Introduction
Neurodevelopmental disorder is a specific learning disability that appears at school age and causes persistent problems in learning to read, write, and do math. Approximately 5% to 15% of school-age children have a specific learning disability [1], and 24% to 52% of them suffer from social, emotional, and behavioral problems [2]. Researchers have found behavioral problems, low self-esteem, poor social self-efficacy, and high anxiety in children with special learning disabilities [3] due to their increased stress in school. A high prevalence of anxiety (28.8%) at school age, especially in children with disorders, create adverse consequences [4], including school distress and distraction [5], poor ability to store information in short-term memory [6], absence from classes, and refusing to do homework [7]. The delay caused by the situation increases school anxiety. Therefore, timely intervention is necessary to prevent the worsening of anxiety. The use of some techniques, such as assertive training, can effectively reduce anxiety symptoms. Assertiveness helps the children express their feelings while respecting the opinions and feelings of others and using talking when facing their opposition [8].
Some studies have shown the effect of assertive group training on increasing self-esteem [9, 10, 11], social adjustment [12], interpersonal interaction; reducing social anxiety [10, 11]; and increasing quality of school life [13]. However, in one study, the effect of assertiveness on reducing anxiety was not significant [14]. In assertiveness education, children are first taught the nature of assertive behavior through social modeling so that they have the opportunity to practice assertive behaviors and receive appropriate feedback on behavioral exercises. Objective methods of assertiveness are then described to children, and situations are adapted from the children’s everyday experiences to exemplify the behaviors in those situations [15]. Since children with special learning disabilities constitute approximately 40% of all children [16], and specific learning disabilities cause repeated failures in students’ education [17], assertive training teaches students to change their self-image, express themselves easily [18], improve their social skills, respect their own and others’ rights, and defend their rights as well [10]. According to the previous findings, children with learning disabilities have higher anxiety and lower self-esteem compared to normal peers [6, 19 20]. There are some contradictory evidence regarding the effect of assertiveness training programs on anxiety [21, 22]. If children are equipped wit,h coping strategies they can deal with their anxiety in daily life and improve their mental health [15]. While there is no sufficient assertiveness training program for educating children with special needs, it seems that designing such programs should be adjusted based on the characteristics of children with learning disabilities [23]. 
Participants and Methods
This quasi-experimental study used a pretest-posttest design with a control group and a 5-week follow-up. Out of the boys aged 8 to 11 years with learning disabilities studying in the second to fourth grades of the elementary school in the academic year 2019-2020, 34 students were randomly selected from five centers in the educational districts of Tehran. They should have met the inclusion criteria (IQ ≥85, anxiety score ≥44) and exclusion criteria (participation at the same time or at least during the last six months in a program similar to assertiveness training, autism spectrum disorder, physical disability, blindness, and deafness). Based on age, grade, and peer socioeconomic status, they were randomly assigned to experimental and control groups (17 in each group). Due to the COVID-19 pandemic, the experimental group participated in an assertiveness training program for ten virtual group sessions (twice a week; each session lasted 90 minutes). At the end of the assertiveness training sessions and five weeks later, all subjects were assessed using the Spence children’s anxiety scale. To observe the ethical principles, the content of the audacity training sessions was presented briefly and, after follow-up, in a virtual session for the students of the control group. 
The data were analyzed using univariate and multivariate analysis of covariance (ANCOVA) and repeated measures analysis of variance (ANOVA) in SPSS software v. 23. Color progressive matrices were used to measure the IQ of the subjects [24]. These matrices are designed for children 5 to 11 years old and adults with mental and physical disabilities and contain 36 items. Most test materials are in colored backgrounds, but the last five materials are presented in black and white [25]. For each correct answer, a score is assigned, and the subject’s raw score set is converted to IQ from the norm table, taking into account the age variable. Progressive color matrices have been reported on the normalization of Iranian students and its retest reliability coefficient in the range of 0.39 to 0.87 [26]. 
