注意缺陷多动障碍儿童认知特点的研究

Cognitive functions of children with attention deficit/hyperactivity disorder

目的 探索注意缺陷多动障碍 (ADHD)儿童认知功能特点。方法 对 6 0例ADHD门诊患儿 ,以及按年龄、性别、母亲文化程度配对的 6 0名正常儿童进行认知功能评定。结果 ADHD儿童言语智商、操作智商、全量表智商及A、B、C因子 (分别为 10 4± 13,98± 14 ,10 2± 13,10 4± 13,10 0± 15 ,10 2± 15 )均低于对照组 (分别为 112± 11,10 8± 13,112± 12 ,111± 12 ,10 7± 13,116± 13) ,差异有非常显著意义 (P均 <0 0 1) ;韦氏记忆测验中 ,ADHD儿童长时、短时、瞬时记忆、记忆商及倒背数字得分 (分别为 4 0± 7,5 8± 12 ,7± 3,95± 15 ,4 2± 1 7)亦明显低于对照组 (分别为 4 9± 5 ,6 3± 10 ,8± 3,10 9± 12 ,5 0± 1 4 ) ,差异有显著意义 (P均 <0 0 5 ) ;ADHD儿童数字划消测验总分低于对照组 ,平均失误率高于对照组 ,差异有非常显著意义 (P均 =0 0 0 0 ) ;Stroop测验中 ,ADHD组A、B、C、D部分完成时间及字义干扰时明显延长 (P均 =0 0 0 0 ) ,C、D部分的错误数显著增加 (P均 <0 0 1) ;瑞文测验标准分等级也低于对照组 (P =0 0 0 0 )。结论 ADHD儿童智力、记忆力、注意力水平低于正常儿童 ,且具有选择性抑制、语音信息的工作记忆和计划的执行功能缺陷。

Objective To investigate the features of cognitive function in children with attention deficit/hyperactivity disorder (ADHD). Methods Wechsler Intelligence Scale for Children RC, Wechsler Memory Scale (WMS), Number Cancellation Test, Ravin′s Standard Progressive Matrices, and Stroop test were conducted among 60 7～12 year old children diagnosed with ADHD and 60 children matched by age, sex, and maternal education level. Results The verbal intelligence quotient, performance IQ, full scale IQ, verbal comprehension IQ, perceptual organization IQ, and freedom from distractibility IQ of the ADHD CHILDREN were 104±13, 98±14, 102±13, 100±15, and 102±15, all less than those of the controls (112±11, 108±13, 112±12, 111±12, 107±13, and 116±13, all P <0.01). The scores of long term memory, short term memory, immediate memory, memory quotient, and reverse digit span in the chldren with ADHD were 40±7, 58±12, 7±3, 95±15, and 4.2±1.7 respectively, all less than those in the controls (49±5, 63±10, 8.4±3.0, 109±12.5, and 5.0±1.4 respectivly, all P <0.05). Number cancellatiion test showed significantly lower total score and higher error rate in ADHD chldren than in the controls (51.5 and 76.4 VS 77.3 and 38.0, both P =0.000). In Stroop test, the ADHD children spent more time for all the four parts, had to make more effort to eliminate the interference of word meaning, and made more errors in the C and D parts. The average standard score of Raven′s Standard Progressive Matrices was 4.0±1.5, significantly higher than that in the controls (2.7±1.2, P =0.000). Conclusion The levels of intelligence, memory, and attention in ADHD children are lower that those in normal children. ADHD children have deficiency in executive functions, such as selective inhibition, working memory and plan implementation.