The central role that executive functions (EFs) play in children’s social capacities, learning, and school readiness is increasingly recognized and promoting EF skills is currently a hot topic in early childhood education (Bierman and Torres 2016; Diamond 2016). Core EFs include attentional flexibility (attention switching or set shifting), working memory (holding information in mind and working with it), and inhibitory control (self-control or impulse control) (Diamond and Lee 2011). These are important skills for helping children master academic tasks and get along with peers (Center on the Developing Child at Harvard University 2011). A growing body of international research has demonstrated the robust relationship between young children’s EF skills and academic outcomes in preschool and across the early school years (Ackerman and Friedman-Krauss 2017). For example, recent evidence from a large USA study indicated that EF deficits in kindergarten children predicted repeated academic difficulties at school over a 3-year period (Morgan et al. 2019). EF skills also play an important role in children’s social-emotional development (Riggs et al. 2006). For instance, in longitudinal research, executive control predicted preschool children’s social competence (Denham et al. 2015). Conversely, EF deficits at age 4 predicted negative behavior at age 5 in ‘hard-to-manage” children (Hughes et al. 2001). EF skills develop rapidly during the preschool school years, influenced by caregiving and environmental factors as well as growth in brain development (Diamond 2016). The importance of improving EF skills early in life is underscored by longitudinal research demonstrating that EF skills in early childhood predict long-term health, wealth, and educational outcomes (Diamond 2016; McClelland et al. 2013; Moffitt et al. 2011). Poor EFs can lead to social problems, such as aggression and crime, and are associated with a poorer quality of life (Moffitt et al. 2011).

A range of interventions in early childhood centers have shown promise in terms of their ability to promote children’s EF skills (for reviews see Ackerman and Friedman-Krauss 2017; Bierman and Torres 2016). For example, a study located in Head Start classrooms found that children who participated in the Preschool PATHS (Promoting Alternative Thinking Strategies) Curriculum, aimed at developing social–emotional skills, showed small improvements in EF skills, based on the Dimensional Change Card Sort task (DCCS), compared to children in control classrooms (Bierman et al. 2008). Another study, based on the Chicago School Readiness Project (CSRP), which incorporated the Incredible Years Teacher Training Program and extensive teacher support, found small, but significant intervention effects for EF skills (i.e., inhibitory control and working memory) (Raver et al. 2011). However, both of these studies included additional components, such as intensive teacher mentoring (Raver et al. 2011) and curriculum enrichment targeting language and literacy (Bierman et al. 2008). As they did not specifically target EF skills, it was not possible to identify which components of the intervention related to positive EF outcomes.

One program that does explicitly target EF skills is the Red Light, Purple Light (RLPL) circle time games intervention (Tominey and McClelland 2011). The intervention includes traditional children’s games that have been modified to increase cognitive complexity. RLPL is cost-effective, requiring minimal training for implementation, few materials, and can be flexibly added to preschool classroom routines (Tominey and McClelland 2011).

Three randomized controlled trials in the USA have evaluated RLPL and found improvements in EF skills for children who participated in the intervention. In Tominey and McClelland’s (2011) pilot study, for children with low scores at the pretreatment assessment, positive treatment gains were found on a composite EF measure, the Head–Toes–Knees–Shoulders task (HTKS) (Cameron Ponitz et al. 2009). In a subsequent trial of RLPL with a Head Start sample (N = 280), children in the intervention group demonstrated significantly higher levels of EF skills after the intervention compared with a control group of children who received their usual curriculum (Schmitt et al. 2015). These intervention effects were obtained on two direct measures of EF, the HTKS and a cognitive flexibility assessment based on the DCCS (Frye et al. 1995). A third trial found that children who participated in a kindergarten readiness program that included RLPL games, experienced more gains in EF skills than children who participated in the readiness program alone (Duncan et al. 2018). These gains, assessed with the HTKS, were seen both at post intervention and 4-month follow-up. However, the study did not include a control condition in the 4-month follow-up, limiting conclusions that could be made about whether follow-up effects were attributable to the intervention.

The present study examined the effects of RLPL on preschool children’s EF skills using a more stringent RCT design that included control group comparisons at both post-intervention and 4-month follow-up. A second limitation addressed by the current study was the inclusion of independent observations of program delivery by teachers. Prior research has relied on ratings by intervention group leaders (Schmitt et al. 2015) or teachers (Duncan et al. 2018) who delivered the intervention, to assess fidelity of implementation.

