目的 分析小组形式注意品质四维度训练对学龄前注意缺陷多动障碍(ADHD)儿童的影响,为采用小组注意品质训练改善ADHD儿童的注意功能提供实验依据和参考。方法 以扬州市妇幼保健院2020年1月—2021年12月儿童康复科门诊收治的64例4~6岁学龄前ADHD儿童为研究对象,随机分至实验组和对照组。对照组采用常规认知行为、感统及社交训练,实验组采用常规训练结合小组注意训练,实验前后使用NJ22B儿童注意力测试仪对儿童进行注意品质评估测试,采用SNAP-Ⅳ对儿童注意缺陷和多动进行评估,全面评价学龄前ADHD儿童在训练前后的变化。结果 干预前实验组与对照组SNAP-Ⅳ注意力不集中、多动和注意稳定性、广度、转移、分配注意品质总分各项目分值两组间差异无统计学意义(P>0.05),实验组SNAP-Ⅳ注意力不集中(t=8.487)、多动(t=8.558)和注意稳定性(Z=4.784)、广度(Z=4.560)、转移(Z=3.087)、分配(Z=3.536)注意品质总分(Z=4.918)各项目干预前后差异有统计学意义(P<0.001)。干预后对照组与实验组在SNAP-Ⅳ多动/冲动(t=2.961)、总分(t=3.461)及注意品质测试中的注意稳定性(Z=2.347)、注意品质总分(Z=2.507)之间差异有统计学意义(P<0.05)。结论 小组注意品质训练能改善学龄前ADHD儿童注意品质各维度能力,减少多动冲动和改善注意力。
Abstract
Objective To analyze the effect of four-dimensional training of attentional quality in group form on preschool children with attention deficit hyperactivity disorder (ADHD), in order to provide experimental basis and reference for improving attentional function of ADHD with group attentional quality training. Method A total of 64 preschool ADHD children aged 4 to 6 who were admitted to the outpatient department of Children's Rehabilitation Department in Yangzhou Maternal and Child Health Hospital from January 2020 to December 2021 were selected as the study subjects, and were randomly divided into the experimental group and the control group. The control group received conventional cognitive behavior, sensory integration and social training, while the experimental group was given group attention training additionally. Before and after the experiment, the NJ22B Children's Attention Tester was used to evaluate the children's attention quality, and the SNAP-Ⅳ was used to evaluate the children's attention deficit and hyperactivity. Results Before intervention, there was no statistical significance between the two groups in the total score of SNAP-Ⅳ in attention, hyperactivity and attention stability, breadth, transfer and distribution of attention quality between the experimental group and the control group (P>0.05). In the experimental group, the scores of SNAP-Ⅳ inattention(t=8.487), hyperactivity(t=8.558) and attention stability (Z=4.784), breadth(Z=4.560), transfer(Z=3.087), distribution(Z=3.536) and the total score of attention quality(Z=4.918) were significantly different before and after intervention (P<0.001). After intervention, there were statistically significant differences between the control group and the experimental group in the SNAP-Ⅳ hyperactivity/impulsivity(t=2.961), total score(t=3.461), as well as attentional stability(Z=2.347) and total attentional quality score(Z=2.507) in the SNAP-Ⅳ test (P<0.05). Conclusion Group attention quality training can improve attention quality ability of preschool ADHD children, reduce hyperactivity impulse and improve attention.
关键词
注意缺陷多动障碍 /
注意缺陷 /
多动冲动 /
注意品质
Key words
attention deficit hyperactivity disorder /
attention deficit /
hyperactivity-impulsivity /
attention quality
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参考文献
[1] 兰红艳,霍言言,吴丹,等. 注意缺陷多动障碍儿童的营养代谢水平及其与脑功能的相关性[J]. 中国儿童保健杂志,2022,30(1):11-14, 38.
Lan HY, Huo YY, Wu D, et al. Nutrition and metabolism level of children with attention deficit hyperactivity disorder and its correlation with brain function[J]. Chin J Child Health Care, 2022, 30(1):11-14, 38.
[2] Aretouli E. How neuropsychology can inform our understanding of preschool ADHD: Clinical and research implications[J]. Appl Neuropsychol Child, 2019, 8(2): 174-181.
[3] Wang T, Liu K, Li Z, et al. Prevalence of attention deficit/hyperactivity disorder among children and adolescents in China:A systematic review and meta-analysis[J]. BMC Psychiatry, 2017, 17(1): 1-11.
[4] Jin WL, Li G, Du YS, et al. ADHD symptoms in children aged 5 to 15 years in Zhabei District, Shanghai[J]. Eur J Psychiat, 2016, 30(3): 173-182.
[5] 刘蕊,王燕,姜艳蕊,等. 儿童注意缺陷多动障碍DSM-Ⅳ和DSM-5诊断的比较研究[J]. 中国儿童保健杂志,2022,30(3):306-309.
Liu R, Wang Y, Jiang YR, et al. Comparative study of DSM-Ⅳ and DSM-5 in diagnosing children's attention deficit hyperactivity disorder[J]. Chin J Child Health Care, 2022,30(3):306-309.
[6] 沈力,王瑜,田园,等. 医教结合对学龄期注意缺陷多动障碍儿童干预效果的研究[J]. 中国儿童保健杂志,2019,27(9):1034-1038.
Shen L, Wang Y, Tian Y, et al. Combination of education with medical treatment for school-aged children with attention deficit hyperactivity disorder[J]. Chin J Child Health Care, 2019,27(9):1034-1038.
[7] Kabat-Zinn J. Mindfulness-based interventions in context: Past, present, and future[J]. Clin Psychol-Sci Pr,2003,10(4):144-156.
