Bental Barbara, Tirosh Emanuel
The Hannah Khoushy Child Development Center, Bnai Zion Medical Center, Haifa, Israel.
J Child Psychol Psychiatry. 2007 May;48(5):455-63. doi: 10.1111/j.1469-7610.2006.01710.x.
Co-morbidity of attention deficit hyperactivity disorder (ADHD) and reading disorder (RD) is frequent. The objective of this investigation was to assess the potential uniqueness of co-morbid ADHD + RD and extend existing findings to the Hebrew language.
A parallel group design with post-hoc analysis of group differences was employed comparing four groups of children (19 ADHD, 17 RD, 27 ADHD + RD, and 23 controls) on reading measures, attention and executive functions (EF) as well as functions of phonemic awareness and rapid naming. Forward stepwise regressions were run in order to delineate significant relationships between phonemic awareness, rapid naming, attention and EF with outcome variables of reading.
The co-morbid group shared the basic characteristic impairments in attention and executive functions with the pure ADHD group and in reading domain functions with the pure RD group. In addition, this group showed unique deficits in rapid naming and a more severe impairment in working memory. Forward stepwise regression pointed to associations between executive functions and word reading accuracy in children with ADHD, in contrast to associations between linguistic functions and word accuracy in non-ADHD.
The combination of cognitive deficits in the subgroup of children with both ADHD and RD and the relationship between accuracy in word decoding and executive functions shown for the ADHD groups point to a distinct clinical profile of the co-morbid condition. Attention and EF should be considered in the diagnosis of RD and in the remediation protocol.
注意缺陷多动障碍(ADHD)与阅读障碍(RD)常合并存在。本研究的目的是评估共病ADHD + RD的潜在独特性,并将现有研究结果扩展到希伯来语环境。
采用平行组设计并对组间差异进行事后分析,比较四组儿童(19名ADHD儿童、17名RD儿童、27名ADHD + RD儿童和23名对照组儿童)在阅读测量、注意力和执行功能(EF)以及语音意识和快速命名功能方面的表现。进行向前逐步回归分析,以确定语音意识、快速命名、注意力和EF与阅读结果变量之间的显著关系。
共病组与单纯ADHD组在注意力和执行功能方面具有共同的基本特征性损害,与单纯RD组在阅读领域功能方面具有共同损害。此外,该组在快速命名方面表现出独特的缺陷,在工作记忆方面有更严重的损害。向前逐步回归分析表明,ADHD儿童的执行功能与单词阅读准确性之间存在关联,而非ADHD儿童的语言功能与单词准确性之间存在关联。
ADHD和RD共病儿童亚组的认知缺陷组合以及ADHD组中单词解码准确性与执行功能之间的关系,表明了共病情况的独特临床特征。在RD的诊断和补救方案中应考虑注意力和EF因素。