Red Light, Purple Light (RLPL) Intervention

RLPL is a classroom-based intervention that uses movement and music games designed to help children practice EF skills in fun and engaging ways. There are five different game activities in which children take part, including Sleeping Game; Freeze Game; Red Light, Purple Light; Conductor; and Drum Beats (for a complete description of the intervention games, see Tominey and McClelland 2011). For example, in “Red Light, Purple Light”, the group leader acts as the stoplight and holds up different-colored construction paper circles to represent stop and go. Children respond to specific color cues (e.g., purple is stop and orange is go), and then opposite cues (e.g., purple is go and orange is stop), with a variety of actions (e.g., clapping). During this game, children need to listen to and remember instructions (i.e., working memory), attend to the group by watching the cues and successfully switch from one rule to another (i.e., attentional flexibility), and resist the natural inclination to engage inappropriately in an action (i.e., inhibitory control). The games are played during circle time, in twice-weekly 20–30-min sessions, for 8 weeks. Across the 16-session program, activities are repeated and additional instructions are added to the games to make them more complicated and children are given plenty of opportunities to practice and learn the basic, and more complicated, versions of the games. Opportunities are incorporated for children to lead activities. For example, in the “Red Light, Purple Light” game, children are given the opportunity to choose a color and act as the stoplight.

The Current Study

The research question examined was: do 4-year-old children who participate in the intervention show stronger EF and classroom behavioral self-regulation skills at post-intervention and 4-month follow-up compared to children in a waitlist control group? Based on prior findings (Duncan et al. 2018; Schmitt et al. 2015), it was hypothesized that children’s participation in the intervention would lead to greater post-intervention gains in EF skills. Similar to Schmitt et al. (2015), multiple measures (HTKS, DCCS, and teacher ratings of classroom behavioral self-regulation) were used to assess intervention effectiveness. The current study aimed to evaluate the efficacy of RLPL when delivered by teachers in New Zealand early childhood education (ECE) classrooms. To date, RLPL has been trialed in the United States, as delivered by researchers (Schmitt et al. 2015; Tominey and McClelland 2011) or teachers (Duncan et al. 2018) in preschool classrooms. Thus, the study provided the opportunity to evaluate the intervention in a different cultural and ECE center-based context. To examine New Zealand ECE teachers’ experience of implementing the games and integrating them into the curriculum, the study also included post-intervention teacher interviews. New Zealand early childhood centers are bound by an overarching national curricular framework, Te Whāriki, prescribed by the Ministry of Education, which is underpinned by bicultural framing, emphasizing NZ’s bicultural foundation. Te Whāriki interprets the notion of curriculum broadly and provides a framework of principles, strands (wellbeing; belonging; contribution; communication; exploration) goals and learning outcomes. At the heart of Te Whāriki, is the importance of respectful, reciprocal and responsive relationships. Such relationships are integral to the healthy development of self-regulation. Te Whāriki specifically endorses the development of self-regulation as a key learning outcome under the Wellbeing strand of the curriculum. Te Whāriki recognizes that New Zealand children are growing up in a diverse society and supports children from all backgrounds to grow up strong in identity, language and culture (Ministry of Education 2017).

Method

Trial Design

The study was a center-based, cluster randomized controlled trial. Centers were randomized to either the RLPL intervention (8 weeks of twice weekly 20- to 30-min sessions of the intervention) or a waitlist control group (business-as-usual, i.e., the same daily activities, routines, and curricula that preceded study participation). Children were assessed individually at pre-intervention (T1), post-intervention (T2), and at 4-month follow-up (T3).

Participants

Fifteen ECE centers participated in the study. These centers provided full-day early-learning and child care and were located in a range of socioeconomic areas (low SES = 7; mid SES = 8) across the Auckland (New Zealand) region. Centers belonged to a large national early care and education provider, who expressed interest in trialing the program.

