نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری روان‌شناسی و آموزش کودکان استثنایی،دانشگاه علامه طباطبائی، تهران، ایران.

2 دانشیار گروه روان‌شناسی و آموزش کودکان استثنایی، دانشگاه علامه طباطبائی، تهران، ایران.

3 استادیار گروه روان‌شناسی و آموزش کودکان استثنایی، دانشگاه علامه طباطبائی، تهران، ایران.

4 استاد گروه روان‌شناسی و آموزش کودکان استثنایی، دانشگاه علامه طباطبائی، تهران، ایران.

چکیده

پژوهش حاضر باهدف بررسی اثربخشی بازتوانی شناختی رایانه‌یار بر مؤلفه‌های حافظة فعال دانش آموزان با اختلال نارسایی توجه/ بیش فعالی انجام شد. روش این پژوهش نیمه آزمایشی با طرح پیش‍آزمون_پس‍آزمون با گروه کنترل بود. جامعه آماری پژوهش شامل تمامی دانش آموزان پسر با اختلال نارسایی توجه-بیش فعالی شهر تهران بود. برای انتخاب نمونه از بین همه دانش آموزان پسر دچار اختلال نارسایی توجه-بیش فعالی شهر تهران، 30 نفر از آن‌ها که در محدوده سنی 7 تا 12 سال (محصل در مقطع ابتدایی) بودند با توجه به ملاک‌های ورود با روش نمونه‌گیری هدفمند به‌عنوان نمونه انتخاب شدند و به‌طور تصادفی در دو گروه آزمایش و گروه کنترل قرار گرفتند. ابزار پژوهش شامل پرسشنامه رفتاری کانر و آزمون حافظه ارقام هوش وکسلر کودکان بود. برنامه توان‎بخشی شناختی رایانه یار کاپیتان لاگ به مدت 10 جلسه 60 دقیقه‍ای و دو بار در هفته برای گروه آزمایش اجرا شد. نتایج تحلیل کوواریانس نشان داد برنامه بازتوانی شناختی رایانه‌یار موجب بهبود مؤلفه‌های حافظة فعال دانش آموزان با اختلال نارسایی توجه/ بیش فعالی شده است (05/0>P) و می‍تواند به‌عنوان روشی مناسب در بهبود حافظه فعال این دانش آموزان به کار رود.

کلیدواژه‌ها

عنوان مقاله [English]

Investigating the Effectiveness of Computer-Aided Cognitive Rehabilitation on Working Memory Components of Students with Attention Deficit/Hyperactivity Disorder

نویسندگان [English]

  • mehdi rasuli 1
  • Saeed Rezayi 2
  • fateme nikkhoo 3
  • .Parviz Sharifi Daramadi 4

1 PhD student in Psychology and Education of Exceptional Children, Allameh Tabatabai University, Tehran, Iran.

2 Associate Professor, Department of Psychology and Education of Exceptional Children, Allameh Tabatabai University, Tehran, Iran.

3 Assistant Professor, Department of Psychology and Education of Exceptional Children, Allameh Tabatabai University, Tehran, Iran.

4 Full Professor, Department of Psychology and Education of Exceptional Children, Allameh Tabatabai University, Tehran, Iran.

چکیده [English]

Abstract
The present study was conducted with the aim of investigating the effectiveness of computer-assisted cognitive rehabilitation on the working memory components of students with attention-deficit/hyperactivity disorder. The statistical population of the research included all male students with attention deficit hyperactivity disorder in Tehran. To select a sample from among all male students suffering from attention deficit hyperactivity disorder in Tehran, 30 of them were in the age range of 7 to 12 years old (students in elementary school) according to the inclusion criteria using the purposeful sampling method. They were selected as samples and were randomly divided into two experimental and control groups. The research tools included Connor's behavioral questionnaire and the Wechsler IQ memory test for children. The cognitive rehabilitation program of Yar Captain Log computer was implemented for 10 sessions of 60 minutes and twice a week for the experimental group. The results of the covariance analysis showed that the computerized cognitive rehabilitation program has improved the active memory components of students with attention-deficit/hyperactivity disorder (P<0.05) and can be used as a suitable method to improve the active memory of these students.
Keywords: Computer-Aided Cognitive Rehabilitation, Working Memory, Students, Attention Deficit/Hyperactivity Disorder.
 
