ORIGINAL RESEARCH

published: 03 April 2019

doi: 10.3389/fpsyg.2019.00750

Short-Term Orchestral Music

Training Modulates Hyperactivity and
Inhibitory Control in School-Age
Children: A Longitudinal
Behavioural Study
Maria C. Fasano 1* , Cristina Semeraro 2 , Rosalinda Cassibba 2 , Morten L. Kringelbach 1,3,4 ,
Lucia Monacis 5 , Valeria de Palo 5 , Peter Vuust 1 and Elvira Brattico 1
1
Center for Music in the Brain, Department of Clinical Medicine, Aarhus University – The Royal Academy of Music, Aarhus,
Denmark, 2 Department of Psychology, Educational Sciences, Communication, University of Bari, Bari, Italy, 3 Department
of Psychiatry, University of Oxford, Oxford, United Kingdom, 4 Institut D’études Avancées de Paris, Paris, France,
5
Department of Humanities, University of Foggia, Foggia, Italy

Survey studies have shown that participating in music groups produces several benefits,
Edited by: such as discipline, cooperation and responsibility. Accordingly, recent longitudinal
Michele Biasutti,
studies showed that orchestral music training has a positive impact on inhibitory control
University of Padova, Italy
in school-age children. However, most of these studies examined long periods of training
Reviewed by:
Annet Bluschke, not always feasible for all families and institutions and focused on children’s measures
Dresden University of Technology, ignoring the viewpoint of the teachers. Considering the crucial role of inhibitory control on
Germany
Alexander Refsum Jensenius, hyperactivity, inattention and impulsivity, we wanted to explore if short orchestral music
University of Oslo, Norway training would promote a reduction of these impulsive behaviors in children. This study
*Correspondence: involved 113 Italian children from 8 to 10 years of age. 55 of them attended 3 months of
Maria C. Fasano
orchestral music training. The training included a 2-hour lesson per week at school and
[email protected]
a final concert. The 58 children in the control group did not have any orchestral music
Specialty section: training. All children were administered tests and questionnaires measuring inhibitory
This article was submitted to
Performance Science,
control and hyperactivity near the beginning and end of the 3-month training period.
a section of the journal We also collected information regarding the levels of hyperactivity of the children as
Frontiers in Psychology perceived by the teachers at both time points. Children in the music group showed
Received: 23 November 2018 a significant improvement in inhibitory control. Moreover, in the second measurement
Accepted: 18 March 2019
Published: 03 April 2019 the control group showed an increase in self-reported hyperactivity that was not found
Citation: in the group undergoing the music training program. This change was not noticed by
Fasano MC, Semeraro C, the teachers, implying a discrepancy between self-reported and observed behavior at
Cassibba R, Kringelbach ML,
Monacis L, de Palo V, Vuust P and
school. Our results suggest that even an intense and brief period of orchestral music
Brattico E (2019) Short-Term training is sufficient to facilitate the development of inhibitory control by modulating the
Orchestral Music Training Modulates levels of self-reported hyperactivity. This research has implications for music pedagogy
Hyperactivity and Inhibitory Control
in School-Age Children: and education especially in children with high hyperactivity. Future investigations will test
A Longitudinal Behavioural Study. whether the findings can be extended to children diagnosed with ADHD.
Front. Psychol. 10:750.
doi: 10.3389/fpsyg.2019.00750 Keywords: collective music training, hyperactivity, inhibitory control, children, El Sistema, ADHD, impulsivity

Frontiers in Psychology | www.frontiersin.org 1 April 2019 | Volume 10 | Article 750

Fasano et al. Orchestral Music Training and Hyperactivity in Children

INTRODUCTION incidence. For this reason, some researchers have started looking
at the inhibitory control as the possible object of early treatment
Survey studies have shown benefits, such as discipline, devoted to prevent or reduce the presence of hyperactivity,
cooperation and responsibility, from participating in music inattention, and impulsivity, better known as ADHD symptoms
groups and needing to work together toward a common goal, (Thorell et al., 2009; Halperin et al., 2013; Re et al., 2015). Re
especially in children (Hallam, 2010). In music education, several et al. (2015) conducted a study where they looked at the effect
methods have acknowledged the benefits of playing in groups that a training program focused on executive functions had on
and incorporated this in the training. The diffusion of these inhibitory control, hyperactivity, inattention, and impulsivity in
innovative approaches has led to a rising interest in exploring children. In this study, they involved both children with and
the effects of collective music training in children (Moreno et al., without a diagnosis of ADHD who were or were not involved
2011; Schellenberg et al., 2015; Jaschke et al., 2018). In particular, in this cognitive training program. Both children with ADHD
in the last years a growing number of studies have focused on symptoms and children with typical development attending the
the effects of orchestral training, such as the El Sistema approach training program improved their performance in tasks measuring
(Habibi et al., 2014, 2016; Alemán et al., 2017; Holochwost et al., control of attention and impulsive behavior compared with the
2017; Sachs et al., 2017), which is a well-documented form of children that did not participate in the training program.
collective music education (Majno, 2012). This music program Considering the capability that long-lasting orchestral playing
aims to promote the inclusion of at-risk children by providing has in enhancing inhibitory control, we therefore wanted
them with high quality music training and instruments for free. to investigate whether orchestral training could be used to
Compared with other types of music training, playing in an promote a reduction of the levels of hyperactivity, inattention
orchestra requires fine motor, rhythmic and visual skills, as well and impulsivity together with an improvement of inhibitory
as the discipline to sit patiently in silence for the entire execution control in children.
of a piece waiting for your turn and, sometimes not playing Furthermore, until now the studies focusing on the effects
for several minutes. Moreover, performing in an orchestra of orchestral music training have considered music programs
or a choir requires constant attention to the gestures of the (provided outside regular school hours) lasting at least one year.
conductor and, at the same time, the ability to synchronize to However, a music program that spans the course of a year
his rhythm and dynamics. Finally and most importantly, playing or more could be financially challenging for the institutions
with others also necessitates listening to and synchronizing and can represent a significant drain on the parents’ time,
with the other players in order for the performers to blend as they need to bring their children to the training in the
their sounds (Biasutti, 2013). All of this represents a real and afternoon, the course often being external. All this can make
constant cognitive and emotional training, amplified by the this valuable and very promising training difficult to replicate,
experience of being part of a real orchestra performing in front especially in the schools. Optimizing the feasibility of this music
of a large, live audience. training could be beneficial for many children who would
In support of this, some researchers recently showed that not otherwise have access to it. Therefore, in our study we
children involved in an orchestral program inspired by the wanted to investigate the effectiveness of orchestral training
El Sistema approach for one, two, or three years, exhibited when implemented over a shorter period of time. Indeed,
better performance in inhibitory control and self-control tasks Moreno et al. (Moreno et al., 2011) showed that children
(Alemán et al., 2017; Holochwost et al., 2017). The careful between 4 and 6 years old randomly assigned to a short-term
planning and monitoring of performance (Palmer and Drake, collective music training program of just 4 weeks (20 sessions
1997), the control over the focus of attention (Duke et al., in total) had better performance on inhibitory control tasks
2011), and the integration of sensorimotor information (Münte compared to children who completed a comparable program
et al., 2002) make ensemble and orchestral performance a proper of visual art training. Nevertheless, in their experiment they
vehicle for neuroplastic and neurocognitive changes. A recent used a training program requiring daily commitment from
functional magnetic resonance imaging (fMRI) study did indeed the children. Moreover, this program was based primarily on
found that children who had participated in a similar music listening activities without any instrumental training. Here, we
program for 2 years had greater involvement of brain regions wanted to investigate if a short-term orchestral program would
known to be involved in cognitive control (supplementary motor also lead to an improvement in inhibitory control, as well as in
cortex, anterior cingulate cortex, inferior frontal gyrus, and impulsive and hyperactive behaviors. To do so, we focused on
insula bilaterally) compared to children who did not participate a short-term intense orchestral training program of 10 lessons
in the music program in trials that require inhibitory control provided in schools.
(Sachs et al., 2017). Since school is one of the most important settings in which
Executive functions, such as attention and inhibitory control, it is possible to observe the children’s behavior during activities
are critical for children’s development and mental health because that require attention and self-control (Re and Cornoldi, 2007),
they represent the basis for the self-regulation needed throughout teachers could be potential valid informants for these scientific
life (Diamond and Lee, 2011). These cognitive skills are impaired investigations. However, their point of view has not been
in children with symptoms of Attention Deficit Hyperactivity adequately investigated in previous studies. Here, we decided to
Disorder (ADHD) (Barkley, 1997; Whelan et al., 2012), a include questionnaires for our participants’ teachers in order to
diagnosis that, according to the most recent statistics, has a high test whether they would provide consistent and complementary