There was a total of 212 consented children across the 15 participating centers. Child characteristics are shown in Table 1. The children ranged in age from 47 to 58 months (M = 52.52 months, SD = 2.93), at the date of the pre-intervention assessments. Fifty two percent of the children were female. On average, children were enrolled at their center for 32.23 h (SD = 11.78) per week and had spent 100.55 weeks (SD = 57.31) at their current center. Thirty-one different ethnic groups were represented within the sample. Most parents nominated one ethnic group (n = 154, 73%) for their child, with Asian descent the most frequent, followed by New Zealand European and Pacific Island origins. Fifty-seven parents (27%) reported their child had two or more ethnicities. The majority of parents reported one main language spoken at home (n = 163, 77.1%), with English the most common (n = 114, 69.9%), followed by Indian (n = 19, 11.7%), and Chinese (n = 13, 8%). Forty-eight parents (22.9%) nominated two or more languages spoken at home.

Table 1 Child characteristics by group and differences between conditions (N = 212)
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Signed consent was obtained from 61 teachers, the majority of whom were female (96.7%), aged between 22 and 61 years (M = 36.43, SD = 9.97), with an average of 6.69 years (SD = 5.70) of ECE teaching experience. A Bachelor of Education/Teaching (ECE) (n = 28, 45.9%) was the most frequently held teacher qualification, followed by a Diploma of Teaching (n = 14, 23.0%). Other qualifications included an ECE certificate, teacher in training, and a Master’s degree.

Recruitment

Twenty ECE centers were invited to take part in the study and 15 center managers consented for their center to participate. Letters were distributed to parents of participating centers, requesting consent for their 4-year-old child to participate in the research and complete the study assessments. The study was confined to 4-year-old children for two reasons: (1) In New Zealand children typically start school at age 5-years, (2) the possibility of floor effects on EF measures used in the study in children under 4 years of age. Floor effects occur when a measure has a lower limit for possible responses and a large concentration of participants score at or near this limit (Hessling et al. 2004). It was thought that floor effects may occur in children younger than 4-years because they may find the tasks too difficult and make no correct responses. Figure 1 shows the flow of centers and children through each stage of the trial, including reasons for exclusions and missing data.

Fig. 1
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Participant flow diagram

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Randomization

Eight centers were randomly assigned to the intervention group and eight to the waitlist control group (subsequently, one of these centers did not participate). Given the variability in the numbers of consented children across ECE centers, paired randomization was used to balance center size across the intervention and control groups. This involved pairing centers based on their similarity in the number of consented children. Randomization was done by a statistician, independent of the study, using the R software package to randomly assign each center in the pair to either the intervention or the waitlist control group. A series of independent t tests and chi-square analyses indicated that at pre-intervention, there were no significant differences between the two groups in family demographic characteristics of the consented children.

At each time point, trained research staff administered two tasks to measure children’s EF skills. All children were assessed in English, with the exception of one child who was assessed in her native Punjabi language. At T1 only, children’s receptive English language understanding was assessed before, and on a separate day to, the EF assessments. The assessments took about 15 min and were conducted in a quiet space within the classroom. At T2 and T3, assessments were conducted at home for some children who had left the center. Ten children were assessed at home at T2 and 38 children at T3. The numbers of parents who refused follow-up home visits or could not be contacted at T2 and T3 are shown in Fig. 1. At the three time-points, teachers rated children on their behavior self-regulation in the classroom. At T3, for children who had started school, with parental consent, schools were contacted for permission for the child’s teacher to complete the questionnaire.

Intervention

A 3-h teacher training session to implement RLPL was provided via webinar, by the program developers at the Oregon State University, USA, to teachers located in New Zealand. Teachers were given a training manual containing detailed guidelines for delivering each RLPL session.

The RLPL intervention took place in the children’s regular classroom, on the same two days each week. Across the eight intervention centers, the number of consented children ranged from 6 to 22 (M = 13.38). Each game session was led by one lead teacher. The 15 ECE qualified teachers who implemented the games had an average of 5.9 years of teaching experience. Teachers were provided with a session checklist to record children who participated in each session and which games were played. The teacher-checklists were compared with researcher-completed checklists during session observations and there was 96% agreement on the games that were played. Five RLPL sessions, spaced over 8 weeks, were observed by the researchers at each intervention center to assess quality and fidelity of program implementation. Eight of the RLPL sessions were jointly observed by two researchers as a check for inter-observer reliability, with 96% agreement obtained between checklist ratings.

Across the eight intervention-group centers the average attendance rate was 12 RLPL sessions (SD = 4.12; range 1 to 16) and 72 children (70%) attended 12 or more intervention sessions. The most common reasons to miss a session was absence due to illness or family circumstances.

