儿童注意缺陷-多动障碍不同入学年龄段构成比研究
- 马骏
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Constituent ratio of children entering school at different age bracket among children with attention deficit/hyperactivity disorder.
- MA Jun.
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摘要
目的 探讨小学一至六年级在上海儿童医学中心发育行为儿科被诊断为注意缺陷-多动障碍(attention deficit/hyperactivity disorder,ADHD)的儿童在不同入学年龄段的构成比方面有无差异。 方法 对2005年1月-2008年1月在上海儿童医学中心发育行为儿科被明确诊断为ADHD的小学儿童,依其三种不同入学年龄段(6岁0个月~6岁5个月;6岁6个月~6岁11个月;7岁及以上)分年级计算其人数构成比,采用χ2检验前两种年龄段人数构成比之间有差异无统计学意义,并观察构成比随年级增长的变化趋势。 结果 一至三年级ADHD儿童在6岁0个月~6岁5个月入学人数构成比和6岁6个月~6岁11个月入学人数构成比比较差异有高度统计学意义(χ2=50.883,P<0.000 1),其相对比为1.656,95%CI为1.434~1.913。随年级增加,这种人数构成比差异不断减小,至四年级及以后已无统计学差异。 结论 在儿童ADHD中入学年龄较小者构成比较大,低年级这种现象尤为明显,提示年龄偏小儿童入学准备不足问题更严重,间接可能导致较多儿童出现ADHD。
Abstract
Objectives To explore the difference of the constituent ratio between children with attention deficit/hyperactivity disorder (ADHD) entering the primary school at the different age. Methods The constituent ratio by grades among the primary school children with ADHD was calculated with the three categories of school entrance age:from 6 years to 6 years and 5 months,from 6 years and 6 month to 6 years and 11 months,7 years and above.Pearson's chi-square test was used to examine whether the difference of the constituent ratio existed between thress categories.The change of the constituent ratio with increasing grade was observed. Results There was significant statistical difference of the constituent ratio between three categories children with ADHD during 1 to 3 grade(χ2=50.883,P<0.0001).The relative ratio was 1.656,95%CI was 1.434~1.913.The difference of constituent ratio was decreasing with the grade increasing.It showed no significant statistical difference in the fourth grade and later. Conclusions The constituent ratio of those entering into the primary school at the younger age among children with ADHD is relatively higher.This phenomenon is salient in the lower grade.It is postulated that the school readiness is deficient in the relatively younger children so that more children entering the primary school at the younger age would develop the symptoms of ADHD.
关键词
注意缺陷-多动障碍 / 入学准备 / 入学年龄 / 儿童 / 脑发育
Key words
attention deficit/hyperactivity disorder / school readiness / school entrance age / children / brain development
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参考文献
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[13] Tamnes CK,stby Y,Walhovd KB,et al.Neuroanatomical correlates of executive functions in children and adolescents:a magnetic resonance imaging (MRI) study of cortical thickness[J].Neuropsychologia,2010,48(9):2496-2508.
[14] Moriguchi Y,Hiraki K.Longitudinal development of prefrontal function during early childhood[J].Dev Cogn Neurosci,2011,1(2):153-162.
[15] Wilmsmeier A,Ohrmann P,Suslow T,et al.Neural correlates of set-shifting:decomposing executive functions in schizophrenia[J].J Psychiatry Neurosci,2010,35(5):321-329.
[16] Stevens HE.Prefrontal cortex:disorders and development[J].J Am Acad Child Adolesc Psychiatry,2010,49(3):203-204.
[17] Shaw P,Gogtay N,Rapoport J.Childhood psychiatric disorders as anomalies in neurodevelopmental trajectories[J].Hum Brain Mapp,2010,31(6):917-925.
[18] Rowe EW,Miller C,Ebenstein LA,et al.Cognitive predictors of reading and math achievement among gifted referrals[J].Sch Psychol Q,2012,27(3):144-153.
[19] O'Connor E.Teacher-child relationships as dynamic systems[J].J Sch Psychol,2010,48(3):187-218.
[2] West J,Denton K,Germino-Gausken E.America's kindergartners:findings from the early childhood longitudinal study,kindergarten class of 1998-1999,fall 1998 (NCES 2000-07-02)[M].Washington DC:National Center for Education Statistics,2000.
[3] Gupta R,Kar BR.Development of attentional processes in ADHD and normal children[J].Prog Brain Res,2009,176:259-276.
[4] Nigg J,Nikolas M,Burt SA.Measured gene-by-environment interaction in relation to attention-deficit/hyperactivity disorder[J].J Am Acad Child Adolesc Psychiatry,2010,49(9):863-873.
[5] Zhang H,Zhu S,Zhu Y,et al.An association study between SNAP-25 gene and attention-deficit hyperactivity disorder[J].Eur J Paediatr Neurol,2011,15(1):48-52.
[6] Nikolas M,Friderici K,Waldman I,et al.Gene x environment interactions for ADHD:synergistic effect of 5HTTLPR genotype and youth appraisals of inter-parental conflict[J].Behav Brain Funct,2010,16(6):23-30.
[7] American Psychiatric Association.Diagnostic and statistical manual of mental disorders,4th Edition(DSM-Ⅳ)[M].Washington DC:American Psychiatric press,1994:80-100.
[8] Willer B,Bredekamp S.Public policy report:redefining readiness:an essential requisite for educational reform[J].Young Child,1990,45(5):22-24.
[9] Pagani LS,Fitzpatrick C,Archambault I,et al.School readiness and later achievement:a French Canadian replication and extension[J].Dev Psychol,2010,46(5):984-994. [10] Schor EL,Abrams MK,Shea K.Medicaid:health promotion and disease prevention for school readiness[J].Health Aff (Millwood),2007,26(2):420-429.
[11] 盖笑松.儿童入学准备研究与实践[M].长春:吉林教育出版社,2007.
[12] Pagani LS,Fitzpatrick C.Children's school readiness:implications for eliminating future disparities in health and education[J].Health Educ Behav,2013 Feb 27.[Epub ahead of print]
[13] Tamnes CK,stby Y,Walhovd KB,et al.Neuroanatomical correlates of executive functions in children and adolescents:a magnetic resonance imaging (MRI) study of cortical thickness[J].Neuropsychologia,2010,48(9):2496-2508.
[14] Moriguchi Y,Hiraki K.Longitudinal development of prefrontal function during early childhood[J].Dev Cogn Neurosci,2011,1(2):153-162.
[15] Wilmsmeier A,Ohrmann P,Suslow T,et al.Neural correlates of set-shifting:decomposing executive functions in schizophrenia[J].J Psychiatry Neurosci,2010,35(5):321-329.
[16] Stevens HE.Prefrontal cortex:disorders and development[J].J Am Acad Child Adolesc Psychiatry,2010,49(3):203-204.
[17] Shaw P,Gogtay N,Rapoport J.Childhood psychiatric disorders as anomalies in neurodevelopmental trajectories[J].Hum Brain Mapp,2010,31(6):917-925.
[18] Rowe EW,Miller C,Ebenstein LA,et al.Cognitive predictors of reading and math achievement among gifted referrals[J].Sch Psychol Q,2012,27(3):144-153.
[19] O'Connor E.Teacher-child relationships as dynamic systems[J].J Sch Psychol,2010,48(3):187-218.
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