Volume 10 -
MEJDS (2020) 10: 177 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Shahi M, Mohammadyfar M A, Tale Pasand S. The Effects of Play Therapy Based on Executive Functions in Promoting Executive Functions in Children with Attention-Deficit Hyperactivity Disorder. MEJDS 2020; 10 :177-177
URL: http://jdisabilstud.org/article-1-1923-en.html
URL: http://jdisabilstud.org/article-1-1923-en.html
1- Department of Educational Psychology, Faculty of Psychology and Education Sciences, Semnan University
Abstract: (1741 Views)
Background & Objectives:Attention–Deficit Hyperactivity Disorder (ADHD) is among the pervasive disorders in childhood, which influences various aspects of life, such as education, social relations, and life satisfaction. Executive Functions (EFs) are impaired in individuals with ADHD. EF is defined as a coordinated function of different processes, i.e., occurring concurrently, and includes procedures, such as selective attention, inhibition, and cognitive flexibility. Various pharmacotherapies are currently being implemented. Medications present short–term effects; accordingly, symptoms will re–generate. Psychological interventions can be employed instead of pharmacological treatment. Play Therapy (PT) is among such interventions. In PT, children express their feelings and learn more adaptive strategies. Thus, the current study aimed to evaluate the effects of PT based on EFs in enhancing the Efs of children with ADHD.
Methods: This was a quasi–experimental research with a pretest–posttest and a control group design. The statistical population of the study included all male primary schoolers in Semnan City, Iran, in 2019–2020. In total, 30 students within the age range of 7 to 11 years were selected by cluster sampling method; subsequently, they were randomly assigned to two groups of EFs–based PT and control (n=15/group). The inclusion criteria of this research were as follows: being in the age range of 7–11 years; receiving ADHD diagnosis based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–5) criteria, not consuming psychiatric drugs (this criterion was investigated during the interview with the study subjects’ parents), the provision of written informed consent by the study participants’ parents. The EFs–based PT group received twelve 50–minute group intervention sessions (n=7–8 students/group). However, the control group received no treatment. The parent version of Child Symptom Inventory–4 (CSI–4) (Gadow & Sprafkin, 1997), as well as the soft versions of Stroop Color–Word Test, Go/No–Go Test, and Wisconsin Card Sorting Test, developed by Sinai Psychological Institute (www.sinapsycho.com) were administered in the study groups. The PT intervention is based on impaired EFs in individuals with ADHD. In this research, a protocol of PT (Asghari Nekah & Ebadi, 2014) was employed, i.e., based on the EFs. The obtained data were analyzed using descriptive statistics (mean & standard deviation) and inferential statistics, including Multivariate Analysis of Covariance (MANCOVA) and one–way Analysis of Covariance (ANCOVA) in SPSS at the significance level of 0.05.
Results: The one–way ANCOVA data concerning selective attention suggested a significant difference between the PT and control groups in incongruence reaction time (p=0.001), congruence error (p=0.028), incongruence error (p=0.012), and congruence correct (p=0.011); however, there was no significant difference between the study groups in congruence reaction time (p=0.177) and incongruence correct (p=0.852). The one–way ANCOVA data respecting the cognitive flexibility variable indicated a significant difference between the PT and control groups in the correct responses (p=0.001) and the frequency of responses on the conceptual level (p<0.001). However, there was no significant difference between the study groups in perseverative errors (p=0.150) and total problem–solving time (p=0.134). Furthermore, the one–way ANCOVA data regarding the inhibition variable revealed a significant difference between PT and control groups in commission error (p<0.001), omission error (p<0.001), and inhibition (p<0.001).
Conclusion: The current research findings demonstrated that presenting the interventions, i.e., focused on promoting EFs in children with ADHD could improve EFs, such as selective attention, inhibition, and cognitive flexibility in them, to some extent. Therefore, it is recommended to present the comprehensive programs of EFs–based PT in individuals with ADHD.
