ABC Brain Games Self-Regulation Intervention

Poor self-regulation (i.e., inability to harness cognitive, emotional or motivational
resources to achieve goals) contributes to a number of unhealthy behaviors across the life
course, including overeating, a lack of physical activity, smoking, alcoholism and substance
abuse that are linked to poor long-term health. The self-regulation processes that generate
the desire for such substances or that make it difficult to engage in healthy habits are
theorized to begin very early in the lifespan. Targeting early self-regulation profiles that
signal risk for engaging in unhealthy behaviors would allow more effective intervention. The
investigators will assess self-regulation during pre-adolescence, a critical transition when
children gain responsibility for managing their health choices and self-regulation becomes
increasingly associated with health outcomes. Obesity is a complex health issue with
early-emerging biological and behavioral precursors that are related to self-regulation; as
such it is a good model for understanding a broad range of health conditions that require
active self-management. Childhood obesity is also an ongoing public health crisis, with
almost 25% of children overweight by age 4 years (35% by school-age). The goal of this study
is to measure childhood self-regulation targets known to be associated with obesity risk and
poor adherence to medical regimens and to assess whether intervening on these mechanisms can
improve self-regulation. The investigators will do so in a cohort of children with a high
rate of obesity who have been extensively phenotyped for bio-behavioral self-regulation and
obesity risk factors from early childhood.

The aim is to, in low-income school-age children from extant cohorts, develop and field-test
interventions designed to address self-regulation targets using a Multiphase Optimization
Strategy (MOST) design to detect intervention effectiveness and child or family factors
(e.g., maternal education, family stress, early childhood eating or stress regulation
pattern) that may moderate intervention effects. The investigators hypothesize that our
interventions will cause change in the self-regulation targets most closely related to the
intervention components (e.g., EF-focused intervention will change EF targets).

Inclusion Criteria:

- Participant in the ABC (Appetite, Behavior, and Cortisol) cohort being followed
longitudinally since recruitment in 2009-2013

- Primary caregiver (mostly mother) has < 4-year college degree at time of initial
enrollment (first study wave; child age ~4 years)

- Child born at 36+ weeks gestation

- Child had no significant perinatal complications.

Exclusion Criteria:

- History of food allergies or medical problems affecting growth

- Non-fluency in English

- Foster child

- Medications affecting cortisol

- Significant developmental delay.