Unleashing children’s potential: An evidence-based narrative review of strategies to enhance cognitive function and intelligence in school-age children

Table 1 Core cognitive domains in school-age children: Neural substrates and modifiable influences

Cognitive domain	Primary neural substrates	Key developmental features (6-12 years)	Major modifiable factors
General intelligence (g)	Distributed frontoparietal network; default mode and executive control networks	Integration of reasoning, learning efficiency, and knowledge acquisition; increasing network efficiency	Quality of education, cognitive stimulation, nutrition, socioeconomic context, and health status
Executive function	PFC (dorsolateral, ventromedial), anterior cingulate cortex, frontostriatal circuits	Progressive maturation of inhibitory control, cognitive flexibility, planning, and self-regulation	Executive-function-based curricula, physical activity, sleep quality, stress reduction, and parenting practices
Working memory	Dorsolateral PFC, posterior parietal cortex, frontoparietal connectivity	Rapid gains in information maintenance and manipulation; strong predictor of academic performance	Cognitive training, instructional design, sleep, nutrition, and emotional regulation
Attention	Frontoparietal attention networks, thalamocortical circuits, locus coeruleus-noradrenergic system	Improved sustained and selective attention; reduced distractibility	Classroom structure, behavioral interventions, physical activity, mindfulness, screen-time regulation
Processing speed	White matter tracts (e.g., corpus callosum), widespread cortical-subcortical connectivity	Increased neural transmission efficiency driven by myelination and network refinement	Physical activity, sleep, health status, enriched learning environments

PFC: Prefrontal cortex.

Table 2 Interaction of biological, environmental, and educational determinants in cognitive development: Mechanisms and targeted interventions

Determinant domain	Specific determinants	Primary neurocognitive mechanisms	Cognitive domains affected	Clinical/educational interventions
Biological	Nutrition (iron, iodine, omega-3 fatty acids, vitamin D)	Myelination, neurotransmitter synthesis, and synaptic efficiency	Processing speed, working memory, and attention	Nutritional screening and supplementation; school meal optimization; pediatric dietary counseling
	Sleep quantity and quality	Memory consolidation, synaptic homeostasis, executive regulation	Learning, attention, EF	Sleep hygiene education, delayed school starting times, and treatment of sleep disorders
	Physical activity and fitness	Neurotrophic signaling (brain-derived neurotrophic factors), cerebral blood flow, and network connectivity	EF, processing speed	Structured physical education; aerobic exercise programs; movement-integrated learning
	Stress physiology (hypothalamic-pituitary-adrenal-axis activation)	Cortisol-mediated disruption of prefrontal and hippocampal function	Attention, emotional regulation, and working memory	Trauma-informed care, stress-reduction programs, and family psychosocial support
Environmental	Parental engagement and home stimulation	Language exposure, experience-dependent plasticity	Verbal intelligence, memory, and metacognition	Parent-training programs; guided home learning activities; literacy promotion
	Socioeconomic context	Chronic stress exposure; access to enrichment	Global cognitive function, academic achievement	Community-based support programs; early academic enrichment; policy-level interventions
	Emotional security and attachment	Regulation of affective-cognitive networks	EF, social cognition	Parenting interventions; school counseling services
Educational	Instructional quality and pedagogy	Executive scaffolding; cognitive load optimization	Fluid intelligence, problem-solving	Executive-function-based curricula; differentiated instruction
	Classroom environment	Attention regulation; motivation and engagement	Attention, processing speed	Reduced class size; structured classroom routines; teacher training
	Cognitive training and enrichment	Network strengthening and cognitive reserve accumulation	Working memory, reasoning	Cognitive training programs; enrichment-based curricula
	Technology-assisted learning	Multimodal engagement; adaptive feedback	Processing speed, metacognition	Digital learning platforms; artificial intelligence-assisted personalized instruction
Integrated/multimodal	Combined health, environmental, and educational inputs	Synergistic enhancement of plasticity and reserve	Broad cognitive outcomes	Multidisciplinary intervention models; school-clinic partnerships

EF: Executive function.

