计算机辅助的执行功能训练对注意缺陷多动障碍患儿的干预研究

李焱,江文庆,李梦瑶,杜亚松

中国儿童保健杂志 ›› 2017, Vol. 25 ›› Issue (3) : 237-241.

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中国儿童保健杂志 ›› 2017, Vol. 25 ›› Issue (3) : 237-241. DOI: 10.11852/zgetbjzz2017-25-03-07
科研论著

计算机辅助的执行功能训练对注意缺陷多动障碍患儿的干预研究

  • 李焱,江文庆,李梦瑶,杜亚松
作者信息 +

Study on computerized executive function training on children with attention deficit hyperactivity disorder

  • LI Yan,JIANG Wen-qing,LI Meng-yao,DU Ya-song
Author information +
文章历史 +

摘要

目的 通过对注意缺陷多动障碍(ADHD)患儿进行计算机辅助执行功能训练,初步探讨计算机辅助训练对患儿症状及执行功能缺陷的改善情况。方法 对56例ADHD患儿分别进行计算机训练及药物治疗,评估其执行功能指标及行为症状变化。结果 计算机辅助训练后的执行功能指标有显著差异,训练后患儿的Stroop测验的乙表正确数、正确率有显著提高(P<0.001);WCST持续错误数减少,概念化水平和持续应答数得分提高(P<0.01);WISC-Ⅳ的背数、译码及符号检索得分均有提高(P<0.05);CANTAB-SWM的总间隔错误、间隔错误、SWM策略分及SOC移动次数得分减少(P<0.05));PSQ评估的ADHD相关行为问题(学习问题、多动指数因子)显著下降(P<0.05)。结论 计算机训练可以改善ADHD患儿的执行功能缺陷,对核心症状也有部分改善,有望成为新的临床干预手段。

Abstract

Objectives To explore whether benefit the deficits in executive functions (EF) and clinical behaviors by focusing on computer-based programs designed to train EF on children with attention deficit hyperactivity disorder (ADHD). Methods Totally 56 children with ADHD were received computerized executive function training and medication respectively,and evaluated the scores of neuropsychological tests and symptom scales at baseline and after training. Results After training,there were significant improvement in main domains of EF tests,including correct number and correct rate in test B of Stroop test(P<0.001),persistent error response,conceptual level and sustained response scores of WCST(P<0.01),the digital-span scores,coding and symbol-search scores of WISC-Ⅳ(P<0.05),SWM errors,interval errors,SWM strategy and SOC average mobile number (3) scores of CANTAB (P<0.05).The learning problems,hyperactive index scores of PSQ were decreased significantly(P<0.05). Conclusions Computer-based training can improve the executive function deficits in ADHD children,as well as the ADHD core symptoms.This training would become a new clinical intervention.

关键词

注意缺陷多动障碍 / 执行功能 / 计算机训练 / 药物治疗

Key words

attention deficit hyperactivity disorder / executive function / computerized training / medication

引用本文

导出引用
李焱,江文庆,李梦瑶,杜亚松. 计算机辅助的执行功能训练对注意缺陷多动障碍患儿的干预研究[J]. 中国儿童保健杂志. 2017, 25(3): 237-241 https://doi.org/10.11852/zgetbjzz2017-25-03-07
LI Yan,JIANG Wen-qing,LI Meng-yao,DU Ya-song. Study on computerized executive function training on children with attention deficit hyperactivity disorder[J]. Chinese Journal of Child Health Care. 2017, 25(3): 237-241 https://doi.org/10.11852/zgetbjzz2017-25-03-07
中图分类号: R179   

