儿童学习障碍原因及早期表现

目的：儿童学习障碍是基本学习技能获得障碍，常常表现为学习困难和情绪行为异常，未经及时干预矫治者，易出现品行障碍、抑郁，甚至人格障碍、反社会行为：为此，回顾了儿童学习障碍原因及早期表现，阐明引起儿童学习障碍的常见原因．主要表现，进而寻求有效的方法进行早期诊断、早期干预：资料来源：应用计算机检索PubMed数据库1985—01／2003—12期间的相关文章，检索词“Learning disabilities，Children，Survey documents”，限定文章语言种类为英文，同时计算机检索中国期刊全文数据库、万方数据库1990—01／2003—12期间的相关文章，检索词“学习障碍，儿童，综述文献”，限定文章种类为中文。资料选择：对资料进行初审．纳入标准：包括儿童学习障碍原因．学习障碍早期表现的随机对照实验以及关于学习障碍儿童的预后及矫治方法的文献。资料提炼：共收集到25篇关于儿童学习障碍原因及早期表现的文献．其中16篇符合标准，其余9篇系重复实验。资料综合：16篇包括3132例学习障碍儿童均符合诊断标准。其中10篇文章调查了2081例儿童学习障碍，发现其原因有遗传因素、脑功能失调、脑结构异常、脑损伤、外部环境影响；6篇文章分析1051例学习障碍儿童的主要表现为阅读障碍、拼写和描写障碍、计算技能障碍、情绪和行为问题，提出学习障碍儿童的预后及矫治方法。结论：儿童学习障碍迄今为止原因不明确，可能是内因和外因多种因素共同作用的结果，具体分为阅读障碍、拼写和书写障碍、计算技能障碍、情绪和行为问题，矫治关键在于早期诊断、早期治疗。     

儿童焦虑障碍的特点及评估

对近十年来国内外儿童青少年期焦虑障碍方面的研究发展情况进行了综述。主要包括儿童焦虑障碍各型(分离性、过渡性/广泛性、恐怖性、社交性焦虑障碍)的流行病学情况、不同年龄阶段儿童焦虑障碍的临床表现特点和美国精神障碍分类与诊断标准第4版(DSM-IV)与DSM-Ⅲ-R对儿童焦虑障碍的诊断的变化情况加以对照阐述,以及国外对儿童焦虑障碍心理量表评估的研究进展状况作了详细阐述,为临床诊断提供参考方法。     

学习障碍儿童的认知及行为特征

目的：研究学习障碍儿童的认知功能和行为特点，为实施合适的矫治手段提供依据。方法：学习障碍儿童采自2003-08／2004-08在白求恩国际和平医院儿童保健门诊就诊的患儿(72例)，正常儿童来自石家庄市某小学。用韦氏儿童智力量表(中国修订本)和Rutter’s儿童行为量表父母问卷对其进行研究，并与72例正常儿童比较。结果：学习障碍儿童言语智商、操作智商和全量表智商[分别为(93．8&;#177;14．6)，(92．6&;#177;13．7)，(92．9&;#177;15．9)分]均低于正常儿童[分别为(108．4&;#177;18．3)，(106．3&;#177;15．4)，(107．6&;#177;17．4)分](t值分别为11．2，10．9，11．1，P&;lt;0．01)，且学习障碍儿童Rutter’s行为量表父母问卷评分异常率[40例(56％)]明显高于正常儿童[13例(17％)](x^2=21．76，P&;lt;0．01)。结论：学习障碍儿童存在认知功能障碍和较多的行为问题。     

学习障碍儿童早期发育史分析

学习障碍（1earning disorder,LD）指智力基本正常的学龄儿童,由于基本的心理过程障碍,导致听说读写和数学推理能力低下而引起学习困难的一类综合征。息儿常因学习受挫而出现各种情绪和行为问题,社会适应能力低下,生活质量下降。本病自然病程大多持续终生,目前尚无切实有效的治疗措施,成为困扰儿童、家长、教师的一大难题。多数儿童在上学后才被诊断,失去了早期干预机会。笔者通过对46例LD儿童早期发育史的回顾性分析,探寻此类儿童早期临床特征,为寻求该病的早期诊断、预防、治疗提供理论依据。     

