家庭环境与学习障碍儿童行为、自我意识、个性的相关性

目的 :探讨学习障碍 (learningdisorders ,LD)儿童的家庭环境特点及其与儿童行为、自我意识、个性特征的相关性。方法 :选用家庭环境量表中文版 (FES -CV)、Rutter儿童行为问卷 (父母问卷 )、艾森克个性问卷 (EPQ -儿童版 )和Piers -Harris儿童自我意识量表分别对 110名LD和 110名学习优秀 (对照 )组儿童进行评定。结果 :资料齐全的LD组儿童 91名 ,对照组 98名。LD组儿童的家庭在FES量表的亲密度、情感表达、成功性、知识性的评分低于对照组 (P <0 0 5 ) ,而矛盾性则高于对照组 (P <0 0 1) ;LD组儿童的行为和自我意识总分显著低于对照组 (均P <0 0 0 1) ,在EPQ的精神质和神经质得分高于对照组(P <0 0 5 ) ,内外向得分低于对照组 (P <0 0 0 1)。FES的某些环境因素分别与LD和对照组儿童的行为、自我意识、个性特点有关。结论 :LD儿童处在相对不良的家庭环境中 ,家庭环境因素对LD组和对照组儿童行为、自我意识、个性的影响不同。     

学习障碍儿童微量元素测定及营养素摄入的分析

目的旨在对儿童学习障碍(LD)的可能发病机制以及促进学习障碍儿童学习成绩提高的膳食指导提供一定的线索,探讨了微量元素与营养素对儿童学习障碍的影响。方法测定LD组与对照组儿童各50名血清Zn、Cu、Fe、Pb含量,并对两组儿童膳食进调查分析。结果LD组儿童血清Zn、Cu、Fe显著低于对照组(P<0.01),而血清Pb显著高于对照组(P<0.01);摄入营养素Zn、Cu、Fe、V itB1、DHA、AA、EPA显著低于对照组(P<0.01),两组儿童维生素C、蛋白质以及钙摄入的差异无统计学意义。结论儿童学习障碍的发生可能与饮食结构失调有关,应重视LD儿童饮食结构的调整,增加富含Zn、Cu、Fe、V itB1、DHA、AA、EPA食物的摄入。     

儿童多动症学龄期的现状调查分析

研究儿童多动症临床表现度以及相关因素 ,提出针对性的宣教措施 ,减少影响多动症儿童生理、心理、智力发展的相关因素。通过对 1 4 3例学龄期儿童多动症按年龄组进行临床表现度分析 ,对 2 4 7位家属按文化程度 ,对儿童有无体罚行为和家庭组成进行分析。小学组发病率明显高于中学组 ( P<0 .0 1 ) ,中学组以继发性学习困难和品行障碍为主。双亲组家庭中儿童出现品行障碍明显比单亲组和其他组低 ( P<0 .0 1 )     

影响儿童肝衰竭预后的相关因素分析

目的　探讨影响儿童肝衰竭预后的相关因素 ,为临床诊断、治疗提供科学依据。方法　10 5例儿童肝衰竭资料用EXCELL 2 0 0 0和STATA 7 0软件进行统计分析。多因素分析用非条件Logistic回归分析。结果　 (1)本组患儿中有 33例存活 ,存活率低 (31 4 % )。 (2 )单因素分析发现 ,患儿的年龄、临床分型及分期、PTA、血清总胆红素 (TBIL)、酶胆分离现象、AIB、并发症和肝性脑病都是影响儿童肝衰竭预后的因素 ;但在性别上差异无统计学意义。 (3)HBV感染、肝豆状核变性与病因不明引起的肝衰竭存活率相比 ,差异无统计学意义。 (4)多因素分析显示 ,患儿的PTA(P =0 0 0 0 )和TBIL(P =0 0 2 9)是影响儿童肝衰竭预后的独立危险因素。结论　儿童肝衰竭预后差 ,病死率高 ,PTA和TBIL是影响儿童肝衰竭预后最危险的因素。通过分析患儿的年龄、临床分型及分期、PTA、TBIL、酶胆分离现象、AIB、并发症和肝性脑病等因素可以及早明确患儿病情 ,指导治疗 ,从而提高存活率     

