6~8岁注意缺陷多动障碍儿童精细动作发展的追踪观察

范碧瑶; 朱笑彤; 任园春; 宋以玲; 姜稳; 陆双; 莫大鹏; 李心社; 毕小羽; 王芳; 刘靖; 吉宁

doi:10.16835/j.cnki.1000-9817.2024185

6~8岁注意缺陷多动障碍儿童精细动作发展的追踪观察

doi: 10.16835/j.cnki.1000-9817.2024185

范碧瑶¹,
朱笑彤¹,
任园春^1, ,,
宋以玲^{1, 2},
姜稳¹,
陆双¹,
莫大鹏¹,
李心社¹,
毕小羽¹,
王芳³,
刘靖⁴,
吉宁^{4, 5}

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

基金项目:

教育部人文社会科学研究项目 21YJA890025

详细信息

作者简介:
范碧瑶(1996-)，女，浙江金华人，硕士，主要研究方向为儿童动作发展与促进

通讯作者:
任园春，E-mail：yuanchun-ren@bnu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 B844.1 Q427 R748
计量
- 文章访问数: 281
- HTML全文浏览量: 118
- PDF下载量: 22
- 被引次数: 0
出版历程
- 收稿日期: 2023-10-08
- 修回日期: 2024-02-08
- 网络出版日期: 2024-06-27
- 刊出日期: 2024-06-25

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

1.
College of Physical Education and Sports, Beijing Normal University, Beijing (100875), China

摘要

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。
- 注意力缺陷障碍伴多动 /
- 行为 /
- 精神卫生 /
- 病例对照研究 /
- 儿童
Abstract: 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 necessary.
- Attention deficit disorder with hyperactivity /
- Behavior /
- Mental health /
- Case-control studies /
- Child
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

表 1 ADHD组与正常对照组在基线时期与追踪时期手部精细动作指标得分比较(x±s)

Table 1. Comparison of scores for hand fine motor indicators between the ADHD group and the typically developing control group at baseline and follow-up periods(x±s)

组别	测试时间点	人数	统计值	总分	惯用手投硬币/插钉	非惯用手投硬币/插钉	穿珠/线	描画轨迹
ADHD组	基线	31		7.4±3.0	7.0±3.3	7.0±3.5	7.9±2.4	9.2±2.7
	追踪	31		8.0±3.4	9.5±3.2	9.5±2.6	5.8±3.1	10.0±3.3
			t值	-1.05	-3.74^**	-3.91^**	3.89^**	-1.16
			效应量	0.19	0.67	0.70	0.70	0.21
正常对照组	基线	31		9.5±2.1	8.4±2.8	9.0±2.8	9.2±1.1	10.5±2.2
	追踪	31		10.5±2.4	11.6±1.6	10.6±2.5	8.2±1.9	10.5±2.6
			t值	-2.12^*	-6.33^**	-2.89^**	2.78^**	0.06
			效应量	0.38	1.14	0.52	0.50	0.01
注： P < 0.05，*P < 0.01。

下载: 导出CSV

参考文献(22)

