Psychology of Exceptional Individuals

Research Paper

Determining the role of patience and moral intelligence in predicting action control (action and state orientation) of mothers of children with autism spectrum disorder

Shahla Zoormand Bonab; Farideh Hosseinsabet; aboalghasem isamorad

Volume 13, Issue 50 , July 2023, Pages 1-42

https://doi.org/10.22054/jpe.2023.71514.2526

Abstract

Abstract Autism spectrum disorder is a persistent neurodevelopmental disability that persistent challenges in the development of social communication, speech, non-verbal communications also behavioral patterns of a child with this disorder can affect mother-child interaction. Therefore, it is important ... Read More Abstract Autism spectrum disorder is a persistent neurodevelopmental disability that persistent challenges in the development of social communication, speech, non-verbal communications also behavioral patterns of a child with this disorder can affect mother-child interaction. Therefore, it is important to pay attention to the factors affecting mother's adaptation in order to promote mother's health and improve mother-child relations. The present study was conducted with the aim of determining the role of patience and moral intelligence in predicting the action control components (action and state orientation) of mothers of children with autism spectrum disorder. The statistical population included about 300 mothers with children with autism spectrum disorder who were members of the male-manahad and self-organized group "Negar's Autism Experimental Question and Answer; Ilya's Mother" in Tehran, of which 169 people were selected by convenience sampling method.To measure the research variables, Hossein Sabet Patience Measurment Scale (PS), Lenick and Kiel Moral Intelligence Questionnaire (MIQ), Action Control Scale-Revised (ACS-R) were used in the internet implementation method. Data analysis was done using spss software and descriptive statistical techniques, Pearson correlation analysis and multivariables regression analysis. The results showed that there is a positive and significant relationship between patience and moral intelligence with the components of disengagement, initiative and persistency and a negative and significant relationship with the components of preoccupation, hesitation and volatility. Therefore, the findings indicate the role of patience and moral intelligence in increasing action orientation and reducing state orientation in mothers of children with autism spectrum disorder. Keywords: Patience, Moral Intelligence, Action Control, Cction Orientation, Sstate Orientation. Extended Abstract Introduction Autism spectrum disorder is one of the important childhood disorders that includes a range of neurodevelopmental disorders and continues throughout life (Nahar, Zambelli & Halstead, 2022). Compared to other social and emotional disorders, this disorder has a confirmed and clearer neurological basis (Kalaivnai & Kalimo, 2018), which is created as a result of abnormal brain development and affects a person's cognitive and social abilities (Perlman & Howe, 2022). The main characteristic of this disorder is mentioned as a range of developmental failures in two main areas; a) failure in communication, social development, and behavioral patterns and b) limited, repetitive, and stereotyped interests and activities (Hyman, Levy & Myers, 2020; Zhou et al, 2018). In this direction and during the late and difficult diagnosis of autism spectrum disorder, the lack of definitive and effective treatments and the not very favorable prognosis of this disorder, increasing psychological pressures are imposed on parents (Aghili et al., 2022). Since the mother is often the first person who is in direct and continuous contact with the child and according to the norms of society and family, she is more responsible for taking care of the children than fathers for this reason, mothers of children with autism spectrum disorder endure a complicated and very challenging life compared to fathers (Frantz, Hansen & Machalicek, 2018) as well as compared to mothers of normal children, mothers of children with chronic diseases, and mothers of other children with special needs (Gobrial, 2018). Therefore in new research, more attention has been paid to the effects these children have on their parents including their mothers. Researchers believe that there are many moderating factors between mothers' mental pressures and child disorders (Falahzadeh et al., 2017). In such a way, if mothers with a child with autism spectrum disorder can see the desired situations in a new way, in fact, their approach to the emergency situation should be multi-dimensional, in that case, they can find ways to deal with it properly according to their personal abilities and environmental factors (Rasouli & Kalantari, 2017). Action control as a retrospective strategy is one of the self-regulation processes that refers to the ability to plan and implement goals in the face of problems and challenges and includes aspects such as: thinking through long-term goals, resistance to temptation, delaying gratification, and controlling emotions; a problem that mothers of children with autism spectrum disorder face because of the constant stress and heavy emotional burden that having a child with this disorder imposes on them (Ingersoll & Hambrick, 2011). To help these mothers, if the solutions used are suitable for their social contexts, the work of treatment and education will be more effective. In this regard, the review of concepts such as patience and moral intelligence showed that these two variables have a close semantic relationship with many psychological characteristics and dimensions of action orientation. Research Question(s) 1- Determining the role of patience and moral intelligence in predicting disengagement_ preoccupation in mothers of children with autism spectrum disorder. 2- Determining the role of patience and moral intelligence in predicting initiative_hesitation in mothers of children with autism spectrum disorder. 3- Determining the role of patience and moral intelligence in predicting persistency_volatility in mothers of children with autism spectrum disorder. 2- Literature Review People with action orientation can regulate emotions intuitively, flexibly, efficiently, and non-repressively, such as the ability to stop thoughts and reflections without any external help. In addition, these people can reduce negative emotions in response to negative life events and continue on their way after failure. In such a way, they can flexibly adapt to the environmental requirements and show more advanced cognitive control against it. Therefore, action orientation is associated with commitment, certainty, low levels of negative emotional thoughts, less vulnerability to stress, and economical processing of information. On the other hand, people with static orientation are not able to perform self-regulating behaviors and tend to ruminate on negative events in life, which reduces the available cognitive resources for moving forward. Therefore, state orientation is also related to the lack of self-regulation ability, rumination, reduction of cognitive resources to perform committed activities, and the inability to activate appropriate adaptive processes (Farokhi & Hossein Chari, 2013). Considering that patience is known as one of the factors that reduce nervous pressure and help people adapt to life's adversities and challenges. on the other hand, it is a structure that allows people to show emotional self-regulation, self-monitoring, and the ability to restrain inner desires against suffering and adversities (Ranjabr et al., 2021; Khormaie, Azadi Deh Bidi & Haghjo, 2015), hence it seems to have similarities to the dimensions of action orientation. Background research shows the importance and effectiveness of patience in reducing negative emotions and depression, increasing the level of happiness, well-being, and psychological well-being (Sharifi-Saki et al., 2017; Mirzaie-Fandokht et al., 2016; Sartipi, Sohrabi and Pasandideh, 2015; Zare Bouani & Hossein-sabet, 2017; Hossein-sabet, 2017). Based on the research of Schnitker (2012) and Schnitker et al. (2019), patience has been introduced as one of the factors affecting hedonistic and virtue-oriented well-being, and its training predicts changes in positive emotions and reduces depression and anxiety. Also, Ibn-Rasoul Sanati, Hossein-sabet, and Motamedi (2017) showed in their research results that patience directly has consequences such as self-control and kindness, each of which helps to reduce negative emotions or increase positive emotions and it can have a powerful effect on regulating emotions. The results of the research show the positive role of moral intelligence and its components in improving the psychological well-being, and mental and physical health of people who have this characteristic (Pourseyed & Pourseyed, 2021; Hejazi & Ghanizadeh, 2017; Pourjamshidi & Beheshti Rad, 2014; Sotoudeh et al., 2015; Brown, 2013). It can be said that people who have higher moral intelligence benefit from the cognitive regulation of positive emotions and the reduction of cognitive errors (Naimi and Golshani, 2018; Mosalman, Zemestani & Mahdavi, 2017). In this regard, Mirghazanfari & Izadi (2021) and Kapri and Rani (2014) also found in their research that people with high moral intelligence have a greater ability to tolerate stress, worry, and anxiety and the possibility of maladaptive behaviors in response to stressful situations. According to the results obtained from various studies, moral intelligence and its dimensions cause responsibility (Rahimi, Madani & Mohammadian, 2014), increasing commitment, stability, and stability of people's performance (Lambert & Dollahite, 2008). Yip & Tse (2009) in research found that the forgiveness factor of moral intelligence is significantly related to interpersonal and social compatibility, psychological well-being, and reduction of depression. Also, Gol Mohammadian (2015) emphasized the role of moral intelligence in the dimensions of women's family functioning (problem-solving, roles, communication, emotional companionship, emotional intercourse, and behavior control). 3- Methodology The present study was a descriptive correlational study. The statistical population included about 300 mothers with children with autism spectrum disorder who were members of the male-managed and self-organized group "Negar's Autism Experimental Question and Answer; Ilya's Mother" in Tehran, of which 169 people were selected by convenience sampling method. To measure the research variables, the Hossein-Sabet Patience Measurement Scale (PS), Lenick and Kiel Moral Intelligence Questionnaire (MIQ), and Action Control Scale-Revised (ACS-R) were used in the Internet implementation method. Data analysis was done using SPSS software and descriptive statistical techniques, Pearson correlation analysis, and multivariable regression analysis. 4- Results Table 1. Simple correlation coefficient between action control components with patience and moral intelligence Statistical index Predictor variable Criterion variable Sig. correlation coefficient 0/000 0/742 patience disengagement_preoccupation 0/000 0/631 moral intelligence 0/000 0/532 patience initiative_hesitation 0/000 0/712 moral intelligence 0/000 0/684 patience persistency_volatility 0/000 0/537 moral intelligence Table 2. Variance analysis of action control prediction and its components based on patience and moral intelligence Adjusted R Square R² Sig. F Mean Square df Sum of Squares Source of changes Title 0/518 0/524 0/000 91/257 280/192 2 384/560 Regression Disengagement_preoccupation based on patience and moral intelligence 2/107 166 349/807 Residual 168 734/367 Total 0/328 0/336 0/000 41/966 111/791 2 223/581 Regression Initiative_hesitation based on patience and moral intelligence 2/664 166 442/194 Residual 168 665/775 Total 0/352 0/352 0/000 74/737 74/737 2 149/474 Regression Persistency_volatility based on patience and moral intelligence 1/606 166 226/586 Residual 168 416/059 Total Table 3. Estimating the prediction coefficients of action control components based on patience and moral intelligence standardized coefficients Unstandardized coefficients Title Sig. t Beta Std. Error B 0/000 8/732 - 0/675 5/897 Constant Disengagement_preoccupation based on patience and moral intelligence 0/000 6/605 0/564 0/011 0/072 patience 0/025 2/257 0/193 0/007 0/016 moral intelligence 0/000 4/901 - 0/759 3/722 Constant Initiative_hesitation based on patience and moral intelligence 0/000 3/638 0/367 0/012 0/044 patience 0/015 0/000 2/447 0/247 0/008 0/020 moral intelligence 0/000 6/774 - 0/590 3/994 Constant Persistency_volatility based on patience and moral intelligence 0/008 4/582 0/453 0/009 0/043 patience 1/764 0/175 0/006 0/011 moral intelligence 5- Discussion & Conclusion In general, with the investigations carried out in the field of problems of mothers of children with autism spectrum disorder, we found that this group of mothers are under pressure and tension due to the constant care of these children; in such a way that compared to the parents of normal children, they experience more dysfunctional attitudes, spontaneous thoughts and negative emotions. This is even though some individual characteristics can help people cope with such issues. In this regard, the results of the present study showed that patience and moral intelligence are among the concepts that have action orientation components in increasing disengagement, initiative and persistency, which means producing positive emotions and reducing negative emotions related to unpleasant events and starting activities and they can protect mothers of children with this disorder against static orientation. Therefore, the findings indicate the role of patience and moral intelligence in increasing action orientation and reducing state orientation in mothers of children with autism spectrum disorder.