Measures

Vocabulary

Each child’s receptive English vocabulary was assessed using the British Picture Vocabulary Scale: Third Edition (BPVS-3), which is widely used and has sound measurement properties (Dunn and Dunn 2009). Given evidence for the predictive effects of verbal ability in longitudinal change in EF (Fuhs and Day 2011), pre-intervention BPVS scores were included as a control variable in the models that tested intervention effects on EF outcomes.

EF Measures

The HTKS task (Cameron Ponitz et al. 2009) was used to assess children’s integration of working memory, attentional flexibility, and inhibitory control. In the HTKS task, children play a game where they are asked to touch their head or toes (or knees/shoulders in the alternate version). They are then asked to do the opposite of what the researcher says. The game requires children to remember up to four rules, pay attention, and demonstrate inhibitory control. The measure has 30 items, with a score range from 0 to 60. To increase score variability, as recommended (M. McClelland, personal communication December 20, 2017), practice items were included in the scoring, increasing the score range from 0–60 to 0–94. Children were given a score of 0 for an incorrect response; a 1 for a self-corrected response (child makes a motion toward the incorrect response but then stops and gives the correct response); and a 2 for a correct response. Higher scores indicate higher levels of EF skills. The HTKS task has high reliability (McClelland and Cameron 2012; McClelland et al. 2014). In the present study, 60 HTKS assessments were jointly observed and scored by pairs of raters, with an excellent interrater agreement of Kw = 0.96.

The second measure of EF skills was the DCCS task from the National Institute of Health (NIH) Toolbox Cognitive Function Battery (Zelazo et al. 2013), which was administered via an app on an iPad. The DCCS task assesses cognitive flexibility and attention. Children are asked to match a series of bivalent test pictures (e.g., yellow balls and blue trucks) to the target pictures, first according to one dimension (e.g., color) and then, after a number of trials, according to the other dimension (e.g., shape). In the final part of the assessment, children are prompted to switch between the two dimensions. For example, after a number of trials matching on color, the child is asked to match by shape and then back again to color. This requires the cognitive flexibility to choose the correct picture.

Teacher Ratings of Classroom Behavioral Self-regulation

Teacher ratings of self-regulation were assessed with the 10-item subscale of the Child Behavior Rating Scale (CBRS; Bronson et al. 1990). The subscale measures children’s task-related behavior in a classroom situation on a 5-point scale from 1 (indicating the child never displays a certain behavior) to 5 (indicating the child always displays a certain behavior). Example items are: “Responds to instructions and then begins an appropriate task without being reminded” and “Attempts new challenging tasks”. In the current sample, internal consistency for this subscale ranged between α = .95 at T1 and T2 and α = .96 at T3. These Cronbach’s alphas are similar to reliability scores found in other studies using the teacher-rated CBRS in preschool samples (e.g. Schmitt et al. 2015; Tamm and Peugh 2019).

Teacher Interviews

After the intervention, 15 teachers took part in a semi-structured interview asking about their experience of running RLPL. Questions included teacher impressions of: (a) benefits of the games for children’s learning and behavior, (b) supportiveness of the training and program materials, (c) any challenges in running the games.

Statistical Analyses

Due to the nested structure of the data (with children nested in ECE centers), hierarchical linear mixed models were used to estimate the effects of the intervention. Separate models were fitted for each EF (HTKS, DCCS) and teacher-rated self-regulation (CBRS) variable (at the second and third time points). The intervention condition was entered as a between-level variable. All models take into account baseline outcome scores, baseline receptive English vocabulary (BPVS), children’s age, and gender. Data analyses were conducted using R (R Core team 2018). Hierarchical linear mixed models were fitted using the R package lme4 (Bates et al. 2015), and multiple imputation was carried out using the R packages mice (Groothuis-Oudshoorn and van Buuren 2011) and pan (Zhao and Schafer 2018).

The effect sizes were calculated as the difference between the fitted means of each output measure at each time point and the standard error of the effect was given by the summary of output of the fitted model. Standardized effects were computed by dividing the effect size by its standard error. Missing data were addressed with an intent-to-treat analysis which entails the evaluation of outcomes for all participants involved at the point of randomization (Kendall et al. 2013).