The Spence Children’s Anxiety Scale was used to measure anxiety. The scale is designed to measure the anxiety of children aged 8 to 15 years [27] in Australia and measures six components. There are 6 items and one of them has two dimension: separation anxiety, social phobia, obsessive-compulsive disorder, panic disorder/agoraphobia, generalized anxiety disorder, personal injury fears. Scoring is based on a 4-point Likert scale, and the range of scores obtained is between 0 and 114. A score of 44 to 88 indicates moderate anxiety [28]. The scale’s reliability by the Cronbach α method is significant between 0.62 and 0.89. At P<0.001, six questionnaire factors were confirmed by confirmatory factor analysis [29]. The overall score of the scale was used as an indicator to measure anxiety symptoms.
Results
The Mean±SD ages of experimental and control groups were 10.45±2.25 and 8.87±1.89 years, respectively. The results of the Chi-square test showed that the differences between experimental and control groups in terms of age (P>0.801) and educational area (P>0.001) were not significant. The mean of general anxiety of the experimental group in the pretest (48.85) was higher than the posttest (35.47), although this value also increased in the follow-up (44.92). Also, this change in anxiety components was observed in the experimental group. Univariate and multivariate analyses of covariance were used to investigate whether assertiveness training reduces anxiety and its components in male students with special learning disabilities. 
All variables (anxiety and its components) were at interval level of measurement, have normal distribution (Shapiro Wilks P>0.05), homogeneous variances (Leven test P>0.05), have a line slope between the score of anxiety in pretest and post test. The results of Wilk's Lambda showed that the effect of group on anxiety and its components is significant (P<0.001, F=1.885).
According to Table 1, the general anxiety of the experimental group significantly decreased after participating in assertiveness training sessions.


According to the Eta coefficient, 66% of the changes in the general anxiety of the experimental group can be explained by their participation in training sessions. Based on the results of multivariate analysis of covariance, the levels of generalized anxiety, obsessive-compulsive disorder, fear of personal injury, social phobia, separation anxiety, and fear of outdoor space in children in the experimental group significantly decreased after participating in assertiveness training sessions. Based on Eta coefficients, 66%, 32%, 63%, 63%, 71%, and 73% of the variance of the components of generalized anxiety, obsessive-compulsive disorder, fear of personal injury, social phobia, separation anxiety, and fear of outdoor space in children with special learning disabilities can be explained, respectively due to their participation in educational sessions. To determine the stability of the effect of assertiveness training on anxiety and its components in the posttest and follow-up, we used the repeated measures analysis of variance.
According to Table 2, for general anxiety and its components (separation anxiety, panic/fear of outdoor space), the difference between factor scores (pretest, posttest, and follow-up) as well as the interaction between factor scores and the two groups are significant (P≤0.05).


Thus, the effect of assertiveness training has been sustained only in reducing the components of pervasive anxiety, fear of personal injury, social phobia, and obsessive-compulsive disorder after five weeks of follow-up. To determine the significant difference of each stage of the test, we used the posttest of least significant difference (LSD) with respect to the homogeneity of variance.
Table 3 indicates that in the experimental group, there is a significant difference between the Pretest and posttest in the mean of general anxiety, separation anxiety, and panic/fear of outdoor space, and between pretest and follow-up in the mean of general anxiety and separation anxiety (P≤0.01).


Indeed, the experimental group’s overall anxiety, separation anxiety, and panic/fear scores changed significantly from pretest to posttest. In addition, there is a significant difference between pretest and posttest as well as between posttest and follow-up in the mean panic/fear of outdoor space in the experimental group. This result indicates that the effectiveness of assertiveness training on panic/fear of the outdoors has been stable after five weeks of follow-up. However, this difference from posttest to follow-up situations was not significant for the general anxiety and separation anxiety components in the experimental group. 
Discussion and Conclusion
This study aimed to determine the effectiveness of assertiveness training on anxiety symptoms in boys with special learning disabilities. The study’s first finding showed that assertiveness training reduced general anxiety symptoms in boys with special learning disabilities, which is consistent with the results of some studies [30, 31]. Some findings [32] show that an assertive program positively affects expressing emotions and rational expression of thoughts and ideas, increases self-esteem, and empowers people to cope with stress. Also, some findings [33, 34] show that participating in an assertive program in students reduces anxiety, stress, and depression and improves the memory of patients with multiple sclerosis. 
