儿童ADHD病因及心理治疗研究进展

根据APA1994年的定义,注意力多动障碍(ADHD)是一种始于儿童期,以注意涣散,多动和冲动为主要特征的常见儿童心理障碍。儿童ADHD的根本病因至今仍没有明确的界定,目前该疾病主要从三个角度来解释:环境因素、儿童的认知因素和生物学因素。文章针对药物治疗的副作用,整合已有的心理治疗成果,以期对未来的研究提供参考。     

The psy-disciplines go to school: psychiatric,psychological and psychotherapeutic approaches to inclusion in one UK primary school

A growing body of research, largely from the global North, and particularly from North America, highlights the increasing psychiatrisation, medicalisation and psychologisation of children and childhood, and suggests that schools and educators play a key role in these processes. This increasing diffusion of psy-expertise within educational spaces signifies a cultural shift that has profound effects on teacher and student subjectivity, and on institutional and professional practices. Educators in many countries are said to be on the ‘front-line’ in identifying mental health issues, recommending treatment pathways, and sometimes helping to administer psychopharmaceuticals. The alacrity with which educators engage in these practices varies internationally, with reported occurrence being much higher in the United States and Canada, compared to the United Kingdom, where there is a lack of research. Drawing upon a case study in a UK primary school, this paper makes an original and timely contribution to research into UK teacher’s perceptions of inclusion in relation to social, emotional and behavioural difficulties and, in particular, attention-deficit hyperactivity disorder, as they navigate the interface of psychology and education. Contrary to some previous research, the educators in this study viewed the distribution of psychopharmaceuticals negatively, and showed a preference for psychotherapeutic approaches to inclusion. This research provides much needed empirical findings to a growing but largely theoretically informed body of research exploring whether, and if so then how, educators are implicated in the mobilisation of psy-expertise within children’s lives.     

Teaching assistants' facilitators and barriers to effective practice working with children with ADHD: a qualitative study

Attention-deficit/hyperactivity disorder (ADHD) rates have increased in recent years, resulting in the need for more classroom support. In Wales, support for many pupils with ADHD is provided by the 16,157 teaching assistants (TAs) employed by local authorities. This qualitative study interviewed 15 primary school TAs to answer three questions concerning their feelings about their job, and the facilitators and barriers to their work with children with ADHD. Using thematic analysis, the researchers identified 10 themes: positive feelings, negative effects, a need for change, support, improvement over time, one-to-one relationship, lack of support, negativity towards ADHD, classroom environment, and poor knowledge and experience with ADHD. This study illustrates the TAs' love for their job and the importance of positive relationships. It also highlights a lack of support for TAs and negativity towards ADHD. Implications of the study and recommendations for the future are discussed.     

A three-factor model of educational practice considerations for teaching neurodiverse learners from a strengths-based perspective

The purpose of this practice paper is to promote the teaching of learners with neurodevelopmental conditions from a neurodiverse perspective. The challenge teachers face in having to draw on up-to-date research evidence and theoretical perspectives, and align these with practical considerations to generate contextualised teaching strategies, are addressed with the introduction of a three-factor model. The utility of considering pupil assessment data gathered from a strengths-based perspective is positioned as a central component to bridging the gap between the incipient neurodiversity literature and the realities of applied teaching practice. Two case examples have presented that draw on the proposed three-factor model to demonstrate how teachers can assess and teach learners from a neurodevelopmental perspective. These case studies focus on supporting learners with Autism and Attention Deficit Hyperactivity Disorder in a secondary setting.     

Epilepsy in school‐aged children: more than just seizures?

Epilepsy is the most common neurological disorder in childhood and can have a significant impact on a child's schooling. Children with epilepsy may have special educational needs due to having learning disability, specific learning difficulties, specific cognitive deficits or having symptoms associated with ASD, ADHD, depression or anxiety. These difficulties are often under‐recognised due to the emphasis placed on the management of seizures. The effects of seizures and side‐effects of anti‐epileptic medications (AEDs) can also influence classroom learning. The significant stigma associated with epilepsy can influence attitudes towards affected children and impact on self‐esteem. Interventions to support children with epilepsy should focus on epilepsy management, learning and behavioural interventions and whole‐school psychosocial interventions. Epilepsy is a spectrum condition and for some children the effects on schooling will be minimal but for others significant supports will be needed. Therefore, an individualised approach within the school environment and close collaboration between teachers, parents and medical professionals are essential in order to meet the children's needs.     

