非言语型学习障碍儿童选择注意功能的神经心理特性

Neuropsychological characteristics of selective attention in children with nonverbal learning disabilities

目的 探讨非言语型学习障碍 (NLD)儿童选择注意功能相关的大脑额叶注意调控、工作记忆、注意维持等神经心理功能特点。方法 采用听觉辨别实验 (ADT)、威斯康星卡片分类测验(WCST)及中国修订版韦氏学龄儿童智力量表 (C WISC)对 14例NLD儿童和 2 3名正常儿童进行测试 ,并对C WISC各类分测验成绩进行了因子分析。结果 NLD组儿童ADT测试中的正确反应率明显低于对照组 (P <0 0 1) ,错误反应数多于对照组 (P <0 0 1) ;在WCST测试中其 2次的分类完成数 (CA)和持续性错误次数 (PE)成绩均显著低于对照组 (P <0 0 5 ) ;因子分析表明 ,与视觉空间功能相关的知觉组织因子和与注意维持功能相关的不分心因子明显低于对照组 (P <0 0 1,P <0 0 5 )。结论NLD儿童存在额叶为主的注意调控功能和工作记忆障碍 。

Objective To investigate the neuropsychological characteristics of selective attention such as attention control, working memory and attention persistence of frontal lobe in children with nonverbal learning disabilities (NLD). Methods With Auditory Detection Test (ADT), Wisconsin Card Sorting Test (WCST) and C-WISC, 14 children with NLD and 23 controls were tested and the results of sub-tests of C-WISC were analyzed with factor analysis. ADT was mainly applied to test the ability of auditory discernment and the function of dominance lateralization in the cerebra; WCST was employed to test the function of working memory which was based on the frontal lobe, and, C-WISC, to test the intelligent structure and characteristics. Results Compared with control group, the correct response rate of ADT in NLD group was much lower (P<0.01), and the number of incorrect response was much larger (P<0.01).Children with NLD had deficits of auditory selective attention. Moreover, the number of categories achieved (CA) and perseverative error (PE) of WCST were much lower (P<0.05), which indicated that children with NLD had the disorders of selective attention and performance function. Factor analysis showed that perceptual organization (PO) related to visual space and freedom from distractibility (FD) related to attention persistence in NLD group were obviously lower than those in control group (P<0.01,P<0.05). These findings further supported the above-mentioned results. Conclusions Children with NLD had attention control disorder and working memory disorder mainly in frontal lobe; we suppose that the disorder in right frontal lobe was distinctive.