Effects of Cognitive Occupational Therapy Interventions in Children with ADHD

Yıl 2025, Cilt: 5 Sayı: 2, 175 - 186, 29.08.2025

Remziye Akarsu , Amine Köklemez , Melek Küçüker , Betül Güler

https://doi.org/10.56061/fbujohs.1646393

Öz

Executive function deficiencies characterize Attention Deficit Hyperactivity Disorder (ADHD), a complicated disorder. The effects of cognitive activities on executive functions in children with ADHD were examined in this study from the perspective of occupational therapy. Eleven children were in the control group and ten in the intervention group, totaling twenty-one children (mean age: 9.82 ± 0.87 years). Over eight weeks, the intervention group received extra cognitive activities, whereas the control group received special education twice a week. Standardized assessments, such as the Verbal Fluency Test (VFT), Stroop Test T-Bag Form (ST-TBAG), and Children's Color Trails Test (CCTT), were used to evaluate both groups before and after the intervention. To assess the data, the Mann-Whitney U test was used for between-group comparisons and the Wilcoxon Paired Sample Test for within-group changes. The study group's performance on the ST-TBAG and CCTT scores improved significantly (p < 0.05). Although there were no other notable changes, the control group did show improvements in a few ST-TBAG time sections (p < 0.05). The findings suggest that integrating cognitive activities into treatment can improve children with ADHD's executive function abilities. To effectively support these children, the study emphasizes how crucial it is to incorporate cognitive occupational therapy interventions into clinical and educational settings.

Anahtar Kelimeler

ADHD , cognitive activities , executive functions , occupational therapy

Effects of Cognitive Occupational Therapy Interventions in Children with ADHD

Öz

Yürütücü işlev problemleri, karmaşık bir bozukluk olan Dikkat Eksikliği Hiperaktivite Bozukluğu'nun (DEHB) karakteristiğidir. Bu çalışmada, DEHB'li çocuklarda bilişsel aktivitelerin yürütücü işlevler üzerindeki etkileri ergoterapi perspektifinden incelenmiştir. Çalışmaya, kontrol grubunda on bir, müdahale grubunda ise on çocuk olmak üzere toplam yirmi bir çocuk katıldı (ortalama yaş: 9,82 ± 0,87 yıl). Müdahale grubuna sekiz hafta boyunca özel eğitime ek olarak bilişsel aktiviteler uygulanırken, kontrol grubu haftada iki kez özel eğitim aldı. Müdahaleden önce ve sonra her iki grubu değerlendirmek için Sözel Akıcılık Testi (VFT), Stroop Testi T-Bag Formu (ST-TBAG) ve Çocuklar İçin Renkli İz Sürme Testi (CCTT) gibi standart değerlendirmeler kullanıldı. Verileri değerlendirmede gruplar arası karşılaştırmalar için Mann-Whitney U testi ve grup içi değişiklikler için Wilcoxon Eşleştirilmiş Örneklem Testi kullanıldı. Çalışma grubunun ST-TBAG ve CCTT puanlarındaki performansı önemli ölçüde iyileşti (p < 0,05). Başka kayda değer bir değişiklik olmasa da, kontrol grubu birkaç ST-TBAG zaman bölümünde iyileşme gösterdi (p < 0,05). Bulgular, bilişsel aktivitelerin tedaviye entegre edilmesinin DEHB'li çocukların yürütücü işlev becerilerini geliştirebileceğini göstermektedir. Bu çalışma, DEHB tanısı olan çocukları etkili bir şekilde desteklemek için bilişsel ergoterapi müdahalelerini klinik ve eğitim ortamlarına dahil etmenin önemli olduğunu vurgulamaktadır.

