《中国康复理论与实践》 ›› 2024, Vol. 30 ›› Issue (1): 1-9.doi: 10.3969/j.issn.1006-9771.2024.01.001
宋以玲1,2, 任园春1(), 朱飞龙1, 匡冬青1, 曹庆久3, 林杨4, 王芳4
收稿日期:
2023-11-22
修回日期:
2023-12-25
出版日期:
2024-01-25
发布日期:
2024-02-04
通讯作者:
任园春(1970-),女,汉族,安徽蚌埠市人,教授,主要研究方向:儿童动作发展与促进。E-mail:yuanchun-ren@bnu.edu.cn
作者简介:
宋以玲(1995-),女,汉族,山东淄博市人,博士研究生,主要研究方向:儿童动作发展与促进。
基金资助:
SONG Yiling1,2, REN Yuanchun1(), ZHU Feilong1, KUANG Dongqing1, CAO Qingjiu3, LIN Yang4, WANG Fang4
Received:
2023-11-22
Revised:
2023-12-25
Published:
2024-01-25
Online:
2024-02-04
Contact:
REN Yuanchun, E-mail: Supported by:
摘要:
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。
中图分类号:
宋以玲, 任园春, 朱飞龙, 匡冬青, 曹庆久, 林杨, 王芳. 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[J]. 《中国康复理论与实践》, 2024, 30(1): 1-9.
SONG Yiling, REN Yuanchun, ZHU Feilong, KUANG Dongqing, CAO Qingjiu, LIN Yang, WANG Fang. Characteristics and relationship between the development of gross motor skills and executive function in children with attention deficit hyperactivity disorder[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 1-9.
表1
ADHD儿童与正常儿童的粗大动作技能和执行功能比较"
测试项目 | 正常儿童(n = 90) | ADHD儿童(n = 90) | t值 | P值 | |
---|---|---|---|---|---|
TGMD-3 | 总分 | 75.49±7.47 | 65.10±13.82 | -6.275 | < 0.001 |
位移动作 | 36.88±4.34 | 32.62±6.95 | -4.928 | < 0.001 | |
物控动作 | 38.64±6.25 | 35.58±11.05 | -2.292 | 0.023 | |
执行功能测试 | |||||
SCWT | 字义反应时/s | 21.96±7.39 | 30.67±15.11 | 4.912 | < 0.001 |
字义错误数 | 0.11±0.41 | 0.71±1.54 | 3.577 | < 0.001 | |
颜色反应时/s | 44.98±15.47 | 55.01±14.56 | 4.479 | < 0.001 | |
颜色错误数 | 0.78±0.99 | 1.99±2.96 | 3.686 | < 0.001 | |
ROCFT | 即时结构记忆 | 3.92±1.69 | 2.49±1.83 | -5.455 | < 0.001 |
即时细节记忆 | 13.31±5.82 | 8.61±5.85 | -5.395 | < 0.001 | |
延时结构记忆 | 3.86±1.80 | 2.36±1.84 | -5.502 | < 0.001 | |
延时细节记忆 | 12.99±6.01 | 8.12±5.98 | -5.460 | < 0.001 | |
TMT | TMT-A反应时/s | 49.22±17.28 | 62.18±28.07 | 3.728 | < 0.001 |
TMT-A错误数 | 0.01±0.12 | 0.27±1.22 | 1.986 | 0.050 | |
TMT-B反应时/s | 144.13±58.39 | 200.54±84.58 | 5.206 | < 0.001 | |
TMT-B错误数 | 0.49±0.88 | 2.68±5.53 | 3.706 | < 0.001 |
表2
ADHD儿童粗大动作技能与执行功能的相关性分析"
项目 | 粗大动作 | 位移动作 | 物控动作 | ||||
---|---|---|---|---|---|---|---|
r值 | P值 | r值 | P值 | r值 | P值 | ||
SCWT | 字义反应时 | -0.261 | 0.013 | -0.337 | 0.001 | -0.098 | 0.360 |
字义错误数 | -0.404 | < 0.001 | -0.501 | < 0.001 | -0.221 | 0.036 | |
颜色反应时 | -0.097 | 0.363 | -0.226 | 0.032 | -0.140 | 0.189 | |
颜色错误数 | -0.326 | 0.002 | -0.426 | < 0.001 | -0.282 | 0.007 | |
ROCFT | 即时结构记忆 | 0.157 | 0.138 | 0.221 | 0.036 | 0.140 | 0.189 |
即时细节记忆 | 0.180 | 0.089 | 0.257 | 0.015 | 0.263 | 0.012 | |
延时结构记忆 | 0.228 | 0.032 | 0.296 | 0.005 | 0.202 | 0.058 | |
延时细节记忆 | 0.200 | 0.059 | 0.278 | 0.008 | 0.263 | 0.012 | |
TMT | TMT-A反应时 | -0.255 | 0.015 | -0.320 | 0.002 | -0.246 | 0.019 |
TMT-A错误数 | -0.329 | 0.002 | -0.274 | 0.009 | -0.238 | 0.024 | |
TMT-B反应时 | -0.214 | 0.043 | -0.210 | 0.046 | -0.182 | 0.086 | |
TMT-B错误数 | -0.474 | < 0.001 | -0.408 | < 0.001 | -0.186 | 0.080 |
表3
ADHD儿童粗大动作技能与执行功能的分层线性回归分析"
因变量 | 自变量 | 非标准化系数 | 标准化系数 | t值 | P值 | R2 | 调整R2 | R2变化 | |
---|---|---|---|---|---|---|---|---|---|
B | SE | Beta | |||||||
抑制控制 | 性别 | -1.674 | 0.680 | -0.245 | -2.463 | 0.016 | 0.187 | 0.148 | 0.087a |
年龄 | -0.487 | 0.261 | -0.196 | -1.870 | 0.065 | ||||
ADHD亚型 | -0.155 | 0.384 | -0.042 | -0.405 | 0.687 | ||||
粗大动作 | -0.064 | 0.021 | -0.298 | -3.007 | 0.003 | ||||
工作记忆 | 性别 | 0.287 | 0.433 | 0.067 | 0.662 | 0.510 | 0.155 | 0.115 | 0.026 |
年龄 | 0.526 | 0.166 | 0.338 | 3.165 | 0.002 | ||||
ADHD亚型 | 0.018 | 0.245 | 0.008 | 0.075 | 0.941 | ||||
粗大动作 | 0.022 | 0.014 | 0.164 | 1.623 | 0.108 | ||||
认知灵活性 | 性别 | -0.721 | 1.235 | -0.056 | -0.584 | 0.561 | 0.234 | 0.198 | 0.225b |
年龄 | -0.044 | 0.474 | -0.009 | -0.092 | 0.927 | ||||
ADHD亚型 | -0.598 | 0.698 | -0.086 | -0.858 | 0.394 | ||||
粗大动作 | -0.193 | 0.039 | -0.481 | -4.997 | <0.001 |
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