مقایسهٔ اثربخشی روش درمانیآموزشی (تیچ) و نوروفیدبک بر ارتقای مهارت‌های شناختی، اجتماعی و فعالیت‌های روزمرهٔ زندگی در کودکان مبتلابه اختلال طیف اتیسم

زمینه و هدف: والدین کودکان دارای اختلالات طیف اتیسم و مربیان آن ها باید بررسی نمایند که کدام یک از مداخلات درمانی، با توجه به شرایط اختلال، موثرتر و مناسب تر است، بنابراین هدف مطالعهٔ حاضر مقایسهٔ اثربخشی روش درمانیآموزشی (تیچ) و نوروفیدبک بر ارتقای مهارت های شناختی، اجتماعی و فعالیت های روزمرهٔ زندگی در کودکان مبتلابه اختلال اتیسم بود.روش بررسی: روش تحقیق از نوع نیمه تجربی با طرح پیش آزمون پس آزمون با گروه گواه بود. جامعهٔ آماری شامل کودکان 127 سالهٔ مبتلابه طیف اتیسم بودند که 45 نفر از افراد واجد شرایط و داوطلب به صورت هدفمند انتخاب شده و به روش تصادفی ساده در دو گروه مداخلهٔ درمانی آموزشی و نوروفیدبک و یک گروه گواه پانزده نفره تقسیم شدند. برای جمع آوری اطلاعات از پرسشنامهٔ سنجش دامنهٔ اتیسم (1999)، مقیاس تجدیدنظر شدهٔ هوش وکسلر کودکان (1969)، پرسشنامهٔ سنجش مهارت های اجتماعی استون و همکاران (2010) و مقیاس وایزمن (2013) استفاده شد. علاوه بر برنامه های آموزشی مرکز، مداخلات دو گروه به صورت انفرادی به مدت بیست جلسهٔ 45 دقیقه ای و دو بار در هفته اجرا شد. گروه گواه صرفاً برنامهٔ روتین مرکز را دریافت کرد. داده ها با نرم افزار spss نسخهٔ 21 و آزمون آماری تی، کای دو، لون، شاپیروویلک، لامبدای ویلکز، تحلیل کوواریانس چندمتغیری و آزمون تعقیبی بن فرونی در سطح معنا داری 0٫05 تجزیه وتحلیل شدند.یافته ها: نتایج نشان داد که تفاوت میانگین در پس آزمون گروه های آزمایش، در متغیرهای ارتقای مهارت های شناختی، اجتماعی و فعالیت های روزمرهٔ زندگی بیشتر از پس آزمون گروه گواه بود و بین دو گروه مداخله (تیچ) و نوروفیدبک با گروه گواه تفاوت معناداری وجود داشت (0٫001>p). همچنین بین تاثیر دو روش مداخله بر متغیرهای ارتقای مهارت های شناختی، اجتماعی و فعالیت های روزمرهٔ زندگی کودکان مبتلابه اختلال طیف اتیسم، تفاوت معنادار نبود.نتیجه گیری: براساس یافته های این پژوهش، مداخلات درمانی آموزشی و نوروفیدبک بر ارتقای مهارت های شناختی، اجتماعی و فعالیت های روزمرهٔ زندگی در کودکان مبتلابه اختلال طیف اتیسم تاثیر داشته اند ولی بین دو روش مداخله در این پژوهش، تفاوت معنا داری در میزان اثرگذاری بر متغیرهای وابسته مشاهده نشد.

Comparison of the Effectiveness of Treatment and education for autistic and related communication handicapped children (TEACCH) and Neurofeedback on the Promotion of Cognitive, Social, and Daily Living Activities in Children with Autistic Spectrum Disorders

Background & Objective: Autism spectrum disorders are a group of disorders that the fifth edition of the diagnostic and statistical guide of mental disorders has presented it into the neurodevelopmental classification which begins before the age of 3 and in a growth period and various genetic and environmental factors lead to the outbreak of this disorder. Children with autism have problems correlating with cognitive skills. Mental disability is perceived in 80% of these individuals (IQ less than 70). Other problems the individuals are dealing with are socializing and interacting with others in a meaningful and productive way in life stages and impairment in executive functions. There are different interventional methods for the treatment of autism. Two methods of treatment that have enticed the interest of researchers are the Treatment and education for autistic and related communication handicapped children (TEACH) and Neurofeedback. Parents of children with autism spectrum disorders and their educators should consider which therapeutic intervention is the most effective and appropriate one according to the status of disorder. Pursuant to the experimental and theoretical shortage in this area and considering the fact that these children are at a growing age, effectiveness plans have greatly empowered them and prevented the recurrence of their problems. Therefore, the purpose of the present study was to compare the effectiveness of the TEACH and neurofeedback method focusing on the promotion of cognitive, social skills, and daily activities in children with autism disorder.Methods: The research method was halfexperimental with pretestposttest design with the control group. The statistical population included 712yearold children with Autism spectrum, in which 45 eligible individuals and volunteers were selected random sampling and divided into two groups of interventioneducational and neurofeedback intervention and a control group of 15 individuals. Inclusion criteria were: diagnosis of autism by a psychiatrist, age 712 years, absence of seizure or control of it, having a moderate to high functional level by administering ASSQ questionnaire, and filling out the consent form by parents. The tools were Autism Domain Assessment Questionnaire (1999), the revised Wechsler intelligence scale (1969), TRIAD social skill assessment (2010), and the WaismanADL scale (2013). In addition to the center training programs, the TEACH method and neurofeedback interventions were performed individually in 20 sessions for 45 minutes and twice a week. The control group received only the routine center program. The obtained data were analyzed using SPSS 21 software and assessed Ttest, chisquare test ShapiroWilk test, Leven’s test, LambdaWilks test, multivariate analysis of covariance, and Bonferroni’s followup test. All tests evaluated at the 0.05 level.Results: The ttest and chisquare test showed that the subjects were homogeneous in terms of age and gender (P=0.005). By using ShapiroWilk, Leven, and Lambda Wilks tests, the covariance test hypotheses confirmed. The results of the analysis of covariance showed that intervention methods (functional behavior analysis and neurofeedback) were effective on a linear combination of dependent variables, and there was a significant difference between the mentioned groups (p<0.001). Also, the Bonferroni’s followup test indicated that among the groups that received training and therapy with the groups were in neurofeedback training; there was no significant difference in the variance of cognitive skills with potential and social skills with the probability and daily activities with potential. But, in all three dependent variables, there was a significant difference between the two experimental groups and a control group (p<0.001).Conclusion: According to the findings of this study, it can be concluded that both TEACH and Neurofeedback treatment methods have significant effects on cognitive and social skills and daily activities in children with autism and opting appropriate therapies depends on the environmental conditions and facilities of schools and institutes as well as parents’ needs.