Frontiers in Psychology | www.frontiersin.org 2 April 2019 | Volume 10 | Article 750

Fasano et al. Orchestral Music Training and Hyperactivity in Children

measures of hyperactivity, inattention and impulsivity of the for monitoring its effects1 . Hence, this study conducted in an
children as perceived by an observer’s perspective. educational setting belongs to the special case described by both
Overall, with this longitudinal study we aimed to explore both the national and the APA guidelines regarding the conduct
near- and far-transfer effects of short orchestral music training, of practicing psychologists2 , 3 for which ethical approval is not
near being a transfer occurring between similar learning contexts required. However, as part of the school activities, the parents
and far a transfer involving skills that are very different from were provided with detailed information concerning the music
each other (Biasutti and Concina, 2013). For this purpose, we program and the administration of tests and questionnaires
selected an inhibitory control task involving auditory processing and gave their written informed consent for both. All data was
to test whether a transfer effect on inhibitory control could be anonymized upon completion of the study. In sum, this study
seen even after less than 3 months of orchestral music training, was carried out in accordance with the ethical guidelines of the
when assessing it using auditory stimulation. At the same time, Declaration of Helsinki.
we administered both to children and teachers questionnaires
and tasks measuring hyperactivity, inattention and impulsivity Music Training Program
to test whether short orchestral training is able to produce far In our study we focused on an innovative standardized orchestral
transfer effects in these specific areas. music training program provided by the association “Music ‘n’
play.” Music ‘n’ play (MusicaInGioco in Italian) is associated
with the Italian Sistema delle Orchestre e dei Cori Giovanili e
Infantili and has in the last decade involved more than 2,000
MATERIALS AND METHODS Italian children in the Apulia region through different initiatives,
becoming deeply rooted in the Southern Italian context. Our
Participants study fell within one of the projects providing this specific
We recruited 130 children 8–10 years of age, enrolled in training called “Armonie per la salute a scuola,” approved
public schools in the Apulia region in Southern Italy. Based and financed by the Apulia region for the years 2015/2016
on interviews with the teachers and on the outcomes of COM and 2016/2017. Since 2014, this project has each year offered
questionnaires (Cornoldi et al., 2004), we excluded from the orchestral training in elementary schools as an after-school
sample children with a psychiatric diagnosis, traits of problematic course of 13 lessons monitored by tests and questionnaires to
behaviors, poor intellectual abilities or other relevant problems evaluate its effects. All the children are given instruments free of
(n = 6). Furthermore, we did not include in the analysis four charge, as well as the opportunity to practice at home every day.
children who left the music training program and six children In particular, in our study the children were given violin, cello,
who were absent during one of the two assessments. The final percussions, flute and piano. Each lesson of this music training
number of participants included in our study was 113 third program lasts 2 h and 15 min: for 45 min the children play in
(n = 66) and fourth (n = 47) graders from four schools. The small groups (instrument sections, each including four to five
sample comprised 57 girls and 56 boys with a mean age of children with the same instrument), and for one and a half hours
8 years and 11 months at the baseline. Approximately, 36% of they play with the entire orchestra. The last lesson consists of
the mothers and 11% of the fathers of our participants were a concert performed in high-profile events. This final concert
unemployed. The majority of mothers and fathers had either represents a crucial part in this specific training program, due to
a high school degree (around 40%) or a secondary school the considerable emotional challenge that it implies. In our study
degree (around 40%). For more details on the demographic the post-test was performed after the 10th lesson instead of the
details, please refer to Table 1. 13th for practical reasons: the beginning of the music training
Our sample included two groups: a music group and a program was delayed and the last three lessons were provided
control group. Both groups were invited to this project from after the end of the school year (more details can be found in
the schools by means of emails and direct communication with the Limitations). For this reason, the Director supervising the
the teachers. Children in the music group (n = 55) attended music program organized two additional concerts in order for all
3 months of an innovative orchestral music training program that of the children to perform during the 10th lesson. In particular,
was implemented for free as extra-curricular course in the schools half of the children participating in the present study performed
involved. The participation in the music training program in a famous theatre in the Apulia region and the other half in an
(lasting around 3 months) was optional. Since the music program anti-mafia event aired on the main Italian TV channel Raiuno1, 4
had a limited number of participants, the teachers selected a This orchestral music program, called Music ‘n’ play, is
group of children without any music education/background to inspired by the El Sistema approach but, at the same time,
take part in the music program. Children in the control group it includes other pedagogical aspects from Freire, Sloboda,
(n = 58) did not participate in the music program and were Dewey, Vygotskij, Orff, Dalcroze, Kodàli, Rolland and Gordon
recruited from the same schools following a similar procedure.
This study was part of the project “Armonie per la salute 1
https://musicaingiocobari.wordpress.com/2016/08/02/armonie-per-la-salute-a-
a scuola” approved and financed by the Apulia region for the scuola-ed-201516/
years 2015/2016 and 2016/2017. The project provided a music 2
https://www.aipass.org/node/11560
training program implemented as part of the school curriculum 3
http://www.apa.org/ethics/code/
and included the administration of tests and questionnaires 4
https://musicaingiocobari.wordpress.com/tag/armonie-per-la-salute-a-scuola/

