儿童少年学习障碍认知特征分析

目的：了解儿童少年学习障碍的认知特征及非智力影响因素。方法：采用修订版儿童学习障碍筛查量表(PRS)对深圳市城区小学及初中学生进行了测评分析。结果：学习障碍筛出率12．20％，其中男17．00％，女7．30％，比例2．3：1，性别差异显著；PRS分析发现学习障碍主要表现在听理解及社会行为两大能区；非智力因素对学习障碍的发生影响重大。结论：学习障碍的预防和矫治要制定个性化措施。     

学习障碍儿童视-听认知训练效果分析

【目的】探讨自行研制的视、听认知训练方法对学习障碍儿童的治疗效果，为临床有效治疗学习障碍提供依据。【方法】对26例学习障碍儿童采用系统化的视、听认知训练软件进行训练，并辅以心理指导干预，治疗前后分别用训练软件评估系统和Conners’量表父母症状问卷（Parents Symptom Questionnaire，PSQ）进行评估，并进行比较分析。【结果】接受治疗的学习障碍儿童在治疗后的认知训练测验正确率有明显提高（P〈0．01），Conners，量表PSQ各因子分明显降低（P〈0．01或〈0．05）。【结论】视、听认知训练软件方法结合心理辅导能有效提高学习障碍儿童的某些认知功能。     

不同亚型学习障碍儿童的认知行为特征

[目的]探讨不同亚型学习障碍儿童的认知行为特征,为临床有效干预提供参考.[方法]根据美国精神障碍诊断与统计手册第4版诊断和分类标准,将180例学习障碍儿童分为阅读障碍、数学障碍和混合学习障碍三个亚型.采用韦氏儿童智力量表、韦氏记忆量表、数字划消测验和Conners儿童行为问卷父母版,对阅读障碍型、数学障碍型、混合学习障碍型和正常对照组儿童的认知行为特征进行对比分析.[结果]与正常对照组儿童比较,各亚型学习障碍儿童的全量表智商、记忆商和数字划消得分均显著降低(P＜0.01),Conners量表总分均显著增高(P＜0.01).学习障碍不同亚型之间比较,可见混合学习障碍型儿童的全量表智商[(80.65±6.62)]、记忆商[(82.11±6.72)]和数字划消得分[(83.55±12.02)分]均最低(P＜0.01),Conners量表总分[(39.22±11.53)]最高(P＜0.01).[结论]不同亚型学习障碍儿童均存在认知行为功能损害,混合学习障碍儿童的认知行为受损最严重.     

学习障碍儿童的视觉认知特征研究

目的 对学习障碍儿童的视觉认知进行研究分析,为临床有效地干预提供依据。方法 对于两组儿童(学习障碍组42例和对照组37例)进行儿童韦氏智力测试、视觉分辨能力测试,视觉-运动整合能力测试以及视觉诱发电位测试,分析二组儿童的视觉认知特征。结果 与正常组儿童相比,学习障碍组儿童的言语智商(VIQ)、操作智商(PIQ)和总智商(FIQ)三项智能分均值都远低于LD组,差异有统计学意义(P值均<0.01)。进一步比较了视觉相关因子,尤其在译码分项目上,LD儿童较正常儿童薄弱,两者的差距达到了37%。 LD组和正常对照组儿童视觉运动整合(VMI)的分值分别为:93±16和115±16,差异有统计学意义(P<0.001)。LD组儿童的视觉分辨失误率平均秩次为62.76,显著大于对照组31.18(P<0.001)。在5个不同的空间频率刺激下,LD组儿童的棋盘格翻转视觉诱发电位(PRVEP)的P100波的潜伏期均较正常对照组延长,差异有统计学意义(P值均<0.05)。 结论 学习障碍儿童虽具备正常的认知能力,但在视觉认知能力方面仍较正常儿童薄弱。应对这类儿童进行多方位的视觉认知能力的评估,实施具有针对性的个性化干预措施。     

