The Effectiveness of Cognitive Rehabilitation on Improving Selective Attention, Cognitive Flexibility and Academic Progress of Students with Specific Learning Disorders

Document Type : Research Paper

Authors

1 Department of Psychology, Faculty Humanities, Semnan Branch, Islamic Azad University, Semnan, Iran.

2 Department of Psychology, Faculty of Humanities, Semnan Branch, Islamic Azad University, Semnan, Iran.

3 Department of Social Medicine, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran.

4 Department of Educational Psychology, Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran.

Abstract

The aim of this research was to investigate the efficacy of cognitive rehabilitation in enhancing academic achievement, cognitive flexibility, and selective attention in students with specific learning disabilities. This applied study employed a semi-experimental design with pretest-posttest, a quantitative research method, and an experimental and control group. The population included all elementary school pupils who were referred to learning disability centers in Zanjan during the academic year 2021-2022. A total of 40 participants (22 boys and 18 girls) were randomly assigned to the experimental and control groups (each group, 20 participants). The selection was conducted through convenience sampling. The control group was placed on a waiting list, while the experimental group received 12 sessions of cognitive rehabilitation interventions. The Stroop and Wisconsin Card Sorting Tests were employed to capture data, which were subsequently analyzed using SPSS24 and repeated measures analysis. The findings showed that after cognitive rehabilitation, the level of selective attention, cognitive flexibility, and academic achievement of the participants increased significantly. Selective attention, cognitive flexibility, and academic achievement were significantly different between the experimental and control groups in the pretest, posttest, and follow-up (P<0.01). Therefore, it is possible to infer that cognitive rehabilitation had a beneficial impact on the academic performance, cognitive flexibility, and selective attention of students with specific learning disabilities. Cognitive rehabilitation is an effective therapeutic approach that learning disability centers should employ to enhance the cognitive performance of students with specific learning disabilities.

