نوع مقاله : مقاله پژوهشی

نویسندگان

• هدی فرامرزی ¹
• سعید رضایی ²
• مهدی دستجردی کاظمی ²
• عنایت‌الله زمان‌پور ³

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 سنجش و اندازه‌گیری، دانشگاه علامه طباطبائی، تهران، ایران.

چکیده

یکی از بارزترین ویژگی‌های کودکان با نارساخوانی و اختلال نارسایی توجه/ بیش‌فعالی، مشکل در پردازش شنیداری است و عدم ارائه مداخله به‌ موقع برای این کودکان عواقب جبران‌ناپذیری را به همراه دارد. هدف از این پژوهش تدوین برنامه توان‌بخشی شناختی یافتن سریع کلمه و اثربخشی آن بر پردازش شنیداری کودکان با نارساخوانی و اختلال نارسایی توجه/ بیش‌فعالی بود. جامعه آماری شامل تمامی دانش-آموزان دوره ابتدایی 7 تا 9 ساله شهر تهران با تشخیص نارساخوانی و اختلال نارسایی توجه/ بیش‌فعالی که در سال نیمسال دوم تحصیلی 1401 مشغول به تحصیل بودند که 30 نفر داوطب واجد شرایط به شیوه تصادفی در دوگروه آزمایش(15 نفر) و گواه(15 نفر) گمارش شدند. گروه آزمایش در 10 جلسه 45 دقیقه‌ای برنامه توان‌بخشی شناختی یافتن سریع کلمه را دریافت کرد. ابزارهای پژوهش شامل نسخه چهارم آزمون هوش وکسلر، آزمون نارساخوانی مرادی و همکاران(1395)، پرسشنامه کانرز-فرم والدین(1998) و سیاهه مشکلات شنیداری فیشر(1976) بود. داده‌ها با استفاده از تحلیل کوواریانس چند متغیره تحلیل شد. یافته‌ها نشان داد که برنامه توان‌بخشی شناختی یافتن سریع کلمه موثر بوده و موجب بهبود پردازش شنیداری کودکان با نارساخوانی و اختلال نارسایی توجه/ بیش‌فعالی در گروه آزمایش شده است. با توجه به این یافته‌ها برنامه توان‌بخشی شناختی یافتن سریع کلمه به عنوان یک مداخله موثر به متخصصان پیشنهاد می‌شود

کلیدواژه‌ها

• اختلال نارسایی توجه/بیش‌فعالی
• توان‌بخشی شناختی
• نارساخوانی
• یافتن سریع کلمه

عنوان مقاله [English]

Development of a Cognitive Rehabilitation Program Fast for Word and Its Effectiveness on the Auditory Processing of Children with Neurodevelopmental Disorders: A Case Study of Children with Dyslexia and Attention Deficit/Hyperactivity Disorder

نویسندگان [English]

• Hoda Faramarzi ¹
• Saeed Rezayi ²
• Mehdi Dastjerdi Kazemi ²
• Inayatullah Zamanpour ³

¹ PhD Student in Psychology & Education of Exceptional Children, Allameh Tabataba’i University, Tehran, Iran.

² Associate Professor, Department of Psychology & Education of Exceptional Children, Allameh Tabataba'i University, Tehran, Iran.

³ Assistant Professor, Department of Measurement & Assessment, Allameh Tabataba’i University, Tehran, Iran.

چکیده [English]

One of the most obvious characteristics of children with dyslexia and attention deficit/hyperactivity disorder is difficulty in auditory processing, and failure to provide timely intervention for these children has irreparable consequences. The purpose of this research was to develop a cognitive rehabilitation program fast for word and its effectiveness on the auditory processing of children with dyslexia and attention deficit/hyperactivity disorder. The statistical population includes all 7-9-year-old elementary school students in Tehran with dyslexia and attention deficit/hyperactivity disorder who were studying in the second semester of 1401 academic year, and 30 eligible volunteers were randomly divided into two experimental groups. 15 people) and witnesses (15 people) were appointed. The experimental group received the fast for word cognitive rehabilitation program in 10 sessions of 45 minutes. The research tools included the fourth version of the Wechsler IQ test, Moradi et al.'s reading and dyslexia test (2015), Connors-Parent Form questionnaire (1998) and Fisher's list of listening problems (1976). Data were analyzed using multivariate analysis of covariance. The findings showed that the fast for word cognitive rehabilitation program was effective and improved the auditory processing of children with dyslexia and attention deficit/hyperactivity disorder in the experimental group. According to these findings, the fast for word cognitive rehabilitation program is suggested to experts as an effective intervention.
Keywords: attention Deficit/Hyperactivity Disorder; Cognitive Rehabilitation; Dyslexia; Fast for Word.
 