Research Paper

The Effect of Square Stepping Exercise on Working Memory and Balance of Children with Autism

Mir Javad Mojarrad Azar; jalal dehghanizade

Volume 13, Issue 50 , July 2023, Pages 43-68

https://doi.org/10.22054/jpe.2023.72432.2550

Abstract

Abstract The purpose of the present study was to investigate the effect of the Square Stepping Exercise on working memory and balance of children with autism. The research method was quasi-experimental with pre-test and post-test design with a control group. The statistical population included all children ... Read More Abstract The purpose of the present study was to investigate the effect of the Square Stepping Exercise on working memory and balance of children with autism. The research method was quasi-experimental with pre-test and post-test design with a control group. The statistical population included all children aged 6 to 12 with mild autism in Urmia city, 30 of them were randomly selected and tested in two groups of 15 (average age: 12.8±1.56) and control (mean age: 7.78 ± 1.58). Stork test is used to measure static balance, the heel-to-toe walking test to measure dynamic balance, and the parent executive functions questionnaire of Balster et al. (2000) in pre-test and post-test similarly. The experimental group performed square stepping exercises for 12 weeks, three sessions a week, and each session lasted 70 minutes. The data were analyzed through a one-way analysis of covariance in SPSS software version 24. The results showed that by controlling the pre-test score, there is a significant difference between the scores of the static and dynamic balance test and working memory of the two experimental and control groups in the post-test (p=0.001). Therefore, performing these exercises can be an effective strategy for improving balance and working memory in children with mild autism. Keywords: Square Steppin, Working Memory, Balance, Autis. Extended Abstract Introduction Autism spectrum disorder (ASD) is a neurodevelopmental disorder with an unknown cause that manifests in difficulties and barriers associated with social communication and repetitive and stereotyped behaviors (American Psychiatric Association, 2013). There has been a recent increase in the prevalence of ASD among children, as in the mid-1990s it was thought to affect 11.6 out of 1,000 people in this age group (Baird et al., 2006), while more recent studies have put this figure as high as 18.5 per 1,000 (Maenner et al., 2020). In addition to impaired social and communication skills, people with autism are deficient in fine motor skills (Choi and colleagues, 2018) and gross motor skills (Staples and Reid, 2010). Up to 83 percent of children with autism have difficulty communicating with age (Ruggeri et al., 2019). Failure in motor skills is in turn linked to the problems of adaptive behavior and daily performance (MacDonald et al., 2013). However, not all motor skills are equally affected by autism. Some studies showed that static balance is significantly more impaired than other motor skills (Ament et al., 2015; Whyatt & Craig., 2012), which indicates that there are features of movement disorder in autism that affect balance. Another feature of children with autism disorder is executive function. Executive function is an umbrella term that includes several skills such as planning, shifting, working memory, problem-solving, monitoring, inhibition, and self-control (Rajendran G, Mitchell., 2007). Working memory is an important component of executive function that plays a role in daily functioning (Wang et al., 2017). Many studies have been conducted in developed countries to evaluate working memory performance in individuals with high-performance autism, which have been reported differently. some studies showed weaknesses in working memory and found no difference in the working memory of individuals with autism compared to conventional controls (Bodner et al., 2012). According to the results of the research and the positive effects of this type of exercise and considering the challenges and cognitive, emotional, communication, social, and movement problems of children with autism, including balance, and working memory, it is necessary to solve these problems as much as possible for these children. reduce and fill the scientific gaps that exist in this field as much as possible, therefore the purpose of this research is to investigate the effect of square stepping exercises on working memory and balance of children with autism. Research Question(s) Do square stepping exercises have an effect on the working memory and balance of children with autism? Literature Review Various physical exercises are often prescribed as a method to improve postural control and reduce the risk of injury in this population (Brussel et al., 2007). On the other hand, despite the challenges in executive functioning experienced by children with autism, and the potential of exercise to reduce these challenges, little work in this field has focused specifically on this population. There is evidence of behavioral improvements in the areas of social-emotional functioning and reduction of repetitive or stereotyped behaviors following exercise in children with autism (Ferreira et al., 2019; Huang et al., 2020; Tse, 2020), with these improvements assuming can be related to improved executive performance (Bremer et al., 2016). Furthermore, a recent meta-analysis of the effect of exercise interventions on cognition reported a large effect in improving specific aspects of cognition (time on task) for children with autism (Tan et al., 2016). Methodology The research method was quasi-experimental with pre-test and post-test design with a control group. The statistical population included all children aged 6 to 12 with mild autism in Urmia city, 30 of them were randomly selected and tested in two groups of 15 (average age: 12.8±1.56) and control (mean age: 7.78 ± 1.58). Stork test is used to measure static balance, the heel-to-toe walking test to measure dynamic balance, and the parent executive functions questionnaire of Balster et al. (2000) in pre-test and post-test similarly. The experimental group performed square stepping exercises for 12 weeks, three sessions a week, and each session lasted 70 minutes. The data were analyzed through a one-way analysis of covariance in SPSS software version 24. Results The results showed that the average of the experimental group improved from the pre-test to the post-test in dynamic and static balance variables. This improvement was also observed in the working memory variable. Therefore, the difference between the two groups in the post-test phase is in favor of the experimental group. Regarding working memory, the results of covariance analysis showed that there is a significant difference between the experimental and control groups. In other words, according to the average of the test group (0.60) compared to the average of the correct answer of the control group (1.27), square stepping exercises lead to a significant improvement in memory. Something has been tested in the group. There is a significant difference between the experimental and control groups in terms of static balance. In other words, according to the average balance of the experimental group (7.89) compared to the average balance of the control group (6.83), the square stepping exercises significantly improved the balance in the experimental group. There is a significant difference between the experimental and control groups in terms of dynamic balance. In other words, according to the average balance of the experimental group (11.46) compared to the average balance of the control group (6.93), the square stepping exercises significantly improve the balance in the group. It has been tested. Conclusion Part of the research results showed that the square stepping exercise program significantly improved the static and dynamic balance of autistic children. In the interpretation of this result, it can be said that balance includes nerve impulses from peripheral sensory receptors to the cerebellum, integrated neural connections in the cerebellum and other related centers, and finally extrapyramidal output to the lower motor neuron. Exercise combined with practice and repetition can facilitate transmission in these neural circuits. A variety of physical activities can likely improve balance. It seems that the effective mechanism of square stepping exercises is such that when the person's balance is disturbed while taking a step and is on the verge of falling, a quick and firm compensatory step is needed to prevent falling, which is done by bending the hips and knees and opening of the ankles. Another part of the research results showed that based on the report of the parents in this research, the practice of square stepping has improved working memory in these children, the results are in line with the findings of Akbari Far et al. (2019); Johnston et al. (2017) and Fathabadi et al. (2020). The participation of children with autism disorder in planned physical exercises with a cognitive aspect (square stepping exercises) leads to involvement and brain activities of areas related to movement in the brain, and this can probably be the reason that with the increase in the activity of the areas a movement in children's brain, their cognitive performance also increases. It can also be said that square-stepping exercises improve the ability of the brain structure to repair itself after ischemic damage by increasing the number of neurotrophic factors (factors that nourish brain nerve cells). As a general conclusion, it can be acknowledged that square stepping exercises can be an ideal intervention method to improve executive functions in children with autism. Acknowledgments We are grateful to all children aged 6 to 12 with autism in Urmia and their families who helped us in this research.

