不同类型学习障碍儿童认知功能和行为问题关系研究

目的探讨不同类型学习障碍儿童认知功能与行为问题之间的关系,为制定相应的学习障碍干预对策提供依据。方法采用自制一般环境问卷、韦氏儿童智力量表(中国修订本)和Conners量表为工具,对185名学习障碍儿童进行调查,并与185名正常儿童调查结果进行比较。结果家庭环境对学习障碍儿童有一定影响;学习障碍儿童言语智商、操作智商和全量表智商均显著低于正常儿童(P值均<0.01),且言语智商和操作智商分离现象普遍,言语型和非言语型学习障碍儿童有不同认知功能特点;学习障碍儿童组有较多的冲动、多动和品行问题。结论学习障碍儿童存在明显认知功能缺陷,不同类型学习障碍儿童有不同的认知损害,儿童行为问题对认知功能有一定的影响。     

非言语型学习障碍儿童的认知方式与行为特征的研究

【目的】 了解非言语型学习障碍(nonverbal learning disabilities,NLD)儿童认知方式与行为特征,探讨影响NLD发病的因素。 【方法】 对符合ICD-10和DSM-III筛查诊断标准31名NLD儿童、24名言语型学习障碍(verbal learning disabilities, VLD)儿童和40名正常儿童,采用镶嵌图形测验(EFT)和棒框测验(RFT)测量认知方式,Achenbach儿童行为量表测量行为问题。数据采用单因素方差分析和多重比较分析。 【结果】 NLD儿童的EFT的不同难度的三部分成绩和总成绩都比正常对照组儿童得分低(P<0.01),而VLD儿童仅总成绩低于正常对照组(P<0.05)。NLD儿童RFT的偏差明显大于正常对照组和VLD儿童(P<0.05),但VLD儿童与正常对照组的差异无统计学意义。NLD男童的社交能力和学校学习情况得分显著低于对照组,VLD男童亦表现出同样的问题;NLD男童各因子的得分明显高于对照组男童,在分裂样、抑郁、强迫性、体诉、社交退缩、多动、攻击性方面也比VLD男童得分高。 【结论】 NLD儿童认知方式以场依存性为主,其行为问题亦比正常儿童和VLD儿童突出。     

儿童感觉统合失调与学习和行为问题的相关研究

目的:调查学龄儿童感觉统合失调现状,探讨感觉统合失调与儿童行为问题和学习不良的关系。方法:整群抽取太原市某小学427名学生,进行感觉统合能力、行为问题及学习成绩的调查。结果:学龄儿童感觉统合失调率为40.75%,以前庭失衡和学习能力发展不足的发生率较高,感觉统合失调有性别差异,不同年龄组间的差异不显著。行为问题儿童的感觉统合失调明显高于无行为问题儿童。感觉统合能力与行为问题呈显著负相关。学习成绩差的儿童感觉统合失调率明显高于中等水平以上儿童。结论:感觉统合失调与儿童行为问题和学习困难密切相关,早期干预对促进儿童感觉统合能力发展、减少心理行为问题的发生有重要意义。     

哌醋甲酯对非言语型学习障碍儿童注意功能的影响

目的 探讨哌醋甲酯（MPH）对学习(LD)和童选择注意功能的作用及其机理。方法 采用ERP技术附加语义、方向及音调辨别等连续执行课题（CPT），对9－14岁12名男性非言语型LD儿童进行服用安慰剂和MPH后的两次测试，并就其准确率、反应时、误反应率、P300振幅和潜伏期等指标进行了比较分析。结果 被检儿童服用MPH后检测结果均较安慰剂结果有显著改善，表现为靶标认知率提高，误答率降低，反应时缩短。服用MPH后P300成分振幅增加，潜伏时缩短；尤其是反映选择注意的负波（认知处理性负波）增多。另外，被检儿童个体间ERP结果差异较显著。结论 LD儿童存在选择注意缺陷，提示与其额叶－基低神经节环路功能障碍有关；MPH不仅改善LD儿童多动症状，亦能够改善其选择注意功能。     

