6~8岁注意缺陷多动障碍儿童精细动作发展的追踪观察  

Tracking observation of fine motor development in children aged 6-8 with attention deficit hyperactivity disorder

作　　者：范碧瑶 朱笑彤 任园春[1] 宋以玲 姜稳 陆双 莫大鹏 李心社 毕小羽 王芳[3] 刘靖[4] 吉宁[4,5] FAN Biyao;ZHU Xiaotong;REN Yuanchun;SONG Yiling;JIANG Wen;LU Shuang;MO Dapeng;LI Xinshe;BI Xiaoyu;WANG Fang;LIU Jing;JI Ning(College of Physical Education and Sports,Beijing Normal University,Beijing(100875),China)

机构地区：[1]北京师范大学体育与运动学院,北京100875 [2]清华大学体育部 [3]北京市海淀区万泉小学体育教研组 [4]北京大学第六医院/北京大学精神卫生研究所/国家精神心理疾病临床医学研究中心 [5]北大医疗脑健康儿童发展中心

出　　处：《中国学校卫生》2024年第6期831-834,共4页Chinese Journal of School Health

基　　金：教育部人文社会科学研究项目(21YJA890025)。

摘　　要：目的探讨注意缺陷多动障碍(ADHD)学龄儿童2年间精细动作的发展特点,为促进ADHD儿童动作发展提供科学依据。方法于2019年4—6月,从北京市某普通公立小学,由2名儿童青少年精神卫生专业副主任医师及以上职称专业人员诊断,筛查出符合《美国精神障碍诊断与统计手册》第五版(DSM-V)诊断标准的31名6~8岁ADHD儿童(ADHD组),并从同年级招募年龄、性别、总智商相匹配的31名正常发育儿童(正常对照组)。采用儿童动作协调能力标准评估工具(MABC-2)中手部精细操作子测验测查精细动作特点并于2021年4—6月进行随访。采用t检验、重复测量方差分析比较两组儿童精细动作发展变化。结果基线与2年后追踪ADHD组儿童手部精细动作总得分(7.4±3.0,8.0±3.4)差异无统计学意义(t=-1.05,P>0.05),正常对照组儿童手部精细动作总得分(9.5±2.1,10.5±2.4)有小效应量的提升(t=-2.12,效应量=0.38,P<0.05)。2年后追踪,ADHD组与正常对照组儿童惯用手投硬币/插钉得分均提升(7.0±3.3,9.5±3.2;8.4±2.8,11.6±1.6)(t值分别为-3.74,-6.33,P值均<0.01;效应量分别为0.67,1.14),ADHD组的提升幅度更小;ADHD组与正常对照组穿珠/线得分均下降(7.9±2.4,5.8±3.1;9.2±1.1,8.2±1.9)(t值分别为3.89,2.78,P值均<0.01;效应量分别为0.70,0.50),ADHD组的下降幅度更大。结论6~8岁ADHD儿童精细动作发展速度缓慢,持续落后于正常发育儿童。应密切监测ADHD儿童精细动作发展,必要时实施针对性干预。Objective To examine the developmental trajectory of fine motor ability in school-age children with attention deficit hyperactivity disorder(ADHD)for two years,so as to provide scientific evidence to promote motor development in ADHD children.Methods From April to June 2019,31 children aged 6-8 years old were selected from a public elementary school.They were diagnosed with ADHD by two psychiatric professionals according to the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-Ⅴ)criteria.Additionally,31 typical developmental children,matched for age,sex and IQ with the ADHD group,were recruited as the control group.Fine motor ability was assessed with tasks of hand manual dexterity in Movement Assessment Battery for Children-2(MACB-2),and a follow-up assessment was conducted from April to June 2021.The development changes of fine motor ability between two groups of children were compared by using t test and repeated measures analysis of variance.Results Between baseline and follow-up periods after two years,the total score of hand fine motor in the ADHD group did not show significant improvement(7.4±3.0,8.0±3.4;t=-1.05,P>0.05),while there was a small effect size improvement in typically developing control group(9.5±2.1,10.5±2.4;t=-2.12,effect size=0.38,P<0.05).Follow-up after two years,coin/peg throwing scores with dominant hand improved between ADHD group and control group(7.0±3.3,9.5±3.2;8.4±2.8,11.6±1.6)(t=-3.74,-6.33,P<0.01;effect size=0.67,1.14),with a smaller improvement in the ADHD group.The score for threading beads/threads decreased in between ADHD group and control group(7.9±2.4,5.8±3.1;9.2±1.1,8.2±1.9)(t=3.89,2.78,P<0.01;effect size=0.70,0.50),with a greater decrease in the ADHD group.Conclusions The development speed of fine motor ability in children with ADHD aged 6-8 is slow and continues to lag behind normal developmental children.Fine motor development in children with ADHD should be closely monitored,and targeted interventions should be implemented when necessa

关 键 词：注意力缺陷障碍伴多动 行为 精神卫生 病例对照研究 儿童 

分 类 号：R179[医药卫生—妇幼卫生保健] B844.1[医药卫生—公共卫生与预防医学] Q427[哲学宗教—发展与教育心理学] R748[哲学宗教—心理学]