学习障碍儿童认知功能的某些特点

目的:探讨学习障碍(LD)儿童的脑认知功能特点.方法:对30例LD儿童和30例正常儿童进行威斯康星卡片(WCST)及儿童韦氏智力测验和比较.结果:1.与正常对照组相比,LD组WCST完成分类数(4.31±1.28/5.10±1.17)和正确应答数低,持续错误数(38.57±10.71/23.87±8.41)、总应答数和错误应答数较高,差异均有显著性(P<0.05).2.LD组总智商(89.00±14.26/112.63±17.03)、言语和操作智商以及算术、理解、积木和拼图因子分均低于正常对照组(P<0.05).3.LD组智力结构失衡发生率(80%)高于正常对照组(30%)(P<0.01).4.相关分析表明,LD儿童智商与WCST完成分类和正确应答数呈正相关(r>0.3),与总应答数、错误应答数和持续错误数呈负相关(r>-0.3).结论:LD儿童存在额叶执行功能障碍,有认知功能缺陷.     

BAIAP2基因多态与儿童注意缺陷多动障碍共患学习困难的关联分析

目的:探讨脑特异性血管发生抑制剂1相关蛋白2(BAIAP2)基因多态与儿童注意缺陷多动障碍(ADHD)共患学习困难(LD)的关联。方法:选取符合美国精神障碍诊断与统计手册第4版(DSM-IV)诊断标准731例共患LD的ADHD儿童和957例健康对照,采用高通量实时荧光定量PCR方法检测基因型,探讨BAIAP2基因的9个单核苷酸多态性(SNPs)位点与共患LD的儿童ADHD的关联。结果:BAIAP2的SNP位点rs8079626/G(病例对照频率0.638 vs.0.604)和rs4969385/T(0.179 vs.0.150)与儿童ADHD共患LD关联,rs3934492/C(0.572 vs.0.532)和rs4969385/T(0.180 vs.0.142)与男性儿童ADHD共患LD关联,rs4969239/G(0.426 vs.0.329)和rs4969358/A(0.472 vs.0.389)与女性儿童ADHD共患LD关联(均P0.05);由rs4969239-rs4969358-rs6565531-rs8079626组成的单体型AAGG与共患LD的儿童ADHD共患LD(0.100 vs.0.065)和男性儿童ADHD共患LD(0.101 vs.0.065)关联(均P0.05)。结论:BAIAP2基因多态性可能与汉族儿童ADHD共患LD的病理机制有关,且这种作用机制可能存在性别差异。     

注意缺陷多动障碍共患对立违抗障碍儿童的家庭环境因素

目的:探讨注意缺陷多动障碍(ADHD)共患对立违抗障碍(ODD)的儿童家庭环境特点及家庭危险因素。方法:选取符合DSM-5诊断的140例ADHD儿童(伴ODD亚组34例、不伴ODD亚组106例),正常对照儿童45例,由父母填写一般情况问卷和家庭环境量表中文版(FES-CV)。采取多重回归分析探讨ADHD、ADHD共患ODD的家庭相关因素。结果:多重回归分析显示,儿童月龄越低(β=-0.03,P0.01)、家庭亲密度(β=-0.50,P0.05)和组织性(β=-0.49,P0.01)越低、矛盾性(β=0.30,P0.05)越高,患ADHD的风险越大;儿童家庭矛盾性(β=0.21,P0.05)和控制性(β=0.20,P0.05)越高,ADHD儿童共患ODD的风险越大。结论:儿童月龄低、家庭亲密度和组织性低、矛盾性高是ADHD的危险因素。家庭矛盾性和控制性高是ADHD共患ODD的危险因素。     