安宁市学习困难儿童述情障碍和行为特征分析

目的探讨学习困难儿童的述情障碍和行为特征,为改善和矫治儿童学习困难提供依据。方法采用对照研究,对安宁市某小学三~六年级儿童进行整群抽样筛查,筛出学习困难儿童158名作为研究组,随机选取非学习困难儿童158名为对照组。采用少儿述情障碍问卷和Conner’s父母问卷对2组儿童进行测评。结果研究组儿童述情障碍的情感辨别障碍、情感描述障碍、外向性思维因子得分高于对照组(P值均<0.05);Conner’s父母症状问卷中,研究组儿童行为问题、学习问题、心身问题、冲动-多动、焦虑、多动指数因子得分均高于对照组(P值均<0.05)。结论学习障碍儿童存在述情障碍,且存在较多的行为问题。     

学习困难儿童智力、行为问题和感觉统合失调分析

目的研究学习困难儿童与对照组儿童的智力、行为问题和感觉统合失调功能的差异，为心理咨询和制订干预措施提供依据。方法用瑞文标准推理测验、Rutter儿童行为问卷和感觉统合评定量表对合肥市某小学学习困难和学习正常儿童各55名进行测评，比较2组儿童智力、行为问题和感觉统合功能的差异。结果学习困难组儿童知觉辨别能力、类同比较能力、比较推理能力、系列关系能力、抽象推理能力得分及智商均低于对照组儿童，而行为问题检出率高于对照组儿童；学习困难组儿童前庭失衡、触觉过分防御、本体感失调、学习能力发展不足等感觉统合失调检出率均高于对照组儿童，差异有统计学意义。结论学习困难儿童推理能力低于正常儿童，而行为问题、感觉统合失调检出率均高于正常儿童。     

学习障碍儿童自我意识及行为问题的比较研究

目的研究学习障碍儿童的自我意识及行为问题状况,为有针对性地提出干预措施提供参考.方法对武汉市某小学一～六年级的儿童560名采用学习障碍筛查表和瑞文智力测验,并根据主要课程学习成绩筛出学习障碍儿童35名.选取与学习障碍儿童同年龄、同性别、同班级的学习成绩中等、优秀儿童各35名为对照组,对儿童进行自我意识、行为问题方面的调查.结果方差分析显示,LD组儿童自我意识量表中6个因子分及总分显著低于一般组和优秀组儿童,LD组儿童在品行问题、学习问题、多动指数方面得分显著高于一般组与优秀组.结论学习障碍儿童较正常儿童表现为自我意识不良,且存在较多的行为问题.     

723例学业不良儿童智力状况分析

目的 为探讨儿童智力状况与学业不良的关系.方法 对723例学业不良儿童进行韦克斯勒智力测试.结果 智力异常者为18.67%.智力正常儿童中,有45.41%的儿童智力结构不平衡,其中86.14%的儿童为语言智商明显低于操作智商.十项分测验的x~2检验分析也显示:智力结构不平衡组与智力结构平衡组之间存在显著差异.结论 智力结构与学业成绩密切相关.     

Hydrocephalic, Dyseidetic Dyslexic, and Low Average Regular Class Children: Intellectual, Visual-Perceptual, and Spatial Reasoning Performance

Hydrocephalic children typically show lower nonverbal than verbal intellectual abilities visual deficits, and muscle incoordination One subgroup of learning disabled children, dyserdetic dyslexics, have the same relative nonverbal weakness, but not the other associated deficits The present investigation compared hydrocephalic (H, n = 8), dyseidetic dyslexic (D, n = 8), and IQ-matched regular class children (C, n = 8) on intellectual, visual-perceptual, and spatial reasoning tasks Univariate analyses indicated that, compared to both other groups, H had significantly lower WISC-R Performance IQ scores, F(2, 21) = 6 14, p < 01, McCarthy Motor Scale scores, F(2, 21) = 7 03, p < 01 and a significantly greater WISC-R VerbalPerformance discrepancy, F(2, 21) = 4 79, p < 05 Hydrocephalic children had deficits large enough to be apparent even when compared to dyseidetic children known to have similar relative nonverbal weaknesses These deficits were present despite early surgical correction and present remission of the hydrocephalus.     