Data were missing on BPVS (10.4% at T1), HTKS (17% at T1 and T2; 30.7% at T3), DCCS (13.7% at T1; 13.2% at T2; 29.7% at T3), and on CBRS (0.9% at T1; 3.3% at T2; 35.4% at T3). These missing values resulted from attrition and other circumstances (e.g. child was away during the scheduled assessment due to sickness or family reasons; child refused assessment). Logistic regressions were run to determine whether demographic variables (i.e., child age, child gender, weekly enrolment hours at ECE, parent employment status) were related to missingness. Child age predicted missingness on the DCCS at T2 and DCCS, HTKS and CBRS at T3. Data on these measures were more likely to be missing for older children in the sample who had started school and could not be contacted for data collection. There were no other significant predictors of missingness. The missing data were imputed separately for each output measure at each time point. Thus, for example, for HTKS at the second time point, separate imputations were carried out for the intervention and waitlist control groups and the two sets of imputed complete data were recombined before analysis. Imputation respecting the hierarchical structure of the data was carried out using the R package pan.

Results

Table 2 shows the adjusted mean scores, based on imputed values for missing data, for T1 English language understanding (BPVS) and T1, T2, and 4-month follow-up (T3) EF (HTKS, DCCS) and teacher-rated self-regulation (CBRS) outcome measures, by group. These results take into account baseline outcome scores, baseline receptive English vocabulary (BPVS), children’s age, and gender. For the HTKS there were floor effects, particularly at T1 (30.1% of the children scored 0). The mean scores, before imputation of missing values, can be found in Online Resource 1. These mean scores are based on the numbers of children who completed a specific assessment at each time point.

Table 2 Adjusted mean scores, SED and ES for intervention and control groups at T1, T2, and T3
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The results show a pattern of greater improvements in EF skills for intervention group children compared to control group children, at post-intervention and 4-month follow-up. Controlling for BPVS and baseline DCCS scores, child gender and age, results indicated that children who participated in the intervention demonstrated stronger EF skills at post-intervention, as measured by the DCCS task. Statistically significant intervention effects did not emerge at post intervention for the HTKS or the CBRS. At T3 (4-month follow-up) on average, intervention group children obtained higher scores on teacher-rated self-regulation (CBRS) than intervention group children (standardized effect 1.85). Statistically significant intervention effects did not emerge at Time 3 for the HTKS, DCCS, or the CBRS.

Table 3 shows the full model results on Time 2 EF skills. The results illustrate that after accounting for the other covariates in the models, baseline receptive English vocabulary (BPVS) and T1 EF scores have considerable predictive power on Time 2 EF scores. A similar pattern of results was also evident at Time 3 (see Table 4).

Table 3 Full model results on T2 EF skills
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Table 4 Full model results on T3 EF skills
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Teacher interviews highlighted other gains for children, in addition to EF skills, including listening and following instructions, language learning, and peer learning support. Incorporating opportunities for children to lead game activities helped to promote self-confidence, leadership skills, and cooperation with peers. Teacher comments indicated a high level of child enjoyment of the games, with many children integrating games into their play at other times of the day. Overall, teachers gave positive feedback about the intervention, the training, and program materials in terms of support and being developmentally appropriate. While most teachers occasionally played one or two games that had some similarity to the intervention games, these did not involve added cognitive complexity like the RLPL games. The main issue regarding implementation was finding suitable times to fit the program around center routines, such as meal times. Several teachers mentioned the benefits of having a support teacher to assist with engaging children and to give one-on-one support to children who need extra attention.

Discussion

This study evaluated the Red Light, Purple Light (RLPL) intervention in a sample of 4-year-old children enrolled in New Zealand early childhood education centers. As hypothesized significant short-term intervention effects were found for increases in executive function (EF) skills. Specifically, children in the intervention group showed greater post-intervention improvements in cognitive flexibility and attentional skills, as measured by the Dimensional Change Card Sort task (DCCS), compared to control group children. These results are consistent with prior research by demonstrating that the intervention was effective in improving executive functioning on the DCCS (Schmitt et al. 2015). Furthermore, this is one of the few studies where early childhood teachers, rather than researchers, have implemented the RLPL intervention. Thus, the current study provides support for the effectiveness of RLPL, delivered by trained teachers in preschool classrooms, for improving children’s EF skills. It also demonstrates the transferability of the program to a different ECE context outside of the USA, where the program was developed.

