مقایسه تاثیرآموزش مفاهیم ذهن خوانی و درمان پاسخ محور بر کارکردهای اجرایی کودکان با اختلال طیف اوتیسم
محورهای موضوعی : روانشناسی
مریم افلاکی ناصری
1
(دانشجوی دکتری روانشناسی عمومی، گروه روانشناسی، واحد تنکابن، دانشگاه آزاد اسلامی، تنکابن، ایران)
محمدرضا زربخش بحری
2
(دانشیار، گروه روانشناسی، واحد تنکابن، دانشگاه آزاد اسلامی، تنکابن، ایران.)
شهنام ابوالقاسمی
3
(دانشیار، گروه روانشناسی، واحد تنکابن، دانشگاه آزاد اسلامی، تنکابن، ایران.)
طاهر تیزدست
4
(استادیار، گروه روانشناسی، واحد تنکابن، دانشگاه آزاد اسلامی، تنکابن، ایران.)
کلید واژه: درمان ذهن خوانی, اوتیسم, کارکردهای اجرایی, درمان پاسخ محور, کودکان,
چکیده مقاله :
این پژوهش با هدف مقایسه اثربخشی آموزش درمان پاسخ محور و درمان ذهن خوانی بر کارکردهای اجرایی کودکان طیف اوتیسم انجام شد. روش تحقیق در این پژوهش نیمه آزمایشی با طرح پیش آزمون – پس آزمون با گروه کنترل بود. جامعه آماری این مطالعه، کودکان اوتستیک شهر لاهیجان بودند. نمونه تحقیق شامل 45 نفر از کودکان 6 تا 13 سال مبتلا به اوتیسم بودند که به شیوه تصادفی ساده از جامعه آماری انتخاب شدند. ابزار جمع آوری داده ها پرسشنامه کارکردهای اجرایی بریف(Gioia, 2000) بود که توسط والدین تکمیل شد. پس از اجرای پیش آزمون، کودکان اوتیسم به صورت تصادفی در سه گروه (دو گروه آزمایشی و یک گروه کنترل) 15 نفره جایگزین شدند. سپس گروه آموزش مفاهیم ذهن خوانی به مدت 10 جلسه و گروه درمان پاسخ محور به مدت 7 جلسه تحت آموزش انفرادی قرار گرفتند. پس از اتمام مداخلات، پس آزمون به عمل آمد. تجزیه و تحلیل داده ها با استفاده از آزمون آماری تحلیل کوواریانس نشان داد درمان پاسخ محور و درمان ذهن خوانی بر کارکردهای اجرایی کودکان اوتیسم موثر است و درمان ذهن خوانی نسبت به آموزش درمان پاسخ محور در میزان مولفه های کارکردهای اجرایی اثربخشی بیشتری دارد (01/0> P). نتیجه آزمون ال اس دی نشان می دهد بین اثربخشی درمان ذهن خوانی و پاسخ محور بر تنظیم رفتار(01/0>P) و نیز فراشناخت (01/0>P) کودکان تفاوت آماری معنی داری وجود دارد. نتایج پژوهش نشان داد نمرات گروه های مداخله در مقایسه با گروه کنترل در مقیاس کارکردها ی اجرایی تغییرات معنی داری داشت. کارکردهای اجرایی پس از انجام مداخلات افزایش یافته و این افزایش در گروه ذهن خوانی بیشتر بوده است. استفاده از این دوروش به درمانگران، روانشناسان و مربیانی که در راستای آموزش به کودکان اوتستیک فعالیت می کنند پیشنهاد می شود.
