Efficacy of Cognitive-Motor Rehabilitation on the Reading Speed and Cognitive Flexibility of Children with Learning Disabilities in Reading

Document Type : Research Paper

Authors

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

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

3 Department of Psychology, Faculty of Education and Psychology, Shahid Beheshti University, Tehran, Iran.

Abstract

The objective of the current study was to investigate the efficacy of cognitive-motor rehabilitation in improving the reading speed and cognitive flexibility of children with disability during the reading learning process. The study was quasi-experimental in nature, utilizing a control group, pretest, and posttest design. A two-month follow-up period was implemented. The statistical population of the survey consisted of second- to fourth-grade children with learning disabilities in reading in district 6 of Tehran during the academic year 2021-2022. The purposive sampling method was employed to select thirty-seven children with learning literacy disabilities (23 boys and 14 girls). These children were randomly assigned to the experimental and control groups. Twelve cognitive-motor rehabilitation sessions were administered to the experimental group over the course of six weeks. In this investigation, the Persian Reading Ability Test (PRAT) and the Tower of London Procedure (TLP) were implemented. The data that was collected were subjected to a mixed ANOVA and a post hoc Bonferroni test using SPSS23 software. The findings indicated that cognitive-motor rehabilitation has a highly significant impact on reading speed (p<0001) and cognitive flexibility (p<0001) of children with reading learning disability. Based on the findings of this study, it can be inferred that cognitive-motor rehabilitation is a viable approach for enhancing the cognitive flexibility and reading speed of children with learning disabilities in reading by employing influencing cortex and applying purposeful cognitive-motor exercises.

Keywords

آقایی ثابت، س. س.، پوراعتماد، ح. ر.، جعفرزاده‌پور، ا.، و حسن‌آبادی، ح. ر. (1392). بهبود عملکرد خواندن از طریق مداخلات دیداری. فصلنامه تازه‌های علوم شناختی، 15(3)، 11-1. http://icssjournal.ir/article-1-111-fa.html
دمهری، ف.، درویشی، ا.، و سعیدمنش، م. (1399). اثربخشی توان‌بخشی شناختی مبتنی بر حرکت بر جهت‌یابی، حافظۀ یادگیری، وضعیت شناختی و توجه کودکان دارای اختلال یادگیری غیرکلامی. طب توانبخشی، 9(2)، 256-249. https://doi.org/10.22037/jrm.2019.112274.2173
رنجبر، م.، حسن‌زاده، س.، و ارجمندنیا، ع.‌ا. (1399). اثربخشی توان‌بخشی شناختی رایانه‌محور در ارتقاء کارکردهای اجرایی کودکان: مروری نظامدار بر پژوهش‌های داخلی. تازه‌های علوم شناختی، 22(1)، 136-128. http://icssjournal.ir/article-1-936-fa.html
رهبرکرباسدهی، ف.، حسین‌خانزاده، ع.، و ابوالقاسمی، ع. (1397). تأثیر آموزش راهبردهای خودتنظیمی بر بهبود مهارت خواندن دانش‌آموزان پسر دارای اختلال یادگیری ویژه با نوع خواندن. مطالعات ناتوانی، 8(2)، 151-142. http://jdisabilstud.org/article-1-938-fa.html   
سیدمحمدی، ح.، احتشام‌زاده، پ.، حافظی، ف.، پاشا، ر.، و مکوندی، ب. (1399). اثربخشی توان‌بخشی شناختی در مقایسۀ با توان‌بخشی شناختی پس از دارودرمانی بر کارکردهای اجرایی مغز کودکان مبتلا به اختلال کم توجهی-بیش فعالی: یک مطالعۀ کارآزمایی بالینی. مجله علمی دانشگاه علوم پزشکی گرگان، 22(1)، 16-7. http://goums.ac.ir/journal/article-1-3494-fa.html
