Abstract
Background & Objectives: Attention–Deficit/Hyperactivity Disorder (ADHD) is the most common psychiatric disorder in children and adolescents. Inhibition is one of the important aspects of executive control and mainly refers to situations that require correct actions and controlling and stopping behavior. These abilities play an important role during the process of growth, adjustment, and improvement of acquired skills, so problems in this field have been reported in ADHD. Among the treatment strategies that have been taken into consideration for children who have ADHD is computer–assisted cognitive rehabilitation. Another method of nonpharmacological treatment of ADHD is play therapy techniques with different approaches. Therefore, the present study compared the effectiveness of computer–assisted cognitive rehabilitation and play therapy based on a cognitive–behavioral approach to behavioral inhibition in children with attention–deficit/hyperactivity disorder.
Methods: This quasi–experimental study employed a pretest–posttest design with a control group. The statistical population consisted of children aged 7 to 13 who were referred to the psychological and psychiatric centers of Golestan Province, Iran, in 2022. Using the cluster sampling method, the sample size was 60 qualified volunteers divided into three groups of 20 people (computer–assisted cognitive rehabilitation group, play–therapy group based on cognitive behavioral approach, and control group). The inclusion criteria for the research were as follows: confirming the diagnosis of children with ADHD, not taking medicine, and aged 7–13 years. The exclusion criteria from the study included the subject's reluctance to continue participating in the research, physical and motor disability, taking medication, and consecutive absence in more than two sessions of treatment. The research data collection tools included clinical interviews, the Connors Children Behavior Problems Scale (Connors, 1990) to diagnose children with ADHD, and the Go/No–Go computer task (Hoffman et al., 1984) used as a pretest and posttest. In this research, the data collected were entered in SPSS version 23 and analyzed based on inferential statistics (analysis of covariance test and Scheffe's post hoc test) at a significance level of 0.05.
Results: The results showed a significant difference in the variable of behavioral inhibition in children with ADHD between computer–assisted cognitive rehabilitation and cognitive–behavioral play therapy (p<0.001). The eta squared of behavioral inhibition was also 0.21. Regarding behavioral inhibition, there was a significant difference between the two groups of cognitive–behavioral play therapy and computer–assisted cognitive rehabilitation (p=0.037), and cognitive–behavioral play therapy was more effective.
Conclusion: According to the findings, the behavioral inhibition of children with ADHD can be improved through the cognitive–behavioral play therapy approach. So, it is suggested that other psychological discomforts and maladaptive behaviors of children with ADHD be examined through this approach.
