Main focus of parents of children with attention deficit hyperactivity disorder and the effectiveness of early clinical screening

BACKGROUND Attention deficit hyperactivity disorder(ADHD)is a common mental and behavioral disorder among children.AIM To explore the focus of attention deficit hyperactivity disorder parents and the effectiveness of early clinical screening METHODS This study found that the main directions of parents seeking medical help were short attention time for children under 7 years old(16.6%)and poor academic performance for children over 7 years old(12.1%).We employed a two-stage experiment to diagnose ADHD.Among the 5683 children evaluated from 2018 to 2021,360 met the DSM-5 criteria.Those diagnosed with ADHD underwent assessments for letter,number,and figure attention.Following the exclusion of ADHD-H diagnoses,the detection rate rose to 96.0%,with 310 out of 323 cases identified.RESULTS This study yielded insights into the primary concerns of parents regarding their children's symptoms and validated the efficacy of a straightforward diagnostic test,offering valuable guidance for directing ADHD treatment,facilitating early detection,and enabling timely intervention.Our research delved into the predominant worries of parents across various age groups.Furthermore,we showcased the precision of the simple exclusion experiment in discerning between ADHD-I and ADHD-C in children.CONCLUSION Our study will help diagnose and guide future treatment directions for ADHD.

Risk for emerging bipolar disorder, variants, and symptoms in children with attention deficit hyperactivity disorder, now grown up

AIM: To determine the prevalence of bipolar disorder(BD) and sub-threshold symptoms in children with attention deficit hyperactivity disorder(ADHD) through 14 years' follow-up, when participants were between 21-24 years old.METHODS: First, we examined rates of BD type Ⅰ?and Ⅱ diagnoses in youth participating in the NIMH-funded Multimodal Treatment Study of ADHD(MTA). We used the diagnostic interview schedule for children(DISC), administered to both parents(DISC-P) and youth(DISCY). We compared the MTA study subjects with ADHD(n = 579) to a local normative comparison group(LNCG, n = 289) at 4 different assessment points: 6, 8, 12, and 14 years of follow-ups. To evaluate the bipolar variants, we compared total symptom counts(TSC) of DSM manic and hypomanic symptoms that were generated by DISC in ADHD and LNCG subjects. Then we sub-divided the TSC into pathognomonic manic(PM) and non-specific manic(NSM) symptoms. We compared the PM and NSM in ADHD and LNCG at each assessment point and over time. We also evaluated the irritability as category A2 manic symptom in both groups and over time. Finally, we studied the irritability symptom in correlation with PM and NSM in ADHD and LNCG subjects.RESULTS: DISC-generated BD diagnosis did not differ significantly in rates between ADHD(1.89%) and LNCG 1.38%). Interestingly, no participant met BD diagnosis more than once in the 4 assessment points in 14 years. However, on the symptom level, ADHD subjects reported significantly higher mean TSC scores: ADHD 3.0; LNCG 1.7; P < 0.001. ADHD status was associated with higher mean NSM: ADHD 2.0 vs LNCG 1.1; P < 0.0001. Also, ADHD subjects had higher PM symptoms than LNCG, with PM means over all time points of 1.3 ADHD; 0.9 LNCG; P = 0.0001. Examining both NSM and PM, ADHD status associated with greater NSM than PM. However, Over 14 years, the NSM symptoms declined and changed to PM over time(df 3, 2523; F = 20.1; P < 0.0001). Finally, Irritability(BD DSM criterion-A2) rates were significantly higher in ADHD than LNCG(χ2 = 122.2, P < 0.0001), but irritability was associated more strongly with NSM than PM(df 3, 2538; F = 43.2; P < 0.0001).CONCLUSION: Individuals with ADHD do not appear to be at significantly greater risk for developing BD, but do show higher rates of BD symptoms, especially NSM. The greater linkage of irritability to NSM than to PM suggests caution when making BD diagnoses based on irritability alone as one of 2(A-level) symptoms for BD diagnosis, particularly in view of its frequent presentation with other psychopathologies.

