fa اثربخشی تحریک الکتریکی مستقیم فراجمجمه ای (tDCS) بر آگاهی واج شناختی کودکان مبتلا به اختلال نارساخوانی تخصصي Special پژوهشي Research <div style="text-align: justify;"><span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span lang="AR-SA" style="font-size:13.0pt"><span b="" nazanin="" style="font-family:">چکیده</span></span></b><span lang="AR-SA" style="font-size:13.0pt"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:107%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">هدف:</span></span></span></b><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:"> به‌تازگی تحریک الکتریکی مستقیم فرا&shy;جمجمه&shy;ای (</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">tDCS</span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">) برای بهبود آگاهی واج&shy;شناختی مورد توجه پژوهش&shy;ها قرار گرفته است. این پژوهش با هدف اثر&shy;بخشی </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">tDCS</span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:"> بر آگاهی واج&shy;شناختی کودکانِ نا&shy;رسا&shy;خوان انجام شد. </span></span></span><b><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">روش:</span></span></span></b><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:"> در این مطالعه، از طرح پیش&shy;آزمون و پس&shy;آزمون با گروه کنترل</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:"> با دوره&shy; پیگری یک‌ماهه</span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:"> استفاده شد. جامعۀ آماری را تمامی دانش&shy;آموزان نا&shy;رسا&shy;خوان (8 تا 12 ساله) مراجعه&shy;کننده به مرکز مشاوره آموزش‌و‌پرورش بهارستان (استان تهران) در آذرماه 1402 تا اردیبهشت 1403 تشکیل می&shy;دادند که از بین آنها 40 دانش&shy;آموز (27 پسر و 13 دختر) به روش نمونه&shy;گیری در‌دسترس انتخاب شدند. دانش&shy;آموزان به‌طور تصادفی در دو گروه آزمایش (تحریک فعال، 20 نفر) و کنترل (تحریک ساختگی، 20 نفر) قرار گرفتند. </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">tDCS</span></span></span><span style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:"> دو&shy;جانبه در کرتکس گیجگاهی- آهیانه&shy;ای (الکترود آند بین </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">TP7</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:"> و </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">P7</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">؛ </span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">الکترود </span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">کاتد بین </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">TP</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">8</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:"> و </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">P8</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">)</span></span></span> <span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">نصب شد. گروه آزمایش و کنترل 12 جلسه (20 دقیقه&shy;ای) به‌ترتیب تحریک واقعی و ساختگی را دریافت کردند</span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">. </span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">برای جمع&shy;آوری داده&shy;ها از </span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">فهرست نشانگان نا&shy;رسا‌خوانی، </span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">آزمون خواندن و نارساخوانی (نما)</span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">،</span></span></span> <span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:"><span style="color:black">ویراست </span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">پنجم</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:"><span style="color:black"> آ</span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:"><span style="color:black">زمون هوش استنفورد- بینه و آگاهی واج&shy;شناختی استفاده شد</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">. </span></span></span><b><span lang="FA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">یافته‌ها:</span></span></span></b><span lang="FA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:"> نتایج نشان داد که </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">tDCS</span></span></span> <span lang="FA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">منجر به بهبودی آگاهی واجی (</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">ترکیب و تقطیع واجی، </span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">تشخیص کلمه‌های با واج آغازین و پایانی یکسان، نامیدن و حذف واج آغازین و پایانی</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">، </span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">حذف واج میانی</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">)</span></span></span> <span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">شد (01/0></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">p</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">)؛ </span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:.3pt">ولی اثر&shy;بخشی معنی&shy;داری بر</span></span></span></span> <span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">آگاهی درون‌هجایی</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:"> و </span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">آگاهی‌هجایی نداشت (05/0<</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">p</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">). <b>نتیجه&shy;گیری: </b>بنابراین، </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">tDCS</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:"> یک مداخله امید&shy;بخش است که توانایی&shy;‌های آگاهی واجی را تقویت می&shy;کند و درمانگران بالینی&shy; می&shy;توانند از آن به‌عنوان یک مداخله مکمل استفاده کنند.