Frontiers in Psychology | www.frontiersin.org 3 April 2019 | Volume 10 | Article 750

Fasano et al. Orchestral Music Training and Hyperactivity in Children

(Gargiulo and Altomare, 2017). The element shared with the El- from both groups underwent the post-test. The testing sessions
Sistema approach is the centrality of orchestral playing, seen as took place in the schools, where the tests and questionnaires
the starting point instead of the ending point of the musical were administered individually by Italian licensed psychologists.
experience. Children start playing together in an orchestra The children were administered a stop-signal test (Walk-No
from their first lesson and, at the end of each year, they Walk Test – Ranette) (Marzocchi et al., 2010), an impulsivity
perform in one or more concerts in theatres with an orchestral control test (Matching Figures MF-14) (Marzocchi et al., 2010)
ensemble that includes anywhere from 50 to 1000 instruments and a rating Scale assessing the levels of Inattention and
with a custom-made repertoire (for more details about this Hyperactivity-impulsivity (SDAB) (Marzocchi et al., 2010). The
approach, see Gargiulo and Altomare, 2017). Music ‘n’ play teachers were also given the instructor version of this last
works on three main areas of music learning, combining formal Scale measuring the levels of Inattention and Hyperactivity-
and informal learning procedures: imitation and repetition impulsivity (SDAI) (Cornoldi et al., 1996). In addition to these
(call and response, body percussion, etc.), improvisation and tests that provided the dependent variables for the current
creativity (including the use of multimedia contents), and study on hyperactivity, impulsivity and inhibitory control, we
formal learning (music reading, technique, intonation). Each administered to the children the Academic Self-Regulation
of these three areas are developed mainly by means of body Questionnaire (ASRQ) for another research question that will
percussion, instrumental and vocal activity. One of the novel be reported separately. Moreover, qualitative data were also
principles of this music program is the “reticularity,” namely collected, but they will be discussed in a separate article. All
the ability of the teacher to adapt each lesson to the needs measures were administered at both time points to children and
and the feedback of the children, with a primary goal of teachers (Figure 1).
maintaining their engagement. The variety of exercises, including
body percussion, call and response, improvisation, multimedia Measures
contents, repertoire, singing, sight reading, respiration, direction
Walk-No Walk Test (Ranette; Frogs)
etc., offers the teachers the possibility to pique the attention
The Walk-No Walk Test (Marzocchi et al., 2010) is a paper-and-
and interest of the children by switching from one exercise
pencil test that evaluates selective and sustained attention and the
to another depending on the children’s feedback. Thanks to
inhibition of an ongoing response. It is derived from the “stop
this learner-centered approach, the children receive a great deal
signal task” of Logan and Cowan (1984). The test includes two A4
of different information, mainly “by doing,” and they have
sheets of paper in which 20 sets of stairs (each including 12 steps)
the possibility to process all this information individually and
are drawn with a small frog on the first step. The task requires
with peers. In this way interest and engagement in learning
children to listen to a tape that will play two sounds: GO tone
are continuously strengthened by activities that stimulate the
and NO-GO tone. The child is asked to fill in a step each time
initiative, finding original solutions to problems and interaction
he or she hears the GO tone, while she/he has to stop every time
with peers. Moreover, the use of informal learning and the
she/he hears the NO-GO tone. The difficulty of the task lies in the
diversity of different music activities offer the performers the
fact that the first 208 ms of both tones are identical, but the NO-
possibility to express their own music creativity through different
GO tone is marked by a concluding vocal exclamation (“D’oh!”).
channels. This strategy, combined with the reconceptualization of
Therefore, the task requires the children to listen to the entire
mistakes as learning opportunities instead of limits, has allowed
sound before providing the response in order to understand if it
this pedagogical approach to be used also with children diagnosed
is a GO or NO-GO signal. For each set of stairs, there are many
with ADHD and other neurodevelopmental disorders. Promising
GO signals and only one NO-GO signal. The number of correct
results have been observed, but not yet scientifically proven.
trials defines the score.
A crucial aim of this music program is indeed to promote the
integration of children who are experiencing difficulties for many
reasons. Therefore, when this program is offered in schools,
the headmasters and the teachers are always invited to include
especially children with a psychiatric diagnosis or with social or
behavioral problems. However, in our study we included only the
healthy children involved in the program, in order to determine
its general effects before moving to identifying its impact on
specific pathologies.

Procedures
Data collection took place between February and March for the
pre-test and early June for the post-test over two subsequent
school years, 2015/2016 and 2016/2017. The pre-test was
followed by 10 2-hours music lessons once a week, distributed
over a 3-month period, for the music group. The last lesson
consisted in a performed concert in theater or on live TV. FIGURE 1 | Trial profile showing the different phases of the experiment.
One week after the concert, the teachers and the children

Frontiers in Psychology | www.frontiersin.org 4 April 2019 | Volume 10 | Article 750