صالحیان بروجردی، ح.، عشایری، ح.، و مهریار، ا. ه. (1399). اثربخشی توان‌بخشی شناختی بر کارکردهای اجرایی و شدت اختلال ناروانی گفتار در کودکان مبتلا به اختلال ناروانی گفتار. علوم پیراپزشکی و توانبخشی مشهد، 9(4)، 26-16. https://doi.org/10.22038/jpsr.2021.43850.2026
صفری، ن.، باعزت، ف.، و غفاری، م. (1399). اثربخشی برنامۀ توان‌بخشی شناختی توجه بر ابعاد توجه و کارآمدی خواندن دانش‌آموزان نارساخوان. سلامت روان کودک، 7(3)، 181-167. http://childmentalhealth.ir/article-1-665-fa.html
شیرانی، ش.، حسین پور، م.، و اصلی آزاد، م. (1399). اثربخشی درمان خودشفقتی بر نشاط ذهنی و احساس تنهایی دانش‌آموزان با اختلال یادگیری. توانمندسازی کودکان استثنایی، 11(1)، 85-73. https://doi.org/10.22034/ceciranj.2020.155168.1074 
عاشوری، م.، و تاج‌ور رستمی، ا. (1399). تأثیر برنامۀ توان‌بخشی شناختی مبتنی بر حافظۀ بر کارکردهای اجرایی دانش‌آموزان با آسیب شنوایی. طب توانبخشی، 9(1)، 232-226. https://doi.org/10.22037/jrm.2019.111495.2032
عباسی فشمی، ن.، اکبری، ب.، و حسین خانزاده، ع. (1399). مقایسۀ اثربخشی توان‌بخشی شناختی و نوروفیدبک بر بهبود کنش‌های اجرایی کودکان مبتلا به نارساخوانی. سلامت روان کودک، 7(2)، 311-294. http://childmentalhealth.ir/article-1-1070-fa.html  
عباسیان بروجنی، ر.، رفیعی، ص.، نمازی زاده، م.، و تجاری، ف. (1399). تأثیر توان‌بخشی شناختی و بازی‌های حرکتی هدفمند بر حافظۀ کاری کودکان دارای اختلال هماهنگی رشدی. طب توانبخشی، 9(2)، 297-287. https://doi.org/10.22037/jrm.2019.112420.2188
کیانی، ب.، و هادیان‌فرد، ح. (1395). تأثیر مداخلۀ مبتنی بر ذهن‌آگاهی بر برنامه‌ریزی نوجوانان با علایم زیرآستانۀ تشخیص اختلال نقص توجه-بیش‌فعالی در آزمون برج لندن. روش‌ها و مدل‌های روانشناختی، 7(23)، 134-117. https://jpmm.marvdasht.iau.ir/article_1908.html
محمدی، ت.، و افروز، غ. (1399). تأثیر توان‌بخشی شناختی گروهی بر توانایی حل مسئله در دانش‌آموزان با اختلال نارسایی توجه/فزون کنشی. سلامت روان کودک، 7(2)، 155-144. http://childmentalhealth.ir/article-1-832-fa.html
معتقدی فرد، م.، باعزت، ف.، نجاتی، و.، و نادری، ح. (1399). طراحی برنامه توان‌بخشی شناختی سرور مبتنی بر رایانه و بررسی تأثیر آن بر کارآمدی هجی کردن و پردازش دیداری-واج‌شناختی دانش‌آموزان نارساخوان-نادرست‌نویس. سلامت روان کودک، 7(4)، 282-263. http://childmentalhealth.ir/article-1-850-fa.html
موسی‌زاده مقدم، ح.، ارجمندنیا، ع. ا.، افروز، غ.، و غباری بناب، ب. (1399). تاثیر برنامه توان‌بخشی شناختی مبتنی بر حافظۀ آینده‌نگر بر میزان توجه کودکان با اختلال نارسایی توجه/فزون‌کنشی. سلامت روان کودک، 7(4)، 262-247. http://childmentalhealth.ir/article-1-606-fa.html
ناجیان، ع.، و نجاتی، و. (1396). تأثیر توان‌بخشی شناختی مبتنی بر حرکت بر بهبود توجه پایدار و انعطاف‌پذیری شناختی کودکان مبتلا به اختلال نقص توجه و بیش فعالی. طب توانبخشی، 6(4 )، 12-1.  https://medrehab.sbmu.ac.ir/article_1100350.html?lang=fa
نظرزاده گیگلو، س.، فتح آبادی، ج.، نجاتی، و.، نظربلند، ن.، و صادقی فیروزآبادی، و. (1400). تأثیر توان‌بخشی شناختی مبتنی بر رایانه بر کارکردهای اجرایی (توجه انتخابی، حافظه کاری و بازداری رفتاری) دانش‌آموزان با اختلال یادگیری خاص. پویش در آموزش علوم تربیتی و مشاوره، 7(15)، 89-69. https://dorl.net/d https://dorl.net/dor/20.1001.1.2783154.1400.1400.15.4.7  
