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目的:探讨学龄前注意缺陷多动障碍(ADHD)儿童的视觉-运动整合能力特点,为实施有针对性的早期干预方案提供依据。方法:采用1∶1病例对照的设计,选取符合美国精神障碍诊断与统计手册第4版(DSM-IV)ADHD诊断标准的4~6岁儿童(混合型37例、注意缺陷为主型28例、多动/冲动为主型14例)及正常对照各79例。采用视觉-运动整合发育测验(VMI)来评定视觉-运动整合情况。结果:ADHD儿童VMI测验异常检出率高于对照组(32.9%vs.7.6%,P<0.01);ADHD各亚型VMI测验异常检出率从高到低依次为混合型、注意缺陷为主型、多动/冲动为主型,各亚型组间差异均有统计学意义(45.9%vs.25.0%vs.14.3%,均P<0.05);ADHD儿童的VMI测验得分低于正常对照组[(90.2±19.4)vs.(100.5±10.7),P<0.05],混合型ADHD儿童的VM I测验得分低于注意缺陷为主型和多动/冲动为主型[(84.5±23.1)vs.(93.7±15.2),(97.9±11.5);均P<0.05]。结论:学龄前ADHD儿童可能存在视觉-运动整合能力方面的缺陷,对学龄前ADHD儿童视觉-运动整合能力的评估有助于早期识别和早期预防学习和行为问题。
Objective: To investigate the visual-motor integration of children with preschool-acquired attention-deficit hyperactivity disorder (ADHD) and to provide evidence for the implementation of targeted early intervention programs. Methods: A one-to-one case-control study was conducted. Forty-six-year-old children (37 in combination and 28 mainly in attention deficit) who met ADHD diagnostic criteria of DSM-IV (DSM-IV) , Hyperactivity / impulse-based 14 cases) and normal control 79 cases. Vision-motor integration development test (VMI) was used to assess visual-motor integration. Results: The detection rate of abnormal VMI test in ADHD children was higher than that in control group (32.9% vs.7.6%, P <0.01). The detection rate of VMI abnormalities in ADHD children was mixed type from high to low, with attention deficit (45.9% vs.25.0% vs.14.3%, all P <0.05). The scores of VMI test in ADHD children were lower than those in normal control group (90.2 ± 19.4 vs. 100.5 ± 10.7, P <0.05). The VM I test score of mixed ADHD children was lower than that of attention deficit predominant and hyperactive / impulsive [84.5 ± 23.1 vs (93.7 ± 15.2), (97.9 ± 11.5), all P <0.05]. CONCLUSIONS: Preschool-age children with ADHD may have deficits in vision-motor integration and assessment of visual-motor integration in preschool-aged children with ADHD is helpful for early identification and early prevention of learning and behavior problems.