Research Paper

The Lived Experience of the Challenges of Adolescents with Intellectual Disability

MOHSEN NIAZI; Sayed Hossein Siadatian Arani

Volume 13, Issue 50 , July 2023, Pages 69-100

https://doi.org/10.22054/jpe.2023.74081.2586

Abstract

Abstract Adolescence is known as one of the most challenging periods in human life, which brings many emotional, social and even educational crises. This course can be faced with more challenges and sufferings for teenagers who are intellectual disability, so the purpose of this research was to explain ... Read More Abstract Adolescence is known as one of the most challenging periods in human life, which brings many emotional, social and even educational crises. This course can be faced with more challenges and sufferings for teenagers who are intellectual disability, so the purpose of this research was to explain the lived experience of the challenges of intellectual disability teenagers. The research population included all boys with intellectual disability in the pre-professional and vocational schools of Kashan who were studying in the academic year 1402-1401, among them 9 people were targeted for Research were selected. The data was collected using semi-structured interviews and analyzed with the 7-step Colaizzi method. The results indicated the extraction of 3 main themes and 9 secondary themes. The main themes are: 1- social challenge (1- job and career future and worry about it, 2- free time, 3- shame and embarrassment of recognition, 4- concern about marriage), 2- individual challenge (1- acceptance) The negatives were 2- positive acceptance, 3- diseases and the need for medicine, 4- financial independence), 3- family challenges (1- family attitude) which were examined in detail in the research. According to the results, it was determined that it is necessary to deal with the problems and challenges of intellectual disability teenagers, and therefore, providing support and educational services for teenagers and their families can reduce their problems. Keywords: Lived Experience, Phenomenological, Adolescent, Intellectual. Extended Abstract Introduction Intellectual disability (ID) is one of the neurodevelopmental disorders that during the developmental period brings various harms to the affected person, family and society. According to the latest definitions of the American Association of Mental and Developmental Disabilities, this disorder is diagnosed with criteria such as damage in the field of mental functions such as reasoning, problem solving, planning, abstract thinking, judgment, learning, practical experience and understanding, as well as adaptive functioning. (Halvarsen et al., 2023). Adolescence is one of the most important stages in the development of human personality. Adolescents face many challenges in this period. These problems are also seen for teenagers with intellectual disabilities, such that weakness in self-confidence, anger control, inability to regulate personal and interpersonal demands, concern about social acceptance are other problems of theirs (Drozd et al., 2020). Research Question The current research seeks to answer the question, what issues, problems and challenges do teenagers with intellectual disabilities face? Literature Review Kedrova and Matantseva (2016) concluded that by teaching self-regulation, a large amount of challenges of adolescents with intellectual disability can be reduced. Pratt and Greydanus (2007) said that if a suitable support system is formed for adolescents with intellectual disability from the family and society, there will be fewer challenges for the adolescent and the family during this period. The only qualitative research conducted in the field of adolescents with intellectual disabilities is Shams-e-Islami, Mousavi and Rezaei (2023), who in their research entitled "Explaining the concept of loneliness in mentally retarded adolescents based on the existential phenomenology approach" showed four main themes in the interviews. "Loneliness as an experience of separation", "consequences of loneliness", "the meaning of loneliness" and "loneliness as a basic life experience" were extracted, and each of these main themes emerged through the analysis of several sub-themes. Methodology The current research was of qualitative type and phenomenological method was used for its implementation. This research, using the research tradition of lived experience, tried to identify the reality, as it appears to the research subjects. In the implementation of this phenomenological research, instead of using data to test hypotheses arising from research literature, which is done in other quantitative researches, verbal reports of people about their experiences were used as data. The statistical population included all boys with mental disabilities who were studying in pre-professional and professional schools in the academic year of 2022-2023 in Kashan city. Data collection was done through in-depth semi-structured interviews, individually and face-to-face in a separate room from the classroom. The questions asked focused on the problems and issues that these teenagers experience in school and outside of school. With the informed consent of the participants and educational staff, the interviews were recorded anonymously. Depending on the willingness of the participants and the conditions of the interview, the duration took between 20 and 45 minutes. For reliability, the findings, including the main themes and sub-themes of the research, were examined, consulted and modified through the opinions of faculty members of the Department of Psychology of Exceptional Children of Isfahan University. The participants in this research were 9 people who were in the age range of 16 to 22 years, and their average age was about 17 years, and the educational level of these people was from 8th to 12th. Results After analyzing the data, 3 main themes and 9 sub-themes were extracted, which can represent the experiences of boys with intellectual disabilities. In Table 1, the main theme and sub-themes extracted from the research are summarized. Table 1 Table 1: Themes extracted from the interviews Main themes Sub-themes Social challenge Career and career future and worry about it Free time Shame and embarrassment of recognition Marriage concern Individual challenge Negative acceptance Positive acceptance Diseases and the need for medicine Financial independence Family challenge Family attitude Discussion By providing the successful employment of teenagers with intellectual disabilities, the goals of education and training of this group are met to a great extent, because many educational processes are designed to achieve a career success for the future. Participating in leisure activities not only strengthens self-confidence, mental vitality and vitality, but also strengthens the sensory and motor skills of people with intellectual disability and reduces behavioral problems, progress in education, personal sufficiency and expansion of interactions. Sexual need is considered as an undeniable need in people with intellectual disabilities, but in the context of the ability of these people to marry and accept the role of wife and parenthood, the intelligence conditions, abilities and skills of these people, as well as support and educational services in that community should be noticed. The higher the quality of educational programs in exceptional educational schools in order to adapt to society, acquire social skills and prepare for jobs, the acceptance rate of these schools can be increased. Conclusion Based on the results obtained in the present research, it can be stated that the challenges faced by boys with intellectual disability can be examined and explained from different personal, family, social and psychological angles, and solutions should be found for each of them. Acknowledgments All the teenagers who participated in this research are thanked and appreciated.

Research Paper

The Effectiveness of Dramatherapy on the Aggression of Children with ADHD Diagnosis

