计算机辅助的执行功能训练对注意缺陷多动障碍患儿的干预研究

Study on computerized executive function training on children with attention deficit hyperactivity disorder

目的通过对注意缺陷多动障碍(ADHD)患儿进行计算机辅助执行功能训练,初步探讨计算机辅助训练对患儿症状及执行功能缺陷的改善情况。方法对56例ADHD患儿分别进行计算机训练及药物治疗,评估其执行功能指标及行为症状变化。结果计算机辅助训练后的执行功能指标有显著差异,训练后患儿的Stroop测验的乙表正确数、正确率有显著提高(P<0.001);WCST持续错误数减少,概念化水平和持续应答数得分提高(P<0.01);WISC-Ⅳ的背数、译码及符号检索得分均有提高(P<0.05);CANTAB-SWM的总间隔错误、间隔错误、SWM策略分及SOC移动次数得分减少(P<0.05));PSQ评估的ADHD相关行为问题(学习问题、多动指数因子)显著下降(P<0.05)。结论计算机训练可以改善ADHD患儿的执行功能缺陷,对核心症状也有部分改善,有望成为新的临床干预手段。

Objectives To explore whether benefit the deficits in executive functions(EF)and clinical behaviors by focusing on computer-based programs designed to train EF on children with attention deficit hyperactivity disorder(ADHD). Methods Totally 56 children with ADHD were received computerized executive function training and medication respectively,and evaluated the scores of neuropsychological tests and symptom scales at baseline and after training. Results After training,there were significant improvement in main domains of EF tests,including correct number and correct rate in test B of Stroop test(P<0.001),persistent error response,conceptual level and sustained response scores of WCST(P<0.01),the digital-span scores,coding and symbol-search scores of WISC-Ⅳ(P<0.05),SWM errors,interval errors,SWM strategy and SOC average mobile number(3)scores of CANTAB(P<0.05).The learning problems,hyperactive index scores of PSQ were decreased significantly(P<0.05). Conclusions Computer-based training can improve the executive function deficits in ADHD children,as well as the ADHD core symptoms.This training would become a new clinical intervention.