Effectiveness of Family-Based Behavioral Treatment Based on Medication Behavior Barkley Compared with Drug Therapy in Reducing the Symptoms of Children with Attention Deficit Disorder-Hyperactivity

Children with attention deficit and hyper activity disorder have various problems such as low academic performance, social and communication problems, anxiety, depression, aggression, conduct disorder and delinquency, and also when they become adults, they have problems in social relationships that these problems can increase or decrease in dealing with family. Hence, this study was performed in order to examine the impact of family-based behavioral treatment compared with Barkley behavior therapy in reducing symptoms of children with attention deficit disorder—ADHD. To meet the aim, 20 of children with age range of 7 to 12 years old with attention deficit disorder—hyperactivity were selected in both experimental and control groups, and exposed to the treatment of behavioral family therapy groups and changes in behavior Barkley. Before and after the treatment, they were evaluated according to the scale of the Conner’s Parent Rating Scale-Revised Short Form (CPRS-R: S). Results of multivariate analysis of covariance indicated that there were significant differences between the experimental group who had received family-based behavioral treatments based on changes in behavior Barkley and a control group who had received drug treatment in variables, including conduct problems, learning problems, psychosomatic symptoms, and signs of impulsive hyperactivity, anxiety and hyperactivity (p < 0.01). These results could be guidance for counsel or sand therapists for children with attention deficit disorder—ADHD.

A Controlled Study of the Effectiveness of EEG Biofeedback Training on Children with Attention Deficit Hyperactivity Disorder

In order to study the treatment of the children with attention deficit hyperactivity disorder (ADHD), the integrated visual and auditory continuous performance test (IVA-CPT) was clinically applied to evaluate the effectiveness of electroencephalogram (EEG) biofeedback training. Of all the 60 children with ADHD aged more than 6 years, the effective rate of EEG biofeedback training was 91.6 % after 40 sessions of EEG biofeedback training. Before and after treatment by EEG biofeedback training, the overall indexes of IVA were significantly improved among predominately inattentive, hyperactive, and combined subtype of children with ADHD (P<0.001). It was suggested that EEG biofeedback training was an effective and vital treatment on children with ADHD.

Whole Exome Sequencing: Novel Genetic Polymorphisms in Saudi Arabian Attention Deficit Hyperactivity Disorder (ADHD) Children

Background: Attention-deficit hyperactivity disorder (ADHD) is a widespread and debilitating disorder with relatively high prevalence in Saudi Arabia. Neuropsychological and radiological investigations have revealed that there are some differences in the components of the brain regions in children with and without ADHD. In this study we have performed whole exome sequencing (WES) in four non-familial cases of ADHD from Makkah Region to identify the genetic polymorphisms associated with the disease in our Saudi population. Methods: Exome sequencing was carried out using Ion Proton with AmpliSeq Exome library methods, and the data were analysed by Ion Reporter 5.6 software. Results: A total of 33 variants were identified from 222 genes selected from the GWAS catalogue for ADHD associated genes. However, the SNPs we identified in these genes were not reported to be associated with ADHD in previous studies. We have identified 2 novel missense variants;one in c.3451G > T;p. (Ala1151Ser) in ITGA1 gene and another is c.988G > A;p. (Ala330Thr) in SPATA13 genes. The variants rs928661, rs11150370 and rs386792899 were the only three variants that appeared on all the 4 patients studied. Six missense variants, rs16841277, rs2228209, rs2230283, rs3741883, rs1716 and rs2272606, were found in 3 different patients, respectively. However, the three documented variants are rs13166360 with bipolar disorder, rs920829 with neuropathic pain, and rs6558702 with schizophrenia. Conclusion: We have identified 2 novel variants in ADHD children. SIFT score of all variants indicates that these substitutions have damaging effects on the protein function. Further screening studies are recommended for confirmation.

MicroRNAs as potential biomarkers for diagnosis of attention deficit hyperactivity disorder

