پديد آورندگان :
حسينعلي زاده، يونس دانشگاه پيام نور، تهران , علي اكبري دهكردي، مهناز دانشگاه پيام نور، تهران - گروه روان شناسي , علي پور، احمد دانشگاه پيام نور، تهران - گروه روان شناسي
كليدواژه :
برنامهٔ درماني مبتني بر مداخلات رفتاري هماهنگ درمان‌گر- خانه - مدرسه , رفتار روزانهٔ مدرسه‌اي , تكليف‌گريزي , اختلال نارسايي توجه/فزون‌كنشي
چكيده فارسي :
زمينه و هدف: دانش‌آموزان مبتلا به اختلال نارسايي توجه/فزون‌كنشي در معرض مشكلات زيادي در حوزه‌هاي كاركردي از جمله وضعيت تحصيلي هستند؛ لذا اين پژوهش به‌منظور بررسي اثر درماني مبتني‌بر مداخلات رفتاري هماهنگ درمان‌گر، خانه و مدرسه بر تغيير رفتار روزانهٔ مدرسه‌اي و كاهش تكليف‌گريزي كودكان با اختلال نارسايي توجه/فزون‌كنشي صورت گرفت.
روش‌بررسي: جامعهٔ آماري شامل تمامي كودكان با اختلال نارسايي توجه/فزون‌كنشي بود كه به يكي از مراكز مشاورهٔ تهران در سال 97-1396 مراجعه كرده بودند. از بين كودكان واجد شرايط با استفاده از روش نمونه‌گيري تصادفي 30 دانش‌آموز پسر 8 تا 9 ساله به‌همراه والدين و معلم‌شان انتخاب و در دو گروه گواه و آزمايش جاي‌دهي شدند. به گروه آزمايش روش درماني هماهنگ درمان‌گر، خانه و مدرسه در طول سه ماه آموزش داده شد. از مقياس مشكلات رفتاري كانرز فرم والدين (1978) و مقياس مشكلات رفتاري كانرز فرم معلم (1998) در اين پژوهش استفاده شد.
يافته‌ها: نتايج نشان داد كه روش درماني رفتاري هماهنگ درمان‌گر، خانه و مدرسه بر تغيير رفتار روزانهٔ مدرسه‌اي (0٫001 نتيجه‌گيري: با توجه به اثربخشي درمان هماهنگ درمان‌گر، خانه و مدرسه پيشنهاد مي‌شود از اين روش آموزشي به‌منظور بهبود وضعيت كودكان با اختلال نارسايي توجه/فزون‌كنشي استفاده شود.
چكيده لاتين :
Background & Objective: Students with attention deficit-hyperactivity disorder may have many problems in functional areas including
education status. Although these children have normal intelligence they display weak performance in school, and their relationship with parents,
teachers, peers, and friends is frequently problematic. For solving the child behavioral problems, the teacher must have active cooperation with
parents. Making behavioral contract between home and school is one of these methods. So, this research investigated the effect of a therapeutic
plan based on the coordinated behavioral intervention of therapist, home, and school on changing daily school behavior and reducing task
avoidance in children with attention deficit-hyperactivity disorder.
Methods: This research was kind of experimental design (pretest-post-test with a control group and follow-up). The statistical population
included all 8-9 years old boys with ADHD who had referred to Tehran psychological services and counseling centers. Among children that
despite of ADHD had not comorbid disorders as mental retardation and obvious physical-sensory-motor disorder and chronic illnesses, received
medical treatment with equal time and amount and were in 8-9 years age range, 30 individuals along with their parents were selected as research
sample and randomly assigned to experimental (N=15) and control (N=15) groups. The therapeutic plan based on the coordinated behavioral
intervention of therapist, home, and school was trained to experimental group for eight sessions. Mother as home agent and teacher as school
agent must be presented. Therapeutic plan based on coordinated behavioral intervention of therapist, home, and school is derived from Skinner`s
theory of operant conditioning (1983) and it`s methods and techniques (such as reinforcement management, token economy, Premack principle)
and positive childrearing method that conducted for 8 sessions, weekly twice, every session 2 hours. After finishing training sessions, took posttest
from every two groups and they were tested after the follow-up period for the third time. The Conners Parent Rating Scale (CPRS) and the
Conners Teacher Rating Scale (CTRS) were used as tools for assessing task avoidance at home and daily school behavior respectively. These
questionnaires were used as the most common tools for screening and to diagnosing of ADHD in most world places and had been suitable tools
for measuring the intensity of symptoms. Data were analyzed with variance analysis and repeated measurements using SPSS 22 (p<0.05). Also,
in order to identify which variables have a significant difference with each other, was used for post hoc tests (LSD) in observing the condition
of homogeneity of variances.
Results: The results showed that the therapeutic method based on the coordinated behavioral intervention of therapist, home, and the school had
a significant effect on changing the daily school behavior (F=21.84, P=0.0001) and reducing task avoidance (F=33.37, P=0.0001). In addition,
effect size showed that about 43% of significant difference daily school behavior and 51% of significant difference task avoidance in home
between two groups due to training of coordinated plan of therapist, home, and school in experimental group, that is this training has been
effective in improving daily school behavior and reducing task avoidance in children with ADHD. Also, the results of a follow-up study showed
that daily school behavior and task avoidance in home had significant difference between two groups in every three phases of pretest, post-test
and follow-up, that is intervention had stable and effective influence in every three phases and intervention effectiveness ever remained after
seven weeks (P<0.001).
Conclusion: According to the results of this research that showed the effectiveness of a therapeutic plan based on coordinated behavioral
intervention of therapist, home and school on reducing task avoidance and improving daily school behavior and multi-dimensional problems of
children with ADHD in home and school and according to advantages of parent intervention and the importance of families-school incorporation
and effectiveness of team interventions is recommended that this method uses as multi-dimensional treatment for children with attention deficithyperactivity
disorder in different educational and therapeutic centers.