[1]	李福轮, 谢晴牧, 赵乾龙, 等. 中国儿童注意缺陷多动障碍患病率的Meta分析[J]. 临床荟萃, 2017, 32(12): 1079-1083. doi: 10.3969/j.issn.1004-583X.2017.12.015 LI F L, XIE Q M, ZHAO Q L, et al. Current prevalence of attention deficit hyperactivity disorder among children: a Meta-analysis[J]. Clin Focus, 2017, 32(12): 1079-1083. (in Chinese) doi: 10.3969/j.issn.1004-583X.2017.12.015
[2]	RIGLIN L, LEPPERT B, DARDANI C, et al. ADHD and depression: investigating a causal explanation[J]. Psychol Med, 2021, 51(11): 1890-1897. doi: 10.1017/S0033291720000665
[3]	TAMM L, LOREN R E A, PEUGH J, et al. The association of executive functioning with academic, behavior, and social performance ratings in children with ADHD[J]. J Learn Disabil, 2021, 54(2): 124-138. doi: 10.1177/0022219420961338
[4]	ATHANASIADOU A, BUITELAAR J K, BROVEDANI P, et al. Early motor signs of attention deficit hyperactivity disorder: a systematic review[J]. Eur Child Adolesc Psychiatry, 2020, 29(7): 903-916. doi: 10.1007/s00787-019-01298-5
[5]	WHITMORIT S, CLARK C. Kinaesthetic acuity and fine motor skills in children with attention deficit hyperactivity disorder: a preliminary report[J]. Dev Med Child Neurol, 2008, 38(12): 1091-1098.
[6]	GOULARDINS J B, RIGOLI D, LICARI M, et al. Attention deficit hyperactivity disorder and developmental coordination disorder: two separate disorders or do they share a common etiology[J]. Behav Brain Res, 2015, 292: 484-492. doi: 10.1016/j.bbr.2015.07.009
[7]	GOULARDINS J B, MARQUES J C B, DE OLIVEIRA J A. Attention deficit hyperactivity disorder and motor impairment: a critical review[J]. Percept Mot Skills, 2017, 124(2): 425-440. doi: 10.1177/0031512517690607
[8]	RASMUSSEN P, GILLBERG C. Natural outcome of ADHD with developmental coordination disorder at age 22 years: a controlled, longitudinal, community-based study[J]. J Am Acad Child Adolesc Psychiatry, 2000, 39(11): 1424-1431. doi: 10.1097/00004583-200011000-00017
[9]	范娟, 杜亚松, 王立伟. Conners父母用症状问卷的中国城市常模和信度研究[J]. 上海精神医学, 2005, 17(6): 321-323. doi: 10.3969/j.issn.1002-0829.2005.06.001 FAN J, DU Y S, WANG L W. The norm and reliability of the Conners Parent Symptom Questionnaire in Chinese urban children[J]. Shanghai Arch Psychiatry, 2005, 17(6): 321-323. (in Chinese) doi: 10.3969/j.issn.1002-0829.2005.06.001
[10]	苏林雁, 耿耀国, 王洪, 等. 注意缺陷多动障碍诊断量表父母版的中国城市儿童常模制定及其信度和效度的检验[J]. 中国实用儿科杂志, 2006, 21(11): 833-836. doi: 10.3969/j.issn.1005-2224.2006.11.013 SU L Y, GENG Y G, WANG H, et al. Norm of ADHD Diagnostic Scale (Parent Version) in Chinese urban children[J]. Chin J Pract Pediatr, 2006, 21(11): 833-836. (in Chinese) doi: 10.3969/j.issn.1005-2224.2006.11.013
[11]	杨莉, 王玉凤, 钱秋谨, 等. 注意缺陷多动障碍患儿的临床分型初探[J]. 中华精神科杂志, 2001, 34(4): 15-18. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHMA200104003.htm YANG L, WANG Y F, QIAN Q J, et al. Primary exploration of the clinical subtypes of attention deficit hyperactivity disorder in Chinese children[J]. Chin J Psychiatry, 2001, 34(4): 15-18. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZHMA200104003.htm
[12]	KAUFMAN J, BIRMAHER B, BRENT D, et al. Schedule for Affective Disorders and Schizophrenia for School-age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data[J]. J Am Acad Child Adolesc Psychiatry, 1997, 36(7): 980-988. doi: 10.1097/00004583-199707000-00021
[13]	JOYCE-BEAULIEU D, SULKOWSKI M L. The diagnostic and statistical manual of mental disorders: fifth edition (DSM-5) model of impairment[M]//GOLDSTEIN S, NAGLIERI J A. Assessing impairment: from theory to practice. Boston, MA: Springer US, 2016: 167-189.
[14]	张厚粲. 韦氏儿童智力量表第四版(WISC-Ⅳ)中文版的修订[J]. 心理科学, 2009, 32(5): 1177-1179. https://www.cnki.com.cn/Article/CJFDTOTAL-XLKX200905046.htm ZHANG H C. The revision of WISC-Ⅳ Chinese version[J]. J Psychol Sci, 2009, 32(5): 1177-1179. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XLKX200905046.htm
[15]	HENDERSON S E, SUGDEN D A, BARNETT A L. Movement Assessment Battery for Children-2 examiner's manual[M]. London: Harcourt Assessment, 2007.
[16]	李斐, 颜崇淮, 沈晓明. 早期精细动作技能发育促进脑认知发展的研究进展[J]. 中华医学杂志, 2005, 85(30): 2157-2159. doi: 10.3760/j:issn:0376-2491.2005.30.022 LI F, YAN C H, SHEN X M. Advances in early fine motor skill development for brain cognitive development [J]. Natl Med J China, 2005, 85(30): 2157-2159. (in Chinese) doi: 10.3760/j:issn:0376-2491.2005.30.022
[17]	GAUL D, ISSARTEL J. Fine motor skill proficiency in typically developing children: on or off the maturation track?[J]. Hum Mov Sci, 2016, 46: 78-85. doi: 10.1016/j.humov.2015.12.011
[18]	KLUPP S, MÖHRING W, LEMOLA S, et al. Relations between fine motor skills and intelligence in typically developing children and children with attention deficit hyperactivity disorder[J]. Res Dev Disabil, 2021, 110: 103855. doi: 10.1016/j.ridd.2021.103855
[19]	MEYER A, SAGVOLDEN T. Fine motor skills in South African children with symptoms of ADHD: influence of subtype, gender, age, and hand dominance[J]. Behav Brain Funct, 2006, 2(1): 33. doi: 10.1186/1744-9081-2-33
[20]	FIETSAM A C, TUCKER J R, KAMATH M S, et al. Manual dexterity and strength and in young adults with and without attention-deficit/hyperactivity disorder (ADHD)[J]. Neurosci Lett, 2022, 766: 136349. doi: 10.1016/j.neulet.2021.136349
[21]	SWEENEY K L, RYAN M, SCHNEIDER H, et al. Developmental trajectory of motor deficits in preschool children with ADHD[J]. Dev Neuropsychol, 2018, 43(5): 419-429. doi: 10.1080/87565641.2018.1466888
[22]	SHAW P, ECKSTRAND K, SHARP W, et al. Attention-deficit/hyperactivity disorder is characterized by a delay in cortical maturation[J]. Proc Natl Acad Sci USA, 2007, 104(49): 19649-19654. doi: 10.1073/pnas.0707741104