Effectiveness of a Cognitive Rehabilitation-Based Intervention on Cognitive Flexibility and Stereotyped Behaviors in Children with Autism Spectrum Disorder
Keywords:
Autism, Stereotyped Behaviors, Cognitive Flexibility, Cognitive Rehabilitation, Based InterventionAbstract
Purpose: The present study aimed to examine the effectiveness of a cognitive rehabilitation-based intervention on cognitive flexibility and stereotyped behaviors in children with autism spectrum disorder.
Methods and Materials: This study employed a quasi-experimental design with a pretest–posttest control group framework. The statistical population included all children aged 9 to 12 years with autism attending rehabilitation centers in Tehran in 2024. From this population, 30 participants were selected through convenience sampling and were randomly assigned to experimental and control groups. The research instruments included the Cambridge Neuropsychological Test Automated Battery (CANTAB) and the Gilliam Autism Rating Scale (GARS). The experimental group received cognitive rehabilitation intervention over eight sessions, while the control group received no intervention during the study period. Data were analyzed using analysis of variance (ANOVA) and the Kolmogorov-Smirnov test.
Findings: The findings indicated that the cognitive rehabilitation intervention significantly increased cognitive flexibility (p < 0.01) and decreased stereotyped behaviors (p < 0.05) in the experimental group compared to the control group.
Conclusion: These results support the effectiveness of cognitive rehabilitation in enhancing cognitive and behavioral functioning in children with autism spectrum disorder and suggest its potential use as a complementary method in therapeutic programs for these children.
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Aghili, S. M., Asghari, M., & Namazi, H. (2022). The effectiveness of music therapy on aggression and stereotyped behaviors in children with autism spectrum disorder. Exceptional Children Quarterly, 22(1), 143-154. https://joec.ir/browse.php?a_id=1561&sid=1&slc_lang=en
Ansari, M., Hojjati, S., Elmieh, N., & Beidabadi, R. (2019). A study of stereotyped and repetitive behaviors in children with autism spectrum disorder. Journal of Neurological Disorders, 14(3), 123-131.
Bazrafshan, A., & Sadeghi, L. (2021). Cognitive and psychological consequences of autism spectrum disorder in children. Sadra Medical Sciences Journal, 9(2), 120-131.
Boyd, B. A., McDonough, S. G., & Bodfish, J. W. (2011). Evidence-based behavioral interventions for repetitive behaviors in autism. Journal of Autism and Developmental Disorders, 42(6), 1236-1248. https://doi.org/10.1007/s10803-011-1284-z
De Vries, M., Prins, P. J. M., Schmand, B. A., & Geurts, H. M. (2015). Working memory and cognitive flexibility-training for children with an autism spectrum disorder: a randomized controlled trial. Journal of Child Psychology and Psychiatry, 56(5), 566-576. https://doi.org/10.1111/jcpp.12324
Emad, V., Bagherzadeh, M., Mohammadi, A., & Aghayari, H. (2023). Comparing the effectiveness of sensory integration exercises with and without robots on stereotyped behaviors in boys with autism spectrum disorder. SID Scientific Journal, 12(1), 151-160. https://doi.org/10.32598/SJRM.12.1.14
Fathi, F., Naderi, H., & Hosseini, R. (2018). The effect of cognitive rehabilitation on reducing stereotyped behaviors in children with autism spectrum disorder. Iranian Journal of Psychological Rehabilitation, 7(2), 25-38.
Ghasemi, M., Zarei, M., & Rahimi, C. (2019). The effect of task-based cognitive rehabilitation program on executive functioning in children with epilepsy. Iranian Journal of Clinical Psychiatry and Psychology, 25(3), 243-256.
Hadjkacem, L., Ayadi, H., Turki, M., & Yaich, S. (2016). Effects of Neurofeedback on Cognitive and Behavioral Issues in ASD. [Unavailable].
Hillman, H. (2021). Child-centered play therapy as an intervention for children with autism: A literature review. https://psycnet.apa.org/record/2018-44224-002
Hyun, J., & C, S. K. (2016). Education-oriented Music Therapy as an After-school Program for Students with Emotional and Behavioral Problems. Arts in Psychotherapy, 37(3), 190-196. https://doi.org/10.1016/j.aip.2010.03.004
Jafari, R., & Yousefi, R. (2023). The effectiveness of social cognition training based on theory of mind on stereotyped behaviors, social interaction, and empathy in children with autism spectrum disorder. Tabriz University Psychology Journal, 18(1), 129-146. https://psychologyj.tabrizu.ac.ir/article_16944_30ea8f2366e42cca4192d031c63379c2.pdf
Jafari, S., Parizad, N., Radfar, M., & Khalkhali, H. (2022). The effect of culturally adapted play therapy with parental involvement on stereotyped behaviors in children with autism. Nursing and Midwifery Journal of Urmia University of Medical Sciences, 20(2), 125-136. https://doi.org/10.52547/unmf.20.2.125
Kaplan, H., & Sadock, B. (2015). Kaplan and Sadock's Synopsis of Psychiatry. Elmi Publishing.
