نوع مقاله : مقاله پژوهشی

نویسندگان

• ابوالقاسم یعقوبی ¹
• محمدرضا روشنائی ²
• زینب قربانی ²
• شهریار یارمحمدی واصل ³

¹ استاد، گروه روان‌شناسی، دانشگاه بوعلی سینا، همدان، ایران.

² دانشجوی دکتری روان‌شناسی، دانشگاه بوعلی سینا، همدان، ایران.

³ استاد گروه روان‌شناسی، دانشگاه بوعلی سینا، همدان، ایران.

چکیده

هدف از این پژوهش بررسی تأثیر آموزش تربیت مخچه بر تنظیم هیجان و حفظ توجه در کودکان دارای نقص توجه-بیش‌فعالی بود. پژوهش حاضر نیمه-آزمایشی از نوع پیش‌آزمون-پس‌آزمون با گروه کنترل بود. جامعه آماری شامل دانش آموزان 9 تا 12 سال شهر تهران بود که از بین آن‌ها، تعداد 40 نفر که دارای نشانه‌های اختلال نقص توجه-بیش‌فعالی بودند، به روش در دسترس انتخاب و به‌صورت تصادفی در دو گروه 20 نفره آزمایش و کنترل جایگزین شدند. ابزارهای مورداستفاده شامل پرسشنامه تنظیم هیجان توسط شیلدز و سیچتی (1997)، آزمون نگهداری توجه/عملکرد پیوسته رازولد و همکاران (1956) و رویکرد آموزش تربیت مخچه آیرس (1974) بود. گروه آزمایش طی 20 جلسه تحت آموزش تربیت مخچه قرار گرفت و سپس از آن‌ها پس‌آزمون گرفته شد. نتایج تحلیل کوواریانس چند متغیره نشان داد تفاوت میانگین نمرات تنظیم هیجان و حفظ توجه بعد از آموزش تربیت مخچه در مقایسه با گروه کنترل معنادار است (01/0P<)؛ به‌طوری‌که آموزش تربیت مخچه موجب بهبود تنظیم هیجان و حفظ در کودکان دارای نقص توجه-بیش‌فعالی توجه شد. بر این اساس می‌توان گفت برنامه آموزش تربیت مخچه به دلیل تکیه بر تجربیات مستقیم حسی، بدنی و حرکتی، بر مخچه تأثیر گذاشته و باعث بهبود عملکرد آن و در ادامه بهبود عملکرد سیستم‌های حسی، هیجانی و توجه می‌شود.

کلیدواژه‌ها

• آموزش تربیت مخچه
• تنظیم هیجان
• حفظ توجه
• اختلال نقص توجه-بیش‌فعالی

عنوان مقاله [English]

The Effect of Cerebellar Training Method on Emotion Regulation and Attention Maintenance in Children with Attention Deficit-Hyperactivity Disorder

نویسندگان [English]

• Abolghasem Yaghoobi ¹
• Mohammad Reza Roshanaei ²
• Zeinab Ghorbany ²
• Yarmohamadi Vasel Shahryar ³

¹ Professor, Department of Psychology, Bu-Ali Sina University, Hamadan, Iran.

² PhD Candidate in Psychology, Department of Psychology, Bu-Ali Sina University, Hamadan, Iran.

³ Professor, Department of Psychology, Bu-Ali Sina University, Hamadan, Iran.

چکیده [English]

Abstract
The aim of this study was to investigate the effect of cerebellar training method on emotion regulation and attention maintenance in children with attention deficit-hyperactivity disorder. The present study was a pre-test-post-test semi-experimental with a control group. The statistical population included students aged 9 to 12 in Tehran, from whom 40 people with ADHD symptoms were selected by convenience sampling and randomly assigned to two experimental and control groups of 20 people. The instruments used included the Emotion Regulation Questionnaire (Shields, & Cicchetti, 1997), the Attention Maintenance/Continuous Performance Test (Rosold et al, 1956), and the Cerebellar Training Approach (Ayres, 1974). The experimental group underwent cerebellar training for 20 sessions and then a post-test was administered. The results of multivariate analysis of covariance showed that the difference in mean scores of emotion regulation and attention maintenance after cerebellar training compared to the control group was significant (P<0.01); So that cerebellar training method improved emotion regulation and attention maintenance in children with attention deficit hyperactivity disorder. Based on this, it can be said that the cerebellar training program, due to its reliance on direct sensory, physical, and motor experiences, affects the cerebellum and improves its function, and subsequently improves the function of the sensory, emotional, and attentional systems.
Keywords: Attention Deficit-Hyperactivity Disorder (ADHD); Attention Maintenance; Cerebellar Training; Emotion Regulation.
 
