注意缺陷多动障碍共患学习障碍儿童的执行功能研究

Executive function in children with attention-deficit/hyperactivity disorder comorbid learning disorder

目的分析注意缺陷多动障碍(ADHD)、学习障碍(LD)、ADHD共患LD儿童执行功能之间的关系,为ADHD共患LD儿童的诊断及干预方法提供科学依据。方法选取2021年7月-2023年2月于郑州大学第三附属医院就诊的ADHD、LD儿童121例为研究对象,采用数字划消智能评定量表、短时记忆、Stroop色词命名任务(SCWT)、Go/No go测试对研究对象的执行功能进行评估,采用韦氏儿童智力量表-第四版(WISC-Ⅳ)测查研究对象的一般认知能力。结果在数字划消智能评定量表测验中,ADHD共患LD组数字划消准确性低于ADHD组和LD组(H=10.101,P=0.006)。在短时记忆中,ADHD共患LD组稳定记忆长度低于ADHD组和LD组(H=5.994,P=0.050),最稳定平均反应时(H=12.153,P=0.002)高于ADHD组和LD组。在SCWT中,ADHD共患LD组的汉字、颜色和色词测试正确率均低于ADHD组和LD组(H=13.743、7.046、11.156,P<0.05)。在Go/No go能力测试中,ADHD共患LD组第一关go正确平均时间更长(H=6.593,P=0.037)。结论ADHD共患LD、ADHD、LD儿童在工作记忆、认知灵活性、抑制控制测试三个核心执行功能方面得分较低,且ADHD共患LD儿童得分低于ADHD儿童、LD儿童。ADHD共患LD、ADHD、LD儿童的执行功能均存在不同程度的损害,且ADHD共患LD儿童的执行功能损害范围更广,程度更重。

Objective To analyze the executive function of children with attention-deficit/hyperactivity disorder(ADHD),children with learning disorder(LD),and children with ADHD comorbid LD,so as to provide scientific basis for the diagnosis and intervention of children with ADHD comorbid LD.Methods A total of 121children with ADHD and LD who were treated in the Third Affiliated Hospital of Zhengzhou University from July 2021to February 2023were selected into this study.The Number Cancelation Test,Short-Term Memory,Stroop Color Word Test(SCWT),Go/No go tests and the Wechsler Intelligence Scale for Children-Fourth Edition(WISC-Ⅳ)were used for assessment.Results In the Number Cancelation Test,the accuracy of digital cancellation in children with ADHD comorbid LD was significantly lower than that in children with ADHD or LD(H=10.101,P=0.006).In short-term memory,the stable memory length in children with ADHD comorbid LD was significantly lower than that in children with ADHD or LD(H=5.994,P=0.050),and the most stable average reaction time were significantly longer than that in children with ADHD or LD(H=12.153,P=0.002).In SCWT,the accuracy rates of word,color,and color-word test in ADHD children comorbid with LD were significantly lower than those in children with ADHD or LD(H=13.743,7.046,11.156,P<0.05).In the Go/No go test,the average correct time of the first round of Go in children with ADHD or LD was significantly longer than that in ADHD children(H=6.593,P=0.037).Conclusions Children with ADHD comorbid LD,ADHD,and LD have lower scores on three core aspects of executive function:working memory,cognitive flexibility,and inhibitory control,and children with ADHD comorbid LD have lower scores than children with ADHD and children with LD.Children with ADHD comorbid LD,ADHD,and LD have varying degrees of impairment in executive function,with children with ADHD comorbid LD having more extensive impairment and more severe impairment of executive function.