Improving Children’s Self-Regulation Through Universal and Targeted Psychosocial Interventions: Meta-Analytic Review of South Korean Studies

Improving Children’s Self-Regulation Through Universal and Targeted Psychosocial Interventions: Meta-Analytic Review of South Korean Studies | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Systematic Review Improving Children’s Self-Regulation Through Universal and Targeted Psychosocial Interventions: Meta-Analytic Review of South Korean Studies Dohyeon Kim This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6320795/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Self-regulation is a prominent target of psychosocial interventions for both the prevention and the treatment of children’s mental health issues, as self-regulation in childhood can predict significant outcomes in later life such as academic success and health. This study aimed to verify the effectiveness of psychosocial interventions in improving the self-regulation of South Korean children aged 3–18 years and confirm the significant moderators by considering intervention level, intervention type, setting, and structural and participants’ characteristics. Thirty-five studies reporting on experimental and quasi-experimental trials were included in the analysis; they showed a moderate overall effect size and considerable heterogeneity. We found that intervention level, use of social skills interventions, and setting moderated self-regulation, while using explicit skills instruction was effective but not a significant moderator. Of the five continuous variables examined, only group size showed a significant but marginal positive correlation with the effect size. The results highlight the importance of applying preventative and targeted self-regulation interventions for children by focusing on the social aspects of self-regulation and the potential of school settings. This is the first meta-analytic review to verify the moderating effects of the methods used in self-regulation interventions, including explicit skills instruction and social skills interventions. The results can help build evidence bases for self-regulation interventions for children in South Korea and potentially worldwide. This study has several implications for future studies. Psychology School Counseling Educational Psychology self-regulation children psychosocial intervention social skills meta-analysis Figures Figure 1 Introduction An increasing number of studies show that self-regulation in childhood can predict significant outcomes in later life such as academic success and health (Howard & Williams, 2018; Robson et al., 2020) and be a long-term protective factor against problematic behaviors and mental health disorders (Keane & Evans, 2022). Thus, it is a prominent target of psychosocial interventions for both the prevention and the treatment of children’s mental health issues. The importance of self-regulation was highlighted during the COVID-19 pandemic, which required more autonomic functioning and conscious exertion of self-management skills to sustain well-being during periods of shutdown and isolation (Zinchenko et al., 2020). Self-regulation is the sum of volitional, goal-directed regulatory functions that control cognition, emotion, motivation, and behavior (Vohs & Baumeister, 2004). Its constructs are distinctive but interrelated and must be harmoniously co-activated for adaptive functioning (Heatherton & Wagner, 2011). Self-regulation corresponds to the development of cognitive and metacognitive functions and the maturation of neural networks (Best et al., 2009). However, these top-down regulatory strengths do not evolve by themselves and interaction with the external environment, particularly social interactions, is crucial to facilitating its development (Carlson, 2009). Vygotsky (1978) emphasized the interaction between infants and caregivers as a prerequisite for acquiring higher self-regulatory functions, which is a transition from being regulated by others and stimuli to volitionally regulating oneself to successfully adapt to the given environment. Continuing through later developmental stages, interactions in extended social networks that provide scaffolding and opportunities to practice regulatory skills closely relate to the development of self-regulation (Carlson, 2009). Similarly, environmental conditions such as socioeconomic status, educational systems, place of residence, culture, and ethnicity facilitate self-regulation development (Murray et al., 2016a). These findings highlight the importance of a comprehensive and holistic approach to enhancing children’s self-regulation. Psychosocial Interventions for Self-Regulation Several studies examine the malleability of self-regulation in children and its approaches, suggesting that interventions targeting fostering self-regulatory strengths and behavioral changes prove effective, which can be moderated by participants’ variables such as age, race, sex, and economic status (Murray et al., 2016b; Piquero et al., 2009, 2016), intervention level (i.e., the tier; Piquero et al., 2009), intervention type (Murray et al., 2022; Pandey et al., 2018; Piquero et al., 2009, 2016), target constructs of self-regulation (Murray et al., 2022), types of outcome measurements (Murray et al., 2022; Piquero et al., 2009), and structural conditions (Piquero et al., 2009, 2016). Based on recent studies, psychosocial interventions for improving children’s self-regulation can be categorized by intervention level (universal or targeted), age of the target receivers, intervention method (cognitive-behavioral approach, curriculum-based instructions, social activities, group counseling, and others), and intervention setting (schools, community institutions, correctional institutions, home, clinics, and others). Intervention Level Interventions for the general population should focus on developing self-regulation. Specific treatments target individuals with socioemotional and behavioral issues such as peer relationship problems, school adjustment challenges, addiction, aggression, and delinquency as well as environmental risk factors such as inadequate parenting and educational support. Pandey et al. (2018) reviewed the effectiveness of universal interventions for children aged 2–17 years and found generally favorable results, though the specific approaches’ moderating effects were unclear. These interventions also positively impacted academic performance, health, and behavioral issues. Murray et al. (2016b) reported that interventions targeting the universal population for children aged three and older generally had small to medium effect sizes. A more recent study by Murray et al. (2022) analyzed interventions from universal (Tier 1) to clinical (Tier 3) levels and found significant effects on emotional regulation in at-risk groups, highlighting the need for further research to optimize intervention elements for specific targets and goals. Explicit Skills Instruction Explicit skills instruction is a frequently adopted methodological approach for improving children’s self-regulation (Murray et al., 2016a). Explicit skills instruction typically focuses on training specific self-regulatory skills and strategies via direct instruction and practice. The targets of these instructions are predominantly categorized into (1) cognitive facets of executive function such as attentional regulation, working memory, and response inhibition (Hannesdottir et al., 2017) and (2) problem-solving or self-management strategies. Training on relatively more practical self-regulatory strategies such as time management, interpersonal problem-solving, controlling self-destructive behaviors, and emotional reactions is broadly provided for receivers of all ages and intervention levels (Hautakangas et al., 2022). For preschool children, explicit skills instruction is typically provided through various playful activities requiring scaffolding and social interaction. A renowned program for preschool children, Tools of the Mind (Bodrova & Leong, 2019), stresses teachers’ verbal guide, use of materials, and modeling for self-regulatory behaviors in various play situations such as self-talk and internalization of roles in a specific social context. Zimmerman (2002) suggested a model of self-regulated problem-solving in adolescence, highlighting the importance of explicit training at each stage. The explicit approach aims to convert the effortful and conscious exertion of the self-regulatory strategy phase to the automatization phase. The effectiveness of this approach, particularly its effects on each age group and intervention level, has not yet been sufficiently identified. Pandey et al. (2018) identified the effects of curriculum-based interventions involving explicit skills instruction, reporting the smallest effect size ( d = 0.34; 95% confidence interval [CI] [0.17, 0.5]) of all the identified intervention types. However, they did not clearly identify whether other types of interventions such as mindfulness and family-based interventions also embed explicit skills instruction, limiting their studies to those reporting performance-based assessment. Murray et al. (2016b) evaluated the effects of explicit skills instruction and reported positive outcomes, although they did not investigate the moderating effect of this approach. This study investigated the moderating effect of explicit skills instruction on improving self-regulation in children. Most of the skills instruction included in this study was implemented based on a cognitive-behavioral approach; otherwise, the authors adhered to their traditional school instruction formats designed and delivered by teachers. Approaches without any explicit skills instruction such as physical exercises, art therapy, role-playing, and play therapy resemble typical school environments in which self-regulation is not a regular subject directly taught in a classroom but instead learned via academic learning experiences and social interactions (Schunk et al., 2022). The activities used in this type of approach, particularly those outside regular routines, can help use or acquire advanced (mostly top-down) processes and new self-regulation strategies (Norman & Shallice, 1986). Social Skills Interventions Intervening in the social aspects of self-regulation is another major approach to self-regulation interventions. Social skills interventions for children typically involve (1) explicit skills instruction or coaching regarding social skills, (2) modeling, (3) paired or group activities, and (4) reinforcement by providing feedback and rewards (Smith et al., 2010). In an earlier analysis (Piquero et al., 2009), social skills development programs were the most common type of self-regulation intervention in the selected studies. Such intervention is based on how self-regulation is activated and acquired in a social context (Baumeister & Vohs, 2007). For this, an individual must intentionally adjust their emotions, thoughts, behaviors, and motives to the surrounding environment and their interactions with others (i.e., intrinsic regulation). This is partially regulated by their social interactions (i.e., extrinsic regulation), including scaffolding, empathizing, directly teaching relevant skills, and modeling, which are mostly provided by caregivers, specifically in early developmental stages (Murray et al., 2016b). The effectiveness of interventions on social aspects of self-regulation has been proved by several recognizable programs (Bierman et al., 2019; Rich et al., 2019; Wenz-Gross et al., 2018), even in participants with neurodevelopmental or pediatric mental disorders (Hannesdottir et al., 2017; Idris et al., 2022; Laugeson & Ellingsen, 2014). An earlier meta-analysis (Piquero et al., 2009) examined the effectiveness of social skills instruction in improving self-control in children aged 10 years or younger and reported a non-significant effect size. In a systematic review, Murray et al. (2016b) identified that over half of the interventions for preschoolers focused on education and training for parents and teachers to help them learn how to provide children with opportunities to acquire self-regulatory skills, although the proportion sharply dropped to approximately 30% for elementary students and to almost none in high school students and young adults. Pandey et al. (2018) analyzed the effects of family-based interventions and reported that more than half of the included studies showed positive outcomes for self-regulation and other related functions such as academic performance and social skills. However, the investigation on the interventions targeting social competence enhancement has been insufficient despite their importance, specifically in South Korea. Setting Schools are the most common setting in which the diverse range of psychosocial interventions for children are provided (Murray et al., 2022; Pandey et al., 2018; Piquero et al., 2009; van Genugten et al., 2017). Pandey et al. (2018) reported that the effect size of school-based self-regulation interventions measured by performance-based assessments was the smallest among all types. Piquero et al. (2016) also suggested that school-based interventions are more prevalent than clinical interventions, albeit with considerable heterogeneity and non-significant moderating effects. The setting is also related to the intervention level since most school-based interventions involve both universal and at-risk receivers, while institutions such as clinics and correctional institutions typically comprise children with high-risk and severe symptoms. Although we excluded participants with a premorbid diagnosis or clinical level of symptoms, the spectrum of difficulties regarding self-regulation deficits may vary according to the setting. This study focused on the moderating effect of the core elements mentioned above on self-regulation development. Notably, this study found few methodologically rigorous studies targeting caregivers. Hence, investigating the effectiveness of treating extrinsic regulation was unfeasible. Relevant Studies Targeting South Korean Children The previous reviews discussed above were mainly limited to American and European populations, with relatively small samples of Asians; hence, South Korean studies have not been addressed in most of the comprehensive analyses. This may be because most South Korean studies (more than 80% of the studies identified in this review) were not published in English. Community institutions and national-level school-based self-regulation interventions have been implemented in South Korea. Most recognizable programs target either the treatment or the prevention of specific behavioral problems (Won et al., 2015) such as Internet addiction (Kim et al., 2017) and bullying (Sung et al., 2020) rather than promoting self-regulation development in the universal population. Shin (2021) examined