To explain the research results, it can be said that assertiveness is one of the life skills that increase cognitive ability by performing exercises. These exercises lead to significant changes in behavior, emotions, and thoughts [34]. During assertiveness training sessions, children are introduced to the benefits of assertiveness. Familiarity with assertive behavior helps the children use the word “no” when necessary [35] and thus, reduces the symptoms of anxiety or stress [36, 37]. 
The second finding showed that assertiveness training reduces anxiety. The findings is consistent with some previous results such as Narimani, Kaplan, and Domino [4, 36, 38]. Assertiveness training is one of the techniques used in psychological therapies that cure anxiety symptoms. It helps people use appropriate methods to vent their emotions and express them logically by observing and modeling during training sessions and role-playing. They learn to monitor their behavior and respond appropriately to criticism from others.
To explain the effectiveness of assertiveness training in reducing social phobia and panic/fear of the outdoors, it can be noted that children with social phobia try to establish effective social interactions with peers, but peers are less likely to respond positively to their efforts. When they learn assertiveness, they face criticism that angers them. Role-playing, viewing patterns in the films presented, and modeling during assertiveness training sessions enable children to cope with challenges and failures [39]. When children with learning disabilities interact with their peers and friends, they experience greater self-efficacy, which contributes to reducing social phobia [40].
In explaining the effectiveness of assertiveness training on obsessive-compulsive disorder, some findings [41, 42] have shown that one-third of children with obsessive-compulsive disorder cannot play, socialize, attend school, and function effectively in the family [43]. Using face-to-face cognitive-behavioral training that uses assertiveness training helps the children perform various cognitive exercises and activities, increase interpersonal relationships and self-confidence, reduce their anxiety and stress, thus preventing the negative consequences of obsessive-compulsive disorder on their psychosocial functioning [44].
Some consistent findings regarding the effectiveness of assertiveness training in reducing pervasive anxiety can be mentioned [45, 46, 47]. Since an assertiveness program is an intervention approach to increase self-esteem, logical and emotional expression of anxiety, and stress, it helps people manage their anxiety in interpersonal relationships and different critical situations [44]. 
To explain the finding that assertiveness training has reduced the fear of personal injury in children with special learning disabilities, we can point to the consistent result [48] that children’s awareness of the causes of fear helps them to experience a sense of security and comfort in situations where people are more likely to be harmed by others, and not allow themselves to be abused or harassed by others. 
Finally, in explaining why the effect of the assertiveness training program on general anxiety and separation anxiety has not been stable after five weeks of follow-up, it can be pointed out that if the training and homework related to assertiveness are included in the daily activities of this group of children to a greater extent and are accompanied by the necessary incentives, one can expect that the learned behavior of assertiveness will not disappear over time. Because during daily activities, the children can be constantly reminded to generalize the response learned in training sessions to different situations and thus can overcome their anxiety for a longer period of time [39].
Children with learning disabilities face difficulties in academic achievement. Since academic failure is inversely related to self-confidence [49], the assertiveness training program as an intervention approach to increase self-esteem and self-confidence helps children learn new skills to prepare for multiple roles in adulthood. Therefore, designing and implementing intervention programs similar to assertiveness training can be the source of positive changes in the mental health and academic performance of children with special needs (especially children with special learning disabilities).
Because of limitations such as not using clinical interviews to measure anxiety and relying solely on the Spence anxiety scale for children, implementing a virtual assertiveness training program due to the closure of schools (caused by the COVID-19 pandemic), lack of control over maternal anxiety, and the type of learning disability (dyslexia, dyslexia and math disorder) in the present study, the results cannot be generalized or drawn conclusions from them. It is suggested to use other techniques to measure the level of anxiety, including the clinical interview. Using the assertiveness training program in real form can lead to different results from its virtual implementation, measuring the level of parental anxiety and examining the effect of the assertiveness training program on the level of anxiety of each child according to the type of learning disorder can lead to more accurate results.

