اثربخشی توان‌بخشی شناختی بر توجه و حل مسئله کودکان با آسیب مغزی تروماتیک

نویسندگان
حسین زارع 1
آزاده نجفی 1
علی اکبر شریفی 2
مهدی شریف الحسینی 3
1 دانشگاه پیام نور تهران جنوب
2 دانشگاه پیام نور فارسان
3 دانشگاه علوم پزشکی تهران
چکیده
هدف از انجام این پژوهش بررسی اثربخشی توانبخشی شناختی بر توجه و حل مسئله کودکان با آسیب مغزی تروماتیک بود. روش این پژوهش، نیمه آزمایشی از نوع پیش­آزمون ـ پس‌آزمون با دوره پیگیری 1 ماهه بود. جهت اجرای این پژوهش 30 نفر از کودکان 9 تا 15 سال دچار آسیب تروماتیک مغزی (12 دختر و 18 پسر) به صورت نمونه‌گیری در دسترس از بین تمام کودکان مبتلا به آسیب مغزی تروماتیک در سال تحصیلی 97-96 شهر تهران، انتخاب و در دو گروه 15 نفره آزمایش و کنترل جایگزین شدند. برای اندازه‌گیری متغیرهای وابسته شامل، توجه انتخابی، توجه پایدار و حل مسئله به ترتیب از آزمون‌های نرم­افزاری استروپ، عملکرد پیوسته و برج لندن استفاده شد. گروه آزمایش پس از اجرای مداخله توان­بخشی شناختی (12 جلسه 45 دقیقه‌ای) و ریزش به 13 نفر و گروه کنترل نیز در نهایت به 13 نفر کاهش پیدا کردند. داده‌ها با مدل تحلیل واریانس مختلط (2 در 3) با استفاده از نرم افزار-SPSS22 تحلیل شدند. نتایج تحلیل واریانس مختلط (2 در 3) تفاوت معناداری بین میانگین نمرات توجه انتخابی، توجه پایدار و حل مسئله گروه آزمایش و گروه انتظار در پس­آزمون نشان داد. به­علاوه معنادار نبودن تفاوت بین نمره­های پس­آزمون و پیگیری در گروه آزمایش حاکی از ماندگاری تأثیر توان­بخشی شناختی بر توجه و حل مسئله کودکان با آسیب مغزی تروماتیک بود. بنابراین توان­بخشی شناختی اثر چشمگیری بر بهبود توجه و حل مسئله کودکان با آسیب مغزی تروماتیک دارد و می­توان از آن به­عنوان روش مؤثر و مفیدی برای بهبود عملکرد توجه و حل مسئله این­گونه بیماران سود جست.

کلیدواژه‌ها
توان‌بخشی شناختی
توجه
حل مسئله
آسیب مغزی تروماتیک

عنوان مقاله English

The Effectiveness of Cognitive Rehabilitation on Attention and Problem Solving of Children with Traumatic Brain Injury.

نویسندگان English

Hossein Zare 1
Azadeh Najafi 1
Ali Akbar Sharifi 2
Mahdi Sharif-Alhoseini 3
1 Payam Noor University, Tehran jonoob branch
2 Payam Noor University, Farsan branch
3 Tehran University of Medical Sciences
چکیده English

The purpose of this study was to investigate the effectiveness of cognitive rehabilitation on the attention and problem solving of children with traumatic brain injury. The Method was A semi-experimental pre-test post-test study was performedwith a one month follow-up period. 30 children from 9 to 15 years old (12 girls and 18 boys) were selected by random sampling from all children with traumatic brain injury in the academic year of 2017-18 in Tehran, and divided into two groups of 15 subjects and control were distributed.To measure dependent variables, namely selective attention, sustained attention, and problem solving, Stroop software tests, continuous performance, and Tower of London have been used. The experimental group after the implementation of the cognitive empowerment (12 sessions 45 minutes) and dropping to 13 and the control group eventually decreased to 13 people. Data were analyzed by mixed analysis of variance (2×3) model with using SPSS-22 software.

The results of mixed analysis of variance (2×3) showed a significant difference between the means of namely selective attention, sustained attention, and problem solving in experimental and waiting- list control groups.

Moreover, the post-test and follow-up scores in the experimental group was not satistically different. So cognitive rehabilitation have significant effect on selective attention, sustained attention, and problem solving in children with traumatic brain injury and it can be used as an effective and helpful method to improve attention and problem solving of these patients.