Maryam Mohammadi Dolatabad; Yasser Rezapour Mirsaleh; Azadeh Choobforoushzadeh

Volume 13, Issue 50 , July 2023, Pages 101-128

https://doi.org/10.22054/jpe.2023.68260.2461

Abstract

Abstract Attention Deficit Hyperactivity Disorder (ADHD) is one of the disorders that causes many problems for children. Numerous treatments have been suggested to improve this disorder, but this is so important to use non-pharmacological treatments that have no side effects. In this study, the effectiveness ... Read More Abstract Attention Deficit Hyperactivity Disorder (ADHD) is one of the disorders that causes many problems for children. Numerous treatments have been suggested to improve this disorder, but this is so important to use non-pharmacological treatments that have no side effects. In this study, the effectiveness of theater therapy on aggression in children with attention deficit hyperactivity disorder was investigated. A quasi-experimental design of pre-test-post-test with control group and follow-up test was used. The statistical population included all children with attention deficit hyperactivity disorder in Rafsanjan City, which 16 children were selected by using available sampling method and were randomly dividedin experimental and control groups. The experimental group participated in theater therapy group sessions, while the control group received no intervention. Data gathered by using Shahim Elementary School Aggression Questionnaire, at three phases: pre-test, post-test and follow-up. Analysis of variance with repeated measurment was used to analyze the data. The results showed that the aggression of the experimental group had decreased compared to the control group after the intervention and also after one month (follow-up stage). Therefore, it can be concluded that theater therapy reduces the rate of aggression in children with attention deficit hyperactivity disorder. Keywords: Aggression, Attention Deficit, Hyperactivity, Dramatherapy. Extended Abstract Introduction Attention deficit hyperactivity disorder is a neurodevelopmental disorder that is defined by damage in the levels of inattention, disorganization, or hyperactivity-impulsivity, which causes serious problems at home, school, and the child's social functions. This disorder causes aggressive and impulsive behaviors and makes the person's social functions difficult. Therefore, aggression as one of the coexistence problems in this disorder has always been the focus of researchers. Theater therapy is usually used in various fields of interventions related to improving children's mental health and is recognized as a useful treatment method. Research Question(s) This research aims to answer the question of whether theater therapy has an effect on the level of aggression of children with attention deficit hyperactivity disorder. Literature Review A research study has investigated passive and active aggression in children with and without attention deficit hyperactivity disorder and negative emotional disability and has reached the conclusion that people who are apparently emotionally unstable become more aggressive over time. (Slaughter et al, 2020) In another research, it was concluded that theater therapy has increased social skills and reduced aggression in working children. (Rasekhinejhad and Khodabakhshi, 2019) Methodology The current research method is a pretest-posttest study with a control group and a follow-up test. The statistical population included all seven-to-twelve-year-old students with attention deficit hyperactivity disorder in Rafsanjan city and considering that theater therapy is usually performed in small groups of five to eight people, the number of 16 people whose attention deficit hyperactivity disorder was diagnosed by referring to medical history and clinical interview and their score in the attention deficit hyperactivity test of Swanson et al (1980) was higher than the average (36) and those who were willing to cooperate were selected as sample members using the available sampling method and were randomly placed in two groups of 8 people, experimental and control. Results According to the statistical results, it can be stated that the intervention based on theater therapy is effective in reducing the aggression of children with attention deficit hyperactivity disorder (P<0.05). Table 1. The results of Ben Feroni's post hoc test to compare the three stages of pre-test, post-test, and follow-up in experimental and control groups Group Pre-test stage and post-test Pre-test stage and Follow up Post-test stage and Follow up Difference In averages statistical significance Difference In averages Statistical significance Difference In averages statistical significance examine control 11/875 0/001 11/500 0/001 -0/375 0/442 0/000 1/000 0/250 0/516 0/250 0/598 * As can be seen in the table, the difference between the pre-test and post-test stages, as well as between pre-test and follow-up in the experimental (theatre therapy) group is significant (P<0.001), but in the control group, these differences are not significant (P>0.05). Also, the difference between post-test and follow-up is not significant in any of the groups (P>0.05). Figure 1. Aggression variable changes by group in three stages Discussion This research was conducted with the aim of investigating the effectiveness of theater therapy on the level of aggression of children with attention deficit hyperactivity disorder. The results of the analysis of variance with repeated measurements indicated that the difference between the mean aggression scores in the post-test stage after controlling the pre-test scores in the two experimental and control groups is significant. Conclusion Based on this research and previous similar studies, it was concluded that with the use of theater therapy techniques, due to the greater involvement of the child's attention and the possibility of better learning concepts in the form of group games, we can see a reduction in the level of aggression in children with Attention deficit hyperactivity disorder. Acknowledgments (Times New Roman 12 bold) In the end, we are grateful to all those who helped the authors in the implementation and compilation of this article.

Research Paper

Comparison of the Effectiveness of Brain-Based Learning Education and Multisensory Method on Working Memory of Third Grade Students with Dyscalculia

mortaza zibaei sani; Mohammad Mohammadi pour; Abulqasem Shakiba

Volume 13, Issue 50 , July 2023, Pages 129-158

https://doi.org/10.22054/jpe.2023.70546.2495

Abstract

Abstract The present study aimed to compare the effectiveness of brain-based and multi-sensory learning on the working memory of third-grade students with math disorders. The study followed an experimental design with a pre-test and post-test, with a control group. Forty-five third-grade students with ... Read More Abstract The present study aimed to compare the effectiveness of brain-based and multi-sensory learning on the working memory of third-grade students with math disorders. The study followed an experimental design with a pre-test and post-test, with a control group. Forty-five third-grade students with math disorders were selected from Sabzevar Learning Disorders Center in the academic year of 2022 through purposeful and accessible sampling, and were randomly divided into three groups of equal size. The experimental groups received separate training in brain-based and multi-sensory learning, while the control group did not receive any training. The research tool was Danmin and Carpenter's Working Memory Scale (1983), and the data was analyzed through a repeated measures design with Benferroni's post hoc test. The results suggested a positive effect of both training methodologies on active memory. The effectiveness of the brain-based learning method was found to be superior to the multi-sensory training in both the post-test and follow-up periods (P<0.05). These findings suggest that both methods can be employed to address working memory difficulties in students with math learning disabilities. Keywords: Brain-Based Learning, Multisensory Method, Working Memory, Dyscalculia. Extended Abstract Introduction Disability in learning has always been a challenge and it becomes more important when students have problems learning in school despite being intelligent, making it difficult for them to continue their education (Chahardooli et al., 2021). Evidence shows that students with dyscalculia generally have defects in using their working memory (Seifnaraghi and Naderi, 2016). Working memory helps to use the memory system flexibly, review the received information, keep it in mind and relate it to the previous knowledge and plan for future activities (Abbasi, 2020). Considering students’ problems in learning disorders has prompted therapists to use various corrective measures to solve memory problems and improve cognitive processes. A measure is brain-based learning education (Hassani et al., 2015). It is the activities done to increase the concentration and improve students’ intellectual abilities. It includes different aspects such as vigilance combined with relaxed alertness for creating a pleasant emotional environment for the brain and learning, orchestrated immersion in complex experience with the aim of creating pleasant, optimal and rich opportunities for learning and ultimately active processing of experience for creating optimal and rich opportunities for learning (Saleh and Mazlan, 2019). Also, another method to repair the students’ problems with learning disabilities is the multisensory method which emphasizes having balance in using the visual, auditory and tactile senses (Seifnaraghi and Naderi, 2016). In this method, we try to create a balance between different senses by involving several sensory receptors, and by combining visual, auditory, kinetic and tactile methods to correct students' learning problems (Kakavand et al., 2017). Research question Is there a difference between the effectiveness of brain-based learning and multisensory learning on the working memory of students with dyscalculia? Method This was an experimental research with pre-test, post-test, and a control group. The statistical population was all the third-grade elementary school students who had been referred to an educational center for the rehabilitation of children with learning difficulties in Sabzevar city, Iran, in the academic year 2021-2022. They were diagnosed with primary dyscalculia by their teachers. Amongst them, 45 students were selected by targeted and accessible sampling method and randomly placed in two experiment groups and a control group. Research tools Danmin and Carpenter's working memory scale (1983) was used to gather the data. This questionnaire measures children's working memory and it has 27 sentences in six parts: two-sentence, three-sentence, four-sentence, five-sentence, six-sentence, and seven-sentence sections. Regarding the internal reliability of this scale, in a preliminary study, Asadzadeh (2008) obtained a reliability coefficient of 0.88. The reliability of this scale in our study was 0.74 using Cronbach's alpha coefficient. The brain-based learning education program was implemented in experiment group 1 based on the 12 principles adapted from Caine et al (2005). In experiment group 2, a multi-sensory training program was implemented with a model that was designed by Mousavi and Ali-Attari (2015) based on Fernald's model (1943) for dyscalculia. The students received the training in eight 60-minute group sessions during the week. Results In the post-test and follow-up, the average working memory score of the experiment groups was higher than that of the control group, which shows the effectiveness of brain-based and multisensory training in increasing the working memory of students with dyscalculia (Table 3). Table 3. Indicators of the research variable in the experiment and control groups in different stages of the study Variable Group Pre-Test Post-Test Follow Up Average Standard Deviation Average Standard Deviation Average Standard Deviation Working Memory Brain-Based 55.93 3.26 63.60 2.27 62 3.35 چند حسی 56.7333 4.03 3.27 56.4 9.10887 Multisensory 56.73 4.03 58.67 3.27 56.4 9.10 Control 55.27 3.71 54.87 3.78 54.47 3.50 Table 5. Bonferroni test results to compare working memory marginal averages according to test stages Source Of Comparison Difference In Averages The Standard Error P Confidence Interval 95% Lower Bank Upper Bank Pre-Test-Post-Test -3.067 0.519 0.000 -4.362 -1.771 Pre-Test-Follow-Up -1.644 0.912 0.236 -3.919 0.630 Post-Test - Follow-Up 1.422 0.845 0.300 -0.685 3.530 Table 6. The results of the estimated marginal means related to the groups Group Levels Average The Standard Error Confidence Interval 95% lower bank upper bank Brain Based Pre-Exam 55.933 0.950 54.016 57.851 Post-Test 93.600 0.848 61.889 65.311 Follow Up 62.000 1.539 58.895 65.105 Multisensory Pre-Exam 56.733 0.950 54.816 58.651 Post-Test 58.667 0.848 56.856 60.377 Follow Up 56.400 1.539 53.295 59.505 Control Pre-Exam 55.267 0.950 53.349 57.184 Post-Test 54.867 0.848 53.156 56.577 Follow Up 54.467 1.539 51.362 57.572 Table 7. Bonferroni test results to compare working memory marginal means Source Of Comparison Difference In Averages The Standard Error P Confidence Interval 95% Lower Bank Upper Bank Brain-Based-Multisensory 3.2444 1.20342 0.030 0.2435 6.2454 Brain-Centered-Witness 5.6444 1.20342 0.000 2.6435 8.6454 Multisensory - Evidence 2.4000 1.20342 0.158 -0.6009 5.4009 There was a significant difference between the effectiveness of brain-based and multisensory training methods (P<0.05). The efficiency of the brain-based method was more than the multisensory method. There was a significant difference between the mean scores of the brain-based and control groups (P<0.05); the brain-based method had a positive effect on working memory, but there was no significant difference between the average scores of the multisensory and control groups (p>0.05); the multisensory method does not seem to have a positive effect on working memory. Discussion The performance of experiment groups increased after participating in the intervention sessions compared to the control group students. Also, regarding working memory, the performance of students in the brain-based experiment group was higher than the multisensory group. In explaining the effect of brain-based learning on the working memory of students with dyscalculia, it can be said that while improving people's capabilities in processing and storing information, verbal and visual memory, this method increases the prefrontal cortex activities, improving students' working memory (Shivandi and Khalili, 2020). As an explanation for the greater effectiveness of brain-based learning education compared to the multi-sensory method on working memory, it can be said that brain-based learning empowers the minds of students with learning disabilities to change their mental focus between different stimuli and have more flexibility. Since this method is based on conscious learning and training, it provides the basis for selective focus in the learning process, which happens less in the multisensory method. So, it is logical that brain-based learning has a greater effect on increasing working memory than the multisensory method.

