranged quasi-randomly. The child is invited to
observe the sequence of blocks “tapped” by the finger of the examiner and to reproduce
the sequence in the same order (forward visuospatial span condition, BTT-F) or in the
opposite order (backward visuospatial span condition, BTT-B). The sequence starts with
two blocks and gradually increases in length up to nine blocks. Each span contains three
sequences, and the task stops when the child fails to correctly reproduce at least two
sequences of a given length. For each of the two conditions, the score is the longest series
that was correctly reproduced at least two out of three times.
Procedure
All participants were individually assessed outside of school hours in a calm room
in their school or home environment. Two assessment sessions were needed. Depending
on the age of the child, each session took approximately 20–30 minutes. The Stroop, the
spans and the verbal fluency tests were presented in a fixed order during the first session,
the Hayling test and the Raven Matrices during the second. All of the tests were
administered in the local Arabic language by trained neuropsychologists using standar-
dized instructions.
Statistical Analyses
The obtained scores in the various tests were subject to the application of descrip-
tive and inferential statistical analysis. Examination of the normal distribution by the
Kolmogorov-Smirnov test revealed that the indices coming from the fluency and Stroop
tasks are distributed normally, while those of Hayling and spans deviate significantly from
normality. Given the power of the analysis of variance (ANOVA; Abdi, 1987) and the
importance of examining the effects of interactions, we opted for the use of parametric
12 T. BELLAJ ET AL.
statistical tools. For comparison, we used one-way, factorial, or repeated measures

ANOVAs followed by an assessment of the weight of the effect with partial eta squared
in order to study the developmental aspects and differential for each process. When the
effects were significant, we used the Fisher post hoc test to refine the results. For the
analysis of associations, we used Pearson’s correlation coefficient. Finally, partial correla-
tions, controlling the variable age, were used to examine the relationships between
processes regardless of the age effect. For all analyses, the significance level for p was
set at .05. All analyses were performed by means of StatSoft, Inc. (2007).
RESULTS
The descriptive data of the various executive measures for each of the different
groups according to gender and age are summarized in Table 2. In what follows, we report
the results analysis by process.
Inhibition Development
To test the effect of age and gender on changes in the Stroop interference score, we
conducted a two-way ANOVA (Age × Gender: 6 × 2, see Figure 1).
The analysis revealed a significant effect of age, F(5) = 4.53, p < .001, ηρ2 = .1735,
whereas the gender effect was non-significant, F(1) = 0.14, p = .7099, ηρ2 = .0013. In
addition, the age by gender interaction effect was also non-significant, F(5) = 1.44,
p = .2169, ηρ2 = .0624.
The post hoc Fisher’s least significant difference (LSD) test indicated that the
interference score was significantly higher for the group of 7-year-old children in com-
parison to the 9-, 11- and 12-year-olds (p < .05). It is also higher for the 8-year-olds as
compared to the 11- and 12-year-olds (p < .05) and, finally, for the 10-year-olds in
comparison to the 11-year-olds (p < .05). The difference between the performance of
the 9- and 11-year-olds showed a marginal effect (p = .055). All other comparison pairs
were non-significant.
To test age and gender effects on errors score variations at the Hayling, we
conducted a two-way ANOVA (Age × Gender: 6 × 2). The analysis indicated a significant
effect of age, F(5) = 3.45, p < .01, ηρ2 = .1379. Gender effect was significant in favor of
boys, F(1) = 4.22, p < .05, ηρ2 = .0376. Age by gender interaction effect was non-
significant, F(5) = 0.98, p = .4312, ηρ2 = .0435. Errors score progression according to age
and gender are represented in Figure 2.
The post hoc Fisher’s LSD test showed that Hayling errors scores were significantly
higher (p < .01) for the 8-year-old children (M = 4.65; σ = 3.69) compared with the older
children (9-year-olds, M = 2.35 and σ = 1.78; 10-year-olds, M = 2.40 and σ = 1.82; 11-
year-olds, M = 2.05 and σ = 1.28; 12 year-olds, M = 2.50 and σ = 2.14). Other pairs of
comparison were non-significant.
In addition, post hoc analyses showed a significant gender effect only between the
group of 8-year-old girls (M = 3.40; σ = 2.32) and boys (M = 5.90; σ = 4.46) of the same
age group (p < .05).
The two-way ANOVA examining the effect of age and gender (6 × 2) on the
Hayling ATT revealed a significant age effect, F(5) = 9.90, p < .0001, ηρ2 = .3143, a non-
significant gender effect, F(1) = 0.03, p = .872, ηρ2 = .0002, and a non-significant age by
gender interaction effect, F(5) = 2.13, p = .0697, ηρ2 = .0898 (see Figure 3).
Table 2 Descriptive Data for Executive Indices by Age and Gender.
1st year (n = 20) 2nd year (n = 20) 3rd year (n = 20) 4th year (n = 20) 5th year (n = 20) 6th year (n = 20)
Girls Boys Girls Boys Girls Boys Girls Boys Girls Boys Girls Boys
M SD M SD M SD M SD M SD M SD M SD M SD M SD M SD M SD M SD
Stroop
Word 158.29 48.77 134.77 32.63 99.2 33.37 99.68 32.86 89 24.76 86.92 23.75 81.93 6.35 76.09 13.32 77.66 38.68 65.57 7.34 59.7 9.6 63.6 8.57
Color 141.05 19.5 143.97 35.44 121.12 32.67 119.86 24.64 113.39 24.47 102.6 22.21 106.43 14.57 92.86 18.25 101.23 26.29 89.64 21.99 81.41 15.89 82.52 15.29
Color/Word 251.46 63.35 236.69 55.64 228.87 58.33 195.75 46.69 175.67 50.36 185.68 51.48 181.23 39.16 170.35 46.02 137.22 19.35 145.78 35.59 127.91 29.56 152.55 47.17
Int. Score 110.41 61.05 92.72 58.8 107.75 49.94 75.89 47.92 62.28 56.81 83.08 33.09 74.8 30.49 77.48 34.72 35.99 40.59 56.14 20.84 46.49 23.58 70.03 35.74
Hayling
Time A 1.3 0.88 1.04 0.81 0.46 0.36 0.63 0.73 0.31 0.25 0.27 0.19 0.26 0.15 0.19 0.03 0.17 0.02 0.17 0.02 0.18 0.02 0.18 0.02
Time B 2.99 1.51 4.35 2.85 3.38 2.31 2.99 1.56 1.49 0.62 1.27 0.78 1.12 0.53 1.01 0.53 1.46 0.61 0.91 0.64 0.88 0.48 0.83 0.42
ATT 1.69 1.61 3.31 2.54 2.92 2.11 2.35 1.44 1.18 0.72 0.99 0.71 0.87 0.54 0.82 0.5 1.29 0.62 0.74 0.64 0.7 0.48 0.65 0.43
Error Score 3 2.49 3.5 2.76 3.4 2.32 5.9 4.46 1.8 1.62 2.9 1.85 2.7 2.21 2.1 1.37 1.8 0.92 2.3 1.57 1.9 1.73 3.1 2.42
Verbal Span
Forward DS 4.7 0.67 4.6 0.97 5.1 0.32 5 0.82 5.2 0.79 5.2 0.79 5.3 0.82 5.4 0.97 5.7 1.42 5.9 1.2 6.1 0.57 6 0.67
Backward DS 3.2 0.63 3.6 1.07 3.3 0.48 3.7 0.82 3.8 0.63 3.8 1.13 4.8 0.42 4.6 0.97 4.7 0.82 5 0.67 5.2 0.63 5.4 0.7
Visuospatial Span
BTT-F 4.7 1.06 5.2 0.63 4.6 0.97 5.1 0.32 5.2 0.42 5.8 1.03 5.4 0.52 5.7 0.67 6 0.82 6.3 0.67 5.7 0.48 6.3 1.16
BTT-B 3.2 1.03 4 1.15 3.5 0.97 4.7 0.67 4.5 0.97 4.8 1.13 4.5 0.71 4.8 1.03 4.6 0.7 5.4 0.52 5.2 0.79 5.7 0.67
Verbal fluency
Animals 14.5 4.72 16.3 3.65 17.3 3.5 18 2.94 20.7 2.94 21.1 2.13 21.3 2.67 22.7 3.06 21.7 4.67 23.8 3.73 26.1 6.23 25 4.94
EXECUTIVE FUNCTION IN TUNISIAN CHILDREN
Letter M 9.1 3.07 11.1 3.25 9.4 3.02 10.3 3.65 14.2 3.39 15.3 2.75 13.3 4.88 14.5 2.68 15.7 3.74 16 3.23 19.9 4.58 19.4 4.45
Clothing/H 10 3.8 9.8 2.25 8.1 1.85 9.5 2.76 12 3.68 12.1 2.08 13.2 2.2 12.5 2.01 14.5 2.91 13.9 4.09 17.6 4.25 15.6 4.4
Stroop test: Word = response time for the card “Word”; Color = response time for the card “Color”; Color/Word = response time for the card “Color/Word”; Int. Score = interference score; Time A = median response time for part
A of the Hayling test; Time B = median response time for part B of the Hayling test; ATT = additional thinking time; Forward DS = forward digit span; Backward DS = backward digit span; BTT-F = forward visuospatial span; BTT-
B = backward visuospatial span; Animals = number of correct words produced for the category “Animals”; Letter M = number of correct words produced for the letter “M”; Clothing/H = number of correct words produced for
alternating between the category “Clothing” and the letter “H”.
13
14 T. BELLAJ ET AL.
130
120
110
100
Mean interference score
90
80
70
60
50
40
30
20
7 8 9 10 11 12
Age
Figure 1 Age effect on the Stroop interference score.
Girls
8
Boys
7
Hayling B Mean Error Score
–1
7 8 9 10 11 12
Age
Figure 2 Age and gender effects on the Hayling errors score progression.
4.0
3.5
3.0
Additional Thinking Time
2.5
2.0
1.5
1.0
0.5
0.0
–0.5
7 8 9 10 11 12
Age
Figure 3 Development of Hayling additional thinking time with age.
The post hoc Fisher test indicated a significantly (p < .001) higher ATT in the
younger children (7- and 8-year-olds) compared to the older children (9- to 12-year-olds).
Other differences were non-significant. Thus, compared to older children, younger chil-
dren take more time to inhibit the dominant responses.
Cognitive Flexibility Development

