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

doi:10.3969/j.issn.1006-9771.2024.01.001

《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

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

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

1.北京师范大学体育与运动学院，北京市 100875
2.清华大学体育部，北京市 100084
3.北京大学第六医院，北京市 100191
4.北京市海淀区万泉小学，北京市 100097

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:
北京市社会科学基金项目(23YTB035)

Characteristics and relationship between the development of gross motor skills and executive function in children with attention deficit hyperactivity disorder

SONG Yiling¹^,², REN Yuanchun¹(), ZHU Feilong¹, KUANG Dongqing¹, CAO Qingjiu³, LIN Yang⁴, WANG Fang⁴

1. College of Physical Education and Sports, Beijing Normal University, Beijing 100875, China
2. Department of Physical Education, Tsinghua University, Beijing 100084, China
3. Peking University Sixth Hospital, Beijing 100191, China
4. Beijing Haidian Wanquan Primary School, Beijing 100097, China

Received:2023-11-22 Revised:2023-12-25 Published:2024-01-25 Online:2024-02-04
Contact: REN Yuanchun, E-mail: yuanchun-ren@bnu.edu.cn
Supported by:
Beijing Social Science Foundation(23YTB035)

摘要/Abstract

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。

关键词: 注意缺陷多动障碍, 粗大动作技能, 执行功能, 动作发展, 儿童

Abstract:

Objective To investigate the developmental characteristics of gross motor skills and executive functions, and the correlation between them in school-age children with attention deficit hyperactivity disorder (ADHD).

Methods From November, 2020 to May, 2021, 90 children with ADHD were recruited from Peking University Sixth Hospital and Beijing Haidian Wanquan Primary School, and other 90 children with normal development from this primary school were recruited matched their age and gender. Gross motor skills were assessed with the Test of Gross Motor Development in Children, Third Edition (TGMD-3), and inhibitory control, working memory, and cognitive flexibility were assessed with Stroop Color Words Test (SCWT), Rey-Osterrich Complex Figure Test (ROCFT) and Trail Making Test (TMT), respectively.

Results The TGMD-3 score was significantly lower in children with ADHD than in normal children (t = -6.275, P < 0.001), while the test results of SCWT, ROCFT and TMT were worse (|t| ≥ 1.986, P ≤ 0.05). The TGMD-3 score of children with ADHD was negatively correlated with the word sense reaction time (r= -0.261), the number of word sense errors (r = -0.404) and the number of color errors (r = -0.326) (P < 0.05), positively correlated with the delayed structural memory scores (r= 0.228) (P < 0.05), and negatively correlated with the TMT-A reaction time (r = -0.255), the number of TMT-A errors (r = -0.329), TMT-B reaction time (r = -0.214) and the number of TMT-B errors (r = -0.474) (P < 0.05). Stratified linear regression analyses showed that the TGMD-3 score of children with ADHD was significant only in predicting test results for inhibitory control and cognitive flexibility (P < 0.05), with explanations of 8.7% and 22.5%, respectively.

Conclusion Developments of both gross motor skills and executive function delay in children with ADHD, and there is a relation between them, especially the level of gross motor skills relating to the developments of inhibitory control and cognitive flexibility.

Key words: attention deficit hyperactivity disorder, gross motor skill, executive function, motor development, children

中图分类号:

R749.93

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.

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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

项目		粗大动作		位移动作		物控动作
项目		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

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
因变量	自变量	B	SE	Beta	t值	P值	R²	调整R²	R²变化
抑制控制	性别	-1.674	0.680	-0.245	-2.463	0.016	0.187	0.148	0.087^a
	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	0.225^b
	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

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

Characteristics and relationship between the development of gross motor skills and executive function in children with attention deficit hyperactivity disorder

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