Ethical Considerations
Compliance with ethical guidelines
This research was approved by the Ethics Committee of the University of Social Welfare and Rehabilitation Sciences (Code: IR.USWR.REC.1399.258). To observe ethical considerations, the officials of the learning disabilities centers and children with special learning disabilities were fully informed about the research objectives. In addition to obtaining written consent, they were assured that their obtained information would remain confidential. The children’s participation in the study was voluntary, and those who did not wish to continue their cooperation would be excluded. While paying attention to children’s mental states and fatigue, an attempt was made to respect their dignity and human rights during the research. After the assertiveness training sessions, the control group was introduced to the content of the assertiveness training program in an intensive session.

Funding
This article is extracted from the MA. thesis of the first author at the Department of Psychology and Exceptional Child Education, Faculty of Behavioral Sciences, University of Rehabilitation Sciences and Social Health, Tehran.

Authors' contributions
Conceptualization and drafting: Mehdi Mohagheghi and Masoume Pourmohamadreza-Tajrishi; Methodology and analysis: Mehdi Mohagheghi, Masoume Pourmohamadreza-Tajrishi, and Mohsen Vahedi; Validation: Mehdi Mohagheghi, Masoume Pourmohamadreza-Tajrishi, Soheila Shahshahani, Gita Mollali, and Mohsen Vahedi; Research: Mehdi Mohagheghi; Sources: Mehdi Mohagheghi, Masoume Pourmohamadreza-Tajrishi, Soheila Shahshahani, and Gita Mollali; Editing and finalizing: Masoume Pourmohamadreza-Tajrishi and Soheila Shahshahani; Supervision: Masoume Pourmohamadreza-Tajrishi, Soheila Shahshahani, Gita Mollali, and Mohsen Vahedi.

Conflict of interest
The authors declared no conflict of interest.

Acknowledgments
We would like to thank the University of Rehabilitation and Social Health for its financial support of the research and all individuals, especially education officials, teachers, students, and parents, who helped us.


 
References

1. American Psychiatric Association (APA). Diagnostic and statistical manual of mental disorders (DSM-5™). 5th ed. Arlington: American Psychiatric Publishing; 2013. https://www.google.com/books/edition/Diagnostic_and_Statistical_Manual_of_Men/-JivBAAAQBAJ?hl=en&gbpv=1&dq=Diagnostic+and+statistical+manual+of+mental+disorders&printsec=frontcover
2. World Health Organization (WHO). ICD-10: International statistical classification of diseases and related health problems: Tenth revision, 2nd ed [Internet]. 2004. Available from: https://apps.who.int/iris/handle/10665/42980
3. Moinalghorabaie F, Islam M, Fadaee M. [Prevalence of learning disabilities among primary school students in north khorasan province (Persian)]. Journal of Learning Disabilities. 2015; 5(1):101-24. http://jld.uma.ac.ir/article_366.html?lang=en
4. Narimani M, Rajabi S. [A study of the prevalence and causes of learning disorders among elementary students of Ardebil Province (Persian)]. Journal of Exceptional Children. 2005; 5(3):231-52. [DOI:20.1001.1.16826612.1384.5.3.1.1]
5. Zakopoulou V, Mavreas V, Christodoulides P, Lavidas A, Fili E, Georgiou G, et al. Specific learning difficulties: A retrospective study of their co morbidity and continuity as early indicators of mental disorders. Research in Developmental Disabilities. 2014; 35(12):3496-507. [DOI:10.1016/j.ridd.2014.07.040] [PMID]