To examine the effects of age and gender on the number of correctly generated
items according to the verbal fluency criterion (semantic, phonemic or alternating fluid-
ity), we conducted a three-way ANOVA (Age × Gender × Criterion: 6 × 2 × 3). Our
comparisons revealed a significant age effect, F(5) = 27.78, p < .0001, ηρ2 = .5626, a non-
significant gender effect, F(1) = 0.79, p = .3763, ηρ2 = .0072, and a non-significant age by
gender interaction, F(5) = 0.45, p = .8113, ηρ2 = .0205. In addition, we found a significant
criterion effect, F(2) = 324.87, p < .0001, ηρ2 = .7505, which significantly interacted with
age, F(10) = 2.01, p < .05, ηρ2 = .0852, but not with gender, F(2) = 1.98, p = .14,
ηρ2 = .018. Lastly, the age by gender by criterion interaction was not significant,
F(10) = 0.39, p = .9478, ηρ2 = .018 (see Figure 4).
The post hoc Fisher’s LSD test revealed that the number of words correctly produced
in semantic fluency condition was significantly lower for the 7-year-old children in compar-
ison to the older children (p < .05). The 8-year-old children also had lower scores than the
older children (p < .01); a similar marginal effect was observed between the 9- and 12-year-
olds (p < .0001), 10- and 12-year-olds (p < .01), and 11- and 12-year-olds (p < .05).
16 T. BELLAJ ET AL.
30
Semantic fluency
28
Letter fluency
26 Alternate fluency
24
22
Mean words production
20
18
16
14
12
10
8
6
4
7 8 9 10 11 12
Age
Figure 4 Progression of number of correctly generated items according to age and criterion on fluency tests.
In phonemic fluency, the number of words correctly generated was lower in the group
of 7-year-old children in comparison to the 9- to 12-year-olds (p < .001). The differences were
also significant between the 8-year-olds and the older age groups (p < .001). The 9-year-olds
produced fewer words than the 12-year-olds (p < .0001), the 10-year-olds less than the 12-
year-olds (p < .0001), and the 11-year-olds less than the 12-year-olds (p < .001).
In alternating fluency, the number of words correctly generated was significantly
lower for the 7-year-olds in comparison to the 10-, 11- and 12-year-olds (p < .01). Their
performance also tended to be less successful than the 9-year-olds (p = .056). The 8-year-
olds correctly generated less words than the older children (p < .01). The 9-year-olds tended
to perform less successfully than the 11-year-olds (p = .056) and deviated significantly from
the performance of the 12-year-olds (p < .0001). Finally, the 10- and 11-year-olds correctly
generated less words than the 12-year-olds (p < .001 and p < .05, respectively).
In addition, the post hoc analysis confirmed a significant criterion effect. Regardless
of age, children produce more words in semantic fluency (SVF) than in phonemic (PVF)
and alternating fluency (AVF) (SVF: M = 20.71 and σ = 5.07; PVF: M = 14.02 and
σ = 4.87; AVF: M = 12.40 and σ = 4.02; with p < .0001). On the other hand, better scores
in phonemic fluency as compared with alternating fluency were significant only at the age
of 9 (PVF: M = 14.75 and σ = 3.06; AVF: M = 12.05 and σ = 2.91; with p < .01) and
12 years (PVF: M = 19.65 and σ = 4.40; AVF: M = 16.60 and σ = 4.33; with p < .001). At
the age of 11, this difference is on the border of statistical significance (p = .0504).
In addition, the performance of children in semantic fluency is regularly high
regardless of age, compared with the performance of children in the phonemic and
alternating verbal fluency tasks (p < .05).
A non-significant age effect was noted for the fluency perseveration number,
F(5) = 0.92, p = .473, ηρ2 = .0407. Gender effect was also non-significant, F(1) = 0.72,
p = .398, ηρ2 = 0.0066, as well as the interaction between these two variables, F(5) = 1.01,
p = .4149, ηρ2 = .0447. However, a significant effect of criterion was found, F(2) = 23.26,
p < .0001, ηρ2 = .1772, while interaction with age was no-significant, F(10) = 0.43,
p = .9316, ηρ2 = .0195, as well as the interaction with gender, F(2) = 0.04, p = .9552,
ηρ2 = 0.0004. Lastly, the interaction effect of criterion by age by gender was non-
significant, F(10) = 1.63, p = .1004, ηρ2 = .07. Post hoc analysis indicated that the
mean number of perseverations in semantic fluency was higher than that of the other
criteria (p < .001), while this number in alternating fluency was higher than that of the
phonemic fluency (p < .05).
Working Memory Development

To test age and gender effect on the word digit span task in its two conditions
(forward vs backward), we conducted a three-way ANOVA (Age × Gender × Condition:
6 × 2 × 2). A significant age effect was observed, F(5) = 18.36, p < .0001, ηρ2 = .4594,
while gender effect and its interaction with age were non-significant, respectively
F(1) = 0.56, p = .455, ηρ2 = .0053 and F(5) = 0.14, p = .983, ηρ2 = .0061. Moreover,
the condition effect has proved to be significant, F(1) = 149.51, p < .0001, ηρ2 = .5806, as
well as interaction with age, F(5) = 2.77, p < .05, ηρ2 = .1136. Other interactions were
non-significant: condition by gender, F(1) = 1.05, p = .3068, ηρ2 = .0097, and condition
by age by gender, F(5) = 0.51, p = .7678, ηρ2 = .0231 (see Figure 5).
7.0
Forward digit span
6.5
Backward digit span
6.0
5.5
Mean digit span
5.0
4.5
4.0
3.5
3.0
2.5
7 8 9 10 11 12
Age
Figure 5 Progression of word digit span by age, gender, and condition.

18 T. BELLAJ ET AL.
Post hoc analysis revealed that the forward digit span was significantly lower for
the 7-year-old children in comparison to the 9- to 12-year-olds (p < .05). This
difference was also significant between the 8-year-olds and the 11- and 12-year-olds
(p < .01), and between the 9-year-olds and the 11- and 12-year-olds (p < .05). These
differences are again significant between the 10- and 12-year-olds (p < .01). The
backward digit span improves between the ages of 7 and 10 years and between the
ages of 11 and 12 years (p < .0001). The scores of the 8-year-old children were also
lower than those of the 10- to 12-year-olds (p < .0001). Differences were again
significant for the 9-year-olds compared to the older age groups (p < .001). The
same results were found for the 10-year-olds compared with the 12-year-olds
(p < .05). Regarding the condition effect, regardless of age, forward digit span was
higher than reverse ones (p < .01).
A three-way ANOVA (Age × Gender × Condition: 6 × 2 × 2) for the visuospatial
span revealed a significant effect of age, F(5) = 14.08, p < .0001, ηρ2 = .3946, and gender,
F(1) = 19.77, p < .0001, ηρ2 = .1548, while the interaction effect was non-significant,
F(5) = 0.36, p = .8722, ηρ2 = .0166. The condition effect was significant, F(1) = 116.11,
p < .0001, ηρ2 = .5181, unlike the interactions with age, F(5) = 1.85, p = .1094,
ηρ2 = .0788, gender, F(1) = 1.14, p = .288, ηρ2 = 0.004, and both age and gender,
F(5) = 0.82, p = .5355, ηρ2 = .04367 (see Figure 6).
The Fisher LSD showed an overall better performance for boys than for girls in
visuospatial spans (p < .001). It also indicated that, at all ages, performance in the forward
7.5
Girls
7.0 Boys
6.5
6.0
Mean visuospatial span
5.5
5.0
4.5
4.0
3.5
3.0
2.5
2.0
Age 8 10 12 Age 8 10 12
7 9 11 7 9 11
Forward Backward
Figure 6 Progression of visuospatial span by age, gender, and condition (direct vs reverse).
visuospatial span condition was better than that in the backward visuospatial span
(p < .05). Age effect is observed almost linearly along different age groups. For BTT-F,
visuospatial span improvement with age was significant between the 7-year-old children
and all other age groups (p < .05) except for the 8-year-olds, who were less efficient than
the older age groups (p < .01). Likewise, the visuospatial span of the 9-year-olds was
lower than that of the 11- and 12-year-olds (p < .05). In addition, the 10-year-olds were
less efficient than the 11-year-olds (p < .05). The visuospatial span did not significatly
differ between the 11- and 12-year-olds. For BTT-B, the visuospatial span evolvement
with age was significant between the 7-year-old children and all other age groups
(p < .001), and between the 8-year-olds and the older groups (p < .01). The performance
was less efficient for the 9- and 10-year-olds compared to the 12-year-olds (both values of
p < .01). No significant difference was identified between the performance of the 11- and
12-year-olds.
Correlation Analyses
Correlation analyses between the educational level of the father and executive
scores were generally non-significant, with the exception of the backward digit span
(p < .01) and Hayling ATT (p < .05). All correlations between executive scores and
educational level of the mother were non-significant. Table 3 contains the whole set of
correlations.
The correlations analysis between the executive scores and the overall intellectual
level identified significant correlations for all measures (see Table 3). After controlling for
age, previously correlations became moderate and non-significant for the forward digit
span, Stroop interference score, and alternating fluidity index (p > .05).
Table 3 Correlations between Executive Scores and Educational Level of Parents.
Intelligence
Variables (Raven Matrices) Mother’s education level Father’s education level
Forward digit span r = .22 r = −.099 r = .09

