学习障碍儿童视学——运动的研究

目的：探讨不同类型学习障碍儿童的视觉－－运动缺陷。方法：选取言语型学习障碍（VLD）、非言语型学习障碍（NLD）儿童和正常儿童各20名,进行镜画仪实验和本德尔视觉－－运动格式塔测验（BGT）测试。结果：在镜画仪实验中,NLD儿童错误次数更多,在时限内完成任务的人数明显不如其他两组;在BGT测试中,BLD儿童在总分,旋转、继画和缺画,分离,角外线条突出和未完成角度方面得分明显高于正常儿童,VLD儿童在总分,继画和缺画两项指标上的得分明显高于正常儿童。结论：NLD儿童在罗为明显的视觉－－运动缺陷,而VLD儿童在BGT测试中表现的不足可能与其内部语言调控不良有关。     

非言语型学习障碍儿童右脑功能的研究

目的：探讨非言语型学习障碍（NLD）儿童的右脑功能状况。方法：选取正常儿童和言语型学习障碍（VLD）、NLD儿童各20名，进行速示下记忆实验和本顿视觉保持测验（VRT）测试。结果：在速示实验中，NLD儿童对规则图形和实物图形的再认成绩明显不如正常组：在VRT测试中，NLD儿童的正确分明显低于其他两组，且遗漏和变形错误分明显多于正常组。结论：与正常儿童相比，NLD儿童右脑功能相对薄弱。     

不同亚型学习障碍儿童的言语及视空间工作记忆

目的:探讨不同亚型学习障碍儿童的言语及视空间工作记忆特点。方法:对163对不同亚型学习障碍儿童和正常对照组儿童进行比较,采用数字排序和计数广度测验反映言语工作记忆,采用视觉空间、视觉图形和视觉面孔工作记忆反映视空间工作记忆。结果:①MD、RD及RD/MD儿童的各项言语工作记忆指标值均低于对照组;MD儿童的计数广度高于RD和RD/MD组。②不同亚型学习障碍儿童的视觉空间、视觉图形工作记忆指标值均低于对照组;在视觉面孔测试中,RD组和RD/MD组低于对照组。结论:学习障碍儿童普遍存在言语及视空间工作记忆缺陷,但不同亚型学习障碍儿童具体缺陷领域和缺陷程度略有差别。     

有行为问题儿童的视知觉发育评估

目的:通过对有行为问题儿童视觉效率和视觉信息处理能力的评估与分析,了解其视知觉发育情况,为实施有针对性的早期干预、提升学习能力提供依据。方法:通过Achenbach儿童行为量表(CBCL),以1个或1个以上因子分超过该因子第98百分位数为判断标准筛选出有行为问题的6~11岁儿童71例,按1∶2配对设计筛选同性别且年龄相差不超过3个月的无行为问题儿童142例。采用发育性眼动测试和快速命名测试分别评估儿童视觉效率和视觉信息处理能力。结果:行为问题组儿童发育性眼动测试的异常检出率高于正常对照组(纵向测试29.6%vs.5.6%;横向测试26.8%vs.7.0%,P0.01),行为问题组儿童快速命名测试中的异常检出率高于正常对照组(物体命名19.7%vs.10.6%;颜色命名15.5%vs.5.6%;数字命名28.2%vs.4.9%;汉字命名19.7%vs.9.2%;数字汉字命名21.1%vs.7.0%;数字汉字颜色命名33.8%vs.11.3%;均P0.05)。结论:行为问题儿童可能存在视知觉发育的缺陷,对行为问题儿童进行视知觉发育的评估有助于早期识别和早期干预。     

