Razi Journal of Medical Sciences

fa مقایسه تاثیر بازی‌درمانی شناختی، آموزش رفتاری مادران، آموزش کلامی کودکان بر بهبود نشانگان اختلال نارسایی توجه و بیش فعالی کودکان 8-10 ساله Comparison of the effect of Play Therapy Based on Cognitive-Behavioral Model and mothers Behavior teaching and children verbal teaching on the Improvement of Attention Deficit/Hyperactivity Disorder Symptoms in 8-10 years old children روانشناسی بالینی Clinical Psychiatry پژوهشي Research <div style="text-align: justify;">زمینه و هدف: اختلال نارسایی توجه‌- بیش‌فعالی یکی از شایع‌ترین اختلالات روان‌پزشکی دوران کودکی است. هدف پژوهش حاضر مقایسه تاثیر بازی درمانی شناختی، آموزش رفتاری مادران، آموزش کلامی کودکان بر بهبود نشانگان اختلال نارسایی توجه و بیش فعالی کودکان 8-10 ساله بود. روش‌کار: روش پژوهش حاضر نیمه‌تجربی (پیش‌آزمون- پس‌آزمون) با استفاده از سه گروه آزمایش و یک گروه کنترل بود. به همین منظور، 60 نفر از کودکان و مادران کودکان پسر دارای اختلال نقص توجه و بیش فعالی با دامنه سنی 8-10 ساله مراجعه‌کننده به مرکز درمانی روان‌شناختی شهر خوی (روان آرام) که براساس تشخیص روان‌پزشک و پرسشنامه‌ی کانرز (فرم والدین) دارای این اختلال تشخیص داده شده‌اند به روش نمونه‌گیری هدفمند انتخاب و در سه گروه‌ آزمایش و  یک گروه کنترل(برای هر گروه تعداد مساوی 15 نفر) جایگزین شدند. سپس گروه‌های آزمایش به مدت ۸ جلسه (هفته‌ای دو جلسه 45 ‌دقیقه‌ای) تحت آموزش به روش بازی‌درمانی شناختی، آموزش رفتاری مادران، آموزش کلامی کودکان قرار گرفتند. در طی این مدت بر روی گروه کنترل هیچ مداخله‌ای صورت نگرفت. همۀ آزمودنی‌ها پیش از آغاز آموزش و پس از آن، مقیاس مشکلات رفتاری کودکان کانرز فرم والدین (1978) را پر کردند. جهت تجزیه و تحلیل داده‌ها از روش تجزیه و تحلیل کوواریانس چندراهه استفاده شد. یافته‌ها: نتایج نشان داد که میانگین نمرات کل اختلال نارسایی توجه و بیش فعالی در گروه آموزش رفتاری مادران نسبت به گروه بازی درمانی شناختی و در گروه  بازی درمانی شناختی نسبت به گروه آموزش کلامی کودکان و در گروه آموزش کلامی کودکان نسبت به گروه کنترل در پس‌آزمون به طور معنی‌داری کاهش یافته است (05/0p<). نتیجه‌گیری: نتایج نشان داد که آموزش رفتاری مادران در کاهش علایم و نشانگان نقص توجه/ بیش فعالی کودکان ۱۰-۸ ساله موثرتر از بازی درمانی شناختی و آموزش کلامی کودکان است.</div> <div style="text-align: justify;">Background & Aims: Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in childhood. For this reason, researchers have been looking for ways to achieve maximum beneficial effects, minimum side effects and negative consequences in the treatment of these people, among which can be mentioned play therapy. Play gives children the opportunity to express their feelings freely and to use symbols to make up for their problems in reality, to find solutions to them, and to make up for the situations they may encounter through play. Play therapy directly and indirectly encourages spontaneity (10). Play therapy has been used by various psychologists and researchers for decades to treat a wide range of disorders and problems and its effectiveness has been demonstrated (12-18). Speech therapy is another cognitive-behavioral therapy program in which children are taught to change their undesirable behavior by talking to themselves [20]. The results of some studies [24-27] indicate that verbal education has improved the symptoms of Attention Deficit / Hyperactivity Disorder. On the other hand, some studies [32-34] showed that parental behavioral education played an important role in reducing child disorders and increasing the self-confidence of parents of children with ADHD. Parental Behavior Education, which is based on the principles of social learning, teaches parents that by recognizing the occurrences and consequences of their children's inappropriate behaviors, identifying them, how to monitor these behaviors, deliberately ignoring and planned, temporary deprivation and other non-corporal techniques without punishment Physically change their children's behaviors, reinforce appropriate behaviors through attention, verbal encouragement, and reward to achieve desired