تاثير آموزش نوروفيدبك بر علائم كودكان مبتلا به اختلال نارسايي توجه / فزون كنشي

Teaching Neurofeedback on the Symptoms of Children Suffering from Attention Deficit- Hyperactivity Disorder

زمينه و هدف اختلال نارسايي توجه / فزون كنشي، شايع ترين اختلال روان پزشكي دوران كودكي از نظر ميزان مراجعه به مراكز خدمات درماني است. پژوهش حاضر به منظور تعيين تاثير آموزش نوروفيدبك بر علائم كودكان مبتلا به اختلال نارسايي توجه يا فزون كنشي انجام شد. روش بررسي طرح پژوهش از نوع نيمه تجربي پيش آزمون-پس آزمون با گروه گواه بود. جامعه آماري پژوهش حاضر، كودكان مبتلا به اختلال نارسايي توجه / فزون كنشي بودند؛ به همين منظور تعداد سي كودك پنج تا دوازده ساله مبتلا به اختلال نارسايي توجه / فزون كنشي، به صورت در دسترس انتخاب شدند و به صورت تصادفي در دو گروه آزمايش و گواه (هر گروه پانزده نفر) تخصيص يافتند. بعد از انجام دادن پيش آزمون، برنامه مداخله اي (آموزش نوروفيدبك) به مدت بيست جلسه يك ساعته اجرا شد. سپس پس آزمون گرفته شد. براي انجام دادن پيش آزمون ها و پس آزمون ها از فرم والد پرسش نامه علائم مرضي كودكان (CSI-4)، (گاداو و اسپرافكين، 1994) استفاده شد. از آزمون هاي خي دو، تي مستقل، شاپيرو ويلك، لوين، تحليل كوواريانس، تي زوجي و نرم افزار SPSS نسخه 23 براي تجزيه وتحليل داده ها استفاده شد. همچنين سطح معنا داري براي تمام آزمون هاي آماري، كمتر از 0٫05 بود. يافته ها نتايج نشان داد آموزش نوروفيدبك بر علائم كودكان مبتلا به اختلال نارسايي توجه يا فزون كنشي باعث بهبود ميانگين نمرات در سه خرده مقياس، نوع نارسايي توجه غالب در مرحله پيش آزمون از 3٫28±13٫20 به 1٫93±6٫20 در مرحله پس آزمون، در نوع غالب فزون كنشي تكانشگري در مرحله پيش آزمون از 3٫04±15٫00 به 2٫63±10٫06 در مرحله پس آزمون و در نوع سندروم كامل در مرحله پيش آزمون از 4٫83±28٫33 به 3٫86±16٫26 در مرحله پس آزمون شد (0٫001>p). نتيجه گيري با توجه به نتايج پيشنهاد مي شود از آموزش نوروفيدبك به عنوان يك روش اثربخش در كنار ساير روش هاي درماني براي كاهش نشانه هاي اختلال نارسايي توجه / فزون كنشي كودكان استفاده شود.

Background & Objective: Attention deficit hyperactivity is one of the most common childhood disorders, which has recently attracted the attention of psychiatrists and psychologists. The main characteristics of this disorder include inability to control motor behavior, learning disability, aggression, educational problems, impulsiveness and motor restlessness. The present study was aimed to determine effect of teaching neurofeedback on symptoms of children suffering from attention deficit–hyperactivity disorder. Methods: Present research was a pretest–posttest study with a control group. In terms of using the results, it was an applied study. The statistical population included the children with attention deficit hyperactivity disorder (ADHD), who were selected using the list of the clients who had referred to Refah Clinic in Tehran over a period of 2 months and were diagnosed with ADHD by a psychiatrist. Convenience sampling method was used to select the study sample that consisted of 30 children (girls and boys) in an age range of 5–10 years. The subjects were selected based on the study’s objectives and the inclusion criteria, which were definitive diagnosis of ADHD by a psychiatrist based on DSM–IV criteria, completion of the written consent to participate in the study by the subjects’ families, age range of 5–12 years, lack of other attention deficit hyperactivity disorders, lack of receiving any other special treatments such as medication. Afterwards, in order to observe ethical considerations, the study’s objectives were explained to the parents and confidentiality of the subjects’ information was assured, the parents entered the study following their complete satisfaction, and they were ensured that their children would not harm at all. After the parents were familiarized with the clinical and research aims by the researcher, they filled out the participation consent form. The 30 chosen children were randomly assigned into two groups (15 children in the neurofeedback training group and 15 in the control group). After the desired sample was obtained, the child symptom inventory–4 (CSI–4) was distributed among the parents as the pretest, and they were required to fill it out. After a week, the experimental group received an intervention program for 20 sessions (every session lasted an hour and was held twice a week). Results: The results obtained from comparing the neurofeedback means of the experimental group in the pretest and posttest stages indicated that the symptoms of attention deficit hyperactivity disorder had a significant decrease in the posttest phase (16.26) compared to the pretest phase (28.33). In the control group; however, the neurofeedback means in the pretest (28.73) and posttest (28.93) had no significant difference. In fact, the results of the present study showed that neurofeedback training led to a decrease in ADHD symptoms (p<0.001). Conclusion: The present study showed that neurofeedback training had a positive impact on the symptoms of children with attention deficit hyperactivity disorder (ADHD). In fact, the results of the present study can theoretically be the basis for the effect mechanism of this method among children with ADHD, and they can practically be a guidance for trainers and those who work with such children. Therefore, it is recommended that this effective method be utilized along with other therapeutic methods in order to reduce ADHD symptoms among children.