p < .05 p = .284 p = .328
Backward digit span r = .51 r = .01 r = .24
p < .0001 p = .884 p < .01
Visuospatial forward span r = .41 r = .08 r = .15
p < .0001 p = .376 p = .094
Visuospatial backward span r = .46 r = .04 r = .07
p < .0001 p = .65 p = .423
Stroop interference score r = −.24 r = −.103 r = −.17
p < .01 p = .261 p = .07
Hayling additional thinking time r = −.45 r = −.09 r = −.199
p < .0001 p = .303 p < .05
Simple semantic fluency r = .42 r = .03 r = .135
p < .0001 p = .703 p = .142
Simple letter fluency r = .46 r = .03 r = .036
p < .0001 p = .743 p = .700
Alternating fluency r = −.39 r = −.04 r = .049
p < .0001 p = .63 p = .596
20 T. BELLAJ ET AL.
Partial correlational analyses showed that inhibitor measures (interference score and
ATT) proved to be independent (r = .07, p = .44). On the other hand, verbal fluency scores
appeared, on the whole, significantly correlated: semantic fluency and phonemic fluency
(r = .4, p < .0001), semantic fluency and alternating fluency (r = .42, p < .0001),
phonemic fluency and alternating fluency (r = .54, p < .0001). Forward and backward
verbal digit spans were also significantly correlated (r = .28, p < .01), as well as
corresponding scores of visuospatial span (r = .43, p < .0001). Correlations between
backward digits and visuospatial spans were also significant (r = .26, p < .01).
Partial correlations analysis between the various executive processes showed that
the Stroop interference score was significantly correlated with the backward visuospatial
span (r = −.18, p < .05). The Hayling ATT was significantly correlated with alternating
verbal fluency (r = −.22, p < .05) and visuospatial spans (BTT-F, r = −.26, p < .01;
BTT-B, r = −.26, p < .01). In addition, semantic fluency was significantly correlated with
backward digit span (r = .28, p < .01) and visuospatial spans (BTT-F, r = .3, p < .01;
BTT-B, r = .18, p < .05). The same result was found for the phonemic fluency (span-E,
r = .25, p < .01; BTT-F, r = .18, p < .05; BTT-B, r = .25, p < .01). Alternating fluency was
correlated with most of the executive scores: backward digit span (r = .37, p < .0001),
visuospatial spans (BTT-F, r = .23, p < .05; BTT-B, r = .18, p < .05), and Hayling
ATT (r = .22, p < .05).
DISCUSSION
The main aim of the current study was to use a cross-sectional design to examine
the developmental trend of three domains of executive control (prepotent response
inhibition, cognitive flexibility, and working memory) and to investigate their mutual
interactions in school-age Tunisian children (Brocki & Bohlin, 2004; Lehto et al., 2003).
Secondary objectives included the assessment of the effects of gender and parents’
education level because of their potential roles in the development of executive control
abilities (Ardila et al., 2005; Armengol, 2002; Brocki & Bohlin, 2004; Klenberg et al.,
2001; Levin et al., 1991). Finally, we analyzed relations between fluid intelligence and
the development of executive processes based on the hypothesis of possible links
between these two domains of competence (Arffa, 2007). The study population was
matched for age, gender, parents’ education level, and fluid intelligence level obtained
by Raven Matrices. This methodological control was necessary to avoid socio-demo-
graphic biases and to ensure the homogeneity of the groups because individual differ-
ences among the children may contribute to variance (Hughes & Graham, 2002; Kline,
1998; Miyake et al., 2000).
For the Hayling test, the Tunisian children’s results are consistent with the data
obtained by Shallice et al. (2002), who found an overall improvement in ATT and the
Error index between 6 and 12 years of age.
Furthermore, it is important to note that with regard to the evolution of the
interference index in the Stroop test, the performance of the Tunisian children was
relatively close to the performance reported for Spanish-speaking children attending
private schools. Other work has found similar comparisons (Armengol & Méndez,
1999; Comalli et al., 1962). However, qualitative analysis of the performance of the
Tunisian children on various cards of the Stroop test revealed some peculiarities. Based on
the average number of corrected errors on the various cards, it was possible to note a
trade-off effect: children balanced response quality and response speed. Indeed, the
percentage of 12-year-old children who committed four or more corrected errors was
approximately equal to the percentage of 7-year-old children who committed the same
number of corrected errors, regardless of the proposed Stroop card (for example, on the
interference card, 65% of 12-year-old children committed more than four corrected errors,
whereas this percentage was only 55% for the 7-year-olds). Regarding the variation in
error scores on the Hayling test with respect to the age of the Tunisian children, our results
confirm the data obtained by Shallice et al. (2002) in a study of the executive profiles of
children with attention deficit disorder with hyperactivity. As in our study, Shallice et al.
found an overall improvement in the index between 6 and 12 years of age. Other studies
based on different paradigms have also found an overall improvement of performance in
school-age children on tasks that assess different aspects of inhibitory processes. For
example, working with a sample of 52 7- to 15-year-old subjects, Levin et al. (1991)
observed improved indices of errors of commission and errors of omission in a Go/No-Go
task, with a particularly noticeable improvement between the older children (7- to 8-year-
olds and 9- to 12-year-olds; no significant differences were found in the 13- to 15-year-
olds). Using a stop-signal task, Williams et al. (1999) also observed an increase in the rate
of predominant response inhibition between 6- to 8-year-olds and 9- to 12-year-olds.
Based on a study of 92 6- to 13-year-old children that evaluated the development of
different dimensions of EF, Brocki and Bohlin (2004) observed improved inhibitory
capacity using a battery of tests, including the Stroop test. However, they noted that the
most striking improvement occurred between 7 years and 6 months and 9 years and
5 months, and between 9 years and 6 months and 11 years and 5 months. Finally, working
with a sample of 170 8- to 12-year-old children, Sevino (1998) found improved perfor-
mance on the Stroop test, with an attenuated level of maturity at 12 years of age compared
to adults.
Moreover, developmental data resulting from comparisons carried out for tasks of
simple and alternating verbal fluency revealed significant overall improvement in sponta-
neous and reactive flexibility skills between 7 and 12 years of age, in accordance with
data reported in the literature. Using similar semantics and phonemic verbal fluency tasks
to assess spontaneous flexibility (Anderson et al., 2001; Brocki & Bohlin, 2004; Klenberg
et al., 2001; Lehto et al., 2003; Levin et al., 1991; Sevino, 1998; Welsh et al., 1991) and
an alternating fluency task to assess reactive flexibility (Sevino, 1998), an overall
improvement with age was observed in school-age populations, albeit with differing
maturity peaks from one study to another. A steady improvement of cognitive capacities
was recorded using other tasks, such as figural fluency (Klenberg et al., 2001; Levin et al.,
1991), the WCST (Welsh et al., 1991), the Brixton test (Shallice et al., 2002) and the Trail
Making Test (Sevino, 1998).
By analyzing the behavioral profiles of Tunisian children with respect to semantic
and phonemic fluency, it is clear that the strategies used for word retrieval depend on the
nature of the task and on the child’s age. In addition, the performance of Tunisian children
with respect to verbal semantic fluency seems to pass through three successive develop-
mental stages: from 7 to 9 years of age, improvement; from 10 to 11 years, stagnation;
from 11 to 12 years, further improvement in the average number of correctly produced
words. With respect to phonemic fluency, we observed two developmental stages: 7 to
8 years of age and 9 to 12 years. Subsequent qualitative analysis would be needed to
better understand these variations and to learn about the underlying processes.
Furthermore, regarding the evolution of the number of words produced in an alternating
influence task, few studies have been conducted on this subject. In a study of 170 8- to
22 T. BELLAJ ET AL.
12-year-old children, Sevino (1998) found a gradual improvement in the index with age,
with a peak of maturity at the age of 12; these results are broadly consistent with the data
we obtained. However, the evolution of this index remains relatively low compared to
those of semantic and phonemic fluency. Additional qualitative analyses will be needed to
highlight the processes underlying this index.
In addition, phonemic fluency performance remained significantly lower than per-
formance for semantic fluency, regardless of age. Kavé (2006) attributes these differences
in performance on the phonemic and semantic fluency tasks to the fact that during
development, children tend to use different strategies for word retrieval. Weaker perfor-
mance on the phonemic and alternating fluency tasks compared to the semantic fluency
task may also be because: (1) they require more cognitive resources; (2) they are less
routine than the semantic fluency task, which is a more ecological task based on natural
categorizations that are available from an early age; (3) they are more sensitive to shifting
capacities dependent on maturation of the frontal lobes (Martin, Wiggs, Lalonde, & Mack,
1994; Mummery, Patterson, Hodges, & Wise, 1996); and (4) they are in part dependent on
the level of literacy (Kremin & Dellatolas, 1996), whereas semantic fluency skills are
based on the natural tendency to categorize that is present from an early age (Kavé, 2006;
Kavé et al., 2008).
Additionally, the number of errors, especially repetitions, increased more or less
constantly with age and was relatively high in the semantic fluency task. Children seemed
to compromise between the speed and accuracy of their responses (trade-off effect).
Developmental data from comparisons of working memory revealed a relatively
constant increase in performance on the verbal and visuospatial digit span tasks in 7-
to 12-year-old children. This increase was more obvious when we compared the
performances of the oldest and youngest children. Moreover, higher performances
were observed for the forward-order span tasks compared to the backward-order
tasks. Indeed, the backward-order verbal and visuospatial span tasks are working
memory tasks because they require the child to perform two consecutive tasks: to
temporarily retain the digit sequence in the presented order (verbal or visuospatial
working memory), then recall the sequence in the reverse order. This requirement
represents a cognitive load for the child. A reduction of this difference with age is
revealed by the verbal and visuospatial working memory improvement that has been
largely described in school-age children (Brocki & Bohlin, 2004; Hale et al., 1997).
Brocki and Bohlin (2004) noted a gradual and steady improvement in performance on
the forward and backward digit span tasks between 6 and 13 years of age, with better
performance on the forward span than the backward. Hale et al. (1997) also found a
significant and sustained improvement in span between different child and adolescent
age groups, with better performance for verbal than visuospatial span (see Gathercole
et al., 2004; Luciana et al., 2005). Our results are consistent with other studies that
have used different paradigms, such as the motor sequence subscale of the Kaufman
Assessment Battery for Children, a duration reproduction lighting a torch task (Brocki
& Bohlin, 2004), the Cambridge Neuropsychological Test Automated Battery (Lehto
et al., 2003), the Tic-Tac-Toe Task, the mental counting task, and the mental running
task (Huizinga et al., 2006), all of which have indicated that working memory
capacities improve, but have suggested different peaks of maturity.
Differences in the developmental schedules and trajectories of executive indices
could be explained by differing population characteristics and by task effects. All
executive tasks involve complex and effortful tasks that require both executive and
non-executive processes (Chan, Shum, Toulopoulou, & Chen, 2008). Further studies
will be needed to elucidate the contribution of these non-executive processes to the
variance and to analyze the strategic behavior of children when they are performing
executive tasks.
Concerning the effect of gender on the variation of the performance of executive
tasks in children, the comparisons did not reveal significant differences, except for the
visuospatial span task, for which boys had an overall higher span than girls. These results
are consistent with those obtained by Klenberg et al. (2001) in their study of develop-
mental differences in attentional and executive processes in a sample of 400 3- to 12-year-
old Finnish children. They also found a significant effect of gender on working memory
capacity. It is important to note that the literature regarding the effect of gender on the
variation of the performance of school-age children on tasks assessing EF is not uniform.
Some studies have found either a non-significant effect (Arán-Filippetti & Allegri, 2011;
Armengol, 2002; Brocki & Bohlin, 2004; Hurks et al., 2010; Welsh et al., 1991) or,
conversely, a significant effect in favor of girls (Anderson et al., 2001; Ardila et al., 2005;
Berlin & Bohlin, 2002; Carlson & Moses, 2001; Klenberg et al., 2001; Levin et al., 1991)
or in favor of boys (Becker et al., 1987; Capitani et al., 1999; Halpern, 2000). Our results
support the idea of global behavior equivalence between girls and boys with respect to
executive competencies (Brocki & Bohlin, 2004; Lehto et al., 2003; Welsh et al., 1991).
Similarly, the correlations between the parents’ education level and the children’s
performance on the executive tasks were not significant. Only the education level of
the father was significantly correlated with the mean inhibitory processing time and
with the backward digit span. While the limited effect of parental level of education
observed in our study contradicts certain previous results (Ardila et al., 2005; Klenberg
et al., 2001), it is consistent with the results of other studies which showed that this
factor has little influence on executive development (e.g., Armengol, 2002; see Gioia,
Isquith, Guy, & Kenworthy, 2000). It is important to note that the correlations observed
by Ardila et al. (2005) between parents’ level of education and executive performance
were not all significant. The strongest correlation did not exceed the significance level
of .05, even though the study population included approximately 622 children. The
uniquely robust differences found for the EF test scores were between private and
public schools. For Armengol (2002), the educational level of the father and mother
predicted only 3% of the variance of the interference index. Moreover, this relative
independence should not mask the potential influence of parental educational practices
as well as the role of sociolinguistic and cultural factors (Bindman, Hindman, Bowles,
& Morrison, 2013; Hoff, 2003a, 2003b) in the general cognitive development of the
child.
The analysis of the correlations between the executive indices and the general
intellectual level (fluid intelligence, Raven Matrices) supports the existence of at least
one common process between these two domains of competence. The significant correla-
tions between the g factor and the executive indices confirm the inclusion of EF in a larger
intellectual system (Arffa, 2007), even after controlling for age. These data support the
idea of a conceptual overlap between fluid intelligence and EF (see Blair, 2006).
After controlling for age, the analysis of inter-task correlations showed significant
moderate links between overall intra-procedure scores for both flexibility and working
memory (median correlations of r = .41 and .27, respectively). Only the analysis of the
inhibitory processing indices (interference score and ATT) showed non-significant corre-
lations (median correlation = .07), which could reflect the dissociations previously
24 T. BELLAJ ET AL.
reported in the literature (Friedman & Miyake, 2004). According to these dissociations,
inhibition would be a multifactorial process including three fundamental functions: filter-
ing, suppression, and blocking. The Stroop test reflects the filtering function, whereas in
the Hayling task, the participant is required to simultaneously activate the functions of
suppression and blocking (Chiappe, Siegle, & Hasher, 2000; Lorsbach, Katz, & Cupak,
1998). Moreover, the grouped data of different tasks that assess cognitive flexibility and
working memory would be in favor of dissociable functions independent of content
(Baddeley, 1986; Shallice, 1988).
Concerning the relations between the indices that assessed distinct executive pro-
cesses (inter-process), weaker but significant correlations were found, with a median
correlation lower than that observed between tasks that call on the same process
(r = .16). These results support the presence of one or many common mechanisms
underlying EF (Miyake et al., 2000), the nature of which remains to be elucidated (Best
et al., 2009; Huizinga et al., 2006).
Thus, the results of the partial correlation analyses seem to be in accordance with
contemporary data obtained among children and adults that supports the idea of separate
but interrelated functions. Indeed, using exploratory and confirmatory analyses per-
formed on executive measures, Lehto et al. (2003) have identified three relatively
independent but interrelated factors of working memory (combining the scores for
WISC-III Mazes; spatial working memory; spatial span; NEPSY Auditory Attention
and Response Set), inhibition (Matching Familiar Figures Test; Tower of London) and
finally, shifting (verbal fluency; Trail Making Test-B). Working with an adult popula-
tion, Miyake et al. (2000) considered the separability of three EF: mental set shifting
(“Shifting”), information updating and monitoring (“Updating”) and the inhibition of
prepotent responses (“Inhibition”) and their roles in complex “frontal lobe” or “execu-
tive” tasks in 137 college students. Confirmatory factor analysis indicated that the three
target EF are moderately correlated with one another, but are clearly separable. From
this point of view, the presence of many EF, partially independent but closely related
and in permanent interaction, can gain legitimacy based on the concept that EF involves
the coordination of mental processes.
Because one of the motivators of this study was the lack of empirical data on the
development of EF in African and Arab countries, and even though we did not perform a
classic cross-cultural comparative study, it is interesting to compare our results to studies
that tested EF in children from European, North American, Latin American, and Asian
cultures. In fact, many comparisons were possible because the studies used similar age
intervals, selected participants according to similar criteria, and utilized the same tests
with similar procedures. For the Stroop test, comparing the Tunisian results to Spanish-
speaking 6- to 12-year-old Mexican children showed concordance regarding the effect of
age on cognitive inhibition; very similar scores on the Stroop interference index were
found for the different ages. For cognitive flexibility, most of the work conducted with
populations of children using different languages and of different cultures have also found
a gradual improvement in verbal fluency skills (phonemic and semantic) during childhood
and adolescence, albeit with lower performance on the phonemic fluency task compared
to the semantic fluency task. For example, working with a population of Hebrew children,
Kavé (2006) noted a steady and gradual improvement in the average number of words
correctly generated in three tasks of semantic fluency (animals, fruits and vegetables,
vehicles) and phonemic fluency (B, G, S). As expected, performance in semantic fluency
was superior to that in phonemic fluency. Arán-Filippetti and Allegri (2011) also
evaluated the performance of fluent Spanish-speaking 8- to 11-year-old children on a

