沙盘游戏治疗学龄前儿童注意缺陷多动障碍的研究

通过对学龄前注意缺陷多动障碍(ADHD)儿童进行沙盘游戏治疗,研究沙盘游戏对学龄前儿童ADHD治疗的有效性及可行性。采用随机对照研究方法,将使用conners父母问卷筛查、并经DSM-V诊断的3岁~5岁ADHD儿童28例随机分为两组。试验组进行12周(每周1次)的沙盘游戏治疗,对照组不予干预。试验结束后再次行conners父母问卷调查,将各组间及组内进行ADHD得分及其他行为问题得分的比较。试验组沙盘游戏治疗后多动指数及多动-冲动得分均较前显著下降(P0.05),品行问题和学习问题也较前显著下降(P0.05)。沙盘游戏能显著改善学龄前儿童ADHD的主要症状,适宜学龄前儿童ADHD的治疗。     

基于学校的儿童注意缺陷多动障碍综合干预

摘 要 对117名注意缺陷多动障碍（ADHD）儿童进行为期8周的综合干预,探讨其长短期的干预效果。综合干预以儿童行为干预和父母训练为主、药物治疗为辅,半年后随访长期效果。发现综合干预组只在短期效果上显著好于药物组与对照组,但长期效果不显著。综合干预组家长对综合干预的依从性显著高于其他两组,并能保持较长时间。不同类型ADHD儿童的长、短期效果不同。     

流动儿童心理健康的干预实验:基于心理健康双因素模型和教育干预的整合取向

目的:基于教育干预的整合取向和心理健康双因素模型,检验流动儿童心理健康的可塑性及整合性教育干预模式的有效性。方法:采用实验组-对照组、前测-后测的等组实验设计,对流动儿童的心理健康问题进行为期半年的整合性教育干预实验。首先对208名流动儿童(实验组108名,对照组100名)实施前测,包括中学生心理健康量表、生活满意度量表和积极/消极情感量表;然后,对实验组实施13周的整合性教育干预训练,包括心理健康专题活动课、团体心理辅导、个别咨询辅导、家庭间接辅导和教师专门辅导;最后,对实验组和对照组被试实施后测。结果:(1)经过整合性教育干预训练,实验组流动儿童的心理健康总体水平显著提高;(2)整合性教育干预对心理问题较为严重的流动儿童(即心理疾患组)的干预效果更为明显;(3)整合性教育干预对流动儿童的主观幸福感的促进作用不明显。结论:流动儿童的心理健康具有可塑性,对流动儿童的心理健康问题进行整合性教育干预是可行而有效的。     

正念冥想在ADHD儿童干预中的应用

正念冥想是有意识、非评判地将注意集中于当下经验的方法。近年来,正念冥想作为一种潜在的方法被引进到ADHD儿童干预领域。因为ADHD儿童的特异性,为了增加正念冥想方案对ADHD儿童的适切性,研究者从练习设置、奖励系统、解释方式和家长纳入几个方面对标准的正念减压训练方案做了改编。越来越多的研究证据表明,正念冥想训练能有效地减轻ADHD儿童的核心缺陷、改善其内外化症状和亲子关系。本文通过对已有相关实证研究的分析认为这些积极的影响可能与ADHD儿童的执行功能与去中心化等心理功能的改善有关,而大脑相关区域激活模式的变化和结构的积极改变可能是正念冥想影响ADHD儿童的神经基础。文章也提出已有研究在内容和方法学上的不足及其以后的探究方向。     

正常与多动儿童的创造力、学习适应性比较研究

本研究比较ADHD儿童和正常儿童在创造性思维测验、学习适应性测验以及教师对其创造力评价上的差异。结果表明：(1)ADHD儿童和正常儿童在数字和图形创造性思维测验上的成绩没有显著的差异。表明ADHD和创造力是彼此独立的两个特质;(2)ADHD儿童在学习态度、学校环境(主要是师生关系和同伴关系)、独立性和毅力等维度上明显偏低;(3)不同学科教师对于ADHD儿童和正常儿童在创造力水平高低的评价上没有显著性差异;(4)对于正常儿童。不同学科教师对其创造力的评价与儿童在创造力测验上的得分呈显著性相关;对于ADHD儿童则没有显著性相关。     