Inappropriate levels of hyperactivity,impulsivity,and inattention characterize attention deficit hyperactivity disorder,a common childhood-onset neuropsychiatric disorder.The cognitive function and learning ability of children with attention deficit hyperactivity disorder are affected,and these symptoms may persist to adulthood if they are not treated.The diagnosis of attention deficit hyperactivity disorder is only based on symptoms and objective tests for attention deficit hyperactivity disorder are missing.Treatments for attention deficit hyperactivity disorder in children include medications,behavior therapy,counseling,and education services which can relieve many of the symptoms of attention deficit hyperactivity disorder but cannot cure it.There is a need for a molecular biomarker to distinguish attention deficit hyperactivity disorder from healthy subjects and other neurological conditions,which would allow for an earlier and more accurate diagnosis and appropriate treatment to be initiated.Abnormal expression of microRNAs is connected to brain development and disease and could provide novel biomarkers for the diagnosis and prognosis of attention deficit hyperactivity disorder.The recent studies reviewed had performed microRNA profiling in whole blood,white blood cells,blood plasma,and blood serum of children with attention deficit hyperactivity disorder.A large number of microRNAs were dysregulated when compared to healthy controls and with some overlap between individual studies.From the studies that had included a validation set of patients and controls,potential candidate biomarkers for attention deficit hyperactivity disorder in children could be miR-140-3p,let-7g-5p,-30e-5p,-223-3p,-142-5p,-486-5p,-151a-3p,-151a-5p,and-126-5p in total white blood cells,and miR-4516,-6090,-4763-3p,-4281,-4466,-101-3p,-130a-3p,-138-5p,-195-5p,and-106b-5p in blood serum.Further studies are warranted with children and adults with attention deficit hyperactivity disorder,and consideration should be given to utilizing rat models of attention deficit hyperactivity disorder.Animal studies could be used to confirm microRNA findings in human patients and to test the effects of targeting specific microRNAs on disease progression and behavior.

Review of barriers and interventions to promote treatment engagement for pediatric attention deficit hyperactivity disorder care

Attention deficit hyperactivity disorder(ADHD)is a common and impairing behavioral health disorder,impacting over 5%of children worldwide.There are multiple evidence-based pharmacological and psychosocial treatments for ADHD,and greater service utilization is associated with improved acute and long-term outcomes.However,long-term outcomes are suboptimal as multimodal treatments are often not accessed and most care ends prematurely.This narrative review discusses barriers to engagement for children and adolescents with ADHD and their families as well as interventions to overcome these barriers.Families face a variety of structural and attitudinal barriers,ranging from cost and access to stigma and low self-efficacy to successfully implement change.There are multiple interventions that may enhance engagement with ADHD care including psychoeducation,integration of behavioral services in general medical settings,telehealth as well as specific adaptations to existing ADHD treatments,such as the use of motivational interviewing or shared decision making.Integration of behavioral health into general medical settings and telehealth have been found in controlled studies to increase access by reducing both structural and attitudinal barriers.Adding motivational interviewing,shared decision making and other engagement interventions to evidence-based ADHD treatments has been found to reduce attitudinal barriers that translates into improved participation and satisfaction while enhancing outcomes.However,little is known about how to promote extended engagement with ADHD services even though a chronic care model for ADHD is recommended.

Attention deficit hyperactivity disorder in children with epilepsy:a multicenter cross-sectional analysis in China

Background The diagnosis and treatment of attention deficit hyperactivity disorder(ADHD)comorbid with epilepsy have been insufficiently addressed in China.We conducted a study in China to investigate the current status,diagnosis,and treatment of ADHD in children to further our understanding of ADHD comorbid with epilepsy,strengthen its management,and improve patients’quality of life.Methods We carried out a multicenter cross-sectional survey of children with epilepsy across China between March 2022 and August 2022.We screened all patients for ADHD and compared various demographic and clinical factors between children with and without ADHD,including gender,age,age at epilepsy onset,duration of epilepsy,seizure types,seizure frequency,presence of epileptiform discharges,and treatment status.Our objective was to explore any possible associations between these characteristics and the prevalence of ADHD.Results Overall,395 epilepsy patients aged 6–18 years were enrolled.The age at seizure onset and duration of epilepsy ranged from 0.1–18 to 0.5–15 years,respectively.Focal onset seizures were observed in 212(53.6%)patients,while 293(76.3%)patients had epileptiform interictal electroencephalogram(EEG)abnormalities.Among the 370 patients treated with anti-seizure medications,200(54.1%)had monotherapy.Although 189(47.8%)patients had ADHD,only 31 received treatment for it,with the inattentive subtype being the most common.ADHD was more common in children undergoing polytherapy compared to those on monotherapy.Additionally,poor seizure control and the presence of epileptiform interictal EEG abnormalities may be associated with a higher prevalence of ADHD.Conclusions While the prevalence of ADHD was higher in children with epilepsy than in normal children,the treatment rate was notably low.This highlights the need to give more importance to the diagnosis and treatment of ADHD in children with epilepsy.

