Rosenberger P B
Learning Disorders Unit, Massachusetts General Hospital, Boston 02114.
Indian J Pediatr. 1990 May-Jun;57(3):353-60. doi: 10.1007/BF02727914.
The precise nature of the relationship among attention deficit, hyperkinesis, and specific learning disabilities remains a mystery. They are encountered in one another's company with far greater than chance frequency. It is clear, on the one hand, that attention deficit and learning disability aggravate one another; that is, that what is difficult to learn is difficult to attend to, and vice versa. Furthermore, in children at least, attending ability and activity level have a reciprocal relationship; that is, improvement of attention tends to reduce activity level, and vice versa. On the other hand, each of these disorders is seen in isolation with sufficient frequency to assure us that none of the three is simply a by-product of one or both of the other two. It is unlikely that a single etiology will be identified to account for a significant number of cases of hyperactivity or attention deficit, and thus unlikely that a "cure" or even a mode of prevention will be found. A change in the attitude of the culture toward formal education would reduce the morbidity of the syndrome, but this is also unlikely in the foreseeable future. What further research does promise to yield are medications that improve attention span with fewer side effects, and perhaps more important, more workable technologies for changing behaviour and engineering environments to encourage academic productivity in the face of this important aptitude deficit.
注意力缺陷、多动症和特定学习障碍之间关系的确切本质仍是一个谜。它们同时出现的频率远远高于偶然概率。一方面,很明显注意力缺陷和学习障碍会相互加重;也就是说,难学的东西难以集中注意力去学,反之亦然。此外,至少在儿童中,注意力能力和活动水平存在相互关系;也就是说,注意力的改善往往会降低活动水平,反之亦然。另一方面,这些障碍中的每一种都有足够的频率单独出现,这向我们保证这三种障碍都不是另外两种中一种或两种的简单副产品。不太可能找到单一病因来解释大量多动症或注意力缺陷病例,因此也不太可能找到“治愈方法”甚至预防方式。文化对正规教育态度的改变会降低该综合征的发病率,但在可预见的未来这也不太可能实现。进一步的研究所有望产生的是副作用更少的能提高注意力持续时间的药物,也许更重要的是,面对这种重要的能力缺陷,能改变行为和设计环境以鼓励学业成绩的更可行技术。