Methods: This was a quasi–experimental research with a pretest–posttest and a control group design. The statistical population of the study included all male primary schoolers in Semnan City, Iran, in 2019–2020. In total, 30 students within the age range of 7 to 11 years were selected by cluster sampling method; subsequently, they were randomly assigned to two groups of EFs–based PT and control (n=15/group). The inclusion criteria of this research were as follows: being in the age range of 7–11 years; receiving ADHD diagnosis based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–5) criteria, not consuming psychiatric drugs (this criterion was investigated during the interview with the study subjects’ parents), the provision of written informed consent by the study participants’ parents. The EFs–based PT group received twelve 50–minute group intervention sessions (n=7–8 students/group). However, the control group received no treatment. The parent version of Child Symptom Inventory–4 (CSI–4) (Gadow & Sprafkin, 1997), as well as the soft versions of Stroop Color–Word Test, Go/No–Go Test, and Wisconsin Card Sorting Test, developed by Sinai Psychological Institute (www.sinapsycho.com) were administered in the study groups. The PT intervention is based on impaired EFs in individuals with ADHD. In this research, a protocol of PT (Asghari Nekah & Ebadi, 2014) was employed, i.e., based on the EFs. The obtained data were analyzed using descriptive statistics (mean & standard deviation) and inferential statistics, including Multivariate Analysis of Covariance (MANCOVA) and one–way Analysis of Covariance (ANCOVA) in SPSS at the significance level of 0.05.
Results: The one–way ANCOVA data concerning selective attention suggested a significant difference between the PT and control groups in incongruence reaction time (p=0.001), congruence error (p=0.028), incongruence error (p=0.012), and congruence correct (p=0.011); however, there was no significant difference between the study groups in congruence reaction time (p=0.177) and incongruence correct (p=0.852). The one–way ANCOVA data respecting the cognitive flexibility variable indicated a significant difference between the PT and control groups in the correct responses (p=0.001) and the frequency of responses on the conceptual level (p<0.001). However, there was no significant difference between the study groups in perseverative errors (p=0.150) and total problem–solving time (p=0.134). Furthermore, the one–way ANCOVA data regarding the inhibition variable revealed a significant difference between PT and control groups in commission error (p<0.001), omission error (p<0.001), and inhibition (p<0.001).
Conclusion: The current research findings demonstrated that presenting the interventions, i.e., focused on promoting EFs in children with ADHD could improve EFs, such as selective attention, inhibition, and cognitive flexibility in them, to some extent. Therefore, it is recommended to present the comprehensive programs of EFs–based PT in individuals with ADHD.
Type of Study: Original Research Article |
Subject:
Psychology
References
1. Yaghoobi Karimui R, Azadi S, Keshavarzi P. The ADHD effect on the actions obtained from the EEG signals. Biocybern Biomed Eng. 2018;38:425–37. [DOI]
2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Washington, D.C: American Psychiatric Association; 2013.
3. Abolhassanzadeh M, Shafiee-Kandjani AR, Vaziri Z, Molavi P, Sadeghi-Movahhed F, Noorazar G, et al. The prevalence and risk factors of attention deficit hyperactivity disorder among the elementary school students in Ardabil, Iran, in 2011-2012. J Anal Res Clin Med. 2016;4(3)146-52. [DOI]
4. Rubia K, Criaud M, Wulff M, Alegria A, Brinson H, Barker G, et al. Functional connectivity changes associated with fMRI neurofeedback of right inferior frontal cortex in adolescents with ADHD. Neuroimage. 2019;188:43–58. [DOI]
5. Shuai L, Daley D, Wang Y-F, Zhang J-S, Kong Y-T, Tan X, et al. Executive function training for children with Attention Deficit Hyperactivity Disorder. Chin Med J (Engl). 2017;130(5):549–58. [DOI]
6. Chmielewski W, Bluschke A, Bodmer B, Wolff N, Roessner V, Beste C. Evidence for an altered architecture and a hierarchical modulation of inhibitory control processes in ADHD. Dev Cogn Neurosci. 2019;36:100623. [DOI]
7. Nugiel T, Roe MA, Engelhardt LE, Mitchell ME, Zheng A, Church JA. Pediatric ADHD symptom burden relates to distinct neural activity across executive function domains. NeuroImage: Clinical. 2020;28:102394. [DOI]
8. Rahimi Pordanjani S, Ghobari Bonab B, Afrooz GA, Faramrzi S. Localized parent-child play therapy interaction and decreasing clinical symptoms of attention deficit hyperactivity disorder in affected preschool children. Practice in Clinical Psychology. 2016;4(3):191–8. [Persian] [DOI]
9. O’Neill S, Rajendran K, Halperin JM. More than child’s play: the potential benefits of play-based interventions for young children with ADHD. Expert Rev Neurother. 2012;12(10):1165–7. [DOI]
10. Pepler DJ, Ross HS. The effects of play on convergent and divergent problem solving. Child Development. 1981;52(4):1202–10. [DOI]
11. Asgari Nekah SM, Abedi Z. The Effectivness of Executive Functions based Play Therapy on improving Response Inhibition,planning and working memory in children with Attention Deficit Hyperactivity Disorder. Journal of Cognitive Psychology. 2014;2(1):41–51. [Persian] [Article]
12. Olson MH, Hergenhahn BR. An introduction to theories of learning. 9th ed. Upper Saddle River, N.J: Pearson Prentice Hall; 2013.
