中国实用儿科杂志

中国实用儿科杂志

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Griffiths发育评估量表-中文版在注意缺陷多动障碍儿童中的发展水平结构模式分析

  

  1. 国家儿童健康与疾病临床医学研究中心  浙江大学医学院附属儿童医院康复科， 浙江  杭州  310003
  • 出版日期:2020-11-06 发布日期:2020-12-10

Griffiths Mental Development Scales-Chinese（GDS-C） applied to children with attention deficit hyperactivity disorder for structural patterns analysis of development

  1. Department of Rehabilitation，the Children’s Hospital，Zhejiang University School of Medicine，National Clinical Research Center for Child Health，Hangzhou  310003，China
  • Online:2020-11-06 Published:2020-12-10

摘要： 目的　应用Griffiths发育评估量表-中文版（GDS-C）评估注意缺陷多动障碍（ADHD）儿童的发育水平，并对各个能区的结构模式进行分析，从而指导制定有效的康复干预方案。方法　选取2018年4月至2019年4月在浙江大学医学院附属儿童医院康复科就诊且符合美国《精神障碍诊断与统计手册（第5版）》（DSM-Ⅴ）关于ADHD诊断标准的28例儿童为ADHD组，将同性别、年龄±1个月1∶1配对的28名健康儿童为对照组。两组儿童均进行GDS-C发育评估，比较两组儿童在运动、个人-社会、听力-语言、手眼协调、表现、实际推理各个能区的得分和总发育商的差别，并分析各个能区的结构模式。结果　ADHD组儿童各个能区的得分和总发育商均低于对照组，且运动、个人-社会、手眼协调能区的得分和总发育商在两组比较中的差异具有统计学意义（t＝-7.07，-4.75，-7.60，-7.65，P＜0.05）。各能区结构模式的分析比较：ADHD组儿童运动能区的体能与力量、深度感觉、身体粗大协调能力、粗大视觉运动协调性，个人-社会能区的交际技巧、做家务技巧、穿衣和自我照顾，听力-语言能区的记忆，手眼协调能区的认识形状、创造性和双侧协调性以及表现能区的视觉空间推理方面均弱于健康对照组儿童，P值均＜0.05。结论　应用Griffiths发育评估量表-中文版（GDS-C）评估，ADHD儿童的总体发育落后于正常儿童，表现在运动、个人-社会和手眼协调能区，且根据GDS-C的评估结果和结构模式分析可以帮助制定ADHD儿童合适水平的个体化训练策略。

关键词: 注意缺陷多动障碍, 儿童, Griffiths发育评估量表, 发育

Abstract: Objective　Use the Griffiths Mental Development Scales-Chinese（GDS-C） to evaluate the developmental level of children with attention deficit hyperactivity disorder（ADHD），and analyze the structural patterns of each subscale to guide the formulation of effective rehabilitation interventions programs. Methods　A total of 28 children，who met the DSM-Ⅴ diagnostic criteria for ADHD and were treated from April 2018 to April 2019 in Department of Rehabilitation，the Children’s Hospital，Zhejiang University School of Medicine，were selected as ADHD group，and 28 healthy children of the same sex and age（±1 month） were matched as control group. Both groups were evaluated by GDS-C，and the differences of scores in locomotor，personal-social，hearing and speech，hand and eye coordination，performance and practical reasoning subscales and the total developmental quotient between the two groups were compared；meanwhile，the structural patterns of each subscale were analyzed. Results　The scores of each subscale and the total developmental quotient of ADHD group were lower than those of the control group，and the score differences in locomotor，personal-social，and hand-eye coordination subscales and the total developmental quotient between two groups were statistically significant（t＝-7.07，-4.75，-7.60，-7.65，P＜0.05）. Comparison of the structural patterns analysis of each subscale：ADHD group had lower scores than the healthy group in the ability of physical energy and strength，depth perception，gross physical coordination ability and coarse visual motor coordination of the locomotor subscale，communication skills，housework skills and dressing and self-care of the personal-social subscale，memory the hearing-speech subscale，shape recognition，creativity and bilateral coordination of the hand-eye coordination subscale，and visual spatial reasoning of performance subscale（P＜0.05）. Conclusion　Griffiths Mental Development Scales-Chinese（GDS-C） can be used to assess the comprehensive development of ADHD children. The development of children with ADHD is behind that of normal children，manifesting in subscales of locomotor，personal-social and hand-eye coordination. Based on the assessment results and structural patterns analysis，the individualized training strategies of appropriate levels for ADHD children can be developed.

Key words: attention deficit hyperactivity disorder, child, Griffiths development assessment scale, development