یاوری برحق طلب، ا.، عسگری، پ.، نادری، ف.، و حیدری، ع. (1400). بررسی اثر توان‌بخشی شناختی بر عملکردهای اجرایی (بازداری پاسخ و برنامه‌ریزی) کودکان دارای اختلال نقص توجه و بیش‌فعالی. طب توانبخشی، 10(1)، 157-146. https://doi.org/10.22037/jrm.2020.112304.2176
References
Abbasi Fashami, N., Akbari, B., & Hosseinkhanzadeh, A. A. (2020). Comparison of the effectiveness of cognitive rehabilitation and neurofeedback on improving the executive functions in children with dyslexia. Journal of Children Mental Health, 7(2), 294-311. http://dx.doi.org/10.29252/jcmh.7.2.25  (In Persian)
Abbasian Borujeni, R., Rafiee, S., Namazizadeh, M., & Tojari, F. (2020). Effect of cognitive rehabilitation and purposeful-movement plays on working memory among children with developmental coordination disorder. Scientific Journal of Rehabilitation Medicine, 9(2), 287-297. https://doi.org/10.22037/jrm.2019.112420.2188 (In Persian).
Aghaei Sabet, S., Pouretemad, H., Jafarzadehpur, E., & Hassanabadi, H. (2013). Improvement of reading performance through vision therapy. Advances in Cognitive Sciences, 15(3), 1-11. http://icssjournal.ir/article-1-111-en.html (In Persian).
Argento, O., Piacentini, C., Santamato, A., Caltagirone, C., Saraceni, V., & Nocentini, U. (2021). Comparison of the effectiveness of motor and cognitive rehabilitation alone compared to the combination of the two in patients with multiple sclerosis. Journal of the Neurological Sciences, 429, 118566. https://doi.org/10.1016/j.jns.2021.118566
Ashori, M., & Tajvar Rostami, A. (2020). Effects of a memory-based cognitive rehabilitation program on executive functions in students with hearing impairment. Scientific Journal of Rehabilitation Medicine, 9(1), 226-232. https://doi.org/10.22037/jrm.2019.111495.2032 (In Persian)
Azizi, A., Drikvand, F. M., & Sepahvandi, M. A. (2018). Comparison of the effect of cognitive rehabilitation and neurofeedback on sustained attention among elementary school students with specific learning disorder: A preliminary randomized controlled clinical trial. Applied Psychophysiology and Biofeedback, 43(4), 301-307.‏ https://doi.org/10.1007/s10484-018-9410-8
Beelen, C., Vanderauwera, J., Wouters, J., Vandermosten, M., & Ghesquière, P. (2019). Atypical gray matter in children with dyslexia before the onset of reading instruction. Cortex, 121, 399-413. https://doi.org/10.1016/j.cortex.2019.09.010
Blom, E., Berke, R., Shaya, N., & Adi-Japha, E. (2021). Cognitive flexibility in children with Developmental Language Disorder: Drawing of nonexistent objects. Journal of Communication Disorders, 93, 1061-1065. https://doi.org/10.1016/j.jcomdis.2021.106137
Carpentier, S., Deng, W., Bottale, S., Hendrickson, T., Zhang, L., … & Winckel, A.V. (2022). Cognitive multisensory rehabilitation for sensory and motor function in adults with spinal cord injury: Proof of concept. Archives of Physical Medicine and Rehabilitation, 103(3), 21-25. https://doi.org/10.1016/j.apmr.2022.01.059
Cartwright, K. B., Coppage, K. A., Lane, A. B., Singleton, T., Marshall, T. R., & Bentivegna, C. (2017). Cognitive flexibility deficits in children with specific reading comprehension difficulties. Contemporary Educational Psychology, 50, 33-44. https://doi.org/10.1016/j.cedsych.2016.01.003