Fasano et al. Orchestral Music Training and Hyperactivity in Children

SDAB and SDAI occupation (Table 1). Furthermore, a comparison of means

The SDAB and SDAI scales (Marzocchi et al., 2010) are used to indicated no significant differences at pre-test across groups for
measure the levels of hyperactivity-impulsivity and inattention. all the outcome measures used except for Walk-No Walk Test,
The SDAI scale is for teachers and includes 18 items and t(105) = 4.31, p < 0.01 with children in the control group scoring
the SDAB is for children and includes 14 items. Half of the higher than the music group.
items relate to hyperactivity-impulsivity and the other half Considering the performance on the Walk-No Walk Test,
relate to inattention. High scores indicate a larger presence of we found a significant main effect of Time, F(1,105) = 21.59,
hyperactivity-impulsivity/inattention. p < 0. 001, η2p = 0.17 and a significantly strong interaction
between Group and Time, F(1,105) = 9.45, p = 0.003, η2p = 0.083
MF-14 Test (Figure 2). Moreover, a main effect of Group was found,
The MF-test (Marzocchi et al., 2010) assesses several executive F(1,105) = 12.33, p = 0.001 with children in the control
components, in particular sustained attention and impulsivity group scoring higher than the music group. The post hoc test
control, and is derived from the impulsivity control MFFT test showed that the music group improved significantly (p < 0.001)
(Kagan, 1966). We chose the short version of the test to reduce between the two measurements, whereas the slight increase in
time spent on test administration and to comply with the school performance of the control group was not significant (p = 0.27).
board’s time requirements. This version, validated for children In order to control for the difference between the groups
from early-primary school, consists of 14 items, including a target at pre-test, we performed further analysis (ANCOVAs) for
picture and six alternative pictures similar to the target. Among the other tests having the inhibitory control scores at pre-
these pictures, only one is identical to the target, and the child test as a covariate.
has to identify it. The pictures represent objects from everyday Regarding our additional test MF-14, for the errors we found
life. Numbers of errors and response time are considered for the a main effect of Time, F(1,111) = 29.01, p < 0.001, η2p = 0.2
scoring of this test. indicating a reduction of errors in the post-test compared to
the pre-test, but no significant interaction emerged between
COM/Teachers Scale Group and Time, F(1,111) = 0.32, p > 0.5, η2p = 0.003. We
The teachers were asked to fill out the COM scale (Cornoldi did not find a significant main effect of Group, F(1,111) = 1.41,
et al., 2004) used to detect the presence of possible traits of p = 0.24. The covariate inhibitory control at pre-test was not
conduct disorder, oppositional defiant disorder, high-functioning significantly related to the MF-14 errors, F(1,104) = 1.42, p = 0.24.
autism, depression, anxiety, and Tourette syndrome in children. After controlling for the effect of inhibitory control, we did not
This questionnaire was added to ensure that the results were not obtain a main effect of Time, F(1,104) = 3.18, p = 0.07, Group,
skewed by possible pathologies in the participating children. The F(1,104) = 0.81, p > 0.1, nor an interaction between Group
children with a score >21 were not included in the sample. and Time, F(1,104) = 1.11, p > 0.1. Considering the MF-14
response time, we did not find any effect of Time, F(1,111) = 1.51,
Statistical Analysis p > 0.1, Group, F(1,111) = 2.33, p = 0.13, or interaction
Data analysis was conducted using the Statistical Package for the between Group and Time, (F < 1). The covariate inhibitory
Social Sciences (SPSS version 25). Equality of variance at the pre- control at pre-test was not significantly linked to the MF-14
measurement for age and all the tests and questionnaires was response time, F(1,104) = 1.42, p = 2.37, and the results did not
analyzed using Levene’s test; a chi-square test was performed change after controlling for the covariate [Time, F(1,104) = 3.18,
for the variables: sex, mother/father education and occupation. p = 0.08; Group, F(1,104) = 0.82, p = 0.37; Group × Time:
Mixed-design Analyses of Variance (ANOVAs) were performed F(1,104) = 1.11, p = 0.29].
examining scores as a function of one repeated measure (Time) For the hyperactivity-impulsivity dimension measured by
and one between-subjects factor (Group). For each outcome the SDAB scale, we found no significant main effect of
measure (Walk-No Walk Test, SDAB, SDAI, MF-14) we wanted Time, F(1,106) = 2.14, p = 0.15 nor Group (F < 1), but
to investigate whether the difference between pre- and post- we found a significant interaction between Group and Time,
test varied as a function of Group (music or control). Thus, F(1,106) = 7.69, p = 0.007, η2p = 0.068 (Figure 3). The
each participant had two scores (pre-test and post-test) for each post hoc test showed that children who did not follow any
outcome measure. Post hoc analyses were performed for each intense music program had a significant increase of hyperactivity-
measure to indicate differences between pre-test and post-test in impulsivity (p = 0.003) from the pre- to the post-test, while
each group. We corrected the multiple testing with false discovery the music group did not yield a significant difference between
rate (FDR) method using a false discovery rate of 0.05 (Table 2). the two measurements (p = 0.37). However, a further post hoc
test showed a significant difference between the two groups
at post-measurement t(108) = 2.42, p = 0.017, reflecting
RESULTS less hyperactivity in the music group as compared with the
control group (for the means, see Table 2). The covariate
Analyses of the groups’ demographic variables at pre-test inhibitory control at pre-test was not significantly related to
confirmed that the music and the control group did not differ at the hyperactivity-impulsivity, F(1,99) = 2.75, p = 0.10. Also in
pre-test in terms of age, sex, COM questionnaire scores, mother’s this case, a significant interaction between Group and Time
education, father’s education, mother’s occupation, and father’s was found, F(1,99) = 6.06, p = 0.016, η2p = 0.06 and no

Frontiers in Psychology | www.frontiersin.org 5 April 2019 | Volume 10 | Article 750

Fasano et al. Orchestral Music Training and Hyperactivity in Children

TABLE 1 | Demographic details of the children and their parents at pre-test.

Music Group Control Group

M SD M SD t p

Age (months) 106.18 6.33 107.60 6.84 1.15 0.25

COM questionnaire 4.00 5.06 4.48 5.50 0.49 0.63

% % χ2 p

Sex (female) 41,8% 58,6% 3.19 0.07

Mother occupation 17% employed 22% employed 8.54 0.07
0% entrepreneur 3% entrepreneur
3% freelance 11% freelance
22% unemployed 16% unemployed
6% other 5% other
Mother education 4% primary school 0% primary school 7.85 0.1
23% secondary 21% secondary
school school
16% high school 24% high school
6% bachelor/master 11% bachelor/master
1% other 0% other
Father occupation 23% employed 31% employed 4.17 0.384
2% entrepreneur 3% entrepreneur
13% freelance 19% freelance
7% unemployed 3% unemployed
1% other 0% other
Father education 5% primary school 0% primary school 8.26 0.08
21% secondary 22% secondary
school school
16% high school 27% high school
5% bachelor/master 5% bachelor/masternewline
1% other 1% other

