Effectiveness of the Cognitive Remediation Therapy (CRT) Program on Behavioral Problems in Children Aged 7 to 9 Years with Attention-Deficit/Hyperactivity Disorder

Authors

    Sahar Shahhosseini Birgani * Master of Clinical Psychology, Psychology Department, Na.C., Islamic Azad University, Isfahan, Iran Sahar.shahhosseini77@gmail.com
    Seyed Mohammadreza Samsam Shariat PhD in Psychology, Department of Psychology, University of Isfahan, Isfahan, Iran

Keywords:

attention-deficit/hyperactivity disorder, behavioral problems, cognitive remediation therapy

Abstract

The purpose of this study was to determine the effectiveness of the CRT program on behavioral problems in children with ADHD. This research was a quasi-experimental study using a pretest–posttest design with a control group. The statistical population consisted of all children aged 7 to 9 years diagnosed with ADHD in Ahvaz in 2024. From this population, 30 children were selected through convenience sampling and randomly assigned to experimental and control groups. The CRT intervention was delivered in ten 60-minute sessions, one session per week, for the experimental group, while the control group received no intervention. Data were collected using the Child Behavior Checklist (CBCL). Descriptive statistics (mean and standard deviation) and inferential statistics (multivariate and univariate analysis of covariance) were used for data analysis, employing SPSS version 26. The results indicated that the CRT intervention had a significant effect on the variables of anxiety/depression, withdrawal/depression, social problems, thought problems, attention problems, and aggressive behavior, leading to improvement in these problems in the experimental group compared to the control group (p < .05). However, the intervention did not have a significant effect on somatic complaints or rule-breaking behavior. The findings of this study confirm the effectiveness of the CRT program as an intervention method for reducing several behavioral problems in children with ADHD. Accordingly, implementing this program alongside other psychological and educational interventions in clinical and school settings is recommended for this group of children. Nevertheless, the lack of impact on some areas, such as somatic complaints, highlights the necessity of complementing CRT with additional approaches or designing more specialized sessions.

Downloads

Download data is not yet available.

References

Asayesh, M. H., & Parsakia, K. (2025). Paradoxical Timetable Therapy and Psychological Problems: Mechanisms of Change and Implications. Mental Health and Lifestyle Journal, 3(3), 1-21. https://doi.org/10.61838/mhlj.3.3.11

Barkley, R. A. (2012). Executive functions: What they are, how they work, and why they evolved. Guilford Press. https://psycnet.apa.org/record/2012-15750-000

Barkley, R. A. (2015). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment. Guilford Press. https://psycnet.apa.org/record/2014-57877-000

Budman, J., Maeir, A., Velder-Shukrun, I., & Zaguri‐Vittenberg, S. (2025). Effectiveness of the Cognitive–Functional Intervention for Adults (Cog–Fun A) in Assessing ADHD: A Retrospective Case Series. American Journal of Occupational Therapy, 79(4). https://doi.org/10.5014/ajot.2025.051045

Cicerone, K. D., Goldin, Y., Ganci, K., Rosenbaum, A., Wethe, J. V., Langenbahn, D. M., Malec, J. F., Bergquist, T. F., Kingsley, K., Nagele, D., Trexler, L. E. F. M., Bogdanova, Y., & Harley, J. P. (2019). Evidence-based cognitive rehabilitation: Systematic review of the literature from 2009 through 2014. Archives of Physical Medicine and Rehabilitation, 100(8), 1515-1533. https://doi.org/10.1016/j.apmr.2019.02.011

Cortese, S., Ferrin, M., Brandeis, D., Buitelaar, J., Daley, D., Dittmann, R. W., Holtmann, M., Santosh, P., Stevenson, J., Stringaris, A., Zuddas, A., & Sonuga-Barke, E. J. (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

Dalsgaard, S., Østergaard, S. D., Leckman, J. F., Mortensen, P. B., & Pedersen, M. G. (2015). Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: A nationwide cohort study. The lancet, 385(9983), 2190-2196. https://doi.org/10.1016/S0140-6736(14)61684-6

Diamond, A. (2012). Activities and programs that improve children's executive functions. Current Directions in Psychological Science, 21(5), 335-341. https://doi.org/10.1177/0963721412453722

DuPaul, G. J., & Stoner, G. (2014). ADHD in the schools: Assessment and intervention strategies. Guilford Press. https://psycnet.apa.org/record/2014-36924-000

Izadkhah, F., Moradi, J., Bahrami, A., & Janbozorgi, Z. (2024). The Effect of Motor and Cognitive Exercises on Working Memory and Selective Attention in Athletes with ADHD. The Journal of Tolooebehdasht. https://doi.org/10.18502/tbj.v23i3.16481

Klingberg, T. (2010). Training and plasticity of working memory. Trends in Cognitive Sciences, 14(7), 317-324. https://doi.org/10.1016/j.tics.2010.05.002

