Department of Pediatrics, School of Medicine, Stanford University, Stanford, California.
Department of Pediatrics, School of Medicine, Stanford University, Stanford, California
Pediatrics. 2019 Aug;144(2). doi: 10.1542/peds.2019-0038. Epub 2019 Jul 22.
To compare school readiness in preschoolers with and without attention-deficit/hyperactivity disorder (ADHD) symptoms using a comprehensive framework. We hypothesized that preschoolers with ADHD symptoms have higher odds of school readiness impairment.
Children ages 4 to 5 years ( = 93) were divided into 2 groups on the basis of presence of ADHD symptoms (ADHD group, = 45; comparison group, = 48). School readiness was assessed through 10 component measures, including direct assessments and standardized questionnaires, regarding 5 school readiness domains: physical well-being and motor development, social and emotional development, approaches to learning, language, and cognition and general knowledge. Analysis of covariance compared group mean scores on component measures. Domain impairment was defined as score ≥1 SD from the test population mean in the unfavorable direction on ≥1 measure in the domain. School readiness impairment was defined as impairment in ≥2 of 5 domains. Logistic regression predicted impairment within domains and overall readiness.
The ADHD group demonstrated significantly worse mean scores on 8 of 10 component measures and greater odds of impairment in all domains except for cognition and general knowledge. Overall, 79% of the ADHD group and 13% of the comparison group had school readiness impairment (odds ratio 21, 95% confidence interval 5.67-77.77, < .001).
Preschoolers with ADHD symptoms are likely to have impaired school readiness. We recommend early identification of school readiness impairment by using a comprehensive 5-domain framework in children with ADHD symptoms paired with targeted intervention to improve outcomes.
使用综合框架比较有和无注意力缺陷/多动障碍（ADHD）症状的学龄前儿童的入学准备情况。我们假设具有 ADHD 症状的学龄前儿童在入学准备方面受损的可能性更高。
根据是否存在 ADHD 症状，将 4 至 5 岁的儿童（n=93）分为两组：ADHD 组（n=45）和对照组（n=48）。通过 10 项组成部分的测量，包括直接评估和标准化问卷，评估 5 个入学准备领域的准备情况：身体福祉和运动发展、社会和情感发展、学习方法、语言以及认知和一般知识。协方差分析比较两组在组成部分测量上的平均得分。在 1 个以上的领域中，有 1 个以上的测量值的得分≥测试人群平均值的 1 个标准差，定义为该领域的得分处于不利方向的域损害。将≥2 个领域受损定义为入学准备受损。逻辑回归预测各领域和整体准备情况的受损情况。
ADHD 组在 10 项组成部分测量中的 8 项上的平均得分明显更差，且除认知和一般知识领域外，所有领域受损的可能性都更高。总体而言，ADHD 组中有 79%的儿童和对照组中有 13%的儿童入学准备受损（优势比 21，95%置信区间 5.67-77.77，<0.001）。
具有 ADHD 症状的学龄前儿童可能入学准备不足。我们建议使用综合的 5 个领域框架，早期识别具有 ADHD 症状的儿童的入学准备受损情况，并结合有针对性的干预措施，以改善结果。