Table 3 Macronutrients, neurobiological mechanisms, cognitive domains, and dietary interventions in school-age children

Macronutrient	Key neurobiological mechanisms	Primary cognitive domains affected	Evidence-based dietary interventions
Protein (quality and distribution)	Neurotransmitter synthesis (dopamine, serotonin, norepinephrine); synaptic plasticity; neuromodulatory balance	Attention, EF, working memory, processing speed	Adequate daily protein intake from high-quality sources (eggs, dairy, legumes, lean meats); protein inclusion at breakfast and lunch
Essential fatty acids (omega-3, docosahexaenoic acid, eicosapentaenoic acid)	Neuronal membrane fluidity and integrity; synaptic signaling; neuroinflammation modulation; connectivity enhancement	Learning, memory, attention, executive control	Increased intake of fatty fish, omega-3-rich plant sources, and supplementation in deficient populations
Carbohydrates (glycemic load)	Brain glucose availability; insulin signaling; neurotransmitter regulation	Attention stability, working memory, processing speed	Low-moderate glycemic index meals; complex carbohydrates; avoidance of refined sugars
Dietary fats (quality)	Myelination support; lipid-mediated signaling pathways	Processing speed, EF	Replacement of trans fats with unsaturated fats; balanced fat intake
Macronutrient balance (meal composition)	Sustained energy delivery; hormonal and metabolic stability	Global cognitive performance, academic endurance	Balanced meals combining protein, complex carbohydrates, and healthy fats
Breakfast consumption	Morning glucose availability; attentional priming	Attention, learning readiness	Regular, nutritionally balanced breakfast programs in schools

EF: Executive function.

Table 4 Key micronutrients, neurobiological mechanisms, cognitive domains, and strength of evidence in school-age children

Micronutrient	Primary neurobiological mechanisms	Key cognitive domains affected	Evidence strength1	Recommended daily intake (6-12 yrs)
Iron	Oxygen transport and cerebral energy metabolism. Myelination of white matter tracts. Dopaminergic neurotransmission	Attention, working memory, processing speed, and learning efficiency	High (consistent longitudinal data; RCT benefit in deficient children)	10-12 mg/day
Iodine	Thyroid hormone synthesis. Regulation of neuronal metabolism and synaptic plasticity	Verbal intelligence, reasoning, EF	Moderate-high (strong biological plausibility; RCTs mainly in deficient regions)	120 μg/day
Zinc	Synaptic signaling and neurogenesis. Modulation of glutamate and GABA receptors	Attention, memory, EF	Moderate (context-dependent; strongest effects in deficient/malnourished populations)	8-10 mg/day
Vitamin D	Neuroimmune regulation. Neurotransmission and neurotrophic signaling	EF, attention, and processing speed	Low-moderate (observational consistency; mixed RCT results)	600 IU/day (15 μg)
Folate (B9)	One-carbon metabolism. DNA methylation and neurotransmitter synthesis	Attention, memory, and academic achievement	Moderate (longitudinal support; limited school-age RCTs)	300 μg/day (dietary folate equivalents)
Vitamin B12	Myelin synthesis. Neuronal integrity and energy metabolism	Memory, processing speed, EF	Moderate (strong mechanistic rationale; limited intervention trials)	1.8-2.4 μg/day
Vitamin B6	Synthesis of serotonin, dopamine, and GABA	Attention regulation, EF	Low-moderate (supportive mechanistic data; limited direct cognitive trials)	1.0-1.3 mg/day
Choline	Acetylcholine synthesis. Cell membrane formation and signaling	Memory, learning, EF	Low-moderate (emerging evidence; paucity of RCTs in school-age children)	375-400 mg/day
Vitamin C	Antioxidant defense; catecholamine synthesis; synaptic plasticity	Attention, learning, and processing speed	Moderate (cohort + mechanistic)	45-75 mg/day (children-adolescents)
Vitamin E	Membrane protection; prevention of lipid peroxidation; synaptic integrity	Memory, EF	Moderate (cohort + biological plausibility)	7-15 mg/day (α-tocopherol equivalents)

¹Evidence strength reflects consistency across randomized controlled trials, longitudinal cohort studies, and mechanistic plausibility in school-age populations (6-12 years). Cognitive benefits of supplementation are most consistently observed in children with documented deficiency or inadequate dietary intake. Upper intake limits should be respected; routine high-dose supplementation is not recommended without clinical indication.

EF: Executive function; GABA: Gamma-aminobutyric acid; RCTs: Randomized controlled trials.