学习障碍儿童的认知及行为特征

目的:研究学习障碍儿童的认知功能和行为特点,为实施合适的矫治手段提供依据。方法:学习障碍儿童采自2003-08/2004-08在白求恩国际和平医院儿童保健门诊就诊的患儿(72例),正常儿童来自石家庄市某小学。用韦氏儿童智力量表(中国修订本)和Rutter's儿童行为量表父母问卷对其进行研究,并与72例正常儿童比较。结果:学习障碍儿童言语智商、操作智商和全量表智商犤分别为(93.8±14.6),(92.6±13.7),(92.9±15.9)分犦均低于正常儿童犤分别为(108.4±18.3),(106.3±15.4),(107.6±17.4)分犦(t值分别为11.2,10.9,11.1,P<0.01),且学习障碍儿童Rutter’s行为量表父母问卷评分异常率犤40例(56%)犦明显高于正常儿童犤13例(17%)犦(χ2=21.76,P<0.01)。结论:学习障碍儿童存在认知功能障碍和较多的行为问题。     

40例学习障碍儿童家庭环境对照研究

目的　研究学习障碍儿童的家庭环境状况 ,探讨家庭环境因素在学习障碍治疗中的作用。方法　对 40例学习障碍儿童进行家庭环境量表评定 ,并与 40例正常儿童对照分析。结果　学习障碍儿童家庭亲密度、情感表达、成功性、文化性、娱乐性和组织性等因子分比正常对照组低 ,矛盾性因子分比正常对照组高 ,差异有显著性 (P <0 . 0 5 )。独立性、道德宗教观和控制性等因子分与正常对照组无差异 (P >0. 0 5 )。结论　学习障碍儿童家庭环境存在缺陷 ,需要家庭干预。     

150例学习障碍儿童病历分析

学习障碍(learning disability，LD)是世界各国普遍存在并引起广泛关注的儿童问题之一。随着我国经济的发展，家庭结构的改变，家长过高的期望，使学习障碍儿童的发生率呈上升趋势，为了提高儿童的学习能力，降低该病的发生率，本文对150例学习障碍儿童进行了分析，现报告如下。     

感觉统合训练在学习障碍儿童中的应用

目的：探讨学习障碍儿童在感觉统合训练后的临床效果。方法：采用标准的感觉统合训练方法,对58例儿童由专人进行训练,1－3疗程不等,时间1－3月,结果：通过训练,学习障碍儿童在运动协调、情绪稳定,注意力、完成作业及学习成绩等方面均有显著提高。     

学习障碍儿童数字与字符信息加工的特征

目的：分析学习障碍儿童数字与字符加工的特征．并与正常儿童作比较。 方法：于2005—06在湖南师范大学教育科学与技术实验室对33名学习障碍儿童和17名学习正常儿童进行数字与字符识别实验。33名学习障碍儿童中阅读障碍儿童17名。数学障碍儿童16名。实验分组为：阅读障碍组（n=17）、数学障碍组（n=16）、正常组（n=17）。实验采用北京师范大学编制的实验心理学实验软件系统中的程序和项目，实验材料分为数字和字符2种。实验过程中通过增加数字或字符的长度来增加难度，长度为1个、2个、4个数字或字符，呈现时间为0.5s，间隔时间为1s。实验方法为再认法，被试对测试项目（数字或字符）进行识别并按键回答。整个实验分为条件1（测试项目包含在学习项目中：肯定回答）和条件2（测试项目不包含在学习项目中：否定回答）2种情形，其结果分别以各组儿童对数字和字符的反应正确性和时间2个指标来衡量。分类进行统计分析。 结果：33名学习障碍儿童和17名学习正常儿童均进入结果分析。①在数字再认任务中：阅读障碍组和数学障碍组儿童随着实验难度的增加，其再认正确性明显不如正常组儿童（条件1：F=3．63，P（0．05；条件2：F=3．79，P〈0．05）；在字符再认任务中与正常组成绩差异不明显。②在反应时成绩表现中：随着实验难度的增加。阅读障碍组和数学障碍组儿童的反应时明显不如正常组儿童（条件1：F=3．93，P〈0．05；条件2：F=9．04。P〈0．05）；在字符识别任务中二者差异不显著。 结论：①学习障碍儿童在熟悉的数字判断任务上的表现明显不如正常组儿童，反映出其短时记忆容量不足和工作记忆加工缺陷。②在字符序列实验中的成绩差异不大。本组结果分析认为，可能是由于字符的相对不熟悉性，学习障碍儿童与正常儿童均采取了猜测方式进行识别与判断，说明改进实验手段是今后深入开展此项研究必须解决的问题。     

