بررسی مقایسه‌ای عوامل توانایی فضایی در کودکان با و بدون اختلال نارسایی توجه/فزون‌کنشی

زمینه و هدف: اختلال نارسایی توجه/فزون‌کنشی با نقایصی در کارکردهای شناختی ازجمله توانایی فضایی همراه است؛ بنابراین هدف این مطالعه بررسی تفاوت‌های موجود در عوامل فضایی در کودکان با و بدون اختلال نارسایی توجه/فزون‌کنشی بود.روش‌بررسی: در این پژوهش توصیفی‌تحلیلی 64 کودک با اختلال نارسایی توجه/فزون‌کنشی با تشخیص روان‌پزشک کودک و براساس ملاک‌های dsm-5 در شهر تهران در سال 1398 شرکت کردند. آن‌ها با شیوهٔ نمونه‌گیری از نوع هدفمند و به‌صورت دردسترس انتخاب شدند؛ همچنین 64 کودک بدون اختلال به‌عنوان گروه گواه در نظر گرفته شدند. عوامل فضایی ازطریق تکالیف توانایی فضایی تهیه‌شده توسط سلوکی و همکاران (2020) ارزیابی شد. هر تکلیف، متغیر‌های مختلفی را نظیر دقت پاسخ و زمان واکنش در بر گرفت که برای مقایسهٔ آن‌ها در کودکان دو گروه از آزمون یومن‌ویتنی استفاده شد. داده‌ها با استفاده از نرم‌افزار spss نسخهٔ 24 در سطح معنا‌داری 0٫05 تجزیه‌وتحلیل شدند.یافته‌ها: کودکان با اختلال نارسایی توجه/فزون‌کنشی درمقایسه با کودکان بدون اختلال نمرهٔ دقت کمتری در تکالیف انعطاف‌پذیری بستن (0٫001>p)، سرعت بستن (0٫001>p)، سرعت ادراک (0٫001>p)، تجسم‌سازی (0٫001>p)، روابط فضایی (0٫001>p)، جهت‌یابی فضایی (0٫001>p) و در فاز حافظۀ نشانه‌های تکلیف مسیریابی (0٫002=p) داشتند. دو گروه به‌لحاظ میانگین زمان واکنش در تکالیف تجسم‌سازی (0٫001>p)، روابط فضایی (0٫001>p) و جهت‌یابی فضایی (0٫005=p) تفاوت معناداری با یکدیگر داشتند.نتیجه‌گیری: باتوجه به یافته‌های این پژوهش مبنی‌بر وجود نقایصی در عوامل مختلف توانایی فضایی در کودکان با اختلال نارسایی توجه/فزون‌کنشی، به‌نظر می‌رسد متخصصان توان‌بخشی شناختی باید عوامل هشت‌گانهٔ توانایی فضایی را در ارزیابی این کودکان مدنظر قرار دهند.

Comparing the Spatial Ability Factors in Children With and Without Attention-Deficit/Hyperactivity Disorder

Background & Objectives: Attention–Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder, diagnosed by the symptoms of inattention, hyperactivity, and impulsivity. Moreover, ADHD can cause deficits in at least two daily living activities. ADHD is associated with deficits in cognitive functions. Despite increasing research interest in ADHD, a consensus is lacked on the specific cognitive deficits that underlie ADHD. From one aspect of the neuropsychological etiology of ADHD, numerous studies that investigated neural impairments in children with ADHD have consistently pointed to anatomical and functional defects in the Intraparietal Lobe (IPL). It has been supported that the parietal lobe underlies different aspects of attention while its essential role in processing spatial information cannot be ignored. Thus, the present study aimed to explore differences in Spatial Ability (SA) factors in children with and without ADHD.Methods: In total, 128 girls and boys aged 9 to 12 years participated as two with and without ADHD groups in this cross–sectional study in Tehran City, Iran, in 2018. Furthermore, 64 children in the ADHD group (14 girls & 50 boys) who have been diagnosed by child psychiatrists according to the Diagnostic and Statistical Manual of Mental Disorders–Fifth Edition in Rofeide Hospital and a private clinic were selected through convenience sampling method. The group of children without ADHD involved 64 children (29 girls, 35 boys) who were selected through a multistage sampling approach from two elementary schools. The inclusion criteria for the ADHD group was obtaining scores >60 in the Revised Conners’ Parent Rating Scale (1998); the same for the Typically–Developing (TD) group was achieving scores <38. The exclusion criteria for both study groups included the presence of intellectual disability, autism spectrum disorders, physical conditions (i.e., visual & hearing impairments, cardiovascular, rheumatic, & orthopedic diseases), neurological disorders, and the regular use of medications except for methylphenidate. A reliable battery of SA tasks designed by Soluki et al. (2020) was used for measuring all factors (i.e., the flexibility of closure, closure speed, perceptual speed, visualization, spatial relation, spatial orientation, spatial–temporal ability, and wayfinding tasks). Statistical analysis was performed using SPSS. The Mann–Whitney U test was used to compare the between–group differences. The significance level of the tests was set at 0.05.Results: Mann–Whitney U test results indicated the poorer performance of children with ADHD, compared to the TD children in SA tasks, including, the flexibility of closure (p=0.036), closure speed (p<0.001), perceptual speed (p<0.001), visualization(p<0.001), spatial relation (p<0.001), spatial orientation (p<0.001), spatial–temporal (p<0.001), and memory of landmark phase of wayfinding (p=0.002) tasks. Additionally, the number of trials in the learning path (p=0.007) and walked path in the short distance phase of the wayfinding task were higher in the ADHD group (p=0.004), compared to the TD group. There was no significant difference in the performance of the two groups concerning the spatial–temporal ability task (p=0.199). In addition, the research groups were significantly different in the mean scores of reaction time in visualization (p<0.001), spatial relation (p<0.001), and spatial orientation (p=0.005) tasks. Conclusion: The current research results revealed that children with ADHD encounter defects in all 8 factors of SA, except for spatial–temporal ability. Considering the importance of SA, it seems necessary for the specialists to include the assessment of all SA factors and training them in cognitive rehabilitation programs for children with ADHD.