Table 5 Effects of exercise modalities on executive and cognitive functions in school-age children

Exercise type	Primary neurobiological and cognitive mechanisms	Executive/cognitive domains affected	Representative intervention examples
Aerobic exercise (moderate-vigorous)	Increased cerebral blood flow; increased brain-derived neurotrophic factors and IGF-1; enhanced hippocampal and prefrontal plasticity; improved insulin sensitivity	Attention regulation, inhibitory control, processing speed, working memory	Daily running or cycling programs; structured physical education classes; aerobics, classroom activity breaks
Coordinative/skill-based exercise	Concurrent motor-cognitive engagement; frontoparietal network activation; enhanced sensorimotor integration	Cognitive flexibility; working memory; task switching; planning	Dance programs, martial arts, and ball games require strategy and rule switching
Cognitively enriched physical activity	Dual-task processing; executive load during movement; increased prefrontal cortex activation	Executive control; divided attention; metacognitive regulation	Movement-integrated academic lessons; physically active problem-solving games
Team sports	Social cognition engagement; goal-directed behavior; emotional regulation; reward-system modulation	Cognitive flexibility; self-regulation; decision-making; attentional control	Soccer, basketball, and handball programs emphasizing rules and teamwork
Resistance/strength training	Hormonal modulation (IGF-1); neuromuscular efficiency; stress regulation	Inhibitory control, attention, and working memory (moderate evidence)	Age-appropriate resistance circuits; body-weight training in school settings
Mind-body movement (e.g., yoga, tai chi)	Autonomic regulation; reduced cortisol; enhanced interoceptive awareness; prefrontal-limbic balance	Sustained attention; inhibitory control; emotional self-regulation	School-based yoga programs; mindfulness-movement sessions
High-intensity interval activity (child-adapted)	Rapid neurotrophic signaling; arousal modulation; catecholamine release	Processing speed, attention, and cognitive alertness	Short-burst activity circuits; interval-based playground games

IGF-1: Insulin-like growth factor-1.

Table 6 Sleep parameters, neurobiological mechanisms, and cognitive outcomes in school-age children

Sleep parameter	Key neurobiological mechanisms	Cognitive/executive domains affected	Representative interventions
Total sleep duration	Synaptic homeostasis; energy restoration; prefrontal cortex efficiency	Attention, working memory, processing speed, and inhibitory control	Age-appropriate sleep schedules; parent-guided bedtime routines
Sleep quality (continuity, fragmentation)	Stable neural oscillations; efficient hippocampal-cortical communication	Learning efficiency, executive control, sustained attention	Sleep hygiene education: Reducing nighttime awakenings
Slow-wave sleep (non-rapid eye movement stage 3)	Memory consolidation; synaptic downscaling; cortical plasticity	Declarative memory, learning retention, executive integration	Consistent sleep timing; minimizing evening arousal and caffeine
Rapid eye movement sleep	Emotional memory processing; procedural learning; cognitive flexibility	Cognitive flexibility, emotional regulation, and problem-solving	Regular sleep-wake cycles; limiting screen exposure before bedtime
Sleep timing/circadian alignment	Synchronization of circadian clocks; optimal melatonin signaling	Attention, academic performance, and executive efficiency	Fixed wake times, morning light exposure, and delayed evening screen use
Sleep regularity (weekday-weekend consistency)	Circadian rhythm stability; neuroendocrine regulation	Sustained attention; behavioral regulation; metacognition	Consistent bedtimes; limiting “social jet lag”
Sleep hygiene behaviors	Reduced cognitive arousal, autonomic balance, and stress modulation	Executive control; emotional regulation; learning readiness	Screen-free bedtime routines; calming pre-sleep activities
Sleep disruption (chronic deprivation)	Prefrontal hypoactivation; increased cortisol; neuroinflammation	Inhibitory control deficits, impulsivity, and attention lapses	Behavioral sleep interventions; school-based sleep education

Table 7 Psychosocial factors, mechanisms, cognitive domains, and intervention strategies in school-age children

Psychosocial factor	Underlying mechanisms	Cognitive/executive domains affected	Evidence-based intervention strategies
Parental responsiveness	Stress buffering (reduce cortisol); prefrontal-limbic regulation; enhanced attentional engagement	Attention regulation, working memory, and emotional self-regulation	Parenting-skills training; responsive caregiving coaching; positive parenting programs
Parent-child verbal interaction	Language network activation; synaptic enrichment; vocabulary expansion	Language skills, verbal working memory, comprehension	Daily parent-child conversation; dialogic interaction training
Shared reading	Narrative processing; inferential reasoning; executive engagement	Language development, sustained attention, and metacognition	Dialogic reading programs; structured home reading routines
Cognitive scaffolding	Guided problem-solving; executive skill internalization	Planning, inhibitory control, cognitive flexibility	Parent coaching in scaffolding techniques; guided learning activities
Home cognitive stimulation	Experience-dependent neuroplasticity; enriched learning exposure	General intelligence; executive function; academic achievement	Home-based enrichment programs; access to books and educational materials
Emotional warmth and support	Secure attachment; autonomic regulation; stress resilience	Executive control; emotional regulation; learning readiness	Attachment-based parenting interventions; family support services
Consistency and structure	Predictability; habit formation; executive stability	Attention; self-regulation; task persistence	Establishing routines; structured home schedules
Reduced cognitive stressors	Lower chronic stress; improved neural efficiency	Working memory; processing speed	Family stress-reduction programs; psychosocial support

