تاثیر تمرینات بینایی بر توانایی حرکتی کودکان مبتلا به اتیسم شهر کابل

مقدمه: افغانستان شاید تنها کشوری است که هیچ سیستم شناسایی، درمانی و مراقبتی از کودکان طیف اتیسم ندارد. بنابراین هدف اصلی پژوهش حاضر، بررسی تاثیرات تمرینات بینایی بر توانایی حرکتی کودکان طیف اتیسم در شهر کابل است.روش کار: پژوهش حاضر از نوع کمی و نیمه ‌تجربی بوده، که با روش میدانی اجراء شده است. جامعه آماری پژوهش شامل کودکان طیف اتیسم شهر کابل بوده که با روش نمونه‌گیری هدف‌مند و در دسترس 14 کودک 6 تا 12 ساله بر اساس مصاحبه تشخیصی اتیسم-تجدید نظر شده adi-r به دو گروه پیش ‌آزمون و پس‌آزمون تقسیم شده بودند و به مدت 6 هفته و جلسه 30 دقیقه‌ای مورد مطالعه قرار گرفتند. از ابزارهای آزمون لک‌لک اصلاح شده، آزمون راه‌ رفتن پاشنه به پنجه و آزﻣﻮن ﺣﺮﮐﺘﯽ دﺳﺖ و اﻧﮕﺸﺘﺎن peabody برای سنجش توانایی حرکتی استفاده شد و در نهایت دادها با نرم‌ افزار spss نسخه 26 تجزیه و تحلیل گردید.یافته‌ ها: یافته‌های نشان داد که، تمرینات بینایی بر توانایی حرکتی کودکان طیف اتیسم در تعادل ایستا، تعادل پویا و در حرکت انگشتان تاثیرات مثبت و معنادار داشته است (0/05>p).نتیجه‌گیری: کودکان طیف اتیسم در افغانستان از محروم‌ترین کودکان طیف اتیسم در دنیا هستند که هیچ برنامه و نهادی برای شناسایی، درمان، مراقبت و حمایت از آنها وجود ندارد. بنابراین، دست‌کم می‌توان با مداخلات و تمرینات جانبی به توانایی، سازگاری و هماهنگی اعضای بدن آنها کمک کرد. 

the impact of visual exercises on motor abilities of children with autism spectrum disorder in kabul, afghanistan