Keywords


استرنبرگ، ر. (1401). روان‌شناسی شناختی. ترجمۀ سید کمال خرازی و الهه حجازی. تهران: سمت.
اسمعیل‌زاده روزبهانی، آ.، بهروزی، ن.، امیدیان، م.، و مکتبی، غ. (1400). تأثیر توان‌بخشی شناختی رایانه‌ای بر کارکردهای اجرایی و حل مسئله در دانش‌آموزان با اختلال یادگیری ریاضی. نشریۀ توانمندسازی کودکان استثنایی. 12(4)، 98-87. https://doi.org/10.22034/ceciranj.2021.264495.1512
انجمن روان‌پزشکی آمریکا (1394). راهنمای تشخیصی و آماری اختلالات روانی (ویراست پنجم). ترجمه و تصحیح یحیی سیدمحمدی. تهران: روان.
البوغبیش، س.، عابدان‌زاده، ر.، شتاب بوشهری، ن.، و دانش‌فر، ا. (1396). تأثیر اثر استروپ و فاصله‌های زمانی بین دو محرک بر دورۀ بی‌پاسخی روان‌شناختی. فصلنامۀ روان‌شناسی شناختی. 5(2)، 60-51. http://dorl.net/dor/20.1001.1.23455780.1396.5.2.3.9
خسرویان، ف. (1401). اثربخشی توان‌بخشی شناختی بر بهبود توجه دانش‌آموزان دارای اختلال یادگیری خاص شهر کرمانشاه. پیشرفت‌های نوین در علوم رفتاری. ۷(۵۵)، 185-177. http://ijndibs.com/article-1-708-fa.html
خلف‌بیگی، م.، اکبرفهیمی، م.، عشایری، ح.، و دوستدار، ه‍. (1392). بررسی تأثیر فعالیت‌های موسیقایی بر عملکرد اجرایی بیماران مبتلا به اسکیزوفرنیا. مجلۀ علمی پژوهشی دانشگاه علوم پزشکی ارتش جمهوری اسلامی ایران. 2(2)، 129-120. https://www.sid.ir/paper/96840/fa
زحمت‌زادخوری، ح. (1401). سنجش و مقایسۀ کنترل ادراکی، بازداری شناختی و توجه انتخابی در کودکان دارای اختلال یادگیری ویژه و بدون آن در شهر بندرلنگه. پایان‌نامۀ کارشناسی ارشد. دانشکدۀ روان‌شناسی. دانشگاه آزاد اسلامی واحد بندر لنگه.
عنایت‌زاده شهرودی، ش.، حسن‌زاده، ر.، و عمادیان، س. ع. (1399). مقایسۀ اثربخشی بازتوانی شناختی و تحریکات وستیبولار بر پیشرفت تحصیلی دانش‌آموزان دختر مبتلابه اختلال یادگیری خاص. مجلۀ سلامت جامعه. 4(2)، 87-78. https://doi.org/10.22123/chj.2020.237978.1532
غلامعلی‌نژاد، ف.، پاکدامن، ش.، و پناغی، ل. (1398). مقایسۀ بارگذاری حافظۀ فعال در حالت استراحت و فعالیت مغز با استفاده از EEG در کودکان دارای اختلال یادگیری ویژه. فصلنامۀ پژوهش‌های کاربردی روان‌شناختی. 10(4)، 227-217.  https://doi.org/10.22059/japr.2020.75079
محمدلو، ا.، مروتی، ذ.، و یوسفی افراشته، م. (1400). اثربخشی توان‌بخشی شناختی رایانه‌ای بر مسئله‌گشایی خلاق و سرعت پردازش اطلاعات دانش‌آموزان دختر مقطع ابتدایی. فصلنامۀ پژوهش‌های کاربردی روان‌شناختی. 12(3)، 333-307. https://doi.org/10.22059/japr.2021.314576.643710
محمدی، م.، رایگانی، و.، اکبر، ع.، جلالی، ر.، قبادی، ع.، و عباسی، پ. (1398). شیوع اختلالات رفتاری در کودکان ایرانی. مجلۀ علمی-پژوهشی دانشگاه علوم پزشکی مشهد. ۲۸(169)، ۱9۱-181. https://www.sid.ir/paper/46115/fa
نظرزاده، گ.، فتح‌آبادی، ج.، نجاتی، و.، نظربلند، ن.، و صادقی فیروزآبادی، و. (1400). تأثیر توان‌بخشی شناختی مبتنی بر رایانه (نرم‌افزار آرام) بر کارکردهای اجرایی (توجه انتخابی، حافظۀ کاری و بازداری رفتاری) دانش‌آموزان با اختلال یادگیری خاص. دوفصلنامۀ پویش در آموزش علوم تربیتی و مشاوره. 7(15)، 89-69. https://www.sid.ir/paper/962296/fa
References
Albogbish, S., Abedanzadeh, R., Shetab-Boushehri, N., & Daneshfar, A. (2017). The effect of Stroop effect and inter-stimulus intervals on psychological refractory period. Journal of Cognitive Psychology, 5(2), 51-60. http://jcp.khu.ac.ir/article-1-2654-fa.html (In Persian)
American Psychiatric Association, DSM-5 Task Force. (2013). Diagnostic and statistical manual of mental disorders: DSM-5™ (5th Ed.). American Psychiatric Publishing, Inc. https://doi.org/10.1176/appi.books.9780890425596
American Psychiatric Associatio.n (2015). Diagnostic and Statistical Manual of Mental Disorders (5th Ed.). Translated and corrected by Seyed Mohammadi, Yahya.Tehran: Ravan Publications. https://www.gisoom.com/book/ (In Persian) 
Aro, T., Eklund K., Eloranta A.-K., Närhi V., Korhonen E., & Ahonen T. (2019). Associations between childhood learning disabilities and adult-age mental health problems, lack of education, and unemployment. Journal of Learning Disabilities, 52(1), 71–83. https://doi.org/10.1177/0022219418775118
 Buonomano, D., & Merzenich, M. (1998). Cortical plasticity: From synapses to maps. Annual Reviews of Neuroscience, 21, 149-186. https://doi.org/10.1146/annurev.neuro.21.1.149
 Buttelmann, F., & Karbach, J. (2017). Development and Plasticity of Cognitive Flexibility in Early and Middle Childhood. Frontiers in Psychology, 8(1040), 1–6. https://doi.org/10.3389/fpsyg.2017.01040
Cartwright, C., Gibson, K., Read, J., Cowan, O., & Dehar, T. (2016) Long-Term Antidepressant Use: Patient Perspectives of Benefits and Adverse Effects. Patient Preference and Adherence. 10(1), 1401-1407. https://doi.org/10.2147/PPA.S110632
