Middle Eastern Journal of Disability Studies

fa مقایسهٔ تأثیر برنامهٔ هدایتگری مهارت‌های اجرایی و توان‌بخشی شناختی مبتنی‌بر ذهن‌آگاهی بر کارکردهای اجرایی کودکان با اختلال کاستی توجه/بیش‌فعالی Comparing the Effectiveness of Executive Skills Coaching Program with Mindfulness-Based Cognitive Rehabilitation Program on the Executive Functions of Children with Attention Deficit/Hyperactivity Disorder روانشناسی Psychology مقاله پژوهشی اصیل Original Research Article چکیده زمینه و هدف: اختلال کاستی توجه/بیش‌فعالی، از شایع‌ترین اختلالات عصب‌تحولی است. پژوهش حاضر باهدف مقایسهٔ اثربخشی برنامهٔ هدایتگری مهارت‌های اجرایی و برنامهٔ توان‌بخشی شناختی مبتنی‌بر ذهن‌آگاهی بر کارکردهای اجرایی کودکان با اختلال کاستی توجه/بیش‌فعالی انجام شد. روش‌بررسی: روش پژوهش، نیمه‌‌آزمایشی با طرح پیش‌آزمون و پس‌آزمون و پیگیری یک‌ماهه همراه با گروه گواه بود. جامعهٔ آماری را کودکان ۹تا۱۲ سال با اختلال کاستی توجه/بیش‌فعالی منطقهٔ سه شهر تهران در سال ۱۴۰۲ تشکیل دادند. شصت نفر از داوطلبان واجد شرایط به‌روش نمونه‌گیری هدفمند وارد مطالعه شدند و به‌طور تصادفی و برابر، در دو گروه آزمایش و یک گروه گواه قرار گرفتند. برای گروه آزمایش اول، برنامهٔ هدایتگری مهارت‌های اجرایی طی دوازده جلسهٔ شصت‌دقیقه‌ای و برای گروه آزمایش دوم، برنامهٔ توان‌بخشی شناختی مبتنی‌بر ذهن‌آگاهی طی شانزده جلسهٔ شصت‌دقیقه‌ای اجرا شد؛ درحالی‌که گروه گواه مداخله‌ای دریافت نکرد. آزمودنی‌ها با مقیاس درجه‌بندی رفتاری کارکردهای اجرایی-ویراست دوم (جیویا و همکاران، ۲۰۱۵) ارزیابی شدند. تحلیل داده‌ها با روش تحلیل واریانس با اندازه‌گیری مکرر و آزمون تعقیبی بونفرونی به‌کمک نسخهٔ ۲۶ نرم‌افزار SPSS در سطح معناداری ۰٫۰۵ صورت گرفت. یافته‌ها: نتایج نشان داد، برنامهٔ هدایتگری مهارت‌های اجرایی بر نمره‌ٔ کل و شاخص‌های رفتاری و شناختی کارکردهای اجرایی تأثیر مثبت و ماندگاری داشت (۰٫۰۰۱>p)؛ اما بر شاخص تنظیم هیجانی مؤثر نبود (۰٫۰۷۱=p)؛ همچنین برنامهٔ توان‌بخشی شناختی مبتنی‌بر ذهن‌آگاهی بر نمرهٔ کل و شاخص‌های کارکردهای اجرایی تأثیر مثبت و ماندگاری داشت (۰٫۰۰۱>p)؛ علاوه‌براین، برنامهٔ هدایتگری مهارت‌های اجرایی از برنامهٔ توان‌بخشی شناختی مبتنی‌بر ذهن‌آگاهی مؤثرتر بود (۰٫۰۰۱>p). نتیجه‌گیری: برنامهٔ هدایتگری مهارت‌های اجرایی درمقایسه با برنامهٔ توان‌بخشی شناختی مبتنی‌بر ذهن‌آگاهی، در ارتقای کارکردهای اجرایی کودکان با اختلال کاستی توجه/ بیش‌فعالی مؤثرتر است. Abstract Background & Objectives: Executive functions are a set of high–level cognitive abilities and excellent mental processes related to each other, which enable humans to filter disturbing and distracting factors, prioritize tasks, set goals, and control impulsiveness. These skills are the basis of children's cognitive, social–emotional, and psychological development. They can improve other cognitive abilities such as attention, cognitive flexibility, working memory, and planning to strengthen self–regulation, self–control, and cognitive, behavioral, and emotional regulation in people. Meanwhile, children with attention deficit/hyperactivity disorder (ADHD) show poor performance in relation to executive functions, and as a result, they face serious challenges in academic and social affairs. Therefore, improving this category of cognitive skills can have positive consequences for this group of children. Thus, the present study was conducted to compare the effectiveness of executive skills coaching and mindfulness–based cognitive rehabilitation programs on the executive functions of children with ADHD. Methods: This research method was quasi–experimental with a pretest–posttest and one–month follow–up design with a control group. The statistical population of this research included all children aged 9 to 12 years with ADHD who were referred to the clinics of District three of Tehran City, Iran, in 2023. Of them, 60 people were selected by a purposive sampling method and randomly and equally placed in two experimental groups and one control group, so there were 20 subjects in each group. The inclusion criteria for the subjects in the study were as follows: receiving a diagnosis of ADHD using a semi–structured clinical interview, a diagnostic questionnaire of ADHD, and a clinical diagnosis by a psychologist and psychiatrist; having an IQ above normal based on the records available in the centers (IQ score greater than 