 
 
Extended Abstract

Introduction

Attention deficit/hyperactivity disorder is one of the most common neuropsychological disorders known in children and adolescents, and longitudinal studies have shown that this disorder is generally stable during development (Tandon and Perjika, 2017). Worldwide, this disorder affects about 8 to 12% of children under 12 years of age (Ronald et al., 2021). But research showed that the prevalence of this disorder among children in Iran is 10 to 12%. (Rafiei et al., 2019). This disorder of attention deficit/hyperactivity disorder is associated with extensive negative consequences (American Psychiatric Association, 2013). This disorder leads to disorder in various fields and affects not only the individual but also the structure of the family and society. (Schneider et al., 2019) One of the areas in which children with attention deficit/hyperactivity disorder have problems and have a lot of failure is working memory (Michelini et al., 2023)
Active memory is a systematic structure that connects short-term and long-term memory functions with other cognitive and emotional dimensions. To put it more clearly, active memory means keeping information in the mind and performing continuous activities on it in the shortest possible time (Criter et al., 2022. (In general, active memory is divided into two parts: visual active memory and auditory active memory. Visual working memory is a part of fundamental function of working memory that allows temporary storage and manipulation of visual information related to an ongoing or imminent behavior or activity (Gambarota and Sessa, 2019). Active auditory memory also refers to the process of keeping sounds in the mind for short periods of time when sounds do not exist in the environment for a relatively long period of time (Kamar et al., 2016). Today, active memory as one of the most important and fundamental issues has attracted the attention of many researchers (Perez Martin et al., 2017; quoted by Fathabadi et al., 2019).
Although there is evidence of the beneficial and effective effects of stimulant drugs such as Ritalin for improving the symptoms of attention deficit/hyperactivity disorder and reducing cognitive problems with attention deficit/hyperactivity disorder, the problem is that some other evidence shows that the symptoms of this disorder recur immediately after stopping the drug, and in addition, parents avoid giving the drug to their children due to the fear of stigma and side effects of the drugs (Killo et al., 2018). Therefore, the importance of dealing with non-pharmacological treatments to improve the complications of this disorder has become more and more in the spotlight, and among them, non-invasive approaches based on computer-based cognitive rehabilitation can be mentioned to improve cognitive performance, including the working memory of these children. (Zinali and Mirzadeh, 2018)
Although many studies have pointed to the effectiveness of cognitive rehabilitation on improving the cognitive performance of students with attention deficit/hyperactivity disorder, and also many studies have pointed to the effectiveness of computer-based cognitive rehabilitation on improving the cognitive performance of other groups, unfortunately, the role of computer use in the cognitive rehabilitation of children with attention deficit/hyperactivity disorder has been neglected, therefore, in view of the above, the present study fills the research gap in this field and is also important from the practical point of view, and the question of the present study is this: Is computer-aided cognitive rehabilitation effective on the working memory of students with attention deficit/hyperactivity disorder?