Cho, H. Y., Kim, K., & Jumg, J. H. (2015). Effects of computer assisted cognitive rehabilitation on brain wave, memory and attention of stroke patients: A randomized control Trial. Journal of Physical Therapy Science, 27(4), 1029-1032. https://doi.org/10.1589/jpts.27.1029
Crane, N., Zusho, A., Ding, Y., & Cancelli, A. (2017). Domain-specific metacognitive calibration in children with learning disabilities. Contemporary Educational Psychology, 50(5), 72-79. https://doi.org/10.1016/j.cedpsych.2016.09.006
Dowker, A. (2009). Use of derived fact strategies by children with mathematical difficulties. Cognitive Development, 24(4), 401-410. https://doi.org/10.1016/j.cogdev.2009.09.005
Easternberg, R. (2022). Cognitive Psychology. Translated by: S. K. Kharrazi and E. Hajazi. Tehran: Samt. http://ijpn.ir/article-1-1593-fa.html (In Persian)
Enayatzadeh Shahroudi, Sh., Hassanzadeh, R., & Emadian, S. A. (2020). Comparison of the effectiveness of cognitive rehabilitation and vestibular stimulation on academic achievement of female students with specific learning disabilities. Journal of Community Health, 4(2), 78-87. https://doi.org/10.22123/chj.2020.237978.1532 (In Persian)
Fisher, M., Loewy, R., Hardy, K., Schlosser, D., & Vinogradov, S. (2013). Cognitive interventions targeting brain plasticity in the prodromal and early phases of schizophrenia. Annual Review of Clinical Psychology, 9, 435-463. https://doi.org/10.1146/annurev-clinpsy-032511-143134
 Fostick, L., & Revah, H. (2018). Dyslexia as a multi-deficit disorder: Working memory and auditory temporal processing. Acta Psychologica. 183(2), 19-28. https://doi.org/10.1016/j.actpsy.2017.12.010
Gabriely, R., Tarrasch, R., Velicki, M., & Ovadia-Blechman, Z. (2020). The influence of mindfulness meditation on inattention and physiological markers of stress on students with learning disabilities and/or attention deficit hyperactivity disorder. Research in Developmental Disabilities, 100, 103630. https://doi.org/10.1016/j.ridd.2020.103630
Gaitán, A., Garolera, M., Cerulla, N., Chico, G., Rodriguez Querol, M., & Canela Soler, J. (2013). Efficacy of an adjunctive computer based cognitive training program in amnestic mild cognitive impairment and Alzheimer's disease: A single blind, randomized clinical trial. International Journal of Geriatric Psychiatry, 28(1), 91-99. https://doi.org/10.1002/gps.3794
Garcia, V. L., Pereira, L. D., & Fukuda, Y. (2007). Selective attention: Psi performance in children with learning disabilities. Brazilian Journal of Otorhinolaryngology73(3), 404–411. https://doi.org/10.1016/s1808-8694(15)30086-0
Georgitsi, M., Dermitzakis, I., Soumelidou, E., & Bonti, E. (2021). The polygenic nature and complex genetic architecture of specific learning disorder. Brain Sciences, 11(5), 631. https://doi.org/10.3390/brainsci11050631
Gholamali Nezhad, F., Pakdaman, Sh., & Panahi, L. (2019). Comparison of active memory load in rest and brain activity using EEG in children with specific learning disabilities. Journal of Applied Psychological Research, 10(4), 217-227. https://doi.org/10.22059/japr.2020.75079 (In Persian)
Goldstein, G., Mayfield, J., Thaler, N. S., Walker, J., & Allen, D. N. (2018). Cognitive and academic achievement changes associated with day hospital rehabilitation in children with acquired brain injury. Applied Neuropsychology: Child, 7(2), 110-116. https://doi.org/10.1080/21622965.2016.1253478
Goldstein, S., & Naglieri, J. A. (Eds.). (2014). Handbook of executive functioning. Springer Science + Business Media. https://doi.org/10.1007/978-1-4614-8106-5
Grant, D. A., & Berg, E. (1948). A behavioral analysis of degree of reinforcement and ease of shifting to new responses in a Weigl-type card-sorting problem. Journal of Experimental Psychology38(4), 404. https://doi.org/10.1037/h0059831
Gualtieri, C. T., & Johnson, L. G. (2006). Reliability and validity of a computerized neurocognitive test battery, CNS Vital Signs. Archives of Clinical Neuropsychology, 21(7), 623–643. https://doi.org/10.1016/j.acn.2006.05.007
Ismaeilzadeh Rouzbehani, A., Behroozi, N., Omidiyan, M., & Mokhtari, Gh. (2021). The effect of computer-based cognitive rehabilitation on executive functions and problem-solving in students with math learning disabilities. Journal of Exceptional Children Empowerment, 12(4), 87-98. https://doi.org/10.22034/ceciranj.2021.264495.1512 (In Persian)