Use of digital console game for children with attention deficit hyperactivity disorder

ADHD or ADD （Attention Deficit/Hyperactivity Disorder） is one of the most frequently diagnosed mental and behavioral disorders of children. Children with ADHD are characterized by poor attention and distractibility and/or hyperactive and impulsive behaviors. Although there is no ＂cure＂ for ADHD, there are accepted treatments that specifically target its symptoms. The most common standard treatments include medication, psychological or behavioral modification, and educational approaches. However, more and more parents began to worry about the side effects of medication. For this reason, this study proposed a new treatment by using digital console games to assist children who suffer from ADD to improve their attention condition. With the advantages of gaming apparatus, this study intends to improve the effect of behavioral intervention and cognitive remediation therapy for ADD children.     

The inadequacy of ADHD: a philosophical contribution

Attention Deficit Hyperactivity Disorder (ADHD) is a widely spread diagnosis. The dominant paradigm of ADHD is biomedical where ADHD is defined as a brain disorder. At the same time, the legitimacy of the diagnosis is being questioned since it is unclear whether or not ADHD can be deemed a medical disorder in itself. The aim of this article is to critically assess the merits of understanding the diagnosis of ADHD as a medical condition defined as a brain disorder. This is being done using the seventeenth century philosopher Benedict Spinoza’s (1632–1677) notions of adequate and inadequate knowledge and his counterintuitive theory of mental health. Doing so it becomes clear that ADHD, however adequate it may seem, is founded on inadequate knowledge and that the legitimacy of the individual diagnosis should therefore be questioned on the grounds that on a long term scale it is passivizing and stigmatizing rather that liberating.     

太极拳锻炼对注意力缺少多动障碍倾向儿童的影响

目的：探讨有规律太极拳锻炼对注意力缺少多动障碍（ADHD）倾向儿童的影响,为太极拳锻炼干预治疗ADHD提供理论依据。方法：采用康纳斯诊断量表筛选出多动指数在1．5以上学龄儿童,随机分成年龄、身高、体重相匹配太极拳组（n ＝18,男童8、女童10）和对照组（n ＝18,男童9、女童9）。在16周太极拳干预前后对两组受试者进行儿童行为量表、儿童感觉系统能力发展和儿童适应性行为量表评估。结果：（1）在儿童行为量表测试中,太极拳组社交退缩、多动和交往不良因子得分显著减小（ P ＜0.05）;（2）感觉综合量表测试中,太极拳组的前庭功能和本体感觉得分显著增加（P ＜0.05）;（3）适应性行为量表测试中,太极拳组的独立因子和认知因子得分非常显著增加（ P ＜0.01）。结论：定期的太极拳锻炼一定程度改善了 ADHD 倾向儿童的症状,建议太极拳锻炼可作为 ADHD儿童的运动疗法。     

The role of personal best (PB) goals in the achievement and behavioral engagement of students with ADHD and students without ADHD

In the context of competitive classroom settings and relativistic assessment schedules, some groups of students may particularly benefit from an emphasis on personal progress and personal growth approaches to their academic development. Building on recent promising results from general samples of high school students (undifferentiated by academically at-risk sub-groups within them) and dominant models of attention and executive functioning, the present study examines the potential of personal best (PB) goals for students with attention-deficit/hyperactivity disorder (ADHD). The study focuses on N = 87 students with ADHD and N = 3374 non-ADHD peers from the same schools and year levels – in addition to a supplementary analysis of a randomly drawn non-ADHD sub-sample of N = 87 and a second supplementary analysis controlling for achievement. Multi-group multivariate path analyses demonstrated (a) significant and positive associations between PB goals and academic outcomes (achievement and behavioral engagement) for students with ADHD, (b) similar positive effects for non-ADHD students (N = 3374), (d) replicated results with the randomly drawn non-ADHD sub-sample (N = 87), (e) similar findings when controlling for achievement, and (f) absolute parameter estimates that trended larger for students with ADHD than non-ADHD students. These findings indicate that the positive role of PB goals may generalize across diverse student groups and that there appears to be merit in broadly promoting PB goals amongst ADHD (and, potentially, other academically at-risk students) and non-ADHD students alike.     

学龄前儿童执行功能与注意缺陷多动症状的元分析:抑制控制和工作记忆的作用

注意缺陷多动障碍(ADHD)的执行功能缺陷理论已在学龄期儿童和青少年中被广泛证明,学龄前是执行功能发展的重要时期,学龄前儿童执行功能与ADHD症状的关系尚存争议.采用元分析的方法整合国内外近十年的文献,探讨学龄前儿童执行功能与ADHD症状的关系,并分析影响因素.通过文献检索,纳入符合要求的文献28篇,共70个有效数据,...