汉语阅读障碍儿童的视空间即时加工能力研究

目的探明汉语阅读障碍（RD）儿童图画知觉过程的视觉即时加工特点，为相关理论的完善和针对性矫治方法的建立提供依据。方法采用眼动仪，分别记录19例汉语阅读障碍儿童对3幅风景图画知觉过程的眼动数据，分析关于注视和眼跳相应的7项眼动指标。结暴3幅图画的结果比较，首次注视时间、平均注视时间、平均眼跳幅度、眼跳距离差异均有统计学意义。其中图2的首次注视时间最长，平均注视时间、平均眼跳幅度和眼跳距离最短；图3的首次注视时间最短，平均眼跳幅度和眼跳距离最长。RD组儿童的平均眼跳幅度（F=6.27,P=0.02）和眼跳距离（F=5.62，P=0.02）明显短于正常儿童。结论图画材料本身特点会显著影响儿童视空间即时加工能力。汉语BD儿童的视空间即时加工能力存在眼跳幅度小和眼跳距离短的特点。     

汉语阅读障碍儿童感觉统合能力评定研究

目的探讨阅读障碍与感觉统合失调之间的关系,为阅读障碍的干预性研究提供科学依据。方法采用病例对照研究的方法,比较小学阅读障碍(RD)儿童与正常儿童感觉统合能力发展水平。结果RD组儿童感觉统合各因子分显著低于非RD组儿童,差异均有统计学意义(P<0.01);RD组儿童感觉统合发展失调轻、中、重度各层次人数均多于非RD组儿童;McNemar’s检验显示,RD组儿童发生感觉统合失调的多于非RD组儿童,差异有统计学意义(P值均<0.01)。结论阅读障碍的发生与感觉统合失调有关。     

汉语阅读障碍儿童抑制功能特征分析

目的探讨汉语阅读障碍儿童工作记忆抑制功能特征,为深入了解汉语阅读障碍儿童的认知特点提供依据。方法按照ICD-10中阅读障碍的诊断标准,从武汉某小学筛选出16名汉语阅读障碍儿童为实验组,并从同性别、同年级的正常儿童中选择对照16人。采用Flanker Task的研究范式,测量两组儿童在抑制任务上的反应时和准确率。结果在一致情境下,阅读障碍组与正常组在抑制任务上的准确率、反应时差异均无统计学意义(t=-1.10,P=0.28;t=-0.80,P=0.43);在不一致情境下,两组的准确率差异有统计学意义(t值=-2.29,P=0.03);两组辨别力差异有统计学意义(t=-2.34,P=0.02)。结论阅读障碍儿童的抑制能力明显低于同龄正常阅读儿童。     

汉语阅读障碍儿童DYX1C1基因多态性研究

目的研究汉语阅读障碍儿童DYX1C1基因多态性特点,为从分子水平揭示阅读障碍的病因机制提供参考。方法采取病例-对照的方法,选取汉语阅读障碍儿童34名,非阅读障碍儿童（对照组）55名。收集儿童口腔上皮细胞提取基因组DNA,进行聚合酶链式反应-限制性片段长度多态性（PCR-RFLP）分析DYX1C1基因第二外显子-3位单核苷酸位点的多态性。结果DYX1C1基因第二外显子-3位单核苷酸位点,在阅读障碍儿童组中AA,AG,GG基因型频率分别为0,5.9%,94.1%,等位基因A和G的频率为2.9%和97.1%;在阅读能力正常儿童组的基因型频率分别为0（AA）,12.7%（AG）和87.3%（GG）,等位基因频率为6.4%（A）和93.6%（G）。该位点的基因型分布及其等位基因频率在阅读障碍儿童组与对照组之间差异均无统计学意义（P值均〉0.05）。DYX1C1基因第二外显子-3位单核苷酸位点的任一突变基因型与发生阅读障碍的危险度无显著性升高（P〉0.05）。结论DYX1C1基因第二外显子-3位点的多态性可能不是影响汉语阅读障碍发生的遗传易感因素。     