Kegel, N. E. (2010). Executive functioning in Asperger’s disorder and Nonverbal learning disabilities: A comparison of developmental and behavioral characteristics. Department of Counseling, Psychology & Special Education Duquesne University. https://dsc.duq.edu/etd/735
Khalfbeigi, M., Akbarfahimi, M., Ashayeri, H., & Doustdar, H. (2013). Investigating the effect of musical activities on executive performance in patients with schizophrenia. Journal of Military Medicine, 2(2), 120-129. https://www.sid.ir/paper/96840/fa (In Persian)
Khasawneh, M. A. S. (2021). Cognitive Flexibility of Students with Learning Disabilities in English Language and Itsproblem behaviours in a classroom setting: Three case studies. The Educational and Developmental Psychologist, 37(1), 4-10. https://doi.org/10.34293/education.v9i3.4003
Khosravian, F. (2022). The effectiveness of cognitive rehabilitation on improving attention in students with specific learning disabilities in Kermanshah city. Advances in Behavioral Sciences, 7(55), 177-185. http://ijndibs.com/article-1-708-fa.html (In Persian)
Kibby, M. Y., & Cohen, M. J. (2008). Memory functioning in children with reading disabilities and/or attention deficit/hyperactivity disorder: a clinical investigation of their working memory and long-term memory functioning. Child Neuropsychol, 14(6), 525-46. https://doi.org/10.1080/09297040701821752
Kim, S. (2015). Cognitive rehabilitation for elderly people with early.stage Alzheimer’s disease. Journal of Physical Therapy Science, 27, 543–546. https://doi.org/10.1589/jpts.27.543
Kolb, B., & Gibb, R. (2014). Searching for the principles of brain plasticity and behavior. Cortex, 58, 251-260. https://doi.org/10.1016/j.cortex.2013.11.012
Lezak, M. D., Howieson, D. B., & Loring, D. W. (2004). Neuropsychological Assessment (4th Ed.). New York: Oxford University Press. https://www.scirp.org/
Longley, W. A. (2022). Cognitive rehabilitation in multiple sclerosis. Australian Journal of General Practice51(4), 233-237. https://doi.org/10.31128/ajgp-08-21-6146
Loosli, S. V., Buschkuehl, M., Perrig, W. J., & Jaeggi, S. M. (2012). Working memory training improves reading processes in typically developing children. Child Neuropsychology, 18(1), 62-78. https://doi.org/10.1080/09297049.2011.575772
Luria, A. R. (1973). The working brain: An introduction to neuropsychology. London: Penguin Books. https://www.scirp.org
Melby-Lervåg, M., & Hulme, C. (2013). Cognitive training and school performance: A meta-analysis. Educational Research Review, 8, 113-128. https://doi.org/10.1037/a0028228
Mohammadi, M., Raiganai, V., Akbar, A., Jalali, R., Ghobadi, A., & Abbasi, P. (2019). Prevalence of behavioral disorders in Iranian children. Medical Journal of Mashhad University of Medical Sciences, 62(5), 181-191. https://www.sid.ir/paper/46115/fa (In Persian)
Mohammadlou, A., Marovvati, Z., & Yousefi Afrashteh, M. (2021). The effectiveness of computerized cognitive rehabilitation on creative problem-solving and information processing speed of female elementary students. Journal of Applied Psychological Research, 12(3), 307-333. https://doi.org/10.22059/japr.2021.314576.643710 (In Persian)
Nazarezadeh, Gh., Fathabadi, J., Nejati, V., Nazarboland, N., & Sadeghi Firouzabadi, V. (2021). The effect of computer-based cognitive rehabilitation (Aramesh software) on executive functions (selective attention, working memory, and behavioral inhibition) of students with specific learning disabilities. Journal of Research in Educational and Counseling Sciences, 7(15), 69-89. https://www.sid.ir/paper/962296/fa (In Persian)
Nie, P., Liu, F., Lin, S., Guo, J., Chen, X., Chen, S., & Lin, R. (2022). The effects of computer-assisted cognitive rehabilitation on cognitive impairment after stroke: A systematic review and meta-analysis. Journal of Clinical Nursing31(9-10), 1136-1148. https://doi.org/10.1111/jocn.16030
Nobre, A. C., & Serences, J. T. (2018). Building on a solid baseline: Anticipatory biases in attention. Trends in Neurosciences41(3), 120-122. https://doi.org/10.1016/j.tins.2018.01.005
