Comparison of the Effect of Cognitive Rehabilitation and Neurofeedback on Sustained Attention Among Elementary School Students with Specific Learning Disorder: A Preliminary Randomized Controlled Clinical Trial

Abstract

Specific learning disorder (SLD) can occur along with the problems of attention performance and be complicated by them. Recent studies have reported the positive effects of cognitive rehabilitation (CR) and neurofeedback (NFB) on sustained attention (SA) in SLD. Nevertheless, it has not yet been determinedwhat kind of treatment may be the most appropriate option for this disorder in terms of the different functions of cognitive status, especially SA. This preliminary study aimed to compare CR and NFB effects on SA among elementary school students with SLD using a randomized controlled clinical trial (RCT). Fifty- three eligible students with a DSM-5 SLD diagnosis, aged 7-10, were randomly allocated in NFB (n = 18), CR (n = 18), and control groups (n = 17). All the participants were evaluated for SA by performing the continuous performance test (CPT) on the studied groups at the time of their inclusion in the study and 7 weeks after it. The intervention groups took part in 20 sessions of CR and 20 sessions of NFB. Conversely, the untreated group were evaluated without any intervention.15 boys and 30 girls in 3 groups completed the study (n = 15 per group). The mean and standard deviation of participants' age were (8.66 ± 1.48) years, (8.40 ± 1.73) years and (8.53 ± 1.63) years in CR, NFB and untreated groups, respectively. The results showed significant differences between the groups based on the variables of the CPT test (p < 0.05). Also, the significant effects of the variables represented the higher scores of the CR compared to the NFB group (p < 0.001). This study provides einitial evidence that CR is more effective than NFB on SA improvement among students with SLD.

Effects of quantitative electroencephalogram normalization using 4-channel live z-score training neurofeedback for children with learning disabilities: preliminary data

“…We found that the odds of moving toward the standard value was greater than the odds of moving outside the standard values after treatment, which is in line with previous studies (Pérez-Elvira et al, 2018;Pérez-Elvira, et al, 2019) reporting that there is little likelihood for z-scores to move out of the normal range due to the LZT intervention. Some authors (Azizi et al, 2018) have concluded that NF is not effective for LD. They compared NF with cognitive rehabilitation for LD, but their study has some methodological limitations.…”

Cognitive deficits in children with autism spectrum disorders: Toward an integrative approach combining social and non-social cognition

“…Initially used for brain-damaged patients, CR use was extended to schizophrenia ( 13 ), and later to several pediatric mental health conditions. CR effectiveness was demonstrated in children and adolescents with attention deficit hyperactivity disorder (ADHD) ( 14 ), anorexia nervosa ( 15 , 16 ), specific learning disorder ( 17 ), intellectual disability ( 18 ) and in early onset psychosis ( 19 ).…”

Teachers' readiness to support effective inclusion of students with specific learning disorders in higher and adult education

“…SLDs encompass difficulties with listening, speaking, reading, spelling or doing mathematical calculations. Reading, writing and mathematics skills are key academic skills (Azizi et al, 2018), the foundation for other academic learning (Abdelraouf et al, 2018). The main symptoms that can also interfere with independent learning required at university level can be poor short-term memory (Kavale & Flanagan, 2007), attention deficits (Marzocchi et al, 2009), difficulty in academic and learning tasks (Esmaili et al, 2016), poor motor skills and motor-related daily functions (Tal-Saban & Weintraub, 2019), inefficient planning and organization (Hendriksen et.al., 2007), processing problems (Cornoldi et al, 2019), difficulties in organizing information and developing learning and cognitive skills (Shenoy, 2016), challenging access to the constant cognitive effort necessary for the rote learning of facts, figures and procedural rules (Savidis et al, 2007), IQ-achievement discrepancy between potential and achievement, significant gap between the true potential and the day to day performance (Kulkarni et al, 2001), disruptive behaviors (Chatzara et al, 2014), despite age-appropriate instruction, long-term remedial efforts (Kirk, 1962;Addison Stone, 1980), normal intelligence, motivation to learn, adequate socio-cultural and learning opportunity (Wang & Chung, 2021).…”