Karna, W., & Stefaniuk, I. (2024). The Influence of Peer Relationships on the Social Development of Children with Autism Spectrum Disorder. Iranian Journal of Neurodevelopmental Disorders, 2(4), 10-18. https://doi.org/10.61838/kman.jndd.2.4.2
Kenworthy, L., Anthony, L. G., Naiman, D. Q., Cannon, L., Wills, M. C., Luong-Tran, C., Werner, M. A., Alexander, K. C., Strang, J., Bal, E., Sokoloff, J. L., & Wallace, G. L. (2014). Randomized controlled effectiveness trial of executive function intervention for children on the autism spectrum. Journal of Child Psychology and Psychiatry, 55(4), 374-383. https://doi.org/10.1111/jcpp.12161
Khaleghi, A., Naderi, F., Johari-Fard, R., & Javadzadeh, M. (2023). Comparison of the effectiveness of task-based cognitive rehabilitation and computer-based cognitive rehabilitation programs on cognitive flexibility in children with epilepsy. Shafa Khatam Journal, 11(3). https://doi.org/10.61186/shefa.11.3.25
Lord, C., Elsabbagh, M., Baird, G., & Veenstra-Vanderweele, J. (2018). Autism spectrum disorder. The lancet, 392(10146), 508-520. https://doi.org/10.1016/S0140-6736(18)31129-2
Mahdavi, M., Ahmadi, H., & Ramazani, N. (2019). The effectiveness of cognitive rehabilitation on executive functioning and cognitive flexibility in children with autism spectrum disorder. Journal of Psychology and Educational Sciences, University of Tehran, 49(3), 275-292.
Miller, H. L., Ragozzino, M. E., Cook, E. H., Sweeney, J. A., & Mosconi, M. W. (2015). Cognitive Set Shifting Deficits and Their Relationship to Repetitive Behaviors in Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 45(3), 805-815. https://doi.org/10.1007/s10803-014-2244-1
Olivares, P. J. (2021). Response inhibition, cognitive flexibility and working memory in obsessive-compulsive disorder, generalized anxiety disorder and social anxiety disorder. International journal of environmental research and public health, 18(7), 3642. https://doi.org/10.3390/ijerph18073642
Pickles, A., Le Couteur, A., Leadbitter, K., Salomone, E., Cole-Fletcher, R., & Tobin, H. (2016). Parent-mediated social communication therapy for young children with autism (PACT): long-term follow-up of a randomized controlled trial. The lancet, 388(10059), 2501-2509. https://doi.org/10.1016/S0140-6736(16)31229-6
Rahman, A., Paul, R., & Sulaiman, N. (2017). Effects of cognitive behavioral intervention on repetitive behaviors among children with autism. Malaysian Journal of Health Sciences, 15(2), 10-18.
Ramezani, Z., & Zangeneh Motlagh, F. (2023). Prediction of life satisfaction based on resilience, coping styles and acceptance of sick children in parents with children with autism. Iranian Journal of Neurodevelopmental Disorders, 2(3), 1-10. https://maherpub.com/jndd/article/view/31
Rashmani, B., & Mojtabaie, M. (2023). The effectiveness of body language training using ABM method on the communication skills of autistic children. Iranian Journal of Neurodevelopmental Disorders, 2(3), 50-57. https://maherpub.com/jndd/article/view/36
Stuss, D. T., & Levine, B. (2002). Adult clinical neuropsychology: Lessons from studies of the frontal lobes. Annual review of psychology, 53(1), 401-433. https://doi.org/10.1146/annurev.psych.53.100901.135220
van Dongen-Boomsma, M., Vollebregt, M. A., Buitelaar, J. K., & Slaats Willemse, D. (2014). Working memory training in young children with ADHD: A randomized placebo-controlled trial. Journal of Child Psychology and Psychiatry, 55(8), 886-896. https://doi.org/10.1111/jcpp.12218
Varanda, C. A., & Fernandes, F. D. M. (2017). Cognitive flexibility training intervention among children with autism: a longitudinal study. Psicologia: Reflexão e Crítica, 30, 15. https://doi.org/10.1186/s41155-017-0069-5
Vosoughi Fard, F., Alizadeh Zarei, M., Kamali, M., & Nazari, M. A. (2013). The effect of neurofeedback and neurofeedback combined with occupational therapy based on cognitive rehabilitation on executive functioning in autistic children. Scientific-Research Journal of Modern Rehabilitation, 7(2), 29-42. https://journals.tums.ac.ir/mrj/article-1-5008-en.html
Wilkey, E. D., Pollack, C., & Price, G. R. (2020). Dyscalculia and typical math achievement are associated with individual differences in number-specific executive function. Child development, 91(2), 596-619. https://doi.org/10.1111/cdev.13194
Wolff, N., Giller, F., Buse, J., Roessner, V., & Beste, C. (2018). When repetitive mental sets increase cognitive flexibility in adolescent obsessive-compulsive disorder. Journal of Child Psychology and Psychiatry, 59(9), 1024-1032. https://doi.org/10.1111/jcpp.12901
Wong, C., Odom, S. L., Hume, K. A., Cox, A. W., Fettig, A., Kucharczyk, S., Brock, M. E., Plavnick, J. B., Fleury, V. P., & Schultz, T. R. (2015). Evidence-based practices for children, youth, and young adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(7), 1951-1966. https://doi.org/10.1007/s10803-014-2351-z
Yousefi Kalehkaneh, Z., Zangouleh-Chi, Z., & Keshavarz, N. (2017). Cognitive flexibility and autism spectrum symptoms. Proceedings of the 6th Congress of the Iranian Psychological Association, 12(Special Issue), 1944-1947. https://www.sid.ir/paper/896838/fa
Zhang, X., Lv, C. C., Tian, J., Miao, R. J., Xi, W., & Hertz, Q. (2024). Long-Term Psychological Effects of Autism Spectrum Disorder. [Unavailable].
Zwaigenbaum, L., & Penner, M. (2018). Autism spectrum disorder: advances in diagnosis and evaluation. bmj, 361, k1674. https://doi.org/10.1136/bmj.k1674
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