Objective To explore the effect of the program for the education and enrichment of relational skills (PEERS®) on the social skills of children with attention deficit hyperactivity disorder (ADHD) aged 6 - 8 years, so as to provide evidence for the clinical application of this project in young ADHD children in China. Methods A total of 74 children aged 6 - 8 years who were diagnosed with ADHD in the Department of Child Health Care of Shanghai Children's Hospital from March to November 2021 were enrolled in this study, and were randomly divided into intervention group and control group. The intervention group received PEERS training for 14 weeks, while the control group did not receive any intervention until the intervention in this study was finished. Social Anxiety Scale for Children (SASC), Social Skills Parent Rating Scale for Primary School Students, Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P) and Strengths and Difficulties Questionnaire (SDQ) were used for evaluation before and after the intervention. Results After 14 weeks of training, there was a statistically significant decrease in the fear of denial rating (t=2.35), social avoidance distress score (t=2.34) and total SASC score (t=3.35) in the intervention group compared with those before intervention, and the scores were significantly lower than those in the control group(P<0.05). In terms of the Social Skills Parent Rating Scale for Primary School Students, scores of intention to interact (t=3.70), group prestige (t=2.84), social sensitivity (t=6.31), masking (t=2.34), individual sensitivity (t=3.10), emotional sensibility (t=3.33), expression skills (t=5.95), interaction skills (t=2.47), social expression and control (t=7.24), social feelings (t=7.71), emotional feelings and control (t=3.78) and total scale score (t=9.14) after intervention were significantly higher than those before intervention in the intervention group,which were significantly higher than those of the control group after intervention (P<0.05). In terms of WFIRS-P, the intervention group had significantly higher scores for family (t=3.06), learning/school (t=3.65), self-concept (t=2.44), social activity (t=3.50), adventure activity score (t=7.29) and total scale (t=8.25) after intervention,which were significantly higher than those of the control group after intervention (P<0.05).Except for conduct problems (t=1.57, P=0.122) and hyperactive attention inability (t=1.78, P=0.08),the intervention group had significantly lower scores for emotional symptoms (t=3.01), peer interaction problems (t=1.78) and total difficulty score (t=5.72) after intervention,which were significantly higher than those of the control group after intervention (P<0.05). After intervention, the hyperactivity-impulsivity score on the SNAP-Ⅳ scale was significantly lower in the intervention group than that before intervention (t=2.29, P=0.025), and the decrease was more significant compared to the control group (P<0.05). Conclusion PEERS training can significantly improve the social skills of ADHD children aged 6 - 8 years, and improve social function and some core symptoms of ADHD children.
Key words
attention deficit hyperactivity disorder /
program for the education and enrichment of relational skills /
social skills
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References
[1] Barnett R.Attention deficit hyperactivity disorder[J].Lancet,2016, 387 (10020): 737.
[2] Danielson ML, Bitsko RH, Ghandour RM, et al.Prevalence of parent-reported ADHD diagnosis and associated treatment among U.S. children and adolescents, 2016[J].J Clin Child Adolesc Psychol,2018, 47 (2): 199-212.
[3] Tudor HJ.ADHD is a social problem[J].BMJ,2013, 347: f7028.
[4] Chou W, Huang M, Chang Y, et al.Social skills deficits and their association with internet addiction and activities in adolescents with attention-deficit/hyperactivity disorder[J]. J Behav Addict,2017, 6 (1): 42-50.
[5] Froehlich T.Comparison of medication treatments for preschool children with ADHD: A first step toward addressing a critical gap[J].JAMA,2021, 325 (20): 2049-2050.
[6] Solmi M, Fornaro M, Ostinelli E, et al.Safety of 80 antidepressants, antipsychotics, anti-attention-deficit/hyperactivity medications and mood stabilizers in children and adolescents with psychiatric disorders:A large scale systematic meta-review of 78 adverse effects[J].World Psychiatry,2020, 19 (2): 214-232.
[7] Pérez de los Cobos J, Siñol N, Pérez V, et al. Pharmacological and clinical dilemmas of prescribing in co-morbid adult attention-deficit/hyperactivity disorder and addiction[J]. Br J Clin Pharmacol,2014,77(2):337-356.
[8] 祖燕飞,杜亚松,姚德胜,等. 上海孤独谱系障碍患儿、母亲社交PEERS团体训练效果的研究[J]. 中国儿童保健杂志,2020,28(5):502-505.
Zu YF, Du YS, Yao DS,et al. Study on the effect of social PEERS group training for mothers of children with loneliness spectrum disorder in Shanghai[J].Chin J Child Health Care, 2020, 28 (5): 502-505.(in Chinese)
[9] Laugeson EA, Gantman A, Kapp SK, et al.A randomized controlled trial to improve social skills in young adults with autism spectrum disorder: The UCLA PEERS(®) program[J].J Autism Dev Disord,2015, 45 (12): 3978-3789.
