اثر توانبخشی شناختی بر عملکردهای اجرایی (حافظه و حل مسئله) کودکان دارای اختلال نقص توجه و بیش فعالی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دوره دکتری روان شناسی سلامت، واحد بین المللی خرمشهر، خلیج فارس، دانشگاه آزاد اسلامی، خرمشهر، ایران

2 دانشیار گروه روانشناسی، واحد اهواز، دانشگاه ازاد اسلامی ، اهواز، ایران

چکیده

مقدمه و اهداف
امروزه نقص توجه و بیش­فعالی از متداول‌ترین اختلال­های دوران کودکی است. این اختلال را اخـتلال عصـبی رشدی می­دانند که سه ویژگی اصـلی آن نارسـایی توجه، بیش­فعالی و تکانشگری است که بـر سه تا هفت درصد کودکان اثـر مـی­گـذارد. نقص در کارکردهای اجرایی موفقیت تحصیلی را کاهش و احتمال رفتارهای خطرآفرین را افزایش می­دهد. کودکان و نوجوانان با اختلال نقص توجه/بیش­فعالی به صورت معناداری در ارزیابی­ های عصب روانشناختی کارکردهای اجرایی نسبت به جمعیت عادی نقص دارند. هدف از مطالعه حاضر، اثر توانبخشی­شناختی بر عملکردهای اجرایی (حافظه و حل مسئله) کودکان دارای اختلال نقص توجه و بیش­ فعالی می­باشد.
مواد و روش ­ها
پژوهش حاضر از نوع شبه ­تجربی با طرح کارآزمایی بالینی پیش­آزمون/پس­آزمون با گروه کنترل است. 30 کودک دارای اختلال نقص توجه و بیش ­فعالی 7-9 سال که در سال 98-1397 به کلینیک مشاوره آمورش­وپرورش ناحیه 1 شیراز مراجعه کردند، با استفاده از آزمون تشخیصی 4-CSI تشخیص­گذاری و با آزمون هوش ریون یکسان­ سازی شدند و به صورت نمونه­ گیری هدفمند انتخاب و به طور تصادفی به دو گروه آزمایش و کنترل تقسیم شدند. کودکان در ده جلسه یک­ساعته هر هفته دو جلسه تحت مداخله برنامه ­های توانبخشی قرار گرفتند. محاسبات آماری با استفاده از نرم­افزار آماری SPSS نسخه 23 انجام گرفت. متغیر حافظه فعال با استفاده از آزمون­های ان­بک و تو­بک و آزمون فراخنای حافظه و ارزیابی متغیر حل مسئله با آزمون کارت­های ویسکانسین انجام شد.
یافته­ ها
کارکردهای اجرایی (حافظه) در پیش‌آزمون و پس‌آزمون در کودکان دارای اختلال نقص توجه و بیش­فعالی تفاوت معناداری را نشان داد (P<0/001)، همچنین کارکردهای اجرایی (حل مسئله) در پیش‌آزمون و پس‌آزمون تفاوت معناداری را (P<0/001) نشان داد.
نتیجه­ گیری
به نظر می‌رسد توانبخشی­ شناختی بر بهبود عملکردهای اجرایی حافظه و حل مسئله کودکان دارای اختلال نارسایی توجه/بیش­فعالی موثر است و کارکردهای اجرایی (حل مسئله و حافظه) را بهبود می­بخشد و جایگزین داروی روان­محرک برای این کودکان است.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Effect of Cognitive Rehabilitation Therapy on Performance (Memory and Problem Solving) of Children with Attention Deficit Hyperactivity Disorder

نویسندگان [English]

  • Elahe Yavari Barhaghtalab 1
  • Parviz Asgary 2
  • Farah Naderi 2
  • Ali Reza Heidarie 2
1 PhD Student of Health Psychology, Khorramshahr International Branch, Persian Gulf, Islamic Azad University, Khorramshahr, Iran
2 Associate Professor ,Department of psychology, Ahvaz Branch ,Islamic Azad University,Ahvaz, Iran
چکیده [English]

Background and Aims: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common disorders in children affecting three to seven percent of children. It is a neuro-developmental disorder with three major criteria: attention deficit, hyperactivity, and impulsiveness. Executive function deficits hamper academic achievement and create high risk behaviors. Children with ADHD have neuropsychological findings in the assessment of executive functions. The ain of the present study was to examin the effect of cognitive rehabilitation therapy on the performance (memory and problem solving) of children with ADHD.
Materials and Methods: The present study followed a quasi-experimental randomized clinical trial design (pretest-posttest with control group). A total of 30 children, aged 7 to 9, who were referred to the clinic at the Ministery of Education, Destrict 1, in Shiraz in 1397-98, were recruited and the diagnosis was made using CSI-4 diagnostic test. Next, they were homogenized using Raven's Intelligence Test and selected as targeted sampling. Then, they were randomly divided into experimental and control groups. The experimental group received cognitive rehabilitation trainings for 10 sessions (two sessions per week). Children were identical in terms of intelligence capability based on Raven's test. Statistical analyses were done using SPSS, version 23. Descriptive statistics and standard deviation were used for data analysis. Data were analyzed using a clinical trial with pretest and post-test design with control group. Assessment of active memory was done using 1Beck, 2Beke, and memory fragmentation tests, which are accurate tools for evaluation of memory disorders. Also, the Wisconsin Cards was used for evaluation of problem solving.
Results: The results showed that there is a significant difference between the performance scores of memory performance in pre-test and post-test in children with ADHD (P<0.001). There was also a significant difference between the performance scores in pre-test and post-test in problem solving skills (P<0.001).
Conclusion: It was found that cognitive rehabilitation is effective in improving memory performance and problem solving in male children with ADHD. Cognitive rehabilitation can help children with ADHD so that they can perform their functions (memory and problem solving) more efficiently and it can be used as a substitute for mental stimulus for children with ADHD.

کلیدواژه‌ها [English]

  • cognitive rehabilitation effect
  • Executive Function
  • Eexecutive memory
  • problem solving
  • children with attention deficit hyperactivity disorder
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