Sara Rouhani; Mohammad Narimani; Nader Hajloo; REZA Farzizadeh
Abstract
Abstract
The formulation of a therapeutic model centered on neurology can be crucial for the effective treatment of neurodevelopmental disorders. This research investigates the development and evaluation of an innovative "Neuro-Exuberant Proliferation Therapy" as a treatment modality for symptoms and ...
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Abstract
The formulation of a therapeutic model centered on neurology can be crucial for the effective treatment of neurodevelopmental disorders. This research investigates the development and evaluation of an innovative "Neuro-Exuberant Proliferation Therapy" as a treatment modality for symptoms and developmental indicators in children diagnosed with Autism Spectrum Disorder (ASD). A mixed-methods approach was employed. In the qualitative component, inductive qualitative content analysis was applied to formulate the theoretical foundations and operational plan of the therapy. In the quantitative phase, an experimental design with a pre-test-post-test control group was used to assess the treatment's effectiveness. A total of 30 participants aged 3-5 years with autism spectrum disorder were recruited through convenience sampling and randomly allocated into an experimental group and a control group, each with 15 individuals. The therapeutic intervention consisted of 36 sessions, each lasting 45 minutes, over a period of 3 months. The measurement tools used were the GARS-3 (Gilliam Autism Rating Scale) and the ASQ-II (Ages and Stages Questionnaires, Parent-Administered). Data were analyzed using the Mann-Whitney U test, revealing significant positive outcomes in the domains of problem-solving, gross motor skills, communication, and autistic symptoms (p < 0.01). However, these positive changes were not observed in the areas of fine motor skills and personal-social behaviors. It can be concluded that Neuro-Exuberant Proliferation Therapy has a positive impact on the development and reinforcement of broader, foundational (macro) functions. However, this intervention does not appear to have a significant direct effect on specific, learned (micro) functions within a 3-month period.
Keywords: Neuro-centered Intervention, Autism Spectrum Disorder, Developmental Indicators, Neuro Exuberant Proliferation Therapy
Extended Abstract
Introduction
Autism spectrum disorder is a neurodevelopmental disorder with a substantial prevalence rate and considerable potential for causing functional limitations. It is characterized by two primary features: persistent deficits in social communication and social interaction, and restricted, repetitive patterns of behavior, interests, or activities (DSM-5). These symptoms pose significant challenges to the cognitive, communication, and social development of affected children (APA). The recent revisions in the DSM-5-TR emphasize the neurological underpinnings of autism spectrum disorder. Additionally, the theme chosen by the World Health Organization (WHO) for World Autism Awareness Day in both 2023 and 2024, which focuses on the necessity to transition toward a neurocentric approach, further underscores the significance of a neurological perspective in autism care.
It is crucial to recognize that autism spectrum disorder is primarily caused by defects in essential neurobiological processes such as neurogenesis, neuronal development, synapse formation, and synaptic plasticity, which disrupt the proper formation of layers of the cerebral cortex, as well as neural differentiation and signaling (Van Koten et al., 2008; Vegil et al., 2010; Parikshak et al., 2013; Gilbert & Manji, 2017). Among the various complications associated with children diagnosed with autism spectrum disorder, comorbid conditions such as depression, anxiety, attention deficit, hyperactivity, and sleep disturbances (Yang et al., 2022), along with cognitive-perceptual dysfunctions, executive dysfunction, and information processing difficulties, are commonplace (Weir et al., 2022). The collective accumulation of these functional and behavioral deficiencies culminates in increasingly divergent patterns of development from normative standards (Woznik et al., 2017). In examining autism spectrum disorder, two principal approaches come to light. The first approach focuses on addressing behavioral symptoms and remediating behavioral deficits via symptom-based interventions. Simultaneously, a neurodevelopmental perspective (which encompasses the researcher's viewpoint) prioritizes a developmental-oriented approach. Since development is intrinsically tied to the functionality of neuronal structures, transformation must originate from changes to those very structures (Chakraburty, 2021).