孤独症患者言语及非言语声音辨识和偏好特征

目的:探究孤独症患者对言语及非言语声音的辨识和偏好特征。方法:从南开大学医学院行为医学中心患者数据库中选取根据美国精神障碍诊断与统计手册第4版(DSM-IV)诊断标准确诊的孤独症患者10名(儿童和成年人各5例),选取与年龄匹配的正常对照10名。所有被试均接受由专业的语音软件Praat录制和生成的语音音高、纯音音高和韵律的实验测试,口头报告其对言语及非言语声音的辨识和偏好结果。结果:孤独症患者在语音音高、纯音音高和韵律的辨识上和正常对照组差异无统计学意义(均P>0.05)。正常对照组比孤独症组更加偏好高声调的语音和纯音(P<0.05),孤独症组比正常组更加偏好频率较低的纯音(P<0.05)。孤独症组和正常对照组在对韵律的偏好差异无统计学意义(均P>0.05)。结论:孤独症患者对言语和非言语声音具有异常的听觉特征。     

孤独症谱系障碍儿童的观点采择能力特点及其相关因素

目的:探讨孤独症谱系障碍(ASD)儿童观点采择特点及其关联因素。方法:纳入符合美国精神病诊断与统计手册第5版ASD诊断标准的儿童100例和年龄、性别匹配的正常对照组儿童100例。采用社会观点采择测验(SPT)评估入组儿童的认知和情感观点采择能力，韦氏儿童智力量表第四版(WISCⅣ)、社交反应量表(SRS)及执行功能行为评定量表分别测评儿童的智力、社交反应能力及执行功能。Pearson偏相关分析观点采择能力与社交及认知功能的相关性。结果:孤独症组SPT中认知及情感观点采择得分均低于对照组儿童(均P<0.001)。不同性别、年龄的孤独症组儿童观点采择得分均低于正常对照组(均P<0.050)。孤独症组认知观点采择得分与总智商正相关(r=0.26,P=0.011),与社交反应量表得分负相关(r=-0.20,P<0.05);情感观点采择能力与总智商正相关(r=0.33,P<0.01),与社交反应量表得分及执行功能评定量表得分负相关(r=-0.32、-0.03,P<0.05)。结论:ASD儿童认知及情感观点采择均存在缺陷，其观点采择能力与智力水平、社交反应能力和执行功...     

焦虑性障碍儿童行为问题与自我意识研究

目的:探讨焦虑性障碍儿童的行为问题与自我意识特点。方法:对湖南中小学生心理健康状况流行病学调查中的全部研究对象进行DSM-IV临床诊断,最后选出单纯儿童焦虑性障碍组(n1=110人)、正常对照组(n2=113人),入组儿童由父母填写Achenbach儿童行为量表(CBCL),其本人(三年级及其以上学生)填写儿童自我意识量表(CSCS)。结果:①焦虑障碍组的行为问题总分高于对照组,除性问题外其余各因子得分焦虑障碍组均高于对照组(P<0.05);社会能力各因子分及总分均低于对照组(P<0.05)。②Piers-Harris儿童自我意识量表各分量表得分及总分焦虑障碍组均低于对照组(P<0.05)。结论:焦虑障碍儿童与正常儿童相比较其行为问题比较多,自我评价低。     

汉语阅读障碍儿童的认知能力[II]

目的 :进一步探讨汉语阅读障碍 (RD)儿童的认知特点及其认知亚型。方法 :采用韦氏儿童智力量表 (C -WISC)和韦氏记忆量表 (WMS -RC)以及汉语阅读技能诊断测验 (CRSDT)对 172例患儿和 6 1例正常儿童进行诊断与评估。结果 :1 RD儿童在Bannatyne、Kaufman智力模型及ACID公式中各变量成绩均低于对照组 ,在Bannatyne智力模型表现出空间能力 >数序列能力 >言语概念化 >获得性知识 ;Kaufman智力模型中表现为左脑加工能力差于右脑加工。 2 聚类分析表明RD儿童可分为三组亚型。结论 :1 RD儿童存在多方面的认知功能缺陷 ,其左右半球功能不平衡。 2 RD儿童存在三种认知障碍亚型。     