significant effect of Time, (F < 1) and Group, F(1,99) = 0.1, the ones referring to the impulsivity separately, performing
p = 0.76 emerged after controlling for inhibitory control at pre- two separate ANOVAs (see Supplementary Material). The
test. To further explore the results in hyperactivity-impulsivity, inattention measured with the SDAB scale did not yield any
we considered the items related to the hyperactivity and main effect of Time, F(1,106) = 3.21, p = 0.076, Group (F < 1),
nor an interaction between Group and Time, (F < 1). Also
in this case, the covariate inhibitory control was not related to
the dependent variable (F < 1) and the results did not change
after controlling for the covariate [Time, F < 1; Group, F < 1;
Group × Time, F < 1].
Finally, we analyzed the ratings given to the children on the
SDAI rating scale by their teachers and found no significant
main effect of Time for the hyperactivity-impulsivity subscale,
F(1,84) = 1.36, p > 0.1, nor a main effect of Group (F < 1).
Moreover, there was no significant interaction between Group
and Time (F < 1). The covariate inhibitory control at pre-test
was not related to the hyperactivity-impulsivity perceived by the
teachers, F(1,78) = 2.13, p = 0.15. We did not find any main
effect of Group (F < 1) and interaction between Group and
Time (F < 1). However, we observed a main effect of Time,
F(1,78) = 9.45, p = 0.003, η2p = 0.11 after controlling for the
inhibitory control at pre-test. For the inattention subscale of
FIGURE 2 | The music group was associated with an increase in inhibitory SDAI, we found a main effect of Time, F(1,84) = 7.26, p = 0.009,
control scores starting from a significantly lower score at pre-test compared to
η2p = 0.08 indicating a reduction of inattention levels in the
the control group. Children’s mean scores as a function of Time (pre-test and
post-test) and Group (music and control). Error bars are standard errors.
post-test compared to the pre-test, but a non-significant main
effect of Group, F(1,84) = 1.91, p = 0.17, and a non-significant

Frontiers in Psychology | www.frontiersin.org 6 April 2019 | Volume 10 | Article 750

Fasano et al. Orchestral Music Training and Hyperactivity in Children

TABLE 2 | Means (M) and standard deviation (SD) of the scores obtained by the two groups (music group and control group) at pre-test and post-test
and ANOVA results.

Music Group Control Group

pre post pre post pre-post

M SD M SD M SD M SD p-value FDR-corrected

Children
Walk-No Walk 13.68 4.04 16.23 3.16 16.57 2.8 17.09 2.88 0.003 0.02
MF errors 8.33 4.59 6.09 4.18 7.21 5.25 5.40 3.93 0.57 0.1
MF time 9.18 4.74 8.82 5.23 10.76 6.21 10.04 5.37 0.68 0.68
SDAB hyperactivity-impulsivity 16.83 2.68 16.35 2.65 16.13 2.76 17.68 3.31 0.007 0.025
SDAB inattention 19.44 2.85 18.52 2.99 19.13 2.94 18.62 3.59 0.6 0.84
Teachers
SDAI hyperactivity-impulsivity 1.14 2.15 1.03 2.99 1.33 2.41 0.80 1.54 0.44 1.03
SDAI Inattention 2.32 3.80 1.57 3.08 3.41 3.80 2.31 2.92 0.62 0.72

interaction between Group and Time (F < 1) (Figure 4). Our

ANCOVA showed that the inhibitory control at pre-test was
not related to the levels of inattention indicated by the teachers,
F(1,78) = 1.63, p = 0.21. There was no significant effect of Time,
F(1,78) = 1.59, p = 0.21, Group F(1,78) = 1.72, p = 0.19, or
Interaction Group by Time (F < 1) after controlling for the effects
of inhibitory control.

DISCUSSION
This study was designed to examine if a short-term orchestral
music training program implemented in schools is able to
enhance inhibitory control and reduce hyperactivity, inattention
and impulsivity in children. For this purpose, we selected a FIGURE 3 | The control group was associated with an increase in
systematic and intense orchestral training program that enables hyperactivity scores that was not found in the music group. Children’s mean
children who have never played a musical instrument before, scores as a function of Time (pre-test and post-test) and Group (music and
to play in an orchestra in front of a large audience after just control). Error bars are standard errors.
3 months of training. In order to explore the effects of this
music program better, we included tasks measuring near- and far-
transfer effects, and we administered questionnaires to both the other variables considered in the study. In order to control for
children and their teachers. the difference in inhibitory control between the two groups at
Concerning the near-transfer effects, our results suggest pre-test, we performed further analyses inserting this variable as
that even short orchestral music training can facilitate the covariate. The ANCOVAs did not alter the main result found for
development of inhibitory control when mediated by auditory the SDAB questionnaire (for children) nor any other interaction
stimulation (Figure 2). However, we noticed lower scores in including Group as factor. However, some effects of the covariate
inhibitory control at baseline measurement in children from the were obtained on the main effect of Time for the MF errors and
music group compared to the control group. The reason for the SDAI questionnaires (for teachers).
this could be related to the use of a community-based quasi- Although we found a significant difference at the baseline
experimental design without randomization of participants: the between the experimental and the control group, our post hoc
inclusive philosophy focused on children with special needs analysis showed that the children who underwent music training
inspiring the music training might have implicitly guided the had a clear-cut improvement (p = 0.004) in the Walk-No
selection of children for the experimental group. It could be Walk test requiring selective attention, sustained attention
argued that the significantly higher scores at the pre-test in and inhibition of an ongoing response. Considering that the
the control group could be the reason why we did not find a orchestral music program selected for this study is directed
significant increase of inhibitory control in this group compared especially to children with behavioral, social or psychological
to the music group which, on the contrary, may have had more difficulties, these results are encouraging and very relevant for
room for improvement. Nevertheless, we found an equality of pedagogical implications. Moreover, this finding shows that a
variance between the two groups (music and control) for all the short orchestral training program of just 10 session over 3 months

Frontiers in Psychology | www.frontiersin.org 7 April 2019 | Volume 10 | Article 750