汉语发展性阅读障碍儿童视空间工作记忆与语言认知相关性的研究

【目的】 研究汉语阅读障碍儿童在视空间工作记忆与正常儿童的差异,探讨视空间工作记忆与基本语言认知的相关性。 【方法】 按照ICD-10中阅读困难的诊断标准, 从武汉某小学筛选出25名汉语阅读障碍儿童为实验组, 并从同性别、同年级的正常儿童中选择正常对照33人。对两组儿童进行识字量、语音意识、正字法等基本语言认知测试,同时采用视空间工作记忆的研究范式-视觉矩阵和Corsi广度,考察两组儿童在视觉工作记忆和空间工作记忆任务上的表现。 【结果】 语言认知测试,阅读障碍组儿童得分均明显低于正常儿童组(P值均<0.05)。阅读障碍组儿童视觉矩阵得分和Corsi广度得分明显低于正常对照组儿童,差异均具有统计学意义(P值均<0.05)。视觉矩阵得分和Corsi广度得分均与儿童识字量、正字法意识测试呈正相关(P值均< 0.05),但与语音意识测试均无显著相关性(P值均＞0.05)。 【结论】 阅读障碍儿童的视空间工作记忆存在缺陷,视空间工作记忆与儿童识字量、正字法意识存在一定相关性。     

Pathogenesis of Musculoskeletal Deficits in Children and Adults with Inflammatory Bowel Disease

Musculoskeletal deficits are among the most commonly reported extra-intestinal manifestations and complications of inflammatory bowel disease (IBD), especially in those with Crohn’s disease. The adverse effects of IBD on bone and muscle are multifactorial, including the direct effects of underlying inflammatory disease processes, nutritional deficits, and therapeutic effects. These factors also indirectly impact bone and muscle by interfering with regulatory pathways. Resultantly, individuals with IBD are at increased risk of osteoporosis and sarcopenia and associated musculoskeletal morbidity. In paediatric IBD, these factors may contribute to suboptimal bone and muscle accrual. This review evaluates the main pathogenic factors associated with musculoskeletal deficits in children and adults with IBD and summarises the current literature and understanding of the musculoskeletal phenotype in these patients.     

Motor Skills in Brazilian Children with Developmental Coordination Disorder versus Children with Motor Typical Development

The aims of the study were to compare the performance of children with probable developmental coordination disorder (DCD) and motor typically developing peers on items from the Assessment of Motor Coordination and Dexterity (AMCD), to determine whether age, gender and type of school had significant impact on the scores of the AMCD items, to estimate the frequency of DCD among Brazilian children ages 7 and 8 years and to investigate whether children with DCD exhibit more symptoms of attention deficit and hyperactivity disorder than children with motor typical development. A total of 793 children were screened by the Developmental Coordination Disorder Questionnaire – Brazilian version (DCDQ‐Brazil); 90 were identified as at risk for DCD; 91 matched controls were selected from the remaining participants. Children in both groups were evaluated with the AMCD, the Movement Assessment Battery for Children (MABC‐II) and Raven's coloured progressive matrices. Thirty‐four children were classified as probable DCD, as defined by a combination of the DCDQ‐Brazil and MABC‐II scores (fifth percentile). The final frequency of DCD among children ages 7 and 8 years was 4.3%. There were significant differences between children with and without DCD on the majority of AMCD items, indicating its potential for identifying DCD in Brazilian children. The use of a motor test (MABC‐II) that is not validated for the Brazilian children is a limitation of the present study. Further studies should investigate whether the AMCD is useful for identifying DCD in other age groups and in children from different regions of Brazil. The application of the AMCD may potentially contribute in improving occupational therapy practice in Brazil and in identifying children that could benefit from occupational therapy services. Copyright © 2014 John Wiley & Sons, Ltd.     

学习障碍儿童工作记忆和执行功能特征分析

目的探讨学习障碍儿童工作记忆和执行功能的心理学特征,为在教育过程中进行有效的干预和训练提供依据。方法利用学习障碍筛查量表和小学生多重测验成就量表,对杭州市西湖区2所小学三至五年级607名学生进行筛查,筛查出33例学习障碍儿童作为研究组,再按性别、年龄和年级相匹配的原则选择30名正常儿童作为对照组,对2组儿童进行言语和空间再认测验和威斯康辛(WCST)卡片测验测试,比较2组间的工作记忆和执行功能的特征和差异。结果空间再认反应时对照组显著低于研究组(P0.01),言语再认反应时两者间比较差异无统计学意义(P0.05);言语再认正确率对照组显著高于研究组(P0.01),空间再认正确率两者间比较差异无统计学意义(P0.05)。WCST成绩比较:除随机错误数2组间差异无统计学意义外(P0.05),其他正确反应数、正确分类数、概括力水平对照组均高于研究组,差异均有统计学意义(P值均0.05),错误反应数和坚持错误数成绩对照组均低于研究组(P0.05)。结论学习障碍儿童存在工作记忆和执行功能的缺陷。     