introductionsome children encounter developmental disorders in biological growth and evolution that significantly impact developmental stages. one of these well-known genetic and neurodevelopmental disorders is autism. autism spectrum disorder (asd) is characterized by various challenges in communication, social interactions, and stereotypical behavior patterns during early developmental stages, leading to prominent functional impairment in individuals. recently, the evolution of motor skills in children diagnosed with asd has gained considerable attention, sparking debates on whether motor impairments could be a primary feature of the autism spectrum. however, weaknesses and inconsistencies in motor abilities can lead to social isolation, limited participation in daily activities, language difficulties, issues with play, eye contact, communication challenges, academic and occupational setbacks, anxiety, learning difficulties, dependence, stereotypical behaviors, aggression, rejection of peers, and more. nevertheless, autism spectrum disorder remains one of the prevalent conditions among children, primarily understood in the context of biological foundations and neurological dysfunction. however, external factors such as the absence of identification, treatment, and care systems, low societal and familial awareness about this disorder, and lack of support for children affected by autism are considered significant societal issues in afghanistan. therefore, the main objective of this research is to investigate the effects of visual exercises on the motor abilities of children with asd in kabul, afghanistan.methodsthe current research is of a quantitative and quasi-experimental nature and is conducted through a fieldwork approach. the statistical population of the study consisted of children with autism spectrum disorder asd in kabul, afghnistan. a purposive and accessible sampling method was employed to select 14 children aged 6 to 12 years who were re-evaluated for autism diagnosis using the autism diagnostic interview-revised (adi-r). these children were divided into pre-test and post-test groups and underwent a 6-week intervention with 30-minute sessions. the critical criteria for sample selection included age (between 6 and 12 years), absence of physical problems and disorders, absence of chronic mental disorders diagnosed by a psychologist, parental and guardian consent, and normal intelligence (iq>70) based on the assessment (23). visual impairment was also not reported. in this study, variables were categorized into three groups: independent, dependent, and control variables. the independent variable encompassed six weeks of visual exercises. the dependent variable included static balance, dynamic balance, and finger movement. finally, the control variable was the intelligence level of the participants. modified leckey assessment, hierarchical assessment of balance and coordination (habc), and peabody developmental motor scales (pdms-2) were used as assessment tools to measure motor abilities. after collecting research data, the data were entered into the spss-26 software. confirming the distribution, normality, and homogeneity of the data was done using central tendency and dispersion indices. subsequently, inferential tests, including the shapiro-wilk test (to determine the normal distribution of data), dependent t-test (for within-group effects), and independent t-test (for between-group differences) were conducted at a significance level of 0.05.resultsbefore data analysis, an examination of statistical indices was conducted. the report of this section indicated that the mean scores of the research groups in both experimental and control conditions were normal, and no significant abnormal difference was found. additionally, before investigating the interventions of visual exercises on motor abilities among the research samples, it was necessary to examine the homogeneity of the groups. for this purpose, an independent t-test was used to assess and compare the visual abilities of children with autism (experimental group and control group) in the pre-test stage. the results showed that in the pre-test stage, considering the test statistics, a significant difference was observed in the motor abilities of the research samples. dependent t-test results indicated that visual exercises led to significant changes in the motor abilities of the research samples to varying extents. the presented table indicated differences in the scores of research groups resulting from the interventions of these exercises, and statistically, all these differences were reported as significant (p<0.05). furthermore, an independent t-test was used to compare the effects of visual exercises on motor abilities between groups. the results demonstrated that there were significant differences in the effects of visual exercises on dynamic balance, static balance, and finger movement of children with autism in the experimental group compared to the control group (p<0.05). the findings of these tests suggest that children with autism have diverse motor abilities, and these abilities can be improved and directed toward better adaptability through various interventions and exercises, including visual exercises. in conclusion, the research findings indicated that visual exercises had positive and significant effects on the motor abilities of children with autism in static balance, dynamic balance, and finger movement.conclusionchildren with asd in afghanistan are among the most underserved globally, lacking any programs or institutions for identification, treatment, care, and support. therefore, at the very least, interventions and auxiliary exercises can assist in improving the abilities, adaptability, and coordination of their body parts. this research, employing a semi-experimental and field-based approach, has aimed to take a small step towards opening up the culture of research and investigation related to the autism spectrum. it calls for the attention of all domestic and international educators, medical communities, academic societies, and policymakers to focus on the identification, care, treatment, and support of children on the autism spectrum. in conclusion, the overall findings of the research indicate that children with autism in afghanistan, who are numerous due to general conditions and persistent crises, require identification, treatment, care, and support. on the other hand, society and families must be aware of the rights and living conditions of these children. compassionate communities and families are the primary needs of these children. moreover, it is essential to establish institutions for the identification, treatment, and care of these children. families also need to embrace some basic and even professional exercises and interventions to help these children adapt to life and society. one such intervention is visual exercises, which have a great deal of positive and improving effects on these children’s motor abilities, including static balance, dynamic balance, and finger movements.ethical considerationscompliance with ethical guidelinethe research objectives and details have been explained to the families and guardians of the research samples, and informed consent forms have been completed.authors’ contributionsboth authors have actively participated in all phases of the research. the first and corresponding author contributed 60% to the design, analysis, and interpretation of the data, as well as the preparation of the draft of the article, and the second author contributed more to its review, and correction, and approval of the final version for publication. besides, both authors are responsible for all aspects of the research.fundingthis research received no financial support from any individuals or legal entities.acknowledgmentsthe present research expresses gratitude to all the families, physicians, and the sahat tefeel hospital for facilitating the conduct of the sessions.conflicts of interestthe authors declared no conflicts of interest with any individuals or legal entities in this research.