Chang, W. H., Wu, C., Kuo, C., & Chen, L. H. (2018). The role of athletic identity in the development of athlete burnout: The moderating role of psychological flexibility. Psychology of Sport and Exercise, 39, 45-51. https://doi.org/10.1016/j.psychsport.2018.07.014
Corallo, F., Buono, V. L., Di Cara, M., De Salvo, S., Vermiglio, G., & Rifici, C. (2018). Effects of cognitive and motor rehabilitation in non-convulsive status epilepticus: A case report. Journal of Clinical Neuroscience, 54, 137-139. https://doi.org/10.1016/j.jocn.2018.06.024
Demehri, F., Darvishi, E., & Saiedmanesh, M.  (2020). Effectiveness of motor based cognitive rehabilitation on orientation, learning memory, attention, and cognition in children with non-verbal learning disorder. Scientific Journal of Rehabilitation Medicine, 9(2), 249-256. https://doi.org/10.22037/jrm.2019.112274.2173 (In Persian)
Fostick, L., & Revah, H. (2018). Dyslexia as a multi-deficit disorder: Working memory and auditory temporal processing. Acta Psychologica, 183, 19-28. https://doi.org/10.1016/j.actpsy.2017.12.010
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
Gray, S. A., Chaban, P., Martinussen, R., Goldberg, R., Gotlieb, H., Kronitz, R., & Tannock, R. (2012). Effects of a computerized working memory training program on working memory, attention, and academics in adolescents with severe LD and comorbid ADHD: A randomized controlled trial. Journal of Child Psychology and Psychiatry, 53(12), 1277-1284.‏ https://doi.org/10.1111/j.1469-7610.2012.02592.x
Hajri, M., Abbes, Z., Yahia, H. B., Ouanes, S., & Amado, I. (2016). Effects of cognitive remediation therapy in children with autism spectrum disorder: Study protocol. International Journal of Science and Research, 5(7), 112-116.‏ http://dx.doi.org/10.21275/v5i7.ART201648
Injoque-Ricle, I., & Burin, D. I. (2011). Working memory and planning in children: Validation of the Tower of London Task. Neuropsicología Latinoamericana, 3(2), 31–38. Link
Julien, A., Danet, L., Loisel, M., Brauge, D., Pariente, J., Péran, P., & Planton, M. (2023). Update on the efficacy of cognitive rehabilitation following moderate to severe traumatic brain injury: A scoping review. Archives of Physical Medicine and Rehabilitation, 104(2), 315-330. https://doi.org/10.1016/j.apmr.2022.07.007
Kiani, B., & Hadianfard, H. (2016). The impact of intervention based on mindfulness on planning of adolescents with subthreshold symptoms of attention deficit-hyperactivity disorder in Tower of London Test. Psychological Methods and Models, 8(23), 115-134. https://jpmm.marvdasht.iau.ir/article_1908.html?lang=en (In Persian)
Lezak, M. D. (1995). Neuropsychological assessment (3rd Ed.). New York: Oxford University Press. https://psycnet.apa.org/record/1995-97708-000
Mohammadi, T., & Afrouz, G. A. (2020). The effect of group cognitive rehabilitation therapy on the problem solving skills of students with attention deficit hyperactivity disorder. Journal of Children Mental Health, 7(2), 144-155. http://dx.doi.org/10.29252/jcmh.7.2.13 (In Persian)
Motaghedifard, M., Baezzat, F., Nejati, V., & Naderi, H. (2021). Designing COROOR computer-based cognitive rehabilitation program and investigating its effect on spelling efficacy and visual-phonological processing in students with dyslexia–dysorthographia. Journal of Children Mental Health, 7(4), 264-283. http://dx.doi.org/10.52547/jcmh.7.4.17 (In Persian)