the effectiveness of psychosocial interventions targeting South Korean juvenile offenders and reported an overall large effect size ( g = 1.12), with most of the psychosocial interventions adopting cognitive-behavioral approaches or art therapies administered in a group session. In their meta-analytic review of targeted interventions for adolescents with Internet addiction, Kwon and Jang (2016) reported outcomes favoring the experimental groups, with significantly higher effect sizes found in cognitive-behavioral approaches and coping strategy training. Another notable trend found in the South Korean literature is that self-regulation in academic skills, including academic self-regulation and self-regulated learning (Lee, 2011), has been highlighted, while the other aspects of self-regulation have been relatively disregarded. This may be aligned with the tendency for academic achievement to be prioritized above the mental health issues of South Korean adolescents (So & Kang, 2014). To the best of our knowledge, comprehensive analytic reviews of universal and targeted interventions for improving the integrated self-regulation of South Korean children have not been published; hence, the evidence base for the intervention approach remains inadequate. The Present Meta-Analysis This is the first comprehensive review of the effectiveness of self-regulation interventions for South Korean children and the potential moderators. This study aimed to examine effective practices of self-regulation interventions applicable to the South Korean population and suggest implications for interventions for the self-regulation of children across cultures and ethnicities. In response, we present the results from a meta-analysis of randomized controlled trials and quasi-experimental trials that confirmed the effectiveness of psychosocial interventions targeting the enhancement of children’s self-regulation and examined the significant moderators, including intervention level, intervention type, setting, and structural and participants’ characteristics. We only examined the immediate effects since fewer trials reported the effects measured at a follow-up of more than a month ( N = 2). Methods Literature Search The studies were identified through a search of databases, including RISS, KISS, DBpia, the National Assembly Digital Library, Google Scholar, and Dcollection (dissertation database). The search terms and their variants were self-regulation, self-control, intervention, treatment, program, and training. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) search protocol (Moher et al., 2009), we screened and assessed the identified studies for eligibility using the inclusion and exclusion criteria described in Fig. 1. As this study only used previously published data, no ethical guidelines needed to be followed. (Insert Fig. 1 about here) Inclusion and Exclusion Criteria Based on the population, intervention, comparison, outcomes, and study design (PICOS) criteria (Tacconelli, 2010), the studies were assessed as eligible if they met the following inclusion criteria: (1) South Korean population aged 3–18 years without diagnosis of neurodevelopmental disorders, mental health disorders, or medical conditions/exposure to medication that could affect the mental state; (2) trials were administered from 2000 to 2022; (3) trials involved control or comparison groups that received the regular curriculum exclusively in school settings; and (4) outcome variable was self-regulation, measured by at least one of self-report, teacher report, parent report, clinical assessment, and task performance. Regarding the comparison and study design criteria, as most of the interventions run in preschools and schools involved preexisting classrooms rather than the randomized allocation of participants and control groups that received instructions following the regular curricula, these school-based interventions were included in the quasi-experimental designs. Studies were excluded if (1) participants were not South Korean; (2) the study was neither a doctoral dissertation nor published in a peer-reviewed journal; (3) only the focal components of self-regulation (e.g., emotional regulation) were included in the outcomes; (4) the description on the interventions was insufficient for coding; (5) the outcome assessment tools were not validated by more than one validation study with the South Korean population; (6) they were a quasi-experimental trial, but the baseline differences between the experimental and control groups were not verified or the outcome data were not adjusted to address the imbalance; and (7) spiritual or religious activities were the major elements of the intervention. Coding for Moderators The studies included in the final screening were coded according to intervention level, intervention type, and setting as well as five continuous variables (see below). Intervention Level The studies were categorized as universal or targeted interventions based on the characteristics of the target participant and intervention aims. Universal interventions targeted children who have not reported mental health issues or considerable adversities and aim to promote self-regulation. Targeted interventions were delivered to at-risk children who reported subclinical levels of problems such as internalizing or externalizing behaviors and primarily aimed to treat the problems by improving self-regulation. Intervention Type Two of the most common intervention types, namely, explicit skills instruction and social skills interventions, were coded as either “yes” or “no”. Studies were coded as “yes” for explicit skills instruction if the intervention included all the following components: (1) explicit instructions on self-regulatory skills, (2) skills practice, and (3) instructor feedback. Studies were coded as “yes” for social skills interventions if the intervention met all the following criteria: (1) mainly targeting social skills improvement, (2) modeling, (3) paired or group activities, and (4) providing feedback and rewards. In other words, interventions that only included group sessions did not meet the inclusion criteria for social skills interventions because their structures are not necessarily linked to active social learning. The coders referred primarily to the intervention protocols and descriptions of the procedures provided by the authors. Setting The setting was coded as preschools and schools, community institutions, and correctional institutions. As trials conducted at home or in clinics were insufficient, the moderating effects of these two types of settings were excluded. Preschools and schools, including preschools and elementary, middle, and high schools, provide the national curriculum. Correctional institutions are facilities for special education for juvenile offenders. Community institutions include the other educational facilities that provide extra care, mostly run by community members as part of the government’s welfare service. Continuous Variables Age, total number of sessions, number of sessions per week, duration per session (min), and group size were coded as continuous variables. If participants’ ages were heterogeneous, the mean age was used. Group size indicates the number of participants who simultaneously participated in the session. Studies that did not identify these variables were excluded from the analysis; fewer than 12% of the studies were excluded owing to the absence of these variables. Effect Size and Meta-Regression Analyses The pooled effect sizes of the immediate post-intervention outcomes between the studies were calculated using Hedges’ g , the standardized mean differences (Hedges & Olkin, 1985) with the random effects model, which is used when the included studies are heterogeneous in population and measurements (Borenstein et al., 2010). If a study provided multiple outcomes such as the emotional regulation score, behavioral regulation score, and cognitive regulation score or multiple treatment groups with one control group, the synthesized effect size within the study was calculated (Cheung, 2019); otherwise, only the total score was used. The z score was used to prove the significance of the effect sizes. The significance of the heterogeneity within or between the studies was assessed using Q statistics. A probability level of 0.05 was used to assess significance. A 95% CI was calculated for each effect size. Comprehensive Meta-Analysis Software version 4 was used for the calculations. Meta-regression analyses using a random effects model were performed on the five continuous variables. Risk of Bias Analysis Publication bias refers to distortions in reviews caused by the tendency that studies with significant outcomes may be more published than studies with null outcomes or several characteristics regarding experimental design, such as a small sample size and delayed outcome measurement at follow-up (Thornton & Lee, 2000). We assessed the risk of bias using a funnel plot, Duval and Tweedie’s (2000) trim-and-fill test, Egger’s regression test (Sterne & Egger, 2005), and the fail-safe N test (Orwin, 1983; Rosenthal, 1979). Funnel plots can detect possible reporting bias (Sterne & Egger, 2001); however, the graphical asymmetry of the plot requires further investigation and cautious interpretation, particularly when the analysis includes fewer small trials (Egger et al., 1997). Egger’s regression test, which is regarded as an objective test to verify asymmetry in the funnel plot and capture small-study effects (Sterne & Egger, 2005), was administered. Additionally, to estimate the effects of potential bias on the actual effect sizes, the outcome was adjusted by adding the potential missing studies to the actual effect size using the trim-and-fill test (Duval & Tweedie, 2000). A fail-safe N test was also conducted on the estimated number of unpublished studies to make the actual effect size non-significant (Orwin, 1983). Rosenthal (1979) suggested the statistical criterion of 5 k +10 ( k = the number of included studies), a figure less than which indicates concerns about the risk of publication bias. The alpha value was set at 0.05 overall. The risk of bias was assessed using five criteria of the Risk of Bias 2 tool (Sterne et al., 2019) that examined potential biases arising from (1) the randomization process, (2) deviations from intended interventions, (3) missing outcome data, (4) the measurement of the outcome, and (5) the selection of the reported result. For each criterion, studies were assessed as low risk, some concerns, or high risk based on the guidelines. Results Studies’ Characteristics Supplementary Table 1 summarizes the descriptive statistics of the included studies. A total of 35 studies with 1,624 samples were included in the final analysis. Most studies were published in the last decade (85.7%). The mean age of the participants was 12.87 and school-aged children were the targets of more than two-thirds of the studies (74.3%). Regarding intervention level, universal interventions accounted for slightly more than half of the studies (54.3%). Sixty percent of the studies involved explicit skills instruction and 45.7% focused on social skills interventions. Almost two-thirds of the trials were conducted at schools and preschools (65.7%), followed by community institutions (20%) and correctional institutions (14.3%). The average total number of sessions was 12.37 and most interventions were provided once or twice a week (68.6%). The average duration per session was 65.3 minutes and approximately one-third of the interventions lasted 30 minutes to an hour in each session (34.3%). Most trials were provided to a group of more than seven participants (80%) and the average group size was 12.5. Self-reporting (71.4%) was the most common method of outcome measurement, followed by teacher reporting (20%). As the trials targeting younger participants mostly adopted teacher reports and the number of studies that used performance-based assessment was insufficient ( N = 3), the analysis of the moderating effect of outcome measurement was excluded (see Supplementary Table 2 for a list of the included studies). Meta-Analytic Results Table 1 shows the overall effect size ( g ) was 0.767 (95% CI [0.628, 0.906]), which ranged from zero ( z = 10.811, p < 0.001) to medium in magnitude, according to Cohen’s standard (Cohen, 1992). Notably, this was larger than those found by Murray et al. (2022) ( g = 0.15 for self- and other-report assessments) and Piquero et al. (2009) ( g = 0.60 for self-reporting and g = 0.28 for teacher reporting). However, as comparable effect sizes in the field are still insufficient, their magnitude must be noted solely as a technical interpretation (Brydges, 2019). Considering that the level of heterogeneity was also significant ( Q = 89.147, p < 0.001), the effect size must be explained with caution and the presence of potential moderators that may cause deviations in the outcomes is indicated. Table 1 Results of the Meta-Analysis Variable k ( n ) g (95% CI) z Q- within Q- between Overall 35 (1,624) 0.767 [0.628, 0.906] 10.811*** 89.147*** Intervention level a Universal 19 (1,005) 0.959 [0.809, 1.109] 12.53*** 23.548 8.623** Targeted 16 (619) 0.567 [0.352, 0.781] 5.179*** 52.052*** Explicit skills instruction b Yes 21 (1,176) 0.782 [0.602, 0.961] 8.552*** 45.191*** 10.957 No 14 (448) 0.747 [0.506, 0.987] 6.092*** 43.418*** Social skills interventions c Yes 16 (812) 1.043 [0.884, 1.201] 12.88*** 29.449* 13.261*** No 19 (812) 0.597 [0.418, 0.777] 6.514*** 49.644*** Setting d Preschools and schools 23 (1,174) 0.910 [0.771, 1.049] 12.85*** 35.377* 12.61** Correctional institutions 5 (160) 0.456 [0.132, 0.781] 2.756** 8.356 Community institutions 7 (290) 0.489 [0.246, 0.732] 3.94*** 8.078 Continuous variables k (n ) Coefficient ( SE ) 95% CI Q ( p ) Age 35 (1,624) -0.023 (0.014) [-0.051, 0.006] 2.47 (0.1159) Duration per session (min) 33 (1,541) 0.000 (0.001) [-0.002, 0.002] 0.06 (0.8000) Total number of sessions 35 (1,624) -0.009 (0.006) [-0.021, 0.002] 2.45 (0.1180) Number of sessions per week 31 (1,395) -0.041 (0.061) [-0.162, 0.079] 0.45 (0.5030) Group size 33 (1,398) 0.025 (0.009) [0.007, 0.043] 7.08 (0.0078) Note . k = number of studies, n = number of samples, g = Hedges’ g , CI = confidence interval, N/A = not available, SE = standard error, Q = Q statistic, p < 0.1 * p < 0.05. ** p < 0.01. *** p < 0.001 a Intervention level indicates the tiers of the interventions; universal interventions target the general population without a clinical level of mental problems, while targeted interventions target participants with symptoms requiring specialized or more intensive care. b The interventions were divided into those containing explicit skills instruction, where self-regulation strategies were taught directly via explanations, worksheets, and media aids, and those excluding them. c Studies were