感觉统合训练对多动症儿童的行为及智力的疗效研究

目的探讨感觉统合训练对ADHD儿童的行为与智力的疗效。方法将30例ADHD儿童作为实验组给予感觉统合训练,将30名正常儿童志愿者为对照组不予任何干预。在干预前后主要采用Conners父母评定量表(Conners Parents SymPtomQuestionnaire,PSQ)和瑞文智力测验联合型(Combined Raven’s Test,CRT)评定。结果实验组训练后PSQ各项指标得分均低于训练前(t=10.49,10.7,5.14,7.05,5.9,8.7;P<0.001)。实验组训练后在PSQ的学习问题、冲动一多动和多动指数3项因子上得分低于对照组(t=2.12,2.35,2.75;P<0.05)。实验组训练后在CRT的IQ值及知觉辨别力、比较推理能力、系列关系能力上得分均高于训练前(t=-6.6,-2.72,-3.81,P<0.01);但与对照组比较无显著差异(P>0.05)。结论感觉统合训练能有效提高ADHD儿童注意力,改善其多动、冲动行为,对儿童的智商及空间知觉和比较推理能力有一定程度的提高。     

广西壮族少年儿童心理卫生特点

目的:探讨广西壮族儿童心理卫生特点。方法:采用艾森克个性问卷(儿童版)(EPQ)、Piers-Harris儿童自我意识量表(PHCSS)、儿童主观生活质量问卷、Conners儿童行为量表父母问卷和教师评定量表、儿童适应行为评定量表、儿少一般情况调查表对7033例4岁-16岁各民族儿童进行测试,重点分析壮族儿童的心理卫生特点。结果:壮族儿童的E分低于汉族(P<0.01),N分和P分与汉族无明显差异(P>0.05),自我意识和主观生活质量总分低于汉族(P<0.01)。适应商数与汉族无明显差异(P>0.05)。共检出各类心理问题2678例,检出率38.08%。其中壮族1614例(40.1%),汉族811例(33.4%),瑶族176例(41.5%),其他少数民族76例(32.8%),差异有高度显著性(P<0.01)。不同性别、年龄儿童在行为问题、自我意识降低、行为偏差上检出率有显著性差异(P<0.01)。农村儿童的心理卫生问题明显高于城市儿童(P<0.01)。结论:壮族少年儿童的心理卫生状况有与其他民族不同的特点,心理卫生问题的检出率处于较高水平,应引起有关部门和社会的广泛关注。     

The neuropsychological phenotype of velocardiofacial syndrome (VCFS): relationship to psychopathology.

Children with velocardiofacial syndrome (VCFS; N=14) and a comparison group of siblings (N=8) underwent comprehensive neuropsychological assessment to examine the relationship between cognitive functioning and psychopathology. Significant group differences were obtained on tests of full scale and verbal intellectual functioning and perceptual-motor skills. With the exception of performance on tests of attention and executive functioning, children with VCFS displayed a profile consistent with nonverbal learning disability (NLD). However, within group comparisons revealed significantly poorer visuospatial intellectual and nonverbal memory functioning in sibling controls as well. No significant group differences were obtained on tests of motor speed, academic, language, attention, memory, or executive functioning, with significant variability in children with VCFS frequently accounting for the lack of robust differences. Parent-report measures revealed profiles consistent with ADHD. No clinically significant symptoms of psychosis, depression or anxiety were noted on either self- or parent-report measures. Wisconsin Card Sorting Test performance was found to be highly and negatively correlated with the Thought Problems subscale of the Child Behavior Checklist (CBCL) for VCFS children only, suggesting a possible at-risk indicator for later onset psychopathology.     