semantic fluency task (animals) and three phonemic fluency tasks (F, A, S). They
observed an increased number of words generated in the semantic fluency task relative
to the task of phonemic fluency. In addition, all of the evidence found was significantly
stronger for the group of older children compared to the younger group. In a recent study,
John and Rajashekhar (2014) used a task of semantic fluency (animals) to assess capacity-
building recovery and the generation of words in 5- to 15-year-old Malayalam-speaking
Indian children. The data obtained also showed a gradual improvement in the number of
words correctly produced. Furthermore, regarding the evolution of the number of words
produced in an alternating influence task, few studies have been conducted on this subject.
However, Sevino (1998) found a gradual improvement in the index with age, with a peak
of maturity at 12 years of age, which is broadly consistent with the data we obtained.
However, the evolution of this index was relatively low compared to the previous two (the
indices of semantic and phonemic fluency). Additional qualitative analyses will be needed
to highlight the processes underlying this index. In accordance with our results, the effects
of gender on EF performance observed in other cultures have been rare and weak. In
contrast, a correlation between performance on executive tests and IQ have consistently
been found significant and of similar magnitude (Ardila et al., 2000).
The influence of culture on EF performance and development has been primarily
discussed according to two themes: the impact of bilingualism and the effects of social
models and experience. Concerning the impact of bilingualism on EF, Bialystok (1999,
2001) found that bilingual children who are simultaneously exposed to two languages
from an early age have more developed executive skills than monolingual children. These
findings have been reinforced by the work of Green (1998), Carlson and Meltzoff (2008),
Luo, Luk, and Bialystok (2010), and Morales, Calvo, and Bialystok (2013), who observed
generally higher executive performance in bilingual children compared to monolingual
children with respect to concept formation, mental reorganization, abstract and divergent
thinking, mental flexibility, cognitive inhibition and working memory. Working with
Arabic bilinguals, Soliman (2014) and Abdelgafar and Moawad (2014) confirmed these
conclusions in part and noted a lack of consensus regarding these effects (see Baker,
2011). In fact, the debate is still open due to the many methodological pitfalls possible
when dealing with the effects of bilingualism on cognition (differences in or a lack of
control over parents’ socioeconomic and socio-educational level, the degree of partici-
pants’ proficiency in each language, frequency of use of each language, and the language
of assessment). Regarding the effect of social models and experience on EF, Lewis,
Koyasu, Ogawa, Short, & Huang (2009) believe that EF has a basis in social interaction
and described studies that show more developed self-control in northeast Asian children
compared to their North American peers (Sabbagh, Xu, Carlson, Moses, & Lee, 2006). It
is well known that Chinese educators and parents emphasize the importance of respect
and self-control in everyday conduct (Chao & Tseng, 2002). Empirical results have shown
an advantage of Korean children on inhibition (conflict inhibition and delay inhibition
tests) and switching measures (alternating fluency and the Dimensional Change Card Sort
tests), but not in working memory measures (backward span) compared to English
children (Oh & Lewis, 2008). According to Lewis et al. (2009), the Confucian culture
widely adopted in Chinese, Korean, and Japanese societies may contribute to the
improved performance on executive tasks. What about the specifics of EF development
in Tunisian and Arabic cultures in general? Because there have not been any cross-cultural
studies that directly target EF and that compare populations of children from such cultural
26 T. BELLAJ ET AL.
backgrounds to others, no conclusions can be drawn. Nevertheless, it is important to note

