اثربخشی آموزش مبتنی بر بازتوانی شناختی در بهبود حافظه دیداری و شنیداری کودکان با اختلالات یادگیری همراه با بیش‌فعالی و اختلالات یادگیری بدون بیش‌فعالی
محورهای موضوعی : روانشناسی تربیتیزینب خانجانی 1 , خدیجه صالحی‌اقدم 2 , الهه عافی 3
1 - استاد گروه علوم تربیتی و روانشناسی دانشگاه تبریز
2 - کارشناس ارشد روانشناسی عمومی
3 - کارشناس ارشد روانشناسی عمومی
کلید واژه: بیش‌فعالی, اختلالات یادگیری, بازتوانی شناختی, حافظه دیداری و حافظه شنیداری,
چکیده مقاله :
تحقیقات در حیطه ی کودکان دارای ناتوانی‌های یادگیری نشان می دهد که این کودکان اغلب دارای اختلالاتی در زمینه ادارک، زبان، پردازش واجی و مشکلات حرکتی و حافظه هستند. مشکلات حافظه بسیاری از این کودکان با فرآیندهای دیداری و شنیداری آنها پیوند دارد. اختلالات حافظه در این کودکان ممکن است باعث نقص در سایر حوزه‌های شناختی نیز شود. به همین دلیل اثر بخشی در این حوزه از اهمیت خاصی برخوردار است. لذا هدف پژوهش حاضر، بررسی اثربخشی درمان مبتنی بر بازتوانی شناختی در بهبود حافظه دیداری و شنیداری کودکان با اختلالات یادگیری همراه و بدون اختلال نقص توجه - بیش‌فعالیمی‌باشد. ابزارهای مورد استفاده در این تحقیق پرسشنامه CSI-4 و نرم‌افزار درمانی N-back بود. بدین منظور 26 نفر از کودکان مبتلا به اختلالات یادگیری (10 نفر مبتلا به اختلال نقص توجه- بیش‌فعالی و 16 نفر بدون اختلال نقص توجه- بیش‌فعالی) انتخاب و تحت بازتوانی از طریق نرم‌افزار N-back (21 جلسه نیم ساعته) قرار گرفتند. داده‌ها با استفاده از روش تحلیل کوواریانس چند متغیری(MANCOVA) تحلیل شد. یافته‌ها نشان داد که روش بازتوانی شناختی برای گروه‌های فوق‌الذکر مؤثر بوده و تفاوت اثربخشی برای حافظه شنیداری در دو گروه معنی‌دار بود. میزان بهبودی در حافظه شنیداری کودکان مبتلا به اختلال یادگیری همراه با بیش‌فعالی در مقایسه با گروه مبتلا به اختلال یادگیری بدون بیش‌فعالی بیشتر بوده است.
Researches in the field of children with learning disabilities show that these children often have disturbances in perception, language, phonological processing, motor disorders and memory. Memory problems of many of children with learning disabilities associated with various auditory and visual processes and memory disorders in these children may be deficient in other cognitive domains. On the one hand, the researches in the field of cognitive rehabilitation show the improvement of executive functions such as attention and memory through this method. Considering the findings and aimed to compare the effectiveness of cognitive rehabilitation in children with learning disabilities (with and without ADHD) in auditory and visual memory improvement, 26 cases of children with learning disabilities (10 with ADHD and 15 without ADHD) was selected and assessed with CSI-4 and rehabilitated through N-back software (21 half-hour sessions) and data were analyzed using multivariate analysis of covariance and t-test. Results showed that cognitive rehabilitation for groups have been effective and differences in effectiveness for auditory memory in the two groups was significant and effective for auditory memory in LD children with ADHD was significant compared to the group without ADHD. The difference for visual memory was not significant.
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Cohen, D., Plaze, M., Perez Diaz, F., Lanthier, O., Chouvin, D., Hambourg, N., & Wilson, A. J. (2006). Individual cognitive training of reading disability improves word identification and sentence comprehension in adults with mild mental retardation. Research in Developmental Disabilities, 27, 501-516.
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Klinberg, G., & Fernell, D. (2005). Deficits in attention motor control and perception, and other syndromes attributed to minimal brain dysfunction. J. Aicardi (ED). Diseases of nevus system in children. Clinics in developmental medicine, 12 (5), 138-172.
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Taroyan, N. A., Nicolson, R. I., & Fawcett, A. J. (2007). Behavioral and neurophysiological correlates of dyslexia in the continuous performance task. Clinical Neurophysiology, 118 (4), 845-855.
Thorell, L. B., Lindqvist, S., Nutley, S. B., Bohlin, G., & Klingberg, T. (2008). Training and transfer effects of executive functions in preschool Children. Developmental Science, 106–113.