认知训练和心理治疗综合干预儿童学习障碍的效果分析

目的:探讨视、听认知训练和心理治疗综合干预儿童学习障碍的效果。方法:对26例学习障碍儿童采用系统化的视、听认知训练方案和心理治疗、药物治疗进行综合干预,治疗前后分别运用学习障碍儿童视、听认知训练软件、Conners量表父母症状问卷(PSQ)评估,进行治疗前后比较。结果:接受治疗的学习障碍儿童在治疗后的认知训练测验正确率有明显提高(P<0.01),Conners量表PSQ各因子分明显降低。结论:视、听认知训练和心理治疗综合干预能有效地治疗儿童学习困难。     

儿童认知能力与学习障碍的关联性研究

目的 分析二~五年级小学生认知加工缺陷与不同类型学习障碍的关联性,为其针对性干预措施的建立提供参考依据。方法 2019年12月通过分层整群随机抽样抽取广州市二~五年级1 905名小学生,采用学习障碍筛查量表(PRS)筛查学习障碍儿童,采用儿童汉语阅读障碍筛查量表(DCCC)了解其认知特征,采用χ²检验、t检验及Logistic回归进行数据统计分析。 结果 存在书面表达障碍(OR=2.70, 95%CI:1.01~7.18)、注意力障碍(OR=4.44, 95%CI:1.50~13.10)和视知觉障碍(OR=2.93, 95%CI:1.35~6.35)的儿童发生学习障碍的风险更高(P<0.05)。注意力障碍儿童发生言语型学习障碍的风险更高 (OR=9.02, 95%CI:1.82~44.84),视知觉障碍儿童发生非言语型学习障碍的风险更高 (OR=4.01, 95%CI:1.59~10.10),注意力障碍(OR=6.06, 95%CI:1.88~19.49)和视知觉障碍(OR=4.61, 95%CI:1.76~12.04)同时存在的儿童发生混合型学习障碍的风险更高。 结论 多维度的认知障碍与学习障碍的发生相关,其中注意力障碍儿童更易存在言语型学习障碍,视知觉障碍更易存在非言语型学习障碍,混合型学习障碍则同时与注意力障碍和视知觉障碍显著相关。     

共患和不共患注意缺陷多动障碍的学习障碍儿童家庭环境及认知特征比较

目的探讨共患和不共患注意缺陷多动障碍(ADHD)的学习障碍儿童家庭环境和认知的差异。方法选取2015年2月-2018年2月该院儿童保健科收治的学习障碍儿童165例,选用韦氏学龄期儿童智力量表和家庭环境量表中文版对165例学习障碍儿童及其家长进行评估。结果 165例中共患ADHD 85例,年龄(8. 0±1. 2)岁,其中男70例,女15例;不共患ADHD 80例,年龄(8. 4±1. 9)岁,其中男62例,女18例。共患ADHD组儿童家庭环境量表的控制性和组织性因子分低于不共患ADHD组,差异有统计学意义(P0. 05)。共患ADHD组的总IQ、言语IQ高于不共患ADHD组,其中在词汇、理解两个言语项目和填图一个操作项目中,共患ADHD组表现较好,差异有统计学意义(P0. 05)。结论相对于不共患ADHD的学习障碍儿童来说,共患ADHD的学习障碍儿童家庭的组织性和控制性较差;共患ADHD的学习障碍患儿的总IQ、言语IQ要稍高于不共患ADHD的学习障碍儿童,其中在词汇、理解和填图这三个项目中表现更好。     

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。     

注意儿童缺陷多动障碍儿童认知功能研究进展

儿童注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)是最常见的儿童期精神障碍之一,认知缺陷是其核心缺陷。ADHD儿童在觉醒和持续注意、动机抑制、执行功能、学习和记忆等许多任务中都显示出平均以下或相当差的操作表现。有关ADHD儿童认知功能的研究有很多,涉及认知理论、神经影像学、神经电生理及神经心理测查等多方面领域。本文拟就ADHD认知功能做一简要回顾。     