[10] Frankel F, Myatt R, Sugar C, et al.A randomized controlled study of parent-assisted Children's Friendship Training with children having autism spectrum disorders[J].J Autism Dev Disord,2010, 40 (7):827-842.
[11] 李改智, 杜亚松.社交技能教育和促进项目对孤独谱系障碍青少年社交技能的提升作用研究进展[J].中国儿童保健杂志,2017, 25 (9): 917-920.
Li GZ, Du YS.Research progress on the improvement of social skills of adolescents with loneliness spectrum disorder by social skills education and promotion program[J] Chin J Child Health, 2017, 25(9): 917-920.(in Chinese)
[12] 施萍.儿童年龄分期及胎儿期、围生期保健重点[J].中国社区医师,2011,27(42):28.
Shi P. Age staging of children and key health care points in fetal and perinatal period[J]. Chinese Community Physician, 2011, 27 (42):28.(in Chinese)
[13] Gnanavel S, Robert RS.Diagnostic and statistical manual of mental disorders, fifth edition, and the impact of events scale-revised[J].Chest,2013, 144 (6): 1974-1975.
[14] 樊宁. 注意缺陷多动障碍患儿社交功能特点及干预效果的研究[D].上海:上海交通大学,2020.
Fan N.Study on the characteristics of social function and intervention effect of children with attention deficit hyperactivity disorder [D].Shanghai:Shanghai Jiaotong University, 2020.(in Chinese)
[15] 孟红. 小学生社会技能家长评定表的编制与试用研究[D]. 长沙:湖南师范大学,2004.
Meng H.A Study on the preparation and trial use of the Parent Assessment Form for Primary School Students' Social Skills[D].Changsha: Hunan Normal University, 2004.(in Chinese)
[16] Laugeson EA, Frankel F, Gantman A, et al.Evidence-based social skills training for adolescents with autism spectrum disorders:The UCLA PEERS program[J].J Autism Dev Disord,2012, 42 (6): 1025-1036.
[17] Gardner DM, Gerdes AC, Weinberger K.Examination of a parent-assisted, friendship-building program for adolescents With ADHD[J].J Atten Disord,2019, 23 (4): 363-373.
[18] Idris S, Van Pelt B J, Jagersma G, et al.A randomized controlled trial to examine the effectiveness of the Dutch version of the Program for the Education and Enrichment of Relational Skills (PEERS®)[J].BMC Psychiatry,2022, 22 (1): 293.
[19] Shum K, Cho W, Lam L, et al.Learning how to make friends for Chinese adolescents with autism spectrum disorder: A randomized controlled trial of the Hong Kong Chinese version of the PEERS® intervention[J]. J Autism Dev Disord,2019, 49 (2): 527-541.
[20] Greca AL, Dandes SK, Wick P, et al.Development of the Social Anxiety Scale for children: Reliability and concurrent validity[J]. Clin Child Psychol P,1988, 17 (1): 84-91.
[21] 李飞, 苏林雁, 金宇. 儿童社交焦虑量表的中国城市常模[J]. 中国儿童保健杂志, 2006, 14(4):335-335.
Li F, Su LY, Jin Yu.Chinese urban norm of Children's Social Anxiety Scale[J].Chin J Child Health Care, 2006, 14 (4): 335-335.(in Chinese)
[22] 钱英,杜巧新,曲珊,等.Weiss功能缺陷量表父母版的信效度[J].中国心理卫生杂志,2011,25(10):767-771.
Qian Y, Du QX, Qu S, et al.Reliability and validity of the Chinese version of Weiss Functional Impairment Scale-Parent form for school age children[J].Chinese Mental Health Journal,2011, 25 (10): 767-771.(in Chinese)
[23] 许文兵,王孟成,邓嘉欣,等. 长处和困难问卷中文版的信度概化分析[J]. 中国临床心理学杂志,2019,27(1):67-72.
Xu WB, Wang MC,Deng JX, et al. Reliability generalization analysis of the Chinese Version of the Strengths and Difficulties Questionnaire[J]. Chinese Journal of Clinical Psychology, 2019,27(1):67-72.(in Chinese)
[24] 井卫英, 陈会昌, 孙铃. 幼儿的游戏行为及其与社会技能,学习行为的典型相关分析[J]. 心理发展与教育, 2002, 18(2):12-16.
Jing WY, Chen HC, Sun L. Children's play behavior and its typical correlation analysis with social skills and learning behavior[J] Psychological Development and Education, 2002, 18 (2): 12-16.(in Chinese)
[25] 顾静雯, 闻萍, 刘明霞,等. 注意缺陷多动障碍患儿社会功能损害的情况[J]. 中华实用儿科临床杂志, 2015,30(8):633-634.
Gu JW, Wen P, Liu MX, et al. Impairment of social function in children with attention deficit hyperactivity disorder[J] Chinese Journal of Practical Pediatrics, 2015,30(8):633-634.(in Chinese)
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