6. Bayrami M, Hashemi T, Shadbafi M. [Comparison of emotional-social problems in students with and without specific learning disabilities in reading and mathematics (Persian)]. Journal of Child Mental Health. 2017; 4(3):69-78. http://childmentalhealth.ir/article-1-196-en.html
7. Bakhla AK, Sinha P, Sharan R, Binay Y, Verma V, Chaudhury S. Anxiety in school students: Role of parenting and gender. Industrial Psychiatry Journal. 2013; 22(2):131-7. [DOI:10.4103/0972-6748.132927] [PMID] [PMCID]
8. Sridevi G, George AG, Sriveni D, Rangaswami K. Learning disability and behavior problems among school going children. Journal of Disability Studies. 2015; 1(1):4-9. http://www.pubs.iscience.in/journal/index.php/jds/article/view/280
9. Ariapooran S. [Comparing the emotion expression, emotional literacy and social self-efficacy in children with and without learning disabilities (Persian)]. Journal of Learning Disabilities. 2016; 5(2):7-26. http://jld.uma.ac.ir/article_389_72.html?lang=en
10. Cervin M, Perrin S, Olsson E, Claesdotter-Knutsson E, Lindvall M. Incompleteness, harm avoidance, and disgust: A comparison of youth with OCD, anxiety disorders, and no psychiatric disorder. Journal of Anxiety Disorders. 2020; 69:102175. [DOI:10.1016/j.janxdis.2019.102175] [PMID]
11. Mirzakhany N, Kangarani Farahani M, Rezaee M, Akbarzadeh Baghban A, Sadeghi E. [Comparison of assertiveness skills and anxiety between students with learning disability and typical peers in elementary schools of Tehran (Persian)]. Scientific Journal of Rehabilitation Medicine. 2016; 5(2):209-18. http://medrehab.sbmu.ac.ir/article_1100208.html?lang=en
12. Andreescu C, Mennin D, Tudorascu D, Sheu LK, Walker S, Banihashemi L, et al. The many faces of anxiety-neurobiological correlates of anxiety phenotypes. Psychiatry Research. 2015; 234(1):96-105. [DOI:10.1016/j.pscychresns.2015.08.013] [PMID] [PMCID]
13. Sobba KN. Correlates and buffers of school avoidance: A review of school avoidance literature and applying social capital as a potential safeguard. International Journal of Adolescence and Youth. 2019; 24(3):380-94. [DOI:10.1080/02673843.2018.1524772]
14. Avşar F, Ayaz Alkaya S. The effectiveness of assertiveness training for school-aged children on bullying and assertiveness level. Journal of Pediatric Nursing. 2017; 36:186-90. [DOI:10.1016/j.pedn.2017.06.020] [PMID]
15. Wolpe J. Psychotherapy by reciprocal inhibition. Conditional Reflex. 1968; 3(4):234-40. [DOI:10.1007/BF03000093] [PMID]
16. Khodabakhshi Kolaee A, Mehrara M, Navidian A, Mosalanejhad L. [The effectiveness assertiveness skills training on students’ mental health-related factors (Persian)]. Iranian Journal of Pscychiatric Education. 2014; 1(4):74-85. http://ijpn.ir/article-1-245-en.html
17. Lin YR, Shiah IS, Chang YC, Lai TJ, Wang KY, Chou KR. Evaluation of an assertiveness training program on nursing and medical students’ assertiveness, self-esteem, and interpersonal communication satisfaction. Nurse Education Today. 2004; 24(8):656-65. [DOI:10.1016/j.nedt.2004.09.004] [PMID]
18. Pasha R. [The effect of assertiveness training on self-esteem, social anxiety and definitiveness in students (Persian)]. Journal of Educational and Scholastic Studies. 2014; 3(4):99-114. http://pma.cfu.ac.ir/article_503.html?lang=en
19. Rahimian Boogar E, Shareh H, Habibi Askarabad M, Besharat MA. [Effect of assertiveness training methods on social adjustment (Persian)]. Journal of Educational Innovations. 2007; 6(4):29-54. https://www.sid.ir/en/journal/ViewPaper.aspx?id=126058