学习困难儿童病例对照研究

【目的】了解家庭环境，出生情况和心理行为问题对学习困难（learning disability，LD）儿童的影响，为其综合防治提供依据。【方法】用中国比内测验智力诊断量表（第三次修订本）自编家庭情况问卷为工具，对200例LD儿童家庭情况、出生时情况、幼儿教育进行调查及对他们的智能心理进行测量。【结果】家庭环境对学习困难儿童有一定影响。LD儿童智力心理素质低于正常儿童。【结论】对学习困难儿童应综合调处，改善家庭环境从孕期抓起，防治心理卫生问题。     

认知行为干预在学习障碍儿童自我意识重塑中的作用

【目的】探讨认知行为干预在学习障碍儿童自我意识重塑中的作用。【方法】对30例学习障碍儿童进行系统的认知行为干预12个月,干预前后,采用韦氏记忆量表、韦氏儿童智力量表、数字划消测验、Conners儿童行为问卷和Piers-Harris儿童自我意识量表进行测评,以对比分析干预前后患儿的认知行为特征和自我意识水平。【结果】干预后,患儿的记忆商、智商、数字划消得分和自我意识水平均显著提高,Conners儿童行为问卷得分显著降低,干预前后比较差异具有高度统计学意义(P0.01)。【结论】认知行为干预能显著改善学习障碍儿童的认知行为能力,重塑患儿的自我意识。     

数学学习障碍儿童视空间工作记忆与数学能力各因素之间关系的研究

【目的】 探讨数学学习障碍儿童视空间工作记忆特征以及视空间工作记忆与数学能力各因素的关系。 【方法】 采用《中国小学生数学能力测试量表》对某小学3~6年级703名学生进行数学能力的测试,结合上一学期期末数学成绩及《联合型瑞文智力测试》结果筛选出48名数学学习障碍儿童及与其同班学生48名正常对照,随后对数学学习障碍组和对照组进行视空间工作记忆测试。 【结果】 数学能力各因子及视空间工作记忆两组比较差异均有统计学意义(P＜0.05)。数学运算和空间-视觉能力均与视空间工作记忆成呈相关(r=0.333,P=0.001;r=0.228,P=0.026)。数学学习障碍儿童的视空间工作记忆与图形计数(P=0.036)、方块计数(P=0.016)相关。正常儿童的视空间工作记忆与乘法(P=0.043)相关。 【结论】 数学学习障碍儿童各方面数学能力均低下,视空间工作记忆存在缺陷;视空间工作记忆与数学能力之间的关系在两组儿童中表现不同,可能与两组儿童在数学解决任务中所用策略不同有关。     

Supporting people with learning difficulties in self-advocacy groups and models of disability

This paper addresses the support offered by 'advisors' to people with learning difficulties in self-advocacy groups. Previous literature has failed to account for the multifaceted nature of self-advocacy support. This failure has resulted in simplistic and unfair attacks on professional (staff) supporters; a lack of conceptualizations of 'support' which are grounded in the empowering discourse of the social model of disability; and ignored the self-determination of self-advocates with learning difficulties themselves. I will present vignettes of support ('interventions') offered by advisors that I observed, which were empowering and disempowering, drawing on an ethnographic study of four self-advocacy groups. These interventions can be best understood as either reflecting a social model or an individual model of disability. Three pairs of intervention are presented reflecting the social-individual dichotomy. With reference to disability theory it is argued that those acts which reflect a social model offer a more authentic means of promoting the self-advocacy skills of people with learning difficulties. Finally, the intra-support networks of self-advocates are exemplified, suggesting that any support offered by professionals or advisors needs to be sensitive to the interventions of people with learning difficulties themselves. This paper concludes by offering practical pointers to policy-makers, service providers and others working with people with learning difficulties.     