To effectively address this class of neurodevelopmental disorders through rehabilitation, it is imperative to identify interventions capable of instigating transformation in the neural development process and activating intrinsic self-repair mechanisms by harnessing the adaptive capabilities of the nervous system. Studies have revealed that certain techniques traditionally employed solely for educational purposes can also stimulate brain function and promote neurogenesis. Aerobic exercise is one such intervention that falls into this category. Aerobic exercise functions by activating the cardiovascular system and increasing heart rate while simultaneously pumping greater amounts of oxygen to the brain (Datta, 2019). Another highly effective intervention within the field of neurodevelopmental disorders is sports training. This is significant given that anomalies in the central oxytocinergic and serotonergic systems are recognized as a root cause behind the social-functional deficits exhibited by individuals diagnosed with autism spectrum disorder (Mohdi et al., 2013). It has been documented that sports training can help modulate this metabolism (Mohdi et al., 2013), which furthermore diminishes disruptive behaviors such as aggression.
The essence of this research revolves around the deliberate design of a therapeutic approach, coined as "Neuro-Exuberant Proliferation Therapy" by the researcher. This approach embodies a comprehensive, neurodevelopmental orientation, taking into account the dimensions and scope of the impairment and the unique individual variations of each child. By applying principles of play therapy, a targeted regimen of exercises is implemented to achieve desired transformational outcomes. The differentiation of the "Neuro-Exuberant Proliferation Therapy" method from traditional utilization of sports or mental exercises lies in its emphasis not only on employing the principle of synergy but also on directly targeting the activation of brain structures, fostering neurogenesis, and promoting neural network formation through behavioral interventions.
The execution model of "Neuro-Exuberant Proliferation Therapy" adheres to the mind's networking model, which pertains to the utilization of cognitive and executive functions. The exercises employed are designed to mimic the developmental stages of children's cognitive and executive functions. This modeling approach facilitates the activation of brain networks associated with cognitive tasks and decision-making. The foundational theory behind the Neuro-Exuberant Proliferation Therapy (NEPT) methodology is centered on the premise that the proliferation of beneficial neurons leads to the formation of developmental stages and milestones. Over time, this process leads to the elimination of non-useful neuronal pathways. From this perspective, exercises have been selected that are extensively researched and proven to yield significant neurodevelopmental advancements, specifically those categorized as "exuberant proliferation."
Literature Review
The meta-analysis conducted by Delani (2021) reveals that employing aerobic exercise, particularly at high intensity, is highly effective in mitigating the symptoms associated with autism spectrum disorder. Some observed effects of this intervention include a reduction in stereotyped behaviors and repetitive movements, as well as improvements in sleep pattern regularity and attention span. According to Delani (2021), these findings have the potential to substantially influence the design of therapy programs and the organization of special education in schools. Additionally, recent research by Jackson et al. (2022) highlights that performing aerobic exercises synergistically can yield even more substantial positive effects.
It has also been observed that when these exercises are performed intermittently at a high intensity and at a moderately to intensely challenging level, they can lead to significant enhancements in cognitive flexibility and social performance among individuals (Mamari et al., 2017). Sensory integration plays a pivotal role in the effectiveness of these interventions. Researchers have observed that the successful integration of sensory inputs, encompassing the proprioceptive (body position), vestibular (balance and movement), and interoceptive (internal bodily sensations) systems, has a profound impact during combined exercise training. This integrated sensory input is critical for developing the skills necessary for participating in a broad spectrum of daily activities (Miller et al., 2014).
Methodology
The research employed a mixed-methods approach, being both fundamental and applied in nature. To design and assess the desired intervention, the Goodman Delphi method (1987) was utilized. In the first step, the "pre-clinical stage," an extensive review of scientific databases was conducted using the keywords "Neurodevelopment," "Autism," and "Proliferation." A total of 103 studies demonstrating the highest reported rates of neurodevelopmental progress in children diagnosed with neurodevelopmental disorders, particularly autism spectrum disorder, were identified and collected for reference.