20. Nobandegani N, Momeni Javid M, Hosseinian S. [Effectiveness of training assertiveness behavior on life quality in school and social anxiety of females’ students (Persian)]. New Educational Approaches. 2015; 10(2):101-16. https://nea.ui.ac.ir/article_20907.html
21. Rosemberg FK, Lapco A, Llorensc M. The teacher’s role in the application of an assertive discipline program for students in a venezuelan primary school. School Psychology International. 1990; 11(2):143-6. [DOI:10.1177/0143034390112008]
22. Mohammadi M, Farid A, Habibi Kalibar R, Mesrabadi J. [Effectiveness of assertiveness training on assertion and social problem solving of male students who are victims of bullying (Persian)]. Journal of Psychological Studies. 2021; 16(4):93-107. [DOI:10.22051/PSY.2021.30461.2165]
23. Bagheri K, Mirzaian B, Fakhri MK. [The effectiveness of life skills training (anger management, assertiveness and effective communication) on hardiness and coping derelict adolescent (Persian)]. Journal of Psychology New Ideas. 2017; 1(2):55-62. http://jnip.ir/article-1-95-en.html
24. Goldstein S, Brooks RB. Handbook of resilience in children. 2nd ed. Berlin: Springer; 2013. [DOI:10.1007/978-1-4614-3661-4]
25. Kirk S, Gallagher JJ, Coleman MR. Educating exceptional children (14th ed.). 14th ed. CA: Belmont: Cengage Learning; 2015. https://www.google.com/books/edition/Educating_Exceptional_Children/kVo8AwAAQBAJ?hl=en&gbpv=0
26. Mabbott DJ, Bisanz J. Computational skills, working memory, and conceptual knowledge in older children with mathematics learning disabilities. Journal of Learning Disabilities. 2008; 41(1):15-28. [DOI:10.1177/0022219407311003] [PMID]
27. Forneris T, Danish SJ, Scott DL. Setting goals, solving problems, and seeking social support: developing adolescents’ abilities through a life skills program. Adolescence. 2007; 42(165):103-14. [PMID]
28. Rabiei L, Eslami AA, Masoudi R, Salahshoori A. [Assessing the effectiveness of assertiveness program on depression, anxiety and stress among high school students (Persian)]. Journal of Health System Research. 2012; 8(5):844-56. https://hsr.mui.ac.ir/article-1-440-en.html
29. Yen CF, Yang P, Wang PW, Lin HC, Liu TL, Wu YY, et al. Association between school bullying levels/types and mental health problems among Taiwanese adolescents. Comprehensive Psychiatry. 2014; 55(3):405-13. [DOI:10.1016/j.comppsych.2013.06.001] [PMID]
30. Saidi S, Rezvani F, Rezvan A. [Assertiveness training on shyness and behavioral incompatibility in female students (Persian)]. Middle Eastern Journal of Disability Studies. 2020; 10:88. [DOR:20.1001.1.23222840.1399.10.0.12.1]
31. Kashizade P, Haroon Rshidi H, Kazemiyan Moghadam K. [Effectiveness of emotion regulation training in improving self-perception and assertiveness of students with learning disabilities (Persian)]. Journal of Exceptional Children. 2020; 20(3):37-48. [DOR:20.1001.1.16826612.1399.20.3.10.5]
32. Serber M, Nelson P. The ineffectiveness of systematic desensitization and assertive training in hospitalized schizophrenics. In: Wolpe J, Reyna LJ, editors. Behavior Therapy in Psychiatric Practice. Pergamon: Pergamon Press; 1976. p. 153-5. [DOI:10.1016/B978-0-08-021148-0.50034-7]
33. Jacobs NCL, Dehue F, Völlink T, Lechner L. Determinants of adolescents’ ineffective and improved coping with cyberbullying: A Delphi study. Journal of Adolescence. 2014; 37(4):373-85. [DOI:10.1016/j.adolescence.2014.02.011] [PMID]
34. Shan G, Ma C. A comment on sample size calculation for analysis of covariance in parallel arm studies. Journal of Biometrics & Biostatistics. 2014; 5:1. [DOI:10.4172/2155-6180.1000184]