coded as “yes” for social skills interventions if the interventions mainly targeted social skills and involved modeling, paired or group activities, and providing feedback and rewards. d Preschools and schools, including preschools and elementary, middle, and high schools, provide the national curriculum. Correctional institutions are facilities for special education for juvenile offenders. Community institutions include the other educational facilities that provide extra care, mostly run by community members as part of the government’s welfare service. (Insert Table 1 near here) Bias Assessment According to the risk of bias assessment, 12 studies (34.4%) contained sufficient randomization processes, while in 11 studies, some concerns arose, as they partially reported on the blinded allocation of the participants but verified the non-significant baseline difference between the groups. Two of the included studies contained a high risk of bias in randomization, as the allocation was concealed; however, the process was not adequately explained and the baseline difference between the groups was not estimated. All the studies except one showed adequate implementation of the intended intervention. Regarding attrition bias, 23 studies (65.7%) reported the final results with adequate control of attrition bias, although 12 studies reported missing data of less than 5 ~ 10% primarily owing to dropouts, raising some concerns. Ten studies (28.6%) showed some concerns in the measurement of the outcome, as they partially reported blinding in teacher reporting or performance-based assessments, and the remaining studies that used self-report measurement indicated a high risk of bias. Notably, most South Korean studies reviewed in the screening process and included in the final analysis used self-reporting as a primary outcome assessment tool. Although the tools were all validated in a domestic population, the measurements were subjective and unblinded, indicating potential bias. Thirty-two studies (91.4%) had an adequate selection of the reported results, indicating a low risk of bias. Typically, the publication bias test revealed a non-significant bias. As the funnel plot showed asymmetry, we conducted Duval and Tweedie’s trim-and-fill test (Duval & Tweedie, 2000) and Egger’s regression test (Sterne & Egger, 2005) to detect publication bias. The results revealed seven missing studies, and the adjusted effect size dropped from g = 0.767 to 0.643 (95% CI [0.497, 0.789]) but was still significant. The result of Egger’s regression test also indicated marginal effects of potential publication bias (intercept = -0.0765, 95% CI [-1.146, 0.993], p > 0.05). The fail-safe N test showed that the number of potentially missing studies was 2,777, which exceeded 185, the standard figure suggested by Rosenthal (1979), again supporting the acceptable quality of the current analysis. Moderators Intervention Level Both the universal ( z = 12.53, p < 0.001) and the targeted ( z = 5.179, p < 0.001) interventions were effective in improving self-regulation, although the universal interventions showed significantly better outcomes ( g = 0.959; 95% CI [0.809, 1.109]) than the targeted interventions ( g = 0.567; 95% CI [0.352, 0.781]; Q = 8.623, p < 0.01). Furthermore, we found significant heterogeneity only in the targeted interventions (see Table 1 ). Explicit Skills Instruction Explicit skills instruction was generally effective ( z = 8.552, p < 0.001) but not a significant moderator overall ( Q = 10.957, p = 0.819). Furthermore, the considerable heterogeneity of this approach was observed in both the universal and the targeted interventions. Social Skills Interventions Social skills interventions were effective ( z = 12.88, p < 0.001) but showed significant heterogeneity ( Q = 29.449, p < 0.05). They also showed remarkably large effect sizes ( g = 1.043, 95% CI [0.884, 1.201]) and significant moderating effects ( Q = 13.261, p < 0.001). Other interventions that did not focus on social skills were also effective ( z = 6.514, p < 0.001), although the effect size was smaller ( g = 0.597, 95% CI [0.418, 0.777]). The effect sizes were also remarkable in interventions with combined explicit skills instruction and social skills interventions ( N = 8; g = 0.989, 95% CI [0.728, 1.250]). Conversely, interventions that targeted neither of these approaches showed significant but relatively small effect sizes ( N = 6; g = 0.478, 95% CI [0.112, 0.843]). Setting The interventions in all three settings showed significant effect sizes (preschools and schools, z = 12.85, p < 0.001; correctional institutions, z = 2.756, p < 0.01; community institutions, z = 3.94, p < 0.001) and the moderating effect was also significant ( Q = 12.61, p < 0.01). Preschools and schools were the most common settings ( N = 23, 65.7%) and they showed the largest effect size ( g = 0.910, 95% CI [0.771, 1.049]) as well as significant heterogeneity ( p < 0.05). Continuous Variables Of the continuous variables, only group size showed a significant but marginal positive correlation with effect size (coeff = 0.025, Q = 7.08, p = 0.0078), indicating that interventions with larger group sizes demonstrated slightly greater effect sizes. As most school-based interventions involved the whole class with a relatively large number of participants, we examined the correlations within each setting. The results showed a positive correlation between group size and effect size exclusively within preschools and schools (coeff = 0.033, Q = 10.76, p = 0.001). Additionally, for intervention level, the significant correlation between group size and effect size was primarily driven by universal interventions (coeff = 0.034, Q = 5.23, p = 0.022) and none of the continuous variables showed any significance when the intervention targeted the at-risk population. Discussion This meta-analysis aimed to examine the effectiveness of psychosocial interventions targeting self-regulation among children aged 3–18 years in South Korea. The results based on 35 studies showed that the interventions were overall effective at immediate post-intervention outcome measurement, which were mostly based on self-reporting or teacher reporting. The overall effect size must be interpreted carefully because of the significant heterogeneity. To the best of our knowledge, this comprehensive analysis is the first to establish evidence bases for self-regulation interventions for South Korean children; hence, the availability of findings to make relevant comparisons is limited. However, compared with the results of studies on the global population, the effect size in this analysis was greater, while the considerable heterogeneity found was congruent with previous findings (Murray et al., 2022; Pandey et al., 2018; Piquero et al., 2009, 2016). However, only two studies reported outcomes at follow-up and we could not verify the long-term effects of the interventions. One of the few relevant studies on delayed outcomes (van Genugten et al., 2017) reported statistically significant long-term effects (longer than six months) of teaching self-regulation techniques on self-esteem in their meta-analysis, although the exact approaches that led to the lasting effects were not distinctly identified and the effect size was small. Pandey et al. (2018) suggested that more than half of the family-based interventions included in their analysis showed positive changes in self-regulation over an extended period compared with other intervention types. Considering that interventions aim to produce lasting positive changes in self-regulation, future research should focus on outcomes at follow-up. Universal interventions were slightly more prevalent than targeted interventions in our review, which aligns with earlier reports (Murray et al., 2016a, 2022). Notably, the interventions benefited at-risk children; however, their effectiveness was not greater than that in the general population. Additionally, the interventions implemented in correctional institutions, wherein most participants reported relatively severe risk factors, showed the smallest effect size. Although other moderators may exist, these results could indicate a negative correlation between the severity of the risk factors and intervention’s effectiveness. Piquero et al. (2016) found a significant moderating effect of intervention level. They reported that both universal and targeted interventions for improving self-regulation were effective for children under 10 years, with the effect sizes higher for universal interventions than for targeted interventions. Notably, the significant moderators in the overall sample in their analysis did not show consistent moderating effects within the targeted population. Furthermore, remarkable heterogeneity was observed in targeted interventions but not in universal interventions. The heterogeneity in the severity of reported behavioral and socioemotional problems and types of environmental risk factors within the targeted population may have contributed to the inconsistent outcomes. Several mental health problems among adolescents can share similar mechanisms of self-regulation failure (Baumeister & Heatherton, 1996), while, simultaneously, each can arise from more specific deficits in certain self-regulatory skills or adverse conditions that must be prioritized such as poor anger management and time management skills in academic settings. Hence, whether the activities and skills targeted in the intervention meet individual needs could moderate the effect and result in a significant variance in the outcomes. The results suggest the importance of tailoring approaches according to the intervention level, with a comprehensive assessment of the specific problems and deficits in self-regulatory skills reported by target participants in the pre-intervention stage. Regarding the mechanism of self-regulation, this may also be due to the relatively high resistance to change presented by the targeted participants, who had already reported more than one difficulty regarding self-regulation. Baumeister and Heatherton (1996) suggested the mechanism of self-regulation failure, borrowing the concept “inertia” from physics; if one fails to prevent or correct uncontrolled behaviors in the early stages, it becomes more challenging to improve one’s behavior later. This suggests the importance of early intervention before a pattern causes non-regulatory behavior and gains momentum. Explicit skills instruction was effective for both universal and targeted interventions. This result aligns with previous findings that skills instruction is generally effective and recommended for treating children’s self-regulation (Murray et al., 2016b, 2022; Pandey et al., 2018; Piquero et al., 2009). However, explicit skills instruction was not a significant moderator and heterogeneity was considerable. One possible source of such variance is the methods used as adjuncts to skills instruction. The skills instruction included in this study involved diverse activities, materials, and structural conditions. Regarding the target domains of skills instruction, training on the cognitive sub-skills of executive function (e.g., attention regulation training for preschool children) and self-regulation strategies (e.g., regulating anger) were included in this study, which could also contribute to the notable inconsistency in the outcomes. We could not verify the variance in the effectiveness of these two approaches owing to fewer interventions for discrete executive functions ( N = 3). Further trials must confirm the most suitable methods combined with explicit skills instruction for specific intervention targets. Social skills interventions were typically effective and significantly moderated these effects. These favorable outcomes support the findings of previous meta-analyses (Murray et al., 2016b; Pandey et al., 2018). Further, the moderating effect was consistent regardless of intervention level. Social skills interventions that focus on teaching social skills explicitly using instruction or group problem-solving activities may enhance social relationships and perceptions of social support, operating as potential therapeutic factors for improving goal-directed behaviors (Hofmann et al., 2015). Additionally, the improvement in self-regulatory strengths reported via self-report assessments may indicate that self-esteem, self-efficacy, and the motivation for the willful exertion of self-regulation have increased (Crocker et al., 2006; Leary, 2004), likely led by positive social interactions and social skills enhancement (Bijstra & Jackson, 1998; Harrell et al., 2009; Mohamed & Shehata, 2023; Seema & Kumar, 2018). Furthermore, as most outcome measurements were not limited to interpersonal self-regulatory skills, the effects of the social competence interventions could be transferred to other aspects of self-regulation. However, few studies have targeted both children and their caregivers, which is an essential aspect of self-regulation development. This feature distinguishes South Korean studies from previous studies across nations (Murray et al., 2016b). Carlson (2009) suggested the need to examine the cultural context when teaching children self-regulation skills in schools and at home, as the prominent perceptions of how self-regulation is nurtured and activated can largely depend on unique cultural values and educational policies. Our results indicate that the significance of caregivers’ external regulation in developing self-regulation is relatively less stressed and that educational methods and programs focusing on nurturing self-regulation must be discussed in South Korea. In exploring South Korean preschool teachers’ perspectives on self-regulation education, Chi (2016) stressed that the problems related to children’s unregulated behaviors may be predominantly owing to a lack of social skills, and self-regulation is directly taught to children or parents exclusively when problematic behaviors manifest, lacking well-organized and planned approaches included in their daily routines. Hence, the majority responded that more theoretically grounded teacher training is required to foster self-regulation. The impacts of external hardship such as low socioeconomic status, insufficient expertise in the region, and dysfunctional families are also neglected in most self-regulation interventions in South Korea. Future studies must investigate the effectiveness of more holistic approaches that encompass nurturing individuals’ internal self-regulatory strength and the corresponding external support. Nonetheless, our results imply the potential of building substantial social competence and relationships to improve children’s self-regulation. Enhanced social bonds and socioemotional skills may be crucial in improving one’s perception of self-regulation and the motivation to exert self-regulatory strength. School-based