Literature Review

In line with the current research, Zare et al. (2019) showed in a research that computerized cognitive rehabilitation is effective in improving the working memory and cognitive flexibility of children with learning disabilities. Ranjbar et al. (2019) showed in a research that computer-based cognitive rehabilitation tasks improved the cognitive processes of children with executive function defects. In a research, Iriwaki et al. (2016) concluded that computerized cognitive rehabilitation has reduced the cognitive deficit of students with learning disabilities. Xiao et al. (2022) showed in a research that computerized cognitive rehabilitation improves the cognitive performance of students, and Skiankaper et al. (2022) showed in a research that computerized cognitive rehabilitation improves the cognitive function of children. In recent years, according to the advancement of the knowledge of psychologists and educational specialists, attention to children's cognitive issues, especially the search for solutions to solve children's cognitive problems, has become prominent, among which cognitive interventions for children with attention deficit/hyperactivity disorder are also of this rule. It is not excluded (Miranda et al., 2013)

Methodology

The research design was a semi-experimental pre-test-post-test type with a control group. The statistical population of the present study includes all male patients suffering from Attention Deficit/Hyperactivity Disorder in Tehran. In this research, to select a sample from among all male students suffering from attention deficit-hyperactivity disorder in Tehran, 30 people were selected as a sample according to the inclusion criteria by purposive sampling method and were randomly divided into two experimental groups and were controlled. In order to collect information and gain access to the sample community, the researcher, after obtaining a research permit from the General Directorate of Education and Education of Region 3, went to educational psychology centers and by presenting a letter of introduction and coordinating with the director of the center, the sample group of boys with Attention-deficit/hyperactivity disorder was selected based on psychiatric records, and after obtaining consent from their parents, Connors questionnaire (parent form) was completed to ensure the diagnosis of attention-deficit/hyperactivity disorder

Results

In the current study, the sample included 30 students who were in the age range of 7-12 years and with an average of 10 years. Descriptive information on the active memory variable and its components are presented separately for groups in two situations: pre-test and post-test.
According to the results of Table 2, the average of the groups shows that the working memory scores in the post-test of the experimental group have improved compared to the pre-test scores. Covariance analysis was used to analyze the data. For this purpose, the assumptions of the analysis of the covariance test, i.e. the assumption of normality of the distribution, were checked using the Kalmogorov-Smirnov test (P>0.05) and the results of the normality of the distribution were confirmed. Levine's test was used to check the homogeneity of error variance. This test did not show any violation of this assumption. Analysis of covariance test was used for the effectiveness of computer-aided cognitive rehabilitation on working memory components of children with attention deficit/hyperactivity disorder.
The results show that there is a significant difference between the experimental and control groups in the variables of auditory and visual active memory (P<0.05). Considering that the average of the experimental group compared to the control group shows an improvement in the dependent variable, it can be concluded that computerized cognitive rehabilitation has led to an improvement in working memory.

Conclusion

In explaining the effectiveness of computer-aided cognitive rehabilitation on the improvement of working memory components (auditory and visual) of students with attention deficit/hyperactivity disorder, it can be said that Captain Log cognitive rehabilitation software was used in this research because this software teaches orientation skills, response inhibition, multi-step commands, and auditory and visual memory, it can improve active auditory and visual memory in these students. Completing the tasks and games in the software requires the engagement of auditory and visual working memory, and by playing the game and moving to higher levels, the amount of this engagement increases, and with practice and repetition, it strengthens the subject's active memory. It is also possible to point out the feature based on the reinforcement of the tasks of this intervention (Nazarzadeh Giglo et al., 1400). In another explanation, it can be said: an active brain forms very important neurological connections for learning, while a brain that is not active does not create this stable and necessary neurological information. Having the ability to adjust the level of difficulty of tasks from simple to difficult increases brain activity, therefore, failure in working memory is related to dysfunction in the frontal lobe, on the other hand, Yar's cognitive rehabilitation with Captain Lockeg software can stimulate these areas (Abdelmohammadi and colleagues, 1401). For this reason, in this research, computerized cognitive rehabilitation has improved the working memory components (auditory and visual) of students with attention deficit/hyperactivity disorder.
In general, according to the findings of the current research on the effectiveness of computer-aided cognitive rehabilitation on improving working memory components (auditory and visual) of students with attention deficit/hyperactivity disorder, it is appropriate that schools and attention deficit/hyperactivity disorder treatment centers use the computerized cognitive rehabilitation package with the aim of improving the working memory components of students with attention deficit/hyperactivity disorder.