Research Paper

The Effectiveness of Reality Therapy Based on Unconditional Positive Self-Acceptance on the Attitude towards Childbearing in Mothers of Children with Autism Spectrum Disorders

Maryam Ebrahimi; Mahboobe Taher; abbasali hossein khanzadeh

Volume 13, Issue 50 , July 2023, Pages 159-186

https://doi.org/10.22054/jpe.2023.71031.2514

Abstract

Abstract Autism spectrum disorders have adverse effects on family life. Based on this, this research was conducted with the aim of investigating the Effectiveness of Reality Therapy Based on Unconditional Positive Self-Acceptance on the Attitude towards Childbearing in Mothers of Children with Autism ... Read More Abstract Autism spectrum disorders have adverse effects on family life. Based on this, this research was conducted with the aim of investigating the Effectiveness of Reality Therapy Based on Unconditional Positive Self-Acceptance on the Attitude towards Childbearing in Mothers of Children with Autism Spectrum Disorders. The present study was an experiment with a pretest-posttest design with a control group. The statistical population of the research was made up of all mothers of children with autism in Sari City in 2021-2022, from which a sample of 30 people was selected using the available sampling method and randomly divided into two groups (15 people in the experimental group and 15 people were placed in the control group. The people in the experimental group received reality therapy intervention based on unconditional positive acceptance for two months in 8 sessions of 60 minutes. The questionnaire used in this research included Soderberg et al.'s (2013) attitude scale towards fertility and childbearing. The results of the test showed that reality therapy based on unconditional positive self-acceptance has a significant effect on the attitude towards fertility and childbearing of mothers of children with autism spectrum disorders. Based on the findings of the present research, it can be concluded that reality therapy training based on unconditional positive self-acceptance, with the benefit of teaching appropriate methods for accepting reality and making moral and responsible choices, can be used as an efficient method to improve the attitude towards fertility and childbearing. Keywords: Reality Therapy, Attitude to Fertility and Childbearing, Mothers, Autism Spectrum Disorders. Extended Abstract Introduction Autism spectrum disorder is one of the neurodevelopmental disorders that leads to many problems in children's interactions and social behaviors in many fields (Diagnostic Guide, Statistics of Mental Disorders, 2020). Children with autism have major problems in social, communication, and language interactions (Morais, Major, Davlantis, Frantz, & Harris, 2018). In Iran, the prevalence of autism spectrum disorder in Iranian children is reported to be 10 per 10,000 people (Mohammadi, Ahmadi, Khaleghi, Zarafshan, & Mostafavi, 2019). Autism spectrum disorder, due to having several characteristics, such as having a diverse range of linguistic, communication, behavioral, and social abnormalities, as well as late diagnosis, can impose various psychological pressures on the child's family and relatives (Khoger, Nejad Farid, Ranjbar, Lotfi & Hakim Shushtri, 2019). Many parents, especially mothers, feel guilty about their autistic child, and accepting the reality is very difficult for parents (Zarafshan, Hakim Shushtari, Mohammadian, Zarei, Karimi, & Hoshangi, 2019). Research on parents of children with autism spectrum disorder shows that parents and especially mothers of these children experience high levels of stress compared to children with normal development and are at high risk of physical and mental problems (Barros, Mendez, Graziano, and Bagner, 2018). Mothers of a child with autism experience a complicated and very challenging life compared to fathers and mothers of other normal and exceptional children, and are less satisfied with their lives (Gabriel, 2018). A review of studies related to fertility decline in Iran shows that fertility decline in recent decades is closely related to structural and modernization factors, family developments, changing the value of children, changing childbearing patterns, producing and expanding family planning programs, improving women's status and increasing women's independence, economic factors, individual characteristics such as age, educational progress, etc. However, no research has been done on mothers with children with an autism spectrum disorder. Looking at different treatment methods, it can be said that Glaser's reality therapy is an approach that can be used for a wide range of subjects and people (Mason, 2016). Reality therapy is one type of therapy that increases responsibility and resilience (Glaser, 2000). Research Question Is reality therapy based on unconditional positive self-acceptance effective on the attitude towards childbearing of mothers with children with autism spectrum disorders? Literature Review In this regard, Ebrahimi and Ebrahimi (2020) found that reality therapy is effective in reducing rumination and anxiety in mothers of autistic children, and also increases the tolerance of mothers of autistic children. The results of studies by Alami et al. (2020) showed that educational intervention based on the theory of planned behavior can have an effect on the fertility intention of single-child women. Emamdoost et al. (2019) found that reality therapy is effective for the parent-child attitude of mothers of children with autism spectrum disorder. The research of Jamasian and Dukanei Fard (2017) showed that group reality therapy is effective in increasing life expectancy and improving the quality of life of infertile women. The results of the research of Popov, Radanovich, and Biro (2016) showed that there is a relationship between self-acceptance and mental health. Methodology The design of the current research was an experimental type with a pretest-posttest design with a control group. The statistical population of the study was made up of all mothers of children with autism in Sari City in 2021-2022. After obtaining the necessary permits to conduct the research, by referring to the specialized treatment and educational center for children with the autism spectrum in the city of Sari, 35 mothers with children with autism spectrum disorders were selected according to the entry and exit criteria. They were randomly placed in two experimental and control Groups (15 people in each group). First, all sample subjects in both groups responded to the fertility and childbearing attitude scale by Soderberg et al. (2013) in the pretest stage, and in the next stage, the experimental group underwent 8 sessions of 60 minutes (1 time per week) of reality therapy intervention based on positive acceptance. They received their unconditional support in the meeting hall of the Nik Andishan Center, and the control group did not receive any intervention. At the end of both groups, a posttest was performed. The intervention was also carried out by a psychologist. The inclusion criteria included mothers with single children with autism spectrum disorders and confirmed according to the records, files, and diagnostic opinion of a psychiatrist or psychologist, at least a diploma education, no use of psychotherapeutic drugs, or substance abuse. Also, the exclusion criteria included: the absence of more than two sessions. Results The results of data analysis showed that there is a significant difference between the two groups in the variables of child as a pillar of life, child as an obstacle, postponing fertility to the future, and fertility requiring the fulfillment of prerequisites. This means that the reality therapy package based on acceptance and commitment has been able to have a significant impact on the components of the child as the pillar of life, the child as an obstacle, postponing fertility to the future, and fertility requires the fulfillment of the prerequisites of mothers of children with autism spectrum disorders. The amount of effect of the reality therapy package is based on acceptance and commitment to the amount of child as a pillar of life, child as an obstacle, postponing fertility to the future, and fertility requires the fulfillment of the prerequisites of mothers of children with autism spectrum disorders, respectively 0.612, 694. 0, 0.718, and 0.736. This means that 61, 70, 72, and 74 percent of the changes in the variables of a child as a pillar of life, child as an obstacle, postponing fertility to the future, and fertility require the realization of the backgrounds of mothers of children with autism spectrum disorders by presenting the independent variable (closed reality therapy based on acceptance and commitment). Table 1. The results of covariance analysis of the effect of reality therapy package based on acceptance and commitment on the attitude towards fertility and childbearing of mothers of children with autism spectrum disorders Effect size P F Mean squared value df sum of squares Source of change 0.852 <0.001 90.540 5785.961 2 11571.922 Modified pattern 0.728 0.123 7.888 1 7.888 Pre-test effect <0.001 154.857 9896.170 1 9896.170 The effect of the independent variable 63.905 27 1725.445 error 30 118555 Total Discussion The present study was conducted with the aim of the effectiveness of reality therapy based on unconditional positive self-acceptance on the attitude towards childbearing of mothers with children with autism spectrum disorders. The results showed that reality therapy based on unconditional positive self-acceptance has a significant effect on the attitude towards fertility and childbearing of mothers of children with autism spectrum disorders. This means that this education can lead to improving the attitude towards having children. Conclusion Reality therapy is based on control theory and assumes that people are responsible for their own lives and their actions, feelings, and behavior. This can certainly lead to a reduction in negative emotions among women who have children with neurodevelopmental disorders (Jamasian and Dukanei Fard, 2017). In the present study, it was tried to encourage women to express their feelings and share their experiences in the group, while helping to release emotions and discover dysfunctional beliefs by giving correct information to improve cognition and correct cognitive errors, and to provide strategies to manage emotions and conditions, and introducing the available options with informational and social support to improve the ability and awareness and to find a better attitude towards fertility and childbearing. Acknowledgments The current research is taken from the doctoral thesis of the first author of the research with a code of ethics (IR.IAU.SHAHROOD.REC.1401.075); we hereby express our gratitude to all the mothers present in the research who cooperated fully in the implementation of the research.