interventions demonstrated the most significant effects of all the settings, accompanied by significant heterogeneity. One possible factor regarding the study design is that a large proportion of school-based trials were quasi-experimental because the interventions were provided to preexisting classroom units without random allocation processes, although the selection of the classes was randomized and the pretest balance was verified. Schools are the recommended settings for psychosocial interventions for the prevention and treatment of children; nevertheless, there are several moderators regarding participant characteristics and program implementation (Paulus et al., 2016; Wilson & Lipsey, 2007). A moderator repeatedly verified in previous reviews was the expertise of providers (e.g., teachers and school counselors), which was closely related to high fidelity in implementing interventions and effectiveness at each intervention level (Franklin et al., 2012, 2017; Han & Weiss, 2005). This study could not analyze the impact of school staff expertise owing to insufficient data. However, given that the school-based interventions included in this review involved both universal and at-risk participants, we conducted a further analysis to verify the moderating effect of intervention level on the outcomes of school-based interventions. The results demonstrated that both universal and targeted interventions proved effective. Although targeted interventions showed lower effect sizes, the difference was not statistically significant. The significant outcomes of the school-based self-regulation interventions demonstrate the possibility of teaching self-regulation within a regular curriculum. The interventions at school that we reviewed often involved the whole classroom, typically with several participants, allowing more flexibility in administering individual, peer, and group activities and providing materials such as worksheets and visual aids similar to instructions for regular subjects. The social aspects of school-based interventions can be another potential advantage in that peer relationships at school can be directly treated and facilitated in the sessions. Consistent with earlier findings, schools can be suitable for administering self-regulation interventions tailored to both universal and targeted populations but further investigations with more rigorous study designs must identify the moderators. The correlation between age and intervention outcomes was not significant, consistent with a previous meta-analysis of universal interventions for children aged 2–17 years reporting no significant association between age and the effects of interventions (Pandey et al., 2018). On the contrary, Piquero et al. (2009) reported that age inconsistently moderated the outcomes based on the types of measurement tools. In clinical assessments, younger participants showed better outcomes, while the trend was reversed in teacher reports and direct observer reports. Investigating the effect of age in each type of measurement was unfeasible in this study, since the types of outcome measurements tended to be adopted based on age, which may act as a potential confounding variable. Future studies should thus investigate the interaction between age and intervention effects while controlling for possible confounders, especially by diversifying the types of outcome measurements. The only structural condition that showed a significant correlation with the outcome variable was group size, but this was limited to school-based and universal interventions. This may be related to the larger heterogeneity in the outcomes of targeted interventions and those administered in non-school settings. Limitations The current study has some limitations. First, the effectiveness of interventions targeting caregivers and environmental conditions, which are crucial external elements significantly impacting the self-regulation development of children, was not examined owing to the low number of studies. Although there can be several practical issues in implementation, further experiments need to consider caregivers and the external environment as the major intervention target and compare the effectiveness with treatments involving only children. Second, the moderating effect of the outcome measures was not examined because of the tendency of South Korean studies with school-aged children to adopt self-report measures to assess outcomes. Similarly, in studies on preschool children, teacher reporting was the most prevalent assessment type and other types of additional measurements were insufficient, which differs from some earlier reviews targeting the worldwide population (Murray et al., 2022; Pandey et al., 2018). The measurements combined to detect the differences in various aspects of self-regulation need to be considered in future intervention studies. Third, the long-term effects were not analyzed because of the low number of studies measuring the prolonged effects at follow-up. Future studies must verify the effects at delayed time points, specifically in school settings wherein students are less prone to loss at follow-up. Conclusion Despite these limitations, the current analysis provides practical implications and promotes evidence-based approaches for interventions building lifelong resources. Psychosocial interventions can improve the self-regulation of children, particularly when they promote social competence. The current findings also emphasize the effectiveness of explicit skills instruction in improving self-regulation and the potential benefits of school-based interventions. 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P., Morosanova, V. I., Kondratyuk, N. G., & Fomina, T. G. (2020). Conscious self-regulation and self-organization of life during the COVID-19 pandemic. Psychology in Russia , 13 (4), 168–182. https://doi.org/10.11621/PIR.2020.0411 Additional Declarations The authors declare no competing interests. Supplementary Files SupplementaryMaterial1.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6320795","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Systematic Review","associatedPublications":[],"authors":[{"id":434852508,"identity":"0f2aea6b-19e6-4f8b-a947-1338424aeeb5","order_by":0,"name":"Dohyeon Kim","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8klEQVRIiWNgGAWjYFAC5gYGCTZmGTb25oMPPhCnhRGshYef51iy4QyitTAAtUjOyDGT5iFGg3zYwTYJizJrHoMbCcbGtjvsEvulDzB++JiDW4vh7cQ2CYlz6TwGZx4kPs49k5w4sy+BWXLmNjxaZie23ZBsO8xjcDzhsHFuG7OxwRmgO3mJ0nIgsU3asq3e2J6QFnlpqBbJjmQ2aca2w3IGPAS0GEgntv8A+QUYyMyGvW3H5STOMDbj9Yv87OTDxhJl1nJs7P0fH/xsq+bh72E++OEjPlsOAONfAlUMFFN4gDxQmpHIdDIKRsEoGAUjFQAAJz1PSYRW/MUAAAAASUVORK5CYII=","orcid":"https://orcid.org/0009-0005-9143-2953","institution":"The Graduate School of Clinical Psychology and Counseling, CHA University","correspondingAuthor":true,"prefix":"","firstName":"Dohyeon","middleName":"","lastName":"Kim","suffix":""}],"badges":[],"createdAt":"2025-03-27 13:02:57","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-6320795/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6320795/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":79579987,"identity":"f3f8cb53-e6b5-447b-b8fc-edf07a7c4230","added_by":"auto","created_at":"2025-03-31 11:44:13","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":41157,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003ePRISMA Flowchart\u003c/em\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6320795/v1/11d5c8e2a7f0b8c85914369c.png"},{"id":79581703,"identity":"e580b91a-0164-4d9d-bcbf-af36d360f2bc","added_by":"auto","created_at":"2025-03-31 12:00:14","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":925263,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6320795/v1/0577544a-7bea-49b5-a099-4fda5598a33a.pdf"},{"id":79579988,"identity":"3301a82c-28de-4a0a-96cb-55b5cb6f670d","added_by":"auto","created_at":"2025-03-31 11:44:13","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":32786,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryMaterial1.docx","url":"https://assets-eu.researchsquare.com/files/rs-6320795/v1/83b9eafb8e835be484919f31.docx"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eImproving Children’s Self-Regulation Through Universal and Targeted Psychosocial Interventions: Meta-Analytic Review of South Korean Studies\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAn increasing number of studies show that self-regulation in\u0026nbsp;childhood can predict significant outcomes in later life\u0026nbsp;such as academic success and health\u0026nbsp;(Howard \u0026amp; Williams, 2018; Robson et al., 2020) and be a long-term protective factor against problematic behaviors and mental health disorders (Keane\u0026nbsp;\u0026amp; Evans, 2022).\u0026nbsp;Thus, it is a prominent target\u0026nbsp;of psychosocial interventions for both the prevention and the treatment of children\u0026rsquo;s mental health issues.\u0026nbsp;The importance of self-regulation was highlighted during the COVID-19 pandemic, which required more autonomic functioning and conscious exertion of self-management skills to sustain well-being during periods of shutdown and isolation (Zinchenko et al., 2020).\u003c/p\u003e\n\u003cp\u003eSelf-regulation is the sum of volitional, goal-directed regulatory functions that control cognition, emotion, motivation, and behavior (Vohs \u0026amp; Baumeister, 2004). Its constructs are distinctive but interrelated and must be harmoniously co-activated for adaptive functioning (Heatherton \u0026amp; Wagner, 2011). Self-regulation corresponds to the development of cognitive and metacognitive functions and the maturation of neural networks (Best et al., 2009). However, these top-down regulatory strengths do not evolve by themselves and interaction with the external environment, particularly social interactions, is crucial to facilitating its development (Carlson, 2009). Vygotsky (1978) emphasized the interaction between infants and caregivers as a prerequisite for acquiring higher self-regulatory functions, which is a transition from being regulated by others and stimuli to volitionally regulating oneself\u0026nbsp;to successfully adapt to the given environment. Continuing through later developmental stages, interactions in extended social networks that provide scaffolding and opportunities to practice regulatory skills closely relate to the development of self-regulation (Carlson, 2009). Similarly, environmental conditions such as socioeconomic status, educational systems, place of residence, culture, and ethnicity facilitate self-regulation development (Murray et al., 2016a). These findings highlight the importance of a comprehensive and holistic approach to enhancing children\u0026rsquo;s\u0026nbsp;self-regulation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePsychosocial Interventions for Self-Regulation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSeveral studies examine the malleability of self-regulation in\u0026nbsp;children\u0026nbsp;and its approaches, suggesting that interventions targeting fostering self-regulatory strengths and behavioral changes prove effective, which\u0026nbsp;can be moderated by participants\u0026rsquo;\u0026nbsp;variables such as age, race, sex, and economic status (Murray et al., 2016b; Piquero et al., 2009, 2016), intervention level (i.e., the tier; Piquero et al., 2009), intervention type (Murray et al., 2022; Pandey et al., 2018; Piquero et al., 2009, 2016), target constructs of self-regulation (Murray et al., 2022), types of outcome measurements (Murray et al., 2022; Piquero et al., 2009), and structural conditions (Piquero et al., 2009, 2016). Based on recent studies, psychosocial interventions for improving\u0026nbsp;children\u0026rsquo;s self-regulation can be categorized by intervention level (universal or targeted), age of the target receivers, intervention method (cognitive-behavioral approach, curriculum-based instructions, social activities, group counseling, and others), and intervention setting (schools, community institutions, correctional institutions, home, clinics, and others).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eIntervention Level\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInterventions for the general population should focus on developing self-regulation. Specific treatments target individuals with socioemotional and behavioral issues such as peer relationship problems, school adjustment challenges, addiction, aggression, and delinquency as well as environmental risk factors such as inadequate parenting and educational support. Pandey et al. (2018) reviewed the effectiveness of universal interventions for children aged 2\u0026ndash;17 years and found generally favorable results, though the specific approaches\u0026rsquo; moderating effects were unclear. These interventions also positively impacted academic performance, health, and behavioral issues. Murray et al. (2016b) reported that interventions targeting the universal population for children aged three and older generally had small to medium effect sizes. A more recent study by Murray et al. (2022) analyzed interventions from universal (Tier 1) to clinical (Tier 3) levels and found significant effects on emotional regulation in at-risk groups, highlighting the need for further research to optimize intervention elements for specific targets and goals.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eExplicit Skills Instruction\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eExplicit skills instruction is a frequently adopted methodological approach for improving\u0026nbsp;children\u0026rsquo;s\u0026nbsp;self-regulation (Murray et al., 2016a). Explicit skills instruction typically focuses on training specific self-regulatory skills and strategies via direct instruction and practice. The targets of these instructions are predominantly categorized into (1) cognitive facets of executive function such as attentional regulation, working memory, and response inhibition (Hannesdottir et al., 2017)\u0026nbsp;and (2) problem-solving or self-management strategies.\u0026nbsp;Training on relatively more practical self-regulatory strategies such as time management, interpersonal problem-solving, controlling self-destructive behaviors, and emotional reactions is broadly provided for receivers of all ages and intervention levels (Hautakangas et al., 2022). For preschool children, explicit\u0026nbsp;skills instruction is typically provided through various playful activities requiring scaffolding and social interaction. A renowned program for preschool children, Tools of the Mind (Bodrova \u0026amp; Leong, 2019), stresses teachers\u0026rsquo; verbal guide, use of materials, and modeling for self-regulatory behaviors in various play situations such as self-talk and internalization of roles in a specific social context. Zimmerman (2002) suggested a model of self-regulated problem-solving in adolescence, highlighting the importance of explicit training at each stage. The explicit approach aims to convert the effortful and conscious exertion of the self-regulatory strategy phase to the automatization phase.