Razi Journal of Medical Sciences

fa مقایسه اثربخشی روش یکپارچگی حسی و روش سازماندهی مجدد اعصاب مرکزی بر توانایی نگهداری ذهنی دانش آموزان دارای اختلال یادگیری خاص Comparison of the Effectiveness of Sensory Integration Method and Central Nervous System Reorganization Method on Mental Maintenance Ability of Students with Special Learning Disorder روانشناسی بالینی Clinical Psychiatry پژوهشي Research <div style="text-align: justify;">زمینه و هدف: اختلال یادگیری، اختلالی عصبی رشدی در کودکان که به علت عوامل ژنتیکی و محیطی ایجاد و بر عملکرد مغز در حیطه‌های درک و پردازش اطلاعات کلامی و غیرکلامی تأثیر می‌گذارد؛ بنابراین شناسایی روشهای مداخلهای تعیین کننده در این حوزه دارای اهمیت است. هدف از پژوهش حاضر مقایسه اثربخشی روش یکپارچگی حسی و روش سازمان‌دهی مجدد اعصاب مرکزی بر نگهداری ذهنی دانش‌آموزان دارای اختلال یادگیری خاص بود. </div> <div style="text-align: justify;">روش کار: جامعه آماری این پژوهش شامل کلیه دانش‌آموزان دارای اختلال یادگیری خاص مراجعه‌کننده به مراکز اختلال یادگیری شهرستان رفسنجان در سال تحصیلی 1400-1399 بودند که تعداد 90 نفر  با استفاده از روش نمونه‌گیری هدفمند انتخاب و بصورت تصادفی در سه گروه یکپارچگی حسی، سازمان‌دهی مجدد اعصاب مرکزی و گروه کنترل جایگزین شدند. ابزار پژوهش شامل تکلیف نگهداری ذهنی مایع که توسط بوگارد و روس (1991) بود. تجزیه و تحلیل داده ها با استفاده از اندازه گیری مکرر با طرح مختلط و تحلیل واریانس چند متغیره به کمک نرافزار spss-24  انجام گرفت. یافته‌ها: یافته ها نشان داد که  اثر گروه (کنترل، یکپارچگی حسی و سازمان‌دهی مجدد اعصاب مرکزی)، در مولفه نگهداری ذهنی (01/0p< و 99/70 = F) معنیدار می‌باشد، لذا تفاوت آشکاری بین نگهداری ذهنی سه گروه  و بین اثربخشی روش‌های آموزشی با در نظر گرفتن اختلال‌های یادگیری وجود دارد. همچنین آموزش یکپارچگی حسی بر افزایش نگهداری ذهنی دانش‌آموزان دارای اختلال یادگیری خاص اثرگذار بوده است. از سویی دیگر تفاوت بین دو گروه یکپارچگی حسی و روش سازمان‌دهی مجدد اعصاب معنی‌دار می‌باشد؛ بنابراین این دو مداخله بر افزایش نگهداری ذهنی دانش‌آموزان اثربخشی متفاوتی داشته‌اند؛ به نحوی که تأثیرات گروه یکپارچگی حسی بر افزایش نگهداری ذهنی دانش‌آموزان بیش از گروه سازمان‌دهی مجدد اعصاب مرکزی بوده است. نتیجه‌گیری: بر اساس این یافتهها میتوان نتیجه گرفت که روش‌های یکپارچگی حسی و سازماندهی مجدد اعصاب در افزایش نگهداری ذهنی دانشآموزان با اختلال یادگیری خاص اثربخش بوده و این اثربخشی در آموزش گروه یکپارچگی حسی نسبت به سازماندهی مجدد اعصاب در توانایی نگهداری ذهنی بالاتر و بیشتر است. <a name="_Hlk81950314"></a></div> <div style="text-align: justify;">Background & Aims: Learning disorder is a neurodevelopmental disorder in children that occurs due to genetic and environmental factors and affects brain function in the areas of understanding and processing verbal and non-verbal information; therefore, it is important to identify decisive intervention methods in this field. Learning disability is one of the most controversial topics of exceptional education. One of the goals of educational systems is to raise the level of students' ability to increase the academic efficiency of learners. According to the Statistical Manual of Mental Disorders, a learning disability has been renamed to a specific learning disability, and reading disorder, writing disorder, and math disorder, each of which was once a distinct and independent disorder, are now considered to specify a specific learning disorder. A neurodevelopmental disorder in children that is caused by genetic and environmental factors and affects brain function in the areas of understanding and processing verbal and non-verbal information; in a way that lasts at least 6 months. This disorder leads to problems in learning and using academic skills in the form of carelessness, poor comprehension, slow reading, difficulty in spelling, problems in written expression, problems in mastering the meaning of numbers or calculations, and problems in mathematical reasoning. These problems are not related to mental retardation, developmental delay, uncorrected vision or hearing problems, or movement or neurological disorders, they are specifically meant in this way. In the education and treatment of learning disorders, one of the most important methods introduced is the sensory integration method. Sensory integration refers to processes whose information enters the brain through the eyes, ears, mouth, nose, skin, muscles, joints, and sense of balance. Ayres presented a theory called sensory integration to relate behavior and neural function, especially sensory information, which examines the specific connections of neural function, sensorimotor behavior, and academic learning in a hypothetical framework, and aims to find specific patterns of dysfunction in Children with learning and sensory problems and special treatment methods for these groups. The method of sensory integration is a neurological flow that receives and organizes sensory information from the body and the environment of a person and uses it for more effective and better functioning in the environment. This method leads to the improvement of excellent brain functions and the abstract levels of the brain from which mathematics is applied; increasing and thus improving the educational efficiency of this student. This intervention engages the child's senses with exercises in the form of a game, and this situation helps coordination and precision in the functioning of the child's senses. Agent concentration is important in maintaining integrity and improving learning performance, so it can play