Volume 5, Issue 4 (January 2025)
2025, 5(4): 161-171 |
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Ethics code: IR.IAU.AMOL.REC.1403.004
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Mohamadzade R, Hasannataj F, Taghipour javan A A. (2025). The Effectiveness of the Floortime Program on Behavioral Problems and Parent-child Interaction in Children with Attention Deficit Hyperactivity Disorder. Journal of Childhood Health and Education. 5(4), 161-171. doi:10.32592/jeche.5.4.161
URL: http://jeche.ir/article-1-256-en.html
URL: http://jeche.ir/article-1-256-en.html
1- Master' s student, Department of Psychology, Amol Branch, Azad University, Amol, Iran
2- Assistant Professor, Department of Psychology, Mazandaran University of Science and Technology, Babol, Iran
3- Assistant Professor, Department of Psychology and Counseling, Farhangian University, Tehran, Iran
2- Assistant Professor, Department of Psychology, Mazandaran University of Science and Technology, Babol, Iran
3- Assistant Professor, Department of Psychology and Counseling, Farhangian University, Tehran, Iran
Keywords: Floortime program, Behavioral problems, Parent-child interaction, Attention deficit hyperactivity disorder
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Background and Aim:
Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by three primary features: inattention, hyperactivity, and impulsivity. The prevalence of this disorder among school-aged children is reported to be between 2% and 7% (American Psychological Association, 2013). One important area of interest for researchers is the mental health of parents of children with ADHD. Parents of children with ADHD face greater parenting challenges and experience higher levels of psychological stress (Barkley & Fischer, 2019). Thus, implementing supportive intervention programs and other supportive measures to improve the mental health of children with ADHD becomes increasingly critical. In this regard, the Floortime therapeutic program is recognized as one of the most common and effective treatment approaches, with its efficacy demonstrated in various aspects of the behavior of children with ADHD and their parents (Bodaghi, Pirani, & Taghavi, 2021). This program, based on a developmental, individual-differences, and relationship-based (DIR) approach, offers a strategy to enhance children's development. It serves as an integrative framework for understanding human psychological development, utilizing the latest findings from neuroscience, developmental psychology, linguistics, communication studies, and clinical experiences to provide a comprehensive model of human growth. This model describes and explains how integrated human development occurs. The Floortime program provides strategies for improving children's growth by focusing on individual differences and relationships, fostering six core developmental skills: self-regulation and interest in the world, intimacy, two-way communication, complex communication, emotional beliefs, and logical thinking. Enhancing these six dimensions is essential for children's intellectual and emotional growth and helps children with autism spectrum disorder (ASD). This approach considers the individual challenges and differences of each child. A key aspect of the Floortime approach is paying close attention to the child’s interests and leveraging their focus to promote development (Greenspan & Wieder, 2023). Two variables of this study that may be influenced by the Floortime program are behavioral problems and parent-child interaction. As children grow, they often encounter specific behavioral and emotional issues arising from developmental pressures and mismatches with familial and societal expectations (Caroline & Gordon, 2023). Given the importance of this topic, research in this area can pave the way for further studies, clarifying the role of Floortime play therapy in reducing behavioral problems and enhancing parent-child interaction among children. These insights can also identify effective methods and strategies for fostering the growth and development of children. Thus, the research question is as follows: Does the Floortime program affect behavioral problems and parent-child interaction in children with ADHD? Methods: This study was a quasi-experimental research with a pretest-posttest design and a control group. The statistical population included all children with ADHD in Babol, Iran, during the 2023-2024 academic year. The sample consisted of 30 children with ADHD (15 in the control group and 15 in the experimental group), who were selected through convenience sampling and randomly assigned into the experimental and control groups. The inclusion criteria for this study were a confirmed diagnosis of ADHD, the absence of physical or psychological illnesses, and no sensory or intellectual disabilities, such as visual impairment, hearing impairment, or intellectual disabilities. The exclusion criteria included missing more than two sessions of the Floortime play therapy protocol, failure to complete the questionnaires, or unwillingness to continue participating in the study. The researcher selected 30 children with ADHD through convenience sampling. After selecting the sample, the Conners' Child Behavior Problems Questionnaire (1978) and the Pianta Parent-Child Interaction Scale (1994) were distributed as pretests and completed individually by the participants. The intervention program involved the Floortime method, delivered as play therapy sessions over two months, with at least two sessions per week for a total of 16 sessions. Following the intervention, the posttest was administered. Throughout the study, the researcher maintained close interaction with the participants, addressing any ambiguities or challenges that arose. Data analysis was performed using SPSS software (version 26). Descriptive statistics (e.g., Mean and Standard Deviation) were used for data analysis, and inferential statistics, specifically Multivariate Analysis