کلیدواژه‌ها English

cognitive rehabilitation
Attention
problem solving
Traumatic Brain Injury
Abedi, M. R., Sadeghi, A., Rabiee, M. (2015). Standardization of the Wechsler IQ test in four children in ChaharmahalvaBakhtiari province. Journal of Psychological Achievements (Educational Sciences and Psychology), 4:2(22). [Persian]
Anderson, V., Godfrey, C., Rosenfeld, J. V., &Catroppa, C. (2012).10 years outcome from childhood traumatic brain injury. International journal of developmental neuroscience, 30(3), 217-224.
Brett, A. W., &Laatsch, L. (1998).Cognitive rehabilitation therapy of brain-injured students in a public high school setting. Pediatric rehabilitation, 2(1), 27-31.
Barman, A., Chatterjee, A., &Bhide, R. (2016).Cognitive impairment and rehabilitation strategies after traumatic brain injury. Indian journal of psychological medicine, 38(3), 172.
Cappa, S. F., Benke, T., Clarke, S., Rossi, B., Stemmer, B., & Van Heugten, C. M. (2003). EFNS guidelines on cognitive rehabilitation: report of an EFNS task force. European Journal of Neurology, 10(1), 11-23.
Cicerone. K. D.,& et al. (2005). Effects of categorization training in patients with TBI during postacute rehabilitation: Preliminary findings. Journal of Head Trauma Rehabilitation. 20(2): 143-157.
Cicerone, K. D., Langenbahn, D. M., Braden, C., Malec, J. F., Kalmar, K., Fraas, M., ...&Azulay, J. (2011). Evidence-based cognitive rehabilitation: updated review of the literature from 2003 through 2008. Archives of physical medicine and rehabilitation, 92(4), 519-530.
Couillet, J., Soury, S., Lebornec, G., Asloun, S., Joseph, P. A., Mazaux, J. M., &Azouvi, P. (2010). Rehabilitation of divided attention after severe traumatic brain injury: a randomised trial. Neuropsychological rehabilitation, 20(3), 321-339.
Diller, L. (2005).Pushing the frames of reference in traumatic brain injury rehabilitation. Archives of physical medicine and rehabilitation, 86(6), 1075-1080.
Ewing-Cobbs, L., Prasad, M. R., Kramer, L., Cox, C. S., Baumgartner, J., Fletcher, S., ...& Swank, P. (2006). Late intellectual and academic outcomes following traumatic brain injury sustained during early childhood. Journal of Neurosurgery: Pediatrics, 105(4), 287-296.
Fay, T. B., Yeates, K. O., Wade, S. L., Drotar, D., Stancin, T., & Taylor, H. G. (2009).Predicting longitudinal patterns of functional deficits in children with traumatic brain injury. Neuropsychology, 23(3), 271.
Ginstfeldt, T., &Emanuelson, I. (2010).An overview of attention deficits after paediatric traumatic brain injury. Brain Injury, 24(10), 1123-1134.
Gray, J. M., Robertson, I., Pentland, B., & Anderson, S. (1992). Microcomputer-based attentional retraining after brain damage: A randomised group controlled trial. Neuropsychological Rehabilitation, 2(2), 97-115.
Hadianfar, H., Najjarian, B., Shekarkan, H., MehrabizadehHonarmand, M. (2000). Preparation and preparation of the Farsi test form for continuous performance. Journal of Psychology, 4:388-404. [Persian]
Hughes, L. A., Banks, P., &Terras, M. M. (2013). Secondary school transition for children with special educational needs: a literature review. Support for Learning, 28(1), 24-34.
Kelkar, A. S. (2014). Treating problem solving deficits in traumatic brain injury.
Klingberg, T., Forssberg, H., & Westerberg, H. (2002).Training of working memory in children with ADHD. Journal of clinical and experimental neuropsychology, 24(6), 781-791.
Lezak, M., Howieson, D., &Loring, D. (2012).Neuropsychological assessment.5th edn Oxford University Press. Oxford, New York, ISBN, 10, 9780195395525.
Lezak, M. D., Howieson, D. B., Loring, D. W., & Fischer, J. S. (2004). Neuropsychological assessment. Oxford University Press, USA.
Lezak, M. D., Howieson, D. B., &Loring, D. W. (1995). Neuropsychological assessment. New York: Oxford Univer. Press. E., &JAckuns, C.(1974) The psychology of sex differences. London: Oxford Univer, 1.
Mousavi, S., Zare, H., &Etemadifar, M. (2018).Evaluating the effectiveness of cognitive rehabilitation on everyday memory in multiple sclerosis patients. Neuropsychological Rehabilitation, 1-11.
Miotto, E. C., Serrao, V. T., Guerra, G. B., Lúcia, M. C. S. D., &Scaff, M. (2008). Cognitive rehabilitation of neuropsychological deficits and mild cognitive impairment: A review of the literature. Dementia &neuropsychologia, 2(2), 139-145.
McKinlay, A., & Hawley, C. A. (2013). Incidence rates for traumatic brain injury in children. International Neurotrauma letter, available at: http://www. Internationalbrain.
Penner, I. K., &Kappos, L. (2006). Retraining attention in MS. Journal of the neurological sciences, 245(1-2), 147-151.
