مقایسه اثربخشی آموزش حافظه کاری و توانبخشی شناختی بر کارکردهای اجرایی و توجه انتخابی دانش آموزان با اختلال یادگیری خاص
محورهای موضوعی : روانشناسی
آرزو فصیحی
1
,
بهنام مولائی
2
*
,
مهریار ندر محمدی
3
,
عذرا غفاری نوران
4
1 - دانشجوی دکتری روانشناسی عمومی، گروه روانشناسی، واحد اردبیل، دانشگاه آزاد اسلامی، اردبیل، ایران.
2 - عضو هیات علمی گروه روانپزشکی دانشگاه علوم پزشکی اردبیل، مدیر دپارتمان و مرکز تحقیقات سلامت خانواده ، دانشگاه علوم پزشکی اردبیل
3 - استادیار، گروه روانپزشکی بیمارستان فاطمی، دانشگاه علوم پزشکی اردبیل، اردبیل، ایران
4 - دانشیارگروه روانشناسی، واحد اردبیل دانشگاه آزاد اسلامی، اردبیل، ایران
کلید واژه: آموزش حافظه کاری, توانبخشی شناختی, کارکردهای اجرایی, توجه انتخابی, اختلال یادگیری خاص,
چکیده مقاله :
چکیده
زمینه و اهدف: شیوع اختلال یادگیری خاص و چالش‌های ناشی از آن برای دانش‌آموزان مبتلا، به‌ویژه در زمینه‌هایی مانند کارکردهای اجرایی و توجه انتخابی، ضرورت انجام پژوهشی برای بهبود این متغیرها را دوچندان می‌کند. هدف پژوهش حاضر، مقایسه اثربخشی آموزش حافظه کاری و توانبخشی شناختی بر کارکردهای اجرایی و توجه انتخابی دانش‌آموزان دارای اختلال یادگیری خاص است.
روش: این پژوهش از نظر هدف کاربردی و به لحاظ روش، نیمه‌آزمایشی با طرح پیش‌آزمون-پس‌آزمون با گروه گواه و پیگیری بود. جامعه آماری شامل همه دانش‌آموزان مبتلا به اختلال یادگیری خاص شهر اردبیل در نیمسال دوم ۱۴۰۳-۱۴۰۲ بود. با روش نمونه‌گیری در دسترس، ۴۵ نفر از مراجعه‌کنندگان به مراکز مشکلات ویژه یادگیری انتخاب و به‌صورت تصادفی در دو گروه آزمایش (توانبخشی شناختی و آموزش حافظه کاری) و یک گروه گواه (هرکدام ۱۵ نفر) گمارده شدند. ابزارها شامل پرسشنامه درجه‌بندی رفتاری کارکردهای اجرایی (BRIEF) و آزمون D2 بود. داده‌ها با تحلیل واریانس آمیخته و با استفاده از نرم‌افزار SPSS-26 تحلیل شد.
یافته‌ها: نتایج نشان داد که آموزش حافظه کاری و توانبخشی شناختی تأثیر معناداری بر افزایش کارکردهای اجرایی و توجه انتخابی دانش‌آموزان دارند. این تأثیر برای کارکردهای اجرایی ۰.۳۷، تنظیم رفتار ۰.۲۲، و فراشناخت ۰.۲۳ و برای توجه انتخابی، کارایی تمرکز، خطای حذف و ارتکاب به‌ترتیب ۰.۲۶، ۰.۲۳، ۰.۲۳ و ۰.۲۲ بود. همچنین اثربخشی این مداخلات در پس‌آزمون و پیگیری پایدار بوده و توانبخشی شناختی نسبت به آموزش حافظه کاری اثربخشی بیشتری داشت.
نتیجه‌گیری: آموزش حافظه کاری و توانبخشی شناختی بر کارکردهای اجرایی و توجه انتخابی دانش آموزان با اختلال یادگیری خاص اثربخش بوده و بین اثربخش دو درمان تفاوت وجود دارد به نحوی که توانبخشی شناختی اثربخشی بالاتری نسبت به آموزش حافظه کاری داشته است.
Abstract
Background and Aims: The prevalence of specific learning disorder and its associated challenges for affected students—particularly in areas such as executive functions and selective attention—highlights the importance of conducting research aimed at improving these variables. The present study aimed to compare the effectiveness of working memory training and cognitive rehabilitation on executive functions and selective attention in students with specific learning disorder.
Method: This applied research employed a semi-experimental design with pre-test, post-test, control group, and follow-up. The statistical population included all students with specific learning disorder in Ardabil during the second semester of the 2023–2024 academic year. Using convenience sampling, 45 students referred to special learning disability centers in Ardabil were selected and randomly assigned to two experimental groups (cognitive rehabilitation and working memory training) and one control group (15 participants in each group). Research tools included the Behavior Rating Inventory of Executive Function (BRIEF) and the D2 Attention Test. Data were analyzed using mixed analysis of variance (ANOVA) in SPSS-26 software.