儿童品行障碍危险因素的LOGISTIC回归分析

对１０２例７～１６岁品行障碍儿童采用ＬＯＧＩＳＴＩＣ回归分析其危险因素，发现父母对儿童粗暴打骂、严厉约束、家庭亲密程度差、父母管教儿童态度不一致、母孕期情绪不良、孕期各种疾病、出生时异常、妊娠早产等因素明显与儿童品行障碍发生有关。     

高血压脑出血术后再出血相关危险因素分析

目的分析高血压脑出血术后发生再出血的相关危险因素,为临床预防术后再出血提供依据。方法回顾性分析我院2007年1月至2017年12月收治的413例高血压脑出血患者的临床资料,搜集术后再出血可能存在关联性的相关因素,总结高危因素。结果经单因素非条件Logistic回归分析收缩压、GCS评分、出血量、是否存在凝血功能障碍以及是否使用镇静镇痛药物与高血压脑出血患者术后再出血存在显著的相关性(P 0. 05);经多因素非条件Logistic回归分析收缩压、GCS评分、出血量以及是否存在凝血功能障碍是高血压脑出血患者术后再出血的危险因素(P 0. 05)。结论高血压脑出血患者术后再出血存在诸多的影响因素;围手术期收缩压较高、意识障碍程度较深、出血量较多、凝血功能障碍是术后发生再出血的独立影响因素,在临床工作中应给予足够的重视。     

低出生体重儿童智能发育及其影响因素分析

目的:了解低出生体重儿智能发育状况及其影响因素.方法:采用Gesell婴幼儿智能发育量表,对190例低出生体重儿进行测试,并与正常对照儿童进行比较,同时对可能影响智能发育的相关因素进行了逐步回归分析.结果:1岁和2岁时低出生体重儿童动作能、应物能、应人能等发育商数均低于对照组,2岁时言语能发育商数也低于对照组,差别在统计学上有显著性(P<0.05、P<0.001),逐步回归分析结果提示与儿童智能发育相关的因素是:儿童的年龄、性别、头围、是否为低出生体重儿、父母亲文化水平及喂养方式.结论:低出生体重儿童1岁及2岁时智能发育均落后于正常对照儿童.儿童智能发育水平受多种因素的影响.     

Attitude and knowledge of attention deficit hyperactivity disorder and learning disability among high school teachers

The aims of the study were to investigate teachers’ knowledge and attitudes towards attention deficit hyperactivity disorder (ADHD) and learning disabilities (LD). Forty-six high school teachers were interviewed in this regard. The 46 teachers were divided into two groups: 25 teachers taught at an academic school (School 1); and 21 teachers taught at special education school (School 2) and dealt with ADHD/LD cases regularly. General knowledge about ADHD (71%) and about LD (74%) was relatively low among both groups. Thirteen percent of all teachers considered LD to be the result of parental attitudes, namely ‘spoiling’ the children. The score for attitude and understanding of ADHD children was relatively low (72.5%) for both groups, whereas Group B teachers scored higher regarding LD cases. Almost 40% considered that ADHD children should be rebuked and/or punished in a manner similar to non-ADHD kids. Regarding long-term outcome, 45.7% of the teachers expected ADHD children to experience multiple difficulties in family life during adulthood. In relation to LD cases, the overall scoring for positive attitude was 75%. However, this score was higher for Group B teachers. Three-quarters of the teachers favored increasing peer awareness and comprehension as to the problems LD kids encounter at school. Ninety-five percent believed LD patients should enjoy a more lenient school education. There was no correlation between teachers, knowledge of ADHD and LD and their attitude. The main sources for this knowledge were: specialized textbooks, continuous education, TV shows, journals and newspapers, and medical personnel.     