移情与后果认知训练对儿童欺负行为影响的实验研究

研究以移情和后果认知为训练内容,运用个体心理咨询、团体心理咨询等教育干预手段对有欺负行为的18名儿童进行了为期3个月的教育干预。结果表明:综合性的教育干预能够有效地减少儿童的欺负行为。     

国内自闭症干预与康复现状调查与分析

近年来,自闭症已经从一种严重的个体内部障碍演变成一个复杂的社会问题,自闭症群体的干预质量和康复水平是解决该问题的关键。本研究以国内X市为例,对30家自闭症康复机构的教师和家长进行问卷调查,结果发现,自闭症干预与康复领域从早期诊断、专业认知到教育干预等层面都面临着一系列的难题和挑战。同时,本研究还提出相应的解决策略,以期为康复机构和相关部门的决策提供参考意见,也为教师和家长的专业成长提供反思素材。     

空手道训练对大学生自我控制能力的影响:来自行为和脑电的证据

为考察空手道训练能否提高大学生的自我控制能力,研究采用Go/Nogo任务测量个体的认知自控及相应的脑电活动,并加入靠墙直角坐任务测量个体的行为自控能力,比较个体在4周训练干预前后认知和行为自控能力的变化。结果显示,空手道训练组在各项任务中的表现均显著优于无额外运动组,而蹬车运动组介于两组之间且与两组差异均不显著。因此,空手道训练能够稳定有效地提高个体的认知和行为自控能力,原因可能是训练降低了自控资源的易损性。     

生物反馈疗法对大学生考试焦虑的治疗作用

探讨生物反馈疗法对大学生考试焦虑的治疗作用。在某大学随机抽取学生1500名,采用考试焦虑量表进行筛查,选取焦虑组和对照组各30名。利用生物反馈疗法进行干预,采用脑电α波相对功率、肌电和皮电导联进行检测,每周2次,持续4周。结果表明：1.经过4周的干预,焦虑组干预前后各生理指标存在差异;2.生物反馈疗法干预考试焦虑在疗效上存在性别差异。结论：生物反馈疗法能有效降低大学生考试焦虑水平,对其治疗取得良好的效果。     

“热”执行对注意缺陷多动障碍和阅读障碍儿童言语工作记忆的影响

ADHD儿童在与背外侧前额叶(DLPFC)相关的"冷"执行功能上的缺陷已大量证实,但在与眼眶和中前额叶皮层(OMPFC)相关的"热"执行功能上,ADHD儿童是否存在缺陷则未可知。与儿童赌博任务实验范式(该任务中"热"启动对"冷"执行起到抑制作用)不同,本研究考察趣味言语N-back任务是否对ADHD和阅读障碍儿童的成绩有促进作用。枯燥N-back任务考察的是言语工作记忆的纯认知特征,而趣味任务则卷入了"热"执行对"冷"执行的影响。结果表明,在枯燥任务上,ADHD和阅读障碍儿童的成绩均明显低于正常儿童,二者之间差异不显著,在趣味任务成绩上,ADHD儿童与正常儿童的成绩没有显著差异,而阅读障碍儿童成绩落后于正常控制组和ADHD组,在成绩变化的趋势上,ADHD儿童在趣味任务上成绩明显提高,而阅读障碍儿童则无明显改善。结果说明ADHD和阅读障碍儿童的言语工作记忆均存在明显的缺陷,但是机制不同,"热"执行对提高ADHD的言语工作记忆有明显的促进作用,ADHD的"冷"执行缺陷能够通过"热"执行的调节得到改善。     