Park, N. W. (1999). Evaluation of the attention process training programme. Neuropsychological Rehabilitation, 9(2), 135-154.
PoorabolghasemHosseini, S. Hosseinkhanzadeh, A. A, Mousavi, S. V. (2018). The Efficacy of Attention and Concentration Training on Problem Solving Skills and Quiz Stress of Female Students .hrjbaq.; 3 (2) :114-121. [Persian].
Powel, T. (2016). The Brain Injury Workbook, Exercises for Cognitive Rehabilitation. Translated by: Zare, H., &Mousavi, S. h. Tehran: Arjmand.
Reed, J., Byard, K., Fine, H. (2017). Neuropsychological Rehabilitation of Childhood, A Practical Guide. Translated by: Zare, H., Sharifi, A. A., Mousavi, S. h. Tehran: Aeeizh.
Sohlberg, M. M. &Mateer, C. A. (2001).Cognitive Rehabilitation: An integrative neuropsychological approach. New York.
Sohlberg, M. M., Mateer, C. A. (2010). Cognitive rehabilitation: integrative neuropsychological approach. New York. Guilford Press.
Seidman, L. J. (2006). Neuropsychological functioning in people with ADHD across the lifespan. Clinical psychology review, 26(4), 466-485.
Stathopoulou, S., &Lubar, J. F. (2004). EEG changes in traumatic brain injured patients after cognitive rehabilitation. Journal of Neurotherapy, 8(2), 21-51.
Salazar, A. B., & et al. (2000).Cognitive rehabilitation for traumatic brain injury. Journal of American Medical Association (JAMA). 283(23): 30753081.
Sharifi, A. A., Zare, H., &Hatami, J. (2015).The Impact of Computerized Cognitive RehabilitationonWorkingMemoryPerformanceinPatientswith Traumatic Brain Injury.Advances in Cognitive Science.; 17(4):71-78. [Persian]
Toglia, J., Johnston, M. V., Goverover, Y., & Dain, B. (2010). A multicontext approach to promoting transfer of strategy use and self regulation after brain injury: An exploratory study. Brain Injury, 24(4), 664-677.
Tsaousides, T., & Gordon, W. A. (2009). Cognitive rehabilitation following traumatic brain injury: assessment to treatment. Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine: A Journal of Translational and Personalized Medicine, 76(2), 173-181.
Vakili, A., & Langdon, R. (2016). Cognitive rehabilitation of attention deficits in traumatic brain injury using action video games: A controlled trial. Cogent Psychology, 3(1), 1143732.
van’tHooft, I., Andersson, K., Bergman, B., Sejersen, T., Von Wendt, L., &Bartfai, A. (2005). Beneficial effect from a cognitive training programme on children with acquired brain injuries demonstrated in a controlled study. Brain Injury, 19(7), 511-518.
Vartaeian, M., Hatami, J., Khazaee, A., &Bahrami, E. (2016). The Effect of Group Therapy Based on Cognitive Rehabilitation on Memory and Executive Functions of Brain Injuries. Psychological Applications Research. 7(2): 1-15. [Persian]
Vallat-Azouvi, C., Pradat-Diehl, P., &Azouvi, P. (2009). Rehabilitation of the central executive of working memory after severe traumatic brain injury: Two single-case studies. Brain Injury. 23 (6): 585-594.
Wade, S. L., Cassedy, A. E., Fulks, L. E., Taylor, H. G., Stancin, T., Kirkwood, M. W., ... &Kurowski, B. G. (2017). Problem-solving after traumatic brain injury in adolescence: associations with functional outcomes. Archives of physical medicine and rehabilitation, 98(8), 1614-1621.
Wilson, B. A., Evans, F. G. J. J., & Bateman, A. (2017).Neuropsychological Rehabilitation, Theory, Models, Therapy & Outcome.Translated by: Zare, H., Nazari, S. M., &Abedin, M. Tehran: Arjmand.
Yorston, K. M., Jaffe, K. M., Polissar, N. L., Liao, S., & Fay, G. C. (1997). Written language production and Neuropsychological function in children with traumatic brain injury. Archives of physical Medicine and Rehabilitaition. (78):1096-102.
Yishay, Y. B., Diller, L. (2015). Handbook of Holistic Neuropsychological Rehabilitation.Outpatient Rehabilitation of Traumatic Brain Injury. Translated by: Zare, H., &Sharifi, A. A. Tehran: Aeeizh.
Yeates, K. O., Armstrong, K., Janusz, J., Taylor, H. G., Wade, S., Stancin, T., &Drotar, D. (2005). Long-term attention problems in children with traumatic brain injury. Journal of the American Academy of Child & Adolescent Psychiatry, 44(6), 574-584.
Zare, H., &Sharifi, A. A. (2017).Cognitive Psychology. Tehran: Payam Noor University. [Persian]
Zare, H., &Abdollahzadeh, H. (2014).Application of tests in cognitive psychology. Tehran: Payam Noor University. [Persian]
Zare, H., &Siahjani, L. (2018). The Efficacy of Cognitive Rehabilitation on Mental state and Memory function of the Elderly with Mild Alzheimer’s. Advances in Cognitive Science 20(3): 52-66. [Persian]
Zare, H., &Sharifi, A. A. (2017).The Effect of Computerized Cognitive Rehabiliitation on Working & Prospective Memory Function in Multiple Sclerosis Patients.Journal of Cognitive Psychology. 5(1): 1-10. [Persian]