Findings: The results showed that working memory training and cognitive rehabilitation had significant effects on improving executive functions and selective attention in students. The effect sizes were 0.37 for executive functions, 0.22 for behavioral regulation, and 0.23 for metacognition. For selective attention, concentration efficiency, omission errors, and commission errors, the effect sizes were 0.26, 0.23, 0.23, and 0.22, respectively. Moreover, the effects of these interventions remained stable in both post-test and follow-up stages, with cognitive rehabilitation proving more effective than working memory training.
Conclusion: Working memory training and cognitive rehabilitation are effective in enhancing executive functions and selective attention in students with specific learning disorder, with cognitive rehabilitation demonstrating greater efficacy compared to working memory training.
1. American Psychiatric Association. DSM-5: Manual Diagnóstico e Estatístico de Transtornos Mentais. Porto Alegre: Artmed. 2015; Available from:
https://doi.org/https://dislex.co.pt/images/pdfs/DSM_V.pdf 2. Piroozi B, Saeed BA, Shokri A, Safari H, Moradpour F, Zokaei M, Bagajan KQ, Mohamadi-Bolbanabad A, Zarezadeh Y. Prevalence of Mental Disorders Suspicion among Adults with Disabilities and Socioeconomic Inequalities in West of Iran. Medical Journal of the Islamic Republic of Iran. 2025 Feb 12;39:25. https://doi.org/10.47176/mjiri.39.25
3. Horowitz-Kraus T. Pinpointing the deficit in executive functions in adolescents with dyslexia performing the Wisconsin card sorting test: an ERP study. Journal of learning disabilities. 2014 May;47(3):208-23. https://doi.org/10.1177/0022219412453084
4. Stein B, Hoeft F, Richter CG. Stress, resilience, and emotional well-being in children and adolescents with specific learning disabilities. Current Opinion in Behavioral Sciences. 2024 Aug 1;58:101410. https://doi.org/10.1016/j.cobeha.2024.101410
5. Caetano T, Pinho MS, Ramadas E, Clara C, Areosa T, Dixe MD. Cognitive training effectiveness on memory, executive functioning, and processing speed in individuals with substance use disorders: a systematic review. Front Psychol. 2021;12:730165. Available from: https://doi.org/10.3389/fpsyg.2021.730165
6. Bressane A, Zwirn D, Essiptchouk A, Saraiva AC, de Campos Carvalho FL, Formiga JK, de Castro Medeiros LC, Negri RG. Understanding the role of study strategies and learning disabilities on student academic performance to enhance educational approaches: A proposal using artificial intelligence. Computers and Education: Artificial Intelligence. 2024 Jun 1;6:100196. https://www.journals.elsevier.com/computers-and-education-artificial-intelligence
7. Wang LC, Chung KK. The influences of cognitive abilities on self-regulated learning in online learning environment among Chinese university students with learning disabilities. The Internet and Higher Education. 2024 Jun 1;62:100947. https://doi.org/10.1016/j.iheduc.2024.100947
8. Alesi M, Giordano G, Ingoglia S, Inguglia C. The association among executive functions, academic motivation, anxiety and depression: a comparison between students with specific learning disabilities and undiagnosed peers. European Journal of Special Needs Education. 2024 Sep 2;39(5):805-19. http://dx.doi.org/10.1080/08856257.2023.2300172
9. Amani E, Fadaei E, Tavakoli M, Shiri E, Shiri V. Comparison of planning, selective attention, and cognitive flexibility in students with and without specific learning disorder (reading disability). Learning Disabilities. 2017;7(2):94–111. Available from: https://doi.org/10.22098/JLD.2018.617
10. Khalili M, Emadian SO, Hassanzadeh R. Effectiveness of Attention Training based on Fletcher’s Program, Delacato’s Neuropsychological Treatment, and Computerized Cognitive Rehabilitation on Executive Functions in Children with Special Learning Disability. Int Clin Neurosci J [Internet]. 2020 Dec. 30 [cited 2025 Jun. 27];8(1):30-6. Available from: https://journals.sbmu.ac.ir/neuroscience/article/view/31930
11. Groome D. An introduction to cognitive psychology: Processes and disorders. Psychol Press. 2021;:. Available from: https://doi.org/10.4324/9781351020862 12. Agostini F, Zoccolotti P, Casagrande M. Domain-general cognitive skills in children with mathematical difficulties and dyscalculia: A systematic review of the literature. Brain Sci. 2022;12(2):239–45. Available from: https://doi.org/10.3390/brainsci12020239
13. Wiest GM, Rosales KP, Looney L, Wong EH, Wiest DJ. Utilizing cognitive training to improve working memory, attention, and impulsivity in school-aged children with ADHD and SLD. Brain Sci.
