The objective of this review was to evaluate attention and executive function performance in children with neurodevelopmental conditions across the first 5 years of life, compared to neurotypical peers. MEDLINE, EMBASE, and PsycINFO databases were searched until June 30, 2023, and studies comparing attention or executive function between children with (or at risk for) neurodevelopmental conditions and neurotypical (or low risk) peers, 0 to 5 years old, were included. Of the 4338 studies identified, 111 studies with 12292 participants were included in the meta-analysis. The qualitative analysis of brain development included 5 studies. Primary outcomes were the standardised mean difference (Hedges’ g) in attention and executive function between groups. Meta-regressions examined moderating effects of age, biological sex, diagnosis, and measure type. Children with neurodevelopmental conditions showed small delays in attention (n = 49 studies, k = 251 outcomes, g = 0.36, 95% CI 0.23-0.48, p < 0.001) and moderate delays in executive function (n = 64 studies, k = 368 outcomes, g = 0.64,95% CI 0.53–0.76, p < 0.001). Attention and executive function delays could not be identified in the first year (equivalence tests, p < 0.001), small to moderate delays were found in toddlerhood and moderate delays by preschool. Delays identified were largely transdiagnostic, although there was some evidence of diagnosis-specific delays for attention and moderation by measure type (informant rating vs performance-based vs physiological). Qualitative analysis described how delays were underpinned by a divergence of brain development in medial prefrontal regions. These findings highlight the potential of using attention and executive measures to detect delay and to intervene in neurodevelopmental conditions early in life.

本综述的目的是评估神经发育状况儿童在生命前 5 年与神经典型同龄人相比的注意力和执行功能表现。检索 MEDLINE、EMBASE 和 PsycINFO 数据库至 2023 年 6 月 30 日，并纳入了比较患有（或有风险）神经发育疾病的儿童与 0 至 5 岁神经典型（或低风险）同龄人之间的注意力或执行功能的研究。在确定的 4338 项研究中，荟萃分析纳入了 111 项研究，涉及 12292 名参与者。大脑发育的定性分析包括 5 项研究。主要结局是各组之间注意力和执行功能的标准化平均差 （Hedges' g）。Meta 回归分析了年龄、生理性别、诊断和测量类型的调节作用。患有神经发育状况的儿童表现出注意力轻微延迟（n = 49 项研究，k = 251 个结果，g = 0.36,95% CI 0.23-0.48，p < 0.001）和执行功能中度延迟（n = 64 项研究，k = 368 个结果，g = 0.64,95% CI 0.53-0.76，p < 0.001）。 第一年无法识别注意力和执行功能延迟（等效检验，p < 0.001），幼儿发现小到中度延迟，学龄前发现中度延迟。确定的延迟主要是跨诊断的，尽管有一些证据表明按测量类型（线人评级 vs 基于表现 vs 生理）的注意力和调节存在诊断特异性延迟。定性分析描述了内侧前额叶区域大脑发育的差异如何支撑延迟。 这些发现强调了使用注意力和执行措施来检测延迟并在生命早期干预神经发育状况的潜力。