 
 
Extended Abstract

Introduction

Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent childhood neurodevelopmental disorder characterized by persistent inattention and/or hyperactivity-impulsivity that can substantially impair social and academic functioning (Nourkojouri et al., 2024; Choi et al., 2022; Wang et al., 2024). Global prevalence in youth is estimated at 6–7%, with a higher reported incidence in boys than girls (Fang et al., 2024; Sadock, 2015). Symptoms typically become more evident during the school years and may persist into adulthood; disruptive behaviors, such as excessive motor activity, fidgeting, impulsivity, and excessive talking, can interfere with daily performance (Salari et al., 2023; Sharma & Couture, 2014).
In addition to core symptoms, many children with ADHD demonstrate difficulties in emotion regulation, which can intensify impairment and is associated with executive-function weaknesses (Groves et al., 2022). Emotion regulation involves processes shaping which emotions occur and how they are experienced and expressed (Gross, 2015); it is considered a key transdiagnostic factor in child and adolescent mental health (Hosseinjani & Zemestani, 2023). Evidence suggests that emotion-management deficits in ADHD may contribute to broader regulation problems, potentially reflecting overlapping cognitive-affective neural mechanisms affecting both emotional and impulse control (Javidipour & Dehghan, 2022; Nigg & Casey, 2005; Sanchez et al., 2019).
Children with ADHD also commonly struggle with sustaining attention (Frank, 2024). Because attention supports higher-level executive functions (Diamond, 2006; Goldstein & Naglieri, 2014), it remains a critical rehabilitation target (Nejati, 2021). Although medications and psychosocial interventions are widely utilized, adherence can be limited by side effects and resource demands (Briars & Todd, 2016; Kim et al., 2020). Cerebellar training is a feasible, school-based, game-like movement program integrating perceptual-motor, sensorimotor, and balance exercises (Kazemzadeh, 2021). Given evidence implicating fronto-cerebellar and attention networks in ADHD (Yadav et al., 2021), the present study examines whether cerebellar training can improve emotion regulation and sustained attention.
Research Question
Does cerebellar training significantly improve emotion regulation (specifically reducing lability/negativity) and sustained attention (measured via CPT indices) in 9–12-year-old children with ADHD compared to a control group, after controlling for pre-test scores?

Literature Review

Emotion dysregulation is increasingly recognized as a clinically significant aspect of ADHD, as it can exacerbate impairment and is closely linked to executive-function deficits (Groves et al., 2022). Emotion regulation—defined as the processes shaping how emotions arise, are experienced, and expressed—is also considered a key transdiagnostic factor in youth mental health (Gross, 2015; Hosseinjani & Zemestani, 2023). Research suggests that emotion-management weaknesses among children with ADHD may contribute to broader regulatory difficulties, potentially reflecting shared cognitive-affective neural mechanisms underlying both emotional and impulse-control deficits (Javidipour & Dehghan, 2022; Nigg & Casey, 2005; Sanchez et al., 2019).
Deficits in sustained attention are similarly fundamental to ADHD (Frank, 2024). Attention serves as a gateway to cognitive processing (Baddeley & Weiskrantz, 1993) and comprises hierarchical components, such as focused and sustained attention (Sohlberg & Mateer, 2001). Since attention underpins higher-level executive functions (Diamond, 2006; Goldstein & Naglieri, 2014), it remains a critical rehabilitation target (Nejati, 2021). Given the limitations of conventional treatments (Briars & Todd, 2016; Kim et al., 2020) and evidence implicating cerebellar and attention networks in ADHD (Yadav et al., 2021), cerebellar training—which integrates perceptual-motor, sensorimotor, and balance exercises—has been proposed as a feasible complementary approach (Kazemzadeh et al., 2021; Reynolds & Nicholson, 2007; Behmard et al., 2022; Heydari Fatsami et al., 2023).

