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兴奋剂药物对 ADHD 儿童学习学业课程的影响:一项随机交叉研究。

The effect of stimulant medication on the learning of academic curricula in children with ADHD: A randomized crossover study.

机构信息

Department of Psychiatry.

Center for Children and Families.

出版信息

J Consult Clin Psychol. 2022 May;90(5):367-380. doi: 10.1037/ccp0000725.

Abstract

OBJECTIVE

Evaluate whether stimulant medication improves acquisition of academic material in children with attention deficit hyperactivity disorder (ADHD) receiving small-group, content-area instruction in a classroom setting.

METHOD

Participants were 173 children between the ages of 7 and 12 years old (77% male, 86% Hispanic) who met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for ADHD and were participating in a therapeutic summer camp. The design was a triple-masked, within-subject, AB/BA crossover trial. Children completed two consecutive phases of daily, 25-min instruction in both (a) subject-area content (science, social studies) and (b) vocabulary. Each phase was a standard instructional unit lasting for 3 weeks. Teachers and aides taught the material to small groups in a summer classroom setting. Each child was randomized to be medicated with daily osmotic-release oral system methylphenidate (OROS-MPH) during either the first or second of the instructional phases, receiving placebo during the other.

RESULTS

Medication had large, salutary, statistically significant effects on children's academic seatwork productivity and classroom behavior on every single day of the instructional period. However, there was no detectable effect of medication on learning the material taught during instruction: Children learned the same amount of subject-area and vocabulary content whether they were taking OROS-MPH or placebo during the instructional period.

CONCLUSIONS

Acute effects of OROS-MPH on daily academic seatwork productivity and classroom behavior did not translate into improved learning of new academic material taught via small-group, evidence-based instruction. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

摘要

目的

评估在课堂环境中接受小组内容区域教学的注意力缺陷多动障碍(ADHD)儿童使用兴奋剂药物是否能提高学术材料的习得。

方法

参与者为 173 名 7 至 12 岁的儿童(77%为男性,86%为西班牙裔),符合《精神障碍诊断与统计手册》第五版(DSM-5)ADHD 标准,并参加了治疗性夏令营。设计为三盲、自身对照、AB/BA 交叉试验。儿童连续完成两阶段的每天 25 分钟的(a)主题内容(科学、社会研究)和(b)词汇教学。每个阶段都是为期 3 周的标准教学单元。教师和助手在暑期教室环境中以小组形式教授材料。每个孩子随机分配在第一或第二教学阶段接受每日口服渗透压控释系统哌甲酯(OROS-MPH)治疗,在另一个阶段接受安慰剂治疗。

结果

药物治疗对儿童在整个教学期间的学术座位工作生产力和课堂行为有显著、有益的影响。然而,药物治疗对所教授材料的学习没有明显影响:无论儿童在教学期间服用 OROS-MPH 还是安慰剂,他们学习到的主题内容和词汇量相同。

结论

OROS-MPH 对日常学术座位工作生产力和课堂行为的急性影响并没有转化为通过小组、基于证据的教学来提高新学术材料的学习。(PsycInfo 数据库记录(c)2022 APA,保留所有权利)。

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