Investigating the effectiveness of visual tracking interventions on sustained attention performance of children with attention deficit hyperactivity disorder

Dissertation for obtaining a master's degree

Aim: considering the high frequency and prevalence of attention deficit hyperactivity disorder (ADHD) as one of the most common psychiatric disorders and the occurrence of numerous problems in the field of behavioral and cognitive issues following this disorder, research on the causes and solutions to improve the problems that have arisen for these children and their families is always one of the research axes in the field It has been rehabilitation and especially occupational therapy. The purpose of this study is to investigate the sustained attention of children with attention deficit hyperactivity disorder using visual tracking exercises. Research method: Thirty boys between the ages of 6 and 10 in the test and control groups, who were homogeneous in terms of intelligence and age, were randomly divided into control and test groups. The control group had the usual occupational therapy interventions, but the test group was also subjected to vision tracking interventions. Both groups were examined with the Connors parents' questionnaire as well as the continuous performance test (CPTII) in two pre-test and post-test sessions. Data analysis will be done using SPSS16 software. The dependent t-test will be used to compare the variables in each of the experimental and control groups separately, and the independent t-test will be used to compare the variables in the experimental and control groups before and after the intervention.

Findings: Vision tracking interventions have led to a reduction in cognitive problems and hyperactivity in children in the intervention group. (P<0.05) as well as visual tracking interventions have led to an increase in the recognition threshold and reaction speed and a decrease in the omission error, commit error, variability and repetition of children in the intervention group. (P<0.05) (P<0.01)

Conclusion: According to the results of the study, it can be stated that strengthening visual tracking patterns will be effective on the sustained attention of children with attention deficit hyperactivity disorder. An overview of the statement of the problem, as well as the necessity of investigation, research objectives and hypotheses, and the definition of key words are discussed. 1-1 Introduction Attention is one of the important prerequisites of memory, and these two together are one of the primary requirements for learning processes (Wood [1] 1987, quoted by Anvers [2] 1999). It is accepted that the deep and severe impact of attention deficit and disorder in memory and executive functions of the brain on a person's daily activities. Mild attention deficits may make it difficult or even impossible to perform some daily activities (Solberg[3] 2004).  Attention is the mental effort to focus on sensory or mental events. Attention deficit has a negative and fundamental effect on the ability to do homework in children. Children with attention deficit often have problems and disorders in one or a number of dimensions and types of attention, and this lack of efficiency leads to the occurrence of disorders and includes a special spectrum such as attention deficit hyperactivity disorder (ADHD[4]). Children with attention-deficit-hyperactivity disorder experience many attention disorders, among which persistent attention deficit [5] is the most important attention deficit in these children (Barkley [6] 1999).    Several studies have proven sustained attention deficits in children with attention deficit hyperactivity disorder. (Zenthal [7], Falkenberg [8] 1986, Smith 1985 [9]). Also, other studies have investigated eye movement disorders in ADHD children (Douglas[10] and Munns[11] 2003, Bilasma 1989[12], Randall J. Ross 2000[13]).

In this study, the effect of using visual tracking patterns on the sustained attention performance of children with attention deficit hyperactivity disorder was investigated, with the hope that attention interventions special, as a non-pharmacological complementary treatment method for the attention deficits of children with hyperactive attention disorder.

2-1 statement of the problem

William James [14] in 1890 explained attention as follows: Attention is the concentration of the mind on one object among objects in the form of a string of thoughts of association in a clear and vivid way, the basis of which is concentration and concentration. Giving the desired object is the focus of attention [15], concentration [16] and awareness [17].Donald Broadbent also considered attention as the result of an information processing system with limited capacity in the book Perception and Communication. Attention is a very complex skill, and in fact, it includes many skills that each one develops over time and during the development of the nervous system, in sync with the experience and reception of stimuli from the environment. Attention problems cause a wide range of psychiatric disorders in children, which can be referred to disorders such as attention deficit-hyperactivity disorder, developmental-developmental disorders [18] and learning disorders [19].

According to the definition of the DSM-IV-TR mental illness diagnosis guide[20], attention-deficit-hyperactivity disorder is a neuro-developmental condition based on the presence of a persistent pattern of attention deficits (especially persistent attention[21]) or Impulsivity[22] and hyperactivity[23] are characterized as highly repeatable and more severe characteristics than those observed in their developmental peers, and their symptoms do not correspond with the developmental developmental level of the individual. Attention deficit hyperactivity disorder is a persistent pattern of inattention or hyperactivity and impulsive behaviors that are more severe and more common than what is usually seen in children with a similar developmental level. Although many cases are diagnosed years after the appearance of symptoms, but some symptoms must appear before the age of 7 to make this diagnosis. In the United States, the prevalence of the disorder has been reported to be 2-20%, however, 3-7% is a more reassuring figure. The disorder causes harm in normal functions such as academic success, behavior in school, interaction with parents and siblings, and communication with peers. In the etiology of this disorder, genetic causes, developmental factors, brain damage, neurochemical factors, neurophysiological factors, and psychosocial factors are considered. The clinical symptoms of this disorder mainly include attention deficit and hyperactivity along with impulsivity. At home, these children are not willing to be quiet even for a few moments and are often explosive and irritable. Trivial stimuli can easily disturb the child's attention. Among the characteristics that are mentioned the most are hyperactivity, movement perception disorder, emotional instability, lack of general coordination, attention deficit (short attention span, distraction, lingering, inability to finish assignments and poor concentration), impulsivity (acting before thinking, sudden changes in activity and jumping around in class), memory and thinking disorders, specific learning disabilities, speech and hearing defects, vague neurological symptoms and EEG irregularities. (Kaplan and Sadok[24] 2003).

According to the studies, children with attention deficit hyperactivity disorder have problems in a wide range of executive functions of the brain, especially in the field of attention, several studies have shown continuous attention deficit and selective attention in these children (cited by Toka[25] et al. 2008). Attention deficit is the most specific problem of ADHD children and is considered the first diagnostic criterion. (Barclay [26] 1997). Barclay states that the most important attention problem in ADHD children is sustained attention deficit. (Barkley 1997).

Movement problems in children with attention deficit hyperactivity disorder have been proven due to disruption in the frontostriatal and cerebellar pathways. Like the motor system, the oculomotor system of these children is also defective in areas of the cerebellum such as the basal ganglia, thalamus, cerebellum, superior colliculus, and reticular formation of the brainstem. The oculomotor system has been proposed as a mediating system between movement and cognition. (Xi and Lee 2006).

: attention deficit-hyperactivity (ADHD) as one of the common is a one of psychiatric disorder. various behavioral and cognitive problems is seen following this disorder that caused lots of problems for children and their family. so research on this field is a one of research topics on rehabilitation especially occupational therapy. the purpose of this study is to evaluate sustain attention of children with attention deficit-hyper activity by using visual tracking exercises.