流动人口子女父母教养方式与学习环境适应性的关系

目的探讨流动人口子女父母教养方式与学习环境适应性的关系。方法用父母教养方式评价量表（EMBU）、学习适应性测验（AAT）对71名初一流动人口子女进行了调查。结果父亲的温暖理解与子女的学习环境适应性呈正相关．母亲的过度干涉过度保护、拒绝否认与子女的学习环境适应性呈负相关。结论父母教养方式是影响子女学习环境适应性的重要因素，父母应更多地体贴、理解子女，更多地培养子女的独立性。     

Implicit Motor Sequence Learning in Children With Learning Disabilities: Deficits Limited to a Subgroup With Low Perceptual Organization

This study tested whether deficiencies in implicit motor sequence learning occurred exclusively in a subgroup of children with learning disabilities (LD). An experimental motor sequence task showed that LD children with low Perceptual Organization did not learn the sequence through implicit training, whereas they improved considerably after a few explicit test trials. In contrast, children with low Freedom From Distractibility (or sequencing) experienced the same benefit from implicit training as the control children. These results suggest that training motor skills (e.g., writing) should be adapted to suit the visuospatial abilities of a child with LD.     

Evidence-based assessment of learning disabilities in children and adolescents.

The reliability and validity of 4 approaches to the assessment of children and adolescents with learning disabilities (LD) are reviewed, including models based on (a) aptitude-achievement discrepancies, (b) low achievement, (c) intra-individual differences, and (d) response to intervention (RTI). We identify serious psychometric problems that affect the reliability of models based on aptitude-achievement discrepancies and low achievement. There are also significant validity problems for models based on aptitude-achievement discrepancies and intra-individual differences. Models that incorporate RTI have considerable potential for addressing both the reliability and validity issues but cannot represent the sole criterion for LD identification. We suggest that models incorporating both low achievement and RTI concepts have the strongest evidence base and the most direct relation to treatment. The assessment of children for LD must reflect a stronger underlying classification that takes into account relations with other childhood disorders as well as the reliability and validity of the underlying classification and resultant assessment and identification system. The implications of this type of model for clinical assessments of children for whom LD is a concern are discussed.     

Additive effect of three noradrenergic genes (ADRA2A, ADRA2C, DBH) on attention-deficit hyperactivity disorder and learning disabilities in Tourette syndrome subjects

Halperin et al. (Halperin JM. Newcorn JH, Koda VH, Pick L, McKay KE, Knott P. Noradrenergic mechanisms in ADHD children with and without reading disabilities: a replication and extension. J Am Acad Child Adolesc Psychiatry 1997: 36: 1688 1696) reported a significant increase in plasma norepinephrine (NE) in attention-deficit hyperactivity disorder (ADHD) children with reading and other cognitive disabilities compared to ADHD children without learning disabilities (LD). We examined the hypothesis that ADHD + LD was associated with NE dysfunction at a molecular genetic level by testing for associations and additive effects between polymorphisms at three noradrenergic genes the adrenergic alpha2A receptor (ADRA2A), adrenergic alpha2C receptor (ADRA2C), and dopamine beta-hydroxylase (DBH) genes. A total of 336 subjects consisting of 274 individuals with Tourette syndrome (TS) and 62 normal controls were genotyped. Regression analysis showed a significant correlation between scores for ADHD, a history of LD, and poor grade-school academic performance that was greatest for the additive effect of all three genes. Combined, these three genes accounted for 3.5% of the variance of the ADHD score (p = 0.0005). There was a significant increase in the number of variant NE genes progressing from subjects without ADHD (A-) or learning disorders (LD-) to A + LD - to A - LD + to A + LD + (p = 0.0017), but no comparable effect for dopamine genes. These data support an association between NE genes and ADHD, especially in ADHD + LD subjects.     