儿童青少年注意力缺陷障碍合并品行障碍的流行病学研究

目的 探讨儿童青少年注意力缺陷障碍合并品行障碍的流行病学特征. 方法 对武汉市2 188名4～16岁儿童青少年进行"注意力和行为问题调查量表"测评.包括注意力及多动问题调查表、对立违抗障碍与品行障碍调查表. 结果男性注意力缺陷障碍合并品行障碍发生率为4.74%,女性注意力缺陷障碍合并品行障碍发生率为1.83%,其性别差异有统计学意义(P<0.001);性别对不同亚型注意力缺陷障碍合并品行障碍发生率的影响无统计学意义(P>0.05);在注意力缺陷障碍患儿中,无论男女,品行障碍发生率明显升高(P<0.001);年龄对不同亚型注意力缺陷障碍合并品行障碍的发生率存在显著影响.结论 注意力缺陷障碍合并品行障碍在儿童青少年中的发生不可忽视,性别对该病的发生有显著影响,但对不同亚型注意力缺陷障碍合并品行障碍发生率影响无显著差异.     

发育性协调障碍儿童功能性行为特征研究

目的探讨发育性协调障碍（developmental coordination disorder,DCD）儿童的功能性行为特征,为DCD的诊断和干预提供依据。方法以DSM-IV为诊断标准,结合DCDQ问卷在苏州市区2所小学进行筛查,筛选出41名DCD儿童,按1∶1设立对照组,进行功能性行为活动和心理-行为研究。结果DCD儿童体育爱好项目数大于2项、全部参加学校设置的体育课程、每天户外活动时间大于2h、1岁前能熟练爬行、6岁前参加游戏和7岁会用毛笔写字、参加弹琴和6岁前参加画画或涂鸦兴趣班的比例明显低于对照组,差异均有统计学意义（χ^2值分别为56.69,13.46,18.25,49.98,59.89,35.90,16.63,46.99,P值均〈0.01）。多元线性回归分析中,体育爱好项目数大于2项、每天户外活动时间大于2h、1岁前熟练爬行和6岁前参加游泳对M-ABC的总障碍分产生影响。此外,Conners父母评价量表DCD组儿童品行问题、心身障碍、焦虑因子得分均显著高于对照组（t值分别为2.92,2.71,3.68,P值均〈0.01）,学习问题因子得分也高于对照组（t=2.46,P〈0.05）。结论DCD儿童存在功能性活动缺陷和心理-行为问题,DCD的干预模式应采取结合日常性活动训练和心理-行为问题治疗的综合性模式。     

Click-Evoked Otoacoustic Emissions in Children and Adolescents with Gender Identity Disorder

Click-evoked otoacoustic emissions (CEOAEs) are echo-like sounds that are produced by the inner ear in response to click-stimuli. CEOAEs generally have a higher amplitude in women compared to men and neonates already show a similar sex difference in CEOAEs. Weaker responses in males are proposed to originate from elevated levels of testosterone during perinatal sexual differentiation. Therefore, CEOAEs may be used as a retrospective indicator of someone’s perinatal androgen environment. Individuals diagnosed with Gender Identity Disorder (GID), according to DSM-IV-TR, are characterized by a strong identification with the other gender and discomfort about their natal sex. Although the etiology of GID is far from established, it is hypothesized that atypical levels of sex steroids during a critical period of sexual differentiation of the brain might play a role. In the present study, we compared CEOAEs in treatment-naïve children and adolescents with early-onset GID (24 natal boys, 23 natal girls) and control subjects (65 boys, 62 girls). We replicated the sex difference in CEOAE response amplitude in the control group. This sex difference, however, was not present in the GID groups. Boys with GID showed stronger, more female-typical CEOAEs whereas girls with GID did not differ in emission strength compared to control girls. Based on the assumption that CEOAE amplitude can be seen as an index of relative androgen exposure, our results provide some evidence for the idea that boys with GID may have been exposed to lower amounts of androgen during early development in comparison to control boys.