Yu, F., Rose, K. M., Burgener, S. C., Cunningham, C., Buettner, L. L., Beattie, E., Bossen, A. L., Buckwalter, K. C., Fick, D. M., Fitzsimmons, S., Kolanowski, A., Janet, K., Specht, P., Richeson, N. E., Testad, I., & McKenzie, S. E. (2009). Cognitive training for early-stage Alzheimer's disease and dementia. Gerontological Nursing, 35(3), 23-29.
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Van der Sluis, S., De Jong, P. F., & Van der Leij, A. (2003). Inhibition and shifting in children with learning deficits in arithmetic and reading. Journal of Experimental Child Psychology, 87,239–266.
Westerberg, H., & Klingberg, T. (2007). Changes in cortical activity after training of working memory- a single subject analysis. Physiology & behavior article in press, 92(1-2),186-92.
Wykes, T., & Gaag, M. V. (2001). Is it time to develop a new cognitive therapy for psychosis-cognitive remediation therapy (CRT)? Clinical Psychology Review, 21(8), 1227-1256.
_||_Barkley, R. A. (1998). Attention- Deficit/ Hyperactivity Disorder. A Handbook for diagnosis and treatment. Newyork: Guilford press, (3)12, 145-150.
Basak, C., Boot, W. R., Voss, M. W., & Kramer A. F. (2008). Can Training in a Real-Time Strategy Video Game Attenuate Cognitive Decline in Older Adults? Psychology and Aging, (4), 23,765–777.
Cohen, D., Plaze, M., Perez Diaz, F., Lanthier, O., Chouvin, D., Hambourg, N., & Wilson, A. J. (2006). Individual cognitive training of reading disability improves word identification and sentence comprehension in adults with mild mental retardation. Research in Developmental Disabilities, 27, 501-516.
Grey, R. (2010). Bereavement, loss and learning disabilities: A guide for professionals and Carers. Jessica Kingsley Publishers: UK.
Hallahan, D. P., & Kuffman, J. M. (2009). Exceptional children. Tehran. Roshd Promotion [In Persian].
Hulme, C., & MacKenzie, S. (1992). Working memory and severe learning difficulties. Hillsdale (NJ), England: Lawrence Erlbaum Associates, Inc
Jalali, S., Aghayi, A., Molavi, H., & Karahmadi, M. (2009). The Effect of Group Therapeutic Therapy on Specific Predomination of Children aged 5 to 11 Years Referred to Isfahan. Medical Sciences Clinics. Knowledge and Research in Applied Psychology,10(38), 25 – 40 [In Persian].
Jordan, N. C., Glutting, J., & Ramineni, C. (2010). The importance of number sense to mathematics achievement in first and third grades. Learning and Individual Differences, 20, 82-88.
Lafin, M. V. (1999). Learning disabilities. Astan Quds Razavi Promotion. First issue [In Persian].
Jaeggi, S. M., Studer-Luethi, B., & Buschkuehl, M., Su., Y. F, Yi-Fen Su, Jonides, J,. & Perrig, W. J. (2010). The relationship between n-back performance and matrix reasoning — implications for training and transfer. Intelligence, 38(6), 625-635. https://doi.org/10.1016/j.intell.2010.09.001
Lafyn, M. V. (1998). Learning disabilities. Translator Mohammad Taqi Monshi Tusi. Astan Quds Razavi publishing. first turn.
Lim, M. H. X, Liu, K. P. Y, Cheung, G. S. F, Kuo, M. C. C, Li, R, & Ying Tong, C. (2011). Effectiveness of a Multifaceted Cognitive Training Programed for People with Mild Cognitive Impairment, A One-Group Pre- and Posttest Design. Hong Kong Journal of Occupational Therapy, 22, 3e8.
Kamphaus, R, Frick, P. (1996). Clinical assessment of child and adolescent personality and behavior. Boston: Allyn & Bacon.
Kane, M. J., Conway, A. R. A., Miura, T. K., & Colflesh, G. J. H. (2007). Working memory, attention control, and the N-back task: a question of construct validity. Journal of Experimental Psychology: Learning, Memory, and Cognition, 33, 615–622.
Kesler, S. R., Lacayo, N. J., & Jo, B. (2011). A pilot study of an online cognitive rehabilitation program for executive function skills in children with cancer-related brain injury. Department of Psychiatry and Behavioral Sciences, Stanford University, 25(1), 101-12.
Kirchhoff, B. A., Anderson, B. A., Smith, S. E., Barch, D. M., & Jacoby, L. L. (2012). Cognitive training-related changes in hippocampal activity associated with recollection in older adults. YNIMG.09550, 1-9.
Klinberg, G., & Fernell, D. (2005). Deficits in attention motor control and perception, and other syndromes attributed to minimal brain dysfunction. J. Aicardi (ED). Diseases of nevus system in children. Clinics in developmental medicine, 12 (5), 138-172.
Mazzocco, M. M. M., & Hanich, L. B. (2010). Math achievement, numerical processing, and executive functions in girls with Turner Syndrome (TS): Do Girls with Ts have Math Learning Disability? Learning and Individual Differences, 20, 70-81.