The review process, specifically the second step in the research methodology, involved the selection of 15 meta-analysis studies that comprehensively assessed recent research and included larger sample sizes with input from a broad group of expert researchers. The theoretical foundations and main aspects of the desired treatment method were extracted from these studies, in accordance with neurological functions and aligned with relevant specialized texts. The initial treatment plan was subsequently developed under the supervision of psychology professors. The principles, techniques, and theoretical and functional areas considered by the author in designing the chosen treatment method were presented to relevant field experts. These experts evaluated the components and provided feedback, which the author incorporated into the final intervention.
Results
The comparative analysis of the average scores of the subjects in the experimental group between the pre-test and post-test phases demonstrates a favorable progression in the attributes linked to communication, gross motor skills, and problem-solving abilities. The findings indicate a significant impact of the intervention strategy on these three specific factors.
The research data reveal statistically significant improvements in the problem-solving (p = 0.000), communication (p = 0.008), and gross motor skills variables. These three factors also exhibit substantial effect sizes of 43%, 27%, and 26%, respectively. Notably, the personal-social skills and fine motor skills variables, while showing change, were not statistically significant (p = 0.427 and p = 0.221, respectively) and did not demonstrate substantial effects within the three-month study period.
Table 1- The results of multivariate analysis of covariance of ASQ scales
Eta Squared
Level of Significance
F
Mean Square
Degree of Freedom
Sum of Squares
Source
0.269
0.008
8.458
246.637
1
246.637
Communicating
0.256
0.009
7.896
157.877
1
157.877
Gross Movements
0.064
0.221
1.586
4.948
1
4.948
Subtle Movements
0.430
0.000
17.334
161.24
1
161.24
Problem Solving
0.028
0.427
0.653
8.854
1
8.854
Personal-Social Skills
The GARS-3 test scores of the experimental group show considerable improvement between the pre-test and the post-test assessment across all dependent variables. According to the results obtained during the post-test phase, the NEPT method was found to be effective in addressing symptoms related to repetitive and stereotyped behaviors (67%), social interactions (57%), social communication (57%), and emotional reactions (67%). The overall efficacy of the therapy on the total symptoms of autism is estimated at 86%.
Table 2- Mancova test results of GARS-3 Gilliam autism scales
Eta Squared
Level of Significance
F
Mean Square
Degree of Freedom
Sum of Squares
Source
0.674
0.000
47.507
51.252
1
51.252
Stereotyped Behaviors
0.567
0.000
30.091
17.696
1
17.696
Social Interactions
0.570
0.000
30.531
5.936
1
5.936
Social Communication
0.675
0.000
47,860
11.418
1
11.418
Emotional Reactions
0.865
0.000
147.814
392.869
1
392.869
All Symptoms of Autism
Discussion
The findings align with several preceding meta-analytical studies pertaining to stereotypic behaviors, obsessive interests, and emotional reactions (Elliott et al., 1994; Seliberti et al., 1997; Long et al., 2010; Delaney, 2021). However, certain other investigations, such as Linderman et al. (1999), display conflicting results. These discrepancies can be attributed to various factors, including the age of the children at intervention, session quality, the combination of exercises, the level of the child's engagement in activities, and the number of sessions provided.
Studies conducted by Schaff et al. (2014), Basu et al. (2017), and Hong et al. (2020) corroborate the findings of this research. These researchers highlight that aerobic exercise leads to increased levels of brain-derived neurotrophic factor (BDNF), which supports the expansion of neural networks. This process results in modified behavioral patterns through heightened flexibility and the formation of new neural connections (Lees & Hopkins, 2013; Mandelsi et al., 2018; Arida et al., 2021).
Numerous meta-analyses, including those conducted by Liao et al. (2015), Basu et al. (2017), Hong et al. (2020), Jia et al. (2022), and Li et al. (2023), affirm the overall positive influence of aerobic exercise on cognitive performance, tasks related to the prefrontal cortex, and its beneficial impact on emotional states, mood, and emotional regulation. This positive effect can be attributed to the mechanisms of action of brain-derived neurotrophic factor (Caro et al., 2003) and nerve growth factors.