学习困难儿童智力水平与结构分析

学习困难是学龄儿童常见的问题。国外研究报道学习困难的发生率为 2 0 - 2 5 % ,国内一些地区的报道为 13- 17% [1] 。帮助这些儿童一直是我们研究工作者、教师和家长们迫切需要解决而又十分棘手的问题。为了改善学习困难儿童的状况 ,有必要了解其能力和学习的薄弱环节。本研究中对 6 2例学习困难儿童的智力水平和智力结构进行了调查分析 ,报告结果如下。1　对象与方法1.1　对象所有受试者均取自上海浦东三林小学 1～ 4年级的学生 ,年龄在 6 .5～ 11岁。学习困难儿童入组标准 :(1)以ＷＩＳＣ -ＣＲ测查智商 ,总智商 (ＦＩＱ)在70以上 ;(2 )…     

New Ideas About the Unconscious Family Structure

SUMMARY. Unconscious Family Structure (UFS) is the virtual, symbolic space, the deep level level where lies the meaning which organises the family relations or the manifest level. Within the UFS space there are subspaces: that of the marital couple, later to become the parents, that of the children in relation to the parents, that of the children in relation to each other. Within these subspaces certain places are to be found: the father's place, the mother's place and the child's place. Between the spaces lie the relationships or links: the couple or marital link; the filial link between parents and their children; the consanguineous link between siblings. To these I add a fourth: the avunculus link with the representative of the mother's family.
I depict a series of verbal or preverbal stipulations: the unconscious accords, pacts and rules.
In addition I describe four UFS configurations: grade a ('normal'), b ('neurotic'), c'perverse') and d ('psychotic').
I conclude with some observations about family transference and countertransference.     

大学生的父母教养方式特点分析

目的:探讨中国大学生的父母教养方式特点.方法:采用自编一般情况调查表及修订的父母教养方式问卷(PBI).对906名湖南高校大学生进行测评.结果:①父亲与母亲的教养方式有显著差异,同时又有显著相关.②不同子女性别在父母关爱因子上得分有显著差异,独生子女与非独生子女在母亲关爱和父亲控制及鼓励自主上得分有显著差异.不同家长文化程度以及家庭经济情况的大学生在父母教养方式的关爱因子上得分有显著差异.结论:大学生的父母教养方式不同并与父母文化程度、子女性别等因素密切相关.     

学习障碍儿童的本顿视觉保持实验研究

本研究采用国内修订版本顿视觉保持测验（ＶＲＴ）对学习障碍（ＬＤ）儿童和正常儿童进行了测试比较。结果表明，ＬＤ组总体ＶＲＴ成绩明显低于对照组（Ｐ＜０．０１），具体表现在变形、位置错误、遗漏、持续、旋转等错误类型偏多，失误分增加。提示ＬＤ儿童存在短时记忆障碍，视结构能力障碍，视动协调困难等特征     

Water, socioeconomic factors, and human herpesvirus 8 infection in Ugandan children and their mothers

BACKGROUND: Human herpesvirus 8 (HHV-8) infection is common in sub-Saharan Africa, but its distribution is uneven. Transmission occurs during childhood within families by unclear routes. METHODS: We evaluated 600 Ugandan children with sickle cell disease and their mothers for factors associated with HHV-8 seropositivity in a cross-sectional study. HHV-8 serostatus was determined using an HHV-8 K8.1 glycoprotein enzyme immunoassay. Odds ratios for seropositivity were estimated using logistic regression, and factor analysis was used to identify clustering among socioeconomic variables. RESULTS: One hundred seventeen (21%) of 561 children and 166 (34%) of 485 mothers with definite HHV-8 serostatus were seropositive. For children, seropositivity was associated with age, mother's HHV-8 serostatus (especially for children aged 6 years or younger), lower maternal education level, mother's income, and low-status father's occupation (P < 0.05 for all). Using communal standpipe or using surface water sources were both associated with seropositivity (OR 2.70, 95% CI 0.80-9.06 and 4.02, 95% CI 1.18-13.7, respectively) as compared to using private tap water. These associations remained, albeit attenuated, after adjusting for maternal education and child's age (P = 0.08). In factor analysis, low scores on environmental and family factors, which captured household and parental characteristics, respectively, were positively associated with seropositivity (P(trend) < 0.05 for both). For mothers, HHV-8 seropositivity was significantly associated with water source and maternal income. CONCLUSIONS: HHV-8 infection in Ugandan children was associated with lower socioeconomic status and using surface water. Households with limited access to water may have less hygienic practices that increase risk for HHV-8 infection.