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儿童和青少年创伤性脑损伤后的注意力恢复

Attention remediation following traumatic brain injury in childhood and adolescence.

作者信息

Galbiati Susanna, Recla Monica, Pastore Valentina, Liscio Mariarosaria, Bardoni Alessandra, Castelli Enrico, Strazzer Sandra

机构信息

IRCCS E. Medea, La Nostra Famiglia, Lecco, Italy.

出版信息

Neuropsychology. 2009 Jan;23(1):40-9. doi: 10.1037/a0013409.

Abstract

Traumatic brain injury (TBI) frequently affects both the basic and the superordinate components of attention; deficits vary according to patient age. This study evaluated the efficacy of a specific remediation intervention for attention. Sixty-five TBI patients (aged 6?18 years) with attention deficit were assessed at baseline and at 1-year follow-up: 40 patients received attention-specific neuropsychological training for 6 months, and the control group comprised 25 patients. Cognitive assessment included a Wechsler Intelligence Scale (e.g., A. Orsini, 1993) and the Continuous Performance Test II (CPT II; C. K. Conners, 2000). The Vineland Adaptive Behavior Scales (VABS; S. Sparrow, D. Balla & D. V. Cicchetti, 1984) was administered to assess the treatment's ecological validity. At baseline, all patients presented with a mild intellectual disability and pathological scores on the CPT II. At follow-up, significant differences were found between the 2 groups on the CPT II and VABS: The clinical group improved more than the control group. Specific remediation training for attention, including a combination of a process-specific approach and metacognitive strategies, significantly improved attention performance. Improvement in attention skills also affected adaptive skills positively.

摘要

创伤性脑损伤(TBI)常常会影响注意力的基础和高级组成部分;缺陷会因患者年龄而异。本研究评估了一种针对注意力的特定补救干预措施的疗效。对65名存在注意力缺陷的TBI患者(年龄在6至18岁之间)在基线期和1年随访时进行了评估:40名患者接受了为期6个月的针对注意力的神经心理学训练,对照组包括25名患者。认知评估包括韦氏智力量表(例如,A. 奥尔西尼,1993年)和连续操作测验II(CPT II;C.K. 康纳斯,2000年)。使用文兰适应行为量表(VABS;S. 斯帕罗、D. 巴拉和D.V. 西凯提,1984年)来评估治疗的生态效度。在基线期,所有患者在CPT II上均表现出轻度智力残疾和病理分数。在随访时,两组在CPT II和VABS上存在显著差异:临床组的改善程度大于对照组。针对注意力的特定补救训练,包括特定过程方法和元认知策略的结合,显著改善了注意力表现。注意力技能的改善也对适应技能产生了积极影响。

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