Compared with TD peers, ADHD + DD children exhibited impairments in inhibitory control (including Stroop A/B/C/D RT, Stroop B/D error count, and word interference time), all working memory indices, cognitive flexibility (digit-alphabet linking time), and all visual perception measures (all p < 0.05). After intervention the outcomes revealed significant Group × Time differences in EF, including inhibitory control (Stroop B/D RT, word interference time), working memory (delayed detail and structural memory), and cognitive flexibility (digit–alphabet linking time) (p < 0.05). Post-hoc tests confirmed that OSE yielded significantly greater improvements than CSE. For secondary visual perception outcomes, all measures showed significant Group × Time interactions (all p < 0.05). Further adjusted analyses demonstrated that OSE outperformed CSE significantly in visual-motor integration (VMI), copying ability, motor-reduced visual perception (MRP), form consistency, and general visual perception (GVP) (all p < 0.05).
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