Pliszka, S. R. (2015). Comorbid psychiatric disorders in children with ADHD. In Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment (pp. 140-168). Guilford Press. https://psycnet.apa.org/record/2014-57877-005

Polanczyk, G. V. W. E. G., Salum, G. A., Kieling, C., & Rohde, L. A. (2014). ADHD prevalence estimates across three decades: An updated systematic review and meta-regression analysis. International journal of epidemiology, 43(2), 434-442. https://doi.org/10.1093/ije/dyt261

Poon, K., Ho, M. S., Wang, L. C., Lee, H. M., Lau, W. K., & Chan, W. W. L. (2024). Improving cognitive function in Chinese children with ADHD and/or RD through computerized working memory training. BMC psychology, 12(1), 1-15. https://doi.org/10.1186/s40359-024-02065-1

Rabipour, S., & Davidson, P. S. (2015). Do you believe in brain training? A questionnaire about expectations of computerised cognitive training. Behavioural Brain Research, 295, 64-70. https://doi.org/10.1016/j.bbr.2015.01.002

Rabipour, S., & Raz, A. (2012). Training the brain: Fact and fad in cognitive and behavioral remediation. Brain and Cognition, 79(2), 159-179. https://doi.org/10.1016/j.bandc.2012.02.006

Rubia, K. (2018). Cognitive neuroscience of attention deficit hyperactivity disorder (ADHD) and its clinical translation. Frontiers in human neuroscience, 12, 100. https://doi.org/10.3389/fnhum.2018.00100

Shabannezhad, A. (2024). Comparison of Cognitive Behavioral Therapy and Mindfulness on Anxiety, and Positive and Negative Affect in Female Students. Journal of Adolescent and Youth Psychological Studies (JAYPS), 5(1), 133-141. https://doi.org/10.61838/kman.jayps.5.1.16

Shams, A., NosratAbadi, M. E., Sangari, M., & Mirmoezzi, M. (2024). The Effect of Cognitive Rehabilitation, Physical and Concurrent Training on Sustained, Selective and Shifting Attention in Children with ADHD. Iran J Psychiatry Behav Sci, 27(3), 1-10. https://ijpcp.iums.ac.ir/article-1-3176-en.html

Shokoohi Yekta, M., & Motamed Yeganeh, N. (2024). Effects of Cognitive-Based Problem-Solving skills On Changing Parenting Styles and Reducing Parental Anger. Applied Family Therapy Journal (AFTJ), 5(1), 26-35. http://journals.kmanpub.com/index.php/aftj/article/view/1799

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 Ralf, W., Simonoff, E., Zuddas, A., Banaschewski, T., Buitelaar, J., Coghill, D., Hollis, C., Konofal, E., Lecendreux, M., . . . Sergeant, J. (2013). Nonpharmacological interventions for ADHD: Systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. American Journal of Psychiatry, 170(3), 275-289. https://doi.org/10.1176/appi.ajp.2012.12070991

Tavakoli, S., Abbasi, F., Heydari, B., & Akhondzadeh, M. (2024). Comparing the Effectiveness of Cognitive Behavioral Play Therapy and Gestalt Play Therapy on Vandalistic Behaviors, Impulsivity, and Cognitive Flexibility in Aggressive Male Elementary Students. Journal of Assessment and Research in Applied Counseling (JARAC), 6(3), 28-36. https://doi.org/10.61838/kman.jarac.6.3.4

Vosoughi Kalantari, A., Marashian, F. S., Dasht Bozorgi, Z., & Hafezi, F. (2025). Effectiveness of Cognitive-Behavioral Play Therapy on Behavioral Adjustment and Problem-Solving Skills in Students with Dyslexia. International Journal of School Health, 12(1), 1–2. https://doi.org/10.30476/intjsh.2024.103497.1427

World TSRFAC. (2024). Cognitive Behavioral Therapy: Applications and Effectiveness. https://books.google.com/books?hl=en&lr=&id=_jIeEQAAQBAJ&oi=fnd&pg=PA314&dq=Cognitive+behavioral+therapy+(CBT)+has+demonstrated+efficacy+in+managing+pain+by+addressing+maladaptive+cognitions+that+contribute+to+emotional+distress+and+behavioral+problems&ots=cVaBJjf60P&sig=0MxmEOUp-IA5Xs8JjuBdC2qmtWQ

Downloads

Additional Files

Published

2025-12-01

Submitted

2025-06-04

Revised

2025-08-27

Accepted

2025-09-14

Issue

Section

Articles

How to Cite

Shahhosseini Birgani, S., & Samsam Shariat, S. M. (2025). Effectiveness of the Cognitive Remediation Therapy (CRT) Program on Behavioral Problems in Children Aged 7 to 9 Years with Attention-Deficit/Hyperactivity Disorder. Psychological Research in Individuals With Exceptional Needs, 35-45. https://www.journals.kmanpub.com/index.php/prien/article/view/4813