A multitrait-multisource confirmatory factor analytic approach to the construct validity of ADHD rating scales

Confirmatory factor analysis was used to model a multitrait-multisource design to evaluate the construct validity of attention-deficit/hyperactivity disorder (ADHD) rating scales. The 2 trait factors were the ADHD inattention and hyperactivity/impulsivity dimensions. The 2 source factors were parents and teachers. In Study 1, parents and teachers rated 1,475 Australian elementary school children on the ADHD symptoms. In Study 2, parents and teachers rated 285 Brazilian elementary school children on the ADHD symptoms. Similar results occurred in both studies with most of the ADHD symptoms containing more source than trait variance, thus providing weak evidence for the convergent and discriminant validity of the symptoms as measured by rating scales. The study outlines the implications of such strong source effects for understanding ADHD.     

Effects of the EXAT neuropsychological multilevel intervention on behavior problems in children with executive function deficits

This is a clinical intervention study of children with executive function (EF ) deficits. A neuropsychological multimodal group intervention called EXAT (rehabilitation of EX ecutive function and AT tention) was developed at the Psychology Clinic of the University of Tampere. Based on the principles of neuropsychological rehabilitation and behavioral modification, EXAT combines child group training, parent training, and teacher consultations. The aims of this study were to investigate behavior problems before and after the intervention in children attending EXAT and in controls, and to compare intervention effects in hyperactive, inattentive, and EF subgroups based on the primary deficit described in the referral. The participants were 86 children (6–12 years) with a mean IQ of 91.4 attending EXAT and 45 controls. The participants’ parents and teachers completed the Conners’ Rating Scales‐Revised. In addition, the Strengths and Difficulties Questionnaire was completed by the parents attending EXAT . The parents reported statistically significant decreases with medium effect sizes for the CPRS ‐R subscales for impulsivity, hyperactivity, and oppositional behavior. In the controls within the same time interval, there was increase in restless and impulsive behavior, and a decrease in total problems. The teachers reported positive changes after the intervention in ADHD symptoms and anxiousness/shyness, but the effects sizes were small. The intervention effects were larger in the hyperactive subgroup. Positive intervention effects were related to a younger age, lower IQ , and simultaneous learning support. In conclusion, EXAT – a structured multilevel group intervention – has positive effects on children's behavior regulation skills by decreasing impulsivity and restless behavior.     

Parental Influence on Children with Attention-Deficit/Hyperactivity Disorder: II. Results of a Pilot Intervention Training Parents as Friendship Coaches for Children

We report findings from a pilot intervention that trained parents to be “friendship coaches” for their children with Attention-Deficit/Hyperactivity Disorder (ADHD). Parents of 62 children with ADHD (ages 6–10; 68% male) were randomly assigned to receive the parental friendship coaching (PFC) intervention, or to be in a no-treatment control group. Families of 62 children without ADHD were included as normative comparisons. PFC was administered in eight, 90-minute sessions to parents; there was no child treatment component. Parents were taught to arrange a social context in which their children were optimally likely to develop good peer relationships. Receipt of PFC predicted improvements in children’s social skills and friendship quality on playdates as reported by parents, and peer acceptance and rejection as reported by teachers unaware of treatment status. PFC also predicted increases in observed parental facilitation and corrective feedback, and reductions in criticism during the child’s peer interaction, which mediated the improvements in children’s peer relationships. However, no effects for PFC were found on the number of playdates hosted or on teacher report of child social skills. Findings lend initial support to a treatment model that targets parental behaviors to address children’s peer problems.     