McCloskey, G., Perkins, L., & Divner, B. (2009). Assessment and intervention for executive function difficulties. New York: Routledge Press.
Meyer, M. L., Salimpoor, V. N., Wu, S. S., Geary, D. C., & Menon, V. (2010). Differential contribution of specific working memory components to mathematics achievement in 2nd and 3rd graders. Learning and Individual Differences,20(2),101-109.
Milton, H. (2010). Effects of A Computerized Working Memory Training Program On Attention, Working Memory, And Academics, In Adolescents with Severe ADHD/LD. Psychology Journal, 1(14), 120-122.
Murphy, K., & Spencer, A. (2009). Playing video games does not make for better visual attention skills. Journal of Articles in Support of the Null Hypothesis, 6(1) ,1539-8714.
Naismith, S. L., Diamond, K., Carter, P. E., Norrie, L. M., Hodge, M. A. R., Lewis, S. J. G., & Hickie, I. B. (2011). Enhancing Memory in Late-Life Depression: The Effects of a Combined Psychoeducation and Cognitive Training Program. The American Journal of Geriatric Psychiatry,19 ,240-248.
O'Connel, R. G., Bellgrove, M. A., & Robertson, I. H. (2007). Avenues for the neuro-remediation of ADHD: Lessons from Clinical Neurosciences. In M.
Torgesen, J. K., & Houck, D. G. (1980). Processing deficiencies of learning-disabled children who perform poorly on the digit span test. Journal of Educational Psychology, 72(2), 141-160.
Rezaei, F., Fakhraei, A., Farmand, A., Nilofari, A., Hashemi, A., & Shamloo, F. (2014). DSM-5 Diagnostic and Diagnostic Manual. First Edition.
Arjmand Publishing [In Persian].
Rueda, R., & Lina, C. (2012). Enhanced efficiency of the executive attention network after training in preschool children, immediate changes and effects after two months. Developmental cognitive neuroscienc, 25, 192-s204.
Seidman, L. J., Biederman, J., Monuteaux, M. C., Doyle, A. E., & Faraone, S. V. (2001). Learning disabilities and executive dysfunction in boys with attention-deficit/hyperactivity disorder. Neuropsychology, 15(4), 544-56.
Sohlberg, M. C. M., & Matter, C. A. (2001). Cognitive Rehabilitation: An Integrative Neuropsychological Approach. The Guilford Press.
Spaulding, W. D., Fleming, S. K., Reed, D., Sullivan, M., Storzbach, D., & Lam, M. (1999). Cognitive functioning in schizophrenia: implication for Psychiatric rehabilitation. Schizophrenia Bulletin, 25, 275-289.
Swanson, H. L., & Jerman, O. (2006). Math Disabilities: A Selective Meta-Analysis of the Literature. Sage Journals, 76(2), 249-274.
Sprafkin, J., Gadow, K. D., Salisbury, H., Schneider, J., & Loney, J. (2002). Further evidence of reliability and validity of the Child Symptom Inventory-4: Parent checklist in clinically referred boys. Journal of Clinical Child and Adolescent Psychology, 31(4), 513-524.
Taroyan, N. A., Nicolson, R. I., & Fawcett, A. J. (2007). Behavioral and neurophysiological correlates of dyslexia in the continuous performance task. Clinical Neurophysiology, 118 (4), 845-855.
Thorell, L. B., Lindqvist, S., Nutley, S. B., Bohlin, G., & Klingberg, T. (2008). Training and transfer effects of executive functions in preschool Children. Developmental Science, 106–113.
Yu, F., Rose, K. M., Burgener, S. C., Cunningham, C., Buettner, L. L., Beattie, E., Bossen, A. L., Buckwalter, K. C., Fick, D. M., Fitzsimmons, S., Kolanowski, A., Janet, K., Specht, P., Richeson, N. E., Testad, I., & McKenzie, S. E. (2009). Cognitive training for early-stage Alzheimer's disease and dementia. Gerontological Nursing, 35(3), 23-29.
Zelazo, P. D, Qu, L, & Müller, U. (2005). Hot and cool aspects of executive function: Relations in early development. In R. Schneider, Wolfgang; Schumann - Hengsteler (Ed.), Young Children’s Cognitive Development: Interrelationships Among Executive Functioning, Working Memory, Verbal Ability and Theory of Mind.71-95.
Van der Sluis, S., De Jong, P. F., & Van der Leij, A. (2003). Inhibition and shifting in children with learning deficits in arithmetic and reading. Journal of Experimental Child Psychology, 87,239–266.
Westerberg, H., & Klingberg, T. (2007). Changes in cortical activity after training of working memory- a single subject analysis. Physiology & behavior article in press, 92(1-2),186-92.
Wykes, T., & Gaag, M. V. (2001). Is it time to develop a new cognitive therapy for psychosis-cognitive remediation therapy (CRT)? Clinical Psychology Review, 21(8), 1227-1256.