an effective role in improving reading and writing disorders. The basic premise of this educational method is that children with learning disorders have problems in these sensory pathways. Much research has been done on the effectiveness of this educational method in children with learning disabilities and its effectiveness has been confirmed. The purpose of this study was to compare the effectiveness of the sensory integration method and the central nervous system reorganization method on the explicit and implicit memory of students with specific learning disabilities. Methods: The present study was a pre-test-post-test experiment with a control group and a follow-up period in terms of its practical purpose and design. The statistical population of the research included all students with specific learning disorders (reading/writing, math, and mixed disorders) who were referred to educational and clinical centers in Rafsanjan city in the academic year of 2020-2021, 90 of them were selected using the purposeful sampling method. Completely randomly, they were replaced in three experimental groups of 30 people, including the sensory integration group, the central nervous reorganization experimental group, and the control group. The research tools included the mental fluid maintenance task of Bogard and Rus (1991) and experimental groups of sensory integration training protocol (for 12 sessions and 90 minutes each session) and central nervous system reorganization protocol (for 8 sessions of 90 minutes each session). Data analysis was also done using repeated measurement with mixed design and multivariate analysis of variance using SPSS-24 software. Results: The Results showed that the effect of the group (control, sensory integration, and reorganization of the central nerves) was significant in the component of mental maintenance (p<0.01 and F=70.99). Also, the effect of disorder (reading/writing, math, and mixed) in mental maintenance (p>0.05 and F = 0.716) is not significant, so there is no significant difference between the scores of the groups according to learning disorders. Also, in the between-case factor of the interaction of the group and disorders (reading/writing, math, and mixed), the mental maintenance component (p<0.05 and F=2.85) is significant, and there is a significant difference between the effectiveness of educational methods considering learning disorders. The way that effects of the sensory integration group on the students' mental maintenance ability were more than the central nervous system reorganization group. Conclusion: The present study, like other studies, had limitations, including the uncontrollability of some important psychological factors, such as emotional characteristics and personality traits, along with the biological-neurological foundations involved in specific learning disorders. Considering that the research was carried out in a learning disorder center, generalizing the results to wider groups and different educational levels should be done with caution. Also, the specificity of the research sample only to students with learning disorders in Rafsanjan city limits the generalization of the results to other groups and cultures. Therefore, it is suggested that similar research should be evaluated for other students with special needs with wider samples, students in different educational levels, and different cities and cultures. On the one hand, it is suggested that clinical, educational, and exceptional specialists in the fields of occupational therapy, learning promotion, educational counseling, guidance centers, learning disorders centers, school health centers, and educators use the results of this study to help children with learning disabilities. Based on these findings, it can be concluded that the methods of sensory integration and nerve reorganization are effective in increasing the mental retention of students with specific learning disorders, and this effectiveness in the training of the sensory integration group is more than nerve reorganization. It is higher and more in the ability to keep the mind. Therefore, it is suggested that clinical, educational, and exceptional specialists use the method of integrated sensory interventions and nerve reorganization for students in different educational levels and cultures with learning disabilities. </div> اختلال یادگیری خاص, نگهداری ذهنی, سازمان‌دهی مجدد اعصاب مرکزی, یکپارچگی حسی Specific Learning Disorder, Mental Maintenance, Central Nervous System Reorganization, Sensory Integration 259 269 http://rjms.iums.ac.ir/browse.php?a_code=A-10-7846-1&slc_lang=fa&sid=1 Fatemeh Akhlaghi Yazdinejad فاطمه اخلاقی یزدی نژاد 3900319475328460077466 3900319475328460077466 No PhD in Clinical Psychology, Department of Psychology, Rafsanjan Branch, Islamic Azad University, Kerman, Iran. دکترای تخصصی روانشناسی بالینی، گروه روانشناسی، واحد رفسنجان، دانشگاه آزاد اسلامی، کرمان، ایران. Changiz Rahimi چنگیز رحیمی chrahimi@shirazu.ac.ir 3900319475328460077467 3900319475328460077467 Yes Professor; Department of Clinical Psychology, Shiraz University, Shiraz, Iran. استاد، گروه روانشناسی بالینی، دانشگاه شیراز، شیراز، ایران Nourallah Mohammadi نوراله محمدی 3900319475328460077468 3900319475328460077468 No Professor; Department of Clinical Psychology, Shiraz University, Shiraz, Iran. استاد، گروه روانشناسی بالینی، دانشگاه شیراز، شیراز، ایران.