学龄期注意缺陷多动障碍共患特定学习障碍儿童智力结构与临床特征分析

岳小静; 王承芯; 李洪华; 贾飞勇

doi:10.7499/j.issn.1008-8830.2006047

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中国当代儿科杂志 ›› 2020, Vol. 22 ›› Issue (11) : 1178-1182. DOI: 10.7499/j.issn.1008-8830.2006047

论著·临床研究

学龄期注意缺陷多动障碍共患特定学习障碍儿童智力结构与临床特征分析

岳小静, 王承芯, 李洪华, 贾飞勇

作者信息 +

Intelligence structure and clinical features of school-age children with attention deficit hyperactivity disorder and specific learning disorder

YUE Xiao-Jing, WANG Cheng-Xin, LI Hong-Hua, JIA Fei-Yong

Author information +

文章历史 +

摘要

目的探讨注意缺陷多动障碍（ADHD）共患特定学习障碍（SLD）儿童的智力结构及其他临床特征。方法回顾性选择2018年10月至2019年4月在吉林大学第一医院发育行为儿科门诊明确诊断的学龄期ADHD儿童88例为研究对象，根据有无共患SLD分为单纯ADHD组（n=45）和ADHD共患SLD组（n=43）。分析比较两组患儿的智力结构及其他临床特征。结果 ADHD共患SLD组患儿言语智商（VIQ）、操作智商（PIQ）及总智商（FIQ）得分均显著低于单纯ADHD组（P < 0.05），VIQ中的常识、类同、算数及背数得分显著低于单纯ADHD组（P < 0.05），PIQ的填图、排列、积木及拼图得分显著低于单纯ADHD组（P < 0.05）；共患SLD的发生与FIQ、VIQ、PIQ及常识、类同、算数、背数、填图、排列、积木、拼图能力呈显著负相关（P < 0.05）。结论 ADHD共患SLD患儿FIQ、VIQ及PIQ表现差于单纯ADHD患儿，主要表现在大部分智力结构因子能力偏弱。需要进一步关注学龄期ADHD儿童共患SLD的管理与干预。

Abstract

Objective To study the intelligence structure and clinical features of children with attention deficit hyperactivity disorder (ADHD) and specific learning disorder (SLD). Methods A retrospective analysis was performed on 88 school-age children with ADHD. According to the presence or absence of SLD, they were divided into two groups:simple ADHD group with 45 children and ADHD+SLD group with 43 children. Intelligence structure and clinical features were compared between the two groups. Results Compared with the simple ADHD group, the ADHD+SLD group had significantly lower verbal intelligence quotient (VIQ), performance intelligence quotient (PIQ), and full intelligence quotient (FIQ) (P < 0.05), significantly lower scores of VIQ factors (including information, similarities, arithmetic, and recitation) (P < 0.05), and significantly lower scores of PIQ factors (including picture completion, picture arrangement, block design, and object assembly) (P < 0.05). The development of SLD was negatively correlated with FIQ, VIQ, and PIQ. It was also negatively correlated with the scores of intelligence structure factors (including information, similarities, arithmetic, recitation, picture completion, picture arrangement, block design, and object assembly) (P < 0.05). Conclusions Children with ADHD and SLD have poorer FIQ, VIQ, and PIQ than those with ADHD alone, which mainly manifests as the weak abilities of most intelligence structure factors. It is necessary to pay attention to the management and intervention of SLD in school-age children with ADHD.

导出引用

岳小静, 王承芯, 李洪华, 贾飞勇. 学龄期注意缺陷多动障碍共患特定学习障碍儿童智力结构与临床特征分析[J]. 中国当代儿科杂志. 2020, 22(11): 1178-1182 https://doi.org/10.7499/j.issn.1008-8830.2006047

YUE Xiao-Jing, WANG Cheng-Xin, LI Hong-Hua, JIA Fei-Yong. Intelligence structure and clinical features of school-age children with attention deficit hyperactivity disorder and specific learning disorder[J]. Chinese Journal of Contemporary Pediatrics. 2020, 22(11): 1178-1182 https://doi.org/10.7499/j.issn.1008-8830.2006047

