مقایسۀ اثربخشی برنامۀ آموزش حمایت رفتاری مثبت (pbs) با الگوی والدگری بارکلی بر بهبود نشانگان کودکان دارای اختلال نقص‌توجه/بیش‌فعالی

هدف و زمینه: اختلال adhd یک اختلال عصبی رشدی است که در خط مقدم درمان این اختلال، برای کاهش نشانگان آن، آموزش والدین جایگاه ویژه ای دارد. این پژوهش با هدف مقایسۀ اثربخشی برنامۀ pbs با الگوی والدگری بارکلی بر بهبود نشانگان کودکان adhd انجام شد.روش بررسی: در این پژوهش از روش نیمه آزمایشی پیش آزمون پس آزمون همراه با گروه گواه استفاده شد. روش نمونه گیری به صورت چندمرحله ای و جای گذاری تصادفی ساده در گروه های آزمایش و گواه بود. بدین صورت که از مدارس شهر اصفهان چهار مدرسه و از این مدارس 30 کودک adhd انتخاب و به صورت تصادفی در گروه های آزمایش و گواه گمارده شدند. گروه های آزمایش، طی هشت جلسه تحت آموزش به روش pbs و بارکلی قرار گرفتند. ابزار گردآوری اطلاعات به منظور سنجش نشانگان adhd، پرسش نامۀ کانرز فرم والدین بود. برای تجزیه وتحلیل داده ها از نرم افزار spss نسخۀ 20 و تحلیل کوواریانس چندمتغیره به همراه آزمون های تعقیبی در سطح اطمینان 95درصد به کار گرفته شد.یافته ها: نتایج نشان داد در متغیرهای شناختی/بی توجهی (0٫017=p) و بیش فعالی (0٫047=p) و کاستی توجه/بیش فعالی (0٫021=p) بین دو گروه تفاوت معنادار وجود دارد؛ اما در متغیر مخالفت جویی (0٫063=p) تفاوت معناداری یافت نشد. در متغیر بیش فعالی و کاستی توجه/بیش فعالی تفاوت نمرات هر دو گروهِ آموزش والدگری بارکلی (0٫040=p) و آموزش حمایت رفتاری مثبت (0٫008=p)، با گروه گواه معنادار بود. همچنین در متغیر شناخت/بی توجهی (0٫006=p) و مخالفت جویی (0٫024=p) تنها آموزش حمایت رفتاری مثبت توانست تفاوت معناداری را با گروه گواه ایجاد کند. شایان ذکر است در همۀ خرده مقیاس ها تفاوت آموزش معنادار نبود.نتیجه گیری: نتایج پژوهش نشان داد که آموزش به هر دو روش مذکور، نشانگان adhd را در کودکان بهبود می بخشد.

The Compare Effectiveness of Positive Behavioral Support program and Barkley’s parenting model on improve symptoms in ADHD children

Background & Objective: Attention deficit/hyperactivity disorder (ADHD) is a developmental neurodevelopmental disorder in children who exhibits distressing behavior, impulsivity, or inattention that is not appropriate to his or her age. In the first line treatment of this disorder, education of parents, especially mothers, has a special place in order to reduce its syndrome. The aim of this study was to compare the effectiveness of positive behavioral support (PBS) program with Barkley parenting model on improving the symptoms in ADHD children.Methods: Regarding the subject and research hypothesis in this research, a pretest–posttest test with control group was used. The sampling method was multi–stage, randomized placement in the experimental, and control groups. Four schools were selected from schools in Isfahan city (Isfahan province, Iran) and from these schools, 30 ADHD children and their mothers were selected and randomly assigned to experimental groups (20 mothers) and control group (10 mothers). The criteria for entering the study were, having an ADHD diagnosis from a psychiatrist and a psychologist, having criteria for this disorder according to DSM–5, having no other disorder other than ADHD. To assess the ADHD symptoms, the Conners questionnaire (parent form) was used. This scale is the most commonly used grading scale for attention deficit/hyperactivity disorder and has four subscales: dissonance, cognitive/inattention, hyperactivity disorder, and attention deficit/hyperactivity disorder. All of selected mothers completed a questionnaire in two stages of pre–test and post–test. The mothers of the experimental group received 8 sessions and were treated with PBS and Barkley for about two months. Mothers of the control group did not receive any training; they were placed on the waiting list and received the training after the end of the intervention. To compare the effect of two methods training on ADHD syndrome improvement, multivariate covariance analysis was used to control the pretest effect. The post–hoc test was used to determination the difference between the groups in each variable. Data analysis was performed with SPSS 20 software at 95% confidence level.Results: There was a significant difference between cognitive/inattention (p=0.017) and hyperactive (p=0.047) and inattention/hyperactive (p=0.021) variables between the two groups. However, no significant difference was found in the opposition variable (p=0.063). In the hyperactivity and inattention/hyperactivity, the difference between the two groups of education Barkley parenting education (p=0.040) and PBS education (p=0.008)) was significant with the control group. This means that both methods have been able to reduce and improve the ADHD symptoms. Also, in the variable of cognitive/inattention (p=0.006) and opposition (p=0.024), only PBS program was able to make a significant difference with the control group. There was no significant difference in education in all subscales.Conclusion: the results showed that training with both programs could improve the symptoms of ADHD. Therefore, it is suggested that parent education be widely used in both methods to treat the problems of children with this disorder and their families. In addition, these patterns can use in a group method in schools and childcare centers as well as in child–rearing workshops. Coaches and therapists can also use the contents of these patterns for parenting counseling and ADHD treatment for children.