Olesen, P.J., Westerberg, H., & Klingberg, T. (2004). Increased prefrontal and parietal brain activity after training of working memory. Nature Neuroscience, 7(1), 71-79. https://doi.org/10.1038/nn1165
Olsen, A., Dennis, E. L., Stubberud, J., Hovenden, E. S., Solbakk, A. K., Endestad, T., ... & Tornås, S. (2022). Regional brain volume prior to treatment is linked to outcome after cognitive rehabilitation in traumatic brain injury. NeuroImage: Clinical, 35, 103126. https://doi.org/10.1016/j.nicl.2022.103126
Resch, C., Rosema, S., Hurks, P., de Kloet, A., & van Heugten, C. (2018). Searching for effective components of cognitive rehabilitation for children and adolescents with acquired brain injury: A systematic review. Brain injury32(6), 679-692. https://doi.org/10.1080/02699052.2018.1458335
Sainio, P. J., Eklund, K. M., Ahonen, T. P., & Kiuru, N. H. (2019). The role of learning difficulties in adolescents’ academic emotions and academic achievement. Journal of Learning Disabilities52(4), 287-298. https://doi.org/10.1177/0022219419841567
Sandford, J. A. (2007). Captain's log computerized cognitive training system. Richmond, VA: Brain Train.
Scarpina, F., & Tagini, S. (2017). The stroop color and word test. Frontiers in Psychology8, 241674. https://doi.org/10.3389%2Ffpsyg.2017.00557
SedaÖnen, A., & Koçak, C. (2015).The Effect Of Cognitive Flexibility On Higher School Students: Study Strategies. Social and Behavioral Sciences, 191, 2346-2350. https://doi.org/10.1016/j.sbspro.2015.04.680
Seidman, L. J. (2006). Neuropsychological functioning in people with ADHD across the lifespan. Clinical Psychology Review, 26(4), 466-485. https://doi.org/10.1016/j.cpr.2006.01.004
Siegrist, M. (1997). Test–retest reliability of different versions of the Stroop test. The Journal of Psychology: Interdisciplinary and Applied, 131(3), 299–306. https://psycnet.apa.org/doi/10.1080/00223989709603516
Skalski, S., Pochwatko, G., & Balas, R. (2021). Impact of motivation on selected aspects of attention in children with ADHD. Child Psychiatry & Human Development52(4), 586-595. https://doi.org/10.1007/s10578-020-01042-0
Sohlberg, M. M., & Mateer, C. A. (2017). Cognitive rehabilitation: An neuropsychological approach. Guilford Publications.
Strauss, E., Sherman, E. M. S., & Spreen, O. (2006). A compendium of neuropsychological tests: Administration, norms, and commentary (3rd Ed.). Oxford University Press. https://doi.org/10.1080/09084280701280502
Stroop, J. R. (1935). Studies of interference in serial verbal reactions. Journal of Experimental Psychology18(6), 643. https://psycnet.apa.org/doi/10.1037/h0054651
Swanson, H. L. (2014). Does cognitive strategy training on word problems compensate for working memory capacity in children with math difficulties? Journal of Educational Psychology, 106(3), 831-848. https://psycnet.apa.org/doi/10.1037/a0035838
Tajik-Parvinchi, D., Wright, L., & Schachar, R. (2014). Cognitive rehabilitation for attention deficit/hyperactivity disorder (ADHD): promises and problems. Journal of the Canadian Academy of Child and Adolescent Psychiatry23(3), 207. http://www.ncbi.nlm.nih.gov/pmc/articles/pmc4197521/
Wiest, G. M., Rosales, K. P., Looney, L., Wong, E. H., & Wiest, D. J. (2022). Utilizing cognitive training to improve working memory, attention, and impulsivity in school-aged children with ADHD and SLD. Brain Sciences12(2), 141. https://doi.org/10.3390/brainsci12020141
Yao, X. (2013). The Rol of selective attention in Early Inductive Generalization Doctoral dissertation. The Ohio State University. https://etd.ohiolink.edu/apexprod/
Zahmt Zadkhori, H. (2022). Assessment and comparison of cognitive control, cognitive inhibition, and selective attention in children with and without specific learning disabilities in Bandar Lengeh city. Master's thesis. Faculty of Psychology, Islamic Azad University, Bandar Lengeh Branch. (In Persian)
Zhang, S., Liu, J., Wang, J., Xia, X., Zhang, L., Liu, L., & Jiang, T. (2019). Developing and validating the Learning Disabilities Screening Scale in Chinese elementary schools. International Journal of Educational Research, 96(1), 91-99. http://dx.doi.org/10.1016/j.ijer.2019.06.006
Volume 15, Issue 1
2024
Pages 317-340
  • Receive Date: 20 March 2023
  • Revise Date: 19 May 2023
  • Accept Date: 03 June 2023
  • First Publish Date: 27 September 2023
  • Publish Date: 09 June 2024