\u003c/p\u003e\n\u003cp\u003eThe effectiveness of this approach, particularly its effects on each age group and intervention level, has not yet been sufficiently identified. Pandey et al. (2018) identified the effects of curriculum-based interventions involving\u0026nbsp;explicit\u0026nbsp;skills instruction, reporting the smallest effect size (\u003cem\u003ed\u0026nbsp;\u003c/em\u003e= 0.34; 95% confidence interval [CI] [0.17, 0.5]) of all the identified intervention types. However, they did not clearly identify whether other types of interventions such as mindfulness and family-based interventions also embed\u0026nbsp;explicit\u0026nbsp;skills instruction, limiting their studies to those reporting performance-based assessment. Murray et al. (2016b) evaluated the effects of\u0026nbsp;explicit\u0026nbsp;skills instruction and reported positive outcomes, although they did not investigate the moderating effect of\u0026nbsp;this approach. This study investigated the moderating effect of explicit skills instruction on improving self-regulation in children.\u0026nbsp;Most of the skills instruction included in this study was implemented based on a cognitive-behavioral approach; otherwise, the authors adhered to their traditional school instruction formats designed and delivered by teachers.\u003c/p\u003e\n\u003cp\u003eApproaches without any\u0026nbsp;explicit\u0026nbsp;skills instruction\u0026nbsp;such as\u0026nbsp;physical exercises, art therapy, role-playing, and play therapy\u0026nbsp;resemble typical school environments in which self-regulation is not a regular subject\u0026nbsp;directly\u0026nbsp;taught in a classroom but instead learned via academic learning experiences and social interactions (Schunk et al., 2022).\u0026nbsp;The activities used in this type of approach, particularly those outside\u0026nbsp;regular routines, can help use or acquire advanced (mostly top-down) processes and new self-regulation strategies (Norman \u0026amp; Shallice, 1986).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSocial Skills Interventions\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIntervening in the social aspects of self-regulation is another major approach to self-regulation interventions. Social skills interventions for\u0026nbsp;children\u0026nbsp;typically involve (1)\u0026nbsp;explicit\u0026nbsp;skills instruction or coaching regarding social skills, (2) modeling, (3) paired or group activities, and (4) reinforcement by providing feedback and rewards (Smith et al., 2010). In an earlier analysis (Piquero et al., 2009), social skills development programs were the most common type of self-regulation intervention in the selected studies. Such intervention is based on how self-regulation is activated and acquired in a social context (Baumeister \u0026amp; Vohs, 2007). For this, an individual must intentionally adjust their emotions, thoughts, behaviors, and motives to the surrounding environment and their interactions with others (i.e., intrinsic regulation). This is partially regulated by their social interactions (i.e., extrinsic regulation), including scaffolding, empathizing, directly teaching relevant skills, and modeling, which are mostly provided by caregivers, specifically in early developmental stages (Murray et al., 2016b). The effectiveness of interventions on\u0026nbsp;social\u0026nbsp;aspects of self-regulation has been proved by several recognizable programs\u0026nbsp;(Bierman et al., 2019;\u0026nbsp;Rich et al., 2019;\u0026nbsp;Wenz-Gross et al., 2018), even in participants with neurodevelopmental or pediatric mental disorders (Hannesdottir et al., 2017; Idris et al., 2022; Laugeson \u0026amp; Ellingsen, 2014).\u003c/p\u003e\n\u003cp\u003eAn earlier meta-analysis (Piquero et al., 2009) examined the effectiveness of social skills instruction in improving self-control in children aged 10 years or younger and reported a non-significant effect size.\u0026nbsp;In a systematic review, Murray et al. (2016b) identified that over half of the interventions for preschoolers focused on education and training for parents and teachers to help them learn how to provide\u0026nbsp;children\u0026nbsp;with opportunities to acquire\u0026nbsp;self-regulatory skills, although the proportion sharply dropped to approximately 30% for elementary students and to almost none in high school students and young adults. Pandey et al. (2018) analyzed the effects of family-based interventions and reported that more than half of the included studies showed positive outcomes for self-regulation and other related functions such as academic performance and social skills. However, the investigation on\u0026nbsp;the interventions\u0026nbsp;targeting\u0026nbsp;social competence enhancement\u0026nbsp;has been insufficient despite their importance, specifically in South Korea.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSetting\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSchools\u0026nbsp;are the most common setting in which the\u0026nbsp;diverse range of psychosocial interventions for\u0026nbsp;children are provided\u0026nbsp;(Murray et al., 2022; Pandey et al., 2018; Piquero et al., 2009; van Genugten et al., 2017). Pandey et al. (2018) reported that the effect size of school-based self-regulation interventions measured by performance-based assessments was the smallest among all types. Piquero et al. (2016) also suggested that school-based interventions are more prevalent than clinical interventions, albeit with considerable heterogeneity and non-significant moderating effects. The setting is also related to the intervention level since most school-based interventions involve both universal and at-risk receivers, while institutions such as clinics and correctional institutions typically comprise\u0026nbsp;children\u0026nbsp;with high-risk and severe symptoms. Although we excluded participants with a premorbid diagnosis or clinical level of symptoms, the spectrum of difficulties regarding self-regulation deficits may vary according to the setting.\u003c/p\u003e\n\u003cp\u003eThis study focused on the moderating effect of the core elements mentioned above on self-regulation development. Notably, this study found few methodologically rigorous studies targeting caregivers. Hence, investigating the effectiveness of treating extrinsic regulation was unfeasible.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRelevant Studies Targeting South Korean\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eChildren\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe previous reviews discussed above were mainly limited to American and European populations, with relatively small samples of Asians; hence, South Korean studies have not been addressed in most of the comprehensive analyses. This may be because most South Korean studies (more than 80% of the studies identified in this review) were not published in English. Community institutions and national-level school-based self-regulation interventions have been implemented in South Korea. Most recognizable programs target either the treatment or the prevention of specific behavioral problems (Won et al., 2015)\u0026nbsp;such as Internet addiction (Kim et al., 2017) and bullying (Sung et al., 2020) rather than promoting self-regulation development in the universal population. Shin (2021) examined the effectiveness of psychosocial interventions targeting South Korean juvenile offenders and reported an overall large effect size (\u003cem\u003eg\u003c/em\u003e = 1.12), with most\u0026nbsp;of the\u0026nbsp;psychosocial interventions\u0026nbsp;adopting cognitive-behavioral approaches or art therapies administered in a group session. In their meta-analytic review of targeted interventions for adolescents with Internet addiction, Kwon\u0026nbsp;and Jang\u0026nbsp;(2016) reported outcomes favoring the experimental groups, with significantly higher effect sizes found in cognitive-behavioral approaches and coping strategy training. Another notable trend found in the South Korean literature is that self-regulation in academic skills, including academic self-regulation and self-regulated learning (Lee, 2011), has been highlighted, while the other aspects of self-regulation have been relatively disregarded. This may be aligned with the tendency for academic achievement to be prioritized above the mental health issues of South Korean adolescents (So \u0026amp; Kang, 2014).\u003c/p\u003e\n\u003cp\u003eTo the best of our knowledge, comprehensive analytic reviews of universal and targeted interventions for improving the integrated self-regulation of South Korean\u0026nbsp;children\u0026nbsp;have not been published; hence, the evidence base for the intervention approach remains inadequate.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe Present Meta-Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis is the first comprehensive review of the effectiveness of self-regulation interventions for South Korean\u0026nbsp;children\u0026nbsp;and the potential moderators. This study aimed to examine effective practices of self-regulation interventions applicable to the South Korean population and suggest implications for interventions for the self-regulation of\u0026nbsp;children\u0026nbsp;across cultures and ethnicities.\u0026nbsp;In response, we present the results from a meta-analysis of randomized controlled trials and quasi-experimental trials that confirmed the effectiveness of psychosocial interventions targeting the enhancement of children\u0026rsquo;s self-regulation and examined the significant moderators, including intervention level, intervention type, setting, and structural and participants\u0026rsquo; characteristics. We only examined the immediate effects since fewer trials reported the effects\u0026nbsp;measured at a follow-up\u0026nbsp;of\u0026nbsp;more than a month\u0026nbsp;(\u003cem\u003eN\u0026nbsp;\u003c/em\u003e= 2).\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eLiterature Search\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe studies were identified through a search of databases, including RISS, KISS, DBpia, the National Assembly Digital Library, Google Scholar, and Dcollection (dissertation database). The search terms and their variants were self-regulation, self-control, intervention, treatment, program, and training. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) search protocol (Moher et al., 2009),\u0026nbsp;we screened and assessed the identified studies for eligibility using the inclusion and exclusion criteria\u0026nbsp;described in Fig. 1.\u0026nbsp;As this study only used previously published data, no ethical guidelines needed to be followed.\u003c/p\u003e\n\u003cp\u003e(Insert Fig. 1 about here)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion and Exclusion Criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBased on the population, intervention, comparison, outcomes, and study design (PICOS) criteria (Tacconelli, 2010), the studies were assessed as eligible if they met the following inclusion criteria: (1) South Korean population aged 3\u0026ndash;18 years without diagnosis of neurodevelopmental disorders, mental health disorders, or medical conditions/exposure to medication that could affect the mental state; (2) trials were administered from 2000 to 2022; (3) trials involved control or comparison groups that received the regular curriculum exclusively in school settings; and (4) outcome variable was self-regulation, measured by at least one of self-report, teacher report, parent report, clinical assessment, and task performance. Regarding the comparison and study design criteria, as most of the interventions run in preschools and schools involved preexisting classrooms rather than the randomized allocation of participants and control groups that received instructions following the regular curricula, these school-based interventions were included in the quasi-experimental designs.\u003c/p\u003e\n\u003cp\u003eStudies were excluded if (1) participants were not South Korean; (2) the study was\u0026nbsp;neither a doctoral dissertation nor published in a peer-reviewed journal; (3) only the focal components of self-regulation (e.g., emotional regulation) were included in the outcomes; (4) the description on the interventions was insufficient for coding; (5) the outcome assessment tools were not validated by more than one validation study with the South Korean population; (6) they were a quasi-experimental trial, but the baseline differences between the experimental and control groups were not verified or the outcome data were not adjusted to address the imbalance; and (7) spiritual or religious activities were the major elements of the intervention.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCoding for Moderators\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe studies included in the final screening were coded according to intervention level, intervention\u0026nbsp;type, and setting as well as five continuous variables (see below).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eIntervention Level\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe studies were categorized as universal or targeted interventions based on the characteristics of the target participant and intervention aims. Universal interventions targeted children who have not reported mental health issues or considerable adversities and aim to promote self-regulation. Targeted interventions were delivered to at-risk\u0026nbsp;children\u0026nbsp;who reported subclinical levels of problems such as internalizing\u0026nbsp;or externalizing behaviors and primarily aimed to treat the problems by improving self-regulation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eIntervention Type\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTwo of the most common intervention types, namely,\u0026nbsp;explicit skills instruction and social skills interventions, were coded as either\u0026nbsp;\u0026ldquo;yes\u0026rdquo;\u0026nbsp;or \u0026ldquo;no\u0026rdquo;. Studies were coded as\u0026nbsp;\u0026ldquo;yes\u0026rdquo; for\u0026nbsp;explicit\u0026nbsp;skills instruction if the intervention included all the following components: (1)\u0026nbsp;explicit\u0026nbsp;instructions on self-regulatory skills, (2) skills practice, and (3) instructor feedback. Studies were coded as\u0026nbsp;\u0026ldquo;yes\u0026rdquo;\u0026nbsp;for social skills interventions if the intervention met all the following criteria:\u0026nbsp;(1)\u0026nbsp;mainly targeting\u0026nbsp;social skills\u0026nbsp;improvement, (2) modeling, (3) paired or group activities, and (4) providing feedback and rewards. In other words, interventions that only\u0026nbsp;included group sessions\u0026nbsp;did not meet the inclusion criteria for social skills interventions because their structures are not necessarily linked to active social learning. The coders referred primarily to the intervention protocols and descriptions of the procedures provided by the authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSetting\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe setting was coded as preschools and\u0026nbsp;schools, community institutions, and correctional institutions. As trials conducted at home or in clinics were insufficient, the moderating effects of these two types of settings were excluded.