This study aimed to compare the effect of training pivotal response treatment principles and training Theory of mind principles on executive functions in kids with autism disorder. The method was half- experimental with pre-test, post-test with control group. The statistical population consisted children with autism disorder in Lahijan city. After assessing, 45 child between 6-13 years old were chosen and then randomly divided into three groups of 15, two intervention groups and a control group.Data collection tool was BRIFF executive functions questionnaire which was completed by parents For the first intervention group, the Pivotal response treatment in 7 sessions and for the second group Theory of Mind principals were taught in 10 sessions and the control group did not receive any training.At the end of training post-test was conducted. Data were analyzed using multivariate covariance (MANCOVA) analysis. The findings showed that intervention groups were significantly different in the post-test, compared to the control group in executive function. The rate of executive functions incerease after intervention and the size of this increase was higher in the theory of mind training group. The result showed that theory of mind training has great effect than PRT training on increasing self-differentiation (P<0/01). The result of LSD test shows the difference between the effectiveness of mind reading and response-oriented therapy on behavior regulation (P <0.01) and metacognition (P <0.01) in children. There is a statistically significant. The results showed that the scores of the intervention groups were significantly different from the control group in the scale of executive functions. Executive functions increased after the interventions and this increase was more in the mind reading group. Findings showed that mind reading training has a greater effect on increasing executive functions than response therapy training. The use of these two methods is recommended to therapists, psychologists and educators who work to educate children with autism.
Ahmadi, SJ., Safari, T., Hemmatiyan, M., & Khalili, Z. (2012). Effectiveness of applied behavioral analysis approach on symptoms of autism. Journal of Research in Cognetive Behaveaior Sciences, 10(25), 292-300. [Persian]
Association, P. A. (2013). Diagnostic and statistical manual of mental disorders (DSM-5), American Psychiatric Association Publishment.
Azimi Garousi, S., Abedi, A., Mohseni Ezhiyeh, A., & Vakilizadeh, N. (2016). Effectiveness of the pivotal response treatment on the degree of question-asking of children with autism spectrum disorder: a single-subject research. Iranian Journal of Psychiatry and Clinical Psychology, 22(3), 176-18. [Persian]
Baron-Cohen, S., Leslie, AM., & Frith, U. (1985). Does the autistic child have a ''theory of mind"? Journal of Cognition Behavior, 21(15), 37-46.
Bavandi, Sh. (2010). The study of theory of mind training effect on pragmatic language improvement in autistic children. Masters degree Thesis, Tehran University of Social Welfare and Rehabilitation Sciences. [Persian]
Bahadori, A., & Panahi, M. (2018). The effectiveness of teaching mindfulness homework in increasing the level of social interaction and communication of autistic children. Journal of Sociology Education, 9(2), 27-38. [Persian]
Cole, K., & Mitchell, P. (2000). Siblings in the developmental executive control and theory of mind. Br. Journal of Developmental Psychology, 18(2), 279-95.
Corbett, B., A., Constantine, L. J., Hendren, R., Rocke, D., & Ozonoff, S. (2009). Examining executive functioning in children with autism spectrum disorder, attention deficit hyperactivity disorder and typical development. Journal of Psychiatry Reserch, 166(23), 210-220.
Doenyas, C., Yavuz, H. M., & Selcuk, B. (2018). Not just a sum of its parts: How tasks of the theory of mind scale relate to executive function across time. Journal of Experimental Child Psychology, 166(3), 485-501.
Dawson, P., & Guare, R. (2004). Executive skills in children and adolescents: A practical guide to Assessment and Intervention. New York: Guilford Press.
Faramarzi, S., Mohseni Ezhiyeh, A., & Azimi Garosi, S. (2020). Effectiveness of pivotal response treatment (PRT) on the correct use of different questions in social interactions of children with autism spectrum disorder: A single-subject study. Journal of rehabilitation medicine, 8 (4), 20-29. [Persian].
Fisher, N., & Happe, F. (2005). A training study of theory of mind and executive function in children with autism spectrum and disorders. Journal of Autism Developmental Disorder, 35(6), 757-71.
Fogel, Y., Rosenblum, S., Hirsh, R., Chevignard, M., Josman, N. (2020). Daily performance of adolescents with executive function deficits: An empirical study using a complex-cooking task. Occupational Therapy International, 20(3), 1-11.
Gioia, G.A., Isquith, P.K., Guy, S.C. & Kenworthy, L (2000) Behavior rating inventory of executive function: Professional manual. Odessa, FL: Journal of Psychological Assessment Resources, Incorporated, 6(3), 235-238
Geurts, H., Pol, J. S.E,. Lobbestael, J., & Simons, C.J.P. (2020). Executive functioning in 60+ autistic males: The discrepancy between experienced challenges and cognitive performance. Journal of Autism Developmental Disorder, 50(4), 1380-1390.
