Examining the Effectiveness of a Dual Executive Function Training Package: Protocol for a Randomised Controlled Trial

Executive functions (EF) are a set of higher-order cognitive processes that enable children to regulate their thoughts, emotions, and behaviours in pursuit of goals. Core domains include working memory, inhibitory control, and cognitive flexibility, often referred to as cool EF because they are typically measured in abstract, decontextualised contexts. Cold EFs are top-down cognitive processes that are logically based or mechanistic and operate in affectively neutral contexts. In contrast, hot EF refers to regulation in affectively or motivationally charged situations, encompassing delay discounting, affective/risky decision-making, and interpersonal and social behaviour. Both domains are crucial for children's learning, adaptation, and participation, but they rely on partially distinct neural systems and show different developmental trajectories. Importantly, recent models emphasise that hot and cool EF should not be viewed as isolated constructs but rather as interconnected components along a continuum. In real-world learning and social contexts, cognitive and affective demands are often intertwined. For example, sustaining working memory while managing frustration, or planning actions while negotiating peer dynamics, highlighting the need for interventions that address both hot and cool domains simultaneously.

EF difficulties are particularly salient in the context of special educational needs (SENs). Children with SENs are disproportionately likely to present with impairments in both hot and cool EF, which underpin many of the learning and behavioural challenges they face in schools. Among these, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and specific learning difficulties (SpLD) are the three most prevalent conditions worldwide, and they are consistently associated with executive dysfunction. ADHD, ASD, and SpLD are all characterised by combined hot and cool EF deficits. In ADHD, cool EF weaknesses in working memory, inhibition, and sustained attention are compounded by hot EF problems such as poor delay of gratification, impulsivity, and emotional dysregulation. ASD presents with cool EF impairments in flexibility, planning, and working memory. It also shows hot EF deficits in emotional regulation, reward processing, and theory of mind. SpLD is often framed as academic skill deficits. However, it also involves cool EF challenges in working memory, processing speed, and attention as well as hot EF challenges related to frustration tolerance and motivation. Despite this dual profile, many existing interventions have focused disproportionately on one side of the EF spectrum, typically emphasising cool EF while neglecting hot EF. To provide meaningful support for children with SENs, a more comprehensive approach is needed, one that systematically integrates both domains.

Existing EF interventions provide partial solutions but leave important gaps. Cognitive training studies, such as Re et al. (2015) have demonstrated that children with ADHD symptoms can improve in attention, inhibition, and working memory following structured training. These domains reflect cool EF, and while the programme successfully enhanced cognitive performance, the gains were largely confined to laboratory tasks, with modest evidence of generalisation to socio-emotional or classroom functioning. Hot EF, such as emotional regulation or social reasoning, was not directly addressed. A more ecological approach is seen in the Cognitive-Functional (Cog-Fun) intervention for ADHD. Cog-Fun is an occupational therapy programme that emphasises metacognitive strategy use, planning, organisation, and self-monitoring in daily life. Parents are also coached to support the application of strategies at home. While Cog-Fun is effective in improving organisation, homework performance, and children's self-directed behaviour, its focus remains on cool EF, with only indirect influence on hot EF domains such as emotional regulation and motivation through parent involvement.

More recent work has explicitly attempted to integrate hot EF. Shuai et al. (2017) developed an EF training package for children with ADHD that included not only core cool EF skills (working memory, inhibition, planning, flexibility, and verbal fluency) but also hot EF components such as emotional regulation. Their results showed improvements in both cognitive control and social understanding, underscoring the value of a dual-domain approach. However, the scope of hot EF was narrow, confined to Theory of Mind tasks and behavioural ratings of emotional control, and the programme was delivered in a clinic-based format, limiting scalability and ecological validity in school contexts. Similarly, Jasni et al. (2025) implemented a psychosocial group intervention combining cognitive skills training with social skills and emotional regulation exercises. Although not framed explicitly in hot-cool EF terms, the programme recognised the importance of targeting both domains. Children showed improvements in EF performance and social behaviour. Yet, the hot EF elements were integrated only loosely with cognitive training, and the lack of a systematic framework to connect the two domains limited the intervention's conceptual clarity and generalisability.

Research on EF interventions in ASD and specific learning disabilities (SpLD) reveals similar limitations. For ASD, interventions often focus on improving planning, flexibility, and organisation through structured tasks or cognitive-behavioural strategies, targeting cool EF deficits. Some studies incorporate social skills training, which overlaps with hot EF, but these are typically run as separate programmes rather than integrated EF training. This fragmented approach fails to address the interdependence of cognitive and socio-emotional regulation, both of which are impaired in ASD. In SpLD, interventions predominantly target working memory, inhibition, or attention to support reading or mathematics performance. These cool EF-focused programmes have demonstrated efficacy in improving task-related outcomes, but they neglect hot EF processes such as self-regulation, frustration tolerance, and motivational control, which are equally important for sustaining learning in students with SpLD. The absence of a hot EF component leaves a gap in addressing the broader challenges faced by students with SpLD in daily classroom participation.