Wilkes Sarah, Cordier Reinie, Bundy Anita, Docking Kimberley, Munro Natalie
Faculty of Health Sciences, The University of Sydney, 75 East Street, Lidcombe, New South Wales, NSW 2141, Australia.
Aust Occup Ther J. 2011 Aug;58(4):231-40. doi: 10.1111/j.1440-1630.2011.00928.x. Epub 2011 May 12.
Many children with attention deficit hyperactivity disorder (ADHD) have serious social and peer difficulties that can lead to adverse outcomes in adolescence and adulthood. To date, psychosocial treatments have produced poor outcomes in reducing social impairments commonly associated with ADHD. This study aimed to examine the efficacy of a new intervention designed to improve the play and social skills of children with ADHD and their playmates within the natural context of play.
Participants included children (aged 5-11 years) diagnosed with ADHD, age-matched typically developing playmates (n=14/group) and parents of children with ADHD. The intervention involved seven weekly video-recorded free-play sessions; video feed-forward/feedback and therapist- and peer-modelling were used to promote social play. The Test of Playfulness was used as a pre-/post-test measure. Data were subjected to Rasch analysis to calculate measure scores on interval level; dependant sample t-test and Cohen-d calculations were used to measure effect.
A dependant samples t-test revealed that both children with ADHD (t=8.1; d.f.=13; P<0.01) and their playmates (t=6.9; d.f.=13; P<0.01) improved in their social play. Results demonstrated a large effect in improving the social play of children with ADHD (d=1.5) and their playmates (d=1.3).
Results support the use of play, video feed-forward/feedback techniques, therapist- and peer-modelling and parent involvement as an effective means to develop the social play skills of children with ADHD. Further larger-scale research is required.
许多患有注意力缺陷多动障碍(ADHD)的儿童存在严重的社交和同伴交往困难,这可能导致在青少年期和成年期出现不良后果。迄今为止,心理社会治疗在减少通常与ADHD相关的社会功能损害方面效果不佳。本研究旨在检验一种新干预措施的效果,该措施旨在在自然游戏情境中提高ADHD儿童及其玩伴的游戏和社交技能。
参与者包括被诊断患有ADHD的儿童(5 - 11岁)、年龄匹配的发育正常的玩伴(每组n = 14)以及ADHD儿童的父母。干预包括七次每周一次的视频记录自由游戏环节;使用视频前馈/反馈以及治疗师和同伴示范来促进社交游戏。采用游戏性测试作为前后测指标。对数据进行拉施分析以计算区间水平的测量分数;使用配对样本t检验和科恩d值计算来测量效果。
配对样本t检验显示,ADHD儿童(t = 8.1;自由度 = 13;P < 0.01)及其玩伴(t = 6.9;自由度 = 13;P < 0.01)的社交游戏均有改善。结果表明,在改善ADHD儿童(d = 1.5)及其玩伴(d = 1.3)的社交游戏方面有较大效果。
结果支持将游戏、视频前馈/反馈技术、治疗师和同伴示范以及家长参与作为培养ADHD儿童社交游戏技能的有效手段。需要进一步开展更大规模的研究。