Methodology

A quasi-experimental pre-test–post-test design with a control group was employed. The study population comprised students aged 9–12 years in Tehran. Forty children referred by schools to educational counseling centers in Districts 5 and 22 due to ADHD symptoms were selected via convenience sampling and randomly assigned to the experimental (n=20) and control (n=20) groups. Inclusion criteria consisted of a psychologist-confirmed ADHD diagnosis, absence of comorbid conditions, no physical impairments, and no history of psychological or pharmacological treatment for at least one year prior to the study. Exclusion criteria included absence from more than two intervention sessions and the occurrence of acute physical or family-related problems. Data were collected using the Emotion Regulation Checklist (ERC) and the Continuous Performance Test (CPT) to assess sustained attention, alongside a specialized cerebellar training protocol. Following informed parental consent, both groups completed pre-tests; the experimental group then participated in 20 cerebellar training sessions. Post-tests were subsequently administered to all participants. Data were analyzed using SPSS-26, employing descriptive statistics and Multivariate Analysis of Covariance (MANCOVA) to control for pre-test scores.

Results

The study participants consisted of 40 elementary students in Tehran (academic year 2023–2024), with a mean age of 10.58 years (SD = 0.93). Descriptive findings indicated marked post-test improvements in the experimental group regarding emotion regulation, lability/negativity, and all CPT indices (commission errors, omission errors, correct responses, and reaction time), whereas minimal change was observed in the control group. Statistical assumptions for MANCOVA were met: Shapiro–Wilk normality (p >.05), Levene’s test for homogeneity of error variances (p >.05), non-significant pre-test × group interaction (p >.05), and Box’s M test for homogeneity of covariance matrices (F = 1.195, p >.05). Multivariate tests revealed a significant overall group effect after controlling for pre-test scores (p <.05). Univariate ANCOVA results were significant for emotion regulation (F = 154.38, p =.000), lability/negativity (F = 137.14, p =.000), commission errors (F = 142.14, p =.000), omission errors (F = 326.12, p =.000), correct responses (F = 76.04, p =.000), and reaction time (F = 817.09, p =.000). Reported effect sizes indicated substantial intervention-related variance: 82% for emotion regulation, 81% for lability/negativity, and approximately 85% on average across sustained attention outcomes.

Discussion

The findings indicate that cerebellar training can effectively improve emotion regulation and sustained attention in children with ADHD. Improvements in emotion regulation are consistent with the view that ADHD-related impairment encompasses emotion dysregulation, which is closely tied to executive dysfunction (Groves et al., 2022). Furthermore, these results support the premise that emotion regulation is a critical mechanism influencing pediatric mental health (Gross, 2015; Hosseinjani & Zemestani, 2023). The findings align with prior research on cerebellar-focused interventions (Reynolds & Nicholson, 2007; Heydari Fatsami et al., 2023) and with evidence suggesting that cerebellar abnormalities are linked to emotional processing and regulatory difficulties in ADHD (Rinke et al., 2019). Moreover, coordination-based and cerebellar-relevant physical activities have been associated with enhanced self-regulation and socio-emotional skills in this population (Pillay et al., 2019).
Regarding sustained attention, the observed improvements in CPT indices support theoretical models positioning attention as foundational to executive functioning (Diamond, 2006; Goldstein & Naglieri, 2014) and are consistent with hierarchical attention frameworks (Sohlberg & Mateer, 2001). A plausible mechanism is that cerebellar-focused training strengthens timing and coordination processes that contribute to cognitive control and attentional regulation (Stoodley, 2012); this aligns with neuroimaging evidence implicating fronto-cerebellar and attention networks in ADHD (Yadav et al., 2021). Key limitations of the present study include the use of convenience sampling and the lack of a follow-up assessment to determine the long-term stability of the effects.

Conclusion

In conclusion, a 20-session cerebellar training program significantly improved emotion regulation, reduced lability/negativity, and enhanced sustained attention in children with ADHD compared to a control group, after controlling for pre-test scores. Given the barriers and limitations associated with conventional treatments (Briars & Todd, 2016; Kim et al., 2020), cerebellar training may serve as a practical and accessible complementary approach in educational and clinical settings aiming to enhance emotional stability and sustained attention in children with ADHD (Reynolds & Nicholson, 2007; Yadav et al., 2021).
Acknowledgments
The authors would like to express their sincere gratitude to all participating children and their families, as well as the educational counseling centers and school staff who facilitated the recruitment and implementation of this study. Furthermore, the authors acknowledge the scholars and practitioners whose ongoing contributions continue to advance the fields of child psychology and ADHD intervention research.

کلیدواژه‌ها [English]

• Attention Deficit-Hyperactivity Disorder (ADHD)
• Attention Maintenance
• Cerebellar Training
• Emotion Regulation