非言语型学习障碍儿童社会信息加工的特点

目的: 探讨非言语型学习障碍儿童社会信息加工特点.方法: 本研究为病例对照研究.根据确定学习障碍儿童的标准,先确定学习障碍儿童,然后对学习障碍儿童进行韦氏儿童智力测验,根据测验结果把学习障碍儿童进一步分为非言语型学习障碍组(23人)、言语型学习障碍组(28人),然后按1:1比例选取对照组(51人).设置儿童与同伴、成人相互作用的三类情景,每类情景又分为模糊和清晰两种情况,对三组儿童进行结构性访谈.结果: ①清晰权威情景下.非言语型学习障碍儿童的编码数显著低于对照组儿童[(2.35±1.15)vs.(3.25±1.27),P＜0.01];对人物意图的判断,非言语型学习障碍儿童选择"恶意"的比率(65%)高于言语型学习障碍儿童(29%)(P＜0.05);在工具效能感上,非言语型学习障碍儿童选择有效的比率(74%)高于言语型学习障碍儿童(36%)(P＜0.05).②非言语型学习障儿童在每个情景故事下的总反应数都显著低于对照组儿童[模糊同伴加入情景:(1.17±0.49)vs.(1.09±0.86).P＜0.01;清晰同伴加入情景:(1.09±0.28)vs.(1.69±0.96),P＜0.01;模糊同伴激惹情景:(1.09±0.41)V8.(1.49±0.78),P＜0.05;清晰同伴激惹情景:(1.17±0.49)vs.(1.65±0.95),P＜0.05:模糊权威情景:(0.96±0.36)vs.(1.37±0.72),P＜0.01;清晰权威情景:(1.00±0.30)vs.(1.37±0.59),P＜0.01].结论: ①清晰权威情景下,非言语型学习障碍儿童编码精确性不如对照组儿童;对他人意图的判断非言语型学习障碍儿童比言语型学习障碍儿童倾向于敌意归因;非言语型学习障碍儿童比言语型学习障碍儿童工具效能感高.②在每个情景下,非言语型学习障碍儿童比对照组儿童生成策略少,反应不灵活.     

Children With Adequate Academic Achievement Scores Referred for Evaluation of School Difficulties: Information Processing Deficiencies

Children (7-11 years old) with standardized academic achievement test scores in the normal range referred for evaluation of learning problems were compared to low-achieving children matched for age, sex, and nonverbal cognitive ability, and to children with no known history of learning difficulty matched for age, sex, and reading (all N = 65) on a battery of computerized tasks of nonverbal information processing. The normally achieving referred children performed similarly to the low-achieving group but worse than reading-matched nonreferred counterparts. These findings suggest that children who struggle in school yet perform adequately on standardized achievement measures can have heightened neurodevelopmental vulnerability. Implications are discussed with respect to the underlying substrate of learning disabilities, as well as their diagnosis, classification, and remediation.     

Children with adequate academic achievement scores referred for evaluation of school difficulties: information processing deficiencies

Children (7-11 years old) with standardized academic achievement test scores in the normal range referred for evaluation of learning problems were compared to low-achieving children matched for age, sex, and nonverbal cognitive ability, and to children with no known history of learning difficulty matched for age, sex, and reading (all N = 65) on a battery of computerized tasks of nonverbal information processing. The normally achieving referred children performed similarly to the low-achieving group but worse than reading-matched nonreferred counterparts. These findings suggest that children who struggle in school yet perform adequately on standardized achievement measures can have heightened neurodevelopmental vulnerability. Implications are discussed with respect to the underlying substrate of learning disabilities, as well as their diagnosis, classification, and remediation.     

维-汉双语阅读障碍儿童继时性和同时性加工特征

目的:研究维-汉双语阅读障碍儿童的继时性和同时性认知加工特点。方法:采用实验方法对3-5年级35名存在单独汉语阅读障碍的维吾尔族儿童(汉障组)、28名维语和汉语都存在阅读障碍的维吾尔族儿童(双障组)和在性别、年级及智力等方面与之匹配的27名正常儿童在科西组块、字母回忆广度两种继时性加工任务和形状设计、图形空间判断两种同时性加工任务中的得分做了对比分析。结果:汉障组和双障组在继时性和同时性加工任务中的得分均显著落后于对照组,双障组仅在非言语类继时性加工任务中显著落后于汉障组。结论:汉障组和双障组儿童的继时性和同时性认知加工水平都存在低下,双障组儿童的继时性加工能力低下更具有普遍性;继时性和同时性加工能力对维、汉双语阅读学习都起着重要作用;相比维语,汉语更多依赖同时性加工。     

Cognitive impairment in neurofibromatosis type 1.