Fasano et al. Orchestral Music Training and Hyperactivity in Children

from the director and the other players. They had to do this for
the duration of the entire rehearsal, and carry out many other
regulatory activities of the Music ‘n’ play program. They did not
show an increase in hyperactive behaviours, and it does indeed
appear likely that this was a consequence of the demands of the
music training program.
The engagement produced in the children by the ability
of the conductor to mediate and adapt the different needs
and music competences, together with the incentive salience
of music per se, may have played a crucial role in modulating
these functional behaviors in the children. This result opens
the door to a new way of approaching and treating hyperactive
behaviors and, potentially, ADHD. The interventions that have
been used up until now to train children in regulating their
hyperactive behavior have been directed only to children already
FIGURE 4 | Both the control group and music groups showed a decrease in
inattention scores rated by the teachers. Teachers’ mean scores as a function diagnosed with ADHD and have been focused on cognitive-
of Time (pre-test and post-test) and Group (music and control). Error bars are behavioral strategies and, more recently, on training of executive
standard errors. functions (Re and Cornoldi, 2007; Salvaguardia et al., 2009;
Bergman Nutley et al., 2011; Röthlisberger et al., 2012; Halperin
et al., 2013; Re et al., 2015). Although some positive results
results in a transfer effect on inhibitory control in 8–10 year- are emerging from the interventions focusing on executive
old children. This can have important implications for music functions (Re et al., 2015), they do not offer the children the
pedagogy and education. All the previous studies conducted same degree of engagement that music is able to produce.
with collective instrumental music training have always taken Rewarding and pleasurable activities, such as music listening,
into consideration music programs lasting at least one year playing and going to concerts, peak in early adolescence (North
and, therefore, requiring an amount of financial resources et al., 2000). Therefore, the use of music training as a tool to
not always affordable for institutions such as public schools. improve executive functions and the regulation of behaviors
The possibility to implement short-term, and therefore less could lead to even better results, reinforced exponentially by the
expensive but efficient orchestral music programs involving only strong engagement that music implies, especially for children.
few teachers for a limited period of time, could make music Some researchers have tried to use music therapy to treat
training more accessible for schools. Given that public schools children with ADHD. However, the therapies usually consist
are accessible to all, and provide the opportunity for early of music treatments reserved exclusively for children with
intervention (Diamond and Lee, 2011), this would represent a big ADHD (Rickson, 2006) and with poor results. Oftentimes, the
step forward in education. subscription to programs explicitly created for children with
Although we did not find a significant effect of this music inattention and hyperactivity problems further amplifies their
program on inattention and impulsivity as perceived by the social marginalization, reinforcing their dysfunctional behaviors.
children, a far-transfer effect of this innovative music program Therefore, compared to treatments focused on the enhancement
on hyperactivity-impulsivity was recorded by the SDAB scale (see of specific skills that children diagnosed with ADHD lack,
Figure 3). Comparing the post- with the pre-test, the children a music program involving both children with and without
belonging to the control group showed a strong increment a specific diagnosis of ADHD and presented just as music
of hyperactivity-impulsivity over the three months that was training may represent a way to avoid the inevitable tendency to
not found in the music group (Figure 3). This effect was marginalization. We hypothesize that a teaching method similar
clear especially for hyperactivity (see Supplementary Material). to the one adopted in the music program of this study may
Considering the items used to measure the levels of hyperactivity lead to an improvement of inhibitory control and regulation
(“Do you have difficulties in staying seated? Do you like to of hyperactive behaviors especially in children with ADHD or
dangle your feet or have something in your hands to play with? other developmental diseases thanks to the inclusiveness of
Do you find difficult to not leave the seat in situations where this approach and the role of the conductor of acknowledging
remaining seated is expected? Do you have difficulties in playing the contributions and competences of each performer without
or engaging in leisure activities quietly? Have you been told that labeling any creative contribution as a mistake.
you are not able to stay put?”), we can hypothesize that we found However, the effects of the music training program were less
an increase in the control group at the post-test because the tangible on hyperactivity and inattention as rated by the teachers.
assessment had been conducted in the last days of the schools A global significant reduction of inattention was found from
when the children are usually already in “holiday mode.” On pre- to post-test. Similarly, the hyperactivity indicated by the
the contrary, the children who had followed the music program teachers was significantly smaller in the post-test for both the
had experienced call and response improvisations that implied groups after correcting for the inhibitory control at pre-test.
waiting for a response. They also had to sit still in the orchestra Therefore, part of the improvements seemed to be due to the
constantly paying attention to the multisensory inputs deriving general activities in which the children were involved during

Frontiers in Psychology | www.frontiersin.org 8 April 2019 | Volume 10 | Article 750

Fasano et al. Orchestral Music Training and Hyperactivity in Children

this period and to their associated maturation. However, it is effects on impulsivity. Since we wanted to perform our post-
important to emphasize that the teachers played an active role in test at school to avoid absences and missing data, we needed
the selection of the music group. Therefore, it is possible that the to do it before the end of the school year, slightly before the
teachers tended to be more receptive to the symptoms expressed music program was completed. After the post-test, the children
by the children undergoing the music program, adopting a more received two more lessons and performed in an additional
critical view. This could have affected the evaluation of the final concert (for a total of 13 lessons). Therefore, it may be
reduction of the dysfunctional behaviors, such as inattention, possible that the effect of this short training program would
in the music group. This obtained discrepancy between the have been stronger if measured 1 month later, after the entire
teachers’ attitudes toward the children and the actual school program was completed.
behavior of the students reveals some level of subjectivity that Despite these limitations, this study, to our knowledge,
should be taken into consideration when evaluating the effects provides the first experimental evidence on the effects of a
of an extra-curricular intervention on children and on the school short orchestral music training program on inhibitory control
context in general. and hyperactivity.

