Examining the Effectiveness of Cognitive Rehabilitation Training on Self-control, Sustained Attention, and Cognitive Flexibility in Children with Attention Deficit Hyperactivity Disorder

Moeni Saleh , Mahboobeh; Amini, Nasser; Keykhosrovani , Moloud

Volume 15 - Articles-1404 MEJDS (2025) 15: 60 | Back to browse issues page

Ethics code: IR.BPUMS.REC.1403.168

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Moeni Saleh M, Amini N, Keykhosrovani M. Examining the Effectiveness of Cognitive Rehabilitation Training on Self-control, Sustained Attention, and Cognitive Flexibility in Children with Attention Deficit Hyperactivity Disorder. MEJDS 2025; 15 (0) :60-60
URL: http://jdisabilstud.org/article-1-3586-en.html

Examining the Effectiveness of Cognitive Rehabilitation Training on Self-control, Sustained Attention, and Cognitive Flexibility in Children with Attention Deficit Hyperactivity Disorder

Mahboobeh Moeni Saleh¹

, Nasser Amini ^*²

, Moloud Keykhosrovani²

1- PhD Student in Psychology, Department of Psychology, Faculty of Humanities, Bushehr Branch, Islamic Azad University, Bushehr, Iran
2- Assistant Professor, Department of Psychology, Faculty of Humanities, Bushehr Branch, Islamic Azad University, Bushehr, Iran

Abstract: (328 Views)

Abstract
Background & Objectives: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by significant impairments in the brain's executive functions, particularly in three areas: self–control (response inhibition and emotional regulation), sustained attention (difficulty maintaining focused attention on tasks, especially in the absence of immediate rewards), and cognitive flexibility (difficulty effectively shifting between tasks and adapting to dynamic situations). These deficits not only disrupt children's academic performance and interpersonal relationships but, if left untreated, can lead to long–term negative outcomes such as academic failure and social adjustment problems. Cognitive rehabilitation training aims to reconstruct neural–cognitive networks by enhancing neural plasticity, presenting a promising solution. This intervention directly improves inhibition, attention, and flexibility mechanisms, targeting core symptoms of ADHD, and can induce structural and functional changes in the prefrontal and parietal regions of the brain. Therefore, this study was conducted to evaluate the effectiveness of cognitive rehabilitation training on self–control, sustained attention, and cognitive flexibility in children with ADHD.
Methods: This study was quasi–experimental with a pretest–posttest follow–up design and a control group. The sample consisted of 30 male students with ADHD from Khorasan Razavi Province, Iran, who voluntarily participated through non–random sampling. They were randomly assigned to two groups: an experimental group (15 participants) and a control group (15 participants). The inclusion criteria were as follows: aged between 8 and 12 years, average intelligence quotient (IQ) of 110 based on counseling center records, diagnosis of ADHD by a psychiatrist or clinical psychologist, no other psychological disorders based on clinical interview and DSM–5 diagnostic criteria, no medication use, no concurrent psychological interventions, informed consent from the child, and at least basic computer literacy. The exclusion criteria were as follows: missing more than three consecutive therapy sessions, receiving psychological, behavioral, or pharmacological interventions during the study, failure to complete tests and tasks, and unwillingness to continue treatment. During the pretest, posttest, and 2–month follow–up phases, participants completed the Self–control Questionnaire (Tangney et al., 2004).
Additionally, participants' performance in sustained attention was assessed using the Continuous Performance Test (Rosvold et al., 1956), and psychological flexibility was evaluated using the Wisconsin Card Sorting Computerized Test (WCST) (Grant & Berg, 1984). The subjects in the experimental group received the Computer Test of Previous Multi–Stimulus Task (N–BACK) (Kirchner, 1958) during eight 90–minute sessions. However, no intervention was provided to the control group during this period. Ethical principles such as obtaining informed consent and ensuring participants' privacy and confidentiality were observed. To analyze the research data in the descriptive section, mean and standard deviation were used. In the inferential section, the statistical test of analysis of variance with repeated measures and the Bonferroni post hoc test at a significance level of 0.05 were used. Data analysis was performed in SPSS software version 27.
Results: The results showed a significant difference between the scores of self–control and sustained attention (presentation error, omission error, reaction time) in the pretest–posttest and pretest–follow–up (p<0.05). However, there was no significant difference between the scores of self–control and sustained attention (presentation error, omission error, reaction time) in the posttest–follow–up (p=1.000). Also, there was a significant difference in the scores of cognitive flexibility (persistence, number of errors, number of correct categories) between the pretest–posttest and pretest–follow–up and posttest–follow–up (p<0.05).
Conclusion: It can be concluded that cognitive rehabilitation therapy is an effective treatment for improving executive functions in children with ADHD. Therefore, it is recommended that childhood health specialists utilize this intervention to improve the psychological, cognitive, and executive functioning of these children.

Keywords: Cognitive rehabilitation training, Self–control, Sustained attention, Cognitive flexibility, Children with attention deficit hyperactivity disorder

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Type of Study: Original Research Article | Subject: Rehabilitation

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