Neurofibromatosis type 1 (NF1) is associated with a broad range of relatively nonspecific cognitive impairments, including low IQ, learning disabilities, and behavioral difficulties. While early studies indicated that the cognitive phenotype of NF1 resembles that of nonverbal learning disabilities (NLD), later research has found that the impairments are broader and do not fit the NLD profile well. Language-based deficits and executive dysfunction have also been found in empirical studies. There is some evidence that neuropsychological impairment may be correlated with the underlying central nervous system involvement of NF1, but this theory has not been consistently supported across studies. Further work clarifying the cognitive phenotype of NF1 is needed, especially investigations that employ appropriate comparison groups matched for intellectual level. Am. J. Med. Genet. (Semin. Med. Genet.) 89:45-52, 1999.     

An investigation of visuospatial memory impairment in children with attention deficit hyperactivity disorder (ADHD), combined type

BACKGROUND: Memory impairment is not considered a core cognitive feature of attention deficit hyperactivity disorder, combined type (ADHD-CT), although it is associated with impairments in attentional and executive functions. This study investigates visuospatial memory impairment, in particular encoding and retrieval aspects, in children with ADHD-CT who are stimulant-medication naive and medicated with stimulant medication. METHOD: A cross-sectional study of visuospatial memory in 6- to 12-year-old children with stimulant-medication-naive ADHD-CT (n = 62) and medicated ADHD-CT (n = 58) compared to an age- and gender-matched healthy control group (n = 39) was completed. RESULTS: Both medication-naive and medicated ADHD-CT groups demonstrated subtle yet significant impairment in visuospatial memory. The memory impairment was delay-independent, which, along with other factors, suggest dysfunction of the encoding rather than retrieval phase of visuospatial memory. CONCLUSIONS: Careful study of large ADHD-CT samples does detect deficits in a visuospatial memory task, but these reflect attentional deficits rather than being specifically due to dysfunction of the medial temporal lobe explicit memory system. Children with ADHD-CT may benefit from cognitive and behavioural strategies focused on improving encoding of relevant information rather than retrieval strategies.     

轻度认知障碍患者平衡功能与视空间感知功能的关系

目的:对轻度认知障碍(MCI)患者的平衡功能与视空间感知功能之间的关系进行初步的探讨。方法:通过Berg平衡量表(BBS)测评,将116例MCI患者分为平衡障碍组(BBS46分,29例)和平衡正常组(BBS≥46分,87例)。同时,采用线方向判断测验评估MCI患者的视空间感知功能。结果:平衡障碍组的线方向判断测验评分低于平衡正常组,差异有统计学意义(t=-3.218,P=0.002)。MCI患者的线方向判断测验评分与BBS总分(r=0.256,P=0.006)、动态平衡功能评分(r=0.284,P=0.004)正相关;而与BBS静态平衡功能评分(r=0.163,P=0.369)无显著相关性。结论:MCI患者的视空间感知功能,对患者的平衡功能、特别是动态平衡功能有影响;视空间感知功能受损,可能是MCI患者平衡障碍的一个原因。     

行为问题儿童的社会技能训练效果分析

目的:探讨行为问题儿童的社交焦虑、个性特征及其干预方法和效果。方法:采用儿童行为量表(CBCL)筛查行为问题儿童82名,分为干预组(n=41)和对照组(n=41),随机抽取非行为问题儿童50名作为正常组。对干预组儿童采用以社会技能训练为主的行为干预一个学期,干预前后采用儿童社交焦虑量表(SASC)及艾森克人格问卷(EPQ)进行评估。结果:行为问题组儿童的社交焦虑总分及各因子分均高于正常组儿童,行为问题组情绪稳定性(N)分高于正常组、内外向(E)分低于正常组(P<0.01,0.001)。干预前干预组社交焦虑及个性与对照组比较差异均无显著性意义(P>0.05);干预后干预组与对照组比较,社交焦虑及各因子统计学差异显著(P<0.01),与正常组比较,社交焦虑及个性各因子差异均无显著性(P>0.05)。结论:行为问题儿童和正常儿童在社交焦虑水平、个性特征方面存在差异。以社会技能训练为主的行为干预对行为问题儿童的社交焦虑和个性缺陷有效。