Table 8 Stress, biological pathways, cognitive impact, and resilience-building interventions in children

Stressor	Biological mechanism	Cognitive impact	Resilience intervention
Chronic psychosocial stress (toxic stress)	Sustained hypothalamic-pituitary-adrenal-axis activation; cortisol dysregulation; impaired glucocorticoid receptor signaling	Reduced executive function, impaired attention regulation, diminished working memory	Trauma-informed care; caregiver buffering; stable routines
Early life adversity (poverty, neglect, family instability)	Elevated allostatic load; altered prefrontal-limbic connectivity; reduced synaptic plasticity	Slower processing speed; impaired cognitive flexibility; academic underachievement	Parenting support programs; early childhood enrichment; social services integration
Exposure to violence or unsafe environments	Hyperactivation of amygdala; disrupted fronto-limbic circuitry; threat-biased attentional networks	Increased distractibility; impaired inhibitory control; emotional dysregulation	Safe school initiatives; mentoring programs; community-based interventions
Chronic academic pressure and performance stress	Sympathetic overactivation; reduced prefrontal efficiency; increased cognitive load	Decreased working memory capacity; attentional fatigue; reduced problem-solving efficiency	Mindfulness-based stress reduction; workload restructuring; metacognitive training
Sleep disruption secondary to stress	Altered cortisol circadian rhythm; impaired hippocampal memory consolidation	Learning deficits, impaired memory retention, and reduced executive control	Sleep hygiene education, consistent bedtime routines, and stress-management interventions
Parental mental health stress	Indirect hypothalamic-pituitary-adrenal-axis dysregulation via reduced caregiver responsiveness	Language delays, reduced executive scaffolding, and socio-cognitive difficulties	Parental mental health support; responsive caregiving interventions
Social deprivation or peer rejection	Dysregulated oxytocin-cortisol interaction; altered social brain networks	Impaired social cognition; reduced motivation and attention	Peer-support programs; social-emotional learning curricula

Table 9 Executive function domains, training approaches, outcomes, evidence strength, and implementation contexts

Executive function domain	Training approach	Observed outcomes	Strength of evidence	Clinical implementation	Educational implementation
Working memory	Computerized training programs; curriculum-embedded memory scaffolding; adaptive rehearsal tasks	Reliable improvements in trained and closely related working memory tasks (near transfer); inconsistent effects on reading, mathematics, and global academic achievement (far transfer)	Moderate for near transfer. Low-moderate for far transfer	Individualized or small-group cognitive training (e.g., attention-deficit/hyperactivity disorder, learning disorders)	Classroom scaffolding and curriculum-integrated strategies preferred
Inhibitory control	Classroom-based self-regulation curricula; rule-based games; mindfulness-informed practices; behavioral self-monitoring	Improved attention regulation, classroom behavior, and task persistence; modest gains in early academic skills	Moderate for behavioral outcomes. Low-moderate for academic transfer	Behavioral therapy and emotion regulation programs	Whole-class social-emotional learning and self-regulation curricula
Cognitive flexibility	Problem-based learning; task-switching activities; metacognitive reflection; exposure to novelty and ambiguity	Enhanced adaptive strategy use and task switching; limited direct academic transfer	Low-moderate, limited randomized controlled trials	Cognitive remediation, executive coaching	Inquiry-based and project-based learning
Multi-component EF training	Integrated curricula targeting multiple EF domains within academic content; teacher-guided scaffolding; enriched learning environments	Broader, more durable EF gains; improved engagement and selected academic outcomes	Moderate-high, strongest for embedded interventions	Adjunctive support for at-risk children	Preferred universal or targeted school-based approach
Play-based EF interventions (early childhood)	Structured play, pretend play, and social interaction-based EF challenges	Improved self-regulation, social cognition, and learning readiness	Moderate, strongest in preschool years	Developmental therapy settings	Early childhood and preschool curricula

Across domains, interventions embedded within meaningful educational and social contexts consistently outperform isolated cognitive training in producing far-transfer effects. Evidence strength increases when outcomes include behavioral, classroom-based, and longitudinal measures rather than task-specific cognitive tests alone. EF: Executive function.