that the results obtained for the Tunisian population cannot be generalized to other Arabic
or African countries unless future research supports it. In fact, even if Tunisia recognizes
“Islam as its religion and Arabic as its language” according to the Tunisian Constituent
Assembly (2014, p. 3), it is important to note that it chose to be a republic based on the
rule of “civil” law. It is also a culture that integrates Berber, Punic, African, Roman, Arab,
Othman and French influences, in addition to a long history of Judaic, Christian and
Islamic belief systems. Polyglotism is the main feature of the Tunisian language; the
Arabic Tunisian dialect is the mother tongue, followed by standard Arabic, French,
English and Italian, each with a specific grammar and vocabulary.
However, the culture is open to modernity while remaining attached to its traditional
roots. Tunisians have a unique culture seeped in Arabic culture and Islamic rituals and
heritage. The country is deeply rooted in the African continent and very much influenced
by French philosophy and literature and the French style of life. This is especially obvious
in the everyday practices of Tunisians, seen and observed only by insiders and those who
deeply immerse themselves in Tunisian society. This is similar in some respects to South
Korean culture, in which increasing Westernization conflicts with the daily practice of
collective traditions and in which traditional beliefs are being intellectually influenced by
Western philosophies (Kwon, 2002). However, it seems interesting to conduct cross-
cultural studies of the efficiency of EF by comparing different gradients of cultural
similarities and differences.
Limitations
The current study has some limitations, so the results must be interpreted with
caution. The first issue is that of low construct validity, which refers to the possibility of
executive tasks mapping onto a multitude of cognitive processes, executive as well as
non-executive, which makes the development of individual elements of the processes
difficult to identify. In addition, because there is not an agreed-upon task or set of tasks
used to assess each executive domain, it is likely that the developmental change reflected
in specific tasks represents different aspects of certain executive domains (Welsh, 2002).
This means that previous evidence of developmental changes in EF based on single tests
runs the risk of being task dependent. Because these processes are essential to control, we
tried to compare each process with a more basic task that requires less executive control
resources (naming and word reading for the Stroop and verbal initiation for the Hayling
and forward digit span) and evaluate each component based on two executive tasks
(Inhibition for Stroop and Hayling; cognitive flexibility for simple semantic and simple
phonemic alternating fluency; and working memory for verbal and visuospatial forward
and backward span).
Moreover, it should be noted that many response strategies are possible for non-
routine tasks, so it is sometimes difficult to estimate performance differences between
subjects because of differences in the strategies implemented in response to the proposed
tasks. This is particularly true when the subjects’ difficulties are expressed as a decrease in
reaction time and/or an increase in the number of errors. In the current study, the verbal
fluency tasks in children were characterized by a compromise between the quantity of
words named in 120 seconds and the quality of the words produced, with a high number
of repetitions. The children did not develop a relevant strategy for retrieval and encoding
in long-term memory; instead, they focused on the speed of word production. However,
these findings are not definitive, and further research is needed to highlight the nature of
the strategies used by children for the recovery of words from long-term memory, such as
the work that has previously addressed the issue (Arán-Filippetti & Allegri, 2011; John &
Rajashekhar, 2014; Kavé et al., 2008; Sauzéon et al., 2004). Qualitative analyses based on
the evolution of switching indices and clustering are therefore necessary.
Another aspect that was not considered in this work was the influence of socio-
demographic variables such as the parents’ socioeconomic status (SES), the potential
effects of which on the variation in cognitive performance of children have already been
highlighted in previous work. Indeed, links have been suggested between cognitive
development and socioeconomic level in different countries (Arán-Filippetti & Richaud
De Minzi, 2012; Kohen, Gunn, Leventhal, & Hertzman, 2002). For example, Hoff
(2003b) found that children from high-SES families have larger productive vocabularies
than children from mid-SES families. The influence of environmental factors has also
been shown for the development of other cognitive abilities (e.g., Ardila & Rosselli,
1994). Turkheimer, Haley, Waldron, D’Onofrio, & Gottesman (2003) suggested that the
proportion of IQ variance attributable to familial background and environment vary non-
linearly with SES. Thus, further work will be needed to assess the influence of this factor
on the development of executive skills among Tunisian school children.
Another limitation of this study was the use of a cross-sectional design to document
the development achieved with respect to the ages examined. However, although long-
itudinal studies offer a more valuable design for studying development, cross-sectional
studies offer the opportunity to study and compare wide domains of development
(Korkman, 2001). In addition, several studies have used this design to study EF devel-
opment in children (Anderson et al., 2001; Brocki & Bohlin, 2004; Klenberg et al., 2001;
Lehto et al., 2003; Levin et al., 1991; Sevino, 1998; Welsh et al., 1991). Moreover, only
children between 7 and 12 years of age were included. Because the development of EF is
not confined to the ages studied, it is not feasible to precisely document the age at which
adult performance on tasks of EF is reached using this method of analysis. Nevertheless,
previous studies (Brocki & Bohlin, 2004; Lehto et al., 2003; Sevino, 1998) have used an
age range similar to that of our study, strengthening the ability to generalize the results of
the ages evaluated here.
Finally, the relatively small sample size of each age group makes it difficult to
perform adequate statistical analysis to examine the influence of the two primary vari-
ables, age and gender. However, this limitation is not insurmountable as the statistical
power could be considered sufficient due to the multiple data points collected for each
group.
CONCLUSION
The results of this first study focusing on EF development in Tunisian school-age
children demonstrate a dynamic progression. This development is heterogeneous and
marked by peaks of maturity, which vary according to the type of process assessed and
sometimes according to the task used. This diversity of behavioral profiles strengthens the
developmental dynamics that motivate the behavior of school-age children and supports
the results of international studies conducted on non-African, non-Arabic-speaking chil-
dren (Brocki & Bohlin, 2004; Klenberg et al., 2001; Lehto et al., 2003; Levin et al., 1991;
Welsh et al., 1991). Moreover, while gender and parents’ education level seem to have
little impact on the development of EF in Tunisian children, the interdependence between
28 T. BELLAJ ET AL.
EF and fluid intelligence confirms the involvement of executive control in child cognitive
development.
Future Perspectives
From a prospective point of view, the current study of Tunisian children suggests a
certain universality of the development of EF. This concern represents an important
theoretical and clinical challenge. Only a truly cross-cultural study which identified the
different sources of bias, such as construct bias, method bias, and item bias, and which
ensured structural equivalence, measurement unit equivalence, and full-scale equivalence
(Van Devijver & Tanzer, 2004) would allow clarification of this issue. An ecological
perspective should be integrated in order to obtain a more contextual perspective of the
development of EF in children in different cultures. One way of achieving this goal is
through the use of everyday questionnaires such as the Behavior Rating Inventory of
Executive Function (Gioia et al., 2000).
Moreover, it would also be useful to consider a cross-cultural study of EF in terms
of “hot and cool executive functions” (Brock, Rimm-Kaufman, Nathanson, & Grimm,
2009; Hongwanishkul, Happaney, Lee, & Zelazo, 2005). To study the relationship
between culture and psychological variables, two fundamental aspects would need to be
addressed: (a) the degree of interaction between the psychological and cultural aspects of
each process; and (b) how changes in psychological processes are affected by the
influence of specific cultural contexts. Then it would be possible to understand the nature
of the relationship that could exist between human behavior and the cultural context in
which it developed. This understanding would require a conceptual redefinition and
delimitation of the psychological construct of EF and a readjustment of the ecological
footprints and features that characterize the sociocultural environment of Tunisia.
A final issue to overcome is that of task impurity. Miyake et al. (2000) presented one
way of addressing this problem. They proposed using multiple tasks to measure each EF
component and adopting the latent variables approach to extract the variance common to
those tasks. Latent variables (as incorporated in structural equation models) refer to what is
shared among tasks that are assumed to tap into a given EF. The latent variable approach
minimizes the task impurity problem and is therefore especially informative in develop-
mental studies (e.g., Nunally & Bernstein, 1994). Further work based on analyses of this
type would be interesting to highlight the underlying mechanisms of EF.
Original manuscript received 17 June 2014