参考文献

[1] Wolraich ML,McKeown RE,Visser SN,et al.The prevalence of ADHD:its diagnosis and treatment in four school districts across two states[J].J Atten Disord,2014,18(7):563-575.
[2] Shimoni M,Engel-Yeger B,Tirosh E.Executive dysfunctions among boys with attention deficit hyperactivity disorder (ADHD):performance-based test and parents report[J].Res Dev Disabil,2012,33(3):858-865.
[3] Hinshaw SP.Academic underachievement,attention deficits,and aggression:Comorbidity and implications for intervention[J].Journal of Consulting and Clinical Psychology,1993,60(6):893-903.
[4] Mezzacappa E,Buckner JC.Working memory training for children with attention problemsor hyperactivity:A school-based pilot study[J].School Mental Health,2010,2(4):202-208.
[5] Beck SJ,Hanson CA,Puffenberger SS,et al.A controlled trial of working memory training for children and adolescents with ADHD[J].J Clin Child Adolesc Psychol,2010,39(6):825-836.
[6] Green CT,Long DL,Green D,et al.Will working memory training generalize to improve off-task behavior in children with attention-deficit/hyperactivity disorder[J].Neurotherapeutics,2012,9(3):639-648.
[7] Willcutt EG,Nigg JT,Pennington BF,et al.Validity of DSM-IV attention deficit/hyperactivity disorder symptom dimensions and subtypes[J].Abnormal Psychology,2012,121(4):991-1010.
[8] Thaler NS,Bello DT,Etcoff LM.WISC-IV profiles are associated with differences in symptomatology and outcome in children with ADHD[J].J Atten Disord,2013,17(4):291-301.
[9] Lezak MD,Howieson DB,Loring DW.Neuropsychological Assessment[M].4th ed.New York,NY:Oxford University Press,2004.
[10] 何淑华,静进.威斯康星卡片分类测验用于注意缺陷多动障碍的meta 分析[J].中国实用儿科杂志,2006,18(12):754-757.
[11] Matsuuraa N,Ishitobi M,Arai S,et al.Distinguishing between autism spectrum disorder and attention deficit hyperactivity disorder by using behavioral checklists,cognitive assessments,and neuropsychological test battery[J].Asian Journal of Psychiatry,2014,12(1):50-57.
[12] Conners CK,Sitarenios G,Parker JD,et al.The revised Conners' Parent Rating Scale (CPRS-R):factor structure,reliability,and criterion validity[J].Abnorm Child Psychol,1998,26(4):257-268.
[13] Chamberlain SR,Del Campo N,Dowson J,et al.Atomoxetine improved response inhibition in adults with attention deficit/hyperactivity disorder[J].Biol Psychiatry,2007,62(9):977-984.
[14] Baddeley A.Working memory[J].Curr Biol,2010,20(4):136-140.
[15] Barkley RA,Fischer M.Predicting impairment in major life activities and occupational functioning in hyperactive children as adults:self-reported executive function (EF) deficits versus EF tests[J].Dev Neuropsychol,2011,36(2):137-161.
[16] Klingberg T,Forssberg H,Westerberg H.Training of working memory in children with ADHD[J].Clin Exp Neuropsychol,2002,24(6):781-791.
[17] Klingberg T,Fernell E,Olesen PJ,et al.Computerized training of working memory in children with ADHD-a randomized,controlled trial[J].J Am Acad Child Adolesc Psychiatry,2005,44(2):177-186.
[18] Klingberg T.Training and plasticity of working memory[J].Trends Cogn Sci,2010,14(7):317-324.
[19] Olesen PJ,Westerberg H,Klingberg T.Increased prefrontal and parietal activity after training of working memory[J].Nat Neurosci,2004,7(1):75-79.
[20] 赵鑫,付丽,周仁来.我国注意缺陷多动障碍儿童工作记忆研究的文献计量分析[J].中国特殊教育,2011,181(12):73-76.
[21] Olesen PJ,Westerberg H,Klingberg T.Increased prefrontal and parietal activity after training of working memory[J].Nat Neurosci,2004,7(1):75-79.
[22] 赵滢,杜亚松,蒋良函,等.盐酸托莫西汀对注意缺陷多动障碍儿童行为特征的影响[J].临床精神医学杂志,2011,21(4):240-242.

基金

国家自然科学基金面上项目(81271510);上海市科委引导类课题(15411967500)

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