Evaluating the effects of inhibitory control training as a universal prevention strategy for internalizing complaints in middle childhood.

Internalizing complaints or inwardly directed psychological difficulties such as anxiety, worry and low mood can significantly affect children's emotional well-being and daily functioning. If left untreated, these difficulties can persist into adulthood. Growing evidence has reported the critical role of cognitive control (ability to regulate attention and memory processes) in the development and maintenance of emotional problems such as anxiety. Cognitive control training has shown promise in reducing emotional vulnerability in adults and adolescents. However, studies with children are scant. The present study examined the potential of a gamified inhibitory control training as a universal prevention strategy aimed at reducing emotional vulnerability in children. Given the link between inhibitory control and math achievement (i.e., greater inhibitory control associated with higher math achievement), we also explored whether 15 sessions of daily training could improve math performance. Our randomized controlled trial, conducted in accordance with a pre-registered, published protocol, used a 2 (Group: Inhibitory control training group, n = 62; vs. Active control group, n = 61) × 4 (Time: pre- vs. post-training vs. 1-month vs. 3-month follow-up) design in a non-selected sample of Australian children aged 8-11 years (N = 123). Emotional, cognitive and academic measures were collected at each timepoint. Intention-to-treat analyses using linear mixed models showed no evidence of proximal transfer to untrained inhibitory control measures and limited evidence of beneficial distal transfer to emotional or academic outcomes, with some outcomes showing trends favouring the active control condition. The absence of broader emotional and academic benefits may therefore reflect the lack of improvement in the targeted cognitive process itself. These findings highlight important considerations regarding the design and delivery of cognitive training interventions to universal samples, including the calibration of task demands and the conditions required to support cognitive transfer. Future research should investigate whether stronger transfer effects can be achieved through adaptive training tasks that maintain optimal cognitive challenge, extended or higher-dose training protocols, and interventions targeting children with elevated emotional vulnerability or inhibitory control difficulties.