Limitations
One limitation in this study is the absence of randomization of CONCLUSION
the two groups of participants, as a result of this community-
based approach aiming at studying a music training program Children with a tendency toward hyperactive or impulsive
already successfully implemented in the area. For this reason, our behaviors are usually left without any treatment or training
results should be treated with caution and further investigations until they are diagnosed with ADHD. Once the child is
providing randomized controlled trials are needed. Nevertheless, labeled with this diagnosis, his/her symptoms become more
these results have intrinsic value since they examine an existing resistant and harder to treat due to the social implications
phenomenon of a large music intervention involving thousands that accompany a diagnosis. The results illustrated here suggest
of children in Southern Italy, attracting media attention and that even a short, but systematic and engaging orchestral
funding from local agencies5 . training program can facilitate the development of inhibitory
Moreover, our results are limited by the absence of an control modulating the levels of hyperactivity self-reported by
active control group that would have allowed us to better the children. Therefore, short, systematic music interventions
identify effects linked specifically to learning to play a musical rationalizing financial and teachers’ resources and well-grounded
instrument in an orchestra. However, the improvement of on pedagogical principles might represent a potential educational
the music group in the auditory inhibitory control task tool for school-age children. Moreover, it can prevent tendencies
attests an interaction between the cognitive control system toward hyperactive behavior that could further develop into a
and the auditory domain that is consistent with previous diagnosis and eventually treat ADHD symptoms. Nevertheless,
studies (Amer et al., 2013; Bialystok and DePape, 2009). future investigations should be conducted to test whether the
Music experience has been shown to enhance subcortical findings that we are presenting here with healthy children can be
processing of auditory stimuli in noisy environments with a extended to children diagnosed with ADHD.
related improvement of cognitive control (Parbery-Clark et al.,
2009; Strait et al., 2014). At the same time, the inclusion
of a passive control group not engaging in intensive training
AUTHOR CONTRIBUTIONS
allowed us to control the naturally occurring behavioral and EB and MF contributed equally to the conception and design
psychological maturation in this age range, characterized by rapid of the work. MF, CS, LM, and VdP executed data collection
brain development. supervised by EB, RC, and MK. MF performed the analysis and
In this study, as an additional measure of impulsivity seen created the figures. PV had an important role in the fund raising
as the negative counterpart of inhibitory control, we used the for the project. MF wrote the article. All authors critically revised
short version of the MF-test, MF-14 (Marzocchi et al., 2010). and approved the final version of the manuscript.
We did not administer the full MF-20 test, due to the request
from the school of having assessments as brief as possible. This
test did not show any differences between groups after the FUNDING
music training program, hence mismatching what was found
with the test on inhibitory control. However, the lack of findings This work was supported by Center for Music in the
here might be attributed to the shortened version of the test. Brain (MIB), funded by the Danish National Research
The administration of the long version MF-20 (Marzocchi Foundation (DNRF 117).
et al., 2010) may possibly have shown a different result on
impulsivity measures.
Finally, the limited amount of music lessons between the two ACKNOWLEDGMENTS
measurements may not have been enough to enhance far transfer
We wish to thank all the children participating in this study
5
http://www.musicaingioco.net and their teachers. We also thank other members of our

Frontiers in Psychology | www.frontiersin.org 9 April 2019 | Volume 10 | Article 750

Fasano et al. Orchestral Music Training and Hyperactivity in Children

team who helped with data collection, data entry, and initial cooperation in the process of recruitment and Hella Kastbjerg
analysis, in particular Giada Della Rocca, Valentina Massaro, and Olivia Foster Vander Elst for proofreading the article.
Alessia Destratis, Valeria Ruggieri, Eleonora Russo, Anna Chiara
Cattedra, Adriana Giancaspro, Ida Siemens Lorenzen, Johanna
Pardon, Leonardo Bonetti, and Marina Kliuchko. We gratefully SUPPLEMENTARY MATERIAL
acknowledge the association “MusicaInGioco” (Music ‘n’ play),
in particular Director Andrea Gargiulo, for their commitment in The Supplementary Material for this article can be found
organizing extra concerts with the children before our second online at: https://www.frontiersin.org/articles/10.3389/fpsyg.
measurement. We also thank the primary schools for their 2019.00750/full#supplementary-material

