اثربخشي توان‌بخشي شناختي مبتني بر كاركردهاي اجرايي بر بهبود نارسايي‌هاي شناختي كودكان مبتلا به نارساخواني

The Effectiveness of Executive Functions-Based Cognitive Rehabilitation on Improving Cognitive Deficits in Children with Dyslexia

ﭘﮋوﻫﺶ ﺣﺎﺿﺮ ﺑﺎ ﻫﺪف ﺗﻌﯿﯿﻦ اﺛﺮﺑﺨﺸﯽ ﺗﻮانﺑﺨﺸﯽ ﻣﺒﺘﻨﯽ ﺑﺮ ﮐﺎرﮐﺮدﻫﺎي اﺟﺮاﯾﯽ ﺑﺮ ﻧﺎرﺳﺎﯾﯽﻫﺎي ﺷﻨﺎﺧﺘﯽ ﮐﻮدﮐﺎن ﻧﺎرﺳﺎﺧﻮان اﻧﺠﺎم ﮔﺮﻓﺖ. روش اﯾﻦ ﭘﮋوﻫﺶ آزﻣﺎﯾﺸﯽ و ﻃﺮح آن ﭘﯿﺶآزﻣﻮن و ﭘﺲآزﻣﻮن ﺑﺎ ﮔﺮوه ﮐﻨﺘﺮل ﺑﻮد. ﺟﺎﻣﻌﻪ آﻣﺎري ﭘﮋوﻫﺶ را ﮐﻠﯿﻪ داﻧﺶآﻣﻮزان ﻧﺎرﺳﺎﺧﻮان ﭘﺎﯾﻪﻫﺎي ﭼﻬﺎرم و ﭘﻨﺠﻢ اﺑﺘﺪاﯾﯽ ﺷﻬﺮ ﺗﻬﺮان در ﺳﺎل ﺗﺤﺼﯿﻠﯽ 1397- 1398 ﺗﺸﮑﯿﻞ دادﻧﺪ. ﻧﻤﻮﻧﻪ ﭘﮋوﻫﺶ ﺷﺎﻣﻞ 40 داﻧﺶآﻣﻮز ﻧﺎرﺳﺎﺧﻮان ﺑﻮد ﮐﻪ ﺑﻪ روش ﻧﻤﻮﻧﻪﮔﯿﺮي ﺧﻮﺷﻪاي اﻧﺘﺨﺎب و ﺑﻪﺻﻮرت ﺗﺼﺎدﻓﯽ در دو ﮔﺮوه آزﻣﺎﯾﺶ )20 ﻧﻔﺮ( و ﮐﻨﺘﺮل )20 ﻧﻔﺮ( ﺟﺎﯾﮕﺰﯾﻦ ﺷﺪﻧﺪ. ﺑﻌﺪ از اﺟﺮاي ﭘﯿﺶآزﻣﻮن ﺑﺎ اﺳﺘﻔﺎده از ﻣﻘﯿﺎس ﺗﺠﺪﯾﺪﻧﻈﺮ ﺷﺪه ﮐﻨﺘﺮل ﻫﺪﻓﻤﻨﺪ ﺑﺮ روي ﻫﺮ دو ﮔﺮوه، ﺑﺮﻧﺎﻣﻪ ﺗﻮانﺑﺨﺸﯽ ﻣﺒﺘﻨﯽ ﺑﺮ ﮐﺎرﮐﺮدﻫﺎي اﺟﺮاﯾﯽ در 12 ﺟﻠﺴﻪ و ﻫﺮ ﺟﻠﺴﻪ ﺑﻪ ﻣﺪت 60 دﻗﯿﻘﻪ ﺑﻪﺻﻮرت دو ﺑﺎر در ﻫﻔﺘﻪ ﺑﺮاي ﮔﺮوه آزﻣﺎﯾﺶ اراﺋﻪ ﺷﺪ، وﻟﯽ ﮔﺮوه ﮐﻨﺘﺮل ﻫﯿﭻ ﻣﺪاﺧﻠﻪاي درﯾﺎﻓﺖ ﻧﮑﺮد. ﺳﭙﺲ ﻫﺮ دو ﮔﺮوه ﺑﻪ ﻣﻘﯿﺎس ﻓﻮق ﺑﻪﻋﻨﻮان ﭘﺲآزﻣﻮن ﭘﺎﺳﺦ دادﻧﺪ. دادهﻫﺎ ﺑﺎ اﺳﺘﻔﺎده از آزﻣﻮن ﺗﺤﻠﯿﻞ ﮐﻮوارﯾﺎﻧﺲ ﭼﻨﺪﻣﺘﻐﯿﺮه )ﻣﺎﻧﮑﻮا( ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ ﺷﺪ. ﻧﺘﺎﯾﺞ ﻧﺸﺎن داد ﮐﻪ ﺗﻔﺎوت ﻣﻌﻨﺎداري ﺑﯿﻦ دو ﮔﺮوه آزﻣﺎﯾﺶ و ﮐﻨﺘﺮل در ﻧﺎرﺳﺎﯾﯽﻫﺎي ﺷﻨﺎﺧﺘﯽ ﺣﻮاسﭘﺮﺗﯽ، ﺗﻤﺮﮐﺰ ﺿﻌﯿﻒ، ﺗﻐﯿﯿﺮ دادن ﺿﻌﯿﻒ ﺗﻮﺟﻪ و ﺗﮑﺎﻧﺶوري وﺟﻮد دارد. اﯾﻦ ﻧﺘﺎﯾﺞ ﻧﺸﺎن ﻣﯽدﻫﺪ ﮐﻪ اﺑﺰار راﯾﺎﻧﻪاي ﺗﻮانﺑﺨﺸﯽ ﻣﺒﺘﻨﯽ ﺑﺮ ﮐﺎرﮐﺮدﻫﺎي اﺟﺮاﯾﯽ ﺑﻪ ﺑﻬﺒﻮد ﻧﺎرﺳﺎﯾﯽﻫﺎي ﺷﻨﺎﺧﺘﯽ ﮐﻮدﮐﺎن ﻧﺎرﺳﺎﺧﻮان ﻣﻨﺠﺮ ﺷﺪه ﻟﺬا اﯾﻦ ﻣﺪاﺧﻠﻪ ﻣﯽﺗﻮاﻧﺪ ﺑﺮﻧﺎﻣﻪ ﺗﻮانﺑﺨﺸﯽ ﺷﻨﺎﺧﺘﯽ ﻣﻔﯿﺪي ﺑﺮاي ﮐﻮدﮐﺎن ﻧﺎرﺳﺎﺧﻮان ﺑﺎﺷﺪ.

The aim of this study was to determine the effectiveness of executive functions-based rehabilitation program on cognitive deficits of children with dyslexia. This study was experimental with pre-test and post-test with control group. The statistical population of this study consisted of all students with dyslexia in the fourth and fifth grades of elementary school in Tehran in 1397-1398 academic year. The sample consisted of 40 dyslexic students who were selected by clustering sampling method and randomly assigned into two experimental (n=20) and control (n=20) groups. After conducting the revised effortful Control Scale as pretest on both groups, the executive functions-based rehabilitation program was applied to the experimental group in 12 sessions and each session for 60 minutes twice a week, but the control group received no intervention. Then, both groups responded to mentioned questionnaire as post-test. Data were analyzed using repeated measure ANCOVA. The results showed that there was a significant difference between the experimental and control group in cognitive deficits of distraction, poor concentration, poor attention shifting and impulsivity. These results indicate that executive functions-based rehabilitation program has improved the cognitive deficits in children with dyslexia, thus, this intervention can be a useful program for dyslexic children.