Ghorbani, N., & Jabari, S. (2019). The effect of teaching mind theory on the executive functions of male students with learning disabilities. Quarterly of Psychology of Exceptional Individuals Allameh Tabataba’i University, 8(31), 237-259. [Persian]
Hill, E. L. (2004). Executive dysfunction in autism. Trends in Cognitive Sciences, 8 (1), 26-32.
Hodgdon, A, L. (2000).Solving behavoir problem in autism, improving communication with visual strategies, (Translated by , E,Mohammad Esmaeil & A,Rahmani Resa). Tehran: Danzheh publishment. [Persian]
Howlin, P., Baron-Cohen, S., & Hadwin, J. A. (2010) Teaching children with autism to mind-read: A practical guide for teachers and parents. (Translated by Abdollahzade Rafee M, Nasaiyan A, Yazdani A) Gorgan: Roshde Farhang Publishment. [Persian]
Jalili, F., & Nejati, V., (2013). Compare the ability to recognize basic emotional states of children with highfunctioning autism disorder with normal counterparts. Quarterly Journal Reserch Medicine Sciences, 2(14), 122-34. [Persian]
Javadi, F., Hassanzadeh. S., & Arjomandnia, A. (2014). The effectiveness of pivotal response treatment (PRT) on decrease of clinical symptoms in children with autism and their parental strees. Applied Psychological Research Quarterly, 5(3), 55-69. [Persian]
Johnston, K., Murray, K., Spain, D., Walker, I., & Russell, A (2019). Executive Function: cognition and behaviour in adults with autism spectrum disorders (ASD).Journal of Autism Developmental Disorder, 49(10), 4181-4192.
Karr, J. E., Areshenkoff, C. N., Rast, PH., Hofer, S. M., Iverson, G. L.,& Garcia-Barrera, M. A. (2018). The unity and diversity of executive functions: A systematic review and re-analysis of latent variable studies. Journal of Psychologycal Bulletin, American Paychology Association, 144(11), 1147–1185.
Khodabakhshi, M., Malekpour, M., & Abedi, A. (2015) To evaluate the effectiveness of the training based on theory of mind on the function of mind reading and the executive functions in the children with autism spectrum disorders. Iranian Journal of Psychology and Clinical Psychology, 21(2), 155-166. [Persian]
Kim, S., Bradshaw, J., Gengoux, G. W., Vismara, L. A., Tagavi, D., Oliver, K., & Koegel, B. L. (2019). Pivotal response treatment for autism spectrum disorders. R. L. Koegel, & L. K. Koegel (Eds.). Paul H. Brookes: Publishing Company
Koegel, R. L., Bradshaw, J. L., Ashbaugh, K., & Koegel, L. K. (2014). Improving question-asking initiations in young children with autism using pivotal response treatment. Journal of autism and developmental disorders, 44(4), 816-827.
Koegel, L. K., Koegel, RL., Shoshan,Y., & Mcnerney, E.(1999). Pivotal response intervention II: preliminary long-term outcome data. Journal of Association Persons Severe Handicaps, 24(2), 186-198.
Larkey, U. (2008). New places, new identities: theever changing of heimat. Journal of Berghahn, 26(2), 20-38.
Minjarez, M.B., Williams, E. M., Mercier, E. M., & Hardan A.Y. (2011). Pivotal response group treatment program for parents of children with autism. Journal of Autism Developmental Disorder, 41(3), 92-101.
Pooshaneh, K., & Abshenasan, S. (2018). The effect of integrated applied behavior analysis (ABA) & pivotal response treatment (PRT) method on vocabulary development of children with autism ages 4 to 6. Journal of Exeptional Children, 17(1), 137-146. [Persian]
Premack, D., &Woodruff, G. (1978). Does the chimpanzee have a theory of mind? Journal of Behave Brain Sciences, 1(4), 515-26.