Research Paper

Mediating Role of Emotion Dysregulation and Intolerance of Uncertainty as Transdiagnostic Processes in the Development of Externalizing Psychopathologies in Children with Autism Spectrum Disorder

Fatemeh Hosseinjani; Mehdi Zemestani

Volume 13, Issue 50 , July 2023, Pages 187-223

https://doi.org/10.22054/jpe.2023.71240.2521

Abstract

Abstract Autism spectrum disorder (ASD) is one of the important neurodevelopmental disorders that always has a high comorbidity with other psychiatric disorders. One of the ways to investigate this comorbidity is to identify the underlying mechanisms involved in this association. The aim of the present ... Read More Abstract Autism spectrum disorder (ASD) is one of the important neurodevelopmental disorders that always has a high comorbidity with other psychiatric disorders. One of the ways to investigate this comorbidity is to identify the underlying mechanisms involved in this association. The aim of the present study was to explore the mediating role of emotion regulation and intolerance of uncertainty in the development of externalizing disorders in children with ASD. The current research was a correlational study using structural equation modeling (pathway analysis). The statistical population included all children and adolescents with ASD in the age range of 8 to 18 years from autism schools and the autism society in Tehran, Tabriz, and Mianeh province. Using a convenience sampling method, a sample of 117 children was selected and the data were collected online from parents. Pearson correlation coefficient and pathway analysis were used for the statistical analysis of data by SPSS and AMOS software. The results of the present study showed that the symptoms of autism directly and significantly explain the symptoms of externalizing spectrum disorders. Also, emotion dysregulation and intolerance of uncertainty as mediating factors explain the severity of externalizing spectrum disorders impairments in children with autism disorder. According to these findings, it can be concluded that emotion dysregulation and intolerance of uncertainty as pathological transdiagnostic factors play an important mediating role in the exacerbation of the symptoms of externalizing disorders in children with ASD. Keywords: Autism spectrum disorder, Transdiagnostic factors, Emotion regulation, Intolerance of uncertainty, Externalizing disorders. Extended Abstract Introduction Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by marked social and communication deficits, fixed interests, and repetitive behaviors (American Psychiatric Association, 2022). Children with ASD often have comorbid psychiatric disorders, including internalizing and externalizing disorders (Kaplan, Sadock, & Ruiz, 2019). Co-occurring externalizing problems (e.g. aggression, outburst behaviors, hyperactivity, and irritability) are very common in ASD across the lifespan and are often associated with poorer quality of life over and above the impact of ASD itself (Vaillancourt et al., 2017; Miller et al., 2019). Considering the high prevalence of comorbid externalizing problems with ASD, the negative consequences of this comorbidity, identifying the underlying mechanisms involved in this comorbidity have important implications. Identifying and understanding the possible role of transdiagnostic mechanisms in the development and maintenance of externalizing pathologies in children with ASD have implications in the better explanation of the nature of comorbid disorders with ASD as well as in the modeling and developing effective treatment protocols for these children (Ozsivadjian et al., 2020). Various transdiagnostic factors may play a mediating/moderating role in the development or maintenance of the symptoms of comorbid externalizing problems in children with ASD. Limited research has been conducted on transdiagnostic factors underlying the comorbidity of externalizing disorders in children with ASD. There is emerging empirical support for a number of cognitive-emotional mechanisms being implicated in the development and maintenance of high rates of externalizing problems in ASD (Mazefsky et al, 2013). Among the important transdiagnostic factors that have been highly emphasized in recent studies on the externalizing problems in ASD, we can mention emotion regulation (Mazefsky et al, 2013; Morie et al., 2015) and intolerance of uncertainty (Neil, Olsson, & Pellicano, 2016; Vasa et al., 2018). These two constructs are among the important underlying transdiagnostic factors that have been emphasized in recent research on their influential and mediating role in the creation and continuation of comorbid disorders with autism spectrum disorder (Say et al., 2017; Saiz-Souanes et al., 2020). The present study was conducted to explain the mediating role of emotion dysregulation and intolerance of uncertainty as transdiagnostic mechanisms in the development and maintenance of externalizing problems in children with ASD. The main question of the research was to what extent the two underlying and transdiagnostic constructs of emotion dysregulation and intolerance of uncertainty as mediating variables can explain the symptoms of externalizing symptoms in children with ASD? Literature Review Limited studies have been conducted on the role of emotion dysregulation and intolerance of uncertainty in the development of internalizing and externalizing problems in children with ASD. In this regard, Mazefsky et al. (2011) showed that children with ASD have problems in using adaptive emotion regulation strategies and they use maladaptive strategies to deal with negative daily tensions, which makes them prone to a wide range of internalizing psychopathologies including depression and anxiety. Morie et al. (2015) also showed that defect in emotion regulation plays an important role as a mediator in the development and exacerbation of anxiety and depressive symptoms in youth with ASD. Neil et al. (2016) and Vasa et al. (2018) showed that the high level of intolerance of uncertainty in children with ASD increases the level of tension and anxiety in them, and this tension in turn leads to the possibility of disruptive behaviors in them. Therefore, previous evidence shows that intolerance of uncertainty is an important element in the development and maintenance of internalizing pathologies in them. Therefore, previous pieces of evidence show that emotion dysregulation and intolerance of uncertainty in youth with ASD are among the important mediating risk factors for the development and maintenance of comorbid psychopathologies in them. Methodology A descriptive correlation research approach (structural equation model) is adopted in this study. The statistical population included all children and adolescents with ASD who were referred to exceptional children schools and autistic centers in Tehran, Tabriz, and Mianeh cities in 2019-2020. A convenience sampling method was used to select 117 children and adolescents with ASD as the study sample. The inclusion criteria were receiving ASD diagnosis based on the pediatric psychiatrics interview, ability to write and read, having ages between 8 and 18 years, and willingness to participate in the study. All participants were assessed by the Gilliam Autism Rating Scale-second edition (GARS-2), Strengths and Difficulties Questionnaire (SDQ), and Intolerance of Uncertainty Scale for Children (IUSC). To analyze the data, descriptive statistical metrics such as mean, standard deviation, and Pearson correlation and pathway analysis were employed using the SPSS-22 and Amos-24 software. Results The results of the matrix correlation showed a significant relationship between ASD symptoms, externalizing problems, emotion regulation strategies, and intolerance of uncertainty dimensions. The standardized direct effect of ASD symptoms on externalizing problems, emotion regulation strategies, and intolerance of uncertainty dimensions was significant (p> 0.05). Moreover, evaluation of indirect effects using the bootstrap method showed that the indirect effects of ASD symptoms on conduct problems, hyperactivity, emotion regulation strategies (i.e., suppression, reappraisal), and intolerance of uncertainty dimensions (prospective and inhibitory) were significant. Therefore, the indirect relationship between ASD symptoms and externalizing problems through emotion regulation and intolerance of uncertainty is significant (p> 0.05). Conclusion This study aimed to investigate the mediating role of transdiagnostic factors of emotion dysregulation and intolerance of uncertainty in the association between ASD symptoms and externalizing problems. The results of the present study showed that the symptoms of autism directly explain the externalizing problems in children with ASD. Also, emotion regulation and intolerance of uncertainty as mediating factors explain the severity of externalizing problems in children with ASD. According to these findings, it can be said that emotion dysregulation and intolerance of uncertainty as pathologic transdiagnostic mechanisms probably play an important mediating role in explaining the development and maintenance of externalizing problems in children with ASD. Based on the results of this research, it can be said that the defect in emotional regulation and also the inability to tolerate ambiguous situations in autistic children and adolescents probably lead to the development of externalizing symptoms (conduct problems, hyperactivity) in them. This study has limitations that should be considered in future research. Limitations related to the cross-sectional nature of the study, geographical region, small sample size, sampling method, and using self-reporting questionnaires as a data collection tool.