Accepted manuscript 29 May 2015
First published online 7 July 2015
REFERENCES
Abdelgafar, G. M., & Moawad, R. A. (2014). Executive function differences between bilingual Arabic–
english and monolingual Arabic children. Journal of Psycholinguistic Research. Advance online
publication. doi:10.1007/s10936-014-9309-3
Abdi, H. (1987). Introduction au traitement statistique des données expérimentales. Grenoble: PUG.
Adleman, N. E., Menon, V., Blasey, C. M., White, C. D., Warsofsky, I. S., Glover, G. H., & Reiss,
A. L. (2002). A developmental fMRI study of the Stroop color-word task. NeuroImage, 16(1),
61–75. doi:10.1006/nimg.2001.1046
Aguibi, H., & Bouaziz, M. (1998). Etude différentielle des processus lexico-sémantiques à travers
des tâches de fluence verbale: Effets de l’âge et du niveau d’instruction. Communication aux
10èmes Journées Internationales de Biologie de la Société des Sciences Naturelles de Tunisie
(SSNT, Hammamet 5-7 Novembre 1998.
Anderson, P., Anderson, V., & Lajoie, G. (1996). The tower of London test: Validation and
standardization for pediatric populations. The Clinical Neuropsychologist, 10(1), 54–65.
doi:10.1080/13854049608406663
Anderson, V. A., Anderson, P., Northam, E., Jacobs, R., & Catroppa, C. (2001). Development of
executive functions through late childhood and adolescence in an Australian sample.
Developmental Neuropsychology, 20, 385–406. doi:10.1207/S15326942DN2001_5
Arán-Filippetti, V. A., & Allegri, R. F. (2011). Verbal fluency in Spanish-speaking children:
Analysis model according to task type, clustering, and switching strategies and performance
over time. The Clinical Neuropsychologist, 25(3), 413–436. doi:10.1080/
13854046.2011.559481
Arán-Filippetti, V., & Richaud De Minzi, M. (2012). A structural analysis of executive functions and
socioeconomic status in school-age children: Cognitive factors as effect mediators. The Journal
of Genetic Psychology, 173(4), 393–416. doi:10.1080/00221325.2011.602374
Ardila, A., Pineda, D., & Rosselli, M. (2000). Correlation between intelligence test scores and
executive function measures. Archives of Clinical Neuropsychology, 15(1), 31–36. doi:10.1093/
arclin/15.1.31
Ardila, A., & Rosselli, M. (1994). Development of language, memory and visuospatial abilities in 5-
to 12-year-old children using a neuropsychological battery. Developmental Neuropsychology,
10, 97–120. doi:10.1080/87565649409540571
Ardila, A., Rosselli, M., Matute, E., & Guajardo, S. (2005). The influence of the parents’ educa-
tional level on the development of executive functions. Developmental Neuropsychology, 28
(1), 539–560. doi:10.1207/s15326942dn2801_5
Arffa, S. (2007). The relationship of intelligence to executive function and non-executive function
measures in a sample of average, above average, and gifted youth. Archives of Clinical
Neuropsychology, 22, 969–978. doi:10.1016/j.acn.2007.08.001
Arffa, S., Lovell, M., Podell, K., & Goldberg, E. (1998). Wisconson card sorting test performance in
above average and superior school children: Relationship to intelligence and age. Archives of
Clinical Neuropsychology, 13, 713–720.
Armengol, C. G. (2002). Stroop test in Spanish: Children’s norms. Clinical Neuropsychologist, 16
(1), 67–80. doi:10.1076/clin.16.1.67.8337
Armengol, C. G., & Méndez, M. (1999). Lectura y Stroop en bilingües. La prueba de interferencia
Stroop y la eficacia en la lectura: Estudio normativo en escolares bilingües de cuarto grado
[Reading and Stroop in bilinguals. The Stroop interference test and reading proficiency:
Normative study in bilingual fourth graders]. Revista Española de Neuropsicología, 1(21), 27.
Asato, M. R., Sweeney, J. A., & Luna, B. (2006). Cognitive processes in the development of TOL
performance. Neuropsychologia, 44, 2259–2269. doi:10.1016/j.neuropsychologia.2006.05.010
Baddeley, A. (1986). Working memory. New York, NY: Oxford University Press.
Baddeley, A. D., & Hitch, G. J. (1974). Working memory. In G. H. Bower (Ed.), The psychology of
learning and motivation: Advances in research and theory (Vol. VIII, pp. 47–90). New York,
NY: Academic Press.
Baker, C. (2011). Foundations of bilingual education and bilingualism (5th ed.). Clevedon:
Multilingual Matters.
Balamore, U., & Wozniak, R. H. (1984). Speech–action coordination in young children.
Developmental Psychology, 20, 850–858. doi:10.1037/0012-1649.20.5.850
Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and executive functions:
Constructing a unifying theory of ADHD. Psychological Bulletin, 121, 65–94. doi:10.1037/
0033-2909.121.1.65
30 T. BELLAJ ET AL.
Baron, I. (2003). Neuropsychological evaluation of the child. New York, NY: Oxford University
Press.
Becker, M. G., Isaac, W., & Hynd, G. W. (1987). Neuropsychological development of nonverbal
behaviors attributed to “frontal lobe” functioning. Developmental Neuropsychology, 3, 275–
298. doi:10.1080/87565648709540381
Bellaj, T. (1999). Dysfonctionnement de la mémoire de travail dans la maladie de Parkinson
(Unpublished Doctoral dissertation). Faculté des Sciences Humaines et Sociales de Tunis,
Tunis
Bellaj, T. (2011). Evaluation psychologique et culture: Aspects conceptuels et méthodologiques. In
B. Troadec & T. Bellaj (Eds.), Psychologies et cultures (pp. 209–236). Paris: L’Harmattan.
Bellaj, T., Bouaziz, M., & Bouaziz, Z. (1995). Une version arabe du Stroop. Communication auprès
de la Société de Neuropsychologie de Langue Française (Marseille: 18-19 Mai 1995).
Bellaj, T., & Seron, X. (2014). Les facteurs culturels dans l’évaluation neuropsychologique. In X.
Seron & M. Van Der Linden (Eds.), Traité de neuropsychologie clinique de l’adulte (2ème éd.
pp. 641–658). Marseille: De Boeck-Solal.
Berlin, L., & Bohlin, G. (2002). Response inhibition, hyperactivity, and conduct problems among
preschool children. Journal of Clinical Child & Adolescent Psychology, 31, 242–251.
doi:10.1207/S15374424JCCP3102_09
Best, J. R., Miller, P. H., & Jones, L. L. (2009). Executive functions after age 5: Changes and
correlates. Developmental Review, 29, 180–200. doi:10.1016/j.dr.2009.05.002
Bialystok, E. (1999). Cognitive complexity and attentional control in the bilingual mind. Child
Development, 70, 636–644. doi:10.1111/cdev.1999.70.issue-3
Bialystok, E. (2001). Bilingualism in development: Language, literacy, and cognition. In E.
Bialystok (Ed.), Bilingualism in development: Language, literacy, and cognition (pp. 1–300).
New York, NY: Cambridge University Press.
Bindman, S. W., Hindman, A. H., Bowles, R. P., & Morrison, F. J. (2013). The contributions of
parental management language to executive function in preschool children. Early Childhood
Research Quarterly, 28(3), 529–539. doi:10.1016/j.ecresq.2013.03.003
Bjorklund, D. F., & Harnishfeger, K. K. (1995). The evolution of inhibition mechanisms and their
role in human cognition and behavior. In F. N. Dempster & C. J. Brainerd (Eds.), Interference
and inhibition in cognition (pp. 141–173). San Diego, CA: Academic Press.
Blair, C. (2006). How similar are fluid cognition and general intelligence? A developmental
neuroscience perspective on fluid cognition as an aspect of human cognitive ability.
Behavioral and Brain Sciences, 29, 109–160.
Boone, K. B., Ghaffarian, S., Lesser, I. M., & Hill-Gutierrez, E. (1993). Wisconsin Card Sorting
Test performance in healthy, older adults: Relationship to age, sex, education, and IQ. Journal
of Clinical Psychology, 49(1), 54–60. doi:10.1002/1097-4679(199301)49:1<54::AID-
JCLP2270490108>3.0.CO;2-6
Brocki, K. C., & Bohlin, G. (2004). Executive functions in children aged 6 to 13: A dimensional and
developmental study. Developmental Neuropsychology, 26(2), 571–593. doi:10.1207/
s15326942dn2602_3
Brock, L. L., Rimm-Kaufman, S. E., Nathanson, L., & Grimm, K. J. (2009). The contributions of
‘hot’ and ‘cool’ executive function to children’s academic achievement and learning-related
behaviors, and engagement in kindergarten. Early Childhood Research Quarterly, 24(3), 337–
349. doi:10.1016/j.ecresq.2009.06.001
Bull, R., & Scerif, G. (2001). Executive functioning as a predictor of children’s mathematics ability:
Inhibition, switching, and working memory. Developmental Neuropsychology, 19, 273–293.
doi:10.1207/S15326942DN1903_3
Burgess, P. W., & Shallice, T. (1996). Bizarre responses, rule detection and frontal lobe lesions.
Cortex, 32, 241–259. doi:10.1016/S0010-9452(96)80049-9
Burgess, P. W., & Shallice, T. (1997). The hayling and brixton tests. Thurston, Suffolk: Thames
Valley Test Company.New York, NY: Cambridge University Press
Capitani, E., Laiacona, M., & Barbarotto, R. (1999). Gender affects word retrieval of certain
categories in semantic fluency tasks. Cortex, 35, 273–278. doi:10.1016/S0010-9452(08)
70800-1
Carlson, S. M., & Meltzoff, A. (2008). Bilingual experience and executive functioning in young
children. Developmental Science, 11, 282–298. doi:10.1111/j.1467-7687.2008.00675.x
Carlson, S. M., & Moses, L. (2001). Individual differences in inhibitory control and children’s
theory of mind. Child Development, 72, 1032–1053. doi:10.1111/1467-8624.00333
Chan, R. C. K., Shum, D., Toulopoulou, T., & Chen, E. Y. H. (2008). Assessment of executive
functions: Review of instruments and identification of critical issues. Archives of Clinical
Neuropsychology, 23(2), 201–216. doi:10.1016/j.acn.2007.08.010
Chao, R., & Tseng, V. (2002). Parenting of Asians. In M. H. Bornstein (Series Ed.), Handbook of
parenting: Vol. 4 Social conditions and applied parenting (2nd ed., pp. 59–93). Mahwah, NJ:
Lawrence Erlbaum Associates.
Chiappe, P., Siegel, L., & Hasher, L. S. (2000). Working memory, inhibitory control, and reading
disability. Memory & Cognition, 28(1), 8–17. doi:10.3758/BF03211570
Comalli, P. E., Jr., Wapner, S., & Werner, H. (1962). Interference effects of Stroop Color-Word Test
in childhood, adulthood, and aging. The Journal of Genetic Psychology, 100, 47–53.
doi:10.1080/00221325.1962.10533572
Corsi, P. M. (1972). Human memory and the medial temporal region of the brain (Unpublished
Doctoral dissertation). McGill University, Montreal.
De Mattos Pimenta Parente, M. A., & Lecours, A. R. (1988). L’influence des facteurs culturels en
neuropsychologie et neurolinguistique. Revue Internationale des Sciences Sociales, 115, 109–122.
Dempster, F. N. (1992). The rise and fall of the inhibitory mechanism: Toward a unified theory of
cognitive development and aging. Developmental Review, 12, 45–75. doi:10.1016/0273-2297
(92)90003-K
Denckla, M. B. (1996). A theory and model of executive function: A neuropsychological perspec-
tive. In G. R. Lyon & N. A. Krasnegor (Eds.), Attention, memory, and executive function (pp.
263–277). Baltimore, MD: Paul H. Brookes.
Diamond, A. (2002). Normal development of prefrontal cortex from birth to young adulthood:
Cognitive functions, anatomy, and biochemistry. In D. T. Stuss & R. T. Knight (Eds.),
Principles of frontal lobe function (pp. 466–503). London: Oxford University Press.
Eslinger, P. J., & Grattan, L. M. (1993). Frontal lobe and frontal-striatal substrates for different
forms of human cognitive flexibility. Neuropsychologia, 31, 17–28. doi:10.1016/0028-3932
(93)90077-D
Fisk, J. E., & Sharp, C. A. (2004). Age-related impairment in executive functioning: Updating,
inhibition, shifting, and access. Journal of Clinical and Experimental Neuropsychology, 26,
874–890. doi:10.1080/13803390490510680
Friedman, N. P., & Miyake, A. (2004). The relations among inhibition and interference control
functions: A latent-variable analysis. Journal of Experimental Psychology: General, 133, 101–
135. doi:10.1037/0096-3445.133.1.101
Ganzach, Y. (2000). Parents’ education, cognitive ability, educational expectations and educational
attainment: Interactive effects. British Journal of Educational Psychology, 70, 419–441.
doi:10.1348/000709900158218
Gathercole, S. E., Pickering, S. J., Ambridge, B., & Wearing, H. (2004). The structure of working
memory from 4 to 15 years of age. Developmental Psychology, 40, 177–190. doi:10.1037/
0012-1649.40.2.177
Gerstadt, C. L., Hong, Y. J., & Diamond, A. (1994). The relationship between cognition and action:
Performance of children 312–7 years old on a stroop- like day-night test. Cognition, 53, 129–
153. doi:10.1016/0010-0277(94)90068-X
Gioia, G. A., Isquith, P. K., Guy, S. C., & Kenworthy, L. (2000). Behavior rating inventory of
executive function. Odessa, FL: Psychological Assessment Ressources.
Golden, C. J. (1978). Stroop color and word test. Wood Dale, IL: Stoelting Co.
32 T. BELLAJ ET AL.
Green, D. W. (1998). Mental control of the bilingual lexico-semantic system. Bilingualism:

