Efficacy of multifaceted treatment for children with learning difficulties

Abstract

The present study focused on the relative efficacies of two interventions for children with learning difficulties. The first treatment group participated for two years in a structured multifaceted neurocognitive treatment developed in Santiago de Chile for children coming from lower or lower middle class families (CDA treatment). The second group participated for one year in a treatment that provided an enriched environment and the supervision of school tasks (HAS treatment), and for a second year in CDA treatment. The study was a two year long traditional between-group pre-post measurement experiment with three measurement points. Outcomes on neurocognitive, academic, and behavioral measures were studied. Special interest was focused on the comorbidity of attentional deficits and academic problems. The results indicated that significant gains occurred during both treatment years on most of the measures used. No major differences were found between the treatment groups; but parents whose children participated in CDA treatment, which included a parents' group, reported more improvement in home behavior. Pretreatment negative behavioral traits were associated with lesser academic growth in the group participating in HSA treatment. Inattention rather than hyperactivity-impulsivity was found to be associated with academic problems. On the basis of these findings it was concluded that it was beneficial to continue treatment for a second consecutive year. The findings emphasize the importance of including parents in the treatment of children with learning difficulties. They also suggest that affective and behavioral variables should not be neglected in interventions for learning difficulties, and that inattention and hyperactivity-impulsivity might have differential importance for both the occurrence of academic problems as well as for the treatment outcome. The study shows the multiple nature of the phenomenon treated as well as the difficulties related to group designs. The combination of a group and single case design would allow for the more careful study of the interactional and psychological mechanisms mediating effective interventions.