Research Paper

The Effectiveness of Parent-Child Joint Play on Reducing Impulsivity and Increasing Social Skills of Children with Attention Deficit/Hyperactivity Disorder

Mahsa Zolfaghari; mohsen shakerinasab

Volume 13, Issue 50 , July 2023, Pages 225-254

https://doi.org/10.22054/jpe.2023.71875.2535

Abstract

Abstract Sometimes, the presence of impulsive behaviors in children with attention deficit/hyperactivity disorder increases their social problems, and the amount of interaction with their parents can increase their abilities. Based on this, the present study was conducted with the aim of determining ... Read More Abstract Sometimes, the presence of impulsive behaviors in children with attention deficit/hyperactivity disorder increases their social problems, and the amount of interaction with their parents can increase their abilities. Based on this, the present study was conducted with the aim of determining the effectiveness of parent-child joint play on reducing impulsivity and increasing the social skills of children with attention deficit/hyperactivity disorder. In this research, a semi-experimental method was used with a pre-test and post-test design with a control group, and its statistical population consisted of all children with attention deficit/hyperactivity disorder in Bojnord city and their mothers in 2022, 30 of whom were selected by purposive sampling and were randomly placed in two groups of 15 people, experimental and control. For both groups, the pre-test, including Barth's impulsivity scale (1995) and Matson's social skills scale (1983), was implemented, and the experimental group had 8 two-hour weekly sessions under the joint game. The parent and the child were placed and the control group did not receive any intervention. Both groups completed the post-test again and the results were analyzed through analysis of covariance. The findings showed that Parent-child joint play is effective in reducing impulsivity and increasing the social skills of children with attention deficit/hyperactivity disorder. The results of this research show that parent-child joint play can be used to reduce behavioral problems and increase the social skills of children with attention deficit/hyperactivity disorder. Keywords: Parent-Child Joint Play, Impulsivity, Social Skills, Children with Attention Deficit/Hyperactivity Disorder. Extended Abstract Introduction Attention deficit/hyperactivity disorder in children is one of the most common neurodevelopmental disorders that causes many problems for children. The presence of this disorder causes many problems for these children, and impulsive and thoughtless behaviors are one of the major problems. Unmeasured and sudden behaviors in children with attention deficit/hyperactivity disorder cause them to be criticized and blamed by others, their interpersonal relationships face problems, and their social skills are weakened. The problems related to children with attention deficit/hyperactivity disorder have caused various educational and therapeutic theories and approaches to be used all over the world, and the use of game techniques has been more welcomed by children and therapists due to their diversity and high attractiveness. Some therapists have emphasized the role of parents' therapy in the form of games and stated that parents' participation in play therapy can play a facilitating role. In the joint game between parent and child, it is emphasized to create a strong relationship between parent and child regarding the game, and this advantage is used to improve the child's problematic behavior, which is planned by the therapist and the parent as a facilitator, creates a greater impact. Research Question Is parent-child joint play effective in reducing impulsivity and increasing the social skills of children with attention deficit/hyperactivity disorder? Literature Review In a research, Parlad et al. (2020) showed that the use of mutual play between parents and children is effective in improving children's social functions, and Cohen et al. (2022) also showed that joint play therapy between parents and children can be effective on children's social adaptation due to better interaction and increase their social ability. The research of Branovich and Han (2019) also shows that the use of joint play between parents and children can be effective on children's psychological abilities and provide the possibility of learning social skills and correcting negative behaviors. Also, Dietman et al. (2016) in their research mentioned the role of parent-child communication through play in reducing children's disobedience and stubbornness and stated that this kind of play therapy method provides the possibility of correcting negative behaviors due to the creation of better interactive conditions. Methodology In terms of the method of data collection, the present study was a semi-experimental type with a pretest-posttest design with a control group, and its statistical population was all children aged 4 to 7 years with attention deficit/hyperactivity disorder (predominant hyperactivity) and their mothers, who in 2022, were admitted to one of the private counseling centers in Bojnord city. In addition to obtaining a score higher than 34 in the Connors Attention Deficit/Hyperactivity Disorder diagnosis questionnaire (parent version), these children were also subjected to a clinical interview by the center's psychiatrist based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and a definitive diagnosis of Attention Deficit Disorder / had received hyper-activity. The research sample included 30 of these children along with their mothers, who were selected by purposeful sampling and randomly replaced in two experimental and control groups. Both groups completed the scale of impulsive behaviors and social skills about their child as a pre-test before any intervention in the same conditions. Then, for the experimental group, a joint parent-child game program was implemented; while the group did not receive a training certificate. Finally, after the end of the training sessions, the scale of impulsive behaviors and social skills was implemented again as a post-test for both groups. The data collection tools were: Children with Attention Deficit/Hyperactivity Disorder (CPRS), Impulsive Behavior Scale (BIS), and Social Skills Questionnaire (MESSY). Also, in this study, in the experimental group, the joint play program of parent and child was based on the model. Landreth (2006) was implemented as a group in 8 two-hour sessions for mothers and children of the experimental group. Results The mean and standard deviation of the research variable and their subscales according to the test and control groups in the pre-test and post-test situations are shown in Table 1. Table 1. Mean and standard deviation of the research variable by test and control groups posttest Pretest variables group SD M SD M 2.28 59.75 2.24 74.06 Total impulsivity experimental group 1.28 20.43 1.13 26/87 Lack of planning 1.49 24.22 1.45 28.60 Movement impulsivity 1.44 15.10 1.84 19.13 Cognitive impulsivity 3.64 132.56 3.88 110.45 Total Social skills control group 2.06 29.22 2.12 26.12 Appropriate social skills 2.11 30.67 2.09 24.02 antisocial behaviors 2.04 24.30 2.19 18.11 Aggression and impulsiveness 2.11 20.17 2.18 18.26 Supremacy 2.09 28.20 2.11 24.14 Relationship with peers The findings presented in the table show that in the experimental group, impulsivity and its components decreased in the post-test situation, while there was no significant change in scores in the control group. It can also be seen that social skills and their components increased in the post-test situation, while there was no significant change in scores in the test group. Before conducting the covariance analysis, the assumptions of using parametric statistics such as the Kolmogorov-Smirnov test, the Levin test, and the homogeneity of the regression slope were examined, and the results of the Kolmogorov-Smirnov test showed the level of significance in the test for each of the variables of impulsivity and social skills in the situation. The pre-test and post-test are more than 0.05 and as a result, it can be said that the normality of the distribution of the variables has been confirmed. Also, the assumption of homogeneity of variances was checked with Levine's test, and the results showed that the coefficient of the significance level of the test to check the homogeneity of variances for each of the research variables was more than 0.05, and as a result, it can be said that the variance of the groups has homogeneity. Also, the results of the regression slope investigation showed that the obtained value of both interaction effects is not significant at the 0.05 level, and the assumption of homogeneity of the regression slopes has been met, therefore, there is no problem with the presuppositions under investigation. The results of covariance analysis to determine the effectiveness of parent-child joint play on reducing impulsivity and increasing social skills of children with attention deficit/hyperactivity disorder are according to Table 2. Table 2. Multivariate covariance analysis test Test value F df df error sign eta Pillai effect 0.88 18.67 2 26 0.001 0.92 Wilkes Lambda 0.84 6.87 2 26 0.001 0.92 Hetling effect 4.14 77.18 2 26 0.001 0.92 The largest root on 30.11 7 2 26 0.001 0.92 The results listed in Table 2 show that there is a significant difference between the control and experimental groups in the research variables. In order to investigate this change, the univariate covariance test was used, the results of which are presented in Table 3. Table 3. Univariate covariance analysis test on impulsivity and social skills scores Variable Source of changes SS df MS F sign eta impulsivity Pre-test impulsivity 781.75 1 781.75 18.44 0.001 0.34 Group membership 5291.02 1 5291.02 124/81 0.001 0078 social skills Pre-test impulsivity 793.84 1 793.84 26.97 0.000 0.43 Group membership 4714.23 1 4714.23 45.116 0.000 0.82 As can be seen in the above table, with the pre-test evidence, a significant difference can be seen between the test group and the evidence in the impulsivity variable. In this way, the average post-test scores of the experimental group are significantly lower than the control group; and the effect or difference is equal to 0.78, which means that 78% of the individual differences in impulsivity scores were related to the effect of parent-child joint play. It can also be seen that, with pre-test control, there is a significant difference between the experimental and control groups in the variable of social skills. In this way, the average post-test scores of the experimental group are significantly higher than the control group and the effect or difference is equal to 0.82, which means that 82% of individual differences in social skills scores were related to the effect of parent-child joint play. Discussion It seems that the emphasis on the relationship between the parent and the child in regard to playing therapy has been able to provide a friendly and tension-free atmosphere for the child, which has led to listening more to the parent and imitating his positive behaviors, and in this way, the child has been able to manage impulsive behaviors and reflect on giving answers and develop his social skills. Since the focus of the parent-child joint game approach is on improving the parent-child relationship, the development of the intervention program by the therapist, which was carried out with the aim of correcting the child's problems and increasing his capabilities, has strengthened the child's inner self and his potential abilities to manifest positive behaviors and has helped the mother to better understand the child's emotional world and to gain an attitude be realistic and patient towards your child. This increase in insight and awareness has created a non-judgmental, accepting, and mutual understanding atmosphere and has influenced the behavior of children with attention deficit/hyperactivity disorder and has reduced their psychological problems, and increased their social skills. Conclusion The result of this research shows that parent-child joint play can be used to reduce behavioral problems and increase the social skills of children with attention deficit/hyperactivity disorder. Acknowledgments We are grateful to all colleagues and friends who helped us in the implementation of this research. Also, we are especially grateful to all the children and mothers who participated in this research.