2022;12(2):141. Available from: https://doi.org/10.3390/brainsci12020141 14. Horowitz-Kraus T. Differential effect of cognitive training on executive functions and reading abilities in children with ADHD and in children with ADHD comorbid with reading difficulties. J Atten Disord. 2015;19(6):515–26. Available from: https://doi.org/10.1177/1087054713502079
15. Parhoon K, Coolidge FL, Alizadeh H, Parhoon H, Srivastava A. Effects of a cognitive rehabilitation training program in school-aged children with specific learning disorder. International Journal of School & Educational Psychology. 2024 Jul 2;12(3):164-72.
http://dx.doi.org/10.1080/21683603.2024.2375242 16. Akbarifar H, Ahmadi A, Fathabadi R, Salehi H. Effectiveness of brain cognitive rehabilitation on information processing speed and psychological refractory period in children with specific learning disorder. Neuropsychology. 2019;5(19):41–52. Available from: https://doi.org/10.30473/clpsy.2020.50696.1497
17. Maehler C, Schuchardt K. The importance of working memory for school achievement in primary school children with intellectual or learning disabilities. Res Dev Disabil. 2016;58:1–8. Available from: https://doi.org/10.1016/j.ridd.2016.08.007
18. Thorell LB, Lindqvist S, Bergman Nutley S, Bohlin G, Klingberg T. Training and transfer effects of executive functions in preschool children. Dev Sci. 2009;12(1):106–13. Available from: https://doi.org/10.1111/j.1467-7687.2008.00745.x
19. Magalhães S, Carneiro L, Limpo T, Filipe M. Executive functions predict literacy and mathematics achievements: The unique contribution of cognitive flexibility in grades 2, 4, and 6. Child Neuropsychol. 2020;26(7):934–52. Available from: https://doi.org/10.1080/09297049.2020.1740188
20. Jongbloed-Pereboom M, Nijhuis-van Der Sanden MW, Steenbergen B. Explicit and implicit motor sequence learning in children and adults; the role of age and visual working memory. Hum Mov Sci. 2019;64:1. Available from: https://doi.org/10.1016/j.humov.2018.12.007
21. Kirk HE, Gray K, Riby DM, Cornish KM. Cognitive training as a resolution for early executive function difficulties in children with intellectual disabilities. Res Dev Disabil. 2015;38:145–60. Available from: https://doi.org/10.1016/j.ridd.2014.12.026
22. Bizzaro M, Giofrè D, Girelli L, Cornoldi C. Arithmetic, working memory, and visuospatial imagery abilities in children with poor geometric learning. Learn Individ Differ. 2018;62:79–88. Available from: https://doi.org/10.1016/j.lindif.2018.01.013
23. Meiran N, Dreisbach G, von Bastian CC. Mechanisms of working memory training: Insights from individual differences. Intelligence. 2019;73:78–87. Available from: https://doi.org/10.1016/j.intell.2019.01.010
24. Gathercole SE, Dunning DL, Holmes J, Norris D. Working memory training involves learning new skills. J Mem Lang. 2019;105:19–42. Available from: https://doi.org/10.1016/j.jml.2018.10.003
25. Kakojoibari AA, Amini F, Aliekbari Dehkordi M. The effectiveness of working memory training on attention performance in students with dyslexia learning disorders. Social Cognition. 2018;7(1):73–
88. Available from: https://sc.journals.pnu.ac.ir/article_4846.html 26. Gioia GA, Isquith PK, Guy SC, Kenworthy L. Test review behavior rating inventory of executive function. Child Neuropsychol. 2000;6(3):235–8. Available from: https://doi.org/10.1076/chin.6.3.235.3152
27. Nodei K, Sarami G, Keramati H. The relation between executive function and working memory capacity and students’ reading performance: The role of age, sex and intelligence. Journal of Cognitive Psychology. 2016;4(3):11-24. https://jcp.khu.ac.ir/article-1-2631-en.html
28. Bagheri F. Selective attention, concentration, and effortfulness test. Tehran: Arjmand & Nasl-e-Farda Publications; 2012. https://www.arjmandpub.com/book/938
29. Zadeh SB, Afrouz AA, Maktabi G. The effectiveness of white noise on learning new words, visual working memory and selective attention in elementary students. Journal of psychological science. 2020;19(85):25-32. http://psychologicalscience.ir/article-1-566-en.html
30. Sohlberg MM, Mateer CA. Improving attention and managing attentional problems: Adapting rehabilitation techniques to adults with ADD. Annals of the New York Academy of Sciences. 2001 Jun;931(1):359-75.