REFERENCES Holochwost, S. J., Propper, C. B., Wolf, D. P., Willoughby, M. T., Fisher, K. R.,
Kolacz, J., et al. (2017). Music education, academic achievement, and executive
Alemán, X., Duryea, S., Guerra, N. G., McEwan, P. J., Muñoz, R., Stampini, M., functions. Psychol. Aesthet. Creat. Arts 11, 147–166. doi: 10.1037/aca000
et al. (2017). The effects of musical training on child development: a randomized 0112
trial of el sistema in venezuela. Prev. Sci. 18, 865–868. doi: 10.1007/s11121-016- Jaschke, A. C., Honing, H., and Scherder, E. J. A. (2018). Longitudinal
0727-3 analysis of music education on executive functions in primary
Amer, T., Kalender, B., Hasher, L., Trehub, S. E., and Wong, Y. (2013). Do older school children. Front. Neurosci. 12:103. doi: 10.3389/fnins.2018.
professional musicians have cognitive advantages? PLoS One 8:e71630. doi: 00103
10.1371/journal.pone.0071630 Kagan, J. (1966). Reflection-impulsivity: the generality and dynamics
Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and executive of conceptual tempo. J. Abnorm. Psychol. 71, 17–24. doi: 10.1037/
functions: constructing a unifying theory of ADHD. Psychol. Bull. 121, 65–94. h0022886
doi: 10.1037/0033-2909.121.1.65 Logan, G. D., and Cowan, W. B. (1984). On the ability to inhibit thought and action:
Bergman Nutley, S., Söderqvist, S., Bryde, S., Thorell, L. B., Humphreys, K., a theory of an act of control. Psychol. Rev. 121, 66–95. doi: 10.1037/0033-295X.
and Klingberg, T. (2011). Gains in fluid intelligence after training 91.3.295
non-verbal reasoning in 4-year-old children: a controlled, randomized Majno, M. (2012). From the model of El Sistema in Venezuela to current
study. Dev. Sci. 14, 591–601. doi: 10.1111/j.1467-7687.2010. applications: learning and integration through collective music education.
01022.x Ann. N. Y. Acad. Sci. 1252, 56–64. doi: 10.1111/j.1749-6632.2012.
Bialystok, E., and DePape, A. M. (2009). Musical Expertise, Bilingualism, and 06498.x
Executive Functioning. J. Exp. Psychol. Hum. Percept. Perform. 35, 565–574. Marzocchi, G. M., Re, A. M., and Cornoldi, C. (2010). BIA - Batteria Italiana per
https://doi.org/10.1037/a0012735 l’ADHD. Trento: Erikson.
Biasutti, M. (2013). Orchestra rehearsal strategies: conductor and Moreno, S., Bialystok, E., Barac, R., Schellenberg, E. G., Cepeda, N. J., and
performer views. Music. Sci. 17, 57–71. doi: 10.1177/10298649124 Chau, T. (2011). Short-term music training enhances verbal intelligence and
67634 executive function. Psychol. Sci. 22, 1425–1433. doi: 10.1177/095679761141
Biasutti, M., and Concina, E. (2013). Music education and the transfer of learning. 6999
J. Commun. Res. 5, 397–413. Münte, T. F., Altenmüller, E., and Jäncke, L. (2002). The musician’s brain as a model
Cornoldi, C., Gardinale, M., and Masi, A. P. L. (1996). Impulsività e Autocontrollo. of neuroplasticity. Nat. Rev. Neurosci. 3, 473–478. doi: 10.1038/nrn843
Trento: Erikson. North, A. C., Hargreaves, D. J., and O’Neill, S. A. (2000). The importance of
Cornoldi, C., Molin, A., and Marcon, V. (2004). Il Questionario COM: uno music to adolescents. Br. J. Educ. Psychol. 70(Pt 2), 255–272. doi: 10.1348/
strumento di identificazione di problematiche associate al DDAI. Difficoltà di 000709900158083
Apprendimento 9, 391–412. Palmer, C., and Drake, C. (1997). Monitoring and planning capacities in the
Diamond, A., and Lee, K. (2011). Interventions shown to aid executive function acquisition of music performance skills. Can. J. Exp. Psychol. 51:369. doi: 10.
development in children 4 to 12 years old. Science 333, 959–964. doi: 10.1126/ 1037/1196-1961.51.4.369
science.1204529 Parbery-Clark, A., Skoe, E., and Kraus, N. (2009). Musical experience limits
Duke, R. A., Cash, C. D., and Allen, S. E. (2011). Focus of attention affects the degradative effects of background noise on the neural processing of
performance of motor skills in music. J. Res. Music Educ. 59, 44–55. doi: 10. sound. J. Neurosci. 29, 14100–14107. doi: 10.1523/JNEUROSCI.3256-09.
1177/0022429410396093 2009
Gargiulo, A., and Altomare, E. (2017). Musicabilia - Disabilità, “El Sistema Abreu” Re, A. M., Capodieci, A., and Cornoldi, C. (2015). Effect of training focused
e Neuroscienze. Bari: Radici Future. on executive functions (attention, inhibition, and working memory) in
Habibi, A., Cahn, B. R., Damasio, A., and Damasio, H. (2016). Neural preschoolers exhibiting ADHD symptoms. Front. Psychol. 6:1161. doi: 10.3389/
correlates of accelerated auditory processing in children engaged in fpsyg.2015.01161
music training. Dev. Cogn. Neurosci. 21, 1–14. doi: 10.1016/j.dcn.2016. Re, A. M., and Cornoldi, C. (2007). ADHD at five: a diagnosis-intervention
04.003 program. Adv. Learn. Behav. Disabil. 20, 223–240. doi: 10.1016/S0735-004X(07)
Habibi, A., Ilari, B., Crimi, K., Metke, M., Kaplan, J. T., Joshi, A. A., 20009-6
et al. (2014). An equal start: absence of group differences in cognitive, Rickson, D. J. (2006). Instructional and improvisational models of music therapy
social, and neural measures prior to music or sports training in with adolescents who have attention deficit hyperactivity disorder (ADHD):
children. Front. Hum. Neurosci. 8:690. doi: 10.3389/fnhum.2014 a comparison of the effects on motor impulsivity. J. Music Ther. 43, 39–62.
.00690 doi: 10.1093/jmt/43.1.39
Hallam, S. (2010). The power of music: its impact on the intellectual, Röthlisberger, M., Neuenschwander, R., Cimeli, P., Michel, E., and Roebers, C. M.
social and personal development of children and young people. (2012). Improving executive functions in 5-and 6-year-olds: evaluation of a
Int. J. Music Edu. 28, 269–289. doi: 10.1177/025576141037 small group intervention in prekindergarten and kindergarten children. Infant
0658 Child Dev. 21, 411–429. doi: 10.1002/icd.752
Halperin, J. M., Marks, D. J., Bedard, A. C. V., Chacko, A., Curchack, J. T., Yoon, Sachs, M., Kaplan, J., Der Sarkissian, A., and Habibi, A. (2017). Increased
C. A., et al. (2013). Training executive, attention, and motor skills: a proof-of- engagement of the cognitive control network associated with music training
concept study in preschool children with ADHD. J. Atten. Disord. 17, 711–721. in children during an fMRI Stroop task. PLoS One 12:e0187254. doi: 10.1371/
doi: 10.1177/1087054711435681 journal.pone.0187254

Frontiers in Psychology | www.frontiersin.org 10 April 2019 | Volume 10 | Article 750

Fasano et al. Orchestral Music Training and Hyperactivity in Children

Salvaguardia, F., Re, A. M., Caponi, B., and Cornoldi, C. (2009). Esperienza di Whelan, R., Conrod, P. J., Poline, J. B., Lourdusamy, A., Banaschewski, T.,
un training sulla memoria di lavoro con bambini con tratti di disattenzione Barker, G. J., et al. (2012). Adolescent impulsivity phenotypes characterized
e iperatttività (experience with a working memory training with children by distinct brain networks. Nat. Neurosci. 15, 920–925. doi: 10.1038/nn.
with disattention/hyperactivity traits). Disturbi di Attenzione e Iperattività 4, 3092
171–187.
Schellenberg, E. G., Corrigall, K. A., Dys, S. P., and Malti, T. (2015). Group music Conflict of Interest Statement: The authors declare that the research was
training and children’s prosocial skills. PLoS One 10:e0141449. doi: 10.1371/ conducted in the absence of any commercial or financial relationships that could
journal.pone.0141449 be construed as a potential conflict of interest.
Strait, D. L., O’Connell, S., Parbery-Clark, A., and Kraus, N. (2014). Musicians’
enhanced neural differentiation of speech sounds arises early in life: Copyright © 2019 Fasano, Semeraro, Cassibba, Kringelbach, Monacis, de Palo, Vuust
developmental evidence from ages 3 to 30. Cereb. Cortex 24, 2512–2521. doi: and Brattico. This is an open-access article distributed under the terms of the Creative
10.1093/cercor/bht103 Commons Attribution License (CC BY). The use, distribution or reproduction in
Thorell, L. B., Lindqvist, S., Nutley, S. B., Bohlin, G., and Klingberg, T. other forums is permitted, provided the original author(s) and the copyright owner(s)
(2009). Training and transfer effects of executive functions in are credited and that the original publication in this journal is cited, in accordance
preschool children. Dev. Sci. 12, 106–113. doi: 10.1111/j.1467-7687.2008. with accepted academic practice. No use, distribution or reproduction is permitted
00745.x which does not comply with these terms.

Frontiers in Psychology | www.frontiersin.org 11 April 2019 | Volume 10 | Article 750