学龄期注意缺陷多动障碍共患特定学习障碍儿童智力结构与临床特征分析

Intelligence structure and clinical features of school-age children with attention deficit hyperactivity disorder and specific learning disorder

摘要:

目的 探讨注意缺陷多动障碍（ADHD）共患特定学习障碍（SLD）儿童的智力结构及其他临床特征。方法 回顾性选择2018年10月至2019年4月在吉林大学第一医院发育行为儿科门诊明确诊断的学龄期ADHD儿童88例为研究对象，根据有无共患SLD分为单纯ADHD组（n=45）和ADHD共患SLD组（n=43）。分析比较两组患儿的智力结构及其他临床特征。结果 ADHD共患SLD组患儿言语智商（VIQ）、操作智商（PIQ）及总智商（FIQ）得分均显著低于单纯ADHD组（P < 0.05），VIQ中的常识、类同、算数及背数得分显著低于单纯ADHD组（P < 0.05），PIQ的填图、排列、积木及拼图得分显著低于单纯ADHD组（P < 0.05）；共患SLD的发生与FIQ、VIQ、PIQ及常识、类同、算数、背数、填图、排列、积木、拼图能力呈显著负相关（P < 0.05）。结论 ADHD共患SLD患儿FIQ、VIQ及PIQ表现差于单纯ADHD患儿，主要表现在大部分智力结构因子能力偏弱。需要进一步关注学龄期ADHD儿童共患SLD的管理与干预。

Abstract:

Objective To study the intelligence structure and clinical features of children with attention deficit hyperactivity disorder (ADHD) and specific learning disorder (SLD). Methods A retrospective analysis was performed on 88 school-age children with ADHD. According to the presence or absence of SLD, they were divided into two groups:simple ADHD group with 45 children and ADHD+SLD group with 43 children. Intelligence structure and clinical features were compared between the two groups. Results Compared with the simple ADHD group, the ADHD+SLD group had significantly lower verbal intelligence quotient (VIQ), performance intelligence quotient (PIQ), and full intelligence quotient (FIQ) (P < 0.05), significantly lower scores of VIQ factors (including information, similarities, arithmetic, and recitation) (P < 0.05), and significantly lower scores of PIQ factors (including picture completion, picture arrangement, block design, and object assembly) (P < 0.05). The development of SLD was negatively correlated with FIQ, VIQ, and PIQ. It was also negatively correlated with the scores of intelligence structure factors (including information, similarities, arithmetic, recitation, picture completion, picture arrangement, block design, and object assembly) (P < 0.05). Conclusions Children with ADHD and SLD have poorer FIQ, VIQ, and PIQ than those with ADHD alone, which mainly manifests as the weak abilities of most intelligence structure factors. It is necessary to pay attention to the management and intervention of SLD in school-age children with ADHD.