</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:.3pt"></span></span></span></span></span></span></span></span></span></div> <div style="text-align: justify;"><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span lang="EN" style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Abstract</span></span></b><b><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif"></span></span></b></span></span></span><br> <span style="font-size:10pt"><span style="line-height:85%"><span style="font-family:Calibri,sans-serif"><b><span lang="X-NONE" new="" roman="" style="font-family:" times="">Objective:</span></b> <span lang="EN" new="" roman="" style="font-family:" times="">Recently, transcranial direct electrical stimulation (tDCS) has been the focus of research to improve phonological awareness. This study was conducted with the aim of evaluating the effectiveness of transcranial direct electrical stimulation (tDCS) on the phonological awareness of dyslexic children. <b>Method:</b></span> <span lang="EN" new="" roman="" style="font-family:" times="">The study used a pretest-posttest control group design with one-month follow-up.</span> <span lang="X-NONE" new="" roman="" style="font-family:" times="">The statistical population consisted of all dyslexic students (8&ndash;12 years old) who were referred to </span><span lang="EN" new="" roman="" style="font-family:" times="">Baharestan Education and Training Consulting Center (Tehran Province/Iran)</span><span lang="X-NONE" new="" roman="" style="font-family:" times=""> during November 2023 and April 2024, among which 40 students (27 boys and 13 girls) were selected by convenience sampling method.</span> <span lang="X-NONE" new="" roman="" style="font-family:" times="">The students were randomly assigned into two experimental (active stimulation; n=20) and control (sham stimulation; n=20) groups. </span><span lang="EN" new="" roman="" style="font-family:" times="">Bilateral tDCS was applied over the temporal-parietal cortex (anode electrode between TP7 and P7; cathode electrode between TP8 and P8).</span> <span lang="EN" new="" roman="" style="font-family:" times="">The experimental and control groups received twelve 20-minute sessions of active and sham stimulation, respectively.</span> <span lang="X-NONE" new="" roman="" style="font-family:" times="">The List of Teacher&#39;s Dyslexia Symptoms, Reading and Dyslexia Test (NEMA), Stanford-Binet Intelligence Scales, Fifth Edition (SBIS-5),</span><span lang="EN" new="" roman="" style="font-family:" times=""> and phonological awareness were used to collect the required data. <b>Results</b>: The results showed that tDCS led to the improvement of phonemic awareness (</span><span lang="X-NONE" new="" roman="" style="font-family:" times="">phonetic composition</span><span lang="X-NONE" new="" roman="" style="font-family:" times="">, </span><span lang="X-NONE" new="" roman="" style="font-family:" times="">intersection</span> <span lang="EN" new="" roman="" style="font-family:" times="">of phonemes, </span><span lang="X-NONE" new="" roman="" style="font-family:" times="">recognition of words with the same initial and final phonemes,</span> <span lang="X-NONE" new="" roman="" style="font-family:" times="">naming and deletion of the initial and </span><span lang="EN" new="" roman="" style="font-family:" times="">final</span><span lang="X-NONE" new="" roman="" style="font-family:" times=""> phonemes</span><span lang="EN" new="" roman="" style="font-family:" times="">, and </span><span lang="X-NONE" new="" roman="" style="font-family:" times="">eliminating the middle vowel</span><span lang="EN" new="" roman="" style="font-family:" times="">) (p<0.01); however, it had no significant effect on </span><span lang="X-NONE" new="" roman="" style="font-family:" times="">syllabic intersection</span><span lang="EN" new="" roman="" style="font-family:" times="">, </span><span lang="X-NONE" new="" roman="" style="font-family:" times="">rhyme recognition, and homogeneity detection</span> <span lang="EN" new="" roman="" style="font-family:" times="">(p>0.05). <b>Conclusion:</b></span> <span lang="EN" new="" roman="" style="font-family:" times="">tDCS is, thus, a promising intervention that strengthens phonological awareness abilities. So, clinical therapists can use it as a complementary intervention</span><span lang="X-NONE" new="" roman="" style="font-family:" times=""><span style="letter-spacing:.3pt">.</span></span><span lang="X-NONE" style="font-family:"Times New Roman",serif"></span></span></span></span></div> تحریک الکتریکی فرا‌جمجمه‌ای, نا‌رسا‌خوانی, آگاهی واج‌شناختی. Transcranial direct electrical stimulation (tDCS), Phonological awareness, Dyslexia, Children 77 93 http://joec.ir/browse.php?a_code=A-10-2348-1&slc_lang=fa&sid=1 Mehdi Rezaei مهدی رضایی Mehdi.rezaei15@birjand.ac.ir@gmail.com 100319475328460018065 100319475328460018065 Yes University of Birjand دانشگاه بیرجند Fatemeh Peigodari فاطمه پیگداری peygodarifatemeh1379@gmail.com 100319475328460018066 0009-0004-5246-412X No University of Birjand دانشگاه بیرجند Mohammad Reza Asadi Younesi اسدی محمدرضا اسدی یونسی yoonesi@birjand.ac.ir 100319475328460018067 100319475328460018067 No University of Birjand دانشگاه بیرجند