Musazadeh Moghaddam, H., Arjmandnia, A. A., Afrooz, G. A., & Ghobari-Bonab, B. (2020). Effectiveness of cognitive rehabilitation program based on prospective memory on the attention rate in the children with attention deficit hyperactivity disorder (ADHD). Journal of Children Mental Health, 7(4), 248-263. http://dx.doi.org/10.52547/jcmh.7.4.16 (In Persian)
Najian, A., & Nejati, V. (2018). Effectiveness of motor based cognitive rehabilitation on improvement of sustained attention and cognitive flexibility of children with ADHD. Scientific Journal of Rehabilitation Medicine, 6(4), 1-12. https://medrehab.sbmu.ac.ir/article_1100350.html?lang=en (In Persian)
Nazarzade Gigolo, S., Fathabadi, J., Nejati, V., Nazarboland, N., & Sadeghi Firoozabadi, V. (2021). The impact of computer-based cognitive rehabilitation (ARAM software) on executive functions (selective attention, working memory, and behavioral inhibition) of students with specific learning disorders. Quarterly Journal of "Pouyesh in Education and Consultation, 7(15), 69-89. https://educationscience.cfu.ac.ir/article_2149.html?lang=en (In Persian)
Palser, E. R., Morris, N. A., Roy, A. R. K., Holley, S. R., … & Sturm, V. E. (2021). Children with developmental dyslexia show elevated parasympathetic nervous system activity at rest and greater cardiac deceleration during an empathy task. Biological Psychology, 166, 108-111. https://doi.org/10.1016/j.biopsycho.2021.108203
Peijnenborgh, J. C. A. W., Hurks, P. M., Aldenkamp, A. P., Vles, J. S. H., & Hendriksen, J. G. (2016). Efficacy of working memory training in children and adolescents with learning disabilities: A review study and meta-analysis. Neuropsychological Rehabilitation, 26(5-6), 645-672.‏ https://doi.org/10.1080/09602011.2015.1026356
Peters, L., Beeck, H., & Smedt, B. (2020). Cognitive correlates of dyslexia, dyscalculia and comorbid dyslexia/dyscalculia: Effects of numerical magnitude processing and phonological processing. Research in Developmental Disabilities, 107, 1038-1042. https://doi.org/10.1016/j.ridd.2020.103806
Pontifex, M. B., Saliba, B. J., Raine, L. B., Picchietti, D. L., & Hillman, C. H. (2013). Exercise improves behavioral, neurocognitive, and scholastic performance in children with attention-deficit/hyperactivity disorder. The Journal of Pediatrics, 162(3), 543-551.‏ https://doi.org/10.1016/j.jpeds.2012.08.036
Pouretemad, H. R., Khatibi, A., Zarei, M., & Stein, J. (2011). Manifestation of developmental dyslexia in monolingual Persian speaking students. Archives of Iranian Medicine, 14(4), 259-265. https://journalaim.com/Article/184
Priyamvada, R., Ranjan, R., & Chaudhury, S. (2015). Cognitive rehabilitation of attention and memory in depression. Industrial Psychiatry Journal, 24(1), 48-52. http://dx.doi.org/10.4103/0972-6748.160932 
Rahbar Karbasdehi, F., Hossein Khanzadeh, A., & Abolghasemi, A. (2018). Self-regulation strategies training on improving reading skills of male students with specific learning disabilities with specifier dyslexia. Middle Eastern Journal of Disability Studies, 8(2), 77-77. http://jdisabilstud.org/article-1-938-en.html (In Persian)