Difficult speech-on-speech recognition as a behavioral indicator in children with attention deficit hyperactivity disorder

Attention deficit hyperactivity disorder(ADHD)is one of the most prevalent neurodevelopmental disorders,which is characterized with significant difficulties in attention regulation,hyperactivity,and impulsivity.These symptoms profoundly affect daily functioning and overall quality of life,and frequently persist into adulthood.1,2 ADHD's global prevalence among children and adolescents is estimated at approximately 5%to 6%,3 a statistic echoed by research conducted in China.4 The societal burden imposed by ADHD is profound,affecting educational systems,workplace productivity,and family dynamics.

Cognitive Function of Children and Adolescents with Attention Deficit Hyperactivity Disorder and Learning Difficulties： A Developmental Perspective

Background： The cognitive function of children with either attention deficit hyperactivity disorder （ADHD） or learning disabilities （LDs） is known to be impaired. However, little is known about the cognitive function of children with comorbid ADHD and LD. The present study aimed to explore the cognitive function of children and adolescents with ADH D and learning difficulties in comparison with children with ADHD and healthy controls in different age groups in a large Chinese sample. Methods： Totally, 1043 participants with ADHD and learning difficulties （the ADHD ＋ learning difficulties group）, 870 with pure ADHD （the pure ADHD group）, and 496 healthy controls were recruited. To investigate the difference in cognitive impairment using a developmental approach, all participants were divided into three age groups （6-8, 9-11, and 12-14 years old）. Measurements were the Chinese-Wechsler Intelligence Scale for Children, the Stroop Color-Word Test, the Trail-Making Test, and the Behavior Rating Inventory of Executive Function-Parents （BRIEF）. Multivariate analysis of variance was used. Results： The results showed that after controlling for the effect of ADHD symptoms, the A DHD ＋ learning difficulties group was still significantly worse than the pureADHD group, which was, in turn, worse than the control group on full intelligence quotient （98.66 ± 13.87 vs. 105.17 ± 14.36 vs. 112.93 ± 13.87, P 〈 0.001 ）. The same relationship was also evident for shift function （shifting time of the Trail-Making Test, 122.50 [62.00, 194.25] s vs. 122.00 [73.00, 201.50] s vs. 66.00 [45.00, 108.00] s, P 〈 0.001） and everyday life executive function （BRIEF total score, 145.71 ± 19.35 vs. 138.96± 18.00 vs. 122.71 ± 20.45, P 〈 0.001 ） after controlling for the effect of the severity of ADHD symptoms, intelligence quotient, age, and gender. As for the age groups, the differences among groups became nonsignificant in the 12-14 years old group for inhibition （meaning interference of the Stroop Color-Word Test, 18.00 [13.00, 25.00] s vs. 17.00 [15.00, 26.00] s vs. 17.00 [10.50, 20.00] s, P =0.704） and shift function （shifting time of the Trail-Making Test, 62.00 [43.00, 97.00] s vs. 53.00 [38.00, 81.00] s vs. 101.00 [88.00, 114.00] s, P = 0.778）. Conclusions： Children and adolescents with ADHD and learning difficulties have more severe cognitive impairment than pure ADHD patients even after controlling for the effect of ADHD symptoms. However, the differences in impairment in inhibition and shift function are no longer significant when these individuals were 12-14 years old.