Association of serum concentrations of persistent organic pollutants with the prevalence of learning disability and attention deficit disorder

OBJECTIVE: Even though persistent organic pollutants (POPs) are well-known neurotoxicants, there is no previous study, even cross-sectional, on the association between background exposure to POPs and clinically significant developmental disorders, such as learning disability (LD) or attention deficit disorder (ADD), among children from a general population. DESIGN: Cross-sectional study. SETTING: Study subjects were 278 children aged 12-15 years included in the National Health and Nutrition Examination Survey 1999-2000. The seven most commonly detected POPs (each detectable in >/=20% of children: 3,3',4,4',5-pentachlorobiphenyl; 1,2,3,4,6,7,8-heptachlorodibenzo-p-dioxin (HPCDD); 1,2,3,4,6,7,8,9-octachlorodibenzo-p-dioxin (OCDD); 1,2,3,4,6,7,8-heptachlorodibenzofuran (HPCDF); beta-hexachlorocyclohexane; p,p'-dichlorodiphenyltrichloroethane; and trans-nonachlor) were selected. MAIN RESULTS: Compared with children with non-detectable levels of POPs, adjusted prevalence ORs (95% CIs) of LD among those with detectable levels of HPCDD, OCDD or HPCDF were 2.08 ( 1.17 to 3.68), 2.72 (1.24 to 5.99) and 2.18 (1.15 to 4.15), respectively. For ADD, the corresponding figures were 3.41 (1.08 to 10.8), 3.33 (0.94 to 11.8) and 2.31 (0.62 to 8.63), respectively. CONCLUSIONS: Associations were observed between serum concentrations of POPs belonging to the categories of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans and the prevalence of two clinically significant development problems, LD and ADD. The nature of these associations needs to be clarified by prospective studies.     

综合干预治疗学习困难儿童的疗效评价

目的探讨综合干预措施治疗学习困难（1earning disability，LD）儿童的疗效。方法将2002年12月至2007年12月在福建省清流县医院按学习困难诊断标准确诊的儿童208例，采用随机数字表法分为治疗组[n=116，综合干预治疗（利他林＋多因素干预治疗）]和对照组[n=92，单一药物治疗（利他林）]（分组遵循程序符合福建省清流县医院人体试验委员会所制定的伦理学标准，且分组征得患儿家属知情同意）。两组分别在治疗后第3、第6个月采用《Conners父母量表》进行评定及对学习成绩进行比较。治疗有效率的判断标准采用Conners多动指数标准及相关临床症状、社会功能适应能力、学习成绩等改善情况进行评价。结果治疗组治疗后第3、第6个月有效率分别为86．2％（100／116）和96．5％（112／116），而对照组有效率为73．9％（68／92）和79．3％（73／92），两组治疗后第3、第6个月疗效比较，差异有显著意义（P〈0．05）。结论综合干预治疗法比单一药物治疗法能更有效地改善学习困难儿童的学习困难症状。     

Ethinyl estradiol-to-desogestrel ratio impacts endothelial function in young women

BackgroundEthinyl estradiol (EE) and progestins have the ability to alter endothelial function. The type of progestin and the ratio of EE to progestin used in oral contraceptive pills (OCPs) may determine how they affect the arterial vasculature.Study DesignIn this study, we investigated endothelial function across a cycle in very low dose (VLD) and low dose (LD) combination EE and desogestrel (DSG) OCP users during two phases: active (VLD=20 mcg EE/150 mcg DSG; LD=30 mcg EE/150 mcg DSG) and pill-free. Endothelial function was also measured during an EE-only hormone phase (10 mcg EE) in group VLD.ResultsEndothelium-dependent vasodilation was greater during the active phase compared to the pill-free phase in group LD (9.02±0.72% vs. 7.33±0.84%; p=.029). This phase difference was not observed in group VLD (5.86±0.63% vs. 6.56±0.70%; p=.108). However, endothelium-dependent vasodilation was higher during the EE-only phase, compared to the active and pill-free phases (8.92±0.47% vs. 5.86±0.63%, and 6.56±0.70%; p<.001) in group VLD.ConclusionsThese data suggest DSG may antagonize the vasodilatory activity of EE and that this effect is further modulated by the EE-to-DSG ratio.     