\u0026nbsp;Preschools and schools, including preschools and elementary, middle, and high schools, provide the national curriculum. Correctional institutions are facilities for special education for juvenile offenders. Community institutions include the other educational facilities that provide extra care, mostly run by community members as part of the government\u0026rsquo;s welfare service.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eContinuous Variables\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAge, total number of sessions, number of sessions per week, duration per session (min), and group size were coded as continuous variables. If participants\u0026rsquo; ages were heterogeneous, the mean age was used. Group size indicates the number of participants who simultaneously participated in the session.\u0026nbsp;Studies that did not identify these variables were excluded from the analysis; fewer than 12% of the studies were excluded owing to the absence of these variables.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEffect Size and Meta-Regression Analyses\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe pooled effect sizes\u0026nbsp;of the immediate post-intervention outcomes\u0026nbsp;between the studies were calculated using Hedges\u0026rsquo; \u003cem\u003eg\u003c/em\u003e, the standardized mean differences (Hedges \u0026amp; Olkin, 1985)\u0026nbsp;with the random effects model, which is used when the included studies are heterogeneous in population and measurements (Borenstein et al., 2010). If a study provided multiple outcomes such as the emotional regulation score, behavioral regulation score, and cognitive regulation score or multiple treatment groups with one control group, the synthesized effect size within the study was calculated\u0026nbsp;(Cheung, 2019); otherwise, only the total score was used. The \u003cem\u003ez\u0026nbsp;\u003c/em\u003escore was used to prove the significance of the effect sizes. The significance of the heterogeneity within or between the studies was assessed using \u003cem\u003eQ\u0026nbsp;\u003c/em\u003estatistics. A probability level of 0.05 was used to assess significance. A 95% CI was calculated for each effect size. Comprehensive Meta-Analysis Software version 4 was used for the calculations.\u0026nbsp;Meta-regression analyses using a random effects model were performed on the five continuous variables.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRisk of Bias Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePublication bias refers to distortions in reviews caused by the tendency that studies with significant outcomes may be more published than studies with null outcomes or several characteristics regarding experimental design, such as a small sample size and delayed outcome measurement at follow-up (Thornton \u0026amp; Lee, 2000). We assessed the risk of bias using a funnel plot, Duval and Tweedie\u0026rsquo;s (2000) trim-and-fill test, Egger\u0026rsquo;s regression test (Sterne \u0026amp; Egger, 2005), and the fail-safe \u003cem\u003eN\u003c/em\u003e test (Orwin, 1983;\u0026nbsp;Rosenthal, 1979). Funnel plots can\u0026nbsp;detect possible reporting bias (Sterne \u0026amp; Egger, 2001); however, the graphical asymmetry of the plot requires further investigation and cautious interpretation, particularly when the analysis includes fewer small trials (Egger et al., 1997). Egger\u0026rsquo;s regression test, which is regarded as an objective test to verify asymmetry in the funnel plot and capture small-study effects (Sterne \u0026amp; Egger, 2005), was administered. Additionally, to estimate the effects of potential bias on the actual effect sizes, the outcome was adjusted by adding the potential missing studies to the actual effect size using the trim-and-fill test (Duval \u0026amp; Tweedie, 2000). A fail-safe \u003cem\u003eN\u003c/em\u003e test was also conducted on the estimated number of unpublished studies to make the actual effect size non-significant (Orwin, 1983). Rosenthal (1979) suggested the statistical criterion of 5\u003cem\u003ek\u003c/em\u003e+10 (\u003cem\u003ek\u003c/em\u003e = the number of included studies), a figure less than which indicates concerns about the risk of publication bias. The alpha value was set at 0.05 overall.\u003c/p\u003e\n\u003cp\u003eThe risk of bias was assessed using five criteria of the Risk of Bias 2 tool (Sterne et al., 2019) that examined potential biases arising from (1) the randomization process, (2) deviations from intended interventions, (3) missing outcome data, (4) the measurement of the outcome, and (5) the selection of the reported result. For each criterion, studies were assessed as low risk, some concerns, or high risk based on the guidelines.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003eStudies\u0026rsquo; Characteristics\u003c/h2\u003e \u003cp\u003eSupplementary Table\u0026nbsp;1 summarizes the descriptive statistics of the included studies. A total of 35 studies with 1,624 samples were included in the final analysis. Most studies were published in the last decade (85.7%). The mean age of the participants was 12.87 and school-aged children were the targets of more than two-thirds of the studies (74.3%). Regarding intervention level, universal interventions accounted for slightly more than half of the studies (54.3%). Sixty percent of the studies involved explicit skills instruction and 45.7% focused on social skills interventions. Almost two-thirds of the trials were conducted at schools and preschools (65.7%), followed by community institutions (20%) and correctional institutions (14.3%). The average total number of sessions was 12.37 and most interventions were provided once or twice a week (68.6%). The average duration per session was 65.3 minutes and approximately one-third of the interventions lasted 30 minutes to an hour in each session (34.3%). Most trials were provided to a group of more than seven participants (80%) and the average group size was 12.5. Self-reporting (71.4%) was the most common method of outcome measurement, followed by teacher reporting (20%). As the trials targeting younger participants mostly adopted teacher reports and the number of studies that used performance-based assessment was insufficient (\u003cem\u003eN\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3), the analysis of the moderating effect of outcome measurement was excluded (see Supplementary Table\u0026nbsp;2 for a list of the included studies).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eMeta-Analytic Results\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the overall effect size (\u003cem\u003eg\u003c/em\u003e) was 0.767 (95% CI [0.628, 0.906]), which ranged from zero (\u003cem\u003ez\u003c/em\u003e\u0026thinsp;=\u0026thinsp;10.811, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) to medium in magnitude, according to Cohen\u0026rsquo;s standard (Cohen, 1992). Notably, this was larger than those found by Murray et al. (2022) (\u003cem\u003eg\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.15 for self- and other-report assessments) and Piquero et al. (2009) (\u003cem\u003eg\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.60 for self-reporting and \u003cem\u003eg\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.28 for teacher reporting). However, as comparable effect sizes in the field are still insufficient, their magnitude must be noted solely as a technical interpretation (Brydges, 2019). Considering that the level of heterogeneity was also significant (\u003cem\u003eQ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;89.147, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), the effect size must be explained with caution and the presence of potential moderators that may cause deviations in the outcomes is indicated.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eResults of the Meta-Analysis\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003ek\u003c/em\u003e (\u003cem\u003en\u003c/em\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eg\u003c/em\u003e (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003ez\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eQ-\u003c/em\u003ewithin\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eQ-\u003c/em\u003ebetween\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35 (1,624)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.767\u003c/p\u003e \u003cp\u003e[0.628, 0.906]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10.811***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e89.147***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eIntervention level\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUniversal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19 (1,005)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.959\u003c/p\u003e \u003cp\u003e[0.809, 1.109]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.53***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e23.548\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e8.623**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTargeted\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (619)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.567\u003c/p\u003e \u003cp\u003e[0.352, 0.781]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.179***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e52.052***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eExplicit skills instruction\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21 (1,176)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.782\u003c/p\u003e \u003cp\u003e[0.602, 0.961]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.552***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e45.191***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e10.957\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (448)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.747\u003c/p\u003e \u003cp\u003e[0.506, 0.987]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.092***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e43.418***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eSocial skills interventions\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (812)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.043\u003c/p\u003e \u003cp\u003e[0.884, 1.201]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.88***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e29.449*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e13.261***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19 (812)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.597\u003c/p\u003e \u003cp\u003e[0.418, 0.777]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.514***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e49.644***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eSetting\u003csup\u003ed\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePreschools and schools\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23 (1,174)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.910\u003c/p\u003e \u003cp\u003e[0.771, 1.049]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.85***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e35.377*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e12.61**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCorrectional institutions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (160)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.456\u003c/p\u003e \u003cp\u003e[0.132, 0.781]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.756**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8.356\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCommunity institutions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (290)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.489\u003c/p\u003e \u003cp\u003e[0.246, 0.732]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.94***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8.078\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eContinuous variables\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003ek (n\u003c/em\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCoefficient (\u003cem\u003eSE\u003c/em\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cem\u003eQ\u003c/em\u003e (\u003cem\u003ep\u003c/em\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35 (1,624)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.023 (0.014)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e[-0.051, 0.006]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e2.47 (0.1159)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eDuration per session (min)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33 (1,541)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.000 (0.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e[-0.002, 0.002]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.06 (0.8000)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eTotal number of sessions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35 (1,624)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.009 (0.006)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e[-0.021, 0.002]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e2.45 (0.1180)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eNumber of sessions per week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31 (1,395)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.041 (0.061)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e[-0.162, 0.079]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.45 (0.5030)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eGroup size\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33 (1,398)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.025 (0.009)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e[0.007, 0.043]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e7.08 (0.0078)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u003cem\u003eNote\u003c/em\u003e. \u003cem\u003ek\u003c/em\u003e\u0026thinsp;=\u0026thinsp;number of studies, \u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;number of samples, \u003cem\u003eg\u003c/em\u003e\u0026thinsp;=\u0026thinsp;Hedges\u0026rsquo; \u003cem\u003eg\u003c/em\u003e, CI\u0026thinsp;=\u0026thinsp;confidence interval, N/A\u0026thinsp;=\u0026thinsp;not available, \u003cem\u003eSE\u003c/em\u003e\u0026thinsp;=\u0026thinsp;standard error, \u003cem\u003eQ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;\u003cem\u003eQ\u003c/em\u003e statistic, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.1 *\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05. **\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01. ***\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u003csup\u003ea\u003c/sup\u003eIntervention level indicates the tiers of the interventions; universal interventions target the general population without a clinical level of mental problems, while targeted interventions target participants with symptoms requiring specialized or more intensive care.