Conclusion
It can be stated that the NEPT method, as an initial behavioral intervention with a neurodevelopmentally oriented approach, has demonstrated considerable effects on developmental factors. Emphasizing the importance of development, rehabilitation must transcend survival and focus on nurturing growth. The NEPT method has the potential to spark a profound transformation in the realm of rehabilitation by shifting the focus from survival to comprehensive development.
Mohammad Narimani; Sanaz Eyni; Jhila Neiazi
Abstract
One of the most important issues in blind people is their memory and auditory processing. The purpose of this research was to systematically review the researches conducted in the field of auditory processing and types of memory of blind people compared to sighted people. The method of this research ...
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One of the most important issues in blind people is their memory and auditory processing. The purpose of this research was to systematically review the researches conducted in the field of auditory processing and types of memory of blind people compared to sighted people. The method of this research was a systematic review of 26 articles in the years 1388-1395 and 2004-2022 in the field of research related to memory and auditory processing of blind people compared to sighted people using Google Scholar, Eric, EBSCO, Science Direct, Scopus, PubMed, as well as Magiran, SID, Comprehensive Humanities Portal, Iran Doc, Noormags with the keywords of blindness, visual impairment, auditory processing, sighted and congenitally blind were used and selected for systematic reviews. The findings showed that out of 1381 sample groups, 48 percent were blind and 715 sighted participated. 30% of the studies in the field of short-term memory, 33% in the field of auditory-verbal memory, 15% in working memory, 11% in spatial memory, 7% in olfactory memory and 4% in numerical memory compared blind and sighted people. The findings indicated that, in general, in short-term memory, auditory-verbal memory, and working memory, the performance of blind people was better than that of sighted people. In the field of spatial memory, the results were inconsistent, and there was no significant difference between the olfactory memory of blind and sighted people. In terms of numerical memory, the performance of sighted people was better. In general, it is better to conduct more research focusing on one type of memory so that all aspects of it can be clarified.
Marjan Al-e Behbahani; moloud keykhosrovani; Naser Amini; Mohammad Narimani; Behnam Aldin Jamei
Abstract
The aim of this study was to compare the effectiveness of vibroacoustic therapy and logodotherapy on aggression in children with autism. The research method was quasi-experimental pre-test-post-test with a control group and one-month follow-up. The statistical population of the study included 85 children ...
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The aim of this study was to compare the effectiveness of vibroacoustic therapy and logodotherapy on aggression in children with autism. The research method was quasi-experimental pre-test-post-test with a control group and one-month follow-up. The statistical population of the study included 85 children aged 6-12 years with autism spectrum disorder who referred to two autism rehabilitation centers in Tehran (Shamim and Fariha centers) in the first half of 1398. Among them, 30 people (21 boys and 9 girls) were selected as a research sample by purposive sampling method and 10 people were randomly replaced in three groups of experiments (1, 2) and control. The first experimental group received vibroacoustic therapy for 12 sessions (20 minutes) and the second experimental group received logodotherapy for 12 sessions (45 minutes); The control group was placed on a waiting list. The Shahim Children's Aggression Questionnaire (2006) was used to collect information. In order to analyze the data, repeated measures analysis of variance and Bonferroni post hoc tests were used. Findings from the study showed that by controlling the effect of pre-test, there was a significant difference between the mean scores of aggression components (relational, verbal and physical aggression) in the experimental group and the control group in the post-test and follow-up. . Also, the findings showed that vibroacoustic therapy was more effective than legodotherapy in reducing aggression in children with autism.
Mohamad Javad Ranjbar; sajjad basharpoor; naser sobhi gharamaleki; Mohammad Narimani
Abstract
The purpose of this study was to compare the effectiveness of computer-based cognitive rehabilitation and practical neuropsychological interventions on working memory and sustained attention in students with dyslexia. The method of this study was experimental and its design was multi-group pretest and ...