父母培训法对学习障碍儿童的干预效果评价

目的了解父母培训八步法对学习障碍儿童的干预效果,为儿童学习障碍的干预提供参考依据。方法采用自身对照研究设计,对安宁市某小学三至六年级的儿童进行整群抽样筛查,筛出学习障碍儿童158名作为研究对象。以父母培训八步法为指导,对家长进行每周1次为期16周的父母培训。于培训前和培训结束后使用心理健康测验量表和儿童少年生活质量量表对儿童进行测评,采用亲子关系诊断量表对儿童及其家长进行测评;干预后采用多重成就测验对儿童进行测评。结果干预后儿童心理健康测验量表中的学习焦虑、孤独倾向、自责倾向、过敏倾向因子分和总分低于干预前,少年生活质量量表中的亲子关系、同伴关系、师生关系、学习能力与态度、活动机会性因子分和总分高于干预前;干预后亲子关系诊断量表中,家长报告亲子关系严格型、不安型明显减少,孩子报告亲子关系在消极拒绝、积极拒绝、严格型明显减少。干预后儿童多重成就测验成绩明显提高。结论父母培训八步法能改善学习障碍儿童的心理健康状况、提高生活质量、改善亲子关系,并且能提高学习障碍儿童的学习成绩和学习能力。     

学龄儿童气质特性与学习不良的相关研究

本文应用《学龄儿童气质量表》对285名8～12岁儿童进行测查,对学习不良儿童和正常儿童的气质特性进行了比较研究。结果表明:学习不良组儿童与正常儿童的气质类型有显著性差异,学习不良组儿童以困难型(D型)和近困难型(I—D型)为多.学习不良组儿童在生物活动的节律性、适应能力、注意的持久性、注意广度等气质特性得分与正常组有显著性差异。本文提示:对学习不良儿童进行临床咨询和制定干预措施时,应注意到儿童气质特性对学业成绩的影响     

儿童学习困难危险因素的Logistic分析

目的:探讨儿童学习困难发生的危险因素。方法:以门诊诊断为学习困难的15岁儿童213例为研究组,根据1∶1的比例以同期在其它门诊诊治的同年龄、同性别的非学习困难病例213例作为对照组,对学习困难的危险因素进行条件Logis-tic回归分析。结果:学习困难儿童行为问题发生率与对照组比较在冲动多动、品行问题、学习问题、多动指数方面差异具有显著性意义(P<0·05);多元逐步回归分析发现,父母经常说孩子的缺点、对孩子要求不一致、不太关心孩子的学习、不太注意孩子的想法、孩子感到考试紧张、厌学情绪是导致儿童学习困难发生的危险因素,而母亲文化程度较高、父母期望值较高、家庭和睦温暖、与老师的关系较好、与同学的关系较好则是抑制学习困难发生的因素。结论:儿童学习困难是多种因素综合作用所致。     

