中国一项组织技能训练对注意缺陷多动障碍儿童影响的随机对照试验。

A Randomized Controlled Trial of the Effects of Organizational Skills Training on Children With Attention Deficit Hyperactivity Disorder in China.

机构信息

The Ministry of Health, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, People's Republic of China.

The Child Health Division, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, People's Republic of China.

出版信息

J Atten Disord. 2025 Jan;29(2):128-139. doi: 10.1177/10870547241289848. Epub 2024 Oct 21.

DOI:10.1177/10870547241289848

PMID:39431479

Abstract

BACKGROUND

In addition to attention and hyperactivity problems, children with attention deficit hyperactivity disorder (ADHD) have poorer organizational skills needed to manage time and materials. This study examines the improvement of organizational skills in children with ADHD by studying organizational skills training (OST).

METHODS

This was a prospective, randomized controlled trial. Between September 2023 and January 2024, 70 children with a diagnosis of ADHD and at least one domain of executive dysfunction (EF) were divided into two groups. The conventional group was treated with medication, biofeedback, and behavioral interventions based on the children's actual condition. The OST group received OST in addition to the conventional group.

RESULTS

The mean age of the children was 8.33 ± 1.62 years. A total of 66 children completed the intervention and follow-up, 32 in the conventional group and 34 in the OST group. There were no differences between the two groups of children in terms of their preintervention scores on the BRIEF, SNAP-IV, or IVA-CPT. Postintervention scores on the behavioral scales decreased ( < .05), and IVA-CPT scores increased ( < .05) in both groups compared with those in the preintervention period. The OST group had a lower BRIEF ( = .019) and SNAP-IV Attention deficit subscale ( = .046) and a higher IVA-CPT Attention deficit Index ( = .032) than the conventional group after the intervention. The percentage of children with a normal BRIEF total score in the OST group was 79.41% (27/34) after the intervention, which was greater than the 37.50% (12/32) in the conventional group ( = .001). Compared with the OST group, children in the conventional group were at greater risk of having BRIEF scores that remained abnormal after the intervention. Analysis of covariance revealed a statistically significant effect of group ( = .008), preintervention BRIEF ( < .001), and participation score ( = .036) on postintervention BRIEF.

CONCLUSION

OST can further improve organizational skills in daily life in children with ADHD while improving core symptoms of attention deficit in addition to conventional treatment. The effect of OST on BRIEF is also influenced by the child's BRIEF status at the baseline level and the level of cooperation during the intervention.

TRIAL REGISTRATION

The randomized controlled trial registration number was ChiCTR2300075744.

摘要

背景

除了注意力和多动问题外，患有注意缺陷多动障碍（ADHD）的儿童在管理时间和材料方面的组织技能较差。本研究通过研究组织技能训练（OST）来研究 ADHD 儿童组织技能的提高。

方法

这是一项前瞻性、随机对照试验。在 2023 年 9 月至 2024 年 1 月期间，将 70 名被诊断为 ADHD 且至少存在一个执行功能障碍（EF）领域的儿童分为两组。常规组根据儿童的实际情况接受药物治疗、生物反馈和行为干预。OST 组除常规组外还接受 OST。

结果

儿童的平均年龄为 8.33±1.62 岁。共有 66 名儿童完成了干预和随访，常规组 32 名，OST 组 34 名。两组儿童在干预前 BRIEF、SNAP-IV 或 IVA-CPT 的行为量表评分无差异。与干预前相比，两组儿童的行为量表评分均下降（ < .05），IVA-CPT 评分升高（ < .05）。干预后，OST 组的 BRIEF（ = .019）和 SNAP-IV 注意力缺陷分量表（ = .046）较低，IVA-CPT 注意力缺陷指数（ = .032）较高，均优于常规组。干预后，OST 组正常 BRIEF 总分的儿童比例为 79.41%（27/34），高于常规组的 37.50%（12/32）（ = .001）。与 OST 组相比，常规组的儿童在干预后 BRIEF 评分异常的风险更高。协方差分析显示，组间差异有统计学意义（ = .008），干预前 BRIEF（ < .001）和参与评分（ = .036）对干预后 BRIEF 有影响。