90); being in the age range of 9 to 12 years; not suffering from any other psychological disorder based on the opinions of a psychologist and psychiatrist; lacking any seizures, neurological diseases such as epilepsy, or medical conditions affecting cognitive function; not having any sensorimotor disability, brain injury, or other medical disease that better explains the subjects' cognitive problems; not participating in a similar treatment intervention with the present study design. The exclusion criteria for the subjects from the study were unwillingness to continue the treatment process and missing more than two sessions during the intervention. Then, the executive skills coaching program was implemented for the first experimental group during twelve 60–minute sessions. For the second experimental group, the mindfulness–based cognitive rehabilitation program was implemented during sixtheen 60–minute sessions. While the members of the control group did not participate in any of these interventions. Subject information was collected in the pretest, posttest, and follow–up stages using the Behaviour Rating Inventory of Executive Function, Second Edition: BRIEF2 (Gioia et al., 2015), which has favorable psychometric properties. To statistically analyze the collected data, indicators such as mean and standard deviation were used in the descriptive statistics section, and in the inferential section, the analysis of variance method with repeated measures and Bonferroni post hoc test were used using SPSS software version 26 at a significance level of 0.05. Results: The findings indicated that the executive skills coaching program had a positive and lasting effect on the indicators of behavior regulation, cognitive regulation, and the total score of executive functions (p<0.001), but it was not effective on the emotion regulation index (p=0.071). Additionally, the mindfulness–based cognitive rehabilitation program has had a positive and lasting effect on the indicators of behavior regulation, cognitive regulation, and emotion regulation. It has been effective on the total score of executive functions (p<0.001). In addition, there has been a difference between the effectiveness of the executive skills coaching program and the mindfulness–based cognitive rehabilitation program in relation to the overall score of executive functions. In other words, the executive skills coaching program has been more effective than the mindfulness–based cognitive rehabilitation program (p<0.001). Conclusion: The executive skills coaching program is more effective in improving the executive functions of children with ADHD than mindfulness–based cognitive rehabilitation. Moreover, executive skills coaching programs and mindfulness–based cognitive rehabilitation programs are effective interventions that psychologists and specialists can use to improve the executive functions of students with ADHD. هدایتگری مهارت‌های اجرایی, توان‌بخشی شناختی مبتنی‌بر ذهن‌آگاهی, کارکردهای اجرایی, اختلال کاستی توجه/بیش‌فعالی Executive skills coaching, Mindfulness–Based cognitive rehabilitation, Executive functions, Attention deficit/hyperactivity disorder 16 16 http://jdisabilstud.org/browse.php?a_code=A-12-3587-1&slc_lang=fa&sid=1 Raheleh Gorji راحله گرجی Raahi1390@gmail.com 100319475328460065660 100319475328460065660 No PhD Student in Educational Psychology, Kharazmi University, Tehran, Iran دانشجوی دکتری روان‌شناسی تربیتی، دانشگاه خوارزمی، تهران، ایران Javad Kavousian جواد کاوسیان javadkavousian@khu.ac.ir 100319475328460065661 100319475328460065661 Yes Assistant Professor of Educational Psychology, Kharazmi University, Tehran, Iran استادیار روان‌شناسی تربیتی، دانشگاه خوارزمی، تهران، ایران Alireza Moradi علیرضا مرادی moradi@khu.ac.ir 100319475328460065662 100319475328460065662 No Professor of Clinical Psychology, Kharazmi University, Tehran, Iran استاد روان‌شناسی بالینی، دانشگاه خوارزمی، تهران، ایران Hadi Parhoon هادی پرهون h.parhoon@razi.ac.ir 100319475328460065663 100319475328460065663 No Assistant Professor of Health Psychology, Razi University, Kermanshah, Iran استادیار روان‌شناسی سلامت، دانشگاه رازی، کرمانشاه، ایران