Turgut Turan Sevil, Erdoğan Bakar Emel, Erden Gülsen, Karakaş Sirel
Department of Pediatrics, Akdeniz University School of Medicine, Antalya, Turkey.
Department of Psychology, Ufuk University, Ankara, Turkey.
Noro Psikiyatr Ars. 2016 Jun;53(2):144-151. doi: 10.5152/npa.2015.10024. Epub 2016 Jun 1.
The aim of this study was to develop a neuropsychometric battery for the differential diagnosis of specific learning disability (SLD), with specific respect to attention deficit hyperactivity disorder (ADHD), and to help resolve the conflicting results in the literature by an integrative utilization of scores on both the Bannatyne categories and neuropsychological tests.
The sample included 168 primary school boys who were assigned to SLD (n=21), ADHD (n=45), SLD and ADHD (n=57), and control groups (n=45). The exclusion criteria were a neurological or psychiatric comorbidity other than ADHD, a level of anxiety and/or depression above the cutoff score, medication affecting cognitive processes, visual and/or auditory disorders, and an intelligence level outside the IQ range of 85-129. Psychometric scores were obtained from the SLD Battery and Wechsler Intelligence Scale for Children-Revised in the form of Bannatyne category scores. Neuropsychological scores were from the Visual-Aural Digit Span Test-Form B, Serial Digit Learning Test, Judgment of Line Orientation, and Mangina Test. The battery was called the Integrative Battery of SLD.
The correctness of estimation for classifying cases into the diagnostic dyads (SLD/ADHD, SLD/SLD+ADHD, and SLD+ADHD/ADHD) by an integrative utilization of both the Bannatyne category scores (n=4) and scores from the four neuropsychological tests (n=10) was 92.4%, 81.4%, and 71.8%, respectively. These proportions were generally higher than those obtained using the Bannatyne category scores alone (86.4%, 75.5%, and 73.1%, respectively). The same trend was seen in the classification of children into diagnostic and control groups. However, the proportion of the correctness of estimation was higher than that obtained for the diagnostic dyads.
When conducted using appropriately chosen research designs and statistical techniques and if confounding variables are sufficiently controlled, a neuropsychometric battery that includes capacities that relate to intelligence (Bannatyne categories) and those that relate to neurocognitive processes (neuropsychological tests) can be useful in the differential diagnosis of SLD.
本研究的目的是开发一套神经心理测验组合，用于特定学习障碍（SLD）的鉴别诊断，尤其针对注意力缺陷多动障碍（ADHD），并通过综合利用班纳坦分类法得分和神经心理测验得分来帮助解决文献中相互矛盾的结果。
样本包括168名小学男生，他们被分为SLD组（n = 21）、ADHD组（n = 45）、SLD和ADHD组（n = 57）以及对照组（n = 45）。排除标准包括除ADHD外的神经或精神合并症、焦虑和/或抑郁水平高于临界值、影响认知过程的药物、视觉和/或听觉障碍以及智商水平不在85 - 129范围内。心理测量得分来自SLD测验组合和韦氏儿童智力量表修订版，以班纳坦分类法得分的形式呈现。神经心理测验得分来自视觉 - 听觉数字广度测验B型、连续数字学习测验、直线方向判断测验和曼吉纳测验。该测验组合被称为SLD综合测验组合。
通过综合利用班纳坦分类法得分（n = 4）和四项神经心理测验得分（n = 10），将病例分类为诊断二元组（SLD/ADHD、SLD/SLD + ADHD和SLD + ADHD/ADHD）的估计正确率分别为92.4%、81.4%和71.8%。这些比例总体上高于仅使用班纳坦分类法得分所获得的比例（分别为86.4%、75.5%和73.1%）。在将儿童分类为诊断组和对照组时也观察到了相同的趋势。然而，估计正确率的比例高于诊断二元组。
当使用适当选择的研究设计和统计技术进行研究，并且充分控制混杂变量时，一套包括与智力相关能力（班纳坦分类法）和与神经认知过程相关能力（神经心理测验）的神经心理测验组合可用于SLD的鉴别诊断。
