Cognitive Intervention in Attention Deficit and Hyperactivity Disorder
Condition: ADHD; Cognitive Deficit
MeSH terms: Hyperkinesis; Attention Deficit Disorder with Hyperactivity; Cognition Disorders; Cognitive Dysfunction
Study type: Interventional

Summary: 
      Attention Deficit Hyperactivity Disorder is a disorder in which children show insufficient
      attention span, hyperactivity and impulsivity according to their developmental level. It is
      stated that in the absence of rehabilitation, the child's social and academic functionality
      gradually deteriorates, there are problems in cognitive function processes and executive
      dysfunctions that affect daily life. The aim of this study was to investigate the effects of
      cognitive occupational therapy interventions on executive functions in children with
      Attention Deficit and Hyperactivity Disorder. 21 children aged 9-12 years were included in
      the research (10 study group-11 control group). One individual and one group session was
      applied to the study group at Biruni University Occupational Therapy Unit as 2 times per week
      for 8 weeks. Both groups were evaluated at the beginning and after 8 weeks with Children's
      Color Trails Test, Verbal Fluency Test and Stroop Test T-Bag Form. Wilcoxon Paired Sample
      Test and Mann Whitney U Test were used for analysis of intervention results and comparison
      between groups.
    

Detailed description: 
      Attention-deficit/hyperactivity disorder (ADHD) is a neuropsychiatric disorder marked by an
      ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with
      functioning or growing. In individuals with ADHD, clinical findings may vary depending on
      development. It is frequently observed that ADHD, which has a progressive character,
      continues into adulthood after childhood and adolescence.

      The study was conducted in Biruni University Occupational Therapy Unit. Since the individuals
      participating in the study were under the age of 18, an informed consent form was signed by
      their parents. The research was carried out between June and December 2020. The study
      included children aged 9-12 years who were diagnosed with ADHD according to DSM-V criteria by
      a psychiatrist, did not use any medication for ADHD, or were given a fixed dose 3 months ago
      and did not plan to change their treatment. Children who could not participate in the study
      because of any medical or mental health problems and who were diagnosed with any secondary
      diagnosis were excluded. First of all, the sociodemographic form was applied to the
      participants. The form consisted of questions to determine age, gender, disease history,
      presence of drugs used continuously, education level of parents, and whether the participant
      or family member had neurological or psychiatric disorders. Stroop Test T Bag Form (ST-TBAG),
      The Children's Color Trails Test (CCTT) and Verbal Fluency Test (VFT) were applied to all
      participants before and after intervention. Occupational therapy applications were carried
      out 40 minutes, twice a week (one individual session and one group intervention session) and
      total of 8 weeks. In the sessions, activities aimed at reasoning and empathy skills, problem
      solving, evaluating emotional cues, evaluating events from different perspectives, providing
      personal control, delaying reactions, motor planning, visual perception and prolonging
      attention span were applied. The interventions were varied according to the personal
      characteristics of the individuals. In group interventions with three or four participants,
      group games in the form of cooperation or competition were planned to develop motor planning
      and cognitive strategy and it was aimed to improve children's rapid decision making and
      adaptation skills.

      Research data were evaluated in SPSS 22.0 package program. Mean±standard deviation (X±SD) was
      determined for the variables determined by measurement. The Wilcoxon Paired Two-Sample Test
      was used to compare the first and last evaluation data of the intervention and control groups
      and the Mann Whitney-U test was used to compare the demographic and initial evaluation data
      of both groups. A significance value of p<0.05 was accepted in all statistical analyses.
    

Intervention name(s): Cognitive Occupational Therapy
Intervention type(s): Behavioral
Intervention description(s): In the sessions, activities aimed at reasoning and empathy skills, problem solving, evaluating emotional cues, evaluating events from different perspectives, providing personal control, delaying reactions, motor planning, visual perception and prolonging attention span were applied. The interventions were varied according to the personal characteristics of the individuals. In group interventions with three or four participants, group games in the form of cooperation or competition were planned to develop motor planning and cognitive strategy and it was aimed to improve children's rapid decision making and adaptation skills.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Attention Deficit and Hyperactivity Disorder; Executive functions; Occupational therapy