综合干预治疗儿童学习障碍的效应分析

目的:探讨儿童学习障碍综合干预的治疗效果。方法:对94例学习障碍儿童采用系统化的综合干预方案,3个月为1个周期。分别用学习障碍儿童特征评定表和感觉统合量表做干预前后的比较。结果:除理解能力外,干预后学习障碍儿童特征评定表其他各因子分较干预前有显著降低;视觉运动统合和感觉统合量表各因子分较治疗前升高(χ2=5.64,P<0.05;χ2=13.82,P<0.01)。结论:综合干预能有效地治疗儿童学习障碍。     

Managing sleep disturbances in children with learning disabilities

The view that children with special needs are more likely to experience sleep disturbances is well recognised. various physical and psychological factors associated with the child's condition, as well as the influence that the child's disability has on parents' attitude and management, combine to increase the likelihood of the child developing sleep disturbances. However, these factors should not act as a barrier to trying to find successful solutions.     

A model of independence for children with learning disabilities

This article outlines the work undertaken to find a suitable model for planning respite care for children with disabilities. The model 'This is Me' and the informal life events assessment tool 'Hello, This is Me!', which supports it, are described. The use of a person-centred care planning system is well documented in the care of adults with learning disabilities (Sanderson, 1997). This process should begin at the start of a person's life, as recommended by The Children Act 1989, and the documents 'Signposts for Success' (NHS Executive, 1998) and 'Don't Forget Us' (Mental Health Foundation, 1997). The article describes the development of a person-centred approach to respite care which is underpinned with a basic care premise.     

Specific learning disabilities in children: deficits and neuropsychological profile

The public is gradually becoming aware of specific learning disabilities (SLDs), which are very often the cause of academic difficulties. The aim of the study was to assess the SLDs in the clinic population at the Child and Adolescent Psychiatry Clinic at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh using the National Institute of Mental Health and Neurosciences SLD index and subsequently to assess the children's neuropsychological functions using a battery of tests. Thirty-five children in the age range of 7-14 years (both boys and girls) were recruited as the cohort, diagnosed clinically and assessed using the battery of tests for SLDs and neuropsychological tests consisting of the PGIMER memory scale for children, the Wisconsin card sorting test, the Bender visuo-motor gestalt test and Malin's intelligence scale for Indian children. The study revealed deficits in language and writing skills and impairments in specific areas of memory, executive functions and perceptuo-motor tasks. Identification of SLDs is useful in drawing up a treatment plan specific for a particular child.     

Basic life support and children with profound and multiple learning disabilities

Nurses and other carers of people with learning disabilities must be able to manage choking events and perform basic life support effectively. UK guidelines for assessment of airway obstruction and for resuscitation do not take account of the specific needs of people with profound multiple learning disability. For example, they fail to account for inhibited gag and coughing reflexes, limited body movements or chest deformity. There are no national guidelines to assist in clinical decisions and training for nurses and carers. Basic life support training for students of learning disability nursing at Birmingham City University is supplemented to address these issues. The authors ask whether such training should be provided for all nurses including those caring for children and young people. They also invite comment and discussion on questions related to chest compression and training in basic life support for a person in a seated position.     

Sexuality and learning disabilities

BACKGROUND: Sexuality and sexual health are issues that have been neglected in nursing practice and in the literature. This literature review discusses how the sexuality and sexual health of clients with learning disabilities are perceived and addressed in contemporary society. CONCLUSION: Sexuality and challenging behaviours, such as self-harm, can be linked and by denying or ignoring the sexual needs of clients there might be a case for professional negligence. The attitudes of staff and carers are important in understanding the sexual needs of clients and the shortfall in the education and training of nurses.