The present study was conducted to investigate the effectiveness of cognitive-behavioral play therapy on social anxiety and academic self-concept of elementary school students with stuttering. The method in terms of purpose, was an application and information-gathering aspect, was a semi-experimental type of pre-test, and post-test with a control group. The statistical population of this study included all primary school students in Shiraz of which 30 were selected by available sampling. The research tool was the Social Anxiety Questionnaire (LSAS-SR) and the academic self-concept questionnaire was administered to both groups, and the experimental group underwent intervention for 10 one-hour sessions. The collected data were analyzed using univariate and multivariate analysis of covariance in SPSS-24. The findings showed that there is a significant difference between the average scores of the compared groups in social anxiety in the post-test, which indicates that the average scores of social anxiety in the experimental group (53.93) compared to the control group (57.06) has significantly decreased. Also, there is a significant difference between the average scores of the compared groups in the academic self-concept in the post-exam, which indicates that the average scores of the academic self-concept in the post-exam in the experimental group (47.66) compared to the control group (43.36) ) has increased significantly. Therefore, the hypothesis of the research based on the effectiveness of cognitive-behavioral play therapy on social anxiety and academic self-concept of elementary school students with stuttering is confirmed.
Keywords: Cognitive-Behavioral Play Therapy, Social Anxiety, Academic Self-Concept, Stuttering.
 
 
 
Extended Abstract
Introduction
Stuttering as a communication disorder can lead to serious problems in interpersonal relationships and affect the quality of a person's life. People with stuttering are prone to anxiety and anxiety disorders, especially social anxiety disorder. People with stuttering gradually use avoidance behaviors due to their bitter experiences of stuttering. These behaviors and fears cause refusal of social communication. Social anxiety in childhood and adolescence is associated with problems in cognitive and emotional dimensions and social adaptation. These children have not made much progress in school due to anxiety, they have weak social relationships and have less adaptability than their peers. Lack of academic success causes these students to become discouraged from studying and weaken their morale or drop out. Therefore, these children can have weak self-concepts. Academic self-concept is a form of self-concept that is formed as a result of mutual actions and learning experiences and academic progress, and this shows that academic self-concept is learnable and acquired. Cognitive-behavioral play therapy training leads to the reduction of students' anxiety, tension, shyness and social isolation and increases their health and psychological ability. Therefore, the present study was designed with the aim of determining the effectiveness of cognitive-behavioral play therapy on social anxiety and academic self-concept of elementary school students with stuttering.
Methodology
The current research was a semi-experimental study of pre-test-post-test type with a control group. The statistical population of this research was all elementary school students with stuttering referred to speech therapy centers in Shiraz. The study sample was 30 people from the mentioned statistical population who were selected purposefully and available based on the entry and exit criteria and were placed in two experimental and control groups. The data collection tools including the Leibovitz social anxiety scale questionnaire, and academic self-concept scale were implemented in both groups, and the experimental group underwent cognitive-behavioral play therapy intervention for 10 sessions of 60 minutes with the plan suggested by Rivier (2006). And it was placed in a group. The data were analyzed using univariate and multivariate analysis of covariance in SPSS-24.
Results
To check the presuppositions of covariance analysis, the results of the Shapiro-Wilk test showed that the data distribution is normal (p < 0.05), in order to check the homogeneity of the error variance of the research variable in the three groups, Levin's test was used, which level the significance of the F statistic was greater than 0.05, and in examining the slope of the regression line and the interaction between the groups and the pre-test of the variables, the results showed that the significance level of F is greater than the critical value of 0.05. The results of the covariance analysis and the table of averages show that the average scores of social anxiety in the post-test in the experimental group (53.93) compared to the control group (57.06) have decreased significantly. Also, the discriminant chi-square analysis indicates that cognitive-behavioral play therapy explains 37% of the variance of social anxiety in children with stuttering. Also, the results of the analysis of covariance showed that there is a significant difference between the average scores of the compared groups of academic self-concept in the post-test [P = 0.001, F = 13.25]. Examining the mean table shows that the mean scores of academic self-concept in the post-test in the experimental group (47.66) compared to the control group (43.26) have increased significantly. Also, the discriminant square root analysis indicates that cognitive-behavioral play therapy explains 32% of the variance of academic self-concept in children with stuttering.
Discussion and Conclusion
The findings of the present study showed that cognitive-behavioral play therapy was effective on social anxiety and academic self-concept of elementary school students with stuttering. In cognitive-behavioral play therapy, the therapist accepts children's behavior unconditionally without surprising them, arguing with them, or pointing out the incorrectness of their work. During these games, the child understands the phenomena, understands the relationships and feels comfortable, and uses it as a tool to establish communication, exchange and test and master the external realities. In a way, it can be said that during this course of cognitive-behavioral play therapy in a safe environment, anxious children test the external reality without fear of evaluation. Academic self-concept is influenced by a person's educational experiences and the interpretation of the educational environment, and it expresses knowledge and perceptions in different academic fields. Stuttering can damage the student's perceptions, attitudes and beliefs about his ability. In cognitive-behavioral play therapy, encouragement is one of the main elements, encouragement helps the child to recognize which of his behaviors are approved by the therapist and which are not appropriate, and also helps the child to feel good about to earn.
Ethical considerations
This research is taken from the Master's thesis of Zahra Ezabadi, Department of General Psychology, Ardakan University, Yazd, code 2475187, dated 8/1/2018. Ethical considerations such as confidentiality, informed consent of the participants' parents and confidentiality of identity information have been fully observed in this study.
Acknowledgments
From all the officials of the speech therapy centers in Shiraz and the students of the sample group who cooperated in this research; thanks and appreciation is given.