35. Bilker WB, Hansen JA, Brensinger CM, Richard J, Gur RE, Gur RC. Development of abbreviated nine-item forms of the raven’s standard progressive matrices test. Assessment. 2012; 19(3):354-69. [DOI:10.1177/1073191112446655] [PMID] [PMCID]
36. Kaplan RM. Standardized tests in education, civil service, and the military. In: Kaplan RM, Saccuzzo DP, editors. Psychological Testing: Principles, Applications, and Issues. 7th ed. Belmont: Cengage Learning; 2009. https://www.google.com/books/editUKEwjh683U7cf1AhWNQvEDHXvzBNFegQIHxAH
37. Raven JC. Standardization of progressive matrices. 1938. British Journal of Medical Psychology. 1941; XIX(1):137-50. [DOI:10.1111/j.2044-8341.1941.tb00316.x]
38. Domino G, Domino ML. Psychological testing: An introduction. 2 ed. Cambridge: Cambridge University Press; 2006. [DOI:10.1017/CBO9780511813757] [PMCID]
39. Rajabi GR. [Normalizing the raven coloure progressive matrices test on students of city Ahvaz (Persian)]. Contemporary Psychology. 2008; 3(1):23-32. http://bjcp.ir/article-1-344-en.html
40. Spence SH. Structure of anxiety symptoms among children: A confirmatory factor-analytic study. Journal of Abnormal Psychology. 1997; 106(2):280-97. [DOI:10.1037/0021-843X.106.2.280] [PMID]
41. Mousavi R, Mousavi SS, Mahmoudi Gharaei J, Akbari Zardkhaneh S. [Assessment and diagnosis instruments of anxiety disorders among child and adolescents (Persian)]. Annals of Military and Health Sciences Research. 2008; 6(2):147-54. https://www.sid.ir/en/Journal/ViewPaper.aspx?ID=151994
42. Zarghami F, Heidari Nasab L, Shaeiri MR, Shahrivar Z. [A study in the impact of coping-cat-based Cognitive-Behavior Therapy (CBT) on reduced anxiety in the children aged 8 to 10 with anxiety disorder (Persian)]. Clinical Psychology Studies. 2015; 5(19):183-202. https://jcps.atu.ac.ir/article_1514.html?lang=en
43. Mousavi R, Moradi AR, Farzad V, Mahdavi Harsini SE, Spence S, Navabinejad S. Psychometric properties of the spence children’s anxiety scale with an iranian sample. International Journal of Psychology (IPA). 2007; 1(1):17-26. https://iranjournals.nlaiD2B1728F2CE54A0B31689E71A9.pdf?sequence=-1&isAllowed=y
44. Hussaindeen JR, Shah P, Ramani KK, Ramanujan L. Efficacy of vision therapy in children with learning disability and associated binocular vision anomalies. Journal of Optometry. 2018; 11(1):40-8. [DOI:10.1016/j.optom.2017.02.002] [PMID] [PMCID]
45. Goswami U. A temporal sampling framework for developmental dyslexia. Trends in Cognitive Sciences. 2011; 15(1):3-10. [DOI:10.1016/j.tics.2010.10.001] [PMID]
46. Monga S, Rosenbloom BN, Tanha A, Owens M, Young A. Comparison of child-parent and parent-only cognitive-behavioral therapy programs for anxious children aged 5 to 7 years: Short- and long-term outcomes. Journal of the American Academy of Child and Adolescent Psychiatry. 2015; 54(2):138-46. [DOI:10.1016/j.jaac.2014.10.008] [PMID]
47. Gere MK, Villabø MA, Torgersen S, Kendall PC. Overprotective parenting and child anxiety: The role of co-occurring child behavior problems. Journal of Anxiety Disorders. 2012; 26(6):642-9. [DOI:10.1016/j.janxdis.2012.04.003] [PMID]
48. Kesler SR, Lacayo NJ, Jo B. A pilot study of an online cognitive rehabilitation program for executive function skills in children with cancer-related brain injury. Brain injury. 2011; 25(1):101-12. [DOI:10.3109/02699052.2010.536194] [PMID] [PMCID]