A friendship intervention for children with Attention-Deficit/Hyperactivity Disorder: preliminary findings

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) are known to experience difficulty in peer relationships. Neither standard interventions for ADHD nor peer acceptance-oriented interventions fully remedy this problem. We propose that interventions targeting ADHD children's dyadic friendships may be more realistic strategies for improving peer relationships. Hence, a friendship intervention, implemented within the context of an intensive behavioral treatment program with 209 ADHD children, is described. A model is proposed in which the friend's antisocial behavior relates to parental compliance with the friendship intervention, and both the friend's antisocial behavior and parental compliance predict friendship quality and treatment response. Results indicate that children paired with peers lower on antisocial behavior and children whose parents had higher levels of compliance with the friendship intervention achieved higher quality friendships and were rated by teachers as more improved.     

Intervening to improve communication between parents, teachers, and primary care providers of children with ADHD or at high risk for ADHD

This study examines interventions designed to improve communication between individuals who take care of children with ADHD. A teacher rating of 6,171 elementary school children identifies 1,573 children with ADHD or with high risk for ADHD. Parent interviews and information from teachers are collected on 243 children who are randomized into treatment and control conditions and followed for 39 months. The interventions consisted of group workshops and single one-on-one tutorials with parents, teachers, and providers about the evaluation and treatment of ADHD that stressed the need for communication between the three parties. There are few significant effects on communication that are short lived. Results suggest that the interventions are insufficient to cause significant increase in communication. Future attempts to improve parent-teacher-provider coordination should be continuing rather than single-session interventions.     

Dopamine transporter gene moderates response to behavioral parent training in children with ADHD: a pilot study

There is great variability in the degree to which children with attention deficit/hyperactivity disorder (ADHD) improve through behavioral treatments. This study investigates the influence of the dopamine transporter gene (SCL6A3/DAT1) on outcome of behavioral parent training (BPT). Study subjects were a subsample (n = 50, for whom DAT1 genotypes were available) of a randomized controlled BPT effectiveness study (N = 94) comparing BPT plus ongoing routine clinical care (RCC) versus RCC alone in referred children (4-12 years old) with ADHD. Treatment outcome was based on parent-reported ADHD symptoms and behavioral problems. Presence of 2 versus no or 1 DAT1 10-repeat allele served as moderator variable. Time × Treatment × Genotype effect was analyzed with repeated-measures analysis of variance, controlling for baseline medication status. Results indicate that DAT1 moderated treatment response (p = .009). In children with no or 1 DAT1 10-repeat allele, superior treatment effects of BPT + RCC compared with RCC alone were present (p = .005), which was not the case in children with 2 DAT1 10-repeat alleles (p = .57). Our findings suggest that genetic differences in DAT1 in children with ADHD influence their susceptibility to a behavioral intervention directed at shaping their environment through their parents. The role of the dopamine system in motivation and learning and in the aberrant sensitivity to reinforcement in children with ADHD may explain this moderating effect, given that the management of contingencies is typically addressed in BPT.     

Combining Parent and Teacher Training for Early ADHD: A Randomized Study of Effectiveness

Parent training (PT) has been documented as an effective intervention for early ADHD based on parental assessment, but documentation of transfer of its results outside the family context has been limited. Due to the cross-contextual impairments typically caused by ADHD, it has been proposed that PT in combination with an intervention in kindergarten or school based on systematic teacher training (TT) would be better suited. The objective of this study was to evaluate the effectiveness of a combination of PT and TT in a community sample of children with early ADHD problems. Families of 64 3-8-year old children were randomized to either PT alone with “The Incredible Years” PT or to a combined PT?+?TT intervention. Moderate to large pre-post effect sizes on mother-reported outcomes were revealed in both groups, in line with those generally reported in the literature on PT interventions for early ADHD. With an n of 64, the current study was powered to detect superiority of the PT?+?TT intervention if the difference was of a moderate effect size (Cohen’s d?=?0.5). There were no statistically significant differences between the two groups on any of the outcome measures as rated by parents or teachers. In conclusion, the study did not provide support for the combined PT?+?TT intervention for early ADHD problems as a superior intervention in comparison with PT alone.     

