Suades-González Elisabet, Forns Joan, García-Esteban Raquel, López-Vicente Mónica, Esnaola Mikel, Álvarez-Pedrerol Mar, Julvez Jordi, Cáceres Alejandro, Basagaña Xavier, López-Sala Anna, Sunyer Jordi
Center for Research in Environmental Epidemiology, Barcelona Institute for Global HealthBarcelona, Spain.
Department of Experimental and Health Sciences, Pompeu Fabra UniversityBarcelona, Spain.
Front Psychol. 2017 May 16;8:655. doi: 10.3389/fpsyg.2017.00655. eCollection 2017.
Prospective longitudinal studies are essential in characterizing cognitive trajectories, yet few of them have been reported on the development of attention processes in children. We aimed to explore attention development in normal children and children with attention deficit and hyperactivity disorder (ADHD) symptoms in a repeated measures design using the attention network test (ANT). The population sample included 2,835 children (49.6% girls) aged 7-11 years from 39 schools in Barcelona (Catalonia, Spain) who performed the ANT four times from January 2012 to March 2013. According to teacher ratings, 10.5% of the children presented ADHD symptoms. We performed multilevel mixed-effects linear regression models, adjusting for school and individual, to test the effects of age-related growth on the ANT networks: alerting, orienting and executive attention, and three measurements related to attentiveness: median of hit reaction time (HRT), hit reaction time standard error (HRT-SE) and variability. We observed age-related growth in all the outcomes, except orienting. The curves were steeper at the younger groups, although for alertness the improvement was further at the oldest ages. Gender and ADHD symptoms interacted with age in executive attention, HRT and variability. Girls performed better in executive attention at young ages although boys reached females at around 10 years of age. For HRT, males showed faster HRT. However, girls had a more pronounced improvement and reached the levels of boys at age 11. Children with ADHD symptoms had significant differences in executive attention, HRT and variability compared to children without ADHD symptoms. We detected an ongoing development of some aspects of attention in primary school children, differentiating patterns by gender and ADHD symptoms. Our findings support the ANT for assessing attention processes in children in large epidemiological studies.
前瞻性纵向研究对于刻画认知轨迹至关重要，但关于儿童注意力发展的此类研究报道较少。我们旨在采用注意力网络测试（ANT），通过重复测量设计来探索正常儿童以及有注意力缺陷多动障碍（ADHD）症状儿童的注意力发展情况。研究样本包括来自西班牙加泰罗尼亚巴塞罗那39所学校的2835名7至11岁儿童（49.6%为女孩），他们在2012年1月至2013年3月期间进行了4次ANT测试。根据教师评分，10.5%的儿童表现出ADHD症状。我们进行了多层次混合效应线性回归模型分析，对学校和个体因素进行了调整，以测试年龄相关增长对ANT网络（警觉、定向和执行注意力）以及与注意力相关的三项测量指标（命中反应时间中位数（HRT）、命中反应时间标准误差（HRT-SE）和变异性）的影响。我们观察到，除定向外，所有结果均呈现与年龄相关的增长。在较年轻组中曲线更陡峭，不过对于警觉性而言，在最年长年龄段的改善更为明显。在执行注意力、HRT和变异性方面，性别和ADHD症状与年龄存在交互作用。在年幼时，女孩在执行注意力方面表现更好，不过男孩在10岁左右赶上了女孩。对于HRT，男性的反应速度更快。然而，女孩的改善更为显著，并在11岁时达到男孩的水平。与没有ADHD症状的儿童相比，有ADHD症状的儿童在执行注意力、HRT和变异性方面存在显著差异。我们发现小学生注意力的某些方面在持续发展，并且按性别和ADHD症状呈现出不同模式。我们的研究结果支持在大型流行病学研究中使用ANT来评估儿童的注意力过程。