https://doi.org/10.1111/j.1749-6632.2001.tb05790.x 31. Narimani M, Soleymani E, Tabrizchi N. The effect of cognitive rehabilitation on improving sustained attention and academic achievement in mathematics among students with ADHD. School Psychology. 2015;4(2):118–134.
https://jsp.uma.ac.ir/article_329.html 32. Fazeli A, Dolatshahi B. Shakiba Sh.[The Effectiveness of Cognitive Rehabilitation on Improving Cognitive Deficits in Patients With Chronic Schizophrenia Based on Cognitive Levels (Persian)]. Iranian Journal of Psychiatry and Clinical Psychol-ogy. 2022;28(1):2-19. http://dx.doi.org/10.32598/ijpcp.28.1.2333.2
33. Abedi A, Malekpour M. The effectiveness of early educational-psychological interventions on improving executive functions and attention in children with neuropsychological learning disabilities. Journal of New Educational Approaches. 2010;5(1):67. Available from: https://www.magiran.com/p842108
34. Veloso A, Vicente SG, Filipe MG. Effectiveness of cognitive training for school-aged children and adolescents with attention deficit/hyperactivity disorder: a systematic review. Frontiers in psychology. 2020 Jan 14;10:2983.
https://doi.org/10.3389/fpsyg.2019.02983 35. Kesler SR, Lacayo NJ, Jo B. A pilot study of an online cognitive rehabilitation program for executive function skills in children with cancer-related brain injury. Brain Inj. 2011;25(1):101–12. Available from: https://doi.org/10.3109/02699052.2010.536194
36. Magalhães S, Carneiro L, Limpo T, Filipe M. Executive functions predict literacy and mathematics achievements: The unique contribution of cognitive flexibility in grades 2, 4, and 6. Child Neuropsychology. 2020 Oct 2;26(7):934-52. https://doi.org/10.1080/09297049.2020.1740188
37. Zare H, Cherami F, Sharifi AA. The effectiveness of computerized cognitive rehabilitation on working memory and cognitive flexibility in children with learning disorder. Cognitive Strategies in Learning. 2020;8(15):1–18. Available from: https://doi.org/10.22084/j.psychogy.2020.20055.2030
38. Habibi D, Amiri M, Karimi A. The effect of working memory training on improving selective attention and executive functions in elementary students with attention deficit hyperactivity disorder. Advances in Psychology, Educational Sciences and Education. 2020;3(23):254–264. Available from: https://civilica.com/doc/1353101
39.
Meiran N, Dreisbach G, von Bastian CC. Mechanisms of working memory training: Insights from individual differences. Intelligence. 2019 Mar 1;73:78-87. https://doi.org/10.1016/j.intell.2019.01.010 40. Bathelt J, Holmes J, Astle DE, Centre for Attention Learning and Memory (CALM) Team. Data-driven subtyping of executive function-related behavioral problems in children. J Am Acad Child Adolesc Psychiatry. 2018 Apr;57(4):252-262.e4. https://doi.org/10.1016/j.jaac.2018.01.014
41. beirami, M., hashemi, T., khanjaani, Z., nemati, F., rasoulzadeh, H. Effectiveness of motor-based cognitive rehabilitation on improvement of executive functions (cognitive flexibility, working memory, reaction time, response inhibition, sustained attention) in students with Attention-Deficit/Hyperactivity Disorder (ADHD). Journal of Modern Psychological Researches, 2021; 16(61): 1-18. https://psychologyj.tabrizu.ac.ir/article_12254.html?lang=en
42. Firoozi S, Abolmaali Alhosseini K, Tale Pasand S, Nowkani M. Comparison of the effectiveness of computer-based cognitive rehabilitation, sensory integration, and the combination of both methods on improving cognitive flexibility in students with specific learning disorder. Empowerment of Exceptional Children. 2021;12(3):107–121. Available from: https://doi.org/10.22034/ceciranj.2021.264857.1515
43. Avtzon S. Effect of neuroscience based cognitive skill training on growth of cognitive deficits associated with learning disabilities in children grades 2-4. Journal of Learning Disabilities. 2012; 18(3): 111-22. https://js.sagamorepub.com/index.php/ldmj/article/view/5016
44. Adams EJ, Nguyen AT, Cowan N. Theories of working memory: Differences in definition, degree of modularity, role of attention, and purpose. Lang Speech Hear Serv Sch. 2018;49(3):340–55.
Available from: https://doi.org/10.1044/2018_LSHSS-17-0114