Designing Family-based Cognitive Rehabilitation and Evaluation of Its Effectiveness on Working Memory, Sustained Attention, Inhibition, and Social Skills of Children With Intellectual Disability

Arjmandnia, Ali Akbar; Ghasemi, Solmaz; Lavasani, Masoud Gholamali · 2019 · Crossref

DOI: 10.32598/jmr.13.2.87

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Summary

This study evaluates the effectiveness of a family-based cognitive rehabilitation program on executive functions and social skills in children with intellectual disability (ID). The research was motivated by the critical role of executive functions—specifically working memory, sustained attention, and inhibition—in predicting educational competence and social skills. Children with ID often exhibit deficits in these areas, leading to negative social and educational outcomes. While previous studies have examined cognitive interventions, there was a lack of research on family-based approaches, which offer the advantage of parental support for generalizing skills to daily life. The study employed a quasi-experimental design with 30 students aged 10–14 years with mild to borderline ID recruited from exceptional schools in Tehran, Iran. Participants were randomly assigned to an experimental group (n=15) and a control group (n=15); four students from the control group were excluded due to non-compliance. The experimental group received a 12-session, researcher-designed family-based cognitive rehabilitation intervention. Parents participated alongside children to provide emotional security and learn strategies for supporting their children’s executive functions. Assessments were conducted pre- and post-intervention using the Working Memory Test Battery for Children, the Boshra test for cognitive inhibition, the Integrated Visual and Auditory (IVA) test for attention, the Behavior Rating Inventory of Executive Function (BRIEF), and the Vineland Social Skill Scale. Data were analyzed using Analysis of Covariance (ANCOVA) and Multivariate Analysis of Covariance (MANCOVA). The results indicated that the family-based cognitive rehabilitation significantly improved working memory, sustained attention, and cognitive inhibition in the experimental group compared to the control group (P<0.001). Specifically, MANCOVA results showed significant differences in working memory and inhibition after controlling for pre-test scores. The intervention also yielded significant improvements in attention metrics. However, the intervention did not produce a statistically significant effect on social skills as measured by the Vineland scale. Descriptive statistics confirmed that the experimental group showed marked improvements in visual-spatial sketchpad, phonological loop, and interference scores, while the control group showed no significant changes. The study concludes that family-based cognitive rehabilitation is an effective supplementary intervention for enhancing core executive functions in children with ID. Although it did not directly improve social skills scores, the authors suggest that improving underlying executive functions may help children overcome challenges in social situations indirectly. The findings highlight the potential of involving parents in cognitive rehabilitation to support children’s independence and competence, filling a gap in existing literature regarding family-involved strategies for this population.

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• cognitive capacity variation