Language and Cognition, 1, 67–81.
Hale, S., Bronik, M. D., & Fry, A. F. (1997). Verbal and spatial working memory in school-age
children: Developmental differences in susceptibility to interference. Developmental
Psychology, 33, 364–371. doi:10.1037/0012-1649.33.2.364
Halpern, D. F. (2000). Sex differences in cognitive abilities (3rd ed.). Mahwah, NJ: Lawrence
Erlbaum Associates, Inc.
Hoff, E. (2003a). Causes and consequences of SES-related differences in parent-to-child speech. In
M. H. Bornstein & R. H. Bradley (Eds.), Socioecononomic status, parenting, and child
development (pp. XX–XX). Mahwah, NJ: Lawrence Erlbaum Associates, Inc.
Hoff, E. (2003b). The specificity of environmental influence: Socioeconomic status affects early
development via maternal speech. Child Development, 74, 1368–1378. doi:10.1111/1467-
8624.00612
Hongwanishkul, D., Happaney, K. R., Lee, W., & Zelazo, P. D. (2005). Assessment of hot and cool
executive function in young children: Age-related changes and individual differences.
Developmental Neuropsychology, 28, 617–644. doi:10.1207/s15326942dn2802_4

Hughes, C. (1998). Executive function in preschoolers: Links with theory of mind and verbal ability.
British Journal of Developmental Psychology, 16, 233–253. doi:10.1111/bjdp.1998.16.issue-2
Hughes, C., & Graham, A. (2002). Measuring executive functions in childhood: Problems and
solutions? Child and Adolescent Mental Health, 3, 131–142. doi:10.1111/1475-3588.00024
Huizinga, M., Dolan, C. V., & Van Der Molen, M. W. (2006). Age-related change in executive
function: Developmental trends and a latent variable analysis. Neuropsychologia, 44, 2017–
2036. doi:10.1016/j.neuropsychologia.2006.01.010
Hurks, P. P. M., Schrans, D., Meijs, C., Wassenberg, R., Feron, F. J. M., & Jolles, J. (2010).
Developmental changes in semantic verbal fluency: Analyses of word productivity as a
function of time, clustering, and switching. Child Neuropsychology, 16(4), 366–387.
doi:10.1080/09297041003671184
John, S., & Rajashekhar, B. (2014). Word retrieval ability on semantic fluency task in typically
developing Malayalam-speaking children. Child Neuropsychology: A Journal on Normal and
Abnormal Development to Childhood and Adolescence, 20, 182–195. doi:10.1080/
09297049.2012.760538
Kavé, G. (2006). The development of naming and word fluency: Evidence from Hebrew-speaking
children between ages 8 and 17. Developmental Neuropsychology, 29, 493–508. doi:10.1207/
s15326942dn2903_7
Kavé, G., Kigel, S., & Kochva, R. (2008). Switching and clustering in verbal fluency tasks
throughout childhood. Journal of Clinical and Experimental Neuropsychology, 30, 349–359.
doi:10.1080/13803390701416197
Klenberg, L., Korkman, M., & Lahti-Nuuttila, P. (2001). Differential development of attention and
executive functions in 3-to 12-year-old finnish children. Developmental Neuropsychology, 20
(1), 407–428. doi:10.1207/S15326942DN2001_6
Kline, R. T. (1998). Principles and practice of structural equation modeling. New York, NY:
Guilford.
Klingberg, T., Forssberg, H., & Westerberg, H. (2002). Increased brain activity in frontal and
parietal cortex underlies the development of visuospatial working memory capacity during
childhood. Journal of Cognitive Neuroscience, 14, 1–10. doi:10.1162/089892902317205276
Koenig, O. (1989). Hemispheric asymmetry in the analysis of Stroop stimuli: A developmental
approach. Developmental Neuropsychology, 5, 245–260. doi:10.1080/87565648909540435
Kohen, D. E., Gunn, J. B., Leventhal, T., & Hertzman, C. (2002). Neighborhood income and
physical and social disorder in Canada: Associations with young children’s competencies.
Child Development, 73, 1844–1860. doi:10.1111/cdev.2002.73.issue-6
Koren, R., Kofman, O., & Berger, A. (2005). Analysis of word clustering in verbal fluency of
school-aged children. Archives of Clinical Neuropsychology, 20, 1087–1104. doi:10.1016/j.
acn.2005.06.012
Korkman, M. (2001). Introduction to the special issue on normal neuropsychological development
in the school-age years. Developmental Neuropsychology, 20, 325–330. doi:10.1207/
S15326942DN2001_1
Kremin, H., & Dellatolas, G. (1996). Phonological and semantic ﬂuency in children aged 5 to 8.
Approche Neuropsychologique des Apprentissages chez l’Enfant, 36, 23–28.
Kwon, Y.-I. (2002). Western influences in Korean preschool education. International Education
Journal, 3, 153–164.
Lehto, J. (1996). Are executive function tests dependent on working memory capacity? The
Quarterly Journal of Experimental Psychology Section A, 49, 29–50. doi:10.1080/713755616
Lehto, J. E., Juujärvi, P., Kooistra, L., & Pulkkinen, L. (2003). Dimensions of executive functioning:
Evidence from children. British Journal of Developmental Psychology, 21, 59–80. doi:10.1348/
026151003321164627
Levin, H. S., Culhane, K. A., Hartmann, J., Evankovich, K., Mattson, A. J., Harward, H., &
Fletcher, J. M. (1991). Developmental changes in performance on tests of purported frontal
lobe functioning. Developmental Neuropsychology, 7, 377–395. doi:10.1080/
87565649109540499
Lewis, C., Koyasu, M., Oh, S., Ogawa, A., Short, B., & Huang, Z. 2009.Culture, executive function, and
social understanding. In C. Lewis & J. I. M. Carpendale (Eds.), Social interaction and the develop-
ment of executive function. New Directions in Child and Adolescent Development 123. 69–85.
Lorsbach, T. C., Katz, G. A., & Cupak, A. J. (1998). Developmental differences in the ability to
inhibit the initial misinterpretation of garden path passages. Journal of Experimental Child
Psychology, 71(3), 275–296. doi:10.1006/jecp.1998.2462
Luciana, M., Conklin, H. M., Hooper, C. J., & Yarger, R. S. (2005). The development of nonverbal
working memory and executive control processes in adolescents. Child Development, 76, 697–
712. doi:10.1111/cdev.2005.76.issue-3
Luo, L., Luk, G., & Bialystok, E. (2010). Effect of language proficiency and executive control on
verbal fluency performance in bilinguals. Cognition, 114, 29–41. doi:10.1016/j.
cognition.2009.08.014
Luria, A. R. (1966). Higher cortical functions in man. New York, NY: Basic Books.
MacLeod, C. M. (1991). Half a century of research on the Stroop effect: An integrative review.
Psychological Bulletin, 109(2), 163–203. doi:10.1037/0033-2909.109.2.163
Mahone, E. M., Hagelthorn, K. M., Cutting, L. E., Schuerholz, L. J., Pelletier, S. F., & Rawlins, C., …
Denckla, M. B. (2002). Effects of IQ on executive function measures in children with ADHD.
Psychology Press, 8(1), 52–65.
Marian, V., Blumenfeld, H. K., & Kaushanskaya, M. (2007). The language experience and profi-
ciency questionnaire (LEAP-Q): Assessing language profiles in bilinguals and multilinguals.
Journal of Speech, Language, and Hearing Research, 50(4), 940–967. doi:10.1044/1092-4388
(2007/067)
Martin, A., Wiggs, C. L., Lalonde, F., & Mack, C. (1994). Word retrieval to letter and semantic
cues: A double dissociation in normal subjects using interference tasks. Neuropsychologia, 32,
1487–1494. doi:10.1016/0028-3932(94)90120-1
Matute, E., Rosselli, M., Ardila, A., & Morales, G. (2004). Verbal and nonverbal fluency in Spanish
speaking children. Developmental Neuropsychology, 26, 647–660. doi:10.1207/
s15326942dn2602_7
Meulemans, T. (2006). Les fonctions exécutives: Approche théorique. In P. Pradat-Diehl, P. Azouvi,
& V. Brun (Eds.), Fonctions exécutives et rééducation (pp. 1–10). Paris: Masson.
Miyake, A., Friedman, N. P., Emerson, M. J., Witzki, A. H., Howerter, A., & Wager, T. D. (2000).
The unity and diversity of executive functions and their contributions to complex “frontal lobe”
34 T. BELLAJ ET AL.
tasks: A latent variable analysis. Cognitive Psychology, 41, 49–100. doi:10.1006/

cogp.1999.0734
Morales, J., Calvo, A., & Bialystok, E. (2013). Working memory development in monolingual and
bilingual children. Journal of Experimental Child Psychology, 114(2), 187–202. doi:10.1016/j.
jecp.2012.09.002
Mummery, C. J., Patterson, K., Hodges, J. R., & Wise, R. J. (1996). Generating ‘tiger’ as an animal
name or a word beginning with T: Differences in brain activation. Proceedings of the Royal
Society B: Biological Sciences, 263, 989–995. doi:10.1098/rspb.1996.0146
Nagy, Z., Westerberg, H., & Klingberg, T. (2004). Maturation of white matter is associated with the
development of cognitive functions during childhood. Journal of Cognitive Neuroscience, 16,
1227–1233. doi:10.1162/0898929041920441
Nazel, M. W., El-Morshedy, H., Farghaly, A., Shatat, H., & Barakat, R. (1999). Schistosoma
mansoni infection and cognitive functions of primary school children, in Kafr El Sheikh,
Egypt. Journal of Egyptian Public Health Association, 74(1–2), 97–119.
Nieto, A., Galtier, I., Barroso, J., & Espinosa, G. (2008). Fluencia verbal en ninos espanoles en edad
escolar: Estudio normativo piloto y analisis de las estrategias organizativas. Revista de

