Early health education and cognitive inhibitory control in children: A 20-year pilot study using the go/no-go task in Japan

Noriaki Watanabe¹Masayoshi Kamijyo¹Kazuki Ashida²Fumihito Sasamori³Masao Okuhara⁴suchinda Jarupat Maruo⁵Hisaaki Tabuchi⁶Koji Terasawa^7,8*

• ¹Graduate School of Medicine, Science and Technology, Shinshu Daigaku - Ueda Campus, Ueda, Japan
• ²National Institute of Technology, Nagano College, Nagano Kogyo Koto Senmon Gakko, Nagano, Japan
• ³Faculty of Engineering, Shinshu University, Shinshu Daigaku, Matsumoto, Japan
• ⁴Department of Applied Information Engineering, Faculty of Engineering, Koritsu Suwa Tokyo Rika Daigaku Daigakuin Kogaku Management Kenkyuka, Chino, Japan
• ⁵Mahidol University, Salaya, Thailand
• ⁶Department of Psychology, University of Innsbruck, Universitat Innsbruck, Innsbruck, Austria
• ⁷Faculty of Education and Graduate School of Medicine, Shinshu University, Matsumoto, Nagano-Ken, Japan
• ⁸Shinshu Daigaku, Matsumoto, Japan

Extending healthy life expectancy requires attention not only to physical fitness but also to the development of cognitive self-regulation skills during childhood, which play a critical role in establishing lifelong health behaviors. Early health education has traditionally emphasized physical activity and lifestyle, yet cognitive aspects of self-control and inhibitory processes have received comparatively little attention. Inhibitory control is a central component of executive function, enabling children to regulate impulses, follow rules, and adapt to changing environments. Deficits in this capacity are associated with academic challenges, risk-taking behaviors, and poorer health outcomes later in life. Thus, incorporating assessments of cognitive inhibitory control into early health education may provide valuable insights for both educational and preventive health strategies. This pilot longitudinal study examined the feasibility of using the go/no-go task to assess inhibitory control in children aged 3–14 years in Nagano Prefecture, Japan. Assessments were conducted in 1998, 2008, and 2018, enabling exploration of changes over two decades. The task included three phases—formation, differentiation, and reverse differentiation—allowing for evaluation of both reaction times and error rates as indicators of speed–accuracy trade-offs in inhibitory performance. Results showed that children in 2018 exhibited significantly shorter reaction times but higher error rates compared with those assessed in 2008, suggesting a shift toward prioritizing speed over accuracy. These changes may reflect broader environmental and behavioral influences, such as increased exposure to digital devices, altered patterns of daily activity, or evolving educational contexts. Importantly, these findings indicate that inhibitory control, as captured by a simple cognitive paradigm, can reveal population-level shifts in child development over time. Incorporating cognitive tasks such as the go/no-go paradigm alongside conventional physical fitness testing in school-based health education may therefore enrich understanding of children's self-regulatory capacity. This approach has the potential to strengthen early identification of cognitive and behavioral trends, support tailored educational interventions, and inform broader community health promotion programs. By linking cognitive development with public health practice, it may contribute to strategies aimed at extending healthy life expectancy across the lifespan.