\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u003csup\u003eb\u003c/sup\u003eThe interventions were divided into those containing explicit skills instruction, where self-regulation strategies were taught directly via explanations, worksheets, and media aids, and those excluding them.\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u003csup\u003ec\u003c/sup\u003eStudies were coded as \u0026ldquo;yes\u0026rdquo; for social skills interventions if the interventions mainly targeted social skills and involved modeling, paired or group activities, and providing feedback and rewards.\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u003csup\u003ed\u003c/sup\u003ePreschools and schools, including preschools and elementary, middle, and high schools, provide the national curriculum. Correctional institutions are facilities for special education for juvenile offenders. Community institutions include the other educational facilities that provide extra care, mostly run by community members as part of the government\u0026rsquo;s welfare service.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e(Insert Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e near here)\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eBias Assessment\u003c/h3\u003e\n\u003cp\u003eAccording to the risk of bias assessment, 12 studies (34.4%) contained sufficient randomization processes, while in 11 studies, some concerns arose, as they partially reported on the blinded allocation of the participants but verified the non-significant baseline difference between the groups. Two of the included studies contained a high risk of bias in randomization, as the allocation was concealed; however, the process was not adequately explained and the baseline difference between the groups was not estimated. All the studies except one showed adequate implementation of the intended intervention. Regarding attrition bias, 23 studies (65.7%) reported the final results with adequate control of attrition bias, although 12 studies reported missing data of less than 5\u0026thinsp;~\u0026thinsp;10% primarily owing to dropouts, raising some concerns. Ten studies (28.6%) showed some concerns in the measurement of the outcome, as they partially reported blinding in teacher reporting or performance-based assessments, and the remaining studies that used self-report measurement indicated a high risk of bias. Notably, most South Korean studies reviewed in the screening process and included in the final analysis used self-reporting as a primary outcome assessment tool. Although the tools were all validated in a domestic population, the measurements were subjective and unblinded, indicating potential bias. Thirty-two studies (91.4%) had an adequate selection of the reported results, indicating a low risk of bias.\u003c/p\u003e \u003cp\u003eTypically, the publication bias test revealed a non-significant bias. As the funnel plot showed asymmetry, we conducted Duval and Tweedie\u0026rsquo;s trim-and-fill test (Duval \u0026amp; Tweedie, 2000) and Egger\u0026rsquo;s regression test (Sterne \u0026amp; Egger, 2005) to detect publication bias. The results revealed seven missing studies, and the adjusted effect size dropped from \u003cem\u003eg\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.767 to 0.643 (95% CI [0.497, 0.789]) but was still significant. The result of Egger\u0026rsquo;s regression test also indicated marginal effects of potential publication bias (intercept = -0.0765, 95% CI [-1.146, 0.993], \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05). The fail-safe \u003cem\u003eN\u003c/em\u003e test showed that the number of potentially missing studies was 2,777, which exceeded 185, the standard figure suggested by Rosenthal (1979), again supporting the acceptable quality of the current analysis.\u003c/p\u003e\n\u003ch3\u003eModerators\u003c/h3\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eIntervention Level\u003c/h2\u003e \u003cp\u003eBoth the universal (\u003cem\u003ez\u003c/em\u003e\u0026thinsp;=\u0026thinsp;12.53, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and the targeted (\u003cem\u003ez\u003c/em\u003e\u0026thinsp;=\u0026thinsp;5.179, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) interventions were effective in improving self-regulation, although the universal interventions showed significantly better outcomes (\u003cem\u003eg\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.959; 95% CI [0.809, 1.109]) than the targeted interventions (\u003cem\u003eg\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.567; 95% CI [0.352, 0.781]; \u003cem\u003eQ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;8.623, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01). Furthermore, we found significant heterogeneity only in the targeted interventions (see Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eExplicit Skills Instruction\u003c/h3\u003e\n\u003cp\u003eExplicit skills instruction was generally effective (\u003cem\u003ez\u003c/em\u003e\u0026thinsp;=\u0026thinsp;8.552, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) but not a significant moderator overall (\u003cem\u003eQ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;10.957, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.819). Furthermore, the considerable heterogeneity of this approach was observed in both the universal and the targeted interventions.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eSocial Skills Interventions\u003c/h2\u003e \u003cp\u003eSocial skills interventions were effective (\u003cem\u003ez\u003c/em\u003e\u0026thinsp;=\u0026thinsp;12.88, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) but showed significant heterogeneity (\u003cem\u003eQ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;29.449, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). They also showed remarkably large effect sizes (\u003cem\u003eg\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.043, 95% CI [0.884, 1.201]) and significant moderating effects (\u003cem\u003eQ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;13.261, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Other interventions that did not focus on social skills were also effective (\u003cem\u003ez\u003c/em\u003e\u0026thinsp;=\u0026thinsp;6.514, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), although the effect size was smaller (\u003cem\u003eg\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.597, 95% CI [0.418, 0.777]). The effect sizes were also remarkable in interventions with combined explicit skills instruction and social skills interventions (\u003cem\u003eN\u003c/em\u003e\u0026thinsp;=\u0026thinsp;8; \u003cem\u003eg\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.989, 95% CI [0.728, 1.250]). Conversely, interventions that targeted neither of these approaches showed significant but relatively small effect sizes (\u003cem\u003eN\u003c/em\u003e\u0026thinsp;=\u0026thinsp;6; \u003cem\u003eg\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.478, 95% CI [0.112, 0.843]).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSetting\u003c/h3\u003e\n\u003cp\u003eThe interventions in all three settings showed significant effect sizes (preschools and schools, \u003cem\u003ez\u003c/em\u003e\u0026thinsp;=\u0026thinsp;12.85, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001; correctional institutions, \u003cem\u003ez\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2.756, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01; community institutions, \u003cem\u003ez\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3.94, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and the moderating effect was also significant (\u003cem\u003eQ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;12.61, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01). Preschools and schools were the most common settings (\u003cem\u003eN\u003c/em\u003e\u0026thinsp;=\u0026thinsp;23, 65.7%) and they showed the largest effect size (\u003cem\u003eg\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.910, 95% CI [0.771, 1.049]) as well as significant heterogeneity (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e\n\u003ch3\u003eContinuous Variables\u003c/h3\u003e\n\u003cp\u003eOf the continuous variables, only group size showed a significant but marginal positive correlation with effect size (coeff\u0026thinsp;=\u0026thinsp;0.025, \u003cem\u003eQ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;7.08, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.0078), indicating that interventions with larger group sizes demonstrated slightly greater effect sizes. As most school-based interventions involved the whole class with a relatively large number of participants, we examined the correlations within each setting. The results showed a positive correlation between group size and effect size exclusively within preschools and schools (coeff\u0026thinsp;=\u0026thinsp;0.033, \u003cem\u003eQ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;10.76, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001). Additionally, for intervention level, the significant correlation between group size and effect size was primarily driven by universal interventions (coeff\u0026thinsp;=\u0026thinsp;0.034, \u003cem\u003eQ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;5.23, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.022) and none of the continuous variables showed any significance when the intervention targeted the at-risk population.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis meta-analysis aimed to examine the effectiveness of psychosocial interventions targeting self-regulation among children aged 3\u0026ndash;18 years in South Korea. The results based on 35 studies showed that the interventions were overall effective at immediate post-intervention outcome measurement, which were mostly based on self-reporting or teacher reporting. The overall effect size must be interpreted carefully because of the significant heterogeneity. To the best of our knowledge, this comprehensive analysis is the first to establish evidence bases for self-regulation interventions for South Korean children; hence, the availability of findings to make relevant comparisons is limited. However, compared with the results of studies on the global population, the effect size in this analysis was greater, while the considerable heterogeneity found was congruent with previous findings (Murray et al., 2022; Pandey et al., 2018; Piquero et al., 2009, 2016). However, only two studies reported outcomes at follow-up and we could not verify the long-term effects of the interventions. One of the few relevant studies on delayed outcomes (van Genugten et al., 2017) reported statistically significant long-term effects (longer than six months) of teaching self-regulation techniques on self-esteem in their meta-analysis, although the exact approaches that led to the lasting effects were not distinctly identified and the effect size was small. Pandey et al. (2018) suggested that more than half of the family-based interventions included in their analysis showed positive changes in self-regulation over an extended period compared with other intervention types. Considering that interventions aim to produce lasting positive changes in self-regulation, future research should focus on outcomes at follow-up.\u003c/p\u003e \u003cp\u003eUniversal interventions were slightly more prevalent than targeted interventions in our review, which aligns with earlier reports (Murray et al., 2016a, 2022). Notably, the interventions benefited at-risk children; however, their effectiveness was not greater than that in the general population. Additionally, the interventions implemented in correctional institutions, wherein most participants reported relatively severe risk factors, showed the smallest effect size. Although other moderators may exist, these results could indicate a negative correlation between the severity of the risk factors and intervention\u0026rsquo;s effectiveness. Piquero et al. (2016) found a significant moderating effect of intervention level. They reported that both universal and targeted interventions for improving self-regulation were effective for children under 10 years, with the effect sizes higher for universal interventions than for targeted interventions. Notably, the significant moderators in the overall sample in their analysis did not show consistent moderating effects within the targeted population. Furthermore, remarkable heterogeneity was observed in targeted interventions but not in universal interventions. The heterogeneity in the severity of reported behavioral and socioemotional problems and types of environmental risk factors within the targeted population may have contributed to the inconsistent outcomes. Several mental health problems among adolescents can share similar mechanisms of self-regulation failure (Baumeister \u0026amp; Heatherton, 1996), while, simultaneously, each can arise from more specific deficits in certain self-regulatory skills or adverse conditions that must be prioritized such as poor anger management and time management skills in academic settings. Hence, whether the activities and skills targeted in the intervention meet individual needs could moderate the effect and result in a significant variance in the outcomes. The results suggest the importance of tailoring approaches according to the intervention level, with a comprehensive assessment of the specific problems and deficits in self-regulatory skills reported by target participants in the pre-intervention stage. Regarding the mechanism of self-regulation, this may also be due to the relatively high resistance to change presented by the targeted participants, who had already reported more than one difficulty regarding self-regulation. Baumeister and Heatherton (1996) suggested the mechanism of self-regulation failure, borrowing the concept \u0026ldquo;inertia\u0026rdquo; from physics; if one fails to prevent or correct uncontrolled behaviors in the early stages, it becomes more challenging to improve one\u0026rsquo;s behavior later. This suggests the importance of early intervention before a pattern causes non-regulatory behavior and gains momentum.