Wilkes-Gillan Sarah, Bundy Anita, Cordier Reinie, Lincoln Michelle
Discipline of Occupational Therapy, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales.
Aust Occup Ther J. 2014 Oct;61(5):299-307. doi: 10.1111/1440-1630.12124. Epub 2014 Apr 24.
BACKGROUND/AIM: There is a well-documented need for interventions to successfully address the social difficulties of children with attention deficit hyperactivity disorder. This study aimed to further the development of a previously conducted pilot of a play-based intervention. To achieve this, children's social play outcomes pre-post and 18-month following the intervention were examined by raters unaware of the study's purpose. Additionally, parents' experiences of the intervention were explored.
Participants included five children with attention deficit hyperactivity disorder who had participated in a play-based intervention and their typically developing playmates; parents of children with attention deficit hyperactivity disorder also participated. Children and their playmates attended an 18-month follow-up play session and parents participated in semi-structured interviews. The Test of Playfulness was used to measure children's play outcomes in the context of social play with a peer, pre-post and 18-months following the intervention. Wilcoxon signed-ranks (Z) and Cohen's-d were used to measure effect. Thematic analysis was used to analyse reoccurring themes from parents' interviews.
Children's social play outcomes improved pre-post intervention (Z = 2.02; P = 0.04; d = 1.6) and were maintained 18-month post intervention (Z = 0.14; P = 0.89; d = -0.4). Core themes included: the intervention as an enjoyable experience, a common language for talking about play/social interactions, an observable change in children's skills, transference of skills and the need for support to refresh learnt lessons over time.
The intervention demonstrated preliminary and long-term efficacy in developing the social play skills of children with attention deficit hyperactivity disorder. Further research is required to optimise intervention feasibility and parent involvement prior to conducting a large-scale research.
背景/目的：有充分的文献记载表明，需要采取干预措施来成功解决注意力缺陷多动障碍儿童的社交困难。本研究旨在进一步推进此前进行的基于游戏的干预试点项目的发展。为此，由不了解研究目的的评估人员对干预前后及干预后18个月儿童的社交游戏结果进行了检查。此外，还探讨了家长对该干预措施的体验。
参与者包括五名参与了基于游戏的干预的注意力缺陷多动障碍儿童及其发育正常的玩伴；注意力缺陷多动障碍儿童的家长也参与其中。儿童及其玩伴参加了为期18个月的随访游戏环节，家长参与了半结构化访谈。使用游戏性测试来测量儿童在与同伴进行社交游戏时、干预前后及干预后18个月的游戏结果。采用Wilcoxon符号秩检验（Z）和科恩d值来衡量效果。采用主题分析法分析家长访谈中反复出现的主题。
干预前后儿童的社交游戏结果有所改善（Z = 2.02；P = 0.04；d = 1.6），且在干预后18个月得以维持（Z = 0.14；P = 0.89；d = -0.4）。核心主题包括：干预是一次愉快的经历、是谈论游戏/社交互动的共同语言、儿童技能有明显变化、技能的迁移以及需要支持以便随着时间推移复习所学内容。
该干预措施在培养注意力缺陷多动障碍儿童的社交游戏技能方面显示出初步和长期的效果。在开展大规模研究之前，需要进一步研究以优化干预的可行性和家长的参与度。