کلیدواژه‌ها [English]

  • Computer-Aided Cognitive Rehabilitation
  • Working Memory
  • Students
  • Attention Deficit/Hyperactivity Disorder
آبباریکی، اکرم؛ یزدانبخش، کامران و مؤمنی، خدامراد. (1396). اثربخشی توان‌بخشی شناختی رایانه‌ای بر کاهش نارسایی شناختی دانش آموزان با ناتوانی یادگیری. روان‌شناسی افراد استثنایی 7(26)، 127-157.
حبیبی کلیبر، رامین و بهادری خسروشاهی، جعفر. (1398). اثربخشی توان‌بخشی شناختی رایانه‌ای بر شناخت اجتماعی، کنترل مهاری و اجتناب شناختی دانش‌آموزان دارای اختلال یادگیری ریاض.  عصب روان‌شناسی 5(17)، 89-108.
رفیعی، الهام.، بزرگ‌زاده، محدثه السادات.، اسمعیل درجانی، رقیه. و سنگانی، علیرضا. (1399). با بررسی اثربخشی آموزش تکنیک‌های بازتوانی ذهنی بر عملکرد عصب روان‌شناختی کودکان پسر مبتلا به اختلال نقص توجه و بیش فعالی، سلامت جامعه، 14(2)، 1-10.
رنجبر، مریم؛ حسن‌زاده، سعید و ارجمندنیا، علی‌اکبر. (1399). بررسی تأثیر تکالیف توان‌بخشی شناختی مبتنی بر رایانه (رحا) بر فرآیندهای شناختی کودکان با اختلال کارکردهای اجرایی. عصب روان‌شناسی 6(23)،27-42.
فتح‌آبادی، روح‌الله؛ نصرتی، فاطمه؛ احمدی، احمد و رستمی، بهاره (1399). اثربخشی تمرینات حرکتی ریتمیک بر کارکردهای اجرایی، در مؤلفه‌های بازداری رفتاری و حافظه فعال کودکان پسر اوتیستیک با عملکرد بالا، مجله پژوهش‌های کاربردی روان‌شناختی 11(2)،143-163.
زارع، حسین؛ چرامی، فاطمه و شریفی، علی‌اکبر. (1399). اثربخشی توان‌بخشی شناختی رایانه‌ای بر حافظه کاری و انعطاف‌پذیری شناختی کودکان دارای اختلال یادگیری. دو فصلنامه راهبردهای شناختی در یادگیری 8(15)، 1-18.
زینالی، شیرین و میرزازاده، شیرین. (1398). اثربخشی توان‌بخشی شناختی بر حافظه کاری و سرعت پردازش کودکان اختلال نقص توجه/ بیش فعالی. فصلنامه پژوهش‌های نوین روان‌شناختی 14(56)،213-232.
عابدی، محمدرضا؛ صادقی، احمد و ربیعی، محمد. (1394). هنجاریابی آزمون هوشی وکسلر کودکان چهار در استان چهارمحال و بختیاری. دستاوردهای روان‌شناختی 22(2)، 99-116.
عبدالمحمدی، کریم؛ محمدزاده، علی و غدیری صورمان‌آبادی، فرهاد (1401). اثربخشی توان‌بخشی شناختی رایانه‌ای بر ارتقاء بازداری پاسخ و حافظه کاری در نوجوانان دارای گرایش به مصرف مواد. فصلنامه علمی اعتیادپژوهی. ۱۶ (۶۶): ۷۱-۹۰.
علیزاده، حمید. (1384). تبیین نظری اختلال نارسایی توجه/بیش فعالی: الگــوی بازداری رفتاری و ماهیت خودکنترلی. فصلنامه کودکان استثنایی 5(3)، ۲۳۱-۲۵۲.
نظرزاده، گیگلو، سالار؛ فتح‍آبادی، جلیل نجاتی، وحید؛ نظربلند، ندا و صادقی فیروزآبادی، وحید. (1400). تأثیر توان‌بخشی شناختی مبتنی بر رایانه (نرم‍افزار آرام) بر کارکردهای اجرایی (توجه انتخابی، حافظه کاری و بازداری رفتاری) دانش‍آموزان با اختلال یادگیری خاص. دوفصلنامه پویش در آموزش علوم تربیتی و مشاوره، 7(15)، 89-69.
References
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders. Text Revision (DSM-V). 5th. Arlington: American Psychiatric Association Publication.
Conners, C. K., Sitarenios, G., Parker, J. D., & Epstein, J. N. (1998). Revision and restandardization of the Conners Teacher Rating Scale (CTRS-R): factor structure, reliability, and criterion validity. Journal of abnormal child psychology26, 279-291.‏
