Middle Eastern Journal of Disability Studies

Abstract
Background & Objectives: Learning is the most basic process by which an apprentice becomes a master with cognitive skills and thinking power. Some people face problems in the normal routine of teaching and learning. Some of these people are students with special learning disabilities that are classified as neurodevelopmental disorders. According to DSM–5, specific learning disorder is accompanied by deficits in reading, writing, and mathematics. Considering this topic's importance, it seems necessary to use methods to help solve these children's problems. Regarding the education and treatment of learning disorders, one of the most important methods is the sensory integration method. Sensory integration refers to processes whose information enters the brain through the eyes, ears, mouth, nose, skin, muscles, joints, and sense of balance. The method of reorganizing the central nerves, based on movement therapy and neuromuscular retraining programs, tries to use and consolidate the previously unacquired movement patterns from the lower parts of the brain. The present study compared the effectiveness of the sensory integration and central nervous system reorganization methods on the visual–spatial skills of students with specific learning disabilities.

Methods: This quasi–experimental research employed a pretest–posttest and a follow–up design with a control group. The statistical population of this research included all students with specific learning disabilities (reading/writing, math, and mixed disabilities) who were referred to educational and clinical centers in Rafsanjan City, Iran, in the 2020–2021 academic year. Of them, 90 qualified volunteers (30 with reading/writing disabilities, 30 people with mathematics disabilities, and 30 people with mixed disabilities) were included in the study using available and targeted sampling methods. Then, they were randomly assigned to three groups: sensory integration, central nervous reorganization experimental, and control. The inclusion criteria were as follows: having a learning disability, being 13 to 15 years old, showing normal intelligence, lacking problems like hyperactivity, and not having special mental or physical problems. The exclusion criteria were as follows: absence of more than one session, non–cooperation of the child or family, hyperactivity of the child, and not tolerating the study conditions.

The first experimental group received the sensory integration training program in 12 ninety–minute sessions using the Ayres (1972) theoretical and therapeutic principles of sensorimotor integration. The second experimental group received the central nervous system reorganization training program in 8 ninety–minute sessions using the theoretical and therapeutic bases of Delacato (1992). No intervention was provided to the control group during this period. The research data was collected using the visual–spatial memory test of Cornoldi (1998). Data were analyzed using repeated measurement with mixed design and multivariate analysis of variance at a significance level of 0.05 using SPSS software version 24.

Results: There was a significant difference between the experimental group of sensory integration and the control group in the visual–spatial skills of children with learning disabilities (p<0.001), as well as between the central nervous system reorganization group and the control group in the visual–spatial skills of children with learning disabilities. There was a significant difference in learning (p<0.001), but no significant difference was observed between the two groups of sensory integration and reorganization of central nerves in visual–spatial skills in the general state. Also, in the sensory integration and central nervous system reorganization groups, there was a significant difference between the pretest and posttest scores and between the pretest and follow–up scores in terms of visual–spatial skills scores (p<0.001). However, there was no significant difference between the posttest and follow–up scores in the sensory integration and central nervous system reorganization groups, indicating that the interventions of sensory integration and reorganization of the central nerves continued in the follow–up phase. Also, the effect of the disorder and its interaction with group and time was not significant, and the results showed no difference between the experimental groups in the three categories of disorders (reading/writing, math, and mixed).

Conclusion: Based on the findings of the research and considering the follow–up tests, it was concluded that the sensory integration and reorganization of the central nervous system reorganization methods had the same effect on the visual–spatial skills of children with learning disabilities. Both methods in this research equally increased the visual–spatial skills of children with a learning disorder.