The Effects of Play and Competition-Based Cognitive Therapy
Condition: Dyslexia; Executive Dysfunction
MeSH terms: Dyslexia
Study type: Interventional

Summary: 
      Purpose: The aim of this study was to investigate the effects of play and competition-based
      cognitive therapy (PCB-CT) on executive function and occupational routines in children with
      dyslexia.

      Method: In this randomized control trail, 64 children with dyslexia (between 7-12 ages) were
      randomly selected from the 162 clients who applied to the clinic. Children were divided
      randomly into a treatment group and a control group. Children in the intervention group was
      given cognitive therapy for 10 weeks, 3 days a week for one hour sessions while no therapy
      was received to the control group. In order to evaluate the cognition of the children Test of
      Visual Perceptual Skills-3 (TVPS-3) and Dynamic Occupational Therapy Cognitive Assessment
      (DOTCA-Ch), to evaluate executive functions the Behavior Rating Inventory of Executive
      Function (BRIEF) and to evaluate occupational routine The Executive Functions and
      Occupational Routines Scale (EFORTS) were used. The evaluations were done at baseline, after
      treatment and the end of the 3rd month for both groups.
    

Detailed description: 
      The participants included in this study if they had only dyslexia diagnosis, aged between
      7-12 years and had a 90 and above IQ score (normal IQ), in addition didn't have multiple
      conditions (neurological problems such as epilepsy) or primary psychiatric comorbidities
      (i.e. depression, anxiety, psychosis).

      Test of Visual Perceptual Scale-3(TVPS-3); The TVPS-3 was originally designed for children
      but the author Dr. Gardner also reported statistically significant differences between three
      groups diagnosed as having either developmental delay, head injury or learning disability.
      This test in its third edition has been revised by Martin for appropriate use in an adult
      population, with scores compared against the highest age group of scores (i.e. 18y 00-18y
      11m) (Martin, 2006). There are seven subtests of eighteen stimuli figures each, which assess
      seven key areas of visual perception. Each subscale consisting of eighteen figures including
      two example items and sixteen test items are arranged in order of increasing complexity (see
      App. A). The test is largely an untimed instrument with the exception of subtests for visual
      memory and visual sequential memory being allocated a five second presentation time per item.
      Response time is however not restricted for any of the items.

      The Dynamic Occupational Therapy Cognitive Assessment instrument designed to assess the
      cognitive abilities and learning potential of children from ages 6 to 12 years via a dynamic
      mediation testing process. DOTCA-Ch, a criterion-referenced assessment, was designed to fill
      this need. Originally based on the Loewenstein Occupational Therapy Cognitive Assessment
      (LOTCA), an assessment for adults with neuropsychological deficits, the DOTCA-Ch represents
      an adapted and modified format that is appropriate for use with school-age children. The
      DOTCA-Ch battery consists of 22 subtests in 5 cognitive domains: Orientation, Spatial
      Perception, Praxis, Visuomotor Construction, and Thinking Operations. Construct validity was
      supported by comparing children with traumatic brain injury and learning disabilities to
      typically developing children, and ecological validity of children with attention deficit
      hyperactivity disorder by comparing performance on the DOTCA-Ch to the School Function
      Assessment. Results of the intraclass correlation coefficients analysis revealed very high
      reliability coefficients for all cognitive domains, ranging from .87 to .99.

      The Behavior Rating Inventory of Executive Function (BRIEF) assesses problem behaviors
      associated with executive function. The form consists of 86 brief descriptions of behavior
      problems, the frequency of which teachers and parents are asked to rate as occurring either
      never, sometimes, or often. Responses are aggregated to form eight subscales (Inhibit, shift,
      emotional control, initiate, working memory, plan/organize, organization of materials and
      monitor scale). Examples of test items from each subscale are shown in the Appendix C and D.
      T-scores are calculated for each measure. The scales showed high internal consistency on the
      BRIEF (a=.80-.90) for both Teachers and Parents form. The moderate test-retest reliabilities
      for teachers BRIEF (.90-.92) and for the parent BRIEF (.80-.83). Interrater reliability of
      the teachers BRIEF is reported as .17-.28, and of the parents BRIEF as .32-.34. Both tools
      are reported to have evidenced for content of the items, convergence and divergence of their
      scores with other measures.
    

Intervention name(s): Play and Competition-Based Cognitive Therapy
Intervention type(s): Other
Intervention description(s): The intervention group was received play and competition-based cognitive therapy for 10 weeks, 3 days a week, 1 hour per day; the control group was the group who continued the special education program
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Before randomization, 80 children were performed the tests (TVPS-3 and DOTCA-Ch) and questionnaires (BRIEF and EFORTS) were given to their parents and teachers. Then, SPSS 24.00 was randomized with the program and the control group was divided into 2 equal groups (intervention group n = 40; control group n = 40). The intervention group was received cognitive therapy for 10 weeks, 3 days a week, 1 hour per day; the control group was the group who continued the special education program (Figure 3.1). Both groups were evaluated three times at baseline, at the end of the 10th week and at the end of the third month (follow up).
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Dyslexia; Executive function; Cognitive control; Inhibition; Working memory; Prefrontal Cortex