 
 
Extended Abstract

Introduction

Children diagnosed with Dyslexia and Attention-Deficit/Hyperactivity Disorder (ADHD) display distinct functional and anatomical differences in specific components of the central auditory nervous system compared to their neurotypical peers. One of the most notable characteristics commonly seen in these children is difficulty in auditory processing. Children grappling with auditory processing issues typically encounter difficulties in accurately processing and interpreting auditory information, especially when dealing with multiple speech streams or environmental noises. These difficulties can encompass challenges in discerning words amidst background sounds and following verbal instructions when multiple sounds compete for attention.
Fast ForWord is a cognitive rehabilitation program recognized for its effectiveness in addressing language-based learning impairments. The program trains a broad array of cognitive functions related to language, encompassing sound decoding, content comprehension, and the formation of connections between learning and brain development (Doidge, 2007; Ghasemzadeh, 2014). Over the past 25 years, Fast ForWord has seen significant advancements in both research and clinical applications for language therapy. The first area involves using neuroimaging and behavioral techniques to examine individual differences in language development and the causes of language-based learning disorders. The second area explores neurobiological methods initially developed to study neural plasticity in animal models. Research indicates that children who have completed the Fast ForWord program exhibit significant improvements in standardized assessments of speech, language, and auditory processing (Doidge, 2007; Ghasemzadeh, 2014).
Delays in providing timely intervention for dyslexia and Attention-Deficit/Hyperactivity Disorder can lead to repercussions that are difficult to reverse. Such delays often trigger a cascade of academic failures and cause substantial harm to a child's self-esteem. These consequences underscore the critical importance of early and accurate diagnosis, coupled with innovative and prompt intervention. Research has shown that the earlier a child receives intervention, the more favorable the outcomes will be (Chiappedi et al., 2007).
The lack of research on the use of the "Fast ForWord" intervention for children with comorbid dyslexia and Attention-Deficit/Hyperactivity Disorder highlights a significant gap in the literature. Moreover, the limited availability of training programs for the "Fast ForWord" method in Iran further underscores this deficiency. The development of effective educational programs tailored to the unique needs of children with these co-occurring conditions is widely regarded as a significant educational priority. The principal objective of this research is, therefore, to design a cognitive rehabilitation program based on "Fast ForWord" and to assess its efficacy in improving the auditory processing abilities of children diagnosed with both dyslexia and Attention-Deficit/Hyperactivity Disorder.
Research Question
This study examines the effectiveness of the "Fast ForWord" cognitive rehabilitation program in improving the auditory processing abilities of children diagnosed with dyslexia and attention-deficit/hyperactivity disorder.

Literature Review

Gilam et al. (2008) conducted a study to assess the effects of the "Fast ForWord" intervention on children with language impairment. The findings demonstrated that the participants exhibited notable enhancements in their overall language scores and auditory background test performance. In another study, Camarata (2016) examined the efficacy of the Fast ForWord treatment in enhancing language abilities among children diagnosed with language impairments. The outcomes indicated that Fast ForWord significantly improved the participants' language scores.

Methodology

The research approach for this study involved both theoretical and methodological components. In the initial stage, the "Fast ForWord" program was developed and its content validity was assessed. In the subsequent stage, a quasi-experimental method was employed using a pre-test, post-test design with a control group and a follow-up period. The statistical population consisted of all 7- to 9-year-old elementary school students in Tehran diagnosed with comorbid dyslexia and Attention-Deficit/Hyperactivity Disorder (ADHD) in the second semester of the 1401-1402 academic year. From this population, 30 participants were selected and randomly assigned to two groups: an experimental group (n=15) and a control group (n=15).
Specific inclusion and exclusion criteria were established to ensure the selected subjects were appropriate for the study. The inclusion criteria were: (1) age between 7 and 9 years; (2) current enrollment in an elementary school in Tehran; (3) no documented history of other psychological disorders; and (4) a confirmed diagnosis of both dyslexia and Attention-Deficit/Hyperactivity Disorder (ADHD) by a specialist.
The exclusion criteria, designed to maintain the study's integrity, were: (1) concurrent participation in any other rehabilitation program; (2) voluntary withdrawal from the study; or (3) absence from more than two sessions. Informed consent was obtained from both the children and their families. Psychiatric records and diagnostic tests were used to validate the diagnoses.