49. Abadi F, Nejati V, Pouretemad HR. [The effect of PARIA rehabilitation program on improving the ability of Emotion recognition in children with high functioning autism disorder (Persian)]. Studies in Medical Sciences. 2016; 27(7):570-5. http://umj.umsu.ac.ir/article-1-3281-en.html
50. Ardi Z, Sisin M. The Contribution of assertive technique behavioral counseling to minimize the juvenile delinquency behavior. Jurnal Konseling dan Pendidikan. 2018; 6(2):67-77. [DOI:10.29210/127400]
51. Parmasksiz I, Kılıçarslan S. The relationship between assertiveness and separation-individuation in adolescents. Pegem Eğitim ve Öğretim Dergisi. 2020; 10(3):869-88. [DOI:10.14527/pegegog.2020.027]
52. Abbasi M, Abdi M. [The effects of group teaching of assertiveness on social skills and social anxiaty in male students (Persian)]. Journal of Pediatric Nursing. 2018; 5(1):46-52. http://jpen.ir/article-1-296-en.html
53. Arrindell WA, Sanderman R, Van der Molen H, Van der Ende J, Mersch PP. The structure of assertiveness: A confirmatory approach. Behaviour Research and Therapy. 1988; 26(4):337-9. [DOI:10.1016/0005-7967(88)90087-3]
54. Ahmadi H, Sharifi Daramadi P, Asadi-Samani M, Givtaj H, Mahmoudian Sani MR. Effectiveness of group training of assertiveness on social anxiety among deaf and hard of hearing adolescents. The International Tinnitus Journal. 2017; 21(1):14-20. [DOI:10.5935/0946-5448.20170004] [PMID]
55. Hannesdottir DK, Ollendick TH. Social cognition and social anxiety among icelandic schoolchildren. Child & Family Behavior Therapy. 2007; 29(4):43-58. [DOI:10.1300/J019v29n04_03]
56. Piacentini J, Langley AK. Cognitive-behavioral therapy for children who have obsessive-compulsive disorder. International Society of Clinical Psychology. 2004; 60(11):1181-94. [DOI:10.1002/jclp.20082] [PMID]
57. Olatunji BO, Rosenfield D, Monzani B, Krebs G, Heyman I, Turner C, et al. Effects of homework compliance on cognitive-behavioral therapy with d-cycloserine augmentation for children with obsessive compulsive disorder. Depress and Anxiety. 2015; 32(12):935-43. [DOI:10.1002/da.22423] [PMID]
58. Helbing MLC, Ficca M. Obsessive-compulsive disorder in school-age children. The Journal of School Nursing. 2009; 25(1):15-26. [DOI:10.1177/1059840508328199] [PMID]
59. Sert AG. The effect of an assertiveness training on the assertiveness and self esteem level of 5th grade children [MSc. Thesis]. Ankara: Middle East Technical University; 2003. https://etd.lib.metu.edu.tr/upload/1217686/index.pdf
60. GhamkharFard Z, Bakhtiari M, Hajiheidari Z, Pouravari M, Tahmasian K. [The effectiveness of group cognitive-behavioral therapy in anxiety and boredom proneness in generalized anxiety disorder girls (Persian)]. Knowledge & Research in Applied Psychology. 2019; 20(20):122-32. [DOI:10.30486/JSRP.2019.547561.]
61. Paterson M, Green JM, Basson CJ, Ross F. Probability of assertive behaviour, interpersonal anxiety and self-efficacy of South African registered dietitians. Journal of human nutrition and dietetics: The Official Journal of the British Dietetic Association. 2002; 15(1):9-17. [DOI:10.1046/j.1365-277X.2002.00326.x] [PMID]
62. Warland J, McKellar L, Diaz M. Assertiveness training for undergraduate midwifery students. Nurse Education in Practice. 2014; 14(6):752-6. [DOI:10.1016/j.nepr.2014.09.006] [PMID]
63. Wong DF, Ng TK, Zhuang XY, Wong PW, Leung JT, Cheung IK, et al. Cognitive-behavior therapy with and without parental involvement for anxious Chinese adolescents: A randomized controlled trial. Journal of Family Psychology. 2020; 34(3):353-63. [DOI:10.1037/fam0000585] [PMID]