Gambarota, F., & Sessa, P. (2019). Visual working memory for faces and facial expressions as a useful “tool” for understanding social and affective cognition. Frontiers in psychology10, 2392.‏
Gathercole, S. E. (1998). The development of memory. The Journal of Child Psychology and Psychiatry and Allied Disciplines39(1), 3-27.‏
Keilow, M., Holm, A., & Fallesen, P. (2018). Medical treatment of Attention Deficit/Hyperactivity Disorder (ADHD) and children’s academic performance. PloS one13(11), e0207905.‏
Kreither, J., Papaioannou, O., & Luck, S. J. (2022). Active working memory and simple cognitive operations. Journal of cognitive neuroscience34(2), 313-331.‏
Kumar S, Joseph S, Gander PE, Barascud N, et al(2016). A brain system for auditory working memory. Journal of Neuroscienc 36(16): 4492-45050.
Ludyga, S., Gerber, M., & Kamijo, K. (2022). Exercise types and working memory components during development. Trends in cognitive Sciences26(3), 191-203.‏
Michelini, G., Lenartowicz, A., Diaz-Fong, J. P., Bilder, R. M., McGough, J. J., McCracken, J. T., & Loo, S. K. (2023). Methylphenidate, Guanfacine, and Combined Treatment Effects on Electroencephalography Correlates of Spatial Working Memory in Attention-Deficit/Hyperactivity Disorder. Journal of the American Academy of Child & Adolescent Psychiatry62(1), 37-47.‏
Miranda, A., Presentación, M.J., Siegenthaler, R., & Jara, P. (2013). Effects of a Psychosocial Intervention on the Executive Functioning in Children With ADHD. Journl of Learning Disabilities, 46 (4): 363-376.
Ronald, A., de Bode, N., & Polderman, T. J. (2021). Systematic review: how the attention-deficit/hyperactivity disorder polygenic risk score adds to our understanding of ADHD and associated traits. Journal of the American Academy of Child & Adolescent Psychiatry60(10), 1234-1277.‏
Schneider, M., VanOrmer, J., & Zlomke, K. (2019). Adverse childhood experiences and family resilience among children with autism spectrum disorder and attention-deficit/hyperactivity disorder. Journal of Developmental & Behavioral Pediatrics40(8), 573-580.‏
Sciancalepore, F., Tariciotti, L., Remoli, G., Menegatti, D., Carai, A., Petruzzellis, G., ... & Group, A. M. S. (2022). Computer-based cognitive training in children with primary brain tumours: A systematic review. Cancers14(16), 3879.‏
Tandon M, & Pergjika D. (2017). Attention deficit hyperactivity disorder in preschool-age children. Child Adolesc Psychiatr Clin N Am, 26(3): 523-38.
Xiao, Z., Wang, Z., Song, G., Zhong, Y., & Zhang, W. (2022). Rehabilitation efficacy comparison of virtual reality technology and computer-assisted cognitive rehabilitation in patients with post-stroke cognitive impairment: A network meta-analysis. Journal of Clinical Neuroscience103, 85-91.‏