Research Paper

The Effectiveness of the Compassion-Based Approach on Alexithymia and Sense of Coherence in Mothers with Intellectually Disable Children

Jafar Mahmoodi; Iman Mesbah; Ali rezaeisharif

Volume 13, Issue 50 , July 2023, Pages 255-286

https://doi.org/10.22054/jpe.2023.72796.2557

Abstract

Abstract The current study has been conducted to get the amount of effectiveness of the compassion-based approach on alexithymia and the sense of coherence in mothers with intellectually disabled children. It has been in progress for two months with a semi-experimental design using pre-test and post-test, ... Read More Abstract The current study has been conducted to get the amount of effectiveness of the compassion-based approach on alexithymia and the sense of coherence in mothers with intellectually disabled children. It has been in progress for two months with a semi-experimental design using pre-test and post-test, accompanied by a control group. The whole population of the study involved 56 mothers having intellectually disabled children, who registered them in the Marand Well-being Organization Office from 2017 to 2022, of whom 30 had the required condition to get into the research. The study used a purposeful method for choosing the samples and put them randomly in two experimental and control groups. Compassion-based approach training was conducted in eight sessions for the experimental group while the control group received nothing. The data collected were analyzed and collected through alexithymia and the sense of coherence scales and were undergone the SPSS-22 software for the latter analysis and variance calculations. According to the results obtained compassion-based approach therapy for alexithymia and sense of coherence had a meaningful effect (p≤0/05). The follow-up stage has also demonstrated that the effect of compassion-based treatment on alexithymia and the sense of coherent sense of mothers with intellectually disabled children has been stable. Based on the results, psychology and counseling experts could use compassion-based training programs for alexithymia reduction and coherence sense enhancement of intellectually disabled children’s caregivers. Keywords: Alexithymia, Compassion-Based Therapy, Intellectual Disability, Sense of Coherence. Extended Abstract Introduction Mental intellectual (intellectual developmental disorder) is a disorder that begins during the development period and includes a person's lack of adaptive functioning and intelligence in the practical, social, and conceptual domains (American Psychiatric Association, 2022). The presence of a mentally retarded child can cause a change in the mental health and dynamics of the family system (Bahadori Khosrowshahi and Habibi-Kaleiber, 2015). When parents find out about their child's disability, they experience various forms of stress and psychological pressure, social isolation, and mental health problems (Popa, 2020). In the meantime, mothers, in the position of the main caretaker of the child, bear the biggest burden of the problem (Milani Far, 1400, p. 184). As most of the caretaking time for the child and interacting with him is usually taken by the mother, and due to the intellectual disability of the child, it has many problems in the intelligence, cognitive, emotional, and behavioral development field, there are major tensions in this regard directed at the mother (Gupta and Kaur, 2010). One of the therapeutic interventions that seem to be effective in empowering mothers with mentally retarded children is self-compassion therapy (Rostampour-Brinjistanki, Abbasi, and Mirzaeian, 2019). Compassion therapy was founded by Gilbert (2005) as the main therapy and even complementary therapy (Lucre and Clapton, 2021). This treatment is a patient-centered behavior change strategy, and its purpose is to identify and reduce a person's doubts about changing their behavior, change in lifestyle and routine, and improve the person's perception of the importance of behavior change (Hacken and Taylor, 2021). Research Question Is compassion-based therapy effective in increasing the sense of coherence and reducing alexithymia of mothers with mentally retarded children? Literature Review The results of various studies show that compassion therapy increases self-coherence adaptability, reduces negative spontaneous thoughts (Ardashirzadeh, Bakhtiarpour, Homaei, Iftikhar Saadi, 2019), increases the sense of coherence (Ghaffari, Ismali, Atashgir, Hakim-abadi, 2017; Lloyd, 2017), improves the symptoms and quality of life (Nashi et al., 2019), reduces depression and anxiety (Safarinia, Mortezai Karhrodi, Alipur, 2022), increases the tolerance of distress and reduces of guilt in mothers with physically disabled children movement (Mahmoudpour, Dehghanpour, Ejadi and Mohammadi, 2021), improves of psychological flexibility in mothers with mentally retarded children (Rostampour Brijstanaki et al., 2016) and improves of alexithymia (Ahmadi Malairi, Rahmani, Pourasghar, 2021) Tajdin, Al-Yasin, Heydari, and Davoudi, 2019). Methodology The current research method was a semi-experimental pre-test post-test type with a control group with a 2-month follow-up. The statistical population of the present study was mothers with mentally disabled children who had a disability file for their children in Marand Welfare Department from 2017 to 2022 (N=56). In order to select the statistical sample of the research, by referring to the Marand Welfare Organization and using the purposeful sampling method, 30 mothers with mentally retarded children who have alexithymia (above 60) and sense of coherence (below 63) scales were selected and randomly replaced in the experimental and control groups. Results The results of multivariate tests showed that the interaction between time and group is significant for all variables. Therefore, compassion-based treatment training was effective on all variables and caused changes in alexithymia and sense of coherence (P<0.05). The obtained results showed that there is a significant difference between the pre-test and post-test scores in the two variables of emotional ataxia and sense of coherence (P<0.001). In other words, the effect of compassion-based intervention on research variables is confirmed. Also, there is a significant difference between pre-test and follow-up scores in both variables (P<0.001). In other words, the effect of time is confirmed. Meanwhile, no significant difference was observed between the post-test and follow-up scores in the two variables of alexithymia and the sense of coherence (P<0.05). Table 1. Benferoni test to investigate the effectiveness of compassion-based therapy for research variables over time Comparison Alexithymia sense of coherence Mean difference standard error Significance level mean difference standard error Significance level Pre-test post-test 16.24 1.82 0.001 8.51 1.37 0.001 Post-test follow-up 0.97 1.26 0.07 0.48 1.18 0.69 Pre-test follow-up 6.42 2.11 0.001 8.93 1.42 0.001 Discussion The present study was conducted with the aim of the effectiveness of the compassion-based approach on emotional ataxia and sense of coherence in mothers with intellectually disabled children. Based on the obtained results, compassion-based therapy reduced alexithymia in mothers with mentally retarded children, which is in agreement with the results of some studies (Ahmadi Malairi et al., 2021; Tajdin et al., 2019; Marsh, Chan, and McBeth, 2018; Kiel and Pidgon, 2017). Another finding of the research was that compassion-based therapy is effective in increasing the sense of coherence of mothers with mentally disabled children. The result obtained in accordance with the research results of Aghalar and Akrami (2021), Ardeshirzadeh et al. (2019), Narimani and Eyni (2019), Li, Liu, Han, Zhu, and Wang (2017), and Lloyd (2017). Conclusion The present study showed that the participants had clinically significant improvement in each scale and it seems that the intervention based on compassion was effective. The results of the follow-up test were not significantly different from the final test, and the therapeutic method based on compassion had a lasting effect on increasing the sense of coherence and reducing alexithymia. Acknowledgments We would like to thank all those who participated in this study.

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Volume & Issue: Volume 13, Issue 50, July 2023

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The Effectiveness of the Compassion-Based Approach on Alexithymia and Sense of Coherence in Mothers with Intellectually Disable Children

Abstract