目的 观察基于社会技能训练的“行为矫正”对儿童注意缺陷多动障碍(ADHD)的干预效果,为临床治疗提供参考依据。方法 将100例ADHD患儿随机分为干预组和等待组各50例。给予干预组为期12周的社会技能训练,同时应用以“正性强化”为主的多种“行为矫正”策略。采用ADHDRS-Ⅳ-Parent量表和Rutter父母问卷分别于基线和干预结束后进行行为评定,并对干预效果进行评价。结果 干预组儿童干预后ADHDRS-Ⅳ-Parent量表的总分和注意缺陷分、多动/冲动分均显著下降(P<0.01),其中多动/冲动分的降分率高于注意缺陷分;Rutter父母问卷的总分和A分、N分均明显降低(P<0.01或<0.05);患儿、家长和老师均认为满意,其中患儿的满意率最高,老师的满意率最低。结论 “行为矫正”训练对治疗ADHD有较好的干预效果。
Abstract
Objective To evaluate the effect of "behavioral modification" based on social skills training on children with attention deficit hyperactivity disorder(ADHD). Methods A total of one hundred ADHD children were divided to intervention group and waiting group randomly.The intervention group received 12-week social skill trainings,"behavioral modifications" priority to "positive reinforcement" were used throughout the whole process,and ADHDRS-Ⅳ-Parent scale and Rutter parent scale were used to evaluate the effect before and after intervention. Results Before intervention,the scores of ADHDRS-Ⅳ-Parent Scale and Rutter Parent Scale between two groups had no difference.After intervention,the scores of both ADHDRS-Ⅳ-Parent Scale and Rutter Parent Scale of intervention group were decreased rapidly,and had significant difference with the waiting group (P<0.01).The subtraction rate of attention deficit score was much larger than the hyperactivity/impulsity score (P<0.05 or <0.01).The ADHD children,parents and teacher were all satisfied with the training,but the satisfied rate of ADHD children was the highest,and the teacher's was the lowest. Conclusion The reinforced behavioral training is helpful in the treatment of children with ADHD.
关键词
注意缺陷多动障碍 /
行为矫正 /
正性强化 /
社会技能训练 /
儿童
Key words
attention deficit hyperactity disorder /
behavioral modification /
positive reinforcement /
social skills training /
child
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Talge NM,Allswede DM,Holzman C.Gestational age at term,delivery circumstance,and their association with childhood attention deficit hyperactivity disorder symptoms[J].Paediatr Perinat Epidemiol,2016,30(2):171-180.
[2] Lidija SP,Beti ZI,Kristin V,et al.Prevalence,gender distribution and presence of attention deficit hyperactivity disorder by certain socio-demographic characteristics among university students[J].Mater Sociomed,2014,26(4):253-255.
[3] Luman M,Papanikolau A,Oosterlaan J.The unique and combined effects of reinforcement and methylphenidate on temporal information processing in attention-deficit/hyperactivity disorder[J].J Clin Psychopharmacol,2015,35(4):414-421.
[4] Silvetti M,Wiersema JR,Sonuga-Barke E,et al.Deficient reinforcement learning in medial frontal cortex as a model of dopamine-related motivational deficits in ADHD[J].Neural Netw,2013,46(2):199-209.
[5] Furlong M,McGilloway S,Bywater T,et al.Behavioral and cognitive behavioral group-based parenting programmes for early-onset conduct problems in children aged 3 to 12 years[J].Cochrane Database Syst Rev(Online),2012,2:CD008225.
[6] De Bmin EI,Verheij F.Social skills training in children with PDDNOS:an exploratory study[J].Int J Psychiatry Clin Pract,2012,16(1):60-67.
[7] 汪毅,薛云,李丽,等.社会技能训练干预儿童行为问题在学校中的应用研究[J].中华行为医学与脑科学杂志,2015,24(11):1033-1036.
[8] Amori YM,Mary J,Jennifer JN.Social skills training[J].Child and Adolescent Psychiatric Clinics of North America,2014,23(4):775-788.
[9] Huang YH,Chung CY,Ou HY.Treatment effects of combining social skill training and parent training in Taiwanese children with attention deficit hyperactivity disorder[J].Journal of the Formosan Medical Association,2015,114(2),e260-267.
[10] Tamma L,Epsteina JN,Peugh JL,et al.Preliminary data suggesting the efficacy of attention training for school-aged children with ADHD[J].Developmental Cognitive Neuroscience,2013,4(1):16-28.
[11] Corkum P,Corbin,N,Pike,M.Evaluation of a school-based social skills program for children with attention-deficit/hyperactivity disorder[J].Child & Family Behavior Therapy,2010,32(2):139-151.
[12] Evans SW,Owens JS,Bunford N.Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder[J].J Clin Child Adolesc Psychol,2014,43(4):527-551.
基金
湖北省自然科学基金重点项目(2012FFA064)