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Volume 25, Issue 1 (Spring 2023)
Advances in Cognitive Sciences 2023, 25(1): 161-177 |
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Research code: IR.SHAHED.REC.1401.036
Ethics code: IR.SHAHED.REC.1401.036
Clinical trials code: IR.SHAHED.REC.1401.036
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Sarvarian Z, Roshan Chesli R, Naeinian M R, Farahani H, Yaghoubnezhad S. The effectiveness of cognitive rehabilitation on working and visual memory of students with dysgraphia. Advances in Cognitive Sciences 2023; 25 (1) :161-177
URL: http://icssjournal.ir/article-1-1511-en.html
URL: http://icssjournal.ir/article-1-1511-en.html
Zahra Sarvarian1 
, Rasol Roshan Chesli * 2, Mohammad Reza Naeinian3 , Hojjatollah Farahani4 , Sajed Yaghoubnezhad5
, Rasol Roshan Chesli * 2, Mohammad Reza Naeinian3 , Hojjatollah Farahani4 , Sajed Yaghoubnezhad5
1- PhD Student in Clinical Psychology, Faculty of Humanities, Shahed University, Tehran, Iran
2- Professor, Department of Clinical Psychology, Faculty of Humanities, Shahed University, Tehran, Iran
3- Assistant Professor, Department of Clinical Psychology, Faculty of Humanities, Shahed University, Tehran, Iran
4- Assistant Professor, Department of Psychology, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
5- Assistant Professor, Department of Counseling and Education of Exceptional Children, Faculty of Psychology, Farhangian University, Tehran, Iran
2- Professor, Department of Clinical Psychology, Faculty of Humanities, Shahed University, Tehran, Iran
3- Assistant Professor, Department of Clinical Psychology, Faculty of Humanities, Shahed University, Tehran, Iran
4- Assistant Professor, Department of Psychology, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
5- Assistant Professor, Department of Counseling and Education of Exceptional Children, Faculty of Psychology, Farhangian University, Tehran, Iran
Abstract: (820 Views)
Introduction
One of the critical disorders in learning problems is writing disorder or dysgraphia (1). Working memory plays a role in reading and writing disorders (2). Active memory is described as a short-term cognitive system that allows information to be temporarily stored for simultaneous processing or close to the reference, so active memory has been considered one of the essential concepts in the neuroscience area (3). On the other hand, the problems of children with dysgraphia in the visual-spatial component may cause problems for them in doing homework, reading maps spatially, or copying the contents of the visual-spatial active memory from the board (4). Today, cognitive rehabilitation is one of the non-pharmacological treatments for developing cognitive abilities in children with learning disabilities (18). Cognitive rehabilitation therapy is an approach to increase children’s abilities and executive functions in attention, memory, inhibition and organization, planning and decision-making, and the like employed to treat and rehabilitate cognitive disorders and therapeutic services to strengthen damaged or replaced domains. It provides new models to compensate for the disorder (21). Considering the effects of dysgraphia on the psychological aspect of affected students, and on the other hand, research gods in this field, conducting such studies and using the results of these studies in the field of prevention and reduction of problems associated with dysgraphia in children and adolescents is one of the crucial needs of research in any country. Therefore, any study, diagnosis and identification, prevention, control, and treatment will be valuable. Accordingly, the present study aimed to determine the effectiveness of cognitive rehabilitation on the working and visual memory of dysgraphia students.
Methods
The present study was semi-experimental with a pre-test and post-test design with a follow-up period with a control group. The research population included all second and third-grade female students with dysgraphia in Tehran, Iran, in the academic year of 2021-2022, who were referred from regular schools to educational and rehabilitation centers for special learning problems. Among them, 28 people were selected and randomly placed in two experimental and control groups. Moreover, they responded to Yaqoubi et al.'s dysgraphia diagnostic scale (1400), N-BACK (2001), and Kim Karad's visual memory test (1945). Then, the experimental group received the cognitive rehabilitation training program, but only school training was provided to the control group. For data analysis, a repeated measurement test was used with SPSS version 24 software at a significance level 0.05.
Results
According to the study results, in the experimental group, six people (42.9 subjects) were eight years old, and eight people (57.1 percent) were nine years old, but in the control group, seven people (50 percent) were eight years old, and seven people (50 percent) were nine years old. Based on obtained the results, the average scores of the attention and response inhibition variables in the cognitive rehabilitation treatment group were increased compared to the control group in the post-test and follow-up stages compared to the pre-test stage. Besides, based on the results of repeated measures analysis of variance, the difference between attention scores (P<0.01) and response inhibition variable (P<0.01) is significant in the three stages of the research. The results revealed that 99.3% and 75.5% of the individual differences in the attention and response inhibition variables were related to the difference between the two groups, respectively. In addition, the interaction between research stages and group membership is also significant in all research variables (P<0.01). In other words, the difference between scores in all research variables in the three stages of research in two groups is significant. Thus, it can be concluded that cognitive rehabilitation treatment has been effective in the attention and response inhibition of dysgraphia students. The results of pairwise comparisons of the mean difference in the three stages of the test showed that in the cognitive rehabilitation treatment group, the difference between the average scores of the pre-test stage and the post-test and follow-up stages is significant (P<0.01), indicating both the effectiveness of the treatment and the stability of the effects of the treatment with time passes. The difference between the scores of the post-test phase and the scores of the follow-up phase is also significant (P<0.01). In the control group, the difference between the scores of the pre-test stage and the post-test and follow-up stages, and between the scores of the post-test stage and the follow-up scores, is insignificant (P<0.05). Based on this, it is concluded that the cognitive rehabilitation treatment has been effective in the attention and response inhibition of dysgraphia students.
