注意缺陷多动障碍患儿日常生活组织技能训练的初步研究

Organizational skills trainningin real life for children with ADHD:A preliminary study

目的:研究组织技能(OST)训练对注意缺陷多动障碍(ADHD)患儿日常生活中组织技能的改善情况。方法:选取6名小学3年级确诊ADHD的儿童作为研究对象。训练基于OST训练操作手册进行,所有受试者经过13周,共24节课,每周2次,每次1小时的组织技能训练,并比较受试者治疗前后执行功能行为评定量表2(BRIEF2)、SNAP-Ⅳ量表、Achenbach儿童行为量表(CBCL)、数字划消测验、Piers-Harris儿童自我意识量表(PHCSS)和WEISS功能缺陷量表父母版(WFIRS-P)的评估数据。结果:经过组织技能训练后,ADHD患儿自我监控、情绪控制、工作记忆、计划和组织、行为调节指数、情绪调节指数、认知调节指数和总合成分的下降具有显著统计学差异(t=2.67,3.57,2.96,6.17,2.97,2.65,35.00,13.56;P<0.05),SNAP-IV量表的3个分量表的分数及总分数均降低(t=3.08,3.15,4.00,5.25;P<0.05);CBCL多动、违纪行为明显减少(t=2.71,3.50;P<0.05);自我意识总得分高于治疗前(t=-2.84,P<0.05);WFIRS得分和数字划消实验得分与治疗前的差异无显著统计学意义。结论:组织技能训练能够改善ADHD患儿日常生活中的组织技能,同时改善了ADHD核心症状。

Objective:To study the effect of OST training on the improvement of ADHD children’s daily life skills.Methods:Six children diagnosed with ADHD in grade 3 of primary school were selected as the subjects.The training was carried out based on OST training manual.All the subjects underwent 13 weeks,24 classes,2 times a week,1 hour of organizational skills training each time.The subjects were compared before and after treatment with the implementation of Behavior Rating Inventory of Executive Function,Second Edition(brief2),SNAP-IV,Achenbach Child Behavior Checklist(CBCL),digital erasure test,Piers-Harris Children’s self-concept Scale(PHCSS)and Weiss Functional Impairment Scale-Parent form,(WFIRS-P).Results:After the training of organizational skills,the decrease of self-monitoring,emotion control,working memory,planning & organization,behavior regulation index,emotion regulation index,cognitive regulation index and total composition of ADHD children was statistically significant(t=2.67,3.57,2.96,6.17,2.97,2.65,35.00,13.56;P<0.05).The scores and total scores of the three subscales of SNAP-IV decreased(t=3.08,3.15,4.00,5.25;P<0.05);The hyperactivity and disciplinary violations of CBCL decreased significantly(t=2.71,3.50;P<0.05);the total score of self-awareness was higher than that before treatment(t=-2.84,P<0.05);there was no significant difference between the score of WFIRS-P and the score of digital erasure experiment and that before treatment.Conclusion:Organizational skills training can improve the daily life of ADHD children,and improve the core symptoms of ADHD.