A cost function analysis of residential services for adults with a learning disability

Successive UK governments have pursued a policy of community care for people with learning disabilities which, in the past ten years, has led to a marked change in the nature of residential provision. Research evidence on the costs and quality of alternative forms of community provision is inconclusive and contradictory. It is therefore timely to consider whether or not community residential facilities have delivered the expected quality of service at appropriate cost. The paper presents the results of a cost function analysis of a random stratified sample of staffed community facilities in England excluding London. Both costs and quality of care were found to vary greatly amongst community residential facilities. The most important factors explaining differences in cost were case-mix factors relating to client age, dependency and length of stay. Facility characteristics such as the type of building, the internal layout and the structural quality were not significant. Quality of service measures such as the extent to which care-regimes were client orientated and made use of local community services were positively and significantly associated with costs. Type of provider had no impact on costs independent of differences in case-mix and quality of care with the exception of the private for profit sector which appeared less expensive than other agencies. The shortcomings of the methods and implications of these findings for policy makers are discussed.     

Assessment of body mass index for the residents of a long-stay institution for people with learning disability

Background: Body mass index (BMI) was used to assess the population of Royal Earlswood, a long-stay institution for people with learning disability. Method: Height and weight measurements were taken for each resident. Where available, previous weight records were used to compare the study BMI measurement with that 3 years previously – the time at which the Dietetic Service was first set up. Results: This study indicated that 56.4% of the residents in Royal Earlswood had a BMI that was outside of the ideal range. The Dietetic Service knew of 60% of these residents, and the weight status of over three-quarters of those receiving dietary advice had already been improved. The remaining 40% had not previously been identified as having an unhealthy weight. Conclusions: This paper supports previous research in demonstrating that people with learning disability are more likely than the general population to have a body weight that is outside the healthy range. In this study dietetic input is generally shown to have influenced BMI beneficially.     

学习障碍儿童的视觉诱发电位研究

【目的】 探索学习障碍儿童在5个不同的空间频率刺激下模式翻转视觉诱发电位(pattern reversal visual evoked potential,PRVEP)的特点。 【方法】 采用ICD-10学习障碍诊断标准入组学习障碍组42人;正常对照组来源于普通小学共37人。对所有对象进行儿童韦氏智力量表以及5个不同空间频率刺激下的视觉诱发电位测试。 【结果】 1)在5个不同的空间频率由低空间频率到高空间频率两组儿童均有出波,随着空间频率的增大,两组儿童的P100波的潜伏期均逐渐延长,波幅均逐渐减小。2)5个不同的空间频率刺激下的P100波的潜伏期学习障碍组均较对照组延长,差异有统计学意义(P<0.05);在视角为27'、13'、7'这三个中高空间频率刺激下的P100波的振幅,学习障碍组较对照组显著减小(P<0.05)。 【结论】 学习障碍儿童P100波潜伏期延长,波幅减小,表明其视网膜神经节细胞至视觉中枢的信息处理存在着异常,视觉认知能力异常。     

Continuity,commitment and context: adult siblings of people with autism plus learning disability

Sibling relationships are usually lifelong and reciprocal. They can assume particular significance when a brother or sister has a learning disability. Until recently, adult siblings of people with disabilities such as severe autism have been ignored by policy, practice and research. This qualitative study contributes to an emerging literature by exploring how adult siblings, who have a brother or sister with autism (plus learning disability) and living in England, give meaning to their family (and caring) relationships and engage with service delivery. We spoke to 21 adult siblings using semi‐structured interviews and met with 12 of their siblings with autism. Our analysis, using a broad narrative approach, demonstrates the continuity of the sibling relationship and an enduring personalised commitment. The nature of this relationship, however, is sensitive to context. How non‐disabled adult siblings relate to their childhood experience is fundamental when making sense of this, as is their need to fulfil other social and family obligations, alongside their ‘sense of duty’ to support their disabled brother or sister. Sibling experience was further mediated by negotiating their ‘perceived invisibility’ in social care policy and practice. Our work concludes that by understanding the way relationships between siblings have developed over time, adult siblings’ contribution to the lives of their brother or sister with autism can be better supported for the benefit of both parties. Such an approach would support current policy developments.