\u003c/p\u003e \u003cp\u003eExplicit skills instruction was effective for both universal and targeted interventions. This result aligns with previous findings that skills instruction is generally effective and recommended for treating children\u0026rsquo;s self-regulation (Murray et al., 2016b, 2022; Pandey et al., 2018; Piquero et al., 2009). However, explicit skills instruction was not a significant moderator and heterogeneity was considerable. One possible source of such variance is the methods used as adjuncts to skills instruction. The skills instruction included in this study involved diverse activities, materials, and structural conditions. Regarding the target domains of skills instruction, training on the cognitive sub-skills of executive function (e.g., attention regulation training for preschool children) and self-regulation strategies (e.g., regulating anger) were included in this study, which could also contribute to the notable inconsistency in the outcomes. We could not verify the variance in the effectiveness of these two approaches owing to fewer interventions for discrete executive functions (\u003cem\u003eN\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3). Further trials must confirm the most suitable methods combined with explicit skills instruction for specific intervention targets.\u003c/p\u003e \u003cp\u003eSocial skills interventions were typically effective and significantly moderated these effects. These favorable outcomes support the findings of previous meta-analyses (Murray et al., 2016b; Pandey et al., 2018). Further, the moderating effect was consistent regardless of intervention level. Social skills interventions that focus on teaching social skills explicitly using instruction or group problem-solving activities may enhance social relationships and perceptions of social support, operating as potential therapeutic factors for improving goal-directed behaviors (Hofmann et al., 2015). Additionally, the improvement in self-regulatory strengths reported via self-report assessments may indicate that self-esteem, self-efficacy, and the motivation for the willful exertion of self-regulation have increased (Crocker et al., 2006; Leary, 2004), likely led by positive social interactions and social skills enhancement (Bijstra \u0026amp; Jackson, 1998; Harrell et al., 2009; Mohamed \u0026amp; Shehata, 2023; Seema \u0026amp; Kumar, 2018). Furthermore, as most outcome measurements were not limited to interpersonal self-regulatory skills, the effects of the social competence interventions could be transferred to other aspects of self-regulation. However, few studies have targeted both children and their caregivers, which is an essential aspect of self-regulation development. This feature distinguishes South Korean studies from previous studies across nations (Murray et al., 2016b). Carlson (2009) suggested the need to examine the cultural context when teaching children self-regulation skills in schools and at home, as the prominent perceptions of how self-regulation is nurtured and activated can largely depend on unique cultural values and educational policies. Our results indicate that the significance of caregivers\u0026rsquo; external regulation in developing self-regulation is relatively less stressed and that educational methods and programs focusing on nurturing self-regulation must be discussed in South Korea. In exploring South Korean preschool teachers\u0026rsquo; perspectives on self-regulation education, Chi (2016) stressed that the problems related to children\u0026rsquo;s unregulated behaviors may be predominantly owing to a lack of social skills, and self-regulation is directly taught to children or parents exclusively when problematic behaviors manifest, lacking well-organized and planned approaches included in their daily routines. Hence, the majority responded that more theoretically grounded teacher training is required to foster self-regulation. The impacts of external hardship such as low socioeconomic status, insufficient expertise in the region, and dysfunctional families are also neglected in most self-regulation interventions in South Korea. Future studies must investigate the effectiveness of more holistic approaches that encompass nurturing individuals\u0026rsquo; internal self-regulatory strength and the corresponding external support.\u003c/p\u003e \u003cp\u003eNonetheless, our results imply the potential of building substantial social competence and relationships to improve children\u0026rsquo;s self-regulation. Enhanced social bonds and socioemotional skills may be crucial in improving one\u0026rsquo;s perception of self-regulation and the motivation to exert self-regulatory strength.\u003c/p\u003e \u003cp\u003eSchool-based interventions demonstrated the most significant effects of all the settings, accompanied by significant heterogeneity. One possible factor regarding the study design is that a large proportion of school-based trials were quasi-experimental because the interventions were provided to preexisting classroom units without random allocation processes, although the selection of the classes was randomized and the pretest balance was verified. Schools are the recommended settings for psychosocial interventions for the prevention and treatment of children; nevertheless, there are several moderators regarding participant characteristics and program implementation (Paulus et al., 2016; Wilson \u0026amp; Lipsey, 2007). A moderator repeatedly verified in previous reviews was the expertise of providers (e.g., teachers and school counselors), which was closely related to high fidelity in implementing interventions and effectiveness at each intervention level (Franklin et al., 2012, 2017; Han \u0026amp; Weiss, 2005). This study could not analyze the impact of school staff expertise owing to insufficient data. However, given that the school-based interventions included in this review involved both universal and at-risk participants, we conducted a further analysis to verify the moderating effect of intervention level on the outcomes of school-based interventions. The results demonstrated that both universal and targeted interventions proved effective. Although targeted interventions showed lower effect sizes, the difference was not statistically significant. The significant outcomes of the school-based self-regulation interventions demonstrate the possibility of teaching self-regulation within a regular curriculum. The interventions at school that we reviewed often involved the whole classroom, typically with several participants, allowing more flexibility in administering individual, peer, and group activities and providing materials such as worksheets and visual aids similar to instructions for regular subjects. The social aspects of school-based interventions can be another potential advantage in that peer relationships at school can be directly treated and facilitated in the sessions. Consistent with earlier findings, schools can be suitable for administering self-regulation interventions tailored to both universal and targeted populations but further investigations with more rigorous study designs must identify the moderators.\u003c/p\u003e \u003cp\u003eThe correlation between age and intervention outcomes was not significant, consistent with a previous meta-analysis of universal interventions for children aged 2\u0026ndash;17 years reporting no significant association between age and the effects of interventions (Pandey et al., 2018). On the contrary, Piquero et al. (2009) reported that age inconsistently moderated the outcomes based on the types of measurement tools. In clinical assessments, younger participants showed better outcomes, while the trend was reversed in teacher reports and direct observer reports. Investigating the effect of age in each type of measurement was unfeasible in this study, since the types of outcome measurements tended to be adopted based on age, which may act as a potential confounding variable. Future studies should thus investigate the interaction between age and intervention effects while controlling for possible confounders, especially by diversifying the types of outcome measurements.\u003c/p\u003e \u003cp\u003eThe only structural condition that showed a significant correlation with the outcome variable was group size, but this was limited to school-based and universal interventions. This may be related to the larger heterogeneity in the outcomes of targeted interventions and those administered in non-school settings.\u003c/p\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eThe current study has some limitations. First, the effectiveness of interventions targeting caregivers and environmental conditions, which are crucial external elements significantly impacting the self-regulation development of children, was not examined owing to the low number of studies. Although there can be several practical issues in implementation, further experiments need to consider caregivers and the external environment as the major intervention target and compare the effectiveness with treatments involving only children.\u003c/p\u003e \u003cp\u003eSecond, the moderating effect of the outcome measures was not examined because of the tendency of South Korean studies with school-aged children to adopt self-report measures to assess outcomes. Similarly, in studies on preschool children, teacher reporting was the most prevalent assessment type and other types of additional measurements were insufficient, which differs from some earlier reviews targeting the worldwide population (Murray et al., 2022; Pandey et al., 2018). The measurements combined to detect the differences in various aspects of self-regulation need to be considered in future intervention studies.\u003c/p\u003e \u003cp\u003eThird, the long-term effects were not analyzed because of the low number of studies measuring the prolonged effects at follow-up. Future studies must verify the effects at delayed time points, specifically in school settings wherein students are less prone to loss at follow-up.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eDespite these limitations, the current analysis provides practical implications and promotes evidence-based approaches for interventions building lifelong resources. Psychosocial interventions can improve the self-regulation of children, particularly when they promote social competence. The current findings also emphasize the effectiveness of explicit skills instruction in improving self-regulation and the potential benefits of school-based interventions. Future studies must investigate the advantages and moderating effects of interventions targeting the external elements of self-regulation development, including the influence of caregivers and environmental conditions, and their long-term effectiveness using more multifaceted outcome measurements. Furthermore, we call for more comprehensive analyses to establish a substantial evidence base applicable to not only the domestic population but also worldwide.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eReferences marked with an asterisk indicate studies included in the meta-analysis.\u003c/li\u003e\n\u003cli\u003e*Bae, Y., \u0026amp; Baik, J. (2011). The effects of Tea Ceremony Program on self-efficacy and self-control of high school students. \u003cem\u003eYouth Facilities and Environment\u003c/em\u003e, \u003cem\u003e9\u003c/em\u003e(2), 39\u0026ndash;46. https://shorturl.at/54BLL \u003c/li\u003e\n\u003cli\u003eBaumeister, R. 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Conscious self-regulation and self-organization of life during the COVID-19 pandemic. \u003cem\u003ePsychology in Russia\u003c/em\u003e,\u003cem\u003e 13\u003c/em\u003e(4), 168\u0026ndash;182. https://doi.org/10.11621/PIR.2020.0411\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"The Graduate School of Clinical Psychology and Counseling, CHA University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"self-regulation, children, psychosocial intervention, social skills, meta-analysis","lastPublishedDoi":"10.21203/rs.3.rs-6320795/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6320795/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eSelf-regulation is a prominent target of psychosocial interventions for both the prevention and the treatment of children’s mental health issues, as self-regulation in childhood can predict significant outcomes in later life such as academic success and health. This study aimed to verify the effectiveness of psychosocial interventions in improving the self-regulation of South Korean children aged 3–18 years and confirm the significant moderators by considering intervention level, intervention type, setting, and structural and participants’ characteristics. Thirty-five studies reporting on experimental and quasi-experimental trials were included in the analysis; they showed a moderate overall effect size and considerable heterogeneity. We found that intervention level, use of social skills interventions, and setting moderated self-regulation, while using explicit skills instruction was effective but not a significant moderator. Of the five continuous variables examined, only group size showed a significant but marginal positive correlation with the effect size. The results highlight the importance of applying preventative and targeted self-regulation interventions for children by focusing on the social aspects of self-regulation and the potential of school settings. This is the first meta-analytic review to verify the moderating effects of the methods used in self-regulation interventions, including explicit skills instruction and social skills interventions. The results can help build evidence bases for self-regulation interventions for children in South Korea and potentially worldwide. This study has several implications for future studies.\u003c/p\u003e","manuscriptTitle":"Improving Children’s Self-Regulation Through Universal and Targeted Psychosocial Interventions: Meta-Analytic Review of South Korean Studies","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-03-31 11:44:09","doi":"10.21203/rs.3.rs-6320795/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"53f89c33-f591-4d3b-8bcc-0e65ba5290c0","owner":[],"postedDate":"March 31st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":46303534,"name":"Psychology"},{"id":46303535,"name":"School Counseling"},{"id":46303536,"name":"Educational Psychology"}],"tags":[],"updatedAt":"2025-03-31T11:44:09+00:00","versionOfRecord":[],"versionCreatedAt":"2025-03-31 11:44:09","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6320795","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6320795","identity":"rs-6320795","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}