of Covariance (MANCOVA), were employed based on the assumptions of the study. Results: The mean behavioral problems score in the experimental group was measured at 103.20 in the pretest and 102.67 in the posttest. Additionally, the mean parent-child interaction score in the experimental group was estimated at 104.60 in the pretest and 108.15 in the posttest. Based on the test results (P=0.30, F=1.33(3,259920))(P=0.30, F=1.33 (3,259920)) (P=0.30,F=1.33(3,259920)), the homogeneity of the dispersion matrices was not significant, indicating that the covariance matrices of the quantitative variables of the study (behavioral problems and parent-child interaction) are equal between the control and experimental groups. The assumption of regression slope homogeneity was tested, and the interaction between the two groups and the pretest scores of behavioral problems and parent-child interaction was not significant. In other words, the data support the hypothesis of regression slope homogeneity (P>0.05)(P > 0.05)(P>0.05). The Wilks' Lambda test (P=0.001, F=0.08(2,35))(P=0.001, F=0.08(2, 35))(P=0.001, F=0.08(2,35)) indicated that the hypothesis of equal means between the two groups based on the dependent variables (behavioral problems and parent-child interaction) is rejected, and the multivariate analysis of covariance is overall significant. The F-value and significance level showed a significant difference (P≤0.05) between the experimental and control groups in terms of behavioral problems and parent-child interaction in children with ADHD. Based on results obtained, it can be concluded that the Floortime program has a significant effect on reducing behavioral problems and improving parent-child interaction in children with ADHD. Discussions: The present study aimed to determine the effectiveness of the Floortime program in addressing behavioral problems and improving parent-child interaction in children with ADHD. The findings were promising, reducing behavioral problems and enhancing parent-child interactions. The results demonstrated that Floortime play therapy effectively reduced behavioral problems in children with ADHD. These findings align with those of Greenspan and Wieder (2023), Solomon et al. (2007), McGee (2020), and Roghani et al. (2022). To explain these results, it can be concluded that hyperactive children, who may initially appear to lack empathy towards others, learn through Floortime therapy to establish secure and developmental interactions characterized by shared attention and genuine connection. In this approach, parents, alongside specialists, gently engage the child in interaction based on their interests. Furthermore, the findings revealed that parent-child interaction improved through Floortime play therapy. Similarly, Pajaria and Rollers (2021) conducted a study on Floortime interventions based on parent training for children aged 2-6 with ADHD. Explaining this finding, it can be noted that the Floortime play therapy intervention actively involved training parents to use the Floortime approach during play with their children. The present study provided a safe and emotionally supportive environment through play, fostering appropriate mother-child relationships. It also demonstrated that increasing mothers' awareness and their active participation at home and in clinics to implement Floortime programs can significantly enhance intimacy, reduce conflict, and ultimately improve the quality of parent-child interactions. Among the limitations of this study, it can be noted that due to its cross-sectional nature, the researcher may not have been able to provide a complete picture of the variables of behavioral problems and parent-child interaction. Given the effectiveness of Floortime therapy in addressing behavioral problems and improving parent-child interactions, it is recommended that such therapies be implemented by counselors in preschools and schools for children with ADHD, as well as by the country’s education and welfare organizations, to address behavioral issues, enhance parent-child relationships, and promote mental health. Ethical Considerations This study was extracted from a Master’s thesis. All common ethical principles and guidelines were strictly followed throughout the study. Participants were informed about confidentiality, privacy protection, anonymity of the questionnaires, and the details of the intervention process. Funding This study received no financial support from public or private institutions or organizations. Authors’ Contributions All authors contributed equally to the drafting, review, and revision of the manuscript. Conflict of Interest According to the authors, there were no financial supports or conflicts of interest associated with this study. Acknowledgments The authors would like to express their gratitude to all the parents who contributed and cooperated in the implementation of this study. References Abareshi Z, Tahmasian K, Mazaheri M A, Panaghi L. (2009). The impact of psychosocial Child Development training program, done through improvement of mother-child interaction, on parental self-efficacy and relationship between mother and child under three. Journal of Research in Psychological Health, 3 (3):49-58. http://rph.khu.ac.ir/article-1-115-en.html
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Article type Original research Pages: 161-171 |
| Corresponding Author’s Info E-mail: azeinali@iaukhoy.ac.ir |
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| Article history: Received: 2024/13/08 Revised: 2024/10/31 Accepted: 2024/09/08 Published online: 2025/02/28 |
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| Keywords: Attention deficit hyperactivity disorder Behavioral problems Floortime program Parent-child interaction |
Type of Study: Research |
Subject:
Special
Received: 2024/10/5 | Accepted: 2024/11/30 | Published: 2025/02/28
Received: 2024/10/5 | Accepted: 2024/11/30 | Published: 2025/02/28
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