13. Barkley RA. Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychol Bull. 1997;121(1):65-94. [DOI]
14. Ulke C, Wittekind DA, Spada J, Franik K, Jawinski P, Hensch T, et al. Brain arousal regulation in SSRI-medicated patients with major depression. J Psychiatr Res. 2019;108:34–9. [DOI]
15. Barimani S, Asadi J, Khajevand A. A comparison between the effectiveness of game therapy and emotional intelligence training on social compatibility and communicative skills of exceptional primary school hyperactive and deaf children. International Journal of Pediatrics. 2018;6(5):7653–66. [DOI]
16. El-Nagger NS, Abo-Elmagd MH, Ahmed HI. Effect of applying play therapy on children with attention deficit hyperactivity disorder. Journal of Nursing Education and Practice. 2017;7(5):104. [DOI]
17. Barzegary L, Zamini S. The effect of play therapy on children with ADHD. Procedia Soc Behav Sci. 2011;30:2216-18. [DOI]
18. Gadow KD, Sprafkin J. ADHD Symptom Checklist-4 Manual. Stony Brook : Checkmate Plus; 1997.
19. Delavar A. Research Methods in psychology and educational sciences. Tehran: Virayesh Pub; 2018. [Persian]
20. Sprafkin J, Gadow KD, Salisbury H, Schneider J, Loney J. Further evidence of reliability and validity of the Child Symptom Inventory-4: parent checklist in clinically referred boys. J Clin Child Adolesc. 2002; 31(4): 513-24. [DOI]
21. Mohamadesmaiel E, Alipour A. A preliminary study on the reliability, validity and cut off points of the disorders of Children Symptom Inventory-4 (CSI-4). Journal of Exceptional Children. 2002;2(3):239–54. [Persian] [Article]
22. Stroop JR. Studies of interference in serial verbal reactions. Journal of Experimental Psychology. 1935;18(6):643–62. [DOI]
23. Lezak MD. Neuropsychological assessment. 4th ed. Oxford ; New York: Oxford University Press; 2002.
24. Khadadadi M, Saremi M, Khayati F, Amani H. Complex stroop software. Institute for behavioral and cognitive sciences. Tehran: Islamic Republic of Iran; 2014.
25. Gualtieri CT, Johnson LG. Reliability and validity of a computerized neurocognitive test battery, CNS Vital Signs. Arch Clin Neuropsychol. 2006;21(7):623–43. [DOI]
26. Malek A, Hekmati I, Amiri S, Pirzadeh J, Gholizadeh H. The standardization of Victoria Stroop Color-Word Test among Iranian bilingual adolescents. Arch Iran Med. 2013;16(7):380–4.
27. Fassbender C, Murphy K, Foxe JJ, Wylie GR, Javitt DC, Robertson IH, & et al. A topography of executive functions and their interactions revealed by functional magnetic resonance imaging. Brain Res Cogn Brain Res. 2004;20(2):132-43. [DOI]
28. Waldvogel D, van Gelderen P, Muellbacher W, Ziemann U, Immisch I, Hallett M. The relative metabolic demand of inhibition and excitation. Nature. 2000;406:995–8. [DOI]
29. Grant DA, Berg EA. A behavioral analysis of degree of reinforcement and ease of shifting to new responses in a Weigl-type card-sorting problem. J Exp Psychol. 1948;38(4):404–11. [DOI]
30. Chiu EC, Wu WC, Hung JW, Tseng YH. Validity of the Wisconsin card sorting test in patients with stroke. Disabil Rehabil. 2018; 40(16): 1967-71. [DOI]
31. Shahgholian M, Azadfallah P, Fathi-Ashtiani A, Khodadadi M. Design of the Wisconsin Card Sorting Test (WCST) computerized version: theoretical fundamental, developing and psychometrics characteristics. Clinical Psychology Studies. 2012;1(4):110–34. [Perisan] [Article]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