behaviors. [35] Therefore, The aim of present research is to study the Comparison of Effectiveness of Play Therapy Based on Cognitive-Behavioral Model and mothers Behavior teaching and children verbal teaching on the Improvement of Attention Deficit/Hyperactivity Disorder (ADHD) Symptoms in 8-10 years old children. Methods: A Semi-experimental design was conducted (pre-test and post-test) with three experimental and one control groups. For this purpose, 60 children and mothers of boys with attention deficit hyperactivity disorder with an age range of 10-8 years referred to Khoy Psychiatric Treatment Center (Calm mind) who based on the diagnosis of a psychiatrist and Connors questionnaire (parent form) have this The diagnosed disorders were selected by purposive sampling and replaced in three experimental groups and one control group (equal to 15 people in each group). Then the experimental groups were trained in cognitive play therapy and mothers Behavior teaching and children verbal teaching for 8 sessions (Week, 45-minute two-session) and the control group did not receive any training. Prior and after the training, the subjects completed Connors Children's Behavioral Problems Scale - Parent Form (40). Multivariate analysis of covariance was used to analyze the data. Results: The results showed that the mean scores of Attention Deficit / Hyperactivity Disorder in the mothers Behavior teaching group compared to the cognitive play therapy group and in the cognitive play therapy group compared to the verbal education group and in the verbal education group compared to the control group in the post-test decreased significantly (Table 4). Conclusion: The results showed that mothers Behavior teaching is more effective than cognitive play therapy and children verbal teaching in reducing symptoms of attention deficit / hyperactivity disorder in children aged 8-10 years. There is no report in the research literature on comparing the effectiveness of these trainings on the improvement of attention deficit hyperactivity disorder and hyperactivity disorder in children aged 8-10 years; But the obtained result is consistent with the results of studies (7, 11-18, 24-27, 36-39). According to the results of this study and its confirmation through previous studies, the use of cognitive play therapy along with verbal education of children and behavioral education of mothers is suggested as an effective and combined program to reduce the symptoms and symptoms of attention deficit / hyperactivity disorder in children. 10-8 years old, especially children with ADHD in kindergartens and primary schools, by all psychologists of welfare centers, counseling and treatment in the country with the aim of guiding and helping teachers and parents of these children to prevent many behavioral problems of children, considered by education officials And special clinics for children with ADHD.  </div> بازی درمانی شناختی, آموزش رفتاری مادران, آموزش کلامی کودکان, اختلال نارسایی توجه و بیش فعالی Play Therapy Based on Cognitive-Behavioral Model, Mothers Behavior Teaching, Children Verbal Teaching, Attention Deficit / Hyperactivity Disorder (ADHD) 110 124 http://rjms.iums.ac.ir/browse.php?a_code=A-10-5902-1&slc_lang=fa&sid=1 Hamdolah Zeynali حمداله زینالی zeynali.psy.1356@gmail.com 3900319475328460061731 3900319475328460061731 No Department of Psychology, Tabriz Branch, Islamic Azad University, Tabriz, Iran واحد تبریز، دانشگاه آزاداسلامی، تبریز، ایران Amir Panahali امیر پناه علی zeynali.psy.1356@gmail.com 3900319475328460061732 3900319475328460061732 Yes Department of Psychology, Tabriz Branch, Islamic Azad University, Tabriz, Iran. واحد تبریز، دانشگاه آزاداسلامی، تبریز، ایران Marziye Alivandi Vafa مرضیه علیوندی وفا zeynali.psy.1356@gmail.com 3900319475328460061733 3900319475328460061733 No Department of Psychology, Tabriz Branch, Islamic Azad University, Tabriz, Iran. واحد تبریز، دانشگاه آزاداسلامی، تبریز، ایران