Effects of Executive Function Skills Training on Visual-Spatial Processing and Working Memory in Elementary School Children with Learning Disorders

Learning Disorder (LD), an information–processing problem, interferes with learning skills and using them effectively. LDs usually affects individuals with average or above–average Intelligence Quotient (IQ). Prevalent LDs affect childrenchr('39')s reading and writing abilities, as well as mathematics, verbal, and nonverbal skills. Numerous children may challenge in school with some topics or skills. A significant number of children, despite having an average or higher IQ, present severe and significant deficiencies in intelligence tests and experience problems in normal adaptive abilities associated with educational learning. LDs cause social, emotional, and academic problems in students. An executive function is a group of essential mental skills. It is an umbrella term for neurological–based skills, involving emotional self–regulation. An executive function disorder can impair an individual’s ability to organize self and control their behavior. Individuals with executive function issues may encounter troubles controlling emotions or impulses, as well as problems with starting, organizing, planning, or completing tasks. Visual-Spatial processing and working memory are critical aspects of executive function in children with intellectual disabilities. Visual–Spatial processing is an individualchr('39')s ability to process visual signals to discern spatial relationships between objects and to visualize different scenarios or images. Moreover, working memory is defined as the part of short–term memory, i.e., concerned with immediate conscious conceptual and linguistic processing. The current study aimed to investigate the effects of executive function skills training on visual–spatial processing and working memory in children with LDs.

This was a quasi–experimental study with a pretest–posttest and a control group design. The statistical population of the study included all boys in the first and second grades of elementary school who were referred to the local Learning Disabilities Centers in Zahedan City, Iran, in 2017–2018. Accordingly, the study subjects were diagnosed with LDs based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–5). Of this population, 28 students met the inclusion criteria; four students failed to continue the study. The inclusion criteria were receiving a diagnosis of LDs, the age range of 7–8 years, signing informed consent forms, having an IQ of <70, comorbidity with attention deficit disorders, having any visual and auditory disorders, and having any other disorders (e.g., conduct disorder, developmental disorders, etc.). The exclusion criteria were absence from >3 training sessions and unwillingness to continue participating in the research. Finally, 24 students were selected by voluntary sampling method and randomly assigned into the experimental and control groups (n=12/group). The executive function skills training was performed in 15 sessions for the experimental group. The Tehran–Stanford–Binet Intelligence scale was used for data collection. This tool is a modified version of the Stanford–Binet Intelligence Scale for the Persian–speaking population. It is a cognitive ability and intelligence test, i.e., generally used to diagnose developmental or intellectual deficiencies in young children. The collected data were analyzed using Analysis of Covariance (ANCOVA) in SPSS. 

The present study results indicated significant differences between the experimental and control groups concerning working memory and visual–spatial processing scores after presenting executive functions skills training. Therefore, in the posttest stage, the working memory and visual–spatial processing scores of the experimental group were significantly higher than those of the controls (p<0.001). In other words, executive functions skills training significantly increased the working memory and visual–spatial processing scores of students with LDs in the posttest stage.

The current study findings suggested that the implication of the approach presented in this study improves skills related to learning in children with LDs; thus, it could be helpful, at least as a complementary method in this group.