Anahtar Kelimeler

DEHB , bilişsel aktiviteler , ergoterapi , yürütücü işlevler

Kaynakça

• Banaschewski, T., Becker, K., Döpfner, M., Holtmann, M., Rösler, M., & Romanos, M. (2017). Attention-deficit/hyperactivity disorder. Dtsch Arztebl International, 114(9), 149–159. https://doi.org/10.3238/arztebl.2017.0149PubMed
• Carbray, J. A. (2018). Attention-deficit/hyperactivity disorder in children and adolescents. Journal of Psychosocial Nursing and Mental Health Services, 56(12), 7–10. https://doi.org/10.3928/02793695-20181112-02 Healio Journals+1ReferenceCitationAnalysis+1
• Chen, S., Yu, J., Zhang, Q., Zhang, J., Zhang, Y., & Wang, J. (2022). Which factor is more relevant to the effectiveness of the cognitive intervention? A meta-analysis of randomized controlled trials of cognitive training on symptoms and executive function behaviors of children with attention deficit hyperactivity disorder. Frontiers in Psychology, 12, 810298. https://doi.org/10.3389/fpsyg.2021.810298
• Cortese, S., Ferrin, M., Brandeis, D., Buitelaar, J., Daley, D., & Dittmann, R. W. (2015). Cognitive training for attention-deficit/hyperactivity disorder: Meta-analysis of clinical and neuropsychological outcomes from randomized controlled trials. Journal of the American Academy of Child & Adolescent Psychiatry, 54(3), 164–174. https://doi.org/10.1016/j.jaac.2014.12.010
• Davies, W. (2014). Sex differences in attention deficit hyperactivity disorder: Candidate genetic and endocrine mechanisms. Frontiers in Neuroendocrinology, 35(3), 331–346. https://doi.org/10.1016/j.yfrne.2014.03.003Orca+1PubMed+1
• Diamond, A. (2013). Executive functions. Annual Review of Psychology, 64, 135–168. https://doi.org/10.1146/annurev-psych-113011-143750DevCogNeuro+3PubMed+3ResearchGate+3
• Fernandes, V. R., Ribeiro, M. L., Melo, T., de Tarso Maciel-Pinheiro, P., Guimarães, T. T., Araújo, N. B., ... & Deslandes, A. C. (2016). Motor coordination correlates with academic achievement and cognitive function in children. Frontiers in Psychology, 7, 318. https://doi.org/10.3389/fpsyg.2016.00318
• Gallo, E. F., & Posner, J. (2016). Moving towards causality in attention-deficit/hyperactivity disorder: Overview of neural and genetic mechanisms. The Lancet Psychiatry, 3(6), 555–567. https://doi.org/10.1016/S2215-0366(16)00096-1
• Hahn-Markowitz, J., Manor, I., & Maeir, A. (2011). Effectiveness of cognitive-functional (Cog-Fun) intervention with children with attention deficit hyperactivity disorder: a pilot study. The American journal of occupational therapy : official publication of the American Occupational Therapy Association, 65(4), 384–392. https://doi.org/10.5014/ajot.2011.000901
• Hahn-Markowitz, J., Berger, I., Manor, I., & Maeir, A. (2020). Efficacy of Cognitive-Functional (Cog-Fun) occupational therapy intervention among children with ADHD: An RCT. Journal of Attention Disorders, 24(5), 655–666. https://doi.org/10.1177/1087054716666955
• Karakaş, S., Erdoğan, E., Sak, L., Soysal, A. Ş., Ulusoy, T., Ulusoy, İ. Y., & Alkan, S. (1999). Stroop test TBAG form: Standardisation for Turkish culture, reliability and validity. Klinik Psikiyatri Dergisi, 2(2), 75–88.
• Kelsey, K. M. (2013). Review of “Executive functions: What they are, how they work, and why they evolved” by Russell A. Barkley. Developmental Neuropsychology, 38(1), 78–80.
• Lambez, B., Harwood-Gross, A., Golumbic, E. Z., & Rassovsky, Y. (2020). Non-pharmacological interventions for cognitive difficulties in ADHD: A systematic review and meta-analysis. Journal of Psychiatric Research, 120, 40–55. https://doi.org/10.1016/j.jpsychires.2019.10.007
