Document Type : Research Article (s)

Authors

1 Department of Psychology, Ahv.C., Islamic Azad University, Ahvaz, Iran

2 Department of Psychology, Ramh.C., Islamic Azad University, Ramhormoz, Iran

Abstract

Background: Learning disabilities (LD) affect a substantial proportion of students worldwide, including in Iran. LD is regarded as persistent difficulties in reading, writing, and mathematics. The present study investigated the efficacy of cognitive behavioral play therapy (CBPT) in enhancing visual attention and mathematical concept acquisition among students with learning disabilities (LDs) in Dezful, Iran.
Methods: This was a quasi-experimental study with pre-test, post-test, and one-month follow-up assessments, and a control group. The target population encompassed all male and female second- and third-grade primary school students diagnosed with LD who were enrolled in educational and rehabilitative services at Dezful Developmental and Educational Assessment Center, Dezful, Iran. A convenience sample of 30 students (15 per group) was selected based on DSM-5 criteria. The experimental group underwent 10 ninety-minute sessions of CBPT, delivered twice weekly. Data were collected using the Continuous Performance Test (CPT) to measure omission and commission errors of visual attention and Key Math Diagnostic Assessment (scored from 0 to 100). Repeated Measures ANOVA with standard assumptions, including sphericity checks, was employed for data analysis using SPSS version 26.
Results: According to our results, CBPT significantly improved visual attention and mathematical concept acquisition in the experimental group as compared with the control group in the post-test phase (P<0.001, partial η²=0.62 for visual attention, 0.78 for mathematical concepts). For visual attention, mean omission errors in the experimental group decreased from 4.69 (SD=0.94) to 2.63 (SD=1.14), and commission errors from 5.63 (SD=1.20) to 3.06 (SD=0.99), while the control group showed minimal change (omission errors: 4.94 [SD=0.89] to 4.24 [SD=1.42]; commission errors: 5.41 [SD=1.06] to 6.06 [SD=1.02]). For mathematical concept acquisition, the mean score in the experimental group increased from 42.81 (SD=5.02) to 70.81 (SD=3.92), while the mean score in the control group remained stable (45.24 (SD=3.83) to 45.12 (SD=4.56)). These effects persisted at follow-up (visual attention: partial η²=0.58; mathematical concepts: partial η²=0.74), with minimal decline in scores.
Conclusions: The findings demonstrated that CBPT produced significant and sustained improvements in visual attention (reduced omission and commission errors) and mathematical concept acquisition among students with LDs compared with the control group.