妊娠期糖尿病与儿童注意缺陷多动障碍的关系及预测模型研究

目的 分析妊娠期糖尿病与儿童注意缺陷多动障碍(attention deficit and hyperactivity disorder,ADHD)发生关系及预测模型研究。方法 选取门诊诊治的ADHD患儿120例设为研究组,根据ADHD父母评定量表再将研究组分为病情轻度组、病情中度组及病情重度组;于患儿入组后,记录并采用χ^(2)检验比较不同病情患儿其母妊娠期糖尿病发生情况,另选同时段来院检查的健康儿童120例作为对照组,收集所有受试者相关资料;采用logistic单因素、多因素分析影响ADHD发病的因素;探讨妊娠期糖尿病与ADHD发生关系;建立受试者工作特征(ROC)曲线下面积(AUC)评估妊娠期糖尿病预测ADHD发生的效能。结果 母亲妊娠期糖尿病发生率比较,重度组>中度组>轻度组和对照组,差异有统计学意义(P<0.05);研究组存在妊娠期糖尿病、妊娠期肥胖占比,父亲文化程度、母亲文化程度初中及以下占比,教育方式为训斥/批评占比均高于对照组,差异有统计学意义(P<0.05);logistic回归分析结果显示,妊娠期糖尿病、妊娠期肥胖、父亲文化程度、母亲文化程度、教育方式为ADHD发病的相关影响因素,妊娠期糖尿病及基于妊娠期糖尿病构建的ADHD发病预测模型预测ADHD发病的AUC分别为0.617、0.806。结论 妊娠期糖尿病增加ADHD风险,其预测模型对预测ADHD发病具有一定的参考价值。

导致儿童注意力缺陷多动障碍的孕期和围产期危险因素Scoping综述

目的对导致儿童注意力缺陷多动障碍(ADHD)的孕期和围产期相关危险因素进行Scoping综述。方法检索中国知网、万方数据库、PubMed和Web of Science儿童ADHD的孕期和围产期危险因素相关的文献,时间为建库至2021年7月1日,提取作者、国家、发表时间、研究对象、年龄、样本量、纳入时间、研究设计、诊断标准、评价工具和相关危险因素。结果共检索到文献2721篇,最终纳入35篇,来自11个国家,多数文献来源于儿科学、精神病学、神经病学及流行病学相关主题期刊,研究主要集中在2008年至2021年,研究方法大多数采用病例对照研究和队列研究,研究主要涉及儿童ADHD诊断方法、孕期及围产期危险因素评价方法和相关危险因素。儿童ADHD的诊断标准主要采用《精神疾病诊断与统计手册》和《国际疾病分类标准》,结合父母和老师用调查问卷做出最终诊断。孕期及围产期危险因素是从医疗记录中提取生产记录、出生记录、母亲病史记录、围产期住院和门诊记录和孕期母亲药物使用记录中的信息,或采用问卷调查法(父母/新生儿)汇总信息。孕期及围产期危险因素主要分为孕期自身因素、宫内因素、环境因素和围产期意外四个方面,其中孕期自身因素包括孕妇低龄、妊娠期肥胖、孕期不良生活习惯、孕期有害物质暴露、孕期病史和孕期营养素缺乏;宫内因素包括宫内胎儿发育不佳、流产和怀孕次数;环境因素包括生活环境和社会环境;围产期意外包括分娩意外和新生儿健康状况不佳。结论导致儿童ADHD相关的孕期和围产期危险因素主要包括母体自身因素、宫内因素、环境因素和围产期意外四个方面。其中,孕期心理健康状况不佳是导致儿童ADHD的主要危险因素。

Review of the effects of SARS-CoV2 infection and COVID-19 on common pediatric psychiatric illnesses

Severe acute respiratory syndrome coronavirus-2 is a novel coronavirus strain that causes pneumonia and acute respiratory distress syndrome along with other morbidities,collectively known as coronavirus disease 2019(COVID-19)disease.There has been widespread discussion about the psychological impact of COVID-19 particularly on children and adolescents.There have been overarching negative effects with regards to decreased physical activity,more screen time,increasingly unhealthy diets,and irregularities in sleep/wake schedules.This,coupled with disruptions in ongoing mental health treatment and associated support structures,has caused unprecedented declines in the emotional and psychosocial wellbeing of children and adolescents.This review aims to systematically review the literature to provide a general overview of the ways in which COVID-19 has affected common psychiatric illnesses in children and adolescents.The included articles in all subsections concluded that symptoms of these common childhood psychiatric disorders have generally been exacerbated by the COVID-19 pandemic.This review indicates that quarantine and the consequent isolation have had multiple significant and consistent negative implications on the mental health of children and adolescents.Our study indicates that there should be increased vigilance among providers and families to mitigate the negative psychological effects that the COVID-19 pandemic has on children with common childhood psychiatric disorders.

