Interventions targeting executive functions in children and young people exposed to complex trauma: A systematic review

Previous research has established that children and young people exposed to complex trauma (i.e., abuse and/or neglect; and/or domestic, family, and sexual violence) have significantly greater deficits in executive function (EF) and a higher incidence of psychopathology. Poor EF is associated with poorer academic, social, and relational outcomes across the lifespan and poorer overall wellbeing. Despite this, the efficacy of interventions aimed at remediating executive dysfunction in this population have not been established. The current PRISMA-guided systematic review aimed to critically analyse the existing evidence and inform practice guidelines for clinicians working with impacted children and young people. A systematic search identified six studies: three utilized computerized cognitive training, two utilized individual education plans, and one utilized trauma-focused cognitive behavioural therapy. Findings identified two approaches that produced significant improvements in EF and warrant further investigation with more rigorous methodology: computerized cognitive training and trauma-focused cognitive behavioural therapy. Several methodological limitations were identified, including a lack of adequate control groups, little consensus on classification of EF domains, and failure to delineate trauma type, onset, and duration. This review highlights the need for further methodologically robust research to inform clinical practice guidelines for EF interventions for young people exposed to complex trauma.