青春发动时相提前与心理行为问题关联性的性别差异

目的 探讨青少年青春发动时相提前与心理行为问题的关联及性别差异。方法 2014年11月采用整群抽样方法,对北京市和沈阳市各2所小学在校2～3年级女生、3～4年级男生和各2所中学在校7～8年级男女生进行问卷调查,问卷内容包括一般情况、体力活动、户外活动时间、视频时间、青春发育量表(PDS)和长处与困难问卷(SDQ),对青春发动时相提前及心理行为问题检出率进行描述统计分析,运用单因素和多项logistic回归分析比较青春发动时相提前对心理行为问题的影响。结果 共纳入3 253名学生,其中518人青春发动时相提前;情绪因子、品行因子、多动/注意缺陷、同伴交往因子、亲社会行为和客观困难异常检出人数(率)分别为269 (8.3%)、297(9.1%)、 211(6.5%)、534(16.4%)、299(9.2%)和448(13.8%)。多项logistic回归分析显示,青春发动时相提前是女生品行异常(OR=2.260,95%CI:1.322～3.863)和多动/注意缺陷(OR=1.980,95%CI:1.111～3.527)的危险因素,青春发动时相提前是男生客观困难异常的危险因素(OR=1.449,95%CI:1.018～2.063)。结论 青春发动时相提前会增加女生品行异常和多动/注意缺陷的风险,青春发动时相提前的男生客观困难异常风险增加,青少年心理行为干预应考虑性别特点。     

安徽省3~6岁儿童行为问题及相关因素

  目的  调查分析安徽省3~6岁儿童行为问题状况及相关因素,为儿童行为问题早期干预提供依据。  方法  采用多阶段分层随机整群抽样方法,使用Conners父母用量表和一般情况调查表对9 541名,3~6岁幼儿园在园儿童的家长进行调查。采用χ2检验对3~6岁儿童行为问题检出率进行单因素分析,使用多因素非条件Logistic回归分析模型分析儿童行为问题的影响因素。  结果  3~6岁儿童行为问题检出率为14.3%,学习问题和心身问题是3~6岁儿童较突出的行为问题。多因素Logistic回归分析模型结果显示:男童、3~＜6岁、独生子女、近半年常与父母一方居住和睡眠不足是儿童行为问题发生的危险因素,近半年主要代养人为父母是其保护因素。  结论  安徽省3~6岁儿童行为问题较为多见。行为问题干预应从儿童早期进行,应重点关注男童、独生子女、隔代教养和留守儿童。     

Supporting the development of young children’s metacognition through the use of video-stimulated reflective dialogue

ABSTRACT

This paper reports on a study exploring metacognition in young children. Developing metacognitive skills helps children become responsible and ‘thoughtful about their learning’ [Chatzipanteli, A., Grammatikopoulos, V., & Gregoriadis, A. (2014). Development and evaluation of metacognition in early childhood education. Early Child Development and Care, 184(8), 1223] and can improve educational outcomes [Hattie, J. (2012). Visible learning for teachers: Maximising impact on learning. Abingdon: Routledge]. This paper explores how conducting video-stimulated reflective dialogues with young children about their thinking supported their metacognitive and cognitive development. Performance on a number of standardized tests was compared to that of a control group. Results indicated that the intervention group made more progress than the control group, became better at discussing their thinking and demonstrated an increase in metacognitive behaviours during classroom activities. The results suggest that VSRD with young children is valuable – as a participatory research tool, but also as a pedagogical strategy to support the development of metacognition and reflection.     

Comparison of the play of children with attention deficit hyperactivity disorder by subtypes

Background: Studies have found differences in the nature and severity of social problems experienced by children with different subtypes of attention deficit hyperactivity disorder (ADHD). Given that play is often the context for acquiring social skills, there is surprisingly limited research examining whether these differences distinguish the play of children within the groups. Methods: Using the Test of Playfulness (ToP), we examined the similarities and differences in play between children (aged 5–11 years) diagnosed with the three DSM‐IV ADHD subtypes: inattentive (I‐subtype;n = 46), hyperactive‐impulsive (HI‐subtype;n = 28) and combined subtypes (C‐subtype;n = 31). Results and conclusions: Bias interaction, an item‐by‐item analysis, revealed that the hierarchy of ToP items was similar for children with the HI‐ and C‐subtypes, but differed for children with the I‐subtype. Specifically, children with the I‐subtype found it more difficult to become intensely engaged in play and to take on playful mischief and clowning; however, they found social play items to be easier. Conversely, whereas mischief and clowning were relatively easier for children with the HI‐ and C‐subtypes, many items reflecting social interaction were more difficult. These findings suggest that interventions can be tailored to these differing presentations. However, further research is needed to confirm the findings.