學齡期注意力不足過動症－混合表現型兒童執行功能研究

朱慶琳; 黃敏怡; 葉啟斌; 姜忠信

doi:10.6172/BSE.201803_43(1).0003

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P53 - 78

社会科学 > 教育学

DOI： 10.6172/BSE

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学龄期注意力不足过动症－混合表现型儿童执行功能研究

Executive Function in Elementary School Children with Attention-Deficit/Hyperactivity Disorder Combined Presentation

朱庆琳(Ching-Lin Chu) ；黄敏怡(Min-Yi Huang) ；叶启斌(Chin-Bin Yeh) ；姜忠信(Chung-Hsin Chiang)

特殊教育研究学刊； 43 卷 1 期 (2018 / 03 / 31) ， P53 - 78

繁体中文 DOI： 10.6172/BSE.201803_43(1).0003

注意力不足／过动症—混合表现；执行功能；学龄期； ADHD-combined presentation ； elementary school children ； executive function

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摘要 │ 参考文献 (54) │ 被引用文献 (2) │ 国际计量

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Purpose: Children with attention-deficit/hyperactivity disorder (ADHD) who have executive function (EF) deficit show inconsistency in patterns of EF impairments. Certain methodological limitations might contribute to these confounding factors, such as ADHD subtype, intelligence quotient (IQ), chronological age, psychiatric comorbidity, and medication. This study examined the EF patterns in elementary school children with ADHD-combined presentation (ADHD-C) and determined whether EF tasks could help in effectively distinguishing between children with ADHD-C and controls. Methods: Sixty children from several elementary schools, their parents, and their teachers were recruited. Thirty children with ADHD-C and 30 healthy controls who were matched for sex, age, and IQ were enrolled. All the children with ADHD-C who were recruited had either never taken ADHD medication or had discontinued the medication at least a year before the study. Children with other psychiatric comorbidities were also excluded. Each child was tested on five major EF domains comprising eight different subdomains, including inhibition (of an ongoing response and interference control), working memory (verbal and nonverbal), cognitive flexibility, planning, and fluency (verbal and nonverbal). All the children were examined using the Wechsler Intelligence Scale for Children–Fourth Edition short form followed by the eight EF tasks. Parents and teachers in each group were required to finish the Swanson, Nolan, and Pelham Version IV scale for ADHD. Profile analyses were conducted to explore the differences in EF between the two groups. Canonical discriminant function analysis was used to determine whether a set of tasks effectively predicted ADHD-C. Results/Findings: The profiles of eight EF tasks were similar between the ADHD-C and control groups. Moreover, the global EF was relatively low in the ADHD-C group. Further analyses indicated that children with ADHD-C had poorer interference control, nonverbal working memory, and cognitive flexibility, and slightly lower levels in planning and in verbal and nonverbal fluency. Scores on the three EF tasks, including the knock and tap task, spatial working memory task, and the children’s color trial test, had an overall correct discriminative rate of 78.3% for the two groups. Conclusions/Implications: After the confounding factors were excluded, the study revealed that EF impairment may exist in children with ADHD-C. Compared to that in controls, EF performance was globally lower for children with ADHD-C. Among the EF subdomains, interference control, nonverbal working memory, and cognitive flexibility presented more deficits than the other subdomains, providing information about the phenotype of ADHD-C and the association with their neuropsychopathology. The clinical and educational implications of these findings are discussed. Further research on this subject is warranted.

参考文献 ( 54 ) 〈TOP〉

刘昱志、刘世恺、商志雍、林健禾、杜长龄、高淑芬(2006)。注意力缺陷过动症中文版Swanson, Nolan, and Pelham, Version IV（SNAP-IV）量表之常模及信效度。台湾精神医学，20(4)，290-304。
连结：
洪俪瑜（2014）：情绪行为障碍学生监定办法说明。取自http://iweb.ntnu.edu.tw/spe/identify2014/file/08.pdf。[Hung, Li-Yu (2014). Students with emotional/behavioral disorders identification manual. Retrieved from http://iweb.ntnu.edu.tw/spe/identify2014/file/08.pdf]
Alderson, R. M.,Rapport, M. D.,Kofler, M. J.(2007).Attention-deficit/hyperactivity disorder and behavioral inhibition: A metaanalytic review of the stop-signal paradigm.Journal of Abnormal Child Psychology,35(5),745-758.
American Psychiatric Association(2000).Diagnostic and statistical manual of mental disorder text revision.Washington, DC:Author.
American Psychiatric Association(2013).Diagnostic and statistical manual of mental disorder text revision.Washington, DC:Author.

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