The Effectiveness of Training Neuropsychological Skills on Executive Function in Deaf Students with Cochlear Implants: A Single-Subject Research

Document Type : Original Articles


1 Associate Professor, Department of Psychology and Education for Children with Special Needs, School of Education and Psychology, University of Isfahan, Isfahan, Iran

2 - Department of Psychology, School of Educational Sciences and Psychology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran

3 PhD Student, Department of Psychology and Education for Children with Special Needs, School of Education and Psychology, University of Isfahan, Isfahan, Iran



Introduction: Children with cochlear implants, due to previous hearing deprivation, have damages in the areas of neuropsychological skills, including their executive functions. Since the executive functions are linked with a range of skills such as speech, language, communication, and education, this research aimed to investigate the effectiveness of training neuropsychological skills on executive function problems in deaf students with cochlear implants.Materials and Methods: This study was a single-subject research with A-B design. The study population consisted of all deaf children with cochlear implants at the age of 6 to 12 years in Isfahan City, Iran. Among them, 5 were selected using purposive sampling method. The research instrument was the Connors Neuropsychological Questioner. To analyze the obtained data, after drawing the diagrams, we used visual analyses, trending, and stability, as well as percentages of non-overlapping and overlapping data. Results: The mean scores of 5 subjects decreased from 62.47, 58.12, 61.19, 61.46, and 59.61 at the baseline to 48.22, 51.21, 49.30, 49.74, and 50.94 at the end of intervention, respectively. According to the visual analyses of the data diagrams, the intervention was effective on the studied subjects. The percentage of non-overlapping data in the two baseline and intervention situations for the subjects was 90%, 70%, 90%, 100%, and 80%. This effectiveness was observable in the follow-up stage.Conclusion: According to the results of this study, we can judge that training neuropsychological skills reduce executive function problems in deaf students with cochlear implans, and this approach can be used in the training and rehabilitation centers of children with cochlear implants.


  1. Adelabu B, Ojogbane V. Coping with Handicapped and Exceptional Learners by Student Teachers of Tertiary Institutions. International Journal of Innovative Research and Development 2012; 1(11): 69-80.
  2. Bubbico L, Rosano A, Spagnolo A. Prevalence of prelingual deafness in Italy. Acta Otorhinolaryngol Ital 2007; 27(1): 17-21.
  3. Thompson DC, McPhillips H, Davis RL, Lieu TL, Homer CJ, Helfand M. Universal newborn hearing screening: Summary of evidence. JAMA 2001; 286(16): 2000-10.
  4. Faramarzi S, Mohseni Ezhiyeh A, Abtahi SH, Sepehrnejad M. Research paper: Relationship of parent-child stress with cochlear implanted children's developmental skills. J Rehab 2016; 17(2): 118-27. [In Persian].
  5. Hintermair M, Sarimski K. Fathers of deaf and hard-of-hearing infants and toddlers-experiences, needs, and challenges. J Deaf Stud Deaf Educ 2018; 24(2): 84-94.
  6. Whicker JJ, Munoz K, Nelson LH. Parent challenges, perspectives and experiences caring for children who are deaf or hard-of-hearing with other disabilities: A comprehensive review. Int J Audiol 2019; 58(1): 5-11.
  7. Geers A, Tobey E, Moog J, Brenner C. Long-term outcomes of cochlear implantation in the preschool years: from elementary grades to high school. Int J Audiol 2008; 47(Suppl) 2: S21-S30.
  8. Beer J, Kronenberger WG, Pisoni DB. Executive function in everyday life: implications for young cochlear implant users. Cochlear Implants Int 2011; 12(Suppl 1): S89-S91.
  9. Marc M, Patricia ES, David BP, Christopher MC, William GK, Shirley H, et al. Executive function, cognitive control, and sequence learning in deaf children with cochlear implants. In: Marschark M, Spencer PE, editors. The Oxford handbook of deaf studies, language, and education. Oxford, UK: Oxford University Press; 2010.
  10. Gioia GA, Isquith PK, Guy SC. Assessment of executive functions in children with neurological impairment. In: Simeonsson R, Rosenthal S, editors. Psychological and developmental assessment: children with disabilities and chronic conditions. New York, NY: The Guilford Press; 2001. p. 317–56.
  11. Kronenberger WG, Pisoni DB, Henning SC, Colson BG. Executive functioning skills in long-term users of cochlear implants: a case control study. J Pediatr Psychol 2013; 38(8): 902-14.
  12. Spencer M, Richmond MC, Cutting LE. Considering the role of executive function in reading comprehension: a structural equation modeling approach. Scientific Studies of Reading 2020; 24(3): 179-99.
  13. Henry LA, Messer DJ, Nash G. Executive functioning in children with specific language impairment. J Child Psychol Psychiatry 2012; 53(1): 37-45.
  14. Barkley RA. Executive functions: What They are, how they work, and why they evolved. New York, NY: The Guilford Press; 2012.
  15. Baezat F. The effects of neuropsychological intervention (HAS) on reading and writing efficiency of linguistically dyslexic students: Single case study. Journal of Applied Psychology, 2009; 3(11): 7-19. [In Persian].
  16. Jadidi Feighan M, Abedi A, Jamali Paghale S, Jadidi Feighan M. Effectiveness of neuropsychological interventions on the reading components (Speed, accuracy and understanding) of students with dyslexic. Research in Clinical Psychology and Counseling 2015; 4(1): 115-34. [In Persian].
  17. Abedi A. Investigation of effectiveness of neuropsychological interventions for improving academic performance of children with mathematics learning disabilities. Advances in Cognitive Science, 2010; 12(1): 1-16. [In Persian].
  18. Faramarzi S, Yarmohamadian A, Malekpour M, Shirzadi P, Qasemi M. The effect of neuropsychological interventions on language performance in preschool children with specific language impairment (SLI): A case study. Middle Eastern Journal of Disability Studies 2016; 6: 304-16. [In Persian].
  19. Faramarzi S, Shirzadi P, Qasemi M, Yarmohamadian A. The effect of neuropsychological interventions on language performance of children with specific language impairment (SLI): A single subject study 2016; 4(4): 51-61.
  20. Ghasemi F, Karimi M, Dabaghi P. The effectiveness of Mindfulness-Based Cognitive Therapy on the quality of life in women with breast cancer. Nurse and Physician within War 2018; 6(20): 51-9. [In Persian].
  21. Ledford JR, Gast DL. Single subject research methodology in behavioral sciences. New York, NY: Routledge; 2014.
  22. Semrud-Clikeman M, Ellison PAT. Child neuropsychology: assessment and interventions for neurodevelopmental disorders. 2nd ed. New York, NY: Springer; 2009.
  23. Dawson P, Guare R. Executive skills in children and adolescents: A practical guide to assessment and intervention. New York, NY: The Guildford Press; 2010.