Ranjbar, M., Hassanzadeh, S., Arjmandniya, A.A. (2020). The effectiveness of computerized cognitive rehabilitation on children’s executive function: Systematic review on national studies. Advances in Cognitive Sciences, 22(1), 128-136. http://dx.doi.org/10.30699/icss.22.1.128 (In Persian)
Safari, N., Baezzat, F., & Ghaffari, M. (2020). Effectiveness of cognitive rehabilitation program on attention dimensions and reading efficacy in students with dyslexia. Journal of Children Mental Health, 7(3), 167-181. http://dx.doi.org/10.52547/jcmh.7.3.14 (In Persian)
Salehian Boroujerdi, H., Ashayeri, H., & Mehryar, A. H. (2021). The effectiveness of cognitive rehabilitation on executive functions and severity of ‎fluency disorder in children with childhood onset fluency disorder. Journal of Paramedical Sciences and Rehabilitation, 9(4), 16-26. https://doi.org/10.22038/jpsr.2021.43850.2026 (In Persian)
Santana, A. N., Roazzi, A., & Nobre, A. P. M. C. (2022). The relationship between cognitive flexibility and mathematical performance in children: A meta-analysis. Trends in Neuroscience and Education, 28, 100179. https://doi.org/10.1016/j.tine.2022.100179
Seyedmohammadi, S. H., Ehteshamzadeh, P., Hafezi, F., Pasha, R., & Makvandi, B. (2020). Comparison of the effectiveness of cognitive rehabilitation and cognitive rehabilitation after drug therapy on executive brain functions of children with attention deficit hyperactivity disorder: A clinical trial study. Journal of Gorgan University of Medical Sciences, 22(1), 7-16. http://goums.ac.ir/journal/article-1-3494-en.html (In Persian)
Shallice, T. (1982). Specific impairments of planning. Philosophical Transactions of the Royal Society B: Biological Sciences, 298(1089), 199-209. https://doi.org/10.1098/rstb.1982.0082
Shirani, S. H., Hoseinpour, M., & Asli Azad, M. (2020). Effectiveness of teaching self-compassion on subjective vitality and loneliness feeling in students with learning disability. Empowering Exceptional Children, 11(1), 73-85. https://doi.org/10.22034/ceciranj.2020.155168.1074 (In Persian)
Wang, X., Liu, X., & Feng, T. (2021). The continuous impact of cognitive flexibility on the development of emotion understanding in children aged 4 and 5 years: A longitudinal study. Journal of Experimental Child Psychology, 203, 105018. https://doi.org/10.1016/j.jecp.2020.105018
Whitford, V., Byers, N., O'Driscoll, G.A., & Titone, D. (2023). Eye movements and the perceptual span in disordered reading: A comparison of schizophrenia and dyslexia. Schizophrenia Research: Cognition, 34, 100289. https://doi.org/10.1016/j.scog.2023.100289
Yavari Barhaghtalab, E., Asgary, P., Naderi, F., & Heidarie, A. (2021). Effect of Cognitive Rehabilitation on Executive Function (Response Retention and Scheduling) in Children with Attention Deficit Hyperactivity Disorder. Scientific Journal of Rehabilitation Medicine, 10(1), 146-157. https://doi.org/10.22037/jrm.2020.112304.2176 (In Persian)

Articles in Press, Accepted Manuscript
Available Online from 31 December 2025
  • Receive Date: 19 September 2022
  • Revise Date: 29 April 2023
  • Accept Date: 30 July 2023
  • First Publish Date: 24 June 2024
  • Publish Date: 31 December 2025