At 4-month follow-up, on average, teacher ratings of classroom behavioral regulation (CBRS) were higher for children in the intervention group than for children in the control group, with increases in effect sizes over time. While these follow-up results were not statistically significant, the findings suggest the intervention-related changes may have translated into changes in classroom behavior, such as concentration and task completion skills, that were detected by teachers. Support for this possibility comes from the intervention effects for the DCCS task, which taps similar behaviors to the CBRS, including paying attention, listening to and following directions, and ignoring distractions.

Contrary to other studies (Duncan et al. 2018; Schmitt et al. 2015), there were no intervention effects for the HTKS task (the second EF measure). One possible explanation may relate to the range of English language understanding in the sample. In support of this possibility, the study found that children’s English receptive vocabulary significantly predicted their EF scores. It is noteworthy that 26 children in the intervention group were from non-English speaking homes. Secondary data analysis showed that children from English speaking homes showed a significantly greater increase in HTKS scores from pre- to post-intervention than children from non-English speaking homes. Teachers at some centers where these children were located stated that children were having difficulty understanding some concepts used in the intervention games, such as doing opposite actions. The HTKS task requires children to do the opposite action of what the researcher tells them to do. Thus, children who had not mastered the concept of opposite, might have had difficulty following the researcher’s instructions. Teachers mentioned that they needed to provide additional teaching and integrate these concepts within the regular center program to help these children’s learning and language understanding. These teacher comments indicate that some children may need additional language support to benefit from the RLPL intervention.

This study had a number of strengths. Based on teacher comments, the use of movement and music games, and opportunities for children to lead activities, was highly effective at encouraging engagement and promoting language and social skills. These teacher reflections suggest that participation in the intervention has other benefits in addition to improving children’s EF skills. This possibility could be investigated in future research by including pre- and post-intervention measures of language, and observations and teacher ratings of child social skills.

This study benefits from independent observations of the intervention delivery, which was implemented with fidelity by teachers who were trained by the program developers. The study design used an intent-to-treat approach (to avoid selection biases associated with level of treatment participation) and hierarchical linear modelling that accounted for nesting of children in centers (Raudenbush and Bryk 2002). This approach allowed the likely effects of the intervention to be tested in “real-world’’ education settings. The feasibility and inexpensive nature of the targeted EF intervention, could have practical implications for policy aimed at improving school readiness.

Although the present study provides support for the effectiveness of the RLPL intervention in enhancing children’s EF skills, there are a number of limitations. Given the nested structure of the data, the study sample size of 15 centers and 212 children may not have provided sufficient power to detect a broader range of intervention effects at post-intervention and follow-up (Torgerson and Torgerson 2008). Further studies with larger numbers of centers and children are needed to investigate this possibility. Whilst the present study did include seven centers (46%) that were located in low socioeconomic areas, future work also needs to include a larger number of children from disadvantaged backgrounds who are especially important to target for preschool EF interventions. As documented in other studies there were floor effects for the HTKS, which is a second study limitation (Schmitt et al. 2015). This may have limited the ability to detect variability in EF skills on this measure for children with low levels of these skills. Thus, the inclusion of the additional measure of EF skills (the DCCS) in this study was critical to investigate variability in EF for children who had not developed the necessary skills to score above 0 on the HTKS (Schmitt et al. 2015). Future research evaluating RLPL could also include measures that tap other specific EF skills such as working memory and inhibitory control, and academic skills. Further studies could also investigate components of the intervention that target parents, given “that early childhood may be a critical period during which cognitive parental behavior is especially influential” (Valcan et al. 2018, p. 607) for EF development, and evidence that integrating parents into preschool self-control interventions has been fairly successful (Gagne and Nwadinobi 2018). A final limitation is that we did not measure what other activities control teachers were participating in with children at their centers. Thus, it is possible that they may have engaged in similar activities to RLPL games that could potentially have diluted intervention effects.

In summary, the present study was a cluster randomized controlled trial evaluating the effectiveness of the RLPL intervention for 4-year-old children attending ECE centers in New Zealand. Building on and extending prior research, results from this study support the efficacy of the intervention in improving children’s EF skills. Other gains associated with participating in the program were also noted, such as helping children’s social skills and confidence.