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The purpose of this study was to compare the effectiveness of computer-based cognitive rehabilitation and practical neuropsychological interventions on working memory and sustained attention in students with dyslexia. The method of this study was experimental and its design was multi-group pretest and posttest with control group. Statistical population of this study included elementary students with dyslexia in Amol and Mahmoudabad cities during the academic year of 1397-98, who were referred to learning disability centers. 45 students were selected by convenience sampling method and assisted by diagnostic tests of Raven and reading and dyslexic test (NAMA). They were randomly assigned to experimental and control groups. The experimental groups were received 14 interventions sessions. The computer version of the n-back test and computer version of the continuous performance task were used for gathering data in two pre and posttest stages. Data were analyzed by multivariate analysis of covariance. The results showed that computer-based rehabilitation was more effective (P<0.05) on the amount of correct responses in sustained attention, and correct response and reaction time in working memory in comparing to practical neuropsychological exercises. These results reveal that computerized cognitive rehabilitation with providing the visual and audio attractions and the creation of opportunities appropriate to the level of child's development can provide a more appropriate field for improving the defects of the high-quality functions of the minds of people with dyslexia.
Mohammad Narimani; Masoud Talebi Jooybari; Abbas Abolqassemi
Volume 3, Issue 10 , March 2013, , Pages 41-64
Abstract
Thepresent paper aims atcomparing the attributionalstyle and resilience in students with visual or motor disabilities and normalstudents. In this applied and field research, the statistical populationincludes all normal and disabled students aged between 15 and 19 years old inSari and Qaemshahr Cities. ...
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Thepresent paper aims atcomparing the attributionalstyle and resilience in students with visual or motor disabilities and normalstudents. In this applied and field research, the statistical populationincludes all normal and disabled students aged between 15 and 19 years old inSari and Qaemshahr Cities. 120 students (60students with visual and motor disability and 60 normal students) from the school of Sari and Qaemshahr cities participated in thestudy. All participants were asked to complete the attributional style questionnaire (ASQ) and (CD-RTS9) resilience questionnaire. Analysis of the data involved both descriptiveand inferential statistics including means, standard deviation, multivariateanalysis of variance, correlation coefficient and multivariate regression. The result of analysis of variance show that there isa significant difference between students with (visual and motor) disabilitiesand normal students in components of unpleasantinternal-external attribution, unpleasant temporary-stable attribution,geneal-specific attribution and resilience. This indicatesa more pessimistic attributionalstyle in the first group. There is a positive correlation betweenattributional style and resiliency. The regressionanalysis shows that the components of attributional style can predict theresiliency (p<0.01). The results of this study suggest that educationprofessionals should embark on planning and implementing combined therapeuticprograms for students with visual and motor disabilities who suffer fromemotional disorders
Hassan Reza’i Jamalooyi; Abbas Abolqassemi; Mohammad Narimani; Adel Zahed
Volume 2, Issue 8 , February 2012, , Pages 77-98
Abstract
The purpose of the present research is to compare peer acceptance in students with learning disability and students with low, moderate and high academic achievement.Statistical population of this applied and causal-comparativeresearchincludes the second-grade middle school students in Ardabil City. The ...
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The purpose of the present research is to compare peer acceptance in students with learning disability and students with low, moderate and high academic achievement.Statistical population of this applied and causal-comparativeresearchincludes the second-grade middle school students in Ardabil City. The research sample consists of 160 students (40 with learning disability, 40 with low, 40 with moderate, and 40 others with high academic achievement) selected through multistage cluster random sampling. In order to collect data, reading, writing and math tests, peer acceptance scale and Moreno’S sociomotric test were used. The MANOVA results show that there is a significant difference between students with learning disability and students with low, moderate and high academic achievement in peer acceptance. The results indicate that students with learning disability and the ones with low academic achievement have bigger problems in peer acceptance.The findings of this study have important implications about education and counseling servicesfor exceptional students. Therefore, it is suggested that by teaching social communicative skills to students with learning disabilities, they should be helped to increase their popularity among their classmates to overcome their academic problems.