Table 10 Cognitive training and brain games: Evidence, transfer effects, and recommended use

Training type	Evidence base	Transfer effects	Recommended use
Computerized working memory training	Multiple randomized controlled trials and meta-analyses demonstrate consistent improvements on trained tasks	Strong near transfer; weak and inconsistent far transfer to academic outcomes	Adjunctive use in clinical populations (e.g., attention-deficit/hyperactivity disorder); not recommended as a standalone educational intervention
Attention and processing speed games	Moderate evidence for task-specific gains; variable methodological quality	Near transfer common; limited generalization to classroom performance	Supplementary tool to support attentional engagement alongside structured instruction
Commercial “brain game” platforms	Heterogeneous evidence; limited independent validation	Predominantly near transfer; minimal evidence for durable far transfer	Use cautiously; appropriate for engagement and motivation, not cognitive remediation
Multidomain cognitive training programs	Emerging evidence suggests broader cognitive engagement	Modest transfer when integrated with educational content	Best implemented within hybrid educational or therapeutic frameworks
Game-based training integrated into curricula	Growing support from school-based trials	Improved classroom engagement; selective academic transfer	Preferred educational model, especially when teacher-guided
Clinician-guided cognitive remediation	Stronger evidence in neurodevelopmental and clinical populations	Functional improvements are more likely with individualized targets	Clinical settings for targeted cognitive deficits, combined with behavioral support

Cognitive training and brain games are most effective when embedded within broader educational or clinical ecosystems. Isolated use yields limited generalization, whereas integrative, contextually grounded approaches increase the likelihood of meaningful and sustained impact.

Table 11 Strength-based and compensatory approaches for learning disabilities and neurodiverse profiles

Learning disabilities type	Core challenge	Strengths leveraged	Compensatory strategies
Dyslexia	Phonological processing deficits: Slow or inaccurate decoding	Visual-spatial reasoning; narrative and oral language skills; creative thinking	Text-to-speech software; audiobooks; multisensory reading instruction; extended time
Dyscalculia	Numerical magnitude processing; arithmetic fluency	Verbal reasoning; conceptual understanding; real-world problem solving	Visual representations; manipulatives; calculator use; stepwise problem scaffolding
Written expression disorder (dysgraphia)	Handwriting, spelling, and written organization	Verbal expression; oral reasoning; idea generation	Speech-to-text tools; graphic organizers; reduced handwriting demands
Nonverbal learning differences	Visual-spatial processing; social perception	Strong verbal memory; rule-based learning; factual knowledge	Explicit social instruction; visual scaffolds; structured routines
Auditory processing differences	Speech discrimination in noise; auditory memory	Visual learning; pattern recognition	Visual aids, written instructions, and preferential classroom seating
Attention-related learning profiles	Sustained attention; organization	Hyperfocus on areas of interest; creativity	Task chunking; external organizational supports; movement-based learning
Autism-associated learning profiles	Cognitive rigidity; pragmatic language differences	Systematic thinking, detail orientation, and strong memory	Predictable routines; visual schedules; assistive communication tools

Effective cognitive enhancement in learning disabilities emphasizes access, adaptation, and agency, allowing children to demonstrate higher-order thinking without being constrained by persistent processing differences.

Table 12 Cognitive enhancement strategies for gifted and twice exceptional learners

Profile	Core needs	Targeted strategies
Gifted	Intellectual challenge, depth and complexity, autonomy in learning	Curriculum compacting; subject acceleration; inquiry-based and project-based learning; mentorship; metacognitive skill training
Twice exceptional	Simultaneous enrichment and support; EF scaffolding; emotional regulation	Strength-based enrichment with accommodation; assistive technologies; EF coaching; flexible assessment formats
Gifted with attention-deficit/hyperactivity disorder traits	Cognitive stimulation with structure; regulation of attention and impulsivity	Advanced content with task chunking; time-management supports; movement-integrated learning
Gifted with learning disabilities	Access to complex ideas without output constraints	Reduced mechanical demands; alternative demonstration of knowledge; speech-to-text and visual organizers
Gifted with autism-associated profiles	Predictability; social-pragmatic support alongside intellectual rigor	Structured enrichment; visual schedules; explicit social-cognitive instruction; interest-based learning

Optimal cognitive enhancement for gifted and twice exceptional learners requires precision alignment between advanced cognitive capacity and individualized supports, preventing both underachievement and burnout. EF: Executive function.