Peer-reviewed article

Specific Early Childhood Experiences Predict Executive Function Skills During Later Childhood and Adolescence: Evidence from the ECHO Cohort.

Drexler C, Mansolf M, Calma-Birling D, Sherlock P, Blackwell CK et al. · 15 Jul 2026

Abstract

The healthy development of executive function (EF) skills in childhood and adolescence provides a crucial foundation for later outcomes, from mental and physical health to academic achievement and socio-emotional functioning. Although meta-analyses have identified associations between children's EF skills and early experiential factors, these are often examined in terms of broad categories (e.g., socioeconomic status) or cumulative risk factors (e.g., adverse childhood experiences; ACEs). The current study leverages longitudinal data (N = 1295) from six cohorts from the Environmental influences on Child Health Outcomes (ECHO) program to identify unique associations among specific prenatal, perinatal, and early life conditions and three specific EF skills (inhibitory control, working memory, and cognitive flexibility) measured later in childhood. Indicators of socioeconomic status, birth outcomes, parental characteristics, and pre- and post-natal exposures to alcohol and tobacco were measured before age 6 years. EF skills and language were measured from ages 6-15 years (M = 9.95, SD = 1.92), using measures from the NIH Toolbox. Two complementary statistical methods, a psychological network approach and regression trees, were employed to disaggregate early predictors of EF development. Results from both methods converged to suggest that specific early conditions showed associations with specific EF skills, and that higher birth weight (independent of pre-term status) was a stronger predictor of better EF skills than other early conditions. Neither approach showed meaningful associations between EF skills and maternal ACEs. Birth weight appears to serve as a particularly sensitive summary index of prenatal influences on EF development.