参考文献

[1] 美国精神医学学会. 精神障碍诊断与统计手册(第5版)[M]. 张道龙, 刘春宇, 童慧琦, 等, 译. 北京:北京大学出版社, 2016:34-35.
[2] Fortes IS, Paula CS, Oliveira MC, et al. A cross-sectional study to assess the prevalence of DSM-5 specific learning disorders in representative school samples from the second to sixth grade in Brazil[J]. Eur Child Adolesc Psychiatry, 2016, 25(2):195-207.
[3] 肖朝华, 王庆红, 罗甜甜, 等. 儿童注意缺陷多动障碍共患病及功能损害研究[J]. 中国当代儿科杂志, 2013, 15(9):728-732.
[4] DuPaul GJ, Gormley MJ, Laracy SD. Comorbidity of LD and ADHD:implications of DSM-5 for assessment and treatment[J]. J Learn Disabil, 2013, 46(1):43-51.
[5] Nuñez A, San Miguel L, Keene J, et al. Deconstructing cognitive heterogeneity in Puerto Rican Spanish-speaking children with ADHD[J]. J Int Neuropsychol Soc, 2020, 26(7):714-724.
[6] 董敏, 王玉凤, 钱秋谨. 注意缺陷多动障碍患儿共患病的学业成就特征及其与执行功能的相关性研究[J]. 中华精神科杂志, 2019, 52(1):62-69.
[7] Chordia SL, Thandapani K, Arunagirinathan A. Children ‘at risk’ of developing specific learning disability in primary schools[J]. Indian J Pediatr, 2020, 87(2):94-98.
[8] Faedda N, Romani M, Rossetti S, et al. Intellectual functioning and executive functions in children and adolescents with attention deficit hyperactivity disorder (ADHD) and specific learning disorder (SLD)[J]. Scand J Psychol, 2019, 60(5):440-446.
[9] 刘豫鑫, 王玉凤. 伴与不伴学习困难的注意缺陷多动障碍患儿认知特点的比较[J]. 中华精神科杂志, 2002, 35(4):31-34.
[10] Mukherjee S, Shah HR, Ramanathan S, et al. Knowledge and attitudes about attention-deficit/hyperactivity disorder and specific learning disorder in an urban Indian population[J]. J Nerv Ment Dis, 2016, 204(6):458-463.
[11] 周晋波, 郭兰婷, 陈颖. 中文版注意缺陷多动障碍SNAP-Ⅳ评定量表-父母版的信效度[J]. 中国心理卫生杂志, 2013, 27(6):424-428.
[12] 静进, 森永良子, 海燕, 等. 学习障碍筛查量表的修订与评价[J]. 中华儿童保健杂志, 1998, 6(3):197-200.
[13] 龚耀先, 蔡太生. 中国修订韦氏儿童智力量表[J]. 中国临床心理学杂志, 1994, 2(1):1-6.
[14] Larson K, Russ SA, Kahn RS, et al. Patterns of comorbidity, functioning, and service use for US children with ADHD, 2007[J]. Pediatrics, 2011, 127(3):462-470.
[15] 范琼丽. 儿童注意缺陷多动障碍的临床检出率及其共患病研究[D]. 重庆:重庆医科大学, 2017.
[16] 杨斌让. 特定学习障碍[J]. 中华实用儿科临床杂志, 2015, 30(11):810-817.
[17] Baker JM, Klabunde M, Jo B, et al. On the relationship between mathematics and visuospatial processing in Turner syndrome[J]. J Psychiatr Res, 2020, 121:135-142.
[18] Jagger-Rickels AC, Kibby MY, Constance JM. Global gray matter morphometry differences between children with reading disability, ADHD, and comorbid reading disability/ADHD[J]. Brain Lang, 2018, 185:54-66.
[19] 王翠萍. 执行功能训练对儿童早期认知发展和学业成绩的影响[D]. 杭州:浙江大学, 2019.
[20] 司飞飞, 孙黎, 安莉, 等. 注意缺陷多动障碍及共患学习困难儿童大脑灰质、白质和全脑体积磁共振成像研究[J]. 中国心理卫生杂志, 2016, 30(3):179-184.