Highlights

Kaveh Korpi: Google Scholar

Fariba Hafezi: Google Scholar

Keywords

  1. Vidyadharan V, Tharayil HM. Learning Disorder or Learning Disability: Time to Rethink. Indian J Psychol Med. 2019;41(3):276–278. doi: 10.4103/ijpsym.Ijpsym_371_18. PubMed PMID: 31142931; PubMed Central PMCID: PMC6532374. ##
  2. Eskandari Z, Bakhtiarpour S, Dasht Bozorgi Z. Mediating Role of Depression Associated with Social Competence, Cognitive Failures and Academic Performance in Students with Specific Learning Disability. Int J School Health. 2021;8(3):167–175. doi: 10.30476/intjsh.2021.91639.1157. ##
  3. Peters L, Ansari D. Are specific learning disorders truly specific, and are they disorders? Trends Neurosci Educ. 2019;17:100115. doi: 10.1016/j.tine.2019.100115. PubMed PMID: 31685130. ##
  4. Olusanya BO, Kancherla V, Shaheen A, Ogbo FA, Davis AC. Global and regional prevalence of disabilities among children and adolescents: Analysis of findings from global health databases. Front Public Health. 2022;10:977453. doi: 10.3389/fpubh.2022.977453. PubMed PMID: 36249226; PubMed Central PMCID: PMC9554924. ##
  5. Sakhai F, Mazaheri S, Golmohammadi G, Asadollahpour F. Prevalence of Developmental Dyslexia among Primary School Children in Iran: A Systematic Review and Meta-Analysis. Iran J Psychiatry. 2025;20(2):223-240. doi: 10.18502/ijps.v20i2.18204. PubMed PMID: 40521282; PubMed Central PMCID: PMC12159571. ##
  6. Fletcher JM, Grigorenko EL. Neuropsychology of Learning Disabilities: The Past and the Future. J Int Neuropsychol Soc. 2017;23(9-10):930–940. doi: 10.1017/s1355617717001084. PubMed PMID: 29198282; PubMed Central PMCID: PMC6249682. ##
  7. Ouyang X, Zhang X, Zhang Q, de la Torre J, Min S. Subtypes of mathematics disability: A new classification method based on cognitive diagnostic models and their cognitive–linguistic correlates. Journal of Educational Psychology. 2024;116(3):396–410. doi: 10.1037/edu0000829. ##
  8. Paidar F, Amirhooshangi A, Taghavi R. Gender Differences in Students’ Mathematics Self-Concept and Academic Burnout. Int J School Health. 2017;4(1):1–6. doi: 10.17795/intjsh-39351. ##
  9. Heyd-Metzuyanim E. Failure to teach/learn mathematics: a complexity-discursive perspective. Educational Studies in Mathematics. 2025;119(3):515–533. doi: 10.1007/s10649-025-10404-1. ##
  10. Soares N, Evans T, Patel DR. Specific learning disability in mathematics: a comprehensive review. Transl Pediatr. 2018;7(1):48–62. doi: 10.21037/tp.2017.08.03. PubMed PMID: 29441282; PubMed Central PMCID: PMC5803013. ##
  11. Ji L, Zhao Q, Gu H, Chen Y, Zhao J, Jiang X, et al. Effect of Executive Function on Event-Based Prospective Memory for Different Forms of Learning Disabilities. Front Psychol. 2021;12:528883. doi: 10.3389/fpsyg.2021.528883. PubMed PMID: 33746809; PubMed Central PMCID: PMC7973034. ##
  12. Amani M. Executive Functions as a Mediator of the Correlation between Intelligence and Student-Teacher Relationship with Behavioral Problems. Int J School Health. 2024;11(2):126–134. doi: 10.30476/intjsh.2024.101072.1367. ##
  13. Zilaey S, Adibsereshki N, Pourmohamadreza-Tajrishi M. Attention Program and Math Performance of Students With Intellectual Disability. Iranian Rehabilitation Journal. 2017;15(4):333-340. doi: 10.29252/nrip.irj.15.4.333. ##
  14. Draheim C, Pak R, Draheim AA, Engle RW. The role of attention control in complex real-world tasks. Psychon Bull Rev. 2022;29(4):1143–1197. doi: 10.3758/s13423-021-02052-2. PubMed PMID: 35167106; PubMed Central PMCID: PMC8853083. ##
  15. Fishstrom S, Wang HH, Bhat BH, Daniel J, Dille J, Capin P, et al. A meta-analysis of the effects of academic interventions on academic achievement and academic anxiety outcomes in elementary school children. J Sch Psychol. 2022;92:265–284. doi: 10.1016/j.jsp.2022.03.011. PubMed PMID: 35618374; PubMed Central PMCID: PMC9136152. ##
  16. Knell SM. Cognitive-Behavioral Play Therapy. Handbook of Play Therapy; 2015. p. 119–33. ##
  17. Vosoughi Kalantari A, Marashian FS, Dasht Bozorgi Z, Hafezi F. Effectiveness of Cognitive-Behavioral Play Therapy on Behavioral Adjustment and Problem-Solving Skills in Students with Dyslexia. Int J School Health. 2025;12(1):53–62. doi: 10.30476/intjsh.2024.103497.1427. ##
  18. Shayganfard M, Kaboudi B, Arabsheibani K, Shakiba E, Cheshmekaboudi S. Effectiveness of cognitive-behavioral group play therapy on anxiety-based school refusal and behavioral problems in elementary school boys: a preliminary randomized controlled trial. Arch Psychiatr Nurs. 2024;50:108–114. doi: 10.1016/j.apnu.2024.03.019. PubMed PMID: 38789222. ##
  19. Rezaeerezvan S, Kareshki H, Pakdaman M. The Effect of Cognitive-Behavioral Play Therapy on Improvements in Expressive Linguistic Disorders of Bilingual Children. Front Psychol. 2021;12:626422. doi: 10.3389/fpsyg.2021.626422. PubMed PMID: 35069301; PubMed Central PMCID: PMC8770813. ##
  20. Jafari N, Roshani T, Shahbazi G. The Effectiveness of Cognitive-Behavioral Play Therapy on Reducing Hand-writing and Math Problems in Students with Special Learning Disabilities. Quarterly Journal of Research in Academic and Virtual Learning. 2022;9(3):93–100. doi: 10.30473/etl.2022.61408.3652. Persian. ##
  21. Beck LH, Bransome JR ED, Mirsky AF, Rosvold HE, Sarason I. A continuous performance test of brain damage. J Consult Psychol. 1956;20(5):343-50. doi: 10.1037/h0043220. PubMed PMID: 13367264. ##
  22. Hosseini Z, Talepasand S. Psychometric properties of the attention network test in Iranian children and adults. Advances in Cognitive Sciences. 2022;24(1):84-97. doi: 10.30514/icss.24.1.84. ##
  23. Suntup S. Keymath-Revised: A Diagnostic Inventory of Essential Mathematics. Encyclopedia of Special Education; 2008. p. 1204–5. ##
  24. Mohammadesmaeil E, Hooman HA. Adaptation and Standardization of the IRAN KEY-MATH Test of Mathematics. Journal of Exceptional Children. 2003;2(4):323. ##
  25. Lee H, Lee S, Hwang M, Woo K. Effectiveness of game-based digital intervention for attention-deficit hyperactivity disorder in children and adolescents: a systematic review and meta-analysis using Beard and Wilson's conceptualization of perception in experiential learning. Eur Child Adolesc Psychiatry. 2025;34(12):3853–3869. doi: 10.1007/s00787-025-02788-5. PubMed PMID: 40522458; PubMed Central PMCID: PMC12743074. ##
  26. Habibi Khouzani M, Tehranian A, Behzadi MH, Alamolhodaei SH. Comparison of the Effectiveness of Game-Based Therapy and Game-Based Therapy Integrated with Cognitive Rehabilitation on the Math Performance and Attitude towards Mathematics in Students with Learning Disabilities. IEEPJ. 2023;5(2):119-133. doi: 10.61186/ieepj.5.2.119. ##
  27. Mohammadinia N, Fatemi F-S, Nasiri M, Pirnia B. The Effectiveness of Cognitive-Behavioral Play Therapy on Anxiety and Academic Achievement among Children with LD. International Journal of Applied Behavioral Sciences. 2018;5(1):41–8. doi: 10.22037/ijabs.v5i1.23334. ##