Motor abilities of children and adolescents with a psychiatric condition:A systematic literature review

AIM: To summarize research regarding the motor abilities of children and adolescents who suffer from a common psychiatric condition.METHODS: In order to outline the current knowledge regarding the motor abilities of children and adolescents with autism spectrum disorders(ASD), attention deficit hyperactivity disorder(ADHD), disruptive behavior disorders(DBD) and depression, a comprehensive systematic literature search was carried out using Pub Med, Medline and ERIC databases. The databases were searched for relevant English language articles published between January 1990 and April 2014. Only studies that conducted a quantitative evaluation of motor ability and concerned individuals aged 0-18 years were included. A separate search was conducted for each disorder(ASD, ADHD, DBD, depression) in conjunction with each of the following keywords:(psycho/perceptuo) motor/movement skill(s),(psycho/perceptuo) motor/movement abilities,(psycho/perceptuo) motor/movement impairment,(psycho/perceptuo) motor/movement problem(s), motor function, motor coordination, motor performance, motor deficit(s). To detect supplementary relevant literature, the reference lists of the retrieved articles were examined. RESULTS: The search strategy yielded 51 studies meeting the inclusion criteria. In total, 28 studies were included that examined the motor abilities of children and adolescents with ASD. All studies indicated that they performed below average on various standardized motor assessment instruments. The overall prevalence rate for impairment in motor abilities ranged from 33% to 100%. Twenty-seven studies examined the motor abilities of children and adolescents with ADHD. Depending on the type of motor assessment tool and the cut-off points used by different researchers, prevalence rates of impairment in motor abilities are highly variable and ranged from 8% to 73%. Remarkably, there is a paucity of research addressing the motor abilities of individuals with DBD or depression. Furthermore, methodological problems, such as measurement and comorbidity issues, complicate the generalization of the findings. CONCLUSION: Research suggests that motor impairment is highly prevalent in some psychiatric conditions, particularly ASD and ADHD. However, future work is necessary to draw sound conclusions.

抽动及共患注意缺陷多动障碍患儿维生素D含量差异研究

目的探讨血清维生素D含量与抽动障碍(TD)发病及共患注意缺陷多动障碍(ADHD)的关系。方法选取2021年4月至2023年4月于攀枝花市中心医院儿科门诊确诊为TD的161名儿童为研究对象,根据是否共患ADHD分为单纯TD组(n=103)、TD+ADHD组(n=58),比较两组患儿维生素D含量差异情况。结果不同性别TD儿童25(OH)D含量无显著性差异(P>0.05);病程>12个月的TD儿童25(OH)D含量低于病程≤12个月的TD儿童,差异具有统计学意义(t=3.02,P<0.05);病程>12个月组TD儿童血清25(OH)D不足比例高于病程≤12个月组,差异有统计学意义(χ^(2)=6.88,P<0.05);中重度TD儿童的25(OH)D含量明显低于轻度TD儿童(t=3.64,P<0.05);中重度TD组儿童血清25(OH)D不足及缺乏比例明显高于轻度TD组,差异有统计学意义(χ^(2)=18.23,P<0.05);TD+ADHD儿童与单纯TD儿童的25(OH)D含量差异无统计学意义(P>0.05);TD+ADHD组儿童血清25(OH)D不足及缺乏比例高于单纯TD组,差异有统计学意义(χ^(2)=3.85,P<0.01)。结论维生素D缺乏程度与TD的病情、病程及合并ADHD的风险呈正相关性。

家庭辅助训练联合分阶综合运动干预对注意缺陷多动障碍患儿核心症状及认知功能的影响

目的探讨家庭辅助训练联合分阶综合运动干预在注意缺陷多动障碍(ADHD)患儿中的应用价值。方法选取2021年1月至2023年2月九江市妇幼保健院收治的80例ADHD患儿作为研究对象,根据随机数字表法分为观察组(40例)和对照组(40例)。观察组采取家庭辅助训练联合分阶综合运动干预,对照组采取分阶段综合运动干预。比较两组的核心症状、认知功能、生活能力、家庭功能、干预效果及家属满意度。结果两组干预前的核心症状、认知功能、生活能力及家庭功能比较,差异无统计学意义(P>0.05)。干预后,观察组的Conners父母症状问卷(PSQ)评分低于对照组,父母养育方式评价量表(EMBU)评分高于对照组分,差异有统计学意义(P<0.05);瑞文标准推理测验(RSPM)评分低于对照组,婴儿-初中社会生活能力量表评分高于对照组,差异有统计学意义(P<0.05);观察组干预总有效率高于对照组,差异有统计学意义(P<0.05);观察组家属满意度高于对照组,差异有统计学意义(P<0.05)。结论家庭辅助训练联合分阶综合运动干预可以改善ADHD核心症状与认知功能,并提高生活能力、家庭功能,改善家属满意度。