Perner, J., & Lang, B. (1999). Development of theory of mind and executive control. Journal of Trends In Cognitive Sciences, 3(9), 337-344.
Powell, L. J., & Carey, S. (2017). Executive function depletion in children and its impact on theory of mind. Journal of Science Direct, Cognition, 164(4), 150-162.
Rezayi, S. (2015). Social cognition and Autism disorders. Tehran: Avaye Noor Publishment. [Persian]
Rezayi, S., & Lari Lavasani, M. (2017). Motor relationships with social skills and behaviors: A challenge in children with autism spectrum disorder. Psychology of Exceptional Individuals Allameh Tabataba’i University,7(25), 19-33. [Persian]
Salemi Khamene, A., Ghahari, S. H., Soltanlou, M., & Darabi, J. (2013). Effectiveness of pivotal response treatment on communicative and behavioral disorder of 8 -12 years - old autistic boys, Journal of Gorgan university of Medical Sciences, 15(1), 6-11. [Persian]
Samadi, M., Ghamarani, A., & Faramarzi, S. (2019). Effectiveness of pivotal response treatment on future thinking and pass processes in children with autism spectrum disorder. Journal of Reserch Behavaior Sciences, 17(3), 495-507. [Persian]
Schuwerk, T., Schecklmann, M., Langguth, B., Doehnel, K., Sodian, B., & Sommer, M. (2014). Inhibiting the posterior medial prefrontal cortex by TMS decreases the discrepancy between self and other in theory of mind reasoning. Journal of Behavioural Brain Research, 274(1), 312-318.
Shirmohammadi, SH., Shahriari Ahmadi, M., & Salehi, M. (2017). A comparison of the effectiveness of social stories intervention and pivotal response treatment on the reduction of behavioral disorders in children with autism spectrum. Journal of Exceptional Clinical, 17(2), 37-46. [Persian]
Singer, T. (2006). The neuronal basis and ontogeny of empathy and mind reading: review of literature and implications for future research. Journal of Neuroscience Biobehavioural Review, 30(3), 855-863.
Sivaratnam, C., Newman, L., & Rinehart, N. (2018). Emotion-recognition and theory of mind in high-functioning children with ASD: Relationships with attachment security and executive functioning. Research in Autism Spectrum Disorders, 53(5), 31-40.
Udhnani, M., Perez, M., Clasen, L.S., Adeyemi, E., & Raitano Lee, N. (2020).Relations between everyday executive functioning and language in youth with Down syndrome and youth with autism spectrum disorder. Journal of Developmental Neuropsychol, 45(2), 79-93.
Velloso, R. D. L., Duarte, C. P., & Schwartzman, J. S. (2013). Evaluation of the theory of mind in autism spectrum disorders with the Strange Stories. Journal of FciFLO Brazil, test Arquivos de neuro-psiquiatria, 71(11), 871-876.
Ventola, P., Friedman, H. E., Anderson, L. C., Wolf, J. M., Oosting, D., Foss-Feig, J., & Pelphrey, K. A. (2014). Improvements in social and adaptive functioning following short-duration PRT program: A clinical replication. Journal of Autism and Developmental Disorders, 44(11), 2862-2870.
Weismer, S.E.,a Kaushanskaya M., Larson, C., Mathée, J.,& Bolt, D. (2018 ).Executive function skills in school-age children with autism spectrum disorder: association with language abilities. Journal of Speech Language Hear Reserch, 61(11), 2641-2658
Wellman, H. M., Cross, D., & Watson, J. (2001). Meta-analysis of theory-of- mind development: The truth about false belief. Journal of Child Developmental Disorders, 72(3), 655-84.
Zamani, A., & Azizi. M. (2011). Making It A Success: Practical strategies and worksheets for teaching student, 3rd ed.Virayesh publishment, Tehran, Iran. [Persian]
Zhang, T., Chen, L., Wang, Y., Zhang, M., Wang, L., Xu, X., & Zhou, N. (2018). Impaired theory of mind in Chinese children and adolescents with idiopathic generalized epilepsy: association with behavioral manifestations of executive dysfunction. Journal of Epilepsy & Behavior, 79(6), 205-212.
_||_