A systematic review and meta-analysis of effects of early life non-cognitive skills on academic, psychosocial, cognitive and health outcomes


Success in school and the labour market relies on more than high intelligence. Associations between ‘non-cognitive’ skills in childhood, such as attention, self-regulation and perseverance, and later outcomes have been widely investigated. In a systematic review of this literature, we screened 9,553 publications, reviewed 554 eligible publications and interpreted results from 222 better-quality publications. Better-quality publications comprised randomized experimental and quasi-experimental intervention studies (EQIs) and observational studies that made reasonable attempts to control confounding. For academic achievement outcomes, there were 26 EQI publications but only 14 were available for meta-analysis, with effects ranging from 0.16 to 0.37 s.d. However, within subdomains, effects were heterogeneous. The 95% prediction interval for literacy was consistent with negative, null and positive effects (−0.13 to 0.79). Similarly, heterogeneous findings were observed for psychosocial, cognitive and language, and health outcomes. Funnel plots of EQIs and observational studies showed asymmetric distributions and potential for small study bias. There is some evidence that non-cognitive skills associate with improved outcomes. However, there is potential for small study and publication bias that may overestimate true effects, and the heterogeneity of effect estimates spanned negative, null and positive effects. The quality of evidence from EQIs underpinning this field is lower than optimal and more than one-third of observational studies made little or no attempt to control confounding. Interventions designed to develop children’s non-cognitive skills could potentially improve outcomes. The interdisciplinary researchers interested in these skills should take a more strategic and rigorous approach to determine which interventions are most effective.

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Fig. 1
Fig. 2: Effect sizes from studies presenting ‘better-quality’ evidence according to outcome.

Data availability

The data used to undertake this systematic review and meta-analysis are freely available from our BetterStart website (https://health.adelaide.edu.au/betterstart/).


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We thank J. Grant, T. Nuske and T. Goodwin for their research assistance in collecting, and initially screening eligibility, and in the preparation of tables and figures. J.L. is funded by a National Health and Medical Research Council of Australia Partnership Project Grant (1056888) and Centre of Research Excellence (1099422). N.D. is supported by the Economics and Social Research Council (ESRC) via a Future Research Leaders Fellowship (ES/N000757/1). The Medical Research Council (MRC) and the University of Bristol fund the MRC Integrative Epidemiology Unit (MC_UU_12013). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. All authors will have access to the data and will take responsibility for the integrity and accuracy of the review.

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L.G.S., A.C.P.S., C.R.C., G.D.S. and J.W.L. conceived the study. L.G.S., A.C.P.S., C.R.C., N.M.D. and J.W.L. screened the literature and extracted the data. L.G.S., A.C.P.S., C.R.C. and N.M.D. analysed the data. J.W.L. led the drafting of the manuscript, with all authors contributing to the interpretation of the findings and writing of the final manuscript.

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Correspondence to John W. Lynch.

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Smithers, L.G., Sawyer, A.C.P., Chittleborough, C.R. et al. A systematic review and meta-analysis of effects of early life non-cognitive skills on academic, psychosocial, cognitive and health outcomes. Nat Hum Behav 2, 867–880 (2018). https://doi.org/10.1038/s41562-018-0461-x

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