Conclusion
According to the present study, cognitive rehabilitation training effectively improved the working memory of dysgraphia students, and the results continued in the follow-up period. The above finding is consistent with the results of previous studies in this field. In the above explanation, the current study can refer to Hebb's (1994) neuropsychological learning theory, stating that if pre-synaptic and post-synaptic neurons are stimulated at the same time, the synaptic connection is strengthened, and as a result of this strengthening, cognitive functions are improved or improved, or the child's active memory will be able to memorize the commands better and forget them less because these children have problems remembering the commands and remembering the tasks and functions related to themselves. With cognitive rehabilitation training, the child will be able to remove disturbing information from the mind for a more extended time, and others will have to repeat commands less continuously. They will act more competently in academic success and problem-solving, and they will not lose most of the material, face fewer spelling problems, and not miss words and letters. Because subjects can use active memory, and the spoken words will be more stable in their mind.
The results showed that cognitive rehabilitation training was effective on the visual memory of dysgraphia students, and the follow-up period of the results was stable. The obtained results were in line with the results of previous studies in this field. In explaining the obtained result, it can be said that the cognitive rehabilitation method, obtained from integrating cognitive neuroscience with information technology, is a method to improve cognitive function defects, including memory and attention. According to the principle of plasticity and self-repair of the brain, this method causes a stable synaptic change in the brain by successively stimulating the areas of the brain that are less active and, in this way, can improve the cognitive deficits observed in the mentioned disorders.
Among the limitations of the present study, it can be mentioned that the study was carried out in a group of girls and second-and third-grade students, and caution should be observed in generalizing the results to boys and other educational levels. Correspondingly, among other limitations of the current research, this research can mention the lack of control of some demographic variables, such as the the subjects' socio-economic status and the parents' literacy level. Therefore, it is suggested to investigate the role of demographic variables in future studies on boys. According to the research results, considering the attractiveness of this method for children, it is suggested to use this method in combination with other treatment methods by counselors and psychotherapists.
Ethical considerations
Compliance with ethical guidelines
All subjects received information about the study. They were assured that all information will remain confidential and will only be used for research purposes. In addition, in order to respect privacy, the details of the subjects were not recorded. At first, informed consent was obtained from all of them. Besides, the current study recieved the code of ethics IR.SHAHED.REC.1401.036 from the Ethics Committee of Shahed University.
Authors’ contribution
The first author: Implementation, data collection, and writing of the primary text. The second author: As the first supervisor, corresponding author, and project supervisor. The third author: As the second guide and responsible for idea design. The fourth author: As the first consultant professor responsible for statistical analysis. The fifth author: As the second consultant, responsible for editing and finalizing the article.
Funding
This research was carried out at the personal expense of the first author.
Acknowledgments
The authors would like to thank all those who cooperate in this research.
Conflict of interest
There is no conflict of interest between the authors.
One of the critical disorders in learning problems is writing disorder or dysgraphia (1). Working memory plays a role in reading and writing disorders (2). Active memory is described as a short-term cognitive system that allows information to be temporarily stored for simultaneous processing or close to the reference, so active memory has been considered one of the essential concepts in the neuroscience area (3). On the other hand, the problems of children with dysgraphia in the visual-spatial component may cause problems for them in doing homework, reading maps spatially, or copying the contents of the visual-spatial active memory from the board (4). Today, cognitive rehabilitation is one of the non-pharmacological treatments for developing cognitive abilities in children with learning disabilities (18). Cognitive rehabilitation therapy is an approach to increase children’s abilities and executive functions in attention, memory, inhibition and organization, planning and decision-making, and the like employed to treat and rehabilitate cognitive disorders and therapeutic services to strengthen damaged or replaced domains. It provides new models to compensate for the disorder (21). Considering the effects of dysgraphia on the psychological aspect of affected students, and on the other hand, research gods in this field, conducting such studies and using the results of these studies in the field of prevention and reduction of problems associated with dysgraphia in children and adolescents is one of the crucial needs of research in any country. Therefore, any study, diagnosis and identification, prevention, control, and treatment will be valuable. Accordingly, the present study aimed to determine the effectiveness of cognitive rehabilitation on the working and visual memory of dysgraphia students.
