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自闭症谱系障碍和注意力缺陷/多动障碍学龄前儿童的执行功能概况:一项系统综述。

Executive function profiles of preschool children with autism spectrum disorder and attention-deficit/hyperactivity disorder: A systematic review.

作者信息

Christoforou Marina, Jones Emily J H, White Philippa, Charman Tony

机构信息

Department of Psychology Institute of Psychiatry, Psychology and Neuroscience King's College London London UK.

Centre for Brain and Cognitive Development Birkbeck University of London London UK.

出版信息

JCPP Adv. 2023 Jan 7;3(1):e12123. doi: 10.1002/jcv2.12123. eCollection 2023 Mar.

Abstract

BACKGROUND

Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are both associated with differences in Executive Functioning (EF). There is lack of clarity around the specificity or overlap of EF differences in early childhood when both disorders are first emerging.

METHOD

This systematic review aims to delineate preschool EF profiles by examining studies comparing the EF profiles of children with and without ASD or ADHD. Five electronic databases were systematically searched (last search in May 2022) to identify published, quantitative studies of global and specific EF (Inhibition, Shifting, Working Memory (WM), Planning and Attentional Control), comparing children aged 2-6 with a diagnosis of ASD or ADHD to peers without ASD or ADHD.

RESULTS

Thirty-one empirical studies (10 ADHD and 21 ASD studies) met criteria for inclusion. EF profiles in preschool ASD were characterised by consistent Shifting, and, in most cases, Inhibition impairments. ADHD studies consistently reported impairments in Inhibition and Planning, and in most cases WM. Findings with regards to sustained Attention and Shifting in ADHD and WM and Planning in ASD were mixed.

CONCLUSIONS

Overall, current evidence indicates overlap but also some specificity in EF impairments in preschool ASD and ADHD. There were differences in the degree to which individual domains were impaired, with Shifting more consistently impaired in ASD, and Inhibition, WM and Planning in ADHD. Methodological issues and differences in methods of outcome measurement could potentially underlie mixed findings, as informant-based measures revealed more robust EF impairments than laboratory-based tasks.

摘要

背景

自闭症谱系障碍(ASD)和注意力缺陷多动障碍(ADHD)均与执行功能(EF)差异有关。在这两种疾病首次出现的幼儿期,执行功能差异的特异性或重叠尚不清楚。

方法

本系统评价旨在通过审查比较患有和未患有ASD或ADHD儿童的执行功能概况的研究,来描绘学前儿童的执行功能概况。系统检索了五个电子数据库(最后一次检索时间为2022年5月),以确定已发表的关于整体和特定执行功能(抑制、转换、工作记忆(WM)、计划和注意力控制)的定量研究,比较2至6岁被诊断为ASD或ADHD的儿童与未患有ASD或ADHD的同龄人。

结果

31项实证研究(10项ADHD研究和21项ASD研究)符合纳入标准。学前ASD儿童的执行功能概况表现为持续的转换困难,且在大多数情况下存在抑制功能障碍。ADHD研究一致报告存在抑制和计划功能障碍,且在大多数情况下存在工作记忆功能障碍。关于ADHD中的持续注意力和转换以及ASD中的工作记忆和计划的研究结果不一。

结论

总体而言,目前的证据表明学前ASD和ADHD在执行功能障碍方面存在重叠,但也有一些特异性。各个领域受损的程度存在差异,ASD中转换功能障碍更为一致,而ADHD中抑制、工作记忆和计划功能障碍更为常见。方法学问题和结果测量方法的差异可能是研究结果不一的潜在原因,因为基于知情者的测量方法比基于实验室的任务显示出更强的执行功能障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20fc/10241451/f5d61aed55f9/JCV2-3-e12123-g001.jpg

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