[8] 宋蕊,江文庆,樊宁,等.低频度执行功能计算机训练对注意缺陷多动障碍患儿干预效果的研究[J].中国儿童保健杂志, 2020,28(11):1209-1213.
Song R, Jiang WQ, Fan N, et al. Study on the efficacy of low frequency computerized executive function training in children with attention deficit hyperacivity disorder[J]. Chin J Child Health Care, 2020,28(11):1209-1213.
[9] 刘艺. 不同干预方法对儿童ADHD干预效果的研究[D].南昌:江西中医药大学,2021.
Liu Y. Efficacy of different methods in the treatment of children with ADHD[D]. Nanchang:Jiangxi University of Chinese Medicine,2021.
[10] 巢羽桐,张功. 运动干预对注意缺陷多动障碍儿童脑执行功能的影响[J]. 教育生物学杂志,2021,9(2):152-159.
Chao YT, Zhang G. Effects of exercise intervention on brain executive function of attention-deficit/hyperactivity disorder children[J]. Journal of Bio-education, 2021, 9(2):152- 159.
[11] 宋以玲,任园春,姜稳,等.运动干预对注意缺陷多动障碍儿童执行功能的影响研究进展[J].中国运动医学杂志,2021,40(4):306-311.
Song YL, Ren YC, Jiang W, et al. Research progress on the effect of exercise intervention on executive function of children with attention deficit hyperactivity disorder[J]. Chin J Sports Med, 2021,40(4):306-311.
[12] 杜亚松,曹阳,江文庆.注意缺陷多动障碍儿童的执行功能[J].中国儿童保健杂志,2019,27(5):465-468, 472.
Du YS,Cao Y,Jiang WQ. Research advances on executive functions of children with attention deficit hyperactivity disorder[J]. Chin J Child Health Care, 2019,27(5):465-468, 472.
[13] Coratti G, Mallardi M, Coppola C, et al. Early childhood attention battery: Italian adaptation and new expanded normative data[J]. Early Hum Dev, 2020, 144: 105013.
[14] 刘玮洁. 小篮球运动对5~6岁幼儿注意力影响的实践研究[D].大连:辽宁师范大学,2021.
Liu WJ. A practical study on the influence of basketball on attention of 5-6 years old children [D]. Dalian:Liaoning Normal University,2021.
[15] 韩露蕾. 注意品质在小学生移动电子媒体使用与阅读流畅性间的中介效应[D].天津:天津师范大学, 2021.
Han LL. The mediating effect of attention quality between pupils' mobile electronic media use and reading fluency [D]. Tianjin:Tianjin Normal University, 2021.
[16] 张小林,章依文,马骏,等.注意缺陷多动障碍儿童的医教结合干预模式初探[J].教育生物学杂志,2019,7(3):149-155.
Zhang XL, Zhang YW, Ma J, et al. Medical-educational combination intervention model for children with attentiondeficit /hyperactivity disorder[J]. Journal of Bio-education, 2019,7(3):149-155.
[17] American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5[M]. Washington, DC: American psychiatric association, 2013:59-66.
[18] 张慧凤,张劲松,帅澜,等. 学龄前儿童中文版SNAP-Ⅳ评定量表父母版的信效度检验[J]. 中国儿童保健杂志,2016,24(12):1253-1256.
Zhang HF, Zhang JS, Shuai L. Reliability and validity of the Chinese version of the Swanson Nolanand Pelhamversion Ⅳ scale parent form[J]. Chin J Child Health Care, 2016,24(12):1253-1256.
[19] 黄敬之,林明和. 学龄期不同性别注意缺陷多动障碍儿童注意力特征分析[J]. 康复学报,2020,30(5):370-376.
Huang JZ, Lin MH. Analysis of attention characteristics of attention deficit hyperactivity disorder children of different gender in school age[J]. Rehabilitation Medicine,2020,30(5):370-376.
[20] 于敏锋. 注意缺陷儿童注意力特征及其干预研究[D].南昌:江西师范大学,2010.
Yu MF. Characteristics of attention deficit children's attention and intervention[D]. Nanchang: Jiangxi Normal University,2010.
[21] 贾云秋.学前儿童心理发展[M].北京:北京理工大学出版社, 2017:18-26.
Jia YQ. Psychological development of preschool children[M]. Beijing:Beijing University of Technology Press, 2017:18-26.
[22] 杨莉,耿达,柳铭心,等. 4～6岁幼儿持续性注意的发展:基于时间进程的证据[J]. 学前教育研究,2019, 33(2):48-56.
Yang L,Geng D, Liu MX, et al. The Development of Persistent Attention in Children Aged 4-6: Evidence Based on Time Course[J].Xueqian Jiaoyu Yanjiu,2019, 33(2):48-56.
[23] 王娜娜,刘华,延青. 听力障碍合并注意力缺陷多动障碍患儿背景噪音下听觉康复观察[J]. 中国听力语言康复科学杂志,2021,19(2):140-142.
Wang NN, Liu H, Yan Q. The observation of hearing rehabilitation in children with hearing impairment and attention deficit hyperactivity disorder in the presence of background noise[J]. Chinese Scientific Journal of Hearing and Speech Rehabilitation, 2021,19(2):140-142.
[24] 杨思渊,静进.眼动实验在注意缺陷多动性障碍方面的应用[J].国外医学·妇幼保健分册,2004, 15(4):193-195.
Yang SY, Jing J. Application of eye movement test in ADHD[J]. Foreign Medical Sciences (Sciences of Maternal and Child Health),2004, 15(4):193-195.
基金
江苏省扬州市科技发展计划面上项目(YZ2020107)
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