marzieh alsadat khalili

In the range of human individual and social life, there are numerous topics with different ways to learn. Learning can be considered the most fundamental process as a result of which the helpless and helpless creature becomes a transformed person whose cognitive abilities and thinking power know no bounds during the interaction with physical growth. The term executive functions refer to general structures, including several functions such as planning decisions and inhibitions in an organization that require excellent cognitive skills of the brain such as attention, working memory, language, perception, and creative thinking. These functions help people with learning tasks, intelligence stretches, and academic issues. The present study aimed to compare the effectiveness of two methods of attention training based on Fletcher program and computerized cognitive rehabilitation on executive functions and cognitive avoidance of children with particular learning disabilities.

This is a quasi-experimental study with a pre-test-post-test design of three groups with a control group (two experimental and one control group). Attention training based on Fletcher’s program and computerized rehabilitation training for children was applied to two experimental groups. The control did not receive any training. The statistical population of all students aged seven to ten years had learning disabilities referring to learning disability centers in Tehran in the academic year of 2019-2020. Among them, 30 people were selected as the statistical sample by the convenience sampling method. Then, this number was randomly divided into three groups (a 10-person group for attention training based on Fletcher’s program, a 10-person group for computerized cognitive rehabilitation for the child, and one group of ten as the control group). To collect data, this study used Sexton and Dogas’s (2008) cognitive avoidance questionnaires and executive functions (parent form) Gioia et al. (2000), Attention training based on Fletcher’s program (a 12-session of 45 minutes), Computerized cognitive rehabilitation (10 sessions of 30 minutes individually) was used. Inclusion criteria of the present study were interesting in participating in the study, first-to fourth-grade elementary students based on a referral to learning disability centers, IQ test and validation assessment in the center of learning disability, moderate to high intelligence (no mental retardation), no other disorders, and no psychological and medical treatment during the last two months. Exclusion criteria were absent from more than two sessions, students with intelligence under 85, and students whose learning disabilities are due to visual, auditory, motor, or mental retardation, emotional distress, environmental, cultural, or economic deprivation. Children with learning disabilities were selected from the centers for this disorder. Admission to these centers is such that at the discretion of the normal school teacher, they were referred to these centers, and in these centers, they were revised by conducting an intelligence test. The parents of the children received final confirmation of the learning disability, and a case was registered in the learning disabilities center. First, for students with learning disabilities, the cognitive avoidance questionnaire was presented by the student, and the executive functions questionnaire (parent form) was presented by one of the parents (pre-test). In the initial assessment, students with approved criteria remained in the study, and students who did not have the approved criteria and had intelligence under 85 were excluded from the study. Students were divided into three groups based on inclusion and exclusion criteria. After that, training sessions were held in groups for students. A group of ten people for the treatment method of attention training was used based on Fletcher’s program, which was implemented in 12 sessions. A group of ten people used computerized cognitive rehabilitation treatment with self-grammar training in ten sessions individually. The third group was in the control group without therapeutic intervention. Considering the passage of seven to ten days after training and treatment, students were re-evaluated by cognitive avoidance test, and parents were re-evaluated by executive functions test (parent form) (post-test). Post-test was retaken after one month to follow-up on the treatment. Multivariate and univariate analyses of covariance were used to analyze the data using SPSS software version 24.

Considering the level of significance (P<0.05), it can be stated that the rate of cognitive avoidance in the control group is significantly different from the attention training groups based on Fletcher’s program and cognitive rehabilitation (P=0.000). Nevertheless, the cognitive avoidance scores in the attention groups based on Fletcher’s program and computerized cognitive rehabilitation did not show a significant difference (P=0.051). This means that both interventions have been able to reduce cognitive avoidance. Due to the small size of the groups, the comparison of means was used to compare the reduction rate. Considering the significance level of 0.05, it can be stated that in the executive function variable, the score of the control group showed a significant difference from the scores of both attention training groups based on Fletcher program and computerized cognitive rehabilitation method (P<0.001). This indicates that both Fletcher-based attention training interventions and the computerized cognitive rehabilitation method effectively increased children's executive function with unique learning. On the other hand, no significant difference was observed between these two methods (P=0.738).

The results showed that two methods of attention training based on Fletcher’s program and the computerized cognitive rehabilitation affect executive functions and cognitive avoidance of children with particular learning disabilities. Applying cognitive computerized exercises can improve the performance of this range of students in the field of working memory. Besides, the close relationship between memory ability and cognitive processes can improve academic performance. Due to the cognitive processes involved in learning disabilities, the cognitive rehabilitation program mainly focuses on developing cognitive abilities. Thus, it is a special and unique type of treatment. A cognitive training computerized program provides tools that can be used to help improve basic mental processes that are significant in high-level learning.

We aimed to compare and determine the effectiveness of three methods of attention training based on Fletcher’s program, Delacato’s neuropsychological treatment, and computerized cognitive rehabilitation, on executive functions of children with special learning disability (SLD).

This was a four-group pretest-posttest design with a control group (three experimental groups and one control group) quasi-experimental study. The population included all students aged 7 to 12 years with learning disorders referred to the learning disorders treatment centers in Tehran during 2019. First, 40 students were selected from these centers by convenience sampling. This number was then randomly divided into four groups of attention training based on Fletcher’s program, Delacato’s neuropsychological treatment, computerized cognitive rehabilitation, and one group as a control group (N=10). Three methods of attention training based on Fletcher’s program (12 sessions of 45 minutes), Delacato’s neuropsychological method (12 sessions of 50 minutes), computerized cognitive rehabilitation (10 sessions of 30 minutes individually), were separately trained to the three experimental groups. Gerard and colleagues’ Behavioral Rating Inventory of Executive Functions (parent form) was used to collect data.

The results of the study revealed that the three methods were effective on executive functions in children with a SLD (P< 0.05). Based on the results of the post hoc test, the scores of both attention training groups based on Fletcher’s program and computerized cognitive rehabilitation method were significantly different from the control group (P< 0.0001). This indicates that both interventions had an effect on increasing the executive function of children with SLD, but there was no significant difference between the three experimental groups (P>0.05).

Given that computers are available in almost all schools, such programs can be considered as part of the curriculum for students with learning disabilities. Accordingly, through Fletcher’s attention-based training method and computerized cognitive rehabilitation improved the performance of this group and prevented the creation of a defective process of failure in these students by improving their executive functions.