Effectiveness of additional computer-based intervention for the remediation of visual perceptual skills in 7-9 year old learners diagnosed with attention deficit heperactivity disorder

Abstract

Purpose: The purpose of the study was to examine the intervention of visual perceptual problems in learners diagnosed with ADHD using computer technology. Learning, embedded with stepped levels of visual perceptual skills, can be reinforced in a spontaneous and playful manner through using technology. Phase 1 aimed at identifying the most prevalent visual perceptual dysfunction within the population. Thereafter in Phase 2 an intervention criteria was established to assist with the selection of the most appropriate software for the remediation of visual perceptual skills in learners diagnosed with ADHD. The purpose of the intervention criteria was to contribute to the fidelity of the intervention. Finally the effectiveness of the selected computer-based visual perception intervention programme was evaluated in Phase 3. Method: Intervention research design was implemented. The study consisted of three phases. Phase 1 included a record review to identify the most prevalent visual perceptual problems within a sample of children with ADHD. This assisted the researcher to identify the “at risk” visual perceptual constructs that were included in a treatment programme. Phase 2 involved reviewing the literature to identify essential criteria to be included in a visual perception intervention programme. A workshop was presented to experts in the field of visual perception, and content included results of Phase 1, treatment principles, grading principles and activity ideas identified in the literature. The nominal group technique (NGT) followed the workshop to establish the essential intervention criteria required of a computer-based visual perception intervention programme for learners diagnosed with ADHD. An intervention criteria checklist was developed with the participants of the nominal group and this was used to evaluate computer-based programmes which addressed visual perceptual skills. The most suitable computer-based programme was selected, with confirmation by one expert. Phase 3 involved evaluating the effectiveness the selected programme. A longitudinal crossover research design, which is a repeated measurement design, was employed in Phase 3. Results: Phase 1 illustrated that learners diagnosed with ADHD have special educational needs due to their barriers of learning. Their performance at school is less effective than a normative sample (peers) in visual perceptual tasks due to poor visual attention and impulsivity. It was also highlighted that ocular-motor function should be assessed and intervention should be provided for visual perceptual dysfunction in learners diagnosed with ADHD. The most prevalent visual perceptual problems in learners diagnosed with ADHD that was included in the record review were visual discrimination, visual closure, visual spatial relations and visual memory. This impacts on their academic outcomes such as reading and maths and results in lower academic results than their typical peers. Phase 2 emphasised the importance of the integration of clinical reasoning and literature to provide sound evidence that can support evidence-based practice. Grading and treatment principles are essential for ensuring the fidelity of the intervention. Explicit practice principles, goals and activities as well as the need for intervention are essential components in intervention research. Phase 2 demonstrated that there are various computer-based software treatment options available. However not all computer-based software treatment options are equal and it is therefore important to follow scientific guidelines in the selection of the most suitable computer programme for the remediation of visual perceptual skills in 7-9 year old learners diagnosed with ADHD. The intervention criteria checklist developed using a NGT resulted in each intervention criterion being allocated a weighting and which were used with a computer software evaluation form to select the Sea World Adventures™ computer programme that scored 84% of the identified intervention criteria. Phase 3 provided evidence that using an integration of traditional intervention in combination with technology can yield successful results. The within group results for Group 1 and 2 for Beery VMI, motor coordination, the visual perception, all TVPS-3 index scores (overall, basic processes, sequencing and complex processes) and scholastic assessment (reading, addition and subtraction) proved that additional computer-based intervention can have a significant impact. Between group results indicated that significant differences were obtained between Groups 1 and 2 for the scores on the Beery VMI test for VMI and the visual perception during Assessment 2, indicating the effectiveness of intervention A (additional computer-based intervention) for Group 1. Reading was the only scholastic assessment that yielded significant results in Assessment 2 for Group 1 compared to Group 2 after the additional computer-based intervention. This study illustrated that technology is an ideal intervention tool for children diagnosed with ADHD. Feedback provided by technology is immediate, multisensory and therefore reinforces rapid learning. Technology is evolving and a meaningful tool that can be used to promote learning and development. It should be used with judgement and careful selection. Caution should be applied to the intensity and frequency of usage and it should be closely monitored. Computer programmes that are used for the remediation of visual perceptual skills should be used in collaboration with other approaches such as occupational therapy. Learners should be exposed to a variety of activities on both a three dimensional and two dimensional level for the acquisition of visual perceptual skills if these are to be successfully integrated into their academic performance in the classroom.