تدوین برنامه توان‌بخشی رایانه‌یار اختلال پردازش شنیداری مرکزی و بررسی اثربخشی آن بر آگاهی واج‌شناختی و حافظه‌ کاری شنیداری دانش‌آموزان دارای اختلال خواندن

Reading Disorder is a neuro-developmental disorder which, according to DSM-5, is associated with painful efforts in reading and leads the afflicted child to experience problems during reading although he/she enjoys normal Intelligence Quotient, appropriate education and lacks explicit sensory difficulties. One of the characteristics of children with Reading Disorder is their difficulty with Phonological Awareness. Phonological Awareness is the conscious ability to recognize and mentally manipulate spoken sounds, and is regarded as a determining factor for achieving academic skills.
Another problem that children with Reading Disorder deal with is the problem pertaining to the Auditory Working Memory. Working Memory is a set of cognitive processes which are associated with memorizing and manipulating the required information in order to perform daily activities, and it also manages other activities such as controlled attention, manipulation, revision and retrieval of information. In order to treat the above-mentioned problems in children with Reading Disorder, various approaches have been invented so far, one of which is the rehabilitation based on Central Auditory Processing Disorder (CAPD). With regard to the positive and beneficial results that have been observed from the use of computer-assisted programs and the worldwide acceptance that they have gained, it seems that using computer-assisted programs to treat Farsi-speaking students with Central Auditory Processing Disorder could be effective. Therefore, the present research was conducted with the goal of developing a computer-assisted rehabilitation program for Central Auditory Processing Disorder and examining its effectiveness on Phonological Awareness and Auditory Working Memory of students with Reading Disorder.
Materials and Methods: This study was a quasi-experimental, functionally-goaled study with pre-test, post-test design and follow-up with a control group. The statistical population of the present study included all students in the second grade of elementary school who were referred to special centers for learning disabilities in Tehran in the academic year 2016-2017. To select the sample, using the available sampling method, among the children who met the inclusion criteria, 18 students were selected by the available method and randomly assigned to the experimental and control groups. The inclusion criteria in this study were: 1) being a second grade elementary school student; 2) having normal intelligence quotient; 3) having Reading Disorder and Central Auditory Processing Disorder; and 4) not having other neuro-developmental disorders. The exclusion criteria in this study were: 1) lack of tendency among the parents to participate in the study; and 2) not fully completing the treatment course. In this study, the subjects were randomly assigned to the experimental and control groups. Furthermore, the computer-assisted rehabilitation program for Central Auditory Processing Disorder was performed by a trained expert and the subjects were not receiving any other intervention programs during the course of this study. The research instruments were Phonological Knowledge test and Wechsler Intelligence test for children. This project was performed in two steps. During the first step, which mainly comprised of developing the steps and stages of the computer-assisted program, the researcher tried to use various elements which were utilized in the design and development of the latest and most appropriate CAPD-rehabilitation programs that were being used both in Iran as well as English versions of similar computer-assisted programs. During the second step, initially, the samples were selected. Then, the researcher was introduced and referred to different centers for students with Learning Disability by the Exceptional Education Organization of Tehran. In these centers, the required coordination with the principals and teachers were made during which, research goals, responsibilities and commitments of the researchers and the expectations the researchers had of students with Learning Disorder were presented and discussed. After that, the research participants were selected and initial assessments were made. The students were assigned to the experimental and control groups and each subject was given a specific code. The experimental group received an intervention based on the computer-assisted rehabilitation program for Central Auditory Processing Disorder but no intervention was given to the control group. After the period of the intervention and education had terminated, the above-mentioned parameters were re-evaluated during the follow-up stage (one month after the post-test stage). Furthermore, after examining the premises of statistical tests (such as Shapiro-Wilk to determine the normal distribution of data; the Levene test to determine the homogeneity of variances and M-Box test to determine the homogeneity of Co-variances), the Repeated Measures ANOVA and Multivariate Analysis Covariance (MANCOVA) were used.

Findings
The results of the difference between the elements of Phonological Awareness (P˃0/001) and Auditory Working Memory (P˃0/001) in the experimental group and the control group were significant. The results also expressed that the treatment had been effective in the parameters of Phonological Awareness and Auditory Working Memory in the pre-test, post-test and follow-up stages, and that their differences were significant. Therefore, this treatment method was still effective and persistent after the treatment period had terminated.
This research was conducted with the purpose of examining the effectiveness of the Central Auditory Processing Disorder computer-assisted rehabilitation program on Phonological Awareness and Auditory Working Memory in students with Reading Disorder. The results that were obtained from the analyses of the research data demonstrated that the Central Auditory Processing Disorder computer-assisted rehabilitation program had a positive effect on Phonological Awareness and Auditory Working Memory of students with Reading Disorder. As another explanation for the research findings which showed the effectiveness of this computer-assisted rehabilitation program on Auditory Working Memory of students with Reading Disorder, it can be stated that regarding the defects and cognitive-developmental delays that result from Learning Disabilities, and the existence of significant impairments related to cognitive skills in several parts of the brain of these students, the use of a comprehensive, organized and intensive treatment approach can be beneficial. This computer-assisted rehabilitation program for Central Auditory Processing Disorder which has been resulted from the merger of neuro-cognitive sciences with Information Technology is a method to improve the impairments in cognitive functions such as memory and attention.