儿童注意缺陷-多动障碍不同入学年龄段构成比研究

Constituent ratio of children entering school at different age bracket among children with attention deficit/hyperactivity disorder

【目的】探讨小学一至六年级在上海儿童医学中心发育行为儿科被诊断为注意缺陷-多动障碍(attentiondeficit/hyperactivity disorder,ADHD)的儿童在不同入学年龄段的构成比方面有无差异。【方法】对2005年1月-2008年1月在上海儿童医学中心发育行为儿科被明确诊断为ADHD的小学儿童,依其三种不同入学年龄段(6岁0个月～6岁5个月;6岁6个月～6岁11个月;7岁及以上)分年级计算其人数构成比,采用χ2检验前两种年龄段人数构成比之间有差异无统计学意义,并观察构成比随年级增长的变化趋势。【结果】一至三年级ADHD儿童在6岁0个月～6岁5个月入学人数构成比和6岁6个月～6岁11个月入学人数构成比比较差异有高度统计学意义(χ2=50.883,P<0.000 1),其相对比为1.656,95%CI为1.434～1.913。随年级增加,这种人数构成比差异不断减小,至四年级及以后已无统计学差异。【结论】在儿童ADHD中入学年龄较小者构成比较大,低年级这种现象尤为明显,提示年龄偏小儿童入学准备不足问题更严重,间接可能导致较多儿童出现ADHD。

[Objectives] To explore the difference of the constituent ratio between children with attention deficit/hyperactivity disorder （ADHD） entering the primary school at the different age. [Methods] The constituent ratio by grades among the primary school children with ADHD was calculated with the three categories of school entrance age：from 6 years to 6 years and 5 months,from 6 years and 6 month to 6 years and 11 months,7 years and above. Pearson＇s chi-square test was used to examine whether the difference of the constituent ratio existed between thress categories. The change of the con- stituent ratio with increasing grade was observed. [Results] There was significant statistical difference of the constituent ratio between three categories children with ADHD during 1 to 3 grade（X2 = 50. 883, P〈0. 0001）. The relative ratio was 1.656,95 % C I was 1. 434 - 1.913. The difference of constituent ratio was decreasing with the grade increasing. It showed no significant statistical difference in the fourth grade and later. [Conclusions] The constituent ratio of those entering into the primary school at the younger age among children with ADHD is relatively higher. This phenomenon is salient in the lower grade. It is postulated that the school readiness is deficient in the relatively younger children so that more children en tering the primary school at the younger age would develop the symptoms of ADHD.