Methods
The present study was semi-experimental with a pre-test and post-test design with a follow-up period with a control group. The research population included all second and third-grade female students with dysgraphia in Tehran, Iran, in the academic year of 2021-2022, who were referred from regular schools to educational and rehabilitation centers for special learning problems. Among them, 28 people were selected and randomly placed in two experimental and control groups. Moreover, they responded to Yaqoubi et al.'s dysgraphia diagnostic scale (1400), N-BACK (2001), and Kim Karad's visual memory test (1945). Then, the experimental group received the cognitive rehabilitation training program, but only school training was provided to the control group. For data analysis, a repeated measurement test was used with SPSS version 24 software at a significance level 0.05.
Results
According to the study results, in the experimental group, six people (42.9 subjects) were eight years old, and eight people (57.1 percent) were nine years old, but in the control group, seven people (50 percent) were eight years old, and seven people (50 percent) were nine years old. Based on obtained the results, the average scores of the attention and response inhibition variables in the cognitive rehabilitation treatment group were increased compared to the control group in the post-test and follow-up stages compared to the pre-test stage. Besides, based on the results of repeated measures analysis of variance, the difference between attention scores (P<0.01) and response inhibition variable (P<0.01) is significant in the three stages of the research. The results revealed that 99.3% and 75.5% of the individual differences in the attention and response inhibition variables were related to the difference between the two groups, respectively. In addition, the interaction between research stages and group membership is also significant in all research variables (P<0.01). In other words, the difference between scores in all research variables in the three stages of research in two groups is significant. Thus, it can be concluded that cognitive rehabilitation treatment has been effective in the attention and response inhibition of dysgraphia students. The results of pairwise comparisons of the mean difference in the three stages of the test showed that in the cognitive rehabilitation treatment group, the difference between the average scores of the pre-test stage and the post-test and follow-up stages is significant (P<0.01), indicating both the effectiveness of the treatment and the stability of the effects of the treatment with time passes. The difference between the scores of the post-test phase and the scores of the follow-up phase is also significant (P<0.01). In the control group, the difference between the scores of the pre-test stage and the post-test and follow-up stages, and between the scores of the post-test stage and the follow-up scores, is insignificant (P<0.05). Based on this, it is concluded that the cognitive rehabilitation treatment has been effective in the attention and response inhibition of dysgraphia students.
Conclusion
According to the present study, cognitive rehabilitation training effectively improved the working memory of dysgraphia students, and the results continued in the follow-up period. The above finding is consistent with the results of previous studies in this field. In the above explanation, the current study can refer to Hebb's (1994) neuropsychological learning theory, stating that if pre-synaptic and post-synaptic neurons are stimulated at the same time, the synaptic connection is strengthened, and as a result of this strengthening, cognitive functions are improved or improved, or the child's active memory will be able to memorize the commands better and forget them less because these children have problems remembering the commands and remembering the tasks and functions related to themselves. With cognitive rehabilitation training, the child will be able to remove disturbing information from the mind for a more extended time, and others will have to repeat commands less continuously. They will act more competently in academic success and problem-solving, and they will not lose most of the material, face fewer spelling problems, and not miss words and letters. Because subjects can use active memory, and the spoken words will be more stable in their mind.
The results showed that cognitive rehabilitation training was effective on the visual memory of dysgraphia students, and the follow-up period of the results was stable. The obtained results were in line with the results of previous studies in this field. In explaining the obtained result, it can be said that the cognitive rehabilitation method, obtained from integrating cognitive neuroscience with information technology, is a method to improve cognitive function defects, including memory and attention. According to the principle of plasticity and self-repair of the brain, this method causes a stable synaptic change in the brain by successively stimulating the areas of the brain that are less active and, in this way, can improve the cognitive deficits observed in the mentioned disorders.
Among the limitations of the present study, it can be mentioned that the study was carried out in a group of girls and second-and third-grade students, and caution should be observed in generalizing the results to boys and other educational levels. Correspondingly, among other limitations of the current research, this research can mention the lack of control of some demographic variables, such as the the subjects' socio-economic status and the parents' literacy level. Therefore, it is suggested to investigate the role of demographic variables in future studies on boys. According to the research results, considering the attractiveness of this method for children, it is suggested to use this method in combination with other treatment methods by counselors and psychotherapists.
Ethical considerations
Compliance with ethical guidelines
All subjects received information about the study. They were assured that all information will remain confidential and will only be used for research purposes. In addition, in order to respect privacy, the details of the subjects were not recorded. At first, informed consent was obtained from all of them. Besides, the current study recieved the code of ethics IR.SHAHED.REC.1401.036 from the Ethics Committee of Shahed University.
Authors’ contribution
The first author: Implementation, data collection, and writing of the primary text. The second author: As the first supervisor, corresponding author, and project supervisor. The third author: As the second guide and responsible for idea design. The fourth author: As the first consultant professor responsible for statistical analysis. The fifth author: As the second consultant, responsible for editing and finalizing the article.
Funding
This research was carried out at the personal expense of the first author.
Acknowledgments
The authors would like to thank all those who cooperate in this research.
Conflict of interest
There is no conflict of interest between the authors.
Type of Study: Research |
Received: 2023/01/6 | Accepted: 2023/06/7 | Published: 2023/07/10
Received: 2023/01/6 | Accepted: 2023/06/7 | Published: 2023/07/10
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