Neurologia, 46, 2–6.
Nunally, J. C., & Bernstein, I. H. (1994). Psychometric theory (3rd ed). New York, NY: McGraw
Hill.
Oh, S., & Lewis, C. (2008). Korean preschoolers’ advanced inhibitory control and its relation to
other executive skills and mental state understanding. Child Development, 79, 80–99.
doi:10.1111/cdev.2008.79.issue-1
Olson, E. A., & Luciana, M. (2008). The development of prefrontal cortex functions in adolescence:
Theoretical models and a possible dissociation of dorsal versus ventral subregions. In C. A.
Nelson & M. Luciana (Eds.), Handbook of developmental cognitive neuroscience (2nd ed., pp.
575–590). Cambridge, MA: MIT Press.
Pena, E. D., Bedore, L. M., & Zlatic-Giunta, R. (2002). Category-generation performance of
bilingual children: The influence of condition, category, and language. Journal of Speech,
Language and Hearing Research, 45, 938–947.
Posner, M. I. (1978). Chronometric explorations of mind. New York, NY: Lawrence Erlbaum
Associates.
Ratcliff, G., Ganguli, M., Chandra, V., Sharma, S., Belle, S., Seaberg, E., & Pandav, R. (1998).
Effects of literacy and education on measures of word fluency. Brain and Language, 61, 115–
122. doi:10.1006/brln.1997.1858
Raven, J. C., Court, J. H., & Raven, J. (1985). Raven’s progressive matrices. London: J.C. Raven.
Raz, N. (2000). Aging of the brain and its impact on cognitive performance: Integration of structural
and functional findings. In F. I. M. Craik & T. A. Salthouse (Eds.), Handbook of aging and
cognition (pp. 1–90). Mahwah, NJ: Erlbaum.
Riccio, C. A., Hall, J., Morgan, A., Hynd, G. W., Gonzalez, J. J., & Marshall, R. M. (1994).
Executive function and the Wisconsin Card Sorting Test: Relationship with behavioral ratings
and cognitive ability. Developmental Neuropsychology, 10(3), 215–229. doi:10.1080/
87565649409540580
Riva, D., Nichelli, F., & Devoti, M. (2000). Developmental aspects of verbal fluency and con-
frontation naming in children. Brain and Language, 71, 267–284. doi:10.1006/brln.1999.2166
Romdhane, M. N., Bellaj, T., & Attia-Romdhane, N. (2008). Comment sont adaptés et Validés les
Tests Neuropsychologiques en Tunisie? La Tunisie Médicale, 86(7), 746–753.
Sabbagh, M., Xu, F., Carlson, S. M., Moses, L. J., & Lee, K. (2006). The development of executive
functioning and theory of mind. A comparison of chinese and U.S. preschoolers. Psychological
Science, 17, 74–81. doi:10.1111/psci.2006.17.issue-1
Sauzéon, H., Lestage, P., Raboutet, C., N’Kaoua, B., & Claverie, B. (2004). Verbal fluency output in
children aged 7–16 as a function of the production criterion: Qualitative analysis of clustering,
switching processes, and semantic network exploitation. Brain and Language, 89, 192–202.
doi:10.1016/S0093-934X(03)00367-5
Scherf, K. S., Sweeney, J. A., & Luna, B. (2006). Brain basis of developmental change in
visuospatial working memory. Journal of Cognitive Neuroscience, 18, 1045–1058.
doi:10.1162/jocn.2006.18.7.1045
Schroeter, M. L., Zysset, S., Wahl, M., & Von Cramon, D. Y. (2004). Prefrontal activation due to
Stroop interference increases during development-an event-related fNIRS study. NeuroImage,
23(4), 1317–1325. doi:10.1016/j.neuroimage.2004.08.001
Senn, T. E., Espy, K. A., & Kaufmann, P. M. (2004). Using path analysis to understand executive
function organization in preschool children. Developmental Neuropsychology, 26, 445–464.
doi:10.1207/s15326942dn2601_5
Sevino, O. (1998). Les fonctions exécutives: évaluation et développement. Thèse de Doctorat non
publiée, University of Geneva, Geneva, Switzerland.
Shallice, T. (1982). Specific impairments in planning. Philosophical Transactions of the
Royal Society of London Series B. Biological Sciences, 298, 199–209. doi:10.1098/
rstb.1982.0082
Shallice, T. (1988). From neuropsychology to mental structure. Cambridge: Cambridge University
Press.
Shallice, T., Marzocchi, G. M., Coser, S., Del Savio, M., Meuter, R. F., & Rumiati, R. I. (2002).
Executive function profile of children with attention deficit hyperactivity disorder.
Developmental Neuropsychology, 21(1), 43–71. doi:10.1207/S15326942DN2101_3
Sobeh, J., & Spijkers, W. (2013). Development of neuropsychological functions of attention in two
cultures: A cross-cultural study of attentional performances of Syrian and German children of
pre-school and school age. European Journal of Developmental Psychology, 10(3), 318–336.
doi:10.1080/17405629.2012.674761
Soliman, A. M. (2014). Bilingual advantages of working memory revisited: A latent variable
examination. Learning and Individual Differences, 32, 168–177. doi:10.1016/j.
lindif.2014.02.005
Spreen, O., & Strauss, E. (1998). A compendium of neuropsychological tests (2nd ed.). New York,
NY: Oxford University Press.
StatSoft, Inc. (2007). STATISTICA (Version 8.0) [Data analysis software system]. Retrieved from
www.statsoft.com
Talarowska, M., Florkowski, A., Chamielec, M., & Gałecki, P. (2013). Are there any differences in
the working memory of men and women? Polskie Towarzystwo Lekarskie, 34, 29–32.
Tallberg, I. M., Carlsson, S., & Lieberman, M. (2011). Children’s word fluency strategies.
Scandinavian Journal of Psychology, 52, 35–42. doi:10.1111/sjop.2011.52.issue-1
Teachman, J. D. (1987). Family background, educational resources and educational attainment.
American Sociological Review, 52, 548–557.
Tunisian Constituent Assembly. (2014). Constitution of the Tunisian Republic. [In Arabic.]
Retrieved from http://www.chambre-dep.tn/site/main/AR/docs/constition.pdf
Turkheimer, E., Haley, A., Waldron, M., D’Onofrio, B., & Gottesman, I. I. (2003). Socioeconomic
status modifies heritability of IQ in young children. Psychological Science, 14, 623–628.
doi:10.1046/j.0956-7976.2003.psci_1475.x
Van Devijver, F., & Tanzer, N. K. (2004). Bias and equivalence in cross-cultural assessment: An
overview. Revue Européenne de Psychologie Appliquée, 54, 119–135. doi:10.1016/j.
erap.2003.12.004
Wechsler, D. (1996). Manuel de l’échelle d’ intelligence de Wechsler pour enfants, WISC-R
(troisième édition). Paris: Editions du Centre de Psychologie Appliquée.
Welsh, M. C. (2002). Developmental and clinical variations in executive functions. In D. L. Molfese
& V. J. Molfese (Eds.), Developmental variations in learning (pp. 139–185). Mahwah, NJ:
Lawrence Erlbaum Associates, Inc.
36 T. BELLAJ ET AL.
Welsh, M. C., Pennington, B. F., & Groisser, D. B. (1991). A normative-developmental study of

executive function: A window on prefrontal function in children. Developmental
Neuropsychology, 7, 131–149. doi:10.1080/87565649109540483
White, K. R. (1982). The relation between socioeconomic status and academic achievement.
Psychological Bulletin, 91, 461–481. doi:10.1037/0033-2909.91.3.461
Williams, B. R., Ponesse, J. S., Schachar, R. J., Logan, G. D., & Tannock, R. (1999). Development
of inhibitory control across the life span. Developmental Psychology, 35, 205–213.
doi:10.1037/0012-1649.35.1.205
Zacks, R., & Hasher, L. (1997). Cognitive gerontology and attentional inhibition: A reply to Burk
and McDowd. Journal of Gerontology: Psychological Sciences, 52 B, 274–283. doi:10.1093/
geronb/52B.6.P274
Zelazo, P. D., Craik, F. I. M., & Booth, L. (2004). Executive function across the life span. Acta
Psychologica, 115, 167–183. doi:10.1016/j.actpsy.2003.12.005
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Development of executive functioning in school-age Tunisian children

Article in Child Neuropsychology · July 2015

Tarek Bellaj Imène Soumaya Salhi

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Didier Le Gall Arnaud Roy

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Development of executive functioning in school-

Tarek Bellaj, Imen Salhi, Didier Le Gall & Arnaud Roy

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Development of executive functioning in school-age

Tarek Bellaj1,3, Imen Salhi2, Didier Le Gall3, and Arnaud Roy3,4

Keywords: Executive functioning; Development; Neuropsychology; Culture.

© 2015 Taylor & Francis

populations. A search of the major academic databases (PsychINFO, Elsevier, ERIC,

Table 1 Demographic and Psychometric Data.

The Stroop Test

The Junior Hayling Test

Simple and Alternating Verbal Fluency

Timing began immediately.

Say as many words, alternating a word beginning with . . . and a name of . . .,

Corsi Block-Tapping Test

statistical tools. For comparison, we used one-way, factorial, or repeated measures

Table 2 Descriptive Data for Executive Indices by Age and Gender.

Figure 1 Age effect on the Stroop interference score.

Figure 3 Development of Hayling additional thinking time with age.

Cognitive Flexibility Development

Working Memory Development

Figure 5 Progression of word digit span by age, gender, and condition.

Table 3 Correlations between Executive Scores and Educational Level of Parents.

Forward digit span r = .22 r = −.099 r = .09

evaluated the performance of fluent Spanish-speaking 8- to 11-year-old children on a

backgrounds to others, no conclusions can be drawn. Nevertheless, it is important to note

Original manuscript received 17 June 2014

Green, D. W. (1998). Mental control of the bilingual lexico-semantic system. Bilingualism:

Developmental Neuropsychology, 28, 617–644. doi:10.1207/s15326942dn2802_4

tasks: A latent variable analysis. Cognitive Psychology, 41, 49–100. doi:10.1006/

escolar: Estudio normativo piloto y analisis de las estrategias organizativas. Revista de

Welsh, M. C., Pennington, B. F., & Groisser, D. B. (1991). A normative-developmental study of

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