• Llorente, A. M. (2003). Children's color trails test: Professional manual. Psychological Assessment Resources. López-Villalobos, J. A., Serrano-Pintado, I., Andrés-De Llano, J. M., Sánchez-Mateos, J. D., Alberola-López, S., & Sánchez-Azón, M. I. (2010). Usefulness of the Stroop test in attention deficit hyperactivity disorder. Revista de Neurología, 50, 333–340.
• Martinussen, R., Hayden, J., Hogg-Johnson, S., & Tannock, R. (2005). A meta-analysis of working memory impairments in children with attention-deficit/hyperactivity disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 44(4), 377–384. https://doi.org/10.1097/01.chi.0000153228.72591.73
• Migó, M., Guillory, S. B., McLaughlin, C. S., Isenstein, E. L., Grosman, H. E., Thakkar, K. N., et al. (2021). Investigating motor preparation in autism spectrum disorder with and without attention deficit/hyperactivity disorder. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-021-05130-5
• Miller, A. C., Keenan, J. M., Betjemann, R. S., Willcutt, E. G., Pennington, B. F., & Olson, R. K. (2013). Reading comprehension in children with ADHD: Cognitive underpinnings of the centrality deficit. Journal of Abnormal Child Psychology, 41(3), 473–483. https://doi.org/10.1007/s10802-012-9686-8
• Oosterlaan, J., Scheres, A., & Sergeant, J. A. (2005). Which executive functioning deficits are associated with AD/HD, ODD/CD and comorbid AD/HD+ODD/CD? Journal of Abnormal Child Psychology, 33(1), 69–85. https://doi.org/10.1007/s10802-005-0935-ySciSpace+1Vrije Universiteit Amsterdam+1
• Rubia, K., Alegría, A. A., & Brinson, H. (2014). Brain abnormalities in attention-deficit hyperactivity disorder: A review. Revista de Neurología, 58(Supl 1), 3–18.
• Sergeant, J. A., Geurts, H., & Oosterlaan, J. (2002). How specific is a deficit of executive functioning for attention-deficit/hyperactivity disorder?. Behavioural brain research, 130(1-2), 3–28. https://doi.org/10.1016/s0166-4328(01)00430-2
• Shuai, L., Daley, D., Wang, Y. F., Zhang, J. S., Kong, Y. T., Tan, X., & Ji, N. (2017). Executive Function Training for Children with Attention Deficit Hyperactivity Disorder. Chinese medical journal, 130(5), 549–558. https://doi.org/10.4103/0366-6999.200541
• Silva, D., Colvin, L., Hagemann, E., & Bower, C. (2014). Environmental risk factors by gender associated with attention-deficit/hyperactivity disorder. Pediatrics, 133(1), e14–e22. https://doi.org/10.1542/peds.2013-1434
• Sonuga-Barke, E. J., Brandeis, D., Cortese, S., Daley, D., Ferrin, M., Holtmann, M., Stevenson, J., Danckaerts, M., van der Oord, S., Döpfner, M., Dittmann, R. W., Simonoff, E., Zuddas, A., Banaschewski, T., Buitelaar, J., Coghill, D., Hollis, C., Konofal, E., Lecendreux, M., Wong, I. C., … European ADHD Guidelines Group (2013). Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. The American journal of psychiatry, 170(3), 275–289. https://doi.org/10.1176/appi.ajp.2012.12070991
• Thapar, A., & Cooper, M. (2016). Attention deficit hyperactivity disorder. The Lancet, 387(10024), 1240–1250. https://doi.org/10.1016/S0140-6736(15)00238-XPubMed
• Vaucheret Paz, E., Puga, C., Ekonen, C., Pintos, P., Lascombes, I., De Vita, S., Leist, M., Corleto, M., & Basalo, M. J. G. (2020). Verbal Fluency Test in Children with Neurodevelopmental Disorders. Journal of neurosciences in rural practice, 11(1), 95–99. https://doi.org/10.1055/s-0039-3400347
• Wiest, G. M., Rosales, K. P., Looney, L., Wong, E. H., & Wiest, D. J. (2022). Utilizing cognitive training to improve working memory, attention, and impulsivity in school-aged children with ADHD and SLD. Brain Sciences, 12(2), 141. https://doi.org/10.3390/brainsci12020141
• Wu, K. K., Anderson, V., & Castiello, U. (2002). Neuropsychological evaluation of deficits in executive functioning for ADHD children with or without learning disabilities. Developmental neuropsychology, 22(2), 501–531. https://doi.org/10.1207/S15326942DN2202_5