注意缺陷多动障碍儿童粗大动作技能与执行功能发展的特点及关系

目的探讨学龄期注意缺陷多动障碍(ADHD)儿童的粗大动作技能和执行功能的发展特点及其相关关系。方法2020年11月至2021年5月于北京大学第六医院和北京市海淀区万泉小学招募90例ADHD儿童,从该小学另募集年龄和性别匹配的正常发育儿童90例。采用儿童粗大动作发展测试量表第三版(TGMD-3)评估儿童的粗大动作技能,采用Stroop色词测验(SCWT)、Rey-Osterrich复杂图形测验(ROCFT)、连线测验(TMT)分别评估儿童的抑制控制、工作记忆和认知灵活性。结果ADHD儿童TGMD-3得分显著低于正常儿童(t=-6.275,P<0.001),SCWT、ROCFT、TMT测试结果均差于正常儿童(|t|≥1.986,P≤0.05)。ADHD儿童的TGMD-3得分与字义反应时(r=-0.261)、字义错误数(r=-0.404)、颜色错误数(r=-0.326)呈负相关(P<0.05),与延时结构记忆得分(r=0.228)呈正相关(P<0.05),与TMT-A反应时(r=-0.255)、TMT-A错误数(r=-0.329)、TMT-B反应时(r=-0.214)、TMT-B错误数(r=-0.474)呈负相关(P<0.05)。分层线性回归分析显示,ADHD儿童的TGMD-3得分仅对抑制控制和认知灵活性的测试结果具有预测作用(P<0.05),解释率分别为8.7%和22.5%。结论ADHD儿童的粗大动作技能和执行功能均存在发育滞后,且两者之间有一定关联,其中,粗大动作技能水平可在一定程度上影响抑制控制和认知灵活性的发展。

执行障碍康复训练在多动症儿童中的应用效果分析

目的探讨执行障碍康复训练在多动症儿童中的应用效果.方法选取本院2021年8月—2023年7月收治的86例多动症患儿作为研究对象,按照随机数字表法将其分为对照组与观察组,各43例.对照组采用常规康复指导,观察组采用执行障碍康复训练.比较两组患儿的多动症状、认知功能及病情状况.结果训练后,观察组注意力缺陷多动障碍评定量表中多动-冲动、对立违抗、注意缺陷评分分别为(9.92±0.85)分、(7.21±0.54)分、(10.71±1.73)分,均低于对照组的(12.57±1.86)分、(9.57±1.25)分、(13.56±1.95)分,组间差异有统计学意义(P﹤0.05);观察组Conners父母用症状问卷中多动指数、冲动-多动、心身问题、焦虑、学习问题、品行问题评分分别为(2.13±0.38)分、(1.28±0.19)分、(0.64±0.21)分、(0.91±0.17)分、(2.47±0.48)分、(2.43±0.26)分,均低于对照组的(3.94±0.82)分、(1.92±0.36)分、(1.31±0.59)分、(1.45±0.56)分、(3.91±0.82)分、(4.07±0.73)分,组间差异有统计学意义(P﹤0.05);观察组Conner简明症状量表评分为(12.76±1.46)分,低于对照组的(17.68±1.73)分,差异有统计学意义(P﹤0.05).结论在多动症儿童中采取执行障碍康复训练可明显减轻患儿症状,改善病情程度,提高认知功能,适合临床推广使用.

从督论治儿童注意缺陷多动障碍思路探析

基于上海市名中医秦亮甫教授“病变在脑,首取督脉”理论,分析儿童注意缺陷多动障碍(ADHD)的病因病机。笔者认为,儿童ADHD的病机关键为动静失制、阴阳失调,而肾精不足、髓海空虚导致神机失用是该病的发病基础,治疗上应疏通督脉以调神机。通督调神法从督论治儿童ADHD疗效显著,为中医临床诊治本病拓宽了思路。