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題名：Adaptation Impairment in Primary School Children with Attention Deficient Hyperactivity Disorder: A Pilot Study
書刊名：Taiwanese Journal of Psychiatry
作者：張鳳麟／林健禾
作者(外文)：Jang, Fong-lin／Lin, Chien-ho
出版日期：2018
卷期：32:1
頁次：頁72-78+a5
主題關鍵詞：兒童；注意力不足過動症；適應行為；功能缺損；School students；Attention defi cit hyperactivity disorder；Adaptation；Functional impairment
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目的：注意力不足過動症 (ADHD) 是一種神經發展障礙，造成適應功能缺損。本研究在探討ADHD 對兒童家庭與學校適應功能的影響。方法：採病歷回溯的方式，回溯2014年01 月至2017 年07 月之間，初診診斷為ADHD 國小兒童，收集學生適應調查表資料，共 44 位兒童。研究問卷為教育部特殊教育工作小組出版之「學生適應調查表」。依據年齡分布分為低年段（1 到3 年級）與高年段（4 到6 年級）兩組，比較兩組與一般兒童在學校及家庭的適應功能差異。結果：整體適應功能在所有年段中ADHD 顯著低於常模。在學校適應上，兩組ADHD 兒童在各向度上皆顯著地於相對應一般兒童組 (p ＜ 0.01 or p ＜ 0.01)。家庭適應方面，低年段ADHD 兒童在溝通能力 (p ＜ 0.01)、自我指導 (p ＜ 0.001) 顯著低於常模 (n = 281 vs 33)。高年段則在居家生活 (p ＜ 0.01)、人際關係適應 (p ＜ 0.001)、溝通能力 (p＜ 0.001)、自我指導 (p ＜ 0.001 ) 的表現顯著低於常模的兒童 (301 vs. 11)。結論：本研究發現ADHD 整體適應較一般兒童差，建議在規劃ADHD 心理社會介入方案時，應考量不同年齡層、不同情境在適應功能上相對強弱處，做個別化的介入方案。
Objectives: Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsive symptoms, that impair social, academic or occupational functions, resulting in multiple functional deficits. This study was to investigate the impact of ADHD on children's family and school adaptive function. Methods: A retrospectively observational study was conducted at a medical center. We reviewed the medical records of newly diagnosed children with ADHD during January 2014 through July 2017. We enrolled ADHD children who had filled Student Adaptive Behavior Scale (SABS). We compared SABS scores between junior grade students (school year grade 1-3 years) or senior grade group (school year grade 4-6 years), and those of typical children of same grade group. Results: We enrolled 44 children in this study. The overall adaptive function was significantly poorer in ADHD groups (p ＜ 0.5). In school adaptation, both grade ADHD groups got significantly lower score in all subscales (p ＜ 0.01 or p ＜ 0.01). In family adaptation, compared to typical children junior grade ADHD students was found to have significant poorer adaptation in communication skills (p ＜ 0.01), and self-directing (p ＜ 0.001). Compared to typical children senior-grade ADHD students showed significant poorer adaptation in performance in home life (p ＜ 0.01), interpersonal adaptation (p ＜ 0.001), communication skills (p ＜ 0.001), and self-directing (p ＜ 0.001). Conclusion: Overall adaptation of ADHD children was worse than the average children. In designing of a treatment plan for ADHD, clinician should consider the different impact in adaptive function, to make comprehensive and individualized intervention program.
期刊論文
1.Mannuzza, S.、Klein, R. G.、Moulton, J. L.(2008)。Lifetime criminality among boys with attention deficit hyperactivity disorder: A prospective follow-up study into adulthood using official arrest records。Psychiatry Research，160(3)，237-246。  new window
2.Johnston, C.、Mash, E. J.(2001)。Families of children with attention-deficit/hyperactivity disorder: Review and recommendations for future research。Clinical Child and Family Psychology Review，4(3)，183-207。  new window
3.Scahill, L.、Schwab-Stone, M.(2000)。Epidemiology of ADHD in school-age children。Child Adolesc Psychiatr Clin N Am，9，541-555。  new window
4.蔡忠志、楊斯年、諶立中、張文瓊、錢慶文(20091200)。Comparing Uses and Expenses of Medical Care Services between Children with and without Attention-Deficit/Hyperactivity Disorder。Taiwanese Journal of Psychiatry，23(4)，296-306。new window  new window
5.Dupaul, G. J.(2007)。School-based interventions for students with attention-deficit hyperactivity disorder: current status and future directions。Sch Psychol Rev，36，183-194。  new window
6.Hoza, B.(2007)。Peer functioning in children with ADHD。Ambul Pediatr，7，101-106。  new window
7.Flory, K.、Molina, B. S. G.、Pelham, W. E.、Gnagy, E.、Smith, B.(2006)。Childhood ADHD predicts risky sexual behavior in young adulthood。J Clin Child Adolesc Psychol，35，571-577。  new window
8.Molina, B. S. G.、Hinshaw, S. P.、Swanson, J. M.(2008)。MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study。J Am Acad Child Adolesc Psychiatry，48，484-500。  new window
9.Lu, E. T. H.、Lin, Y. L.(2006)。Reliability and Validity of the "Adaptive Behavior Performance Checklist"。Bulletin of Special Education，30，1-25。  new window
10.Tsai, M. F.(2011)。School and family adaptation of children in special education: a comparison between children with attention-deficit/hyperactivity disorder (ADHD) and children with comorbid ADHD and conduct disorder。Research in Applied Psychology，49，31-63。  new window
11.Liu, Y. C.、Liu, S. K.、Shang, C. Y.、Lin, C. H.、Tu, C. L.、Gau, S. S. F.(2006)。Norm of the Chinese version of the Swanson, Nolan and Pelham, version IV scale for ADHD。Taiwanese Journal of Psychiatry，20，290-304。  new window
12.Stein, M. A.、Szumowski, E.、Blondis, T. A.、Roizen, N. J.(1995)。Adaptive skills dysfunction in ADD and ADHD children。Journal of Child Psychology and Psychiarty，36，663-670。  new window
13.Molina, B. S.、Pelham, W. E. Jr.(2003)。Childhood predictors of adolescent substance use in a longitudinal study of children with ADHD。Journal of Abnormal Psychology，112，497-507。  new window
圖書
1.DuPaul, G. J.、Stoner, G.(1994)。ADHD in the schools: Assessment and intervention strategies。New York, NY：The Guilford Press。  new window
2.Hung, L. Y.、Chang, Y. W.、Chiu, Y. N.、Tsai, M. F.、Meng, Y. R.(2000)。Guidance Manual of Student Adaptive Behavior Scale。Taipei：Special Education Working Group of the Ministry of Education。  new window
3.Barkley, R. A.(1998)。Attention Defi cit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment。New York, New York：Guilford Press。  new window
4.American Psychiatric Association(2013)。Diagnostic and Statistical Manual of Mental Disorders (DSM-5)。American Psychiatric Association。  new window
 
 
 
 
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