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注意力缺陷多动障碍和发育性协调障碍儿童的精细运动技能及哌甲酯的作用

Fine motor skills and effects of methylphenidate in children with attention-deficit-hyperactivity disorder and developmental coordination disorder.

作者信息

Flapper Boudien Ct, Houwen Suzanne, Schoemaker Marina M

机构信息

Department of Pediatrics, University Medical Centre Groningen, the Netherlands.

出版信息

Dev Med Child Neurol. 2006 Mar;48(3):165-9. doi: 10.1017/S0012162206000375.

DOI:10.1017/S0012162206000375
PMID:16483390
Abstract

The aims of this study were to investigate fine motor skills of children with both attention-deficit-hyperactivity disorder (ADHD) and developmental coordination disorder (DCD) and those of a control group, and to examine the effects of methylphenidate on these skills. A group of 12 children with ADHD-DCD (11 males, one female; mean age 9y 8mo [SD 1y 7mo]) and 12 age- and sex-matched controls (mean age 9y 7mo [SD 1y 2 mo]) participated. The manual dexterity subtests of the Movement Assessment Battery for Children, the concise assessment method for children's handwriting, and a computerized graphomotor task were used. Results demonstrated that children with ADHD-DCD performed more poorly on the manual dexterity subtests, had poorer quality of handwriting, and drew more rapidly, more fluently, but less accurately than controls on the graphomotor task. On methylphenidate, manual dexterity and quality of handwriting improved, and strokes on the graphomotor task became less fluent but more accurate. ADHD is characterized by persistent symptoms of inattention, impulsivity, and hyperactivity, affecting 3 to 5% of school-age children. Up to 50% of children with ADHD also have motor coordination problems that are severe enough to meet criteria for DCD. In DCD, children demonstrate functional motor performance deficits not explained by the child's (chronological) age or intellect, or by other neurological or psychiatric disorders.

摘要

本研究的目的是调查患有注意力缺陷多动障碍(ADHD)和发育性协调障碍(DCD)的儿童以及对照组儿童的精细运动技能,并研究哌甲酯对这些技能的影响。12名患有ADHD-DCD的儿童(11名男性,1名女性;平均年龄9岁8个月[标准差1岁7个月])和12名年龄及性别匹配的对照组儿童(平均年龄9岁7个月[标准差1岁2个月])参与了研究。使用了儿童运动评估量表的手动灵巧性子测试、儿童笔迹简明评估方法以及一项计算机化的书写运动任务。结果表明,患有ADHD-DCD的儿童在手动灵巧性子测试中的表现更差,笔迹质量更差,并且在书写运动任务中比对照组绘制得更快、更流畅,但准确性更低。服用哌甲酯后,手动灵巧性和笔迹质量有所改善,书写运动任务中的笔画变得不那么流畅但更准确。ADHD的特征是持续存在注意力不集中、冲动和多动症状,影响3%至5%的学龄儿童。高达50%的ADHD儿童还存在严重到足以符合DCD标准的运动协调问题。在DCD中,儿童表现出功能性运动表现缺陷,这些缺陷不能用儿童的(实际)年龄、智力或其他神经或精神疾病来解释。

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