Results

Table 1. The results of univariate covariance analysis of the difference between the experimental and control groups in the sand processing components




Variable


Source


Sum of Squares


Degree of Freedom


Mean Square


F


evel ofL Significance


Effect Size






Understanding


etweenB Groups


36.704


1


36.704


7.711


0.014


0.340




Error


71.396


15


4.760


 


 


 




You are harsh


Between Groups


37.787


1


37.787


5.415


0.034


0.265




Error


104.671


15


6.978


 


 


 




Attention


Between Groups


14.417


1


14.417


5.680


0.031


0.275




Error


38.074


15


2.538


 


 


 




Attention Span


Between Groups


24.344


1


24.344


8.666


0.010


0.366




Error


42.138


15


2.809


 


 


 




Hoarse voice​


Between Groups


27.705


1


27.705


9.451


0.008


0.387




Error


43.972


15


2.931


 


 


 




Differentiation​


Between Groups


146.470


1


146.470


11.265


0.004


0.429




Error


195.030


15


13.002


 


 


 




Short Term Memory


Between Groups


52.389


1


52.389


6.284


0.024


0.295




Error


125.049


15


8.337


 


 


 




Long Term Memory


Between Groups


115.237


1


115.237


15.494


0.001


0.508




Error


111.565


15


7.438


 


 


 




Stage Memory


Between Groups


46.230


1


46.230


7.595


0.015


0.336




Error


91.306


15


6.087


 


 


 




Speech Problems


Between Groups


30.782


1


30.782


5.891


0.028


0.282




Error


78.373


15


5.225


 


 


 




Coordination of Seeing and Hearing​


Between Groups


61.205


1


61.205


12.515


0.003


0.455




Error


73.360


15


4.891


 


 


 




Stigma​


Between Groups


25.422


1


25.422


8.443


0.011


0.360




Error


45.165


15


3.011


 


 


 




Performance


Between Groups


162.359


1


162.359


8.489


0.011


0.361




Error


286.874


15


19.125


 


 


 




The obtained data, as presented in the table, indicate a statistically significant difference in auditory processing levels between the control and experimental groups. Based on these results, it can be concluded that the "Fast ForWord" intervention was effective in improving the auditory processing abilities of children diagnosed with comorbid dyslexia and Attention-Deficit/Hyperactivity Disorder.

Discussion

The primary objective of this research was twofold: first, to develop a cognitive rehabilitation program based on "Fast ForWord," and second, to evaluate its efficacy in improving the auditory processing abilities of children diagnosed with comorbid dyslexia and Attention-Deficit/Hyperactivity Disorder.
This situation aligns with the perspective of experts who posit that children with language-based learning disabilities frequently encounter difficulties in recognizing and rapidly processing auditory information. This challenge is often described as a generalized processing deficit within the temporal region. In this context, the "Fast ForWord" program can be considered a targeted intervention method specifically designed to address the language-specific obstacles these children face.
This theoretical framework posits that language learning difficulties stem from a deficit in the temporal processing of auditory input. It is therefore proposed that intensive training with the "Fast ForWord" program—which adheres to behavioral principles and systematically increases temporal processing demands—can retrain the underlying neural mechanisms. This retraining, in turn, is expected to enhance language abilities and lead to subsequent improvements in auditory processing.

Conclusion

In conclusion, auditory processing deficits in children with comorbid dyslexia and Attention-Deficit/Hyperactivity Disorder significantly contribute to the challenges they face. The implementation of the "Fast ForWord" cognitive rehabilitation program, which emphasizes rapid auditory processing, represents an effective intervention. This program shows considerable potential for improving not only auditory processing skills but also the overall daily functioning of children with these conditions.
Acknowledgments
The authors extend their sincere gratitude to all the participants and their families whose involvement was essential to this study. We also thank the dedicated staff and administrators at Marjoui School for their invaluable cooperation and support throughout the research process. This work would not have been possible without their generous contribution of time and effort.

کلیدواژه‌ها [English]

• Attention Deficit/Hyperactivity Disorder
• Cognitive Rehabilitation
• Dyslexia
• Fast for Word