Interrater agreement on behavioral executive function measures in adolescents with Attention Deficit Hyperactivity Disorder

Background/ObjectiveThough most children with Attention Deficit Hyperactivity Disorder (ADHD) show difficulties in behavioral measures of executive functions (EF), few studies have examined interrater agreement in these measures.Objective: To analyze the agreement between parents, teachers and self-reports of behavioral EF in adolescents with ADHD and controls. Method: A sample of 118 adolescents (75 with ADHD and 43 controls) was rated by parents, teachers and the adolescents themselves using the Comprehensive Executive Function Inventory. The intraclass correlation coefficient (ICC) and Bland and Altman methods were used to evaluate agreement. Results: The ICC between parents, teachers and self-report was poor or moderate in the group with ADHD; in the control group the agreement was fair to good. The Bland and Altman graphs show that, in the control group, most of the scores are below to the clinical cut-off point, while in the group with ADHD they are above. Conclusions: Agreement between all raters was low. Parents, teachers and adolescents agreed on the absence of deficits in behavioral EF in the control group, and on the presence of deficits in the group with ADHD, although they did not agree on the frequency of these deficits.     

Construct Validity of ADHD/ODD Rating Scales: Recommendations for the Evaluation of Forthcoming DSM-V ADHD/ODD Scales

Exploratory structural equation modeling (SEM) was applied to a multiple indicator (26 individual symptom ratings) by multitrait (ADHD-IN, ADHD-HI and ODD factors) by multiple source (mothers, fathers and teachers) model to test the invariance, convergent and discriminant validity of the Child and Adolescent Disruptive Behavior Inventory with 872 Thai adolescents and the ADHD Rating Scale-IV and ODD scale of the Disruptive Behavior Inventory with 1,749 Spanish children. Most of the individual ADHD/ODD symptoms showed convergent and discriminant validity with the loadings and thresholds being invariant over mothers, fathers and teachers in both samples (the three latent factor means were higher for parents than teachers). The ADHD-IN, ADHD-HI and ODD latent factors demonstrated convergent and discriminant validity between mothers and fathers within the two samples. Convergent and discriminant validity between parents and teachers for the three factors was either absent (Thai sample) or only partial (Spanish sample). The application of exploratory SEM to a multiple indicator by multitrait by multisource model should prove useful for the evaluation of the construct validity of the forthcoming DSM-V ADHD/ODD rating scales.     

Tuning in to Kids: an effectiveness trial of a parenting program targeting emotion socialization of preschoolers

This article reports on an effectiveness trial of the Tuning in to Kids (TIK) parenting program. TIK aims to improve emotion socialization practices in parents of preschool children; it is a universal prevention program that teaches parents the skills of emotion coaching and also targets parents' own emotion awareness and regulation. The present study followed a 2 × 2 (Treatment Condition × Time) design. One hundred twenty-eight parents of children ages 4.0-5.11 years were recruited from preschools and randomized into intervention and waitlist conditions. Parents in the intervention condition (n = 62) attended a six-session group parenting program delivered by community practitioners who followed intervention fidelity protocols. Parents and preschool teachers completed questionnaires twice during the preschool year: at preintervention and at follow-up (approximately 7 months later). Parents reported on their emotion socialization beliefs and practices, other parenting practices, and on child behavior. Teachers reported on child behavior (Social Competence and Anger-Aggression). Data were analyzed using multilevel modeling. At follow-up, compared to the control group, intervention parents were significantly less emotionally dismissive in their beliefs, less dismissive and more coaching in their practices in response to children's negative emotions, and more positively involved. Although there were improvements in both conditions over time for parent-reported child behavior and teacher-reported social competence, compared to the waitlist group, intervention parents reported a significantly